Time course of recovery on Mirtazapine - anxiety

Posted , 6 users are following.

Dear fellow anxiety sufferers,

I'm currently taking 15mg mirtazapine (in conjunction with 10mg escitalopram that I am taking since 1 year) - changed dose from 2 weeks 30mg (too sedating) to 15mg that i am now taking since 2 weeks. I feel that the mirtazapine has helped to reduce my anxiety and improved my sleep but it all feels still a bit unsteady and I still struggle on some days (usually more in the first half of the day).

I would like to invite all people (@ katecogs 😉) who have recovered to share their mirtazapine recovery stories here. Ideally with an emphasis on the time course. I am aware of a significant negativity bias on these health forums (recovered people simply don't spend time online on health forums). I also want to highlight that I have a great doc whom I fully trust but I think it would help me and other fellow sufferers a great deal to hear from recovered people how their mirtazapine journey was and how they have overcome the bumps in the road that I am sure we all experience. I hope this thread to become an inspiring one - sort of to counterbalance all these negative scaremonger health forum discussions.

Many thanks in advance for sharing your personal (positive and inspiring) mirtazapine stories here!

May we all get well!

xxx Andy

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  • Posted

    its simple for you. you have to give it more time. 4 weeks in total, with a change in the middle is far too soon. id say you have another 4 to 6 weeks before you notice consistant improvements. its usually quicker in the long run to start low, and increase very slowly. if you go too high, takes much longer to resolve, and gives an unclear idea of how you are doing. patience is key. recoveries seem to take much longer for people in worse states. with you taking a combo, that probably applies to yourself. you shouldnt be thinking about recovery, you should look backwards, and think on balance, i feel better this week, than last week, or 3 weeks ago. improvements are very gradual, and you often get relapses early on. dont judge how you are doing purely on one day, try to think of how you are doing over the last week, as i find thats the minimum period i can reliably compare how i am doing.

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    • Posted

      Thanks Nigel,

      So are you saying that it is normal to have 'setbacks' along the way or is this a sign that one is not on the correct dose? Or should one expect a gradual improvement without setbacks once the correct dose is found? I do understand your point about being too impatient and then potentially increasing doses too quickly - which will eventually prolong the process. I guess it is all about finding ones 'sweet spot' in the end but it would be good to know if one is on the right path, if you see what I mean..

      Thanks again - this is much appreciated.

      xxx Andy

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    • Posted

      safe to say you will get set backs for first 8 weeks or so, give or take. extremely unusual to get consistant improvements, and its small gradual improvements, over a period of time. unlikely to suddenly feel fine one day. anti depressants work slowly, with relapses along way. gradually over time improvements get better and happen more frequently, relapses occur less often and get weaker. you will find it much easier looking backwards for improvements, than waiting to feel well in the future.

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    • Posted

      Did you also experience dull emotions and emotional bluntness at the beginning of treatment? If yes, is it a side effect that will go away after some time?

      THANKS

      XXX

      Andy

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    • Posted

      "you will find it much easier looking backwards for improvements, than waiting to feel well in the future".....this is one of the best pieces of advice i have ever seen on recovering from anxiety and depression. This is so true......

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  • Posted

    Hi everyone,

    I thought it would be time for a quick progress report (week six since starting Mirt):

    I am now taking 22.5 mg since six days and I am planning to keep this dose for at least a few months now (unless something unexpected happens but fingers crossed that it won't). I believe one mistake that I made was to change doses too quickly and to often, always searching for a quick fix. So this is where I am now:

    my nights and evenings are great - I do not even wake up anymore during the night

    my anxiety is fading into the background. It is still there but not as powerful as it used to be

    my concentration at work has significantly improved

    overall, I feel calmer and more relaxed

    Daytime grogginess has decreased by I'd say 50-60%

    I get moments here and there where I do not think about 'It' at all and that I would consider 'normal'.

    I hope that these improvements will continue and that normal moments and days will increase in frequency and duration.

    I will keep you posted.

    xxx Andy

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  • Posted

    Glad you're doing well on it. I was only taking it for insomnia and the 15mg was way to strong for me. The 7.5mg quit working so it was time to get off of it. Glad to see it is helping you.

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  • Posted

    didnt see you post. you are doing unbelievably well. youve got another 7 weeks of further improvements to come.

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    • Posted

      Thanks a lot Nigel for your moral support!

      I really look forward to more peace of mind. So far it looks really promising. Still some bumps on the road and sometimes feeling a bit odd and not with it. But things have certainly improved and I hope that this will continue and that things will further settle.

      xxx Andy

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  • Posted

    Hi Andy,

    my experience with Mirt for anxiety is limited so far but perhaps it will still be some use. I started on Mirt 4 years ago but only for insomnia. 15mg one hour before bedtime and it has been a total life saver.

    The paradox is that 30mg has the opposite effect, so not double the sedation but actually waking me up and then I definitely couldn't sleep. Not that I did this deliberately, sometimes it's just hard to recall whether you've taken it or not, and because I know I won't be able to sleep without it I took one, then remembered I had already taken it, so then I had 30mg on board and no chance of sleep at all. (I know you can get these pill boxes to avoid this but honestly I can't be bothered).

    Trying to not pile on the weight is a constant battle but worth it for the sheer relief of being able to rely on 6 hrs of sleep a night minimum, sometimes more. I have no other side effects as far as I can tell.

    Fast forward 4 years, and now anxiety (and other symptoms) have joined the picture. GP has increased dose to 30mg but only as an intermediate step because it's apparently not a good idea to go straight from 15 to 45.

    Because it only promotes sleep at 15, I can't take 30 before bedtime. And because it's not a good idea to take a sleep inducing drug during the day, I now take the additional 15mg at around 6pm, and my usual 15mg at 10.30pm or so. It means I am intensely sleepy between about 8 and 9 pm, then it wears off a bit. But this way my late night dose is unaffected, I can still sleep at night, and it is only a stepping stone towards 45, which I expect will be 30mg first thing, and 15 at night.

    I've only been on the interim regime for 4 weeks, I don't feel much in the way of difference to my anxiety (which is thankfully not constant but can shoot through the roof in an instant depending on life's events), and hope to move up to 45mg soon. At which point I will report back. I'm pretty optimistic about it for now.

    Jojo

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    • Posted

      Hi Jojo,

      Thanks for your message! I keep my fingers crossed that things will continue to improve for you but it sounds like you are on a good way. I have learned from others here and from myself that patience and perserverance are really key! I too believe that I am on a good way now and I am fairly optimistic that things will continue to improve. I had the two best days Friday and Saturday since I started. Today feeling a bit off and not so good but I guess I have to learn that this happens to 'normal' people too. Overall I would say that things have greatly improved and Nigel who has also posted on this thread said some very wise words: One only realises how much better one feels if one looks back. This truly applies to me too. I am not yet where I want to be but compared to a few weeks ago I am feeling much better. May we all get well, eventually!

      xxx Andy

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    • Posted

      Hi Andy,

      thank you for you kind words and wishes. Yes I believe we can and will get better. You are right, Nigel's posts are thoughtful and it is good, and possibly necessary, to take the long view.

      I feel lucky, not to have insomnia of course, wouldn't wish that on my worst enemy, but to have it at a time when medication is available which has worked, over several years now and at the same dose, but does not make me feel 'knocked out'. The effect of Mirt seems to me to be quite subtle, and perhaps this means improvements too, especially on mood, are subtle and not instantaneous.

      Absolutely right, people who are well have bad days too! So I hope for more good days than bad, which really is something that can only be judged by looking back not ahead. All the best.

      Jojo

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  • Posted

    the looking back over your last week and comparing it with previous weeks, is the only way to accurately measure your improvements yourself.

    during recovery, you have blips or relapses, especially early on. these knock you for six, as you think you are back to square one. the relapses that happen early on, last for longer, happen more frequently, and are more intense. as time goes on, they last for less time, happen less frequently, and become less intense. eventually, after quite a long time, possibly after 2 or 3 months or more, they disappear. this is why you cannot take how you feel on any given day or days, as an indication of your progress. you need to compare one or two weeks, with one or two weeks previous, to be confident of progress.

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