switching from cita to mirtazepine

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Dear All

Would you be able to advise on what to expect when switching from citalopram 40 mg to mirtazepin

I visited my doctor yesterday who agreed that five months on cita hadn't been successful. I have been told to reduce cita from 40 to 20 starting today for next two weeks then introduce mirtazepin.

Can anyone please advise what to expect over this period.

Many thanks in advance

Lorraine x

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  • Posted

    I was only on citalopram for a few weeks so came off it without tapering and without problems. It didn't work for me. But as you have been on it for several months then you might experience some withdrawal symptoms. When you first start on mirtazapine (I have been on it for four years) you will find it very sedating, so make sure you take it at night. Also it has a severe hangover effect for the first few days and you may not feel fully awake until the afternoon. However, stick with it because it is a very good anti-depressant which works very quickly and the drowsiness gets markedly less each day. If it is going to work for you then you should know within a week or so. I find that people wwho say it still isn't doing anything for them after several weeks, never have it work for them. It may well make you gain weight though. Firstly it stimulates your appetite and can give some people a real craving for carbs, and secondly, it does something to your metabolism which means that even people who do not eat more than they normally would often put on weight. I have always been shinny and I put on 20 pounds. I have got most of it off but it is very hard work not to gain weight again.

    Mirtazapine also has a reputation for pooping out on people, sometimes after a few months, sometimes, as in my case, years. I am now tapering off it. Some people have the most terrible and long lasting withdrawal symptoms when they try to get off it. I have cut down from 30mg to 15 over a period of two and a half weeks which is very fast. So far I have had no withdrawal symptoms, but may have those to come when I cut down again, who knows?

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    • Posted

      Bless you what a fantastic response. I was pleased about the weight bit as i have lost so much weight on citalopram. My appetite has not returned in months. I will certainly take your advice and take it at night. Did you get lots of side effects when starting? I got everyone possible when starting cit. Thank you so much for taking the time to respond xxx
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    • Posted

      Hi Lorraine

      Great advice there from Evergreen.

      I'd only add on that I was on Citalopram for 3/4 months before starting Mirt', like yourself I was then put on Mirt whilst still taking the Cit ... I slowly withdrew from Cit, not just over a 2 week period, once you are on 20mg Cit you will be ok to take both - but I would recommend a slow taper of the Cit from there - maybe skipping one tablet one night a week, then 2 nights (say Tues & Fri spacing them out) for a couple of weeks, then missing 3 nights etc ... I didn't have a bad time withdrawing this way, just the odd tingling in my head - or brain zaps as they are sometimes called.

      Mirt' contains a slow release sedative which lasts best part of the following day, so if anxiety or insomnia are your problem they will adjust that.

      Weight gain is the worst side effect, I am doing a slow wd after a year on Mirt' so will be looking forward to a slow weight loss next year !

      Wishing you well Lorraine

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