Mirtazapine 30 mgs

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I had my dose of Mirtazapine increased from 15 mgs to 30 mgs three weeks ago. I am starting to feel less depressed, but I have developed really bad insomnia. I fall asleep quickly, but I wake up two - three hours later and can't get back off to sleep. I have been given Temazapam (reluctantly), but haven't taken it for a couple of nights now, because I feel quite drugged the next day. So there seems to be a choice: sleep very poorly and feel exhausted but with-it (ish), sleep with the aid of Temapazam and feel drugged. I'm getting to my wit's end with it all. Do I reduce the Mirtazapine?

I'm also angry. I feel that those of us with mental health problems don't get the treatment we deserve. Can't get a doc appt until 7 Dec, but will get on the phone Mon am and badger them. I also want to be referred to a psychiatrist.

Hope everyone is doing as well as they can be.

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  • Posted

    What dose of temazepam do you have? I have the 10mg ones and usually only take a half and then take the other half if I still can't sleep after half an hour or so. I never feel groggy the next day. Maybe your dose is too high?
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  • Posted

    Hi Evergreen,

    Thanks for your post.

    i've got the 10 mg ones. I will take one tonight - I'm really at the end of my tether with the insomnia. I must say that the Temazapam makes me feel less groggy and hungover than Zopiclone or Zimovane, but the docs seem far less willing to prescribe Temazapam than the Z-drugs.

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    • Posted

      Hi Amanda

      I wonder if youu might be best to stick with the 15mg Mirt.  The lower doses are more sedating, weird as it sounds, so it will aid sleep.  But then again the 30 mg is better for depression - so tough decision.

      Also, bear in mind that in some people, and we're all different, Mirt' came cause insomnia!  

      Did your doc prescribe Mirt & Zopiclone/Zimovane ... only reason I ask is that my GP said not to take Zopiclone any longer now I'm on Mirt' as it could be dangerous ~ Mirt' can lower the blood pressure, and so do the 'Z' drugs, so I guess that makes sense. 

      Hope a little of this may help, and wish you well.

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    • Posted

      Hi Calmer,

      Yes, I've been wondering whether to lower the Mirt. I never had a problem with insomnia on 15 mgs. I'm wondering whether the 30 mgs is too much for me - I'm also on 20 mgs Citalopram. It's a difficult one as you say, because the Mirt does seem to be helping the depression, and possibly I will even out in a few more weeks.

      I didn't know that about Mirt and Zopiclone. I have an old batch of Zopiclone pills from a few years ago and was going to take a couple tonight, tbh, but I won't now! I've been prescribed a very short course of temazapam. I'm reluctant to take them, but I've felt so bad today after virtually no sleep that I feel I have no choice.

      When I'm well, I generally sleep OK without any sedation.

      Thanks very much for your comments: I really appreciate them.

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    • Posted

      Perhaps best thing would be to see how you go on the 30mg, hoping it will even out as you say - now you have the back up of Temazapam ... just be careful if you do decide to lower the Mirt' dose at any stage, you may well have the nasty WD effects if you go down from 30 to 15 after a while, so ease off slower as and when you need to.  

      I was on Citalopram and Mirt for a while, then tapered off Citalopram when the 15mg Mirt' helped me to sleep so well - I never went to 30mg - so maybe if you don't "even out" and you were well on the 15 mg Mirt' - that could be the answer.  Give it time perhaps?  

      Look after yourself, insomnia is so awful x

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    • Posted

      Hi Calmer,

      I think I will give the 30 mgs a bit more time. They have only given me a week's supply of Temazapam and that's it; they won't allow me any more. In extremis I will take the zopiclone, I think: severe insomnia is awful, as you say.

      I do feel I need more informed advice than I can get from the GP - it's really difficult to get an appointment, let alone anything else. I will have to be more assertive, which isn't easy when you're anxious and depressed!

      I hope you're doing well now, and I'm extremely grateful for your advice. x

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    • Posted

      Try and write down your questions to put to your doctor as and when you think about them, and don't be afraid to go in with your piece of paper and keep your finger on each point - yes doctors are under pressure but seeing you with the paper, marking each point as you go is a sure way to make sure everything is covered.  I did this anyway, the doctor knew I 'needed attention'.

      You might want to google the supplement Magnesium citrate, it is supposed to help sleep also.  Another is Phenergen for sleep aid, in the UK it is supposed to be available over the counter (no prescription needed), just a little something extra to help other than Z's which just knock you out, and the REM sleep isn't good with Z's.  Some keep Phergen ready for withdrawal when the insomnia hits.

      Yes, I agree with Sunbird, ring up first thing Monday, saying the actual words "I can't cope I have to see a doctor" usually does it for me.  I hope you get your sleep back soon, amazing what a difference a day can make.

      Best wishes

       

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    • Posted

      Hi Calmer,

      I'd just finished a reply and lost it!

      I am writing down questions for the doc, and will ring them first thing tomorrow. I am going to google Phenergen in a sec. I have some Magnesium Glycinate - is this the same as Citrate? - but it didn't seem to make any difference, and I was unsure about what dose to take and when. I need to do more research on it. I will give the 30 mgs more time, but I will request advice. Thanks so much for your advice. x

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    • Posted

      Hi, No I think Magnesium Citrate is different ... you may need to ask for the correct dosage, I prefer to up my Magnesium through diet, which I have, and I think I was very low on this before my "episode" originally started.   Some people even swear by Magnesium 'foot soaks' !!  You can buy them on Amazon.  

      I make a smoothy up of raw baby spinach, pumpkin seeds, raw fennel to help cleanse, mint or even mint sauce for flavour, and an apple, along with a cooled cup of warm water which has a sweetner dissolved - or you could add honey or maple syrup - you could add nuts too if you fancy - but hey ... they're nice on their own.  

      Other good sources are beans, soya beans especially, green leafy veg, seeds, all nuts, mackeral, brown rice, avacado etc ...

      Did you get an appointment??

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    • Posted

      Hi Calmer,

      Thanks for info. on Magnesium.

      I have an appointment for Wednesday am! I will make sure that I write everything down, as you suggested, beforehand. I will let you know how I get on.

      I hope you're doing well, and I'm very appreciative of your input: many, many thanks. x

       

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    • Posted

      I hope your appointment goes well for tomorrow,  maybe having more temazapam will reassure you - can but ask maybe?

      Let us know xx

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    • Posted

      Hi Calmer,

      Well, yesterday I did a bit of a mini bail-out. Decided I just couldn't take another day. Took three Temazapam and about four Zopiclone and sort-of slept all day. But good news! Had doc appt this am and she made an urgent referral to the local Community Health Team. They have just rung and are coming to assess me this coming Sunday (that was a surprise. Didn't know they worked on Sundays). I'll keep you posted. Hope you're doing well.

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    • Posted

      WOW, did you tell her of the cocktail you took, I have to say, that that cocktail sounds dangerous - do please be careful ... what dose are the zopiclone?  

      You know if everything gets desperate for you just walk into your local hospital ... don't hesitate, JUST DO IT.  They can't refuse to see you that way.

      Thinking of you, look after yourself, with kindness x

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    • Posted

      Hi Calmer,

      Yes, I told her about the cocktail. The dose of the zopiclone was 7.5 mgs. I found them in my toilet bag (expiry date March 2013). I have two people from the local CMHT coming here on Sunday, and my medication and management are going to be overhauled. Thank Goodness! I'll keep you posted, and if things get like that again, I will walk into my local hospital - I've finally got over the usual 'but there are people much worse off than me..." train of thought. Hope you're well. x

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  • Posted

    Hi Amanda,

    I am really sorry to know that you are having sleep probelems now that you have increased to 30mg.It really is horrible to feel sleep depravation as it effects our mind and body so much.

    We are all different but the same happened to me.

    I was doing ok on 15mg when after 6 weeks my GP said that was a starting dose and I would be better on 30mg!

    My sleep pattern was worse and I felt hungry and aggresive most of the time,quite scary!

    Things may have improved if I had stayed on 30mg for a while longer but I only stuck with it for about 10 days before going back to 15mg and my lovely sleep with entertaining dreams!

    This drug is very strange as every one seems to have a different experience.

    It is a disgrace that you can not get an appointment before December 7.

    It is a good idea to phone them on Monday as they really should be more helpful and understanding.

    I did not have any Temapazam or other sleeping aids as I was worried about creating another WD problem.

    I hope you get an appointment tomorrow and things will improve Amanda.

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    • Posted

      Hi Sunbird,

      Yes, I agree on how Mirtazapine affects different people in different ways: it's very strange. If you were doing OK on 15 mgs, then I really don't understand why your doc wanted to up the dose: mine was increased because I took a real dip.

      I've not had increased hunger, which I know is really common with Mirt. I've been irritable and snappy, but that is probably down to the insomnia.

      I agree with you about sleeping aids. I only use them in extremis; when I am well I normally sleep OK. Until I can stabilise I will use them, because doing so seems to be the lesser of two evils.

      I hope you are doing well, Sunbird. Thanks so much for your comments.

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