Sertraline vs Mirtazapine

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ive been on Sertraline for a few months but when the GP put me up to 100mg it gave me horrendous diarrhoea. He's just changed me into Mirtazapine 30 mg at night which is apparently the only one I can change onto immediately. Having red a few things on here, I'm wondering if this is too high a dose to start off with. I don't mind it making me sleep as I have trouble there but I have to get up in the mornings. Also I don't want to put a lot of weight on obviously. Anyone got any advice for me please?

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  • Posted

    I don't know what effect that it will have on you, but I was originally put on 30 mg at night and I had to reduce it to 15 mg because of its sedative effects in the morning. Even then if I had to not take it if I had an appointment in the morning eg with the bank where I needed to be on the ball.

    In fact, I was sleeping 9 hours on it. If it has the same effect on you I don't see how you can work or do an intellectual activity in the morning.

    Now I have come off it I am sleeping 6 hours.

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  • Posted

    Hi. I started on 30mg for a month, then reduced to 15mg for the last two months. This drug has been brilliant in reducing my anxiety and it's helped me to sleep every night BUT I've put two stone on in weight. I can honestly say my eating pattern has hardly changed. Gone from a size 12 to a size 16 in such a short time. I've decided to try and wean myself off this drug, so started on 7.5mg last night.

    I'm also seeing a psychologist weekly which is helping my depression

    I know everyone is different, but please prepare yourself for possible weight gain over a short space of time. 

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    • Posted

      I don't know whether I put on weight due to that. When my (last) GP ordered me to lose weight he didn't suggest that it was drug induced. Since I came off I have been dieting and lost at least half a stone. I can now run for the bus.

      Incidentally since I have come off various drugs I havent tripped over the pavement. A number of times I tripped and rather than regaining my balance I fell and hit the ground. On one occasion I broke my finger. I was on Lithium as well and tother drugs so it was not necessarily mirt.

      In retrospect I feel that probably the haziness caused by the drugs left me less in control of my balance etc. Indeed I have a mountain bike and I found that balancing that when starting off was very difficult and I lost my balancing when doing so. Cycling is quite a complicatied action and it is quite a long way to fall for an adult. 

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  • Posted

    15mg is the normal starting dose. It is the most sedating antidepreesant available becuase it has to completly block the H1 receptor before the it blockt the HT2 receptor to a degree high enough to have an affect.

    Sertaline has a short half life of only 1 day so would be out of your system in 3-4 days leaving you clear to start anyother AD med. Mirtazapine is normally a 3rd line option SSRI being the first and then an snri or similar affecting tca.

    Do you have kids to look after? If they are very young this med will affect your ability to get up in the night, particulaly the first week.

    Try to take the med as early as possible in the evening to reduce next day drowseness/sedation but take it at least 2 hours before you want to go to sleep.

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    • Posted

      Sorry to clarify, blocking the histamine receptor (H1) causes the sedation.

      Blocking the HT2 serotonin receptors makes for serotonin available for the serotonin HT1 receptor which is what should help with the depression.

      Mirtazapine also affect the adrenaline (epinephrine) but to a lesser degree than the serotonin. 

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    • Posted

      Thank you for this post, I was curious about the neurological activity of these tablets as I was recently switched to mirtazipine from citalopram (didn't agree with me).

      I was prescribed a batch from my local boots that were by two different manufacturers. I take the orodispersible version and one had a cherry flavour and the other orange. Is this normal to get two different manufacturers as this to me seems it has the potential to be dangerous? Thanks

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  • Posted

    Hi,

    I was on 100mg of Sertraline, came off it in Feb, found it was making things worse for me after a year of being on it. IBS affected etc. Now starting Mirt too, on day 2. I'm easing myself in with 7.5 mg to see how I go. Drowsy, mood all over the place but it is helping me sleep which is what I need. I'm hoping the mood will level out after a few more days. Feeling tearful but not crying for long. As is usual with these types of drugs I feel a bit weird but it seems to be taking the edge off my anxiety already! I've gotten to the stage where I'm holding my breath with the GAD so with that & SAD I've had to turn to meds again. I can't seem to get past 8months without ADs I've had SAD for years. Just went for a walk in the Sun & feel a bit wiped out. Iam getting over having flu though. I can't comment as yet on the appetite as I'm craving carbs with the SAD anyway. IBS is bad so I'm not overeating. Sometimes that nasty condition has it's advantages!! 

     

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  • Posted

    Hi Mazza

    not sure if this helps but I started on mirtazapine 15mg 3 weeks ago, I had to reduce it to 7.5mg as I could not wake up.........slept to 2pm so way to drowsy. I take it at 7 to be awake for 8 but feel foggy for an hour. It as gave me the munchies but I had lost weight due to my health so only gaining what I lost .  I would try it as it as helped my mood.

    Debbie

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    • Posted

      I was exactly like thisI I also dropped to 7.5mg for a week then went to 3/4 of a pill for a week more.

      Also after going up a dose it takes 3 -4 days to reach the full dose in the body (steady state) and fully take affect. With that in mind I thought it best to wait at least 4 days on each new dose before progressing to the next higher dosage.

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  • Posted

    hi i started sertraline 2 year gone from 50mg increased to 150mg the sertraline did not really agree on its own with me, but everyone is diferent, i then had the sertraline reduced to 100mg and 30mg mitazapine that was inreased to 45mg the mitazapine give me really vivid dreams and increased appitite stick with it if you can,it helped me apart from dreams and stuffing my face i also have 20mg tamazapam and 200mg quetiapine as i have psycotic episode im level but detached hopefully it will stay level

     

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  • Posted

    I have been on Mirtazapine for 2 month and totally the odd one out as I've lost almost 2 stone. Was hoping for the munchies that everybody said but they haven't come yet. I started on 15mg and slowly worked my way up to 45mg..I found the lower doses more sedative..I don't feel shattered at all throughout the day on 45mg,yet they still help me sleep.

    They have worked wonders for anxiety and are just starting to work on the depression. 

    I've noticed the biggest changes in the last 4 week while on the higher dose.

    Cant be sure if I had side effects as I came off Citalopram with no tapering and straight on to the Mirt so if I was feeling anything,it could of been withdrawal.

    xxx

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  • Posted

    Thanks for your helpful replies. I took my first one last night and forgot to take it early so I'm completely stonkered this morning, staggered a bit! I will have to take it a bit earlier in future. I certainly slept though! I've got 30mg tablets so I suppose I could attempt to cut them in half but it would be difficult.

    It's interesting reading your different responses. I wish I'd asked for smaller dosage to begin with but you have to trust a bit, don't you? I might still have some Sertraline in my system as well. 

    i will have to try and not put weight on as that would make me more anxious. It's early days though, isn't it and I suppose i have to give them a proper try.

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    • Posted

      I'm anxious about gaining weight too. It definitely makes you want to eat more. I've just had 3 pancakes & feel disgusted withmyself ha ha. I'd like to stay a size 8. Anyone else been thirsty with it ? I'm finding that I'm quite thirsty...
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