Increase in Mirtazapine

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My psychiatrist increased my Mirtazapine from 15mg to 30mg 2 weeks ago.

i thought I was feeling better but today I don't feel so good.

i feel low,numb and very tired.

i have been on 45mg before and got back down to 15mg but had a bereavement and started to show signs that I was going down again so that was why I was put up.

when can I expect to feel normal again.

i know that it takes time but I'm quite anxious today.

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  • Posted

    Probably varies by person but as a rule of thumb somewhere between 2- 4 weeks, so you may not be quite feeling the benefits yet.

    That said, you do state you had been feeling a bit better so maybe just try and chalk today down as a difficult day and see what tomorrow brings.  If the Mirt worked for you in the past then I would think there's a good chance it will work for you again.

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  • Posted

    Did you find that Mirtazapine helped you with anxiety/depression at 45mg? I have been on this dose for 2 weeks and am not getting any better. In fact I think I am worse.  Cannot stand to be in the house so get up and go out anywhere to pass the day. Also feel my marriage is being tested to its limits as my husband is exasperated with me. I am so restless and don't know what to do with myself. I feel unable to be in the house to do anything.
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    • Posted

      Hi June26145

      When I went up to 45mg before,I did get better.Stick with it,if you can,as ADs tend to make you feel worse before you get better and that is the time when people give up and stop taking them.It is a trying time for anyone living with someone who is suffering from depression and the person who has depression perceives things differently to how they really

       are. Give the medication a a few more,weeks. It is horrible, I know ,to get through the first few weeks while they get into your system and do their

      job. Have you upped the dose at all from 15mg to 30 then 45?

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    • Posted

      Hi Ele. Was on 15mg for 4 weeks, upped by doc to 30mg but after 6 days on this dose, I was hospitalised as couldn't face another day. Doc at hospital put me on 45mg.  Been at this dose for 15 days now but I don't feel any better, in fact I think the anxiety is worse. Was in hospital for a week and now been home a week and am not coping at all.  I sometimes think what is the point of it all.
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    • Posted

      Hi June,

      Please,please do not think there is no point.

      There is light at the end of the tunnel.

      it is just getting through these really tough days,however hard it may be,and believe me, I've been there many times and always come through.At the moment I'm feeling so numb and just want the bubble to burst.Yesterday I had a bad day,anxiety,feeling worthless and if I'm honest a little bit suicidal.

      All these feelings are the depression and also part of getting better.

      i would not wish depression on my worst enemy,it is a awful illness.

      i know how hard it is for you at the moment but you must carry on.

      it is the toughest thing to do but it will come good.

      you just have to take each day,hour,minute as it comes until one day you will notice little changes.Then all the little changes will come together and you WILL feel normal again.

      You can talk to me anytime

      We will get through this together!

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    • Posted

      Ele, thank you so much for keeping in touch. I know I have anxiety but doc thinks I have got depression as well. This is the toughtest time I have ever had. Had anxiety on and off for 6 years, got better, but seem to have gone down so very quickly this time.

      Patience is practically non-existent. Feeling like this seems never ending. I think you are at about the same level as me for being on a higher dose and so hopefully we can talk more often and help each other through.  I have felt suicidal and think I can't stand this anymore but I do not think I would do anything as I don't want to die although have at times thought I wanted to. Have you got any tactics for getting through these horrendous days? Every minute seems like an hour.

      I have got an appointment with a psychiatrist this coming Friday so will let you know how that goes.

      You say you have been at this point many times and come through it.  And from what you say, Mirtazapine has done it for you. It's just that when you've been taking the tablets and nothing is happening, you start to lose hope and think it will never end. How long do you think we need to be on these doses before we see an improvement?

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    • Posted

      You're very welcome June.i have also suffered from anxiety since childhood.

      i also suffer from OCD with intrusive thoughts and this is often accompanied by depression.

      i was only diagnosed with OCD in 2004 at the age of 43 when I was admitted to the priory hospital with a breakdown.

      i now have a really good psychiatrist who I can get in touch with if and when I need him.He advises me on all my medications.

      i also take 80mg Fluoxetine each morning for the OCD. 

      Its really hard at times but I cope with telling myself that I will be ok.

      i have thought of killing myself when I have been at my lowest but the thought of who I will leave behind and knowing that I will get well again brings me out of it.

      i think this way because I don't like the way I'm feeling and I can't see any way out. 

      I don't want to die but just want some relief from all the bad feelings if you know what I mean.

      when I'm well I love my life and everything about it but when this darkness takes over it is frightening.

      Be kind to yourself and remember you are ill.

      it will take time for your brain to heal. Just like a broken leg but our illness is on the inside that people don't see.

      please keep in touch anytime and well get through this together.X


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    • Posted

      Sorry June I meant to add that it will take a few weeks for the medication to get into your system.

      i have been on the increase Mirtazapine 15mg to 30mg 16 days now.

      I have been up & down.More down than up but I did have a high at the weekend.

      i think that's why I had a low spell on Monday.

      sometimes you will feel like you are getting there and find another day where you feel like giving up- don't!

      The medication has to do its work which means that it has to sort out the bad,making you feel worse, before making you better.

      it varies from person to person but you have to give it 4-6 weeks to fully take effect.

      your body has to get use to the drug before it starts sorting you out.

      there is no magic pill even though we wish there were.

      No matter how many times I've had depression& anxiety I am still impatient when waiting for the meds to work,but they do eventually.

      you just want to feel better NOW! But unfortunately it doesn't work that way.

      your brain has to have time to heal but heal it will.

      however hard you find it you must carry on.

      i have been deep deep down in that black hole as far as you can get and been through horrendous anxiety attacks and I have come through it.

      i wish I never ever had it but I do.

      with medication and CBT which I had for 18mrhs I have learnt to manage it hard as it might be.

      this time round has not been so bad as other times for which I'm glad.

      Bad enough but not so much anxiety this time.

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    • Posted

      Hi Ele. Just read your reply. It is comforting to know someone who is going through the same even though I wish we never had it. I live in Nottingham. where abouts are you? I often think it would help to be with someone in person who is feeling the same.

      The frustration is dreadful. I'm on 16 days now of 45 mg and I think you are on 16 days of 30mg. Felt relaxed last night between 8-10pm. Took my tablets then and slept until about 6am, with only a toilet visit at 4.30am.

      Keeping in touch with you gives me hope.

      What do you do in the day? I just want the day to be over so I can go to bed and sleep.  I just keep thinking that another night of the tablet is a day closer to being better.

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    • Posted

      Hi June,

      Sorry for late reply. I've been at work today but finished now for the summer hols.

      i live in Norfolk.

      I'm pleased to hear that you felt a little relief last night even if it was for a short time. You are doing the right thing in thinking that another night of the tablet is a day closer to feeling better.

      I've had quite a good day today. Didn't feel any anxiety but still feel like I am in a bubble.

      its nice to know that we are not alone in this.

      We will keep in touch and get through this together.

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    • Posted

      Hi Ele

      Felt everso slightly calmer this morning. Even managed to strip the bed and do the washing. But it didn't last long.  Went out for an hour but had to be back as I had a psychiatric nurse coming to see me at 11.30.

      She was brilliant, and explained what has been happening to me. I am looking inwards instead of outwards.  She is coming back on Friday to do a planner with me for activities with her next week.  By the time she came, I had already had 2 diazepam and felt very positive and calm with her.  When she went, I really thought there was hope and nothing wrong with me.  So i decided to go to see my brother some 15 miles away. But it was so hot in the car and I could feel the panic coming on.  I only went 6 miles and had to come back as in total panic.  This really upset me.

      Went to my friend next door to calm down. I dropped off to sleep there for about half an hour, but since waking up and coming home, I have dreadful anxiety and panic and don't know what to do with myself. So have had to take a third diazepam to calm down. I feel awful.

      The nurse has told me to try and cut down on the Diazepam and possibly cut them in half as they are addictive, and only take one when absolutely necessary. I feel a hopeless case. What has upset me is the journey that I couldn't do. And also going to sleep in the day which I don't usually do as I know when I wake up that I will feel awful.  I am so annoyed with myself.

      I don't know how you are managing to go to work. Please reply asap with your advice.

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    • Posted

      Only just seen this June. I know it's easier said than done because I do it too but please don't get annoyed with yourself.

      remember you are ill.

      i have had time off work due to anxiety & depression.Couldnt cope with it.

      i couldn't face going out of the door.

      I work only 2 days a week but even those 2 days I couldn't manage when I was at my worst.

      i know exactly what you mean about the panic.

      At the beginning of the year when I was bad I was driving and could feel a panic attack coming on.

      i didn't know whether to pull over or carry on.

      i kept telling myself I was ok but I was finding it difficult to get a breath.

      i did carry on as it passed.

      The funny thing is when I'm well I find it hard to imagine when I was bad with depression.When I'm ill that's all I think about and of all the times I've been bad.

      This time hasn't been as bad,still bad but bearable if you see what I mean.

      i think I caught it before it escalated as I noticed signs creeping in.

      I lost my dog 6 weeks ago and thought I was coping but I obviously wasn't.

      Don't feel bad about sleeping in the day.Your body needs it so just let go.It is all part of the healing process.

      Hope I've caught you before your bed.

      Hang on in there. X

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    • Posted

      Hi Ele

      Sorry for delay but only just come home.

      Morning as usual at 6am was dreadful. Knew my husband wouldn't get up until about 9 as he wasn't working today. Those hours are the pits. Rang my psychiatric nurse as thought I needed to go back into hospital, didn't feel able to cope anymore.  Forced myself to do some ironing, what a struggle that was.  Nurse rang back and said going back into hospital was not really a step forward, I would still have to come out sometime and face life.  Also she said what more could they do there that wasn't in place now at home. I can see her point of view but at least in hospital there are always people around and she is not the one facing these dreadful lonely times.

      Have taken to cutting 2mg Diazepam in half and have had 3 lots today which only equates to 3mg, whereas I was usually taking 6mg. Been hard but managed it. Not going to worry about tomorrow - I can only take one day at a time. 

      Went out with husband to see his sister. Had lunch out at a pub but it took me all my strength to try and sit and eat.  I was so on edge.

      I am getting tired of people saying I look a lot better but they just don't know the turmoil going on inside.  Tonight will be 17days of 45mg Mirt and I often feel so hopeless and full of despair that they won't do anything.

      How has your day been and what have you been doing? It is so lovely to communicate with you.

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    • Posted

      Hi June,

      i know exactly how you feel.It is an awful illness. People who have never had it just can't understand the turmoil it does to us.

      i have had a quiet day today. I slept in this morning as I was so tired.

      I've just potted around today,washing,getting meal sorted but I did go for a walk this evening as I hadn't been out all day.

      i feel strange,sort of in a dream.

      i don't feel anything really ,totally numb.

      My mood is not as low as it was but I feel I am on auto pilot and I just want to burst out of this bubble.

      i am speaking to my psychiatrist on Monday, whether he'll increase the med,I don't know.

      Are you seeing your psychiatrist tomorrow?

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    • Posted

      Hi Ele

      Wish I could sleep in.  The minute I wake, the churning starts and panic thinking another whole day to face.  Can't see how this is ever going to change.

      I know the numb feeling. I cannot cry and wish I could as it would maybe release some of the emotion.

      Things never work out do they.  My psychiatrist had re-scheduled my appointment to next Monday afternoon.  I felt devastated at this delay although quite what help she can be, I don't know.

      I have been reading our previous blog and that you are on Fluoxetine, Do you think this is helping at all - do you think I maybe need something extra adding in or will the Mirt do the job on its own.

      I don't want to upset you by reminding you about your dog.  I do know the devastation of losing a pet.  I had to have my cat put down a few years ago and I was abolutely bereft for months.

      Do you think you need an increase in your doseage.  I have read so many contradictory comments about the sleep effect.  My psychiatric nurse said yesterday that 15mg is the most sedating and the higher you do, the less sedation you get. 

      I still keep thinking what the point of it all is and wonder if I will ever come out of this.  I know you should look at the positives but sometimes, all hope deserts you.

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    • Posted

      Hi June,

      i take the fluoxetine for my OCD which I've been taking for 10 years.

      i was prescribed Mirtazapine just over a year ago for menopause anxiety.

      I started on 15mg which worked and I stayed on that dose for 6 months then I had a mini breakdown.

      My psychiatrist put me up to 30mg and within a month I was better but after christmas I started to have panicky feelings.

      i had acute anxiety and my OCD went through the roof with intrusive thoughts.I was put up to 45mg Mirtazapine but I was getting worse with the OCD so I was put on risperidone,an anti psychotic drug which did the trick and I finally became well again in about 6 weeks.

      i came off the anti psychotic but stayed on 45mg Mirtazapine for a while then  reduced to 30 and finally back down to 15.

      looking back I think maybe I had come down too soon hence being now on the 30mg.

      it is a long journey and you will get there.It may not seem like you will at the moment but it will happen.

      Do you see an NHS psychiatrist or private one?

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    • Posted

      Hi Ele

      It is so lovely having you to talk.  You really have had a most terrible time and my heart goes out to you. Let us make sure we keep contacting each other,  You just cannot imagine how it lifts me to see your replies.

      I am seeing an NHS psychiatrist,  I did suggest to my nurse that I was prepared to go private but she thinks it is better to see the NHS one as they all keep in contact with one another and you are not getting conflicting messages.

      Time to to take the Mirt again and the sleeping pill. Let's pray that tomorrow brings us happiness and relief and peace.

      Speak tomorrow.

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    • Posted

      Hi Ele

      It's 8.55am Friday morning and all the usual dreadful feelings are back. I am shaking, restless, stomach in knots. Been up since 6am and it seems like an eternity. How will I get through the day?

      Already taken 1mg diazepam and feel the need for another one. This is horrendous.  All I can think about is how awful and frightened I am, cannot escape these thoughts.

      What are you doing today. I so wish you lived closer then we could help each other along.  Or maybe you don't want to be with anyone?

      Seeing the psyc nurse at 12noon. Praying she brings me into a positive frame of mind,


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    • Posted

      Hi June,

      just logged on to reply to your message from last night and saw you were already there.

      June, just take your time with things today.if you are like me when I'm anxious I tend to rush,rush,rush which makes the anxiety worse.

      I probably wouldn't have been up at 6,as when I'm really bad mornings are not good for me and all I want to do is stay in bed as I can't face the day.

      i would eventually force myself up,shower,breakfast and then do what I find  comforting, put the TV on.

      i know a lot of people would tell you to keep busy but for me this only makes me worse.

      so I snuggle up on the sofa with a cuppa and watch daytime telly.

      if I fall asleep, I fall asleep. I just let my body do what it wants- rest.

      this might not be what you want to do but for me it works.

      ive tried going out and doing things but the anxiety escalates and by allowing myself the time to recover and not forcing myself to do things,I find that better and eventually there will come a time when you will feel like doing a little something.

      until eventually all those little something's build up to a normal day for you.

      i find that mornings are always the worst and as the day goes on I do feel a little better.

      just remember you are ill and any negative thoughts you have are just that.

      when a person is depressed they become irrational and to someone else that may seem daft but because the depression takes over they mean a lot to us.

      i really do understand your pain.

      At the moment I'm feeling not too bad, not brilliant but finding it easier.

      i don't have much motivation to do anything as I still feel so numb.

      The terrifying feelings I had have lessened a lot but at the same time I feel they are still deep down in side, not on the surface so I know I'm not right.

      i know when i'm well as I'm so happy and contented and at the moment I don't have that feeling of contentment or well being.

      Once they return then I know I will 100% better.

      I've been up but took tea & toast back to bed and came on here so I must get out and shower.

      Hang on in there June!

      I'm here for you. Although I will be out for part of the day I will always get back to you. Big hug X


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    • Posted

      Hi Ele

      Not a good day. Went out this morning for an hour with husband to take birthday card to friend but had to be back by 12 for nurse.

      That I felt didn't go well.  First of all she told me that my doctor might not let me have anymore sleeping tablets so am waiting to hear from him.  What am I supposed to do at night?  At least when I go to bed I know I will sleep with them.

      Nurse is coming next Tuesday and we are going to a local charity shop to hopefully work there for an hour or two with her supporting me. Can't say I am in the slightest bit interested but I have to start getting into a routine with my day instead of just sitting dwelling on how bad I feel.

      She said the Mirtazapine will start to lift my mood so that I will feel a little more motivated to do something but I have to do my bit and make myself do things in the house. It is so easy for her to sit there and say I can do this or that and that everybody has a bad day.  But the bad days for the likes of us are nothing like the bad days of 'normal' people.  We can't just switch off and relax.

      My stomach is in knots, I've got palpitations and I don't know what to do with myself. Is there any way I could get your telephone number without using this site to do it. I would really like to talk to you.

      I feel worse now she has been and said all this. I don't feel positive at all. I think I had a fairly calm afternoon and evening yesterday and so feeling so down today is awful.

      How can you stay positive when you think this will never end? Yes mornings are the worst as it is another day to face.

      Am looking forward to hearing from you. I feel so unhappy, worthless and dispirited.

      Big hug XX

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    • Posted

      Hi June,

      Sorry to hear you're having a bad day.

      I've just got back from a nice walk along the coast, a cuppa & lunch.

      I did have a little bit of a panic but I told myself ," you're ok"

      Feel better now I'm home but I think getting out did me good.It has lifted me a bit.

      I was wondering if there was any other way for us to keep in touch other than on here even if it's to swop email addresses.

      I'm not sure if this forum has a personal message section like some forums do where you can email each other through the forum but it is private so no one else can see it.

      if I find out I'll let you know.

      You are limited to what you can say on hear as it can be read by anyone.

      It is so difficult for 2 depressed people to help each other,other than understanding what the other is experiencing if you're with me.

      then again it is difficult for a person who hasn't experienced depression to help a depressed person.

      I think what we are doing is good but it could be better if we can talk to each other away from the forum i.e personal emails.

      Until I find out I can't see any other way as we cannot put personal details on here.

      Through another forum I email another lady personally who has suffered too and we talk a bit more openly.

      Let's hope there is a way.

      The reason I asked if you were seeing a NHS or private psychiatrist is because I have a private one.

      I am able to get in touch with him whenever I need and he will always get back to me if he can't speak straight away.

      Remember June you are ill and however awful it is at the moment you  must carry on.

      I have been as far down that black  hole as you can get,thinking I would never get there and with the help of the relevant people and a lot of work myself,I did! And I know I will get there again.

      You will too.

      Big hug X


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    • Posted

      Hi June

      I was wondering how you are now as I am on the 45mg of Mirt 16 days in and I am finding it very dificult?

      Hope you are ok now?

      If anybody else reading this can shine a light on any experiance with Mirt please feel free to message me back :-)



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