Posted , 8 users are following.

I am taking 60mg of Fluoxetine per day and my GP has just started me on 15mg of Mirtazapine as a replacement to 100mg of Trazodone. I've tapered off the Trazodone properly and the withdrawal wasn't great, but I managed. Now I've started the Mirtazapine at 15mg on Friday night and I'm a bit concerned about how I feel today (Tuesday) because I feel like I'm getting 'worse' not 'better'. 

This morning it took a long time to get me going. I felt somewhat shaky internally and my coordination wasn't great. I was a bit agitated once I'd taken my Prozac and was really lightheaded with racing thoughts and anxiety. I'm prone to anxiety anyway, but I haven't had it as bad as this for a long time. Is this normal and will I get better or is it a sign that this isn't the drug for me?

1 like, 9 replies

9 Replies

  • Posted

    What I will say BettyBlue is if you have concerns, please see or speak to your GP ... Mirtazapine is not for everyone ... I had great success but I didn't have any problem (apart from the initial day or two) but you have to listen to your body ... I hope you sort things out ☺ all the best.
    • Posted

      There is always a possible issue of serotonin syndrome. I don't say this lightly as I was helping a friend who had started taking Mirtazapine and he ended up with being more poorly because of my encouragement. Mirtazapine is a fabulous medication if it works for you but if you have any worries, then a GP is always the best way forward. I hope that what you are experiencing is start up issues ... But do not ignore what your body tells you ☺
  • Posted

    It really is early days for you with the mirtazapine - it could take a few weeks for you to feel the full benefit.I know that's not comfortable for you to hear, but you need to hang in there if you possibly can, while you give it a chance to work. Can you try techniques to cope with the anxiety such as relaxation exercises, slow breathing, distract yourself with something you enjoy ( I do crossword puzzles or watch rubbish TV!), warm soak in the bath, etc? Also, my psychiatrist reminded me that recovery from depression and anxiety always have ups and down. You feel bad today, but you could have a better day tomorrow. Try to take one day at a time, or even one hour at a time, and congratulate yourself for every day you get through. I hope that can help.
  • Posted

    Hi Betty

    I wish somebody had given me a heads up to it. But like the previous reply some people get on great with mirtazapine. Personally I hated it. Like you after starting it found I felt worse and my anxiety was going through the roof. I kept going up the doses until full strength and still was suffering. After about 4mths I started duloxetine along side it and only started picking up then. A year later I hav increased the duloxetine whilst slowly coming of mirtazapine. It's been really tough. My 4th week. Hardly sleeping. It's horrible to get of it too.

    Keep a close eye on it and if you continue to feel like this talk to your gp. Watch out for agitation, feeling of rage and anger. And a real increase in appetite. Some people may agree or disagree but I have read alot of discussions on here with people feeling the same.

    Really pay close attention to how you feel and your gut instinct. It didn't work for me and I wish I had given it a miss to be honest. Hope you get some good info on here tho. Good luck. I hope it works for u. Sarah. X

  • Posted

    There is a risk of serotonin syndrome with the two drugs.  You are at a fairly high dose of Prozac.  You could try taking 1/2 of your 15 mg mirt tonight and see if you feel better tomorrow, but should you at any point have more symptoms of SS then go to the hospital. 

    In the meantime, i would contact your doc's office and tell them of your experience.  They might tell you to stop the mirt. About SS:

    Serotonin syndrome symptoms usually occur within several hours of taking a new drug or increasing the dose of a drug you're already taking. Signs and symptoms include:

    Agitation or restlessness


    Rapid heart rate and high blood pressure

    Dilated pupils

    Loss of muscle coordination or twitching muscles

    Muscle rigidity

    Heavy sweating




    Goose bumps

  • Posted

    Mirtazapine was a great drug for me and I honestly saw a massive improvement in my depression after just a couple of days. However, I did feel really drugged and zombie like for a couple of weeks at least. I could not drive until after lunchtime when the fog lifted for that time. But it does lift and I was left feeling absolutely great when it did. Reading through these threads generally shows that mirtazapine works very quickly if it is going to work for you at all. Far, far quicker than other ADs. So, I think if you are not seeing an improvement inside a week then I would ditch it. Also, as others have said, you may be showing sympptoms of serotonin syndrome and so you need to contact your GP/psch before taking any more.
  • Posted

    Thanks, everyone, for your support. I gave myself some TLC last night, distracted myself from the anxiety and to be honest I think that's all it was. Serotonin syndrome, itself being very rare, would have happened by now and I would have been much worse. Anxiety is bad in itself, like it can convince someone they're having a heart attack. I'm feeling better today than yesterday. The fog is starting to lift and I think I'm going to feel a lot better smile
    • Posted

      Good job on nurturing yourself out of the anxiety!  That is a skill that many of us were never taught.  
  • Posted

    Update: this was NOT the drug for me by a long shot. Going back on to Trazodone and feeling so glad! For anyone who is on it and it suits them, I'm glad for you. It had its plus points. I was productive but only because I was so anxious that I had to do something to keep my mind occupied.

    I lost a week of my life - alternating between mad anxiety and feeling seriously doped. This happened alongside mad sugar addiction. I took 15mg for a week thinking things might ease and stopped taking it on Friday evening. Just want it out of my system!

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