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Medication (mirtazapine)

(22 Posts)
ephemeralfairy Fri 20-Nov-15 17:03:08

Have been prescribed mirtazapine for depression and anxiety. I was on fluoxetine over the summer but couldn't cope with the side effects.
I have taken citalopram in the past but doc suggested I try something else as my anxiety is very bad at the moment.
Any experiences anyone? I am pretty low at the moment, can't really see a way out.

FaithLoveandHope Sun 22-Nov-15 23:56:12

Hi ephemeral have you started taking the mirtazapine now? I'm currently on mirtazapine now this time only for 3 weeks so far but previously on them for a good few months. They're the best anti depressants I've ever taken. I've tried fluoxetine in the past and couldn't come with side effects. Mirtazapine are amazing though. The first week I was incredibly drowsy and could barely function but tbh that was a welcome relief given that I'm normally an insomniac. Tonight the only reason I'm still awake is because I took my tablet pretty late but normally within half hour I'm asleep. My boyfriend also takes mirtazapine and he loves it. Like me it's the only anti depressant he's found that helps. Really hope you're getting along with it.

FaithLoveandHope Sun 22-Nov-15 23:58:34

Sorry, meds are kicking in and my typing has gone to pot. Meant I couldn't cope with side effects of fluoxetine. Meant to say Ive also been on citalopram and sertraline in the past but mirtazapine is by far the best. I shouldn't have stopped taking it when I did tbh which is probably one of the main reasons I'm now back on it. But even after just 3 weeks I can feel my mood improving.

Garlick Tue 24-Nov-15 00:16:59

I love my mirtazapine smile I take it in combination with venlafaxine (am a hard nut to crack.) It makes you sleepy, so take it at night. It increases the noradrenaline in your system, as well as serotonin. This gives you the warm fuzzies, a bit like feeling pleased with yourself when you've completed all the day's tasks.

Some people find they put on weight with mirtazapine - I have, and so did my friends who take it. It's not drastic. Mostly seems to go around your waist, and you stop gaining after a few weeks. Doctors will tell you it's because the drug prompts carb cravings. It often does, and there's a biochemical reason for it - it locks an extra glucose molecule in your cells. This is very nice for your cells and gives them more energy, but leaves your brain thinking there's insufficient glucose in the bloodstream so you must eat cake!

You could fight the cake urges - but if you're depressed and want cake, there's a strong argument for having some.

I hope it takes the edges off for you and eases your days smile

CowardlyLyon Thu 26-Nov-15 15:36:42

Garlick can I ask what dose you take? I have been prescribed 30mg and only started taking Mirtrazapine 2 days ago.

I am really worried it will make me feel plastic and distant like Sertraline and Prozac did years ago when I had PND. My anxiety is most probably linked to being peri menopausal but HRT hasn't helped.

I felt so dreadful over the weekend that I struggled to even get dressed or even speak.

suestew123 Thu 26-Nov-15 17:58:49

watching this thread with interest. My hubbie has just started taking this, i believe he is on 15mg. He is taking it for anxiety & stress, he get very angry over nothing, with himself not me. He is not coping very well on it, he is very sleepy but mentally I don't think it's helping him. I thought he seemed better yesterday but he said he didn't feel it. I think he is having very negative thoughts and it's worrying me.

He is only on day 7, how long should he give it do you think?

I am on sertraline and find it really helps, I also took citralopram in the past which I also found very helpful, it just takes the edge off and I can sleep at night which is brilliant.

Garlick Thu 26-Nov-15 20:21:40

Most antidepressants take 3-6 weeks to work properly (as well as they're going to, for each patient & dose.) I'm on 45mg mirtazapine.

The NHS says: Initially 15–30 mg daily at bedtime increased within 2–4 weeks according to response; max. 45 mg daily as a single dose at bedtime or in 2 divided doses.

Is your husband following any self-therapy protocols, sue? It sounds like you're already aware antidepressants aren't actually "happy pills". They can help us be more receptive to therapies, and more confident in our ability to cope.

I can't say how you'll feel during the first few weeks, Lyon. As you know, it's normal to feel pretty strange while your system adjusts. I'm sorry you've been feeling so crap ... You're doing really well to have identified the problem and got help; that can be difficult when your own mind's trying to shut you down. Have a star and some chocolate !

suestew123 Fri 27-Nov-15 14:08:58

hi , he won't do any self help. he only went for tablets because of me. he has a lot of pent up emotions and just won't see anyone. he has in the past but finds it hard to talk

limon Fri 27-Nov-15 18:08:15

I'm hoping to be described effexor and mirtazapine instead of citalopram for my anxiety when I have a medication review with the mentail health team.

Garlick Fri 27-Nov-15 20:12:31

Oh dear, sue ... that sounds difficult.

Good luck, limon. I've just discovered there's a slang term for venlafaxine + mirtazapine: California Rocket Fuel grin I won't say I'm rocket-fuelled (far from it, sadly,) but the addition of mirtazapine made a big difference within the week. I hope the MHT find an effective regime for you, too.

I'm on my second week with the increased venlafaxine and can't stop sleeping! First week, I couldn't stop eating. At least I should be well fed and rested by the time it settles - my granny would be pleased wink

CowardlyLyon Sat 28-Nov-15 09:02:36

garlick is it the serotonin or the noradrenalin that gives you the 'warm fuzzies' (love that term).

When I am low/anxious I am completely unable to feel the 'warm fuzzies' about anything at all. Even when I have completed all that day's tasks etc. It's really horrible to be unable to feel any satisfaction or pleasure in anything.

Garlick Sat 28-Nov-15 13:38:22

Yes, it is horrible. I remember when months - very loooong months! - of my therapy homework was ambling around near my house, finding one thing to appreciate. And really fucking resenting that I had to work so hard at feeling a tiny bit of pleasure in a blue sky or child's laugh, when it 'should' happen naturally all the time! (Then, of course, you have to work on the resentment and it's all bastard hard work ...)

It's the noradrenalin. With high doses of some antidepressants, there's a secondary effect on dopamine. That one works mainly on motor control - Parkinson's is a dopamine deficiency disease - and also on your motivation & reward system. Venlafaxine has this effect; adding mirtazapine enhances it.

I don't know as much about other SSRI/SNRI therapies, as I've only done the hard work on the ones I'm taking. The dose & combination effects aren't exclusive to these two, though.

CowardlyLyon Sat 28-Nov-15 13:48:34

Thanks for that garlick. I have just found that the technical term for this inability to feel any pleasure in anything is adhenonia.

It's awful. Even when my DCs give me a hug it's hard to feel any emotion. But on the days, or weeks, when I feel well that glow of pleasure when they hug me is a natural as breathing.

I have only just started taking Mirtrazapine 30mg. Though last night I only took 15mg because I read that you sleep more deeply on that dose?

But I think maybe I should stick with the 30mg to see if that will help lift me out of this awful low mood at times, and insidious anxiety?

CowardlyLyon Sat 28-Nov-15 13:53:34

And that makes perfect sense about it working in your motivation and reward system. When I am low and anxious I don't have any motivation to do anything at all. I force myself to shower, dress and keep the house tidy because if I didn't it would terrify me how bad I must feel to not do these basic things.

But even having forced myself I don't feel any sense of reward for having tidied up, or putting my make up on.

It is a shitty illness, isn't it? I am 90% sure mine is related to being in peri menopause so could have years and years of it yet.

Garlick Sat 28-Nov-15 14:02:25

It is shitty!

The mirtazapine won't stop you waking up to your children, if that's what you were concerned about. Even modern sleeping pills don't do that. You'll feel groggy if you get up briefly but, casting your mind back to when you were healthy, that's normal. My experience is that it helps me sleep more peacefully and for longer. I'd use the 30mg if I were you, and go to bed earlier.

Garlick Sat 28-Nov-15 14:04:27

I also have really boring dreams, but I don't know whether that's down to the drugs or the depression. The night before last, I had 3 dreams about mushrooms because I needed to buy some yesterday blush wink

CowardlyLyon Sat 28-Nov-15 16:10:41

Luckily our DCs are in their teens so not so worried anymore about waking up for them. They're more likely to bloody wake me when they come to bed?

I thought Mirtrazapine worked in reverse, so the lower the dose the more sedating it is, and the deeper & better you sleep? I took 30mg for first 3 nights and although I was very heavy eyed on the sofa, as soon as I was in bed it took quite a while to drop off. Then I don't feel I slept that well or deeply. Still woke at 6am too, and couldn't drop back off despite feeling sleepy.

I think I'm still very much on edge with taking a AD and I'm also really scared of feeling as dreadful as I did last weekend. I think if I can have a couple of weeks of not feeling too bad on Mirtrazapine then I might be able to 'relax into it' if that makes sense?

Dreaming about mushrooms must be possibly the most boring dream ever? I've been having some weirdly vivid ones since starting Mirtrazapine. One involved scooters, a Little Chef cafe and an orange tennis shirt. The mind boggles.

But it made me realise how rarely I have dreamed these last couple of years. Do you think the Mirtrazapine is sort of 'waking up' my brain a bit?

Garlick Sat 28-Nov-15 16:29:07

Ooh, you're right! It does have more sedative effects at lower doses! It's up to you whether you continue with 15mg or increase. If you feel it's doing more of what you want at 15mg, there's your answer. You've still got the option to double it later if needs be.

Don't know how it's affecting your dreams - but am quite envious of the scooter and the orange tennis shirt wink Unscientifically: perhaps it is helping your mind to process stuff after a period of being 'shut down'. That would be encouraging, if so, wouldn't it?

CowardlyLyon Wed 02-Dec-15 20:07:30

Well I am 9 days into taking Mirtrazapine. I haven't really enjoyed the sedated feeling or great sleep that I have heard described. Instead I feel wired but heavy headed. For the last couple of days I have felt increasingly on edge and twitchy.

This morning it suddenly increased and I had what I think is a panic attack. Heart speeded up, felt icy sensation in chest, hands started to shake and I thought I was about to faint. Really horrible.

It passed within a couple of minutes. Never want another one of those. Think I can't tolerate this one like I couldn't tolerate Sertraline (had same style attacks when I tried it).

Wondering if to switch to Amitriptyline? Have got on well with it in the past.

Garlick Wed 02-Dec-15 20:13:33

Did your doctor suggest serotonin syndrome, Lyon? It sounds a bit like it - I'm having shaky phases at the moment, I assume from the recent dose increase. Mine's not too bad and I'm waiting to see if it'll pass. Some people are just hyper-sensitive to serotonin or, perhaps, have normal levels of the hormone and a different kind of depression.

It probably makes sense to do what you know works smile

Luxyelectro Wed 02-Dec-15 20:21:36

I take 45mg. 15mg has a very sedative affect for a lot of people. It helps but it's not a total a fix for me. I do now, sleep though.

CowardlyLyon Fri 04-Dec-15 11:08:35

It could be that Garlick . My anxiety and depression is definitely cyclical, tending to surface just twice a month and lasting several days both times. So maybe it is other hormones causing the anxiety and depression?

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