Newbie to antidepressants. Can’t believe it. Given choice of sertraline or mirtazapine. Please help

[Marmitemarinaded]

I can’t go in to details
But back from GP and he has all but insisted I go on anti depressants

Phenomenal dr. This is not a quick decision. It’s been going on for years.

Anyway he’s said I can decide.

Please help me decide
Thanks so much

Hopeful bump

Sertraline was better for me. Mirtazapine is an older type antidepressant and is either really good or really bad, depending on how your body reacts to it. Mine did not like it and I turned into a ratty, screeching banshee for months until I stopped taking it - the change was enormous.

How did you fare on setraline
Ans what was your dose?

Thanks so much by the way

Mirtazapine was very effective but the weight gain has been phenomenal.

My young adult DS is on sertraline. He's tried a couple of others and this one suits him by far the best, he's doing really well on it. Not sure what his dose is though.

Whichever you choose, it'll take a couple of weeks to start working and you might initially feel a bit worse. When it starts to kick in you'll feel so much better. It'll be worth it.

Sorry, no advice but, is it normal to be asked to choose?
Panicking already about my GP appointment on Monday in which I intend to not point blank refuse anti-depressants even though I am very much not convinced that they are the right thing. Just deciding whether to agree to them or not will be a massive decision, never mind being asked to choose which ones.

Not sure if “normal”
But I have a very good long standing relationship with him

He said that usual to try sertaline first

However I need to put on weight so suggested the other.

I’m fine with putting on weight (would embrace it actually) but the issue is that sertaline is meant to be more effective. Plus take in morning rather than evening as the other makes you drowsy. I don’t want to be drowsy, single parent and I like to be alert.

Try sertraline first. Honestly, the weight gain on mirtazapine can be ridiculous. My psychiatrist does not prescribe it as a first line treatment, and rarely does to women at all.

I'm on sertraline and it's worked very well for me. First few weeks I felt a bit sick and was clenching my jaw a lot. But once I settled I felt so much better. I went on it after a breakdown so officially for depression. I've stayed on it even after I recovered as I found it did wonders for my anxiety (adhd linked).

I'm on 100mg and take it with my breakfast (anytime between 7 and 11). It didn't make me drowsy but I definitely started sleeping better with it.

It really has helped me get to a point where I could recover. I hope you find something to help too.

Sertraliine is a bit tamer in my experiece. Side effects are like a small dose of MDMA-gurn jaw, sweating,hard to reach climax, blood pressure lowers-take it before bed and with water as it can cause ruthless heartburn.

You'l probably get insane dreams for a while as well but it works brlliantly for me

I'm currently on both. I'd go with the Sertraline, mostly due to the weight gain on mirtazapine.

I know someone (male, in case it makes a difference) on mirtazipine. He felt hungry for a while and then adjusted - no weight gain. He said it's also been amazing for insomnia.

I was on Sertraline when I had a breakdown. I was having suicidal thoughts and huge anxiety so I was put on Mirtazipine. I was so sedated on Mirtazipine it was unreal. I couldn’t drive a car or look after my kids. That lasted for three weeks, then I adjusted. I stayed on it about 5 months I think, and have been drug free since. I needed a rest from my excessive thoughts and can honestly say I got one!! I would try Sertraline first. It may be enough for you.

Sertraline very safe long term if you need it for a long time. Pretty safe well accepted medication that's well proven with minimal side effects. Also very good at treating anxiety and depression together.

I’ve tried both (separately) fairly long term.

They are both pretty good.

Mirtazapine had more/worse side effects, for me. Weight gain, dry mouth, restless legs.

They both make me more sluggish and give interesting dreams. Taken at nighttime is better for me, for both.

I did better on lower doses of Mirtazapine than higher.

I’m on 150mg Sertraline now. My thinking is quite obsessive, so I might need to go up to 200mg eventually to try and calm that down.

I’d be interested in trying a tiny dose of the Mirt with my big dose of Sert actually.

Have tried both and didn’t find Mirtazapine helpful at all.

It can take a while to get the right combination.
I tried mirtazapine a few years ago - didn’t help. Swapped to fluoxetine and complete recovery. Then had a baby and tried to come off altogether. Total disaster.
So started with sertraline and was still very unwell.
Then I was offered a choice of adding either small dose mirtazapine or quietapine. Chose quietapine - complete recovery.
Have managed to wean off quietapine, but on sertraline for the long haul.

I’ve been on both.
Both worked wonders ( also been on AD’s for years).
Currently on mirtazapine as it helps me sleep, def keeps me me calm and less anxious.
Was told sertraline good for depression and mirtazapine more for anxiety/thoughts however they have both worked well for both for me.
Been on them for long time and fine
I think i prefer mirtazapine as it helps me sleep and i’m less anxious now.
I see AD as just another medication.

Also have no interactions

I am so touched with responses on this

Thank you

Setraline it is

@Marmitemarinaded

I am so touched with responses on this

Thank you

Setraline it is

I think that's sensible. And remember nothing is permanent. If it doesn't work for you, you can always alter dose or medication later.

Worried about weight loss
Not a given with setraline?

Lack of appetite I can deal with as I will force myself to eat no matter what

But nausea means I won’t be able to do that

That is what I’m worried about

Only just picked up.
Shall I wait until morning to take?