Mirtazipine Dosage Challenges

Thanks Nigel. Really appreciate your advice. I was on Sertraline 200mg for 16 years which was amazing with no symptoms and then pooped out recently in September

thanks jon. similar for me a year ago. now on venlafaxine. anti depressant principles, recovery and experiences are practically the same for all anti depressants. took 10 weeks for me on ven, to even start working. the higher dose and longer time spent on a med, generally, when they stop working, and you start a new one, it takes much longer to work. made same mistake on citalopram as you intially have done on mirt. went too high, too quickly. completely messed me up, and ended up in a much worse state. fortunately, by the sounds of it, youve got away with it on mirt. you want to stay as you are for a minimum of 6 weeks, possibly longer. most the the experienced people on hear that have recovered, experienced similar long periods you have to wait, and caution against changing doses and meds so quickly and often. give it plenty of time. 30mg sounds right for you now.

Makes sense. I had a really good day today and hoping that continues. It's so tough keeping a brave face on for work and family isnt it. I have 2 kids and dont want to burden them so have learnt to hide it when inside i feel like giving up. Hope for happy years to come keeps me going. Best of luck to you.

I have been taking mirtazapine since three weeks in total now for anxiety. I took 30mgs for the first 2 weeks and my sleep was great and it significantly reduced my anxiety but I was a bit too sedated during the day. So my doc said I should reduce to 15mgs. I am now 6 days in to taking 15mgs and the evenings and nights are really great now. Also, the tiredness during the day has gotten less. I feel though as if everything is a bit unsteady, and I do not really trust the peace (I guess this is part of my anxiety issue in the first place, continiously monitoring how I feel and interpreting every single blip as a big catastrophe) - anxiety still flaring up here and there (but nowhere near where I was a months ago).

I hope that things will settle further and that the anxiety "bumps" on the road will get less intense and less frequent. So what do you guys think? Seems like 15mgs is the right dose for me?

Thanks for your advice!

XXX Andy

hello, only time will tell. 30mg was a little high to be starting with. it can take anywhere from 4 to 12 weeks for the daytime sedation to dissapear, which it does when mirt is fully working. with anti depressants, you have to judge doses over long periods of time, as they take so long to work. 3 weeks is way too soon to expect much at all from mirt. its better to start low, and go up if necessary, it may take longer to work, but it can take even longer going too high, and having to reduce the dose. changing doses, is almost like starting all over again. you cant decide if 15mg is working for you for at least another 4 to 6 weeks. it can take longer. you really have to be patient, and give the dose ling enough for you to be able to make an informed decision. if 15mg isnt doing much in say 4 weeks or so, try increasing to 22.5mg instead of 30mg. patience is key, and saves a lot of wasted time in the long run.

whenever you start or change the dose of an anti depressant, you need to give it at least 4 weeks, before you get even the first idea of how its working for you. if side effects are too extreme, sooner, then you would consider changing before 4 weeks.

I'd echo exactly what Nigel has said. I went up the doses way too quickly with Mirtizipine and thanks to his advice i am now beginning to feel so much better at 22.5mg. It's all too common for GP's to agree with your impatience to feel results and let you increased the dose. You have to let the medication have time to help you so patience is key in sustainable recovery.

thank you both very much! Really appreciate it! I will definitely stick to the 15mg for the next couple of weeks and see where it goes.

Again, many thanks!

xxx Andy

Thanks again,

Can I ask what recovery on Mirtazapine was like for you guys? I mean how did it feel and when did you know "hey ok, I think this is working"? Did you have ups and downs or was it a continuous improvement of symptoms? I do have the feeling that I am on the right track now. It is just that I sometimes tend to not trust the peace and then my anxious mind will start to obsess about how I feel. I am only 7 days in since changing from 30mg to 15mg but I already feel that anxiety is subsiding. To be honest it feels a bit strange sometimes not to have anxiety. But I realise that I have very good moments, especially in the afternoons and evenings and I hope that these phases will expand until eventually I feel 'normal' again all day.

Best wishes,

xxx Andy

Thanks Jon! That sounds really awesome! I'm looking forward to getting there!

Thanks a lot for your support!