Mirtazapine 15mgs to 30mgs

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I am a 51-year-old woman and have suffered with anxiety, depression and insomnia for much of my life. I have been on 15 mgs of Mirtazapine and 20 mgs of Citalopram for a couple of years - can't remember exactly how long. Had Mirtazapine upped to 30 mgs nine days ago as I was getting depressed and anxious again. Since then have got no more than three hours of sleep a night; anxiety and depression very bad; emotions all over the place; can't go to work. Have another doc appt tomorrow. I'm wondering whether to give the 30 mgs more time, or to drop back down to 15 mgs - don't feel I can go on like this. Any feedback from anyone would be great. Thanks a lot.

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  • Posted

    Hi Amanda

    Sounds like the Mirtazapine may well have 'pooped' out ...   I have read of many people going from 15 to 30 mg and having the same symptoms you describe, I suppose it is a shock to the system to suddenly double the dose, you may well even out.

    Whatever you do, bear in mind that if you decide to change AD, or come off Mirt', do a slow taper as the WD is horrible if not.  Also, remember going up and down doses, especially a whole wopping 50% can cause extreme anxiety, so maybe go slowly from the 30 to 15 even.  See the link on this forum:

    https://patient.info/forums/discuss/depression-resources-298570

    Scroll down to: " Reducing ADs using 10% withdrawal method "  

    Have you tried anything else like CBT, Mindfulness,  any therapy at all?  There is something for everyone, it's just finding the right help for you personally?

    I hope you get on OK at the docs, and wish you well.

     

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    • Posted

      Hi Calmer,

      Thanks very much indeed for your response.

      Old Boy has suggested going back down to 15 mgs and increasing the Citalopram. I will give it a go: I can't carry on like this. As I said to Old Boy, one doc told me that Mirt is more sedating at lower doses; another told me the opposite!

      I have tried CBT and I've found it quite useful. I would need to be a bit more together mentally than I am at the moment to be able to put the skills to use again.

      Thanks for the WD info. I am just going to try to hang on in there.

      I hope you are well, and I really value your response.

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  • Posted

    I think you should return to 15mg mirt as a lower dose is often better for insomnia. A higher dose of  Citalopram is more likely to be helpful.
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    • Posted

      I have read some of your posts previously, and have thought them to be sensible and well-informed, so thanks very much for your response.

      I used to be on a higher dose of Citalopram, but it was reduced when the Mirt was upped to 15 mgs at the beginning of this year; I think this was because of the possibility of 'Serotonin Syndrome', which I understand to be extremely rare. I had no difficulties that I can remember when upping the Mirt from 7.5 mgs to 15 mgs.

      The doc upped my mirt from 15 mgs to 30 mgs just under two weeks ago. He said that it was less sedating at higher doses. I spoke to a duty doc last week. She told me that it was more sedating at higher doses! So I am really not sure what to think, although from what I have read, both on this forum and elsewhere, the general consensus seems to be that Mirt is more sedating at lower doses.

      I will knock the Mirt down to 15 mgs this evening as I just don't feel I can carry on like this.

      Thanks very much indeed for your post. I hope you are keeping well.

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    • Posted

      Sounds like you are going through menopause. I had my first ever bout of Depression aged nearly 51. Docs and psychiatrist not interested in connection worth getting your hormones checked and considering HRT.
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    • Posted

      Hi Carolyn,

      I have had a blood test this am, so that should show whether there's anything wrong hormonally.

      I've had depression on and off since my early 20s, but there could be a connection between hormones and this latest bout. Hopefully the blood test will throw some light on things.

      Many thanks for your post.

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  • Posted

    Hi Amanda.

    Thought I'd join in the conversation as I am also in that age group and have also had anxiety and some depression since my twenties on and off. I have been on 50mg Sertraline for 8 weeks and seemed to be getting worse and feeling very desperate. I saw a psychiatrist for the first time 5 days ago who started me on 30mg Mirtazapine as well. She said lower the dose the more sedating so I guess that is why you didn't sleep well. If you lowered the citalopram recently maybe that is the reason for the return of the anxiety?

    I was feeling much calmer with Mirtazapine until today when I feel like crying again and quite low. I'm hoping this will wear off in time.

    Hope you are feeling a bit better now? X

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    • Posted

      Also I would consider carefully before starting HRT. I started patches but felt they were also effecting my moods and its just another thing to add to the mix and confusion!
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