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Mental health

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Original poster

Switching from mirtazapine to Citalopram any experiences ?

35 replies

Babyg1995 · 09/02/2022 21:21

My gp wants me to switch my ads as I've gained so much weight with mirtazapine I'm on 45mg I'm terrified of changing over has anyone done this?

OP posts:

chickywoo · 09/02/2022 21:31

If the mirtazapine is doing it’s job for your mood and you are stabilised and happy with how it’s working for you, I would be reluctant to change it.
As this will involving coming off one whilst to titrating the other which will be unsettling for you.
Are you gaining significant amounts of weight? Is there a way you can manage this in the first instance rather than changing? Is it making you hungry and you are eating more than you
Did before? Or perhaps because your mood has improved and you are eating more?
Mirtazapine is not a first line treatment so the fact that you are on this rather than citalopram ( which is first line) indicates that you need Mirtazapine not citalopram.

Original poster

Babyg1995 · 09/02/2022 21:46

I've gained 4 stone in 2 years being on it it's definitely a concerning amount I'm just starving hungry all the and it's carbs and sweet stuff I'm craving it's uncontrollable binges sometimes. The thought of changing is scary for me I just don't know what to do I've tried healthy eating and I've lost 9lbs in a month but I can feel the cravings and hunger constantly I just don't want to be hungry constantly my mood is OK.

OP posts:

chickywoo · 09/02/2022 22:21

If your mood is ok you could always try gradually reducing the dose to 30mg then to 15mg and see how you go? You
Would have to do this anyway before changing to an ssri so you could try this first ( with support of your gp)
Has gp done bloods to rule out any other physical health issues eg thyroid, ?

chickywoo · 09/02/2022 22:22

Are you on any other meds that increase appetite ? Or hormonal contraceptives?

Original poster

Babyg1995 · 09/02/2022 22:37

No I'm on the copper coil I asked the gp would I get withdrawals and he said I shouldn't and made me the prescription today which I thought was just strange I have 2 weeks worth of mirtazapine left but I'm going to phone in morning I don't want to stop mirtazapine completely one day and start another kind the next I would rather just try and taper off the mirtazapine.

OP posts:

chickywoo · 09/02/2022 23:08

Yes shouldn’t be stopped abruptly and citalopram started next day, it should be cross tapered ie gradually introduce the new one whilst gradually reducing the old one.
Although as you say you could reduce off the mirtazapine before introducing citalopram and see how you feel, you’re the one best placed to know your mood and to judge how that will make you feel.

Mirtazapine is usually more effective though than citalopram so if your mood dips whilst reducing you may want to consider sticking with it for a while or sticking at a lower dose perhaps 30 or 15.
Also , if you feel up to it, talking therapies can be helpful alongside or in place of medication, you can usually self refer and generally people find them more accessible as they are usually telephone appts instead of face to face now.
Also ask your GP about any diet and exercise schemes they can refer you to there is often access to for example free gym or membership to weight loss clubs etc available if you need some support with the weight gain.

Original poster

Babyg1995 · 10/02/2022 08:13

Thanks for your replies much appreciated yeah I'm going to see how I go with reducing the mirtazapine just see how it goes.

OP posts:

morningstruggles · 10/02/2022 08:31

There's a useful thread on here about citalopram, side effects and how effective it's been for people (for me, life changing) so could be worth a search on here for citalopram success stories (I think the thread was called) as may help you to know what u might expect.

No experience of switching though, sorry

Annabell46 · 13/02/2022 17:55

I’m on 15 gm of mirtazapine and citalopram 30 mg. I have tried to get off mirtazapine and its hellish. Still on 15 mg. Even the slightest tiny reduction makes me feel hellishly anxious and weird feeling in head. You may be lucky that you can reduce with no symptoms . 50% of people can. There is a fb group for mirtazapine withdrawals. I really think this drug should be banned. I just wish I had never started it. I was put on it because sertraline made me hellishly anxious and caused insomnia which lasted months. I came off sertraline after 6 weeks as it made me feel 1000 times worse than I was already feeling. Was referred to psychiatrist who put me on mirtazapine for sleep. Just wish I had never started this med.
Why did you go on it? Was it for anxiety? Did it work? I’m still feeling depressed

Annabell46 · 13/02/2022 17:57

Mirtazapine is well known for causing weight gain. Most people seem to gain a big amount on it. It also increases cravings for sugar

theqentity · 13/02/2022 18:00

I managed to get completely off mirtazapine recently. It can be done, slowly and with a lot of understanding on you and your partner/families' part.

WordleAddict17 · 13/02/2022 23:03

@theqentity
How long did it take you to get off it and did you get insomnia as a result?
@Annabell46
You have my sympathy - I am stuck on mirtazapine too and wish I had never started on it.

Annabell46 · 14/02/2022 06:01

@theqentity would love to hear more about how you got off mirtazapine. What were your withdrawals like? Its done nothing for my mood and want off it but the slightest drop and I am in hell. I would never have believed how bad this could be. I feel like my life is over because of this drug. I think I have years ahead tapering off

Annabell46 · 14/02/2022 06:43

@WordleAddict17
How long have you been on it? Have you tried tapering?

tackling · 14/02/2022 07:20

I put on some weight with mirtazapine in the first few months, realised, started dieting and lost it all again (and then some) and have maintained for a few years.

So on the plus side, it is possible to fight the weight gain - it's not one of those drugs that makes you pile on the weight regardless of what you eat. It definitely makes you hungrier though which is the killer.

Even though my weight is fine these days, I vaguely spend half of my days thinking about food and planning for the next meal of the day. Never used to be like that at all, used to forget to eat half the time!

So I'm thinking of trying to taper off, I just worry about cutting up pills as if they have a film over them, you're not supposed to. I worry about digesting them wrong without it.

Annabell46 · 14/02/2022 07:59

@tackling the best way is do liquid taper. There is a fb mirtazapine support and recovery group that recommends this . Cutting pills is meant to not be a reliable way.

tackling · 14/02/2022 09:54

Thanks for the tip @Annabell46, I'll ask my GP!

Annabell46 · 14/02/2022 11:04

@tackling most GPs have no idea about withdrawals and refuse to believe they exist. My psychiatrist said this too. I couldn’t believe the affects when I tried to cut down. There are 4000 people in the mirtazapine withdrawal group on FB people don’t join those groups for no reason.

WordleAddict17 · 20/02/2022 16:56

@Annabell46
Been on it nearly a year but haven’t tried to come off it yet. How about you - how long have you been on it?

theqentity · 20/02/2022 17:01

I didn't do a liquid taper. I went from 30mg to zero.

Day 1: 20mg
Day 2-4: 30mg
Day 5: 20mg
Day 6-7: 30mg
Day 8: 20mg
Day 9: 30mg (my last ever 30mg)
Day 10-17: 20mg
Day 18: 10mg
Day 19-22: 20 mg etc etc etc down to zero

theqentity · 20/02/2022 17:02

I think I was totally off in about a month, which was very quick but I really wanted off it.

Annabell46 · 22/02/2022 18:46

Thanks for your taper advice
Did you have no side affects at all?
I tried reducing by a tiny amount and couldn’t sleep that night and felt hellish the next day. Had shaking legs twitching arms and weird squeezed feeling in head. I think I must be one of the people who will struggle with withdrawals. Have come off sertraline and citalopram before with not much problem

Annabell46 · 22/02/2022 18:49

Been on 9 months nearly and feel I am very addicted as just reducing a tiny bit makes me feel so awful. Normally I don’t suffer anxiety but this makes me feel so twitchy and shaky with just a tiny reduction.
Have managed to lose weight by eating nex to nothing . I’m on citalopram 30 mg also which I think makes appetite go away.
What made you go on mirtazapine?

theqentity · 22/02/2022 18:56

@Annabell46

Thanks for your taper advice Did you have no side affects at all? I tried reducing by a tiny amount and couldn’t sleep that night and felt hellish the next day. Had shaking legs twitching arms and weird squeezed feeling in head. I think I must be one of the people who will struggle with withdrawals. Have come off sertraline and citalopram before with not much problem

I had side effects, I tired and had bad headaches, I also felt cold a lot. I was expecting all that so just rode it out.

theqentity · 22/02/2022 18:56

@Annabell46

Been on 9 months nearly and feel I am very addicted as just reducing a tiny bit makes me feel so awful. Normally I don’t suffer anxiety but this makes me feel so twitchy and shaky with just a tiny reduction. Have managed to lose weight by eating nex to nothing . I’m on citalopram 30 mg also which I think makes appetite go away. What made you go on mirtazapine?

I was on it for three years, you can do it!

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