Took a higher dose and it had the opposite affect. Why???? Someone please help explain

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What's up you guys. I just started Mirtazpine about 1 week ago. I suffer from servere insomnia, racing thoughts,and depression. I suffer from PTSD. Apparently I've been suffering from it since I was around 4years old after attending my Grandmother's funeral. I have a obessive fear of death which doesnt allow me to sleep.I was put on 15mg. It definitely helped me go to sleep. It was like a miracle I mean I couldn't even fall asleep after taking 10mg of Xanax so I was very pleased with Mirtazapine.Last night after having a bad night. I was pretty upset so I decided to take 22.5mg of Mirtazapine and I had the most restless night. I couldn't sleep at all. Why did this happen? Can someone please explain. Am I building a tolerance already after a week?

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  • Posted

    Hi Brian - I've no idea why this happens, perhaps someone else could offer a more detailed explanation but all I do know is that the higher the dose of mirtazapine the lower the sedative effect.   It's nothing to do with tolerance - just something in the way it works I imagine . . . maybe someone with some pharmaceutical knowledge may be able to offer a more complete explanation.   Hope this helps.  Sue
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  • Posted

    HI brian, I have gotten myself OFF Mirtazipine, This is an EVIL drug. I understand your problems BUT this drug is BAD its side effects and withdrawls out way the benifits. Dont increase your dose GET OFF OF IT before its too late
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    • Posted

      I definitely will not be increasing my dose. I'm reading all of the horror stories of coming off of it.
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  • Posted

    Mirt has a very strong histamine block; that is first receptor to get blocked, and so at low doses you have the sedation.  Every taken an antihistamine that knocked you out?

    At higher dosages, the serotonin receptors begin to get blocked, and that is more activating.  

    Now, there's no proof to support the imbalance theory of depression, that it is correcting low serotonin.  For years, this has been known, yet the myth persists. Studies proved that in a group of non-depressed control subjects, their distribution follows a bell-shaped curve, with some having low S, some high, and most in the middle.  When depressed subjects were looked at, guess what?  The same distribution was found!

    So, let's say you are a high S depressed person and you take Mirt.  Now you got WAY more S since the receptors are blocked, keeping lots more in the gap between nerves - now you've got a very activated scenario!  

    If you want it to help you sleep, keep it from 7.5 to 15 mg, for you, probably 7.5 mg.  In your case, low serotonin wouldn't likely be the problem anyway, so no point pushing your S higher.  I would be careful with SSRIs for this reason.

    Now, if you were to stay on the higher level of mirt, this side effect might go away.  Why?  Because your nervous system would make oppositional modifications, down-regulating the serotonin system, to try to bring back your homeostasis.  Now, if you want to come off, you have a problem, because as you drop the med, those changes will be left unopposed, and that causes withdrawal symptoms!  It takes longer for the nervous system to return to it's default than anyone expects.  So, do you want to continue and get your serotonin system hooked to the drug?

    At the lower doses, where serotonin isn't engaged, your histamine receptors will similarly be affected over time, and Mirt has a way of getting its hooks into people quickly.  So, be aware, that if you wanted to come off, you'd still have to taper slowly or run the risk of serious rebound insomnia.

    I hope this makes sense.

    Which came first, the insomnia or the depression?  

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    • Posted

      My insomnia came first. I've had it since I was around 5 years old. This is the first meds to actually help. I use to have to take 6 benadryl to sleep and most of the time that didn't help. Xanax helps with racing thoughts and panic attacks but didn't help me sleep. I started Mirtazapine about a week ago and it was the first time in 15yrs that i didn't have to take atleast 6 benadryl or Tylenol pm to sleep. It was like a miracle but last night i took 22.5 and it totally had the opposite effect.
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    • Posted

      Had you ever tried L-tryptophan or melotonin?  I would not try L-tryptophan while on any AD since there would be a risk of serotonin syndrome, but L-tryptophan can help with sleep.  

      Ok, what came first, PTSD or insomnia :-)

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    • Posted

      I've tried melotonin. It did nothing. I have like 3 bottle now. My Doctor says I may never sleep normal. I'll be 35yrs old on June 13 and I've had insomnia since I was like 5yrs old and waited so long to get help he says It's a possibility I will always have this problem. I'm suppose to start therapy sometime this summer he says that could help also.
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    • Posted

      What is the quality of your insomnia?  Is it hard to fall asleep, or hard to stay asleep?  Do you wake with a start, panic?  Do you ruminate in a troubling way once awake?  Are you on any other psych meds?

      Melotonin is good for helping people fall asleep but not stay asleep.  Some people find lemon balm helpful.  

      I'm just trying to get at whether the insomnia is driven by anxiety.  Waking with a start is usually a cortisol surge, a hypersensitivity of one's alerting system.  Cortisol normally rises in the early morning with light, but when hypersensitized, any ambient light could cause a surge.  So, good sleep hygiene is improtant.  Black-out curtains, sleep mask, covering lights from routers and such, clocks, not reading from tablets before bedtime, shutting off tv and computer by 10 PM, etc.

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    • Posted

      Good explanation, your comment didnt appear for some reason until after I had written mine.  Mirtazapine is an SNRI as opposed to the vile cipromil I tried which is an SSRI.  I don't really understand the difference but I do know there has been more contraversy about the latter, causing heart defects so the medical profession were told to reduce the doseage, also more likely to have suicidal thoughts which happened in my case on just one.  I now learn should have been taken in the morning and not at night!!
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    • Posted

      I have trouble falling alseep and staying sleep. Falling asleep mostly. If I don't have the television on while trying to sleep the racing thoughts begin with the race thoughts a panic attack is most likely to follow. Sometimes I wake up dead from my sleep with racing thoughts as if my brain turned on a switch in my sleep. It's really annoying. I thought I was crazy I never told anyone about it until I was in my late 20s. Growing up I kept everything to myself, my thoughts, fears and feelings period. Noone had any idea. When I wasa little kid I would tell my twin brother about my fears of death but when I got older I stopped telling him. Once in my late 20s I told him it still happens my thoughts. He was shock because he remembered when I would tell him when we were kids but he thought I grew out of that when we were kids because I stopped talking about it. I only told my mother about my condition 2 days ago.
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    • Posted

      I'm sorry, that sounds very difficult to have lived with.  I do think it is possible to put a halt to the ruminating.  I have a friend who has bi-polar and has been able to stop mania from coming on through awareness, noticing when the feeling begins, and then using coping skills and mantras to halt it and bring about calm.  He hasn't had a depressive episode, either, as a result.  I think the tapping is one way to do this.  Some people do sleep meditation.  Meditation in general is very good for the brain and helps keep you present. Ultimately, one must try to develop self-compassion and not tolerate negative self-talk.
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  • Posted

    I've no idea either but once the "tunnel vision" brigade insisted I go on 30mg from 15mg I didnt feel well, I told them but it got brushed off and after a month or so I just decided to halve it myself and am beginning to feel better.  Some of the antidepressants can be quite lethal.  As an example I was once put on cipromil about 14 years ago because of stress and a frozen shoulder, and trying to cope with my poor mother and a diabetic cat to boot.  GP told me to take one at night, which I did about 10.30 and by 3.30 in the morning I was standing at the front door with a voice in my head willing me to go into the river which is just at the bottom of my street.  Not al of these medications suit everyone.   So if you are okay on 15mg stick with that.  This is what I am doing and then hopefully gradually come on that as well.  Hope you feel better soon.
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  • Posted

    Hi hunni.....please do not do anything drastic. Forums and help pages are usually set up by people having either adverse effects or no effects, there's nothing in the middle.

    When u get the medication we are on, it's the big boy stuff so we know their will be side effects....good and bad!

    When ur doc decides to up ur Meds, if like mine they often double the dose so ur fine on what u have taken...and please don't think I agree with self dosing but I fully understand where ur coming from.

    Probably it just gave ur body a big hit and may be why it sent u hyper...speak to ur doc to get his/her opinion. There are higher doses u can take and also things you can take with it to help it work better.

    I am on 45mg and getting confused with other Meds missed taking mine for nearly 3 weeks...there were some difficult side effects but honestly even going total cold turkey...there are others I've found more difficult

    Doubt this helps babe but hang in there x

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