Mirtazapine - mood swings, irritability and loss of motivation

[user0512]

Hi,

My partner has started taking Mirtazapine as he’s quite depressed. Worse than he’s ever been to the point where he’d just want to sleep all day and had no motivation to do anything.

It’s been a week so far and I’ve noticed that he’s more irritable, short tempered, withdrawn, demotivated. Is this a side effect of the medication or does it show that perhaps his depression is getting worse and this isn’t the right medication for him?

Can anyone share their experiences?

TIA. Posted on AIBU for traffic

I found I got worse before I got better. He will need to give it a few weeks to settle.

Edited to add - the NHS suggests giving it at least six weeks to bed in properly.

It takes a while.

I’ve been on it years but increased it a while back after a MH crisis and the side effects were insane.

I was tired, tearful, actually shaking with anxiety. It’s really hard.

Give it a month.

No anti depressant works within a week, most take a few weeks to have a real affect. I recognise how hard it is for you in the meantime

It's also used as a sleeping aid so no wonder he's drowsy on it. It can also cause significant weight gain. Other anti-depressants have more of a stimulating effect, e.g. Escitalopram.

Mirtazapine is a very odd first line choice for depression.
I was on it for 6 months, I hated it
I put on two stone and was a crabby bitch the entire time. Duloxetine on the other hand, absolute game changer.

@Mingou he’s tried Sertraline and another one before and didn’t get on with them and the lack of sleep was one of the reasons Mirtazapine was prescribed

@GrumpyPandahe has no motivation to do anything. Just wants to lay in bed and when he wakes up lays in bed on his phone watching YouTube videos.

@Mucholderlittlewiserwas it worse in terms of the depression or did you experience more irritability and short temper too?

Forgot to mention that he has suspected autism and adhd (resending a referral via right to choose as the first referral ‘got lost’) and I’m not sure if it’s just him checking out or adhd and autism burnout

SNRIs are a better choice with ADHD than SSRIs

I'm not sure about my temper. My panic attacks got markedly worse and my sleep, which wasn't good to start with, got worse. I existed in a fog of exhaustion and panic for a few weeks. Then things started to ease, I sleep well and feel much better.

Every antidepressant I've ever taken has explicitly said that things often get worse initially. It's not great, but hopefully the end is in sight. Worth also adding that not every antidepressant suits everyone so if he's given it a decent period to settle and not seen an improvement he should contact the doctor again.

I take Mirtazapine for anxiety and insomnia - havent heard of it being used for depression, but I'm not a GP. I have put on weight but it has calmed me down , jsut taken the edge off my anxiety and I do sleep much better.

@lovemelongtime when you first started taking it apart from the weight gain did you notice any other side effects?

I have taken it for sleep - terrible lethargy and hunger for sugar - but did make me sleep

ia he on adhd medication?

I took it for a while. First time I was completely zonked out. The sleepiness and tiredness did reduce fairly quickly as far as I remember (2 -3 weeks?). After that I couldn’t stop eating.

I took it for a few weeks, but I was on it as I couldn't sleep, and was suffering quite badly from anxiety.

I would say that in the short term it did work, as I was able to sleep better and calmed down a bit, but it had a real sedative effect and I had very little energy. The weight gain became noticeable as well. I was taken off of it by a new doctor.

I can't say it caused irritability (quite the opposite actually) but side effects are very individual.

@Coriandanope waiting for an official diagnosis via right to choose

@Valeyard15this is interesting. It’s like he’s not bothered about anything. Almost as if he’s numb? But if I ask too many questions he snaps or has a shorter fuse but even in the morning he’ll lay in bed after waking up and watch YouTube, like he can’t be bothered to get out of bed?

My DH didn’t get on with mirtazepine at all. He had terrible mood swings and panic attacks. He punched a kitchen cupboard and broke his hand one night. It was an awful time.

Mirtazipine is an appetite stimulant for anorexics. He will balloon. It is very effective when used with Venlafaxine, California Rocket Fuel as this combo is referred.

And yes, it utterly cabbages you.

Are these symptoms which are getting worse, or new symptoms? I know that some antidepressants can make symptoms feel worse in the very short term before they start improving, but in my (completely and utterly non-medically qualified) opinion I would have thought Mirtazapine a strange choice for someone who would sleep all day given it's sedative effects.

Would counselling by someone who knows about adhd and autism help