Long term mirtazapine stopped working

I have been taking mirtazapine at 60mg per day for over 10 years now - I know that's a whopping big dose but due to chronic treatment resistant depression it was the only dose that actually worked. For over 8 years it worked brilliantly - lifted my depression, eased my anxiety and most importantly, enabled me to sleep. With it i got my life back, managed to hold down a full time professional job. I'd still get my down days and times where my mood was ultra low but generally I'd get over it fairly quickly. It numbed me out I guess and I didn't really cry anymore, the tear ducts seemed incapable of working! I figured this was the trade off for functioning and playing an active role in life after many years of not being able to work with debilitating acrophobia and social anxiety.

However, around two years ago things started to slide - I was working in a hugely stressful target driven environment and bullying was rife from other colleagues and middle management. I was getting more and more responsibility dumped on me and being the people pleaser and perfectionist I was, took it on without complaint. I started to get ill again - avoiding conversation at work, tearful, increasingly anxious and stressed. The biggest factor in my mood was the start of a terrible bout of insomnia where I just couldn't function. I couldn't get to sleep no matter what I tried - reading in bed, exercising, herbal teas, switching off TV, drinking malt drinks - nothing worked. Obviously this then led to a vicious circle - the lack of sleep made me feel more depressed and anxious and stressed and so it continued. Where I had always been used to going to bed around 10pm and falling into a deep sleep around an hour later without waking until my alarm went off at 6 - this literally stopped overnight. I would just lie there hour after hour counting down the clock until I'd have to get up. Or if I did finally manage to sleep I'd be awake an hour later going through the same countdown routine. Now obviously I put this down to my hugely stressful and by now loathsome job keeping me awake and making me depressed so I decided enough was enough and quit. I was fortunate to find another job very quickly with a huge pay increase and a management role. Ideally or so I thought, I had friends that worked there and the company was supportive of its staff - tada! Everything would be great - new job, great environment, I'd start sleeping again my depression would lift and everything would go back to normal...how wrong could I be...

The insomnia continued and my mood continued to plummet I became a wreck. Whereas I'd take enormous pride in my work, staying late completing projects to deadline I just gave up. I sat there every day in a complete haze - couldn't focus, tearful, shaking with anxiety, unable to deal with the smallest of jobs because my sleep deprived brain just couldn't function.. I was lucky to get 10 hours a week sleep in total, a walking zombie is the only way I could describe it. So I walked out - gave up on what could have been my dream job. I now believed I was burnt out from my previous job and I just needed time out to rest, take the pressure off, relax... Not once did I question the mirtazapine - how could I believe this was to blame when it had worked so wonderfully for all these years? It must have been me, I'd had a total breakdown but with time I'd be better surely?!

I didnt visit my Dr - the practice is next to useless and frankly I'd had enough of pych help. But nothing has improved at all - its been a year since I left work and I can not sleep at all - I'm getting more and more depressed by the day, more tired, more stressed, more hopeless. However, one day - two years too late- I had an epiphany- was the mirtazapine to blame? Had it stopped working? I had never been told this could happen. So. Here I am, this site has become my refuge, my only place of solace to know that others are going through similar things. Which finally led me to the conclusion that mirtazapine can actually poop out. I decided to start tapering off mirtazapine - its clearly not working anymore and has led me to believe that it actually may be causing me more harm than good. Seven weeks ago I dropped to 45 mg with few withdrawal effects apart from nausea in week 3 and daily headaches. Something strange happened at this drop - for the first three weeks I actually slept!!!! Three weeks of complete heaven uninterrupted blissful 8 hour sleep. It was absolutely wonderful but alas, short lived. The insomnia abruptly kicked in again and that's where I am right now again. I have since dropped to 30 mg a week ago, hoping that this may trigger another episode of sleep but nope, nothing. I've also been to my gp since then who basically advised he has no idea why the mirtazapine stops working and offered me nothing for my insominia . he advised I should carry on with the reduction and be off them altogether over the next three months or so. But, now what? I'm depressed and have chronic insomnia - do I try something else? Is there another anti depressant which could help me? Because I can't carry on like this, I have no life and no future if I can't get something sorted soon.

Thank you for reading this, I so hope someone can offer some advice.

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