Severe Depression...Don't Know What to Do

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Some advice would be great please. I've been sufferering from severe depression for a number of years now. I've dabbled a bit with therapy, but I'm not a great believer that it can help me. I was prescribed Sertraline about a year ago but after being on it for a couple of months and having the dosage upped, I suffered from serotonin syndrome and came straight off it (Doctors orders). She prescribed me Mirtazapine but it's been sat in the drawer ever since...nearly a year now. 

My depression is now the worst it's ever been. I've booked an appointment with my Dr but she's on holiday till september so it's not for another 3 weeks. My partner says I need to be on tablets now, rather than waiting (he's suffered from, and beaten depression and can't understand why I can't do the same) but he just doesn't understand how bad a reaction I had to tablets last time and therefore doesn't understand why I don't want to just start them - especially with my Dr being away (I don't want to see a locum). He's also pushing me to try therapy as the combination of tablets and that worked for him.

Any advice would be appreciated - what are others take on starting Mirtazapine please and has anyone suffered from serotonin syndrome whilst on this tablet?

Thanks in advance.

 

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  • Posted

    I was prescribed Citalopram in December last year and despite taking ti succesfully previously had really bad startup side effects.  Not totally sure they were Serotonin syndrome but certainly some similarities.

    I was prescribed Mirtazapine which I took with few side effects (tiredness, big appetite and slight irratability).  For me I don't think they helped my anxiety and have now started coming off them.  However I didn't have any of the problems I had with Citalopram.

    Mirtazapine is generally acknowledged as having fewer side effects compared to other ADs.  In addition I believe it is commonly prescribed where there may be a risk of Serotonin syndrome as it is not an SSRI type AD.  Believe technically it's a tri or tetra syclic.  However it does not affect Serotonin levels in the ways that other SSRI based ADs sych as Serraline do.  Indeed sometimes it is presribed withh an SSRO AD.

    I can understand your reticence to try it.  Maybe if you've had the tablets for a year if you can you might be better waiting till your GP is back and discuss it further with her.  However I believe instances of Serotonin Syndrome are far rarer with Mirtazapine than other ADs if that provides any reassurance.

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    • Posted

      Thank you clarkio for the response. I didn't have many side effects whilst actually on the Sertraline apart from it ending in SS. I definitely suffer from anxiety as well as depression.

      I think I'll do that - wait until my GP is back and have a full discussion with her. Thanks again.

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    • Posted

      Do I take it that you are not seeing a psychiatrist. You r GP might be very good but he is not the expert. You say thatyou are not great believer that therapy an help you. You are presumably depressed for a reason which you would like to be addressed by talkin.g I saw a counsellor through MIND where I made a small finacnila contribution. In couselling you talk they just listen. I personallh woud avpod group therapy at all cost - some of the most horrible I hve met have been there. I dion't know maybe you should see a psycchologist - the psychiatrist is the best person to know these things   IMHO.
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    • Posted

      Thanks NickOliver. No, I'm not seeing anyone about it at the moment. I did group therapy and loved it whilst I was there but now that I'm back "on my own" I'm just struggling again. I hated one on one therapy because it was an hour of talking to someone about all the things in life and the past that have hurt me or made me sad. I always felt I came away feeling worse. Maybe it was just the wrong therapist.
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    • Posted

      I am sorry to hear what you hear what you say about 1-1 therapy. Was it therapy or counselling? I say that because counselling is you talking for anhour (well, an hour, if I turned up on time) undirected whereas, and I have not been on therapy, I thought that a therapist would focus or direct your talk rather than talking in one session "about all the things in life and the past that have hurt me or made me sad". Well, you are depressed because of these things and you need to talk about them. Might I suggest that you go and do something active after your session rather than going over what you have talked about. But it shows that you are talking about the things that have been hurting and making you sad ie depressing you.
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  • Posted

    Hi,

    I'm not sure my response will resolve your dilema but I can tell from my experience, that sertraline was not good for me at all, as I was very unstable, I could have two good days and three very bad and then one good again and two bad. Mirtazapine works well for me. It gives you a good sleep and apetite (I'm skinny and need to put on weight - if you're not I'd watch out, in a week I've put on 4 lb). It's not easy to come of Mirt as well but very slow tapering ussualy works best. It's not an ideal drug but I'm only able to function thanks to it. I'm on 7.5mg and would recommend a small dose to start off with, as sometimes it's just enough. Good luck with whatever you decide!

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    • Posted

      Thanks 1980 - I'm going to speak to the Doc and look at maybe starting the Mirt. Good luck to you as well 
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  • Posted

    Read the book first. You may not need the meds.

    I am suffering badly because of mirtazapine. I know everyone reacts differently but wished I had found the book before meds.

    I recommend everyone read it.

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  • Posted

    Start taking the tablets not much point in going to the Drs if you have ignored her last advice I was fine on them only real side effect was weight gain which I didn't like but every tab has a side to them I only use them as a sleeping tablet now 

    good luck don't give up & listen to your partner 

     

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    • Posted

      Hi margaret98523

      I didn't ignore her advice, I was just wary of putting myself in the same position of collapsing once more whilst on meds. I wanted to go back and see her to discuss my options - perhaps see if there are any group therapy places available etc.  The thought of putting on weight on the tablets scares me, weight is something I have struggled with over the years. Thanks for your advice.

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