Mirtazapine and other drug interactions

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I suffer from Anxiety and Depression. In 2012 it became worse and the Cipralex I was on wasn't working for me anymore. I went on Mirtazapine at 30mg. I stayed on Cipralex and My doctor added Clonazapam which also didn't help. I got off of Cipralex and went to Effexor. Effexor helped a little but I still had really bad days. Several months ago I decided to get off of Effexor and try something else. I tried Paxil which was a horrible experience. I tried Tritellix which was also horrible. I finally decided to go back to Cipralex. At 10mg I was OK and then at 15mg I was a basket case. My doctor thought that maybe the Mirtazapine was a problem. We reduced it down to 15mg and a lot of the anxiety and nervousness has gone away. While I have been able to sleep well with Mirtazapine I realy think it's been the cause of my anxiety over the last 4 years. I will try to reduce it to 7.5mg and then to 0.

I wanted to know if anyone experienced the same type of effects and withdrawl.

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  • Posted

    Hi Paul. In my own experience of 12 years with mirtazapine and talking to several doctors and psychs over the years, mirtazapine is quite possibly the most effective non-addictive anxiety med available. It very rarely causes anxiety. Every instance I've read about where anxiety was a factor with mirtazapine has only been when the patient was taking something else with it. SSRIs can cause anxiety. I was on Paxil for a year or so and it made me a nervous wreck, especially the first month or two. It was unbearable.

    Have you ever tried taking only mirtazapine by itself? Clonazepam is a benzo which is the most effective but addictive anxiety med out there, so if that didn't help, that seems strange. Have you had your thyroid checked? A malfunctioning thyroid can cause anxiety, big time.

    Quitting meds like Effexor (and other SSRIs) without a long taper can cause discontinuation syndrome, which can give you the worst anxiety you've ever had in your life. I experienced that when stopping Paxil and benzos, years ago. 

    If you take multiple AD meds at the same time, that may cause an excess of serotonin, called serotonin syndrome. That can can cause terrible anxiety and in extreme cases, much worse than that. 

    I quit mirtazapine cold turkey 5 weeks ago, but if you're having a rough time right now and you're taking other ADs, maybe a taper would be easier for you?

    Have you thought about asking your doctor if you could try just mirtazapine by itself, with a little Clonazepam at first to deal with anxiety from stopping your other meds? You've gone on and off so many meds you must feel like you've been through the wringer. You may just be going through a discontinuation syndrome from your other meds.

    Hang in there!of 12 years with mirtazapine and talking to several doctors and psychs over the years, mirtazapine is quite possibly the most effective non-addictive anxiety med available. It very rarely causes anxiety. Every instance I've read about where where anxiety was a factor with mirtazapine has only been when the patient was taking something else with it. SSRIs can cause anxiety. I was on Paxil for a couple years and it made me a nervous wreck, especially the first month or two. It was unbearable.

    Have you ever tried taking only mirtazapine by itself? Clonazapam is a benzo which is the most effective but addictive anxiety med out there, so if that didn't help, that seems strange.

    Quitting meds like Effexor without a long taper can cause discontinuation syndrome, which can give you the wort anxiety you've ever had in your life. I experienced that when stopping Paxil and benzos, years ago. 

    If you take multiple AD meds at the same time, that may cause an excess of seratonin, called seratonin syndrome. That can can cause terrible anxiety and in extreme cases, much worse than that. 

    I quit mirtazapine cold turkey 5 weeks ago, but if you're having a rough time right now and you're taking other ADs, maybe a taper would be easier for you.

    Have you thought about asking your doctor if you could try just mirtazpine by itself, with a little clonazepam at first to deal with anxiety from stopping your other meds? You've gone on and off so many meds you must feel like you've been through the wringer!

    Hang in there.

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    • Posted

      I'm also taking Cipralex 10mg which I just started about 2 weeks ago. You might be right about the mix of the Meds. I had a hell of a time with Paxil and Trintellix. I was on Paxil for many years before and I never experienced problems. I was also on cipralex years ago and I never had side effects.

      Last night I reduced the remoron to 7.5mg. I didn't sleep as well and I woke up with more anxiety and now feeling nauseous. Took Lorazapam which helped for an hour and then nothing. Left work to try to feel better.

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  • Posted

    Sorry about that crazy long post. For some reason my duplicated. It's supposed to end at the 7th paragraph with "Hang in there!"

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    • Posted

      HI Mudd,

      still feeking cruddy. My doctor thinks I should increase mirt back to 15mg and also increase cipralex to 15mg. I was trying to get off mirt so I only have one drug to worry about. I'm still sleeping ok. Not great but ok.

      worst of all I'm also taking clonazapam and Lorazapam which do seem to be working. 

      what do suggest?

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    • Posted

      Hi PaulMar if you don't want to be on mirt get off it you have the right to do so it's your body just tell your Dr you want off them besides your talking 2 benzodiazepines those are alot harder to taper off I know ?? I hope things work out for you keep me posted ??

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    • Posted

      I agree with the benzo tapering. It took me nealy a year to get off ativan. I found a great doctor, this was back in 2003 or so, who put me on mirtazapine and switched my benzo from ativan to valium, which is easier to come off of. Still took forever. Anxiety was awful but the worst part was the depersonalization and derealization I had for months even after I took my past pill. I thought I was going out of my mind and I would never come back. But I did! I on'y take a benzo a few times a year when I'm absolutely know I take take it anymore or I'm about to have a panic attack. 

      After I typed all that I realized how jealous I am of "normal" people who never have to deal with depression or anxiety. smile

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    • Posted

      Hi mud I know how you feel about being normal wish I were there I am so sick of it pills after pills yeah very depressing but it's the chemical in the brain that causes all this so I think I will be seeing my Dr next week and will ask him questions he is new to me I'll keep you posted ??

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  • Posted

    Sorry to hear about the problems you have had with the different meds PaulMar I know meds can be so complicated and to see which ones are going to work for you seems like mirt is doing ok for your anxiety and that's great ?? I wish you the best Cat196111

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  • Posted

    I tapered mirt over 12 days no we, its was the only need I was on as only for insomnia, over 18 months I put on 21lbs and that is the only reason I decided to come off it
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    • Posted

      Hi All, It's been about 5 days I've been on 7.5mg. I feel pretty tired during the day almost keep noddiing off as I'm working. I also feel nervous and my breathng is irregular. This morning I was much worse until I took a lorazapam. This hlped me quite a bit with anxiety but I'm still not myself. My doctor said that 7.5mg is a low dossage and may not be doing anything. I would rather stay on 7.5 for a few weeks sok I give it and Cipralex time to adjust. 

      What do you think?

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    • Posted

      Hi PaulMar reading what you wrote here's an idea maybe take mirt 2days in a row than skip 1day and try that for a week or two and see how you feel while the other medication is building a tolerance if you feel crudy maybe stop the mirt I did my cravings decreased which is good yet I'm feeling a bit nausea wish you well let me know how it goes ?? Cat196111

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  • Posted

    I forgot to mention my mornings are absolutely awful.
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    • Posted

      Hi Paul

      Sorry to read you are caught up in the discontinuation syndrome going from 15mg to 7.5mg of Mirt, it can be pretty horrific.  The 50% drop is a major step down, not many that I have read about can tolerate the symptoms.  I struggle with 7%  !!!

      At a risk of repeating myself, did you read the advice re doing no more than a 10% taper every 4 weeks?  There is lots of advice for your well informed choice at:  

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

      and then click on the link "REDUCING AD'S USING 10% WITHDRAWAL METHOD".

      Also remember you can do smaller drops by making liquid, see here for further advice:  

      http://patient.info/forums/discuss/mirtazapine-tapering-simplified-510495

      Best wishes, just shout up if I can help in any way, I hope your symptoms ease pretty soon.

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