Insomnia side effect

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Hello people. My husband has been on Mirtazapine 45mg at night for over three months for severe depression and anxiety. His sleep pattern has altered considerably. When he was on 7.5mg he slept a good 6-8 hours. Now he is on 45mg he sleeps 2-3 hours at the most and is awake from 2am onwards most mornings. He was assured the 45mg would knock him out, which clearly they don't. From your experience would splitting the dose to say 15mg at night and 30mg in the morning help? 

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11 Replies

  • Posted

    I have read that the lower doses help people sleep more, unfortunately that's not been the case for me.

    Back to Dr for your husband I think.

    All the best xx

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    • Posted

      Hi SLD35, thanks for your reply. We have appointment to see doctor tomorrow.
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  • Posted

    Sorry to hear about your husband.  When I was increased to the 30mg it actually made me feel depressed, generally unwell and very irritable.  I felt better cutting it down to 15mg but of course the psychs have no concept of side effects, they just want to keep pumping you up with the stuff.  I then cut down to 7.5mg and now 3.75mg.  I sleep badly anyway whatever the dose and want to cut it out completely.  The main thing is to get him to go back to his doctor and definitely not split the dose.  I believe they are only meant to be taken at night time.
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    • Posted

      Hi Elaine, Thanks for your reply. We have an appointment to see his doctor tomorrow.
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  • Posted

    If he was doing okay on the 7.5mg why did the GP increase it to 45mg, that is a hell of a lot!
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  • Posted

    You say he slept okay on 7.5mg.    Presumably it was increased because the depression and anxiety was not controlled?    It is well known that increasing the dose generally takes away the sleep benefit.  I would suggest trying a different AD, and if that causes insomnia to take the 7.5mg of mirt as well (for its sleep benefit).  
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    • Posted

      Hi Oldboy. Thanks for your reply. We have an appointment to see his doctor tomorrow.
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  • Posted

    Hi Kal

    Sorry to read of your husbands difficulty.  Well its easy to say that 2-3 hours sleep isn't sustainable, he will still feel ill, sleep deprevation can trigger depression of course.  So what came first, the depression or the sleep dep?  

    Oldboy has a good point there, clearly the 45 mg isn't working very well for your husband, so I would definately consider either tapering slowly back down to the 15mg, with the doctors knowledge, very slow though, and if this is enough to hold the depression then so be it.  If not, seek another AD.

    Always taper slowly off Mirt', never suddenly stop or rduce quickly.  Best wishes.

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    • Posted

      Hi Calmer, Thanks for your reply. We have an appointment to see his doctor tomorrow.
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  • Posted

    Hi Kal,

    I've had two PDrs. tell me that 7.5 mg of Mirtazapine is the best dose for sleep. As you know it's also prescribed for sleep, depression and anxiety. Maybe your husband can talk to a doctor and find out if the Mirtazapine can be split over the course of the day, taking the 7.5 dose before bedtime. That's what I would try - hopefully taking the Mirtaz. during the day doesn't wipe him out.  It sounds like you may need to experiment with the time your husband take the medication - 2 times a day, three times

    I suggest making a simple chart for time of day taken, dosage, hours and time of sleep, hours and time of  and side effects. Dr.s seem to take people more seriously with concrete documentation. A chart also helps you two in reviewing things and establishing patterns.  Is there anything else that could contribute to the insomnia. Loss of sleep is nasty I hope you can get this straightened out. Remember that there a numerous ADs and if the Mirtazapan isn't working your husband may need to switch it up. wishing you both well.

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