panic and anxiety

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Hi again guys I was originally on 15mg mirt for depression and weight loss but upped to 22.5 myself after finding the lower dose made me too groggy through the day and didn't have much affect on depression. I was doing fine on the 22.5 but my doctor (very young ) said it wasn't a dose she normally prescribed suggested 30mg would be much better to help my depression. Well I've been on this since Friday night and having the most awful anxiety/panic attacks in the mornings which I must add I didn't have before. I'm only just back to work a couple of weeks ago after several months off and I almost didn't make it out of the door it was so bad. I'm hoping it's just body getting used to higher dose but I'm so frightened by these feeling/attacks that I'm tempted to go back to 22.5mg can anyone give me advice as I really want to stick to this drug as I was in a very dark place after my mum died and desperately want my life back thank you

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  • Posted


    I'm on 15mg for anxiety and to help me sleep but I too have mornings where anxiety is unbearable - the annoying thing it can happen  after a good day. Such are the ups and downs of this illness. If I was you I would go back to 22.5mg because you were doing fine on this and it will give you confidence knowing this. You know what feels better for you - not the doctor. Everyone is different. You can always go back  to 30 mg.  

    Keep posting to let us know how you are getting on.

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    • Posted

      Hi thank you for you're reply.

      I took the 30 again half an hour ago but if I'm the same tomoro I'm just going to go back to 22.5g. It's bad enough having depression to deal with but these panic attacks are horrible aren't they very scary. Silly but the only thing that made me able to get out the door to get to work was repeating two random words over and over in my head!! I just want a normal life again. X

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  • Posted

    Hi Kelly, you need to listen to your body.  Mirt has a strange receptor blocking profile.  At lower concentrations it has a huge histamine block which is what causes the sedation, but at those low dosages (below 15) the serotonin receptors aren't as well engaged.  The higher the dose the more saturation that occurs; it's dose dependent, has to do with affinities and such, but only above 30 do those receptors get engaged completely.  That is why the docs want everyone to go up for depression.  I think the lower doses are better for anxiety.  Antidepressants are actually activating, so at the higher dose with mirt acting as an "antidepressant" it has activated your anxiety.  It may not be the drug for you, but now-adays I don't think any drug is good....for another day.  

    If you were content with 22.5 then you should go back.  It may be able to provide just enough of the serotonin blocking there to help you, at least for now.  These drugs should really only be used for the short term.  Long term use causes dependence and tolerance withdrawal which includes, you guessed it, depression and anxiety!  So, keep it short :-)  And, taper off more slowly than your doctor will tell you - horrific withdrawal otherwise.

    In the meantime, look into non-drug alternatives such as cognitive behavior therapy and meditation, which are proven to help anxiety and depression.  Yes, they take a bit  more work than popping a pill, but they create lasting results without the potential for harm.  There's tons of self-help online for CBT and guided meditations, just gotta do some searches. 

    Good luck to you!

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    • Posted

      Thank you betsy

      I've only been on the mirt since beginning of December as my depression after my mum died in march had come back after I'd taken a holiday in July and I think I just had a complete breakdown but by December I didn't want to live and had lost so much weight and with the depression comes all the other physical symptoms as you kniw and being a single mum of 3 teenage boys I couldn't go on. I begged and begged fir help I'd been on dosulepin for many years after my split but this was not working even upping the dose and after finally begging to see someone saying I didn't want to live I was able to s3e a psychiatric nurse that night who agreed with doctor mirtazapine was the right drug for me because I had no appetite and hadn't eaten in 4 weeks. It helped with the appetite almost straight away which then helped build me up a little but I had to come off the dosulepin over 2 weeks. But the 15mg made me so groggy through the day. I wish cbt was the way but for me I think I was at my lowest and and it just didn't help. I still haven't and can't grieve properly I'm just one of those people who find it hard to let my feelings show. My mum was my rock and it was out of the blue so I just need this drug to work to help me get the mum my boys need back x

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    • Posted

      Yes, your boys need their mum!  That's ok, that's how these drugs should be used, to address acute problems such that you have a platform from which you can work on the Self with other methods.  I am so sorry for your loss :-(

      Hopefully the 22.5 mg is a good leg up.  Good diet is important.  Perhaps trying to go gluten free, as there's been interest in gluten being a factor towards depression.  Eating clean, less sugar, caffeine, processed foods in general.  They've even looked at milk as being problematic!  Probiotics for good gut health; our gut flora can affect our mood!  And then supplements:  2 g fish oil/day and magnesium, 100% of the RDA of elemental magnesium/day.  The chelated forms are better, more bioavailable without a laxative effect.  I use 400 mg magnesium glycinate 2x day. Some find inositol powder helpful for stress/anxiety as well, 15 g powder a day.

      I hope you find the relief you need :-)

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