I have been on anti ds for many years...always coped to a degree with spells of anxiety and depression. This past year has been awful..anxiety out of control and depression at the worst I have ever had. My GP felt the citalopram had ceased to be effective (5 years on it at 40mg) and decided to try mirtazapine as I was not sleeping and its sedative effect would benefit me. I started on 15mg...then up to 30mg and finally to 45mg a fortnight ago. I am sleeping but the depression is worsening (each time the dose increased I felt I was slightly improved for a day or two and then back into the depths) I called GP again yesterday..my GP was unavailable so spoke to another as felt a fresh eye on things may help. This GP has put me on to fluoxetine...to have 30mg mirtazapine last night then 15mg tonight then a day without anything starting the fluoxetine on Thursday at 20mg. Does anyone have experience of similar..or just any thoughts of how soon this will improve...I am feeling increasingly desperate. I do not have thoughts of self harming or suicide (never have) but everything feels so sinister just now and I am pinning all hope on this.