Mirtazipine dosage increase

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After 8 weeks of hell on sertraline my doctor changed me to 15mg of mirtazipine. This got to work within days and I had a good 3 weeks of feeling almost normal ! I thought this was a miracle drug but this last week I've felt my anxiety creeping back and this morning was feeling quite desperate. I went to see my GP and he said double the dose. I expressed my concern about the fact that lower doses are better for anxiety and sleep and I was worried that a higher dose wouldn't be good for my anxiety but he dismissed this and sent me off with a 30mg prescription. Do I take it ? I can't go back to were I started I feel so scared and desperate

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  • Posted

    Jessica I think the symptoms youu are suffering now is not the Mirtazapine, but withdrawal or discontinuation syndrome from sertraline ... doctors are good at switching meds without a thought of a tapering off plan, it seems we can't expect our doctors to know everything !!  Unless I'm mistaken and you took a while to come off he Sert?

    Doubling the dose, in my humble opinion, isn't the answer, most people complain their anxiety gets worse on 30mg, not everyone.  I think you're wise to ask here.

     

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    • Posted

      I dropped my dosage of sertraline down over a few days from 100 to 50 and then had to take 25mg sert and 15mg mirtazipine for 2 days and then no sertraline and just 15mg mirtazipine which started working within days and lasted 3 weeks. Wouldn't I have had the sertraline withdrawal symptoms sooner ? I took the 30mg dose last night but now I'm scared I shouldn't have taken it 😔
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    • Posted

      It won't hurt you to take one dose of 30mg, so have no fear on that.  And yes, 3 weeks out you can still get symtpoms of the fast taper from the Sert.  It was too fast, for most.  Make a call to your doctor, see if you can take some Sert' alongside the Mirt - both at the same time.  I think within a few days your symptoms will settle, and stick on the 15mg Mirt.  Once stable, hold on that for a week or two, enjoy some peace, and then do a slower taper from the Sert.

      See what your doctor says, be strong, this phase will pass, just hang on in there.

      x

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  • Posted

    Hi Jessica,  I would suggest you go and see a different gp if possible, in my experience some doctors do not understand mental health issues. You are correct in saying the lower dose of mirt. helps with sleep and anxiety. Good luck, I hope you get sorted soon.
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    • Posted

      I am literally loosing hope ! I took he 30mg dose last night and now I'm scared that I shouldn't have ! I've tried to call my CPN because she was the one who recommended mirtazipine but she signed me off after 3 days on it and said I was in recovery 😢😢
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  • Posted

    Hi Jessica, as I think we all know , the  mental health stuff is far from an exact science. Everyone who has problems seem to have varied side effects from different medication. I can't advise you not to take the advice of your doctor but sadly you have to make the decision whether to increase or alternatively. withdraw from the Mirt. These forums just highlight the many difficulties we as patients have to put up with, but you are not alone so be brave.
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  • Posted

    I might be going against other people on this forum, but I would trust your doctor and take the 30mg mirtazapine, give it a few weeks to work. I was put on 15mg mirtazapine in addition to the venlafaxine I was already on, and it worked to reduce my anxiety as well as lifting my depression, but not completely so I was put up to 30mg, and I've been well on that dosage since then. Also you need to remember that recovery from anxiety and depression is slow and gradual, but rarely a steady upward path - it always involves ups and downs, two steps forward and one step back. So your present anxiety could be one of these blips. Or, as other people have said, it could still be the sertaline kicking you as it leaves your system.
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    • Posted

      Thanks for your reply ! I have suffered very severe anxiety which is what I was medicated for, sertraline made my anxiety a lot worse so I was changed to mirt, it worked well for 3 weeks. Can I really become this bad again while on medication ? I'm starting to thing that nothing will work. My anxiety is back with full force when I'm on medication to stop it how can that be ! I think sertraline leaves your system quickly so I don't think it's that x
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  • Posted

    Antidepressants such as mirtazapine can take up to 6 weeks to reach their full effect, and the fact that you've felt some benefit in the first 3 weeks is actually encouraging, I reckon. I know how it feels to be scared and desperate at this stage, but you need to tell yourself that you can get through it. Try to relax, and take your mind off the anxiety with distraction activities - I used crosswords and trashy telly! Anything to get through the day, then congratulate yourself every evening for getting through it and tell yourself that you WILL get better. Pixie xx
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    • Posted

      How long have you been on mirtazipine ? Do you still take venlafaxine as well ? Is that for anxiety ? Sorry for all the questions just really looking for help. When I get in this state I can't function, I can't sit to watch tv or read or anything my mind is in overdrive 😓 I don't know how I even get my son ready and off to school when I'm like this. It breaks my heart for him
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  • Posted

    Hi Jessica. I've been on venlafaxine for about 10 years, and when I had a relapse about 6 years ago the psychiatrist added mirtazapine. I've been on the 2 together since then, and they've kept me well and enjoying life with minimal side-effects. I had anxiety and depression. I am very gradually reducing the venlafaxine - I take 225mg each day and I've been dropping off 75 mg a week so I hardly notice the difference, but I'm in no hurry to get off them while they are keeping me well. Try not to beat yourself up about being unwell, just concentrate on getting through the day and doing the essentials. Believe me I do understand, i've been there and come through it. Pixie xx
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    • Posted

      I really wish I could see a psychiatrist as my doctor doesn't know what to do with my meds, he literally says to me I don't know what to do with you. I picked up for 3 weeks on the 15mg of mirtazipine but then came crashing back down. I was so happy to have picked up I have a 5 year old son this is destroying me x
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    • Posted

      You must try to see that it is not the Mirt' causing the crash down that you mention, but the stopping Sert' so abruptly that has caused a withdrawal/discontinuation anxiety and lowness ... if you search ( g o og le) taking Mirtazapine & Sert together, you will find lots of advice and even other threads from this website.  That way you can research and see that it is poss to take a little step back, keep on with the Mirt, and reinstate the Sert at maybe 50 and wait to feel stable again, it will settle you, but you have to be prepared to wait a day or two, or even a little longer.  

      A quick withdrawal from either Mirt' or Sert brings about nasty symptoms, most people imagine that it is their old symptoms returning, when in fact it is not, just the discontinuation, body craving the med.

      Hope this might help.  Take a little look, and hang on in there, you will be fine xx

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    • Posted

      Wouldn't I have felt withdrawal side effects from the sertraline sooner ? After finishing sertraline and starting mirtazipine I had 3 good weeks ?

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    • Posted

      Hi Jessica

      No, not necessarily, I think I answered this above ... take a look.  The thing is Mirtazapine can't cover or just 'take over' wd from another AD, only that AD's ISert) reintroduction can restore/alleviate that in your system.  

      How are you feeling today?

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    • Posted

      I feel rubbish ! I just still can't believe this is happening. I don't want this to be my life forever but it just keeps creeping back. I have an amazing partner and little boy but went into severe anxiety in March and now this is me forever ? Why ? ?? Sertraline really didn't agree with me I don't know what I should do. I've got a pressure feeling in my face today too

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