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

I take mine just before bed when i start as you can feel like shit and tired, and work up from a half dose first week.

Sertraline was awful for me so I'd pick Mirtazepine as long as I wasn't already obese. (Which I am 😪)

it’s different for everyone. i resisted for a long time; had very high anxiety. i wish Id tried it earlier. sertraline has been great for me, I take i 50mg tablet every night. i feel just like normal but happier and definitely less anxious. i did feel a bit more on edge at the beginning but all fine now. i hope you get on alright. 😊

i did find sertraline made me sleep easier so i take it at night. are you starting on half a tab? you might as well start this evening.

Sertraline is medically recommended to take in the morning with plenty of water. Also are you starting with a lower or half dose? Usually that’s the best way to go

If you need to gain weight then mirtazapine is your boy!

I have 50mg and told to take half a tablet

Is this “normal”?

Thanks again

Yes for 50mg take half a tablet for 3 days then move up to the 50mg.

Less side effects if you build up slow. I recommend taking at night too.

I'm on citalopram and it makes me spacey for the first 7 hours so taking at bedtime is perfect, then I ping awake and feel good (usually!).

Sertraline when I took it yesrs ago affected my motivation , I took that in the morning, maybe night would have been better.

One thing I would say is try and take it exactly the same time, I really noticed with sertraline my mood was really stable when I took it the same time. Also you still need to eat well and exercise to really feel better, building up is good.

I was on both together at one point and wouldn't take either again but for different reasons.

Sertraline -
Insomnia
Awful awful withdrawal
Stomach pain - felt like my inside were going to fall out
Brain zaps

Mirtazapine
Extreme weight gain (4 stone) - I was under weight and it started me on my journey to being obese.
Nightmares
I felt nothing, all emotions disappeared.
Brain fog that's never really gone away.
Couldn't drag my arse out of bed in the morning & im up at 5am naturally otherwise.

They're all different for everyone. You really won't have any idea if they'll work for you unless you try them but I would start with sertraline.

For me, mirtazapine was better, but I would also try sertraline first because if it works then it's probably the better option in terms of side effects.

I take both. Originally put on Mirtazapine but felt very slow and tired on it. Then started on Sertraline which I felt lifted my mood more but as I couldn’t sleep on Sertraline I now take a tiny bit of Mirtazapine (7mg) before bed too. Even though it’s just a tiny amount I absolutely cannot sleep without it! I have tried to come off the Mirtazapine all together but the insomnia always makes me revert back to it. I was never on a high dose of it even at the beginning but I did put quite a bit of weight on with it.
I don’t think I’ll be able to come off the Mirtazapine until I stop taking Sertraline.

Sertraline only worked for me for a few months. But I had no side effects after the first couple of weeks.

Mirtazapine works better, although not perfect. And I've gained so much weight as others have said. And I was already obese. It doesn't make me sleepy though. It did at the lower dose but not anymore

I went on Mirtazapine due to terrible depression and insomnia. It really did help - i was on it for about 9 months, until a locum doctor took me off of it. While it definitely helped, i've tried to avoid going back on due to the weight gain and sedation.

All so helpful

How quickly did you notice working?
How quickly side effects kick in?

I took 6 hours ago.
And I can’t believe it but I feel… but spaced out and a little…. Off in my stomach.

Ridiculous and just me imagining?
Or possible

I do metabolise things very quickly

A little shaky and a little dizzy
A bit spaced out
Not entirely unpleasant
Not not pleasant either!
Odd!

I see you have started on sertraline. I tried that one first and felt quite awful so couldn't carry on. Mirtazapine worked really well for me and made a huge difference to my mental health. I stayed on it for a year but I did get two stone heavier. I'm off it now and have lost a stone. It probably didn't help taking it in lockdown as I was so inactive.

I lost weight through anxiety, but sertraline took the worst of the anxiety away so I was able to swallow properly again, and I was able to enjoy eating.

I've been on sertraline for ten years! It's a bit like smoking, it never seems a good time to 'come off'. I was thinking of stopping it then we hit lockdown and I ended up doubling my dose again.

The only long term negative effect I've noticed is that I can't cry any more. Used to love a good cry! Good luck x

Day 3
No side effects although perhaps less appetite but trying to eat through it

I feel… just more. At peace I suppose.

Is this just a coincidence and too early? (Quiet day at work!)

I’m on 25mg

Hopeful bump

The first two weeks of sertraline my appetite completely disappeared. It felt strange to eat -the feel of food and liquid in my mouth / stomach was odd, alien, wrong. I lost quite a bit of weight. Then I got used to the medication and my appetite came back with a vengeance! I also couldn't sleep but didn't feel sleepy or tired if that makes sense?

Hope it works for you OP

Sertraline hands down. Best I've taken. Also most commonly prescribed by GPs to GPs.

Really hope it helps.

Had Sertraline and my mood improved but the side effects (diarrhoea, weight gain and constant upset stomach) were awful, doctor wanted to switch me to Mirtazapine but having researched the weight gain angle I declined and am now off all AD but looking at talking therapy.

Sertraline has been life changing for me. I take 50mg dailyand have done for 7 years.
Initially the side effects were tough (jaw clenching/ dreams/ spike in anxiety/ numb feelings) and these took a few weeks to settle down. You have to give it a couple of months to feel the benefits - but absolutely worth it - I feel like myself finally.

Thank you

My question though is… is it daft to think that I feel a fractionally improved after only 4 days of taking?!