Mirtazapine 30mg.... scared to sleep

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Hi, new to this site, recently come off sertraline (150mg) after feeling extremly low and at my wits end with no sleep and no clear focus on the way forward.

After being weaned off sertraline I was started on 15mg of Mirtazapine but quickly felt worse and even more anxious and having panic attacks frequently. Night time brought little relief with horrendous nightmares aswell as night sweats. Shortly after the GP up-ed my dose to 30mg but I almost fear sleeping even though I'm desperate for it as the dreams are just plain awfull and I'm worried that the anxiety will increase.... I've no family or friends to talk to except for my 2 kids who know nothing about my meds and the daily battle I face.... my gp said it would get easier, I hope it does.

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  • Posted

    Mirtazapine does give you vivid dreams. In my case I was lucky because they were like adventure dreams. I'm actually having more nightmares since weaning off the mirt. The dreams do settle down a bit, but if they are super scary, then I don't think your doctor should expect you to endure it. Maybe mirtazapine is not right for you. Perhaps you could try an older AD such as lofepramine. 
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    • Posted

      Thank you evergreen, spoke to my GP today about the dreams, they have all related to death and finding dead people which may be due to my job but certainly never had them previously and to the point I fear sleeping, she's suggested I give it a bit longer before trying something different.

      I'm exhausted and tired all the time and until moving to mirtazapine was self medicating on over the counter sleep aids at triple if not quadruple the dose as desperate to have some sleep.... so now fearing sleep is my worse nightmare...

      Thank you for taking the time to reply x

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  • Posted

    Dear mulan-smooch, so sorry to hear of your troubles with meds and sleep. If your nightmares and anxiety where sleep is concerned continue, you must insist to your doctor that you are taken off those meds and tried on something else. If the doc keeps insisting or dismisses your concerns, get another doc. Drugs affect everyone uniquely because everyone is unique, and there will be help for you somewhere.

    You mention nightmares with death related dreams which could be something to do with the anxiety about sleep; dreams of death also indicate changes in your life - leaving something behind and starting something new; are the dead you find known to you? Are they already deceased friends/family/relatives? If so they may be trying to message you.

    You mention that your work is death related. A nurse perhaps? If you had no previous problems with similar nightmares and the only change in your routine is the drug, then it is the first place to start.

    You will always find loads of information and support on sites like this, by people who are in the same or similar boats. Hang in there and best of luck to you and your kids.

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    • Posted

      Wayne1962 - thank you for your reply.

      I'm booked in to see my GP tomorrow, bizarrely, I've not slept for the past 2 nights, literally not a wink. I assumed having my dose increase would 'sedate' me to a greater degree but it's actually had the opposite effect so I'm guessing in 48hrs I've probably had around 3 hours of broken sleep.

      I even took over the counter sleep aids (nytol around 3 x 50 mg tablets) in addition to the Mirtazapine (30mg) with zero effect so I'm not sure what's going on there.

      I've have awful anxiety/panic attacks over the past few days and found myself at what seems my lowest point but then it flips back to periods of normality (whatever that is) - I can only compare it to watching a TV programmes, Eastenders I guess .....

      I'm really not sure whether to stick with the Mirtazapine and hope for sleep which doesn't scare the life out of me (in answer to your question, I work within the police service - and no, the people I see in my dreams aren't known to me and have ranged from babies to older folk or I'm battling to save my own life) and a reduction in the anxiety OR ask to change onto something different.

      I know everyone is different and the forum has turned out to be a fabulous source of information and its great to hear the positive stories from other people in similar or far worse situations, there's almost comfort from knowing that everything that is happening isn't specific to me but seems to be a common theme for alot of people.

      Thank u again for taking the time to reply, any advice is greatly appreciated x

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    • Posted

      So sorry to hear of your suffering.  I can't help but wonder if some of the torment you are experiencing is from the withdrawal from sertraline, although you did say you had "weaned" off, I wonder how slowly, this is definately a factor to consider.

      Rest assured that you are not going mad; sleep deprevation can cause all sorts of abnormal fears, and it is no wonder you fear going to sleep when you are having nighhtmares - this doesn't sound like Mirtazapine that I know so well, but I could be wrong, we react differently, however from what I have read, most people have weird but wonderful dreams with Mirt initially, and maybe for the first six months or so for some.  

      Have a look at the withdrawal symptoms of sertraline, see if nightmares are there -  HOW DID YOU TAPER ???  And how long have you been stopped.

      Wishing you well.,

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    • Posted

      Hi Calmer, thanks for the post....

      I was on sertraline for 3 months and finished on a 150mg dose, but was weaned off by only taking 50mg for 4 days then a day with nothing at all before starting on 15mg mirtazapine the following night ..... I was only on the 15mg dose for 2 days before my gp increased it to 30mg despite explaining about the nightmares, night sweats (and day-sweats) and panic/anxiety attacks like never experienced before.

      My gp said I cud either go back onto the sertraline or her recommendation was to increase mirtazapine to 30mg and see how I managed on that...

      I'm not sure if the lack of sleep now is due to my subconscious fighting it due to fear or because there's some other reason.... I tried extra over the counter sleep aids last night with my mirtazapine but still no more then an hours sleep initially. .....

      I'm due to go to see my GP tomorrow to see what she feels is the best course of action although at the this rate I'll more then likely be asleep in the waiting room ....

      Thank you for taking the time to reply, it really does mean alot knowing you're part of a 'family' who have been through or are going through similar....., sharing experiences has proved invaluable to me at the moment x

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    • Posted

      That's far too fast to come off the sertraline. I would guess your current problems are to do with withdrawal from sertraline. So sorry you are still having such problems.
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    • Posted

      Thank you evergreen, I must admit the GP phoned the Pharmacist to ask about weaning and this was his recommendation, I hope it settles. It seems to be the case that the initial introduction to the new meds is the worst stage and not one I'd like to experience again anytime soon x
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    • Posted

      From my understanding, the GP's use an advisor as to how to prescribe/wean off AD's & Psychotic drugs.  This advisor is advised by the Maudsley hospital (my own GP told me this).  The Maudsley hospital said to these 2 that it takes 2 weeks to taper of Mirtazapine which is utter rubbish.  Therefore this just confirms what we already realise ~ GP's do not have the resources/knowledge to be in a position to advise us.  

      I think it would be wise to discuss the fact that your current symptoms ARE withdrawal from the Sert, and if it would be possible to reinstate along side the Mirt' - i.e. take the two together - he/she will have to look this up, I don't know - you could ask others on the forum - maybe strart a new thread "Can you take Sert' & Mirt' at the same time.  

      I see you were on 150 mg of the Sert ... maybe reinstate at a lower dose,  if you can't take the two together it would be no good just "stopping" the Mirt' either because you will be hit with WD from that.  Ask your doc - see what he/she says.

      Best wishes, stay with us ... it'll get better, just need to work it out.


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  • Posted

    Hi mulan-smooch - I've read that withdrawal from anti-depressants can cause anxiety to the extreme and depression, includes problems with heavy fatigue, and withdrawals can result in individuals sleeping for long periods or, alternatively, people can be so anxious and depressed that they are unable to sleep at all.

    I think Evergreens and Calmers advice is the best here. Sounds like you came off Setraline too quickly and the horrors you are enduring is a result of that. Talk to your doctor who I hope is treating you well and listening to your concerns - some tend to treat us as experiments. Hang in there, you'll get through this, and there is always some one here to talk to.

    "Officer! Some one has stolen the dashboard from my car. And my steering wheel! And my gearbox!"

    "Sir. You're sitting in the back seat."

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    • Posted

      Wayne1962....... thank u, the end of your post did make me smile and after 2 hours sleep last night it was just what I needed.

      If I'm honest I saw my GP yesterday who actually looked like she cud do with starting Mirtazapine herself. Although she listened to my concerns I don't think she actually heard what I was saying and her nods and occasional 'I see' were quite empty acknowledgements that she understood where I was coming from.

      I think the excessive amount of patients in the waiting room had a bearing on this...

      She prescribed me another 7 days of Mirtazapine and booked me in to see her again once that prescription has been used up, I just hope I can get her to genuinely hear what I'm saying.....

      Thanx again for your reply xx

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