Switching to mirtazapine from citalopram

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citalopram was no longer managing anxiety so gp moved me to 15 mg mirtazapine. Having very unpleasant side effects after one week. Twitching, brain fog, sleepy but not able to sleep. How long before i can expect this to settle?

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  • Posted

    Hi Ibaztoul ...

    There should be others on here who can better your question, but for me? I would say give it another week.

    If you don't get much of a response from other users/members straight away, consider providing a little more info, such as how were you prior to starting on Mirtazapine, How long were you on Citalopram, and was it initially working but then stopped working (hence the change to Mirtazapine)? ...its good for others to get a real feel for someone elase particular situation and might iad someone in giving an answer to any questions etc. Just a humble thought.

    More important than any answer I personally can give, I would humbly suggest you definately do the following:

    ADVICE: Monitor yourself (simple to dobut extremely valuable for assessing who well or not well Mirtazapine worked for YOU. Just get a notepad and scribble a short entry down each and EVERY day. In 2, 3, 4, 5+ weeks you'll be able to compare and see your progress etc.

    All the best and hopes that you begin to feel better real soon!


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  • Posted

    I know how you feel, really I do & I've been through it myself. Antidepressants can take up to 6 weeks to have their full effect, so you need to try it for a bit longer, if you can stick it. Could you try other remedies in the meantime - relaxation, warm baths, distracting yourself with something you enjoy (I use crossword puzzles and TV). They may not do much, but at least you'd feel as though you're doing SOMETHING. If it gets too bad, you need to see your doc again, but I think he/she would say to give the mirtazapine a bit longer to work.
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  • Posted

    What dose were you previously on citalopram, if you've only been taking them for a week you need to give it longer for the side effects to calm down, pretty much the norm to not feel good when you first start
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  • Posted

    Hi Ibaztoul

    I too switched from Citalopram to Mirtazapine last year - for a while I was taking both as there was obviously time needed to withdraw from the Citalopram.  You don't say if you withdrew from Cit s-l-o-w-l-y ...   ...   ...   even if your doctor said it was ok to "just stop".  Could this be adding to your anx' at all.  

    Mirt worked immediately as a sleep aid for me - in fact I was so drowsy for about a week I thought I would not get back to normal (whatever normal is).  But yes, Mirt is one of the best to help sleep.  

    If you should decide that Mirt' is not for you, please do your research (read about wd on here) as you can't just stop.

    Best wishes, you're not on your own, we're all struggling sad

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    • Posted

      Hello, i recently switched over from citalopram to mirtazapine. I have had various episodes of depression and anxiety over the years but due to a number of bad experiences in my personal life i really hit the wall in october. I would not leave the house and felt really unwell.brain fog muscle pain and twitching, dizzyness, feeling of ants running around in my head and so on. Various mayor pannic attacks and feeling of hopelessness also occurd😟I was precribed citalopram. On my birthday the 20th of november i ended up in a metal health centre where they prescribed me lyrca. I also carried on with citalopram. Life got slowly better but nowhere near "normal"I work seasonal and dont work during the winter periods so that helped. About 20 days ago my psychiatrist changed my meds from citalopram to mirtazepan.slowly weening of the citalopram(30mg)and at the same time starting with 30mg of mirt. (15mg the 1st 4 days and than the full 30 mgs) i sleep like a baby but was feeling very dazed and tired during the days. It did help with my overall feeling. I now have been feeling very anxcious for the last 3 days and am very tensed. I have also been experiencing brain zapps and the pins and needles allover my body have returned😳. I dont know if this has enything to do with withdrawl symptoms or the fact that i will start work again next month. I also suffer from osteoarthritis in my hip and neck. My neck is killing me and extremely tense which might cause a lot of my problems. I really dont know what to do anymore. Every time i think it s getting a bit better I start feeling really bad again.😟😟
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    • Posted

      Bozzer you sound like you have a lot going off at the same time, I might be wrong but reading the above it looks like you "came off" citalapram 30 in 20 days - is that right?  Personally that would be too quick for me, and maybe the reason for the return of your anxiety.   Brain zaps (I had those when coming off Cit).  But we are all different and medicine & wd affect us all differently.  I too had a return on anx when I had finally come off Cit - probably a couple of weeks from totally off - it lasted a few days and then I got strong again.

      I would think the pins and needles is not a side effect of wd but another symptom of anxiety (paresthesia) also known as hyperventilation.  There's a good write up here I found :   http://www.calmclinic.com/anxiety/symptoms/needles-and-pins

      It might reassure you to know, and it certainly helped me when my CBT therapist told me - hyperventilating and panic attacks are not actually dangerous, they are brought on by fear - fears can be challenged with some practice, fears are thoughts that we somehow let roller coaster us to a tizz, like a rolling stone gathering more and more crap.  With a bit of practice through relaxation (or even meditation - especially meditation) we can overcome the negative thatseems to take control of us..

      Sorry for your suffering, I hope this may help a little.

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    • Posted

      Hi Bozzer

      Sorry, the moderator still hasn't put up my reply to you of yesterday.  So here is another ...

      I switched from Cit to Mirt last September, the GP said to wean off over 2 weeks - I weened off over 6 weeks taking both of the meds - after that time I got brain zaps occasionally, 3/4 weeks after being completely off Cit (even tho' I got down to nearly nothing once a week) anxiety hit me again, I panicked, went back to the doctor and asked to go back of Cit ... a good friend said try to wait a few days, which I did, and the anx disappeared.

      Now reading your post it 'appears' you came off Cit in 20 days - if that's correct it may well be the wd of Cit and not the initial symptoms of Dep & Anx returning.  It can be most confusing when wd'ing or swapping meds as there is nearly always a degree/rebound of anx'  ... I wonder if you've tried any relaxation / CBT / Mindfulness / Meditation.

      I was in a very bad place last year and was feeling desperate, since then I have done all the therapies mentioned, which lead me up all avenues and became all encompassing for a while.  Now I feel I am putting the "tools" learned into place to ease any negative feeling/anxiety/sleeplessness all all that goes with these terrible episodes.  I am not "there yet" or back to normal - whatever normal is - I have a way to go as I have to come off Mirt' one day - no rush though.

      I wish you well, take each hour and day at a time, try a relaxation cd/body scan if you can find one on the internet.


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    • Posted

      Thank you so much for your reply. Yes i do think i went of the citalopram to fast. 10 days! During this i had to take 15mg of mirt to syart off with and than 30mg. My anxiety effects show up more in dizzyness and teaarfullness. Not too much the breathing side of it eventhough breathing yechniquis do calm me down a bit. I think the thought of going back to work while not feeling ready yet also has a big influence.its a brilliant job with really good hours and brilliant collegues. I just dont think that if i cant do the normal day to day stuff and hobbies yeti wont be able to function in a responsible job yet. This also worries me with the toughts of losing my job . After all i have been ther for 20 yrs. I have just started getting dvd s music and books on mediyation. Yoga for stiff people hahaha and stretch and relax techniques. I have a brilliant and very understanding girlfriend and also friends i can talk to. Just know that this is gonna be a very long road but eventualy i will get to be my old self again !! My other physical problems do stop me from doing a lot of things and sports i used to do. I used to play football and tennis but had to stop due to having had thrombosis twice and are noe on bloodthinners. I also have had a hole in my lrg for 5 yrs which wont heal proper while working because of the many hours being stood up.(i wjob is reception in an hotel here in spain). Thi problem means that i cant go swimming which i turned to when my hip started playing up. I was supposed to have a hip replacement in januari but because of the anxiety and being depressed they decided (and so did i ) to wait for the time being. Also the osteoarthrites in my neck has been giving me a koy of bother ovrr the last few yrars. i used to play the guitar for at least an hour every day and really strugle to play for 30 mins at the moment (per week that is 😟). All in all i have to try and realize that a lot of the things will come back very slowly in time but also have to realisethat i will have to live with osteoarthritis.

      accepting is the first step. Now taking it on is the next !!

      Wish me luck !!

      Any ideas to make this journy a bit easier are very welcome !!! Love to everyone !!!

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  • Posted

    I to have just switched from cit to mirt. I was told by my doctor to stop cit and take 15 mg mirtazipine following day. It's been a week now and I thought I was going off my head. Not sleeping when I feel so tired painfull jumpy legs, crying for silly things. I'm so glad I looked it up on here. Knowing I'm not on my own helps. Family don't understand so I feel totally alone.

    Thank you

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    • Posted

      Hi Michaela

      This thread is a year old, so I'm not sure if the previous folk will reply.

      Although Citalopram isn't one of the difficult AD's to taper from, I'm sure it is responsible for your recent symptoms - sometimes its hard to know causation when you stop one med' and start another.

      I was on both AD's for several months before doing a slow tpaer from CIT, over say 5-6 weeks.  If your symtoms continue maybe discuss with youur doctor that you may have discontinuation syndrome, reinstate 75% or the CIT and every week drop by say 15/20%, no good suffering for sufferings' sake.

      Oh yes, don't expect GP's, general doctors to know much about tapering AD's, some think you can just "switch" which isn't the case at all.

      Wishing you well Michaela smile

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