Mirtazapine making me feel worse…help!

[Anxiousandlow]

Hi everyone,

Hoping someone out there can help me with some advice. Been really low for months and months and have felt myself spiral so significantly that I sought help at the doctors last week.

I was prescribed Mirtazapine (15mg) as I said I was struggling with sleep. So far I’ve been taking it for a week, on an evening as suggested. Sleep has improved a bit - I’m still waking up through the night but getting back to sleep a lot quicker than before.

I was warned by the pharmacist that I could feel worse before I get better, which has certainly been the case. I feel joyless, pretty hopeless and very low. I’m struggling to be a decent parent to my two children (they’re 6 and 7, for context) as I’m snappy and have very little motivation.

I’m going through the motions with getting up and showered and dressed, making my kids’ meals and so on. I’m leaving the house with them to go to the park etc but I’m just not present mentally. It’s like I’m watching my life from the outside, or like there’s a pane of glass between me and my family.

I’ve always battled with my weight but this last week I have eaten like a horse - my appetite has no “off” switch - and I have already gained just under half a stone, which I’m gutted about. I don’t feel I have the strength to use willpower at the moment, so that’s becoming a source of stress and self-disgust, which isn’t helping.

I have generally good support, my partner is aware of how I’m feeling and gives me the space and time, as and when I need it. I am seeing friends and although very anxious beforehand, I push through and do more or less enjoy myself. I find myself very drained afterwards though, like my social battery gets depleted quickly.

Luckily for me, I’m not at work during the school holidays so don’t have that as an additional factor at the moment. The aim was to get myself feeling a bit better before I go back, but it’s looking less likely the more I go on.

Contacted the doctor today for further support and to discuss the meds but the best I’ve been offered so far has been a telephone call in late August. Genuinely don’t think I can cope for that long, so I’ve requested an appointment sooner, which I’m waiting to hear back about.

Sorry this is so long, I just wanted to provide as much context as I can to pre-empt any possible questions. I just feel so pathetic and weak and I know everyone around me deserves a better version of me than this. And I know I deserve better for myself, too.

Does anyone have any experience of taking Mirtazapine? Does it get better? I’ve read some threads on here already but would really benefit from someone who is currently in a similar boat or who is a step or two further along than me. Any help welcome!

How old are you? Any chance it could be perimenopause? I went through a few anti depressants, including mirtazapine, but my mental health and sleep didnt improve until I gor HRT, specifically utrogestan (bio identical progesterone). Literally within a week it helped.

High cortisol and stress could also be to blame. There are videos on YouTube explaining how to do TRE which is incredibly good at releasing long held stress. Then there's exercise, meditation etc.

GPs are very quick to prescribe anti Ds but I have not had much luck with them and think they're over prescribed.

Maybe just have a look at some of the (many many) potential symptoms of perimenopause and see if any apply.

In hindsight, I was experiencing symptoms from my late 30s, but it took years to be given hormones and since then i feel like a different woman. Not in time to save my finances, or my relationship, or some other heartbreak, but in time to save my life.

However I am very aware that this influences my thoughts and it may not apply to you, but try looking into it and see what you think.

Thank you @Alwayschillyatnight
I’m 39 and very much aware perimenopause could be a factor. I should’ve mentioned that in my first post, sorry. I brought that up with the doctor but he was quite dismissive and said that because my periods are regular, it means I’m still ovulating and there’s no way I’m anything close to menopause. I know this is absolute BS but I’m not the best at advocating for myself at the moment and I just felt desperate for any kind of help. In my request for further help today I’ve asked for the doctor I see to be someone who specialises in women’s mental health because I did feel quite dismissed in that regards. I was honestly just sitting in the chair in the surgery trying my best not to completely fall apart.
I will look into your suggestions, thank you ❤️

I was similar to you OP, but am unable to take SSRI’s so was prescribed Mirtazapine, I felt worse for a bit then after about 6/7 weeks felt a lot better! Overall I preferred my SSRI for anxiety but for overall mood lift it was a slow but powerful burn for me. I went up to 45 but gradually came down to 7.5 after about 12-18 months. In my case I think it was menopause so ironically I probably needed HRT not an AD 🤦‍♀️, but this was 10 year ago so no one mentioned menopause. I’ve been in HRT for 5 years and feel Amazibg - I still keep the 7.5mg mirtazapine as it helps me get really deep sleep! I prob should stop it now …! Anyway- give it a bit longer is my experience. Good luck 🤞

Yes, it will get better but mirtazapine is known for causing weight gain so it might not be for you if that’s going to make you miserable. Plenty of alternatives which won’t do that.

Mirtazapine really does make you gain weight, which doesn’t help if it makes you feel bad about the weight gain. I’d go back to the GP and explain everything you’re feeling.

You're so welcome.

Years of declining mental health, then sudden onset of panic attacks whoch id never had before. Not had one since starting the hormones.

I had a particularly bad experience - not precisely medical- with mirtazapine so I am very wary of it.

And it doesn't just increase appetite, it actually makes your body hold onto weight. Although I didn't have a huge weight gain in my case. Still too anxious and stressed.

Op you are doing better than me in the early days of taking Mirtazapine.
For about 3 weeks I was completely out of it til around 4pm the following day.
My GP suggested taking it earlier in the evening, and I ended up taking it at 6.30pm in order to stand any chance of waking up in time for work.
It was a miserable time where I couldnt have cared less about anything or anyone, myself included.
It did however work almost instantly for my anxiety.

Around the 6 week mark it started to kick in for my depression, and I did feel better.

Several months in and I do feel better all round, but still groggier than before I started, and evenings out are impossible as it knocks me out.

Thankfully i have felt slightly nauseous for the entire time I have been on it, so have lost weight rather than gained it.

Thank you @LuckyManifestations for sharing your experiences. I’m so sorry things were so bad for you initially but I’m pleased your anxiety and depression have now had the edge taken off.
I didn’t take my tablet last night, I’ve just worked myself up with the worries of weight gain and the exhaustion. I did fall asleep easily though, so perhaps it’s still in my system, but I woke up a good hour or so earlier today and feel much perkier than previous days.
I woke up to an invitation to book a face to face appointment and was only given female doctors to choose from, so I’m going this morning to speak to someone who will hopefully take a more holistic view of where I’m at. 🤞🏼

Good luck. I hope you get someone who listens and is sympathetic.