Mirtazipine - I don't like it

[MozzchopsThirty]

Have been on sertraline for years but due to recent anxiety my GP has added in Mirtazipine.
I've taken it for 4 days but don't think I can carry on, I feel so groggy in the mornings, even if I've had 9 hours sleep
Yesterday I didn't feel awake until about 4.30pm

Also it says I can't drink whilst taking them which is not conducive to my life at all

I normally eat really well but have binged for the last few days which is unlike me

Should I stop and just increase my sertraline?
Do these effects get better?

My dh takes it and it’s the only thing that’s worked for him. He’s been on other anti depressants for 5 years now. He has quite serious depression (been unable to work with it at times) so for him he loves it - He started on 15mg and the side effects at first were awful, very tired etc as you say but they did ease off after a couple of weeks (any anti depressants take about 2 weeks to start to work / get through the side effects). He then increased it by another 15mg and that’s his long term dose.

It does make him eat a LOT. He’s always hungry and has put some weight on. But he would rather have that than the crippling mania and depression he had.

Being very honest with you if you have depression you are best not to drink at all anyway as alcohol is a depressant. Even if it doesn’t feel it at the time. Dh is teetotal.

I take sertraline for PTSD and anxiety not depression

I just don't think I can get through 2 weeks unless I'm off work and can sleep

What time are you taking it?

4 days is not a lot. If you remember back when you started anti ds, you probably felt sleepy and yawned a lot then also. I would give it at least a couple of weeks before making any changes.

Also I would look into cbt or other therapies that are very successful in treating PTSD type issues. Good luck.

When I started taking it I think it took about 2 weeks for the drowsiness to wear off, but I took it early, about 6pm and went to bed about 8pm so felt OK by about 8am. But after 8 months of barely sleeping at all, I didn't mind that! The munchies never really went and were part of the reason I came off it after 6 months as I'd put on a stone (which is taking a really long time to come off)

I have a friend who was put onto this for anxiety, apparently it’s given to ppl with anorexia to improve appetite. She put on about 4 stone in 18mth, 12 mths later she has lost about half of that and is feeling much better

It gets better ( i do have the odd binge on crisps!) i feel better than ever.

Ive managed to lose weight on it, its just the first few months as you adjust to it

@Jaffacakebeast my mum has literally just started weaning off this this week due to how miserable she is and how much weight she's put on, which in turn has made her incredibly down and her self esteem is shot

Shes put on about 4 stone on 2 years. It's been a nightmare being on this

My friend is still on it, the weight gain seem to plateau and she’s slowly getting back to normal

Yeah I'm not feeling like this for 2 weeks and I'm not gaining a stone either
I didn't take it last night and woke up feeling lovely before my alarm
I'll speak to the GP and up my sertraline

It's well known for weight gain and is marketed as an appetite stimulant. No idea why it's become so popular these days especially with middle aged women like me who already struggle with middle aged spread often enough.

I got prescribed it once and declined due to weight gain worries because that one is definitely one for putting on weight. The Americans use it in conjunction with an AD called Wellbutrin to avoid this but that drug is expensive so of course it's hard to get here.

I've taken mirtazapine for about 5 years and my long term dose is 45mg. At first though was like a zombie and slept all the time but after a couple of weeks it improved and my anxiety symptoms have been very well controlled. It helped me to cope with DH's terminal illness and get through his death, although I now have PTSD which isn't really controlled by the mirtazapine. My GP did suggest changing to a different medication, but because it's worked for the anxiety I didn't want to risk destabilising that, so I'm seeing a psychiatric nurse in October to discuss the best treatment plan.

If you've got anxiety, alcohol is a really bad idea. It's documented to cause it. Perhaps look at a different medication, but also talk to your GP about stopping drinking too?

I don't drink alcohol myself, but really don't see why the OP should go teetotal just because she's got anxiety. It sounds like sertraline works for her and the GP just threw this in rather than upping her sertraline.

It's apparently better on a higher dose when it comes to not putting on weight, but of course, no one will start you on the high dose so you have people putting on loads of weight and becoming obese on it.

I got it due to extreme insomnia but the threat of weight gain put me off and I ended up getting a two week course of sleeping tablets from a friend in Europe that broke my bad jag and solved the problem without putting on a load of weight, which would have really depressed me. As it is I am 50 and do find it much harder to lose weight these days even with loads of exercise. Recently I've been found to have stomach ulcers but for several months before this was discovered I was barely eating and still didn't manage to lose much weight. Can't imagine putting a stone on and trying to get that off.

@timshelthechoice yes I have no intention of 'giving up drinking'. I have a stressful job and enjoy unwinding at the weekend with a few beers or bottle of wine.

I am also of a certain age and have done really well on the Fast800
I'm not putting all that hard work to waste to feel like a zombie

I will phone GP today and get some more sertraline which works well for me

Hope they agree to increase your dosage. Just tell them you're not taking it anymore due to side effects. Personally I take CBD oil and it works a treat but I can see it might not be advisable to use with sertraline.

For some reason it's a trendy anti-depressant to pass out. I asked specifically if it caused appetite increase and weight gain and was told no but researched it and that was the first thing that came up, that weight gain is a very common side effect.

I took this for all of two days. I was completely comatose on it. Simultaneously nearly asleep and jumping out of my skin. I also could NOT get full. I was eating until I was nearly sick but couldn't get full up. totally hated it!

@thisnamechanger yes I've had 2 days of eating to near vomiting

Going from 800 calories to binging has not helped me mentally or physically

I'm stopping it, have a telephone apt with same GP
She did umm and ah about whether to increase the sertraline or start mirtazipine so I don't think it'll be a problem

I'd really like to know when it became so popular to prescribe something that's a bloody appetite stimulant. I'm so glad I never started it, I've work really hard to maintain my weight as exercise is vital to my mood stability and putting weight on would cause further joint point.

Yet people are blamed for no self control and 'the obesity crisis'.

I was watching an episode of 'GPs Behind Closed Doors' one time and a menopausal woman came in with crying and low mood and this is the first thing they handed her. She was already obese! She came in later and complained she'd put on more weight. I mean, WTAF?

No one likes it. Its a cunt. It is, however, a shockingly effective cunt. I couldn't handle it either but the one they initially refused to give me because "we don't really prescribe it anymore due to the side effects/its not generally well tolerated" I was fine on. Never felt better. It just goes to show that not everyone reacts the same. Sometimes it takes a bit of drug hopping to find one that suits you.

The appetite thing is a massive issue for dh, he literally has lost all self control when it comes to eating. He was previously very slim (skinny even) and is now overweight - doesn’t bother me at all but bothers him. He is just endlessly raiding the fridge, he’ll eat dinner and then eat 3 bags of crisps, 2 yoghurts and then another 2 bags of crisps at 11pm or something. He says he feels he can never get full.

However, for dh this is worth it because this is the ONLY medication that works for him. He’s been on so many different ones, many different doses. His depression is very severe, manic almost. He’s had years of barely working due to anxiety / paranoia. Losing jobs months after starting due to terrible intrusive thoughts. Panic attacks. Manic late night behaviour, pacing about, talking to people who aren’t there and then not realising he’s doing it. That sort of thing. This medication has been life changing for him. He’s worked in the same job now for 4 years - a miracle for him. He seems calmer. He takes it at night and actually sleeps. He doesn’t have compulsive manic urges to spend lots of money on gold / clothes / whatever the latest obsession is.

So for us, it’s a game changer and he will put up with the weight and the insatiable appetite because the alternative is no life at all. I appreciate that isn’t for everyone, but for balance I wanted to post because if there’s someone out there reading this, for some people it’s amazing.

I was exactly the same OP. I'd already had to finish work due to my anxiety so I gave it 4 weeks, I barely remember that month! I was asleep for most of it and a zombie for the rest. Poor DH did 4 weeks of school runs, night wakings, all meals for 4 DC completely by himself because I was in no fit state to do anything.

A friend's young adult DS, conversely, has found it to be brilliant. It helps him to sleep but it's effects only last long enough to give him a decent 8-9 hours, he's then refreshed and gets on with his day.

I've since switched to venlafaxine (I'd already tried sertraline but it removed all emotion and I didn't like that) and its definitely the one for me. If your sertraline works well but you're having a rough patch it's probably worth upping it for a while to see you through

The thing is, mirtazapine can be combined with buproprion in patients who have experienced obesity or overweight as a side effect with often good effect, but the NHS doesn't want to pay for the latter. Instead they just leave the people fat, which causes health problems and often further increased depression.

Its not that they won't pay for it, it isn't licensed as an antidepressant in the UK. That's why we can't get it. I looked into it extensively last year when I was struggling to find one that worked.