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Severe morning anxiety with Sertraline 150mg and Mirtazapine 22.5mg

Posted , 5 users are following.

nicolas77734
nicolas77734

Hello everyone,

I have been on 150mg Sertraline (morning intake) and 22.5mg Mirtazapine (bed time) during more than 12 weeks for depression and anxiety. Mirtazapine was prescribed to help with sleeping. I had terrible up and down with the sertraline but now I do not feel like I am depressed anymore and up and down are barely noticeable. However as soon as I wake up, I get like an adrenaline surge and have difficulty to stay in bed and rest. I have to get up and do something. Each morning is a very hard time for me. During the day, things improve and I am usually really fine during the evening.

My P doc says that Sertraline and Mirtazapine can't interact and produce this adrenaline surge. I used to take Sertraline alone at lower dose during years and never experienced such bad wake up time. So does anyone already experienced similar problem while being on sertraline and mirtazapine?

In advance thank you to anyone who could help me.

 

1 like, 21 replies

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  • Chick17418
    Chick17418 nicolas77734

    Posted

    I'm on 150mg of sertraline & propranolol plus diazepam at the monument I always wake up with an adrenalin rush, I'm only taking the diazepam first thing am and pm which have helped me a great deal as my anxiety a week ago was through the roof, but I seem to be getting better, who knows if I hit a wall again but I'm hoping the worse is over. I get the impression that this drug just takes a while to settle. Good luck I think we all need it. I can't believe how many of us suffer with these hideous drugs. X

    • nicolas77734
      nicolas77734 Chick17418

      Posted

      Thank you for your feedback and good luck to you too! 

      Definitely, suffering from this kind of illness and having to take these drugs is just no luck (that's the polite form).

  • ger00232
    ger00232 nicolas77734

    Posted

    I don't get a rush where I need to get up I get more like shaking, worry, fear to where I suffer until yhe evening. I'm on both meds but my mirtazapine is 45mg. Mornings are my worst too.

    • nicolas77734
      nicolas77734 ger00232

      Posted

      Hi ger00232,

      thank you for your feedback.

      how much sertraline do you take? 

      Actually I associate the bad feeling I have to an adrenaline rush but I don't know if that is what is really happening. Most of the morning I feel that adrenaline rush but sometimes like you I am like shaking, worried and have really strange and not nice feeling in the stomach or gut. 

    • ger00232
      ger00232 nicolas77734

      Posted

      I'm on sertraline week week 4 and yesterday it was increased from 100-150. I get exactly like you describe but I don't want to get put of bed.

    • nicolas77734
      nicolas77734 ger00232

      Posted

      I am sorry to read that. I hope that sertraline will help you. Good luck!
    • nicolas77734
      nicolas77734 ger00232

      Posted

      Actually I am on sert 50mg since 2002. First time I tried to stop in 2004, I relapsed 5 months later. Then I had to increase to 100mg to get out of my relapse and returned down to 50mg which I took during 5 years. I decided to try with 25mg and relapsed 4 months later after having decreased the dose. Again, 100mg to overcome the anxiety + depression and back to 50mg during 5 years. A year ago, while being under 50mg sertraline medication, I relapsed again (probably an excess of stress is the reason for that). So, 100mg from november to march seemed not to be enough and went to 125mg from march to june and finally today 150mg (12 weeks). 

      We are all different but for me sertraline is a life saver. My life quality during the relief periods was great. The price to pay for this and for me is to feel very bad during the time the brain adjust to the medication and this time can be very long.

       

    • ger00232
      ger00232 nicolas77734

      Posted

      So are u on 150 mg 12 weeks? If so when did u start to notice any difference?
    • nicolas77734
      nicolas77734 ger00232

      Posted

      I think anyone will react differently but I had many ups and downs. So that one day you can feel very well like almost cured and the day after you can feel very bad. I still experienced an awful up and down 2 weeks ago. So it is difficult to answer but the up and down roller coaster started for me after 3 weeks of any dose increase.  
  • a-new-day
    a-new-day nicolas77734

    Posted

    hello nicolas do u def need to take the mirtazapine?  myself in the past i have found that bad morning anxiety on waking happens when i have too much meds in my system, and have found that backing off a bit is the answer

    perhaps you could just take sertraline and split the dose, 75mg on waking and 75mg at bedtime

    • nicolas77734
      nicolas77734 a-new-day

      Posted

      Hi a-new-day,

      that is the question? I know that Sertraline is mandatory for me but I am afraid to taper off of mirtazapine because I really struggled a lot this time with sertraline and mirtazapine dose increases to get to a stable mood state. But unlike doctor, I think that mixing AD isn't very good for the system as you say.  

    • a-new-day
      a-new-day nicolas77734

      Posted

      your mirtazaine dose is really low, 22mg, it sounds like it did help you along your journey but now you have spent 3 months on sertraline so it would have built up really well in your system by now, and you might find that 150mg sertraline is all you need   (here im on 100mg sertraline each morning and doing really well.  i had truly horrendous depression and anxiety 3 months ago... really suicidal and all the other bad stuff)

      maybe you could just try one week of only taking sertraline?   you could always go back on mirtazapine afterwards if needed.  you might find that your morning anxiety goes away pretty fast (few days)

      also, perhaps you could try just taking the 150mg when you wake up, instead of split doses. this might mean that by the following night/next morning, you have less chance of having the morning anxiety, because there wont be so much of it in your system come morning time

    • a-new-day
      a-new-day

      Posted

      ...or you could just carry on as you are, and perhaps the morning anxiety will eventually go away on its own

      (it's annoying having to experiment to see what's right for you isnt it.. it can be quite a rough and rocky road, to say the least!) rolleyes

    • nicolas77734
      nicolas77734 a-new-day

      Posted

      perhaps yes, perhaps not and no doc will give you the answer! That's what is the most difficult thing, to be alone with the sickness and having to make difficult choices.

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