Please help ?!?

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Ive been on mirtazipine 15mg and citalopram 30mg for a few months but still suffering with foggy head 24/7 , taking cit in mornings and mirt at 7:30 pm , struggling to function all day . Nothing has improved . Feel like giving up ! Tried lowering the mirt for a few days but was worse , back on 15mg no better , no energy or interest in life ! Desperate !

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  • Posted

    Gary

    So sorry to hear how bad you feel - I wonder if like me mornings  are the worse part of the day and that is why you feel desperate just now. I'm writing this feeling desperately anxious and depressed with a foggy head from Mirt. I know another diazepam would help to sedate  but I know it's not the solution  Is there anything this week that is particularly stressing you ? Are you sleeping, eat well. I find B vitamins, fish oil  and Magnesium helps a bit. If you are so low (and believe me I know how it feels) -  you do need to talk with someone - at least phone the doc and do keep us informed. We're in it together on this journey to get better. 

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  • Posted

    Hi Gary. Are you sure it's the mirt causing this and not the cit? This is a side effect of mirt which normally goes away completely after a few weeks. If it is the mirt then I think yoou need to stop it because in cases where the fogginess lasts, it has occasionally caused permanent cognitive depression. Speak to your doctor asap.
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  • Posted

    A combination of SSRI and mirt is often a good treatment.  It works for me.  Sorry it does not work for you.   I see you have tried various doses of citalopram so perhaps you should switch to another SSRI.   I would hesitate to come off the mirt as that is reportedly very difficult, and the mirt may be helping you with sleep?

    I have been where you are.  Please hang in there.  

           

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  • Posted

    Hi Garyflinn, 

    Since this is a new post I don't quite have it in me to search for your other one(s) for history.  What is the history with the cit - increases, decreases, how long you've been on it, and why the mirt was added?

    It's a tricky situation because mirt apparently works better as an antidepressant at higher doses, 30 mg, and is more sedating at lower doses, where you are at.  The problem is, if going higher doesn't do the trick, you are now at a higher dose that you must taper off of because it is such a nasty drug to wean off of.  Evergreen has been tapering off as have myself and Calmer.  Some of us are more sensitive than others and have to take the taper at 10% per month to avoid disabling withdrawal effects.

    Definitely speak with your doctor about this.  As Evergreen said, the sedation of mirt shouldn't last this long.  If you had reduced your Cit dose, or increased it, that may be part of the foggy head problem.

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    • Posted

      Hi

      I was on Cit & Mirt together for some months, I weaned off City slowly and kept on with the Mirt.  

      I am like you Gary, I feel sedated/foggy head on Mirt 24/7, but when you get yourself going/moving/active it goes, disappears, it's only when I sit around I feel it.  For some the sedation seems to be disabling, if you can't get out of it maybe Mirt' isn't for you - having said that the lower doses i.e. 15 mg are usually given for anxiety/insomnia, and 30/45mg for depression ... maybe you need to discuss that with your doctor.

      I think you would benefit from getting out for a power walk/run/gym/whatever floats your boat, as hard as it is to get motivated on Mirt it's pays off tenfold, really lifts you.

      Yep Betsy is right, including Evergreen we are taping off slowly.

      I hope you find the answer and I wish you well.

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  • Posted

    I was on citalopram 20mg for months , settled quite well then was given mirt as wasn't sleeping , all settled then I became anxious again so was put up to 30cit with the mirt , my anxiety and nervousness is there non stop along with shakes , I'm just not calming down at all , I don't know whether I should drop to 20mg cit with the mirt for a while . I'm at my wits end and think I'm losing the plot . I've got no energy , motivation and can't cope
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    • Posted

      Trying to pin down exactly when the anxiety kicked in this time, during the medication changes I mean:

      Started on Cit 20mg, settled well but later wasn't sleeping

      So put on Mirt 15 mg  - then settled down for how long???

      Anx increase so Cit upped to 30 mg

      No I wouldn't drop down the Cit, give it chance to work - when did you start on 30 mg of Cit?

       

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    • Posted

      I settled on 20mg cit with 15mg mirt for around a month .
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    • Posted

      sorry about being vague but so much has gone on over the last 6 months , I'm taking 30cit am , omeprazole , vit d (m.s prescribed) , co-enzyme q10 .

      then 15mg mirt at 7.30pm . Sleep ok but anxious and shaky all day and was not so bad on 20mg cit and 15mg mirt .

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    • Posted

        

      I see the Omeprazole has some side effects that might be in the picture:

      fast, racing, or uneven heartbeat

      mood or mental changes

      trembling ... just a thought.  

      Vitamin D3 is good for us with our condition.

      Well, if you definately were ok on 20 mg Cit and have only had the anxiety since upping to 30mg, I can see no reason why you would want to stay on 30mg.  See if it makes a difference.  I'm sure it can't make it any worse.  But don't stop taking either, these 2 have to have a slow wd, especially the Mirt.

      Do you think you could get up and out in the morning, get some exercise?  Walk in the park even, look to the horizon - it's impossible to feel anxiety whilst looking into the horizon !  Honestly.

      Just a little walk maybe ?

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    • Posted

      So the troubles began with the fact that your sleep was messed up, and so the mirt was brought on board. Then, the increase in cit brought on side effects again - I've read the start up side effects are horrible and include awful anxiety that goes on quite some time before settling.  Increases will cause the same side effects.  You may have had anxiety from mirt on start up which was treated with the increase adding start up side effects of two meds, not one!  How long were you on the mirt before the cit was increased?  I'd be inclined to agree to go back down on the cit and then give it a good couple of weeks to see what changes occur since it takes time.  However, you are at risk of withdrawal doing so.  It would be better if you could step down by 5 instead of 10.  Even that is a bigger cut than is really recommended (10% per month is ideal for a safe taper).  However, since you are having bad side effects, if it is possible to drop by five that might be the way to start.
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  • Posted

    I think Calmer might be on to something.  I ran a drug interaction check on the three with the omeprazole:

    "omeprazole  citalopram 

    Major interaction: Applies to: omeprazole, citalopram

    Talk to your doctor before using citalopram together with omeprazole. Combining these medications may increase the blood levels of citalopram and increase the risk of certain side effects, including an irregular heart rhythm that may be serious or life-threatening. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with these medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor."

    There is also a risk of serotonin syndrome with the following, though I don't think that is the problem; still good to know the symptoms:

    "mirtazapine  citalopram

    Major:  Applies to: mirtazapine, citalopram

    Using mirtazapine together with citalopram can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor."

     

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