Increased mirtazapine anxiety

[TildaSwan]

I've been taking 30mg mirtazapine for around 6 months and although it's been really effective at reducing anxiety, it hasn't touched the sides of my low mood/lack of motivation. I increased the dose to 45mg a week ago, but my anxiety is back with a vengeance - racing thumping heart, jittery, agitated and obviously, no signs of improved mood. I don't know whether to continue with the increased dose or drop back to 30mg. Does anyone have any experience of this and does it get better? I can live with low mood but the anxiety is debilitating, to the point of not being able to leave the house due to panic. Strangely, when I increased the dose from 15mg to 30mg I felt amazing with no side effects at all!

I’ve felt better on mirtazapine since I dropped down to 15mg. It’s a strange drug that seems more effective at a lower dose.

Who’s prescribing it?
It loses its sedative effect when you increase the dose. That’ll be why the anxiety has gotten worse.

Thanks for your responses. It's my gp prescribing. It IS a strange drug, at 45mg it's only hyped up my anxiety. I did a bit of reading yesterday aboyt It - something about at higher doses it works on noradrenaline(?) Which is good for depression but heightens anxiety.

@Jollyjollyjollygoodie can I ask if you take another med alongside mirtazapine? Or have you just stuck to the 15mg?

I’m on 15mg.
My GP didn’t want to increase because of losing the sedation - I need it mainly for sleep- so she added a different antidepressant in the morning. That GP is relatively good with mental health but even she was copying what I was previously prescribed by a psychiatrist.
I honestly don’t trust GPs to prescribe these kinds of meds. Unfortunately a lot of the time these days it is almost impossible to get in front of a psychiatrist if you’re not at crisis point.
It seems to be becoming quite common for GPs to prescribe mirtazapine, which I think is kind of strange because it’s not a go-to drug for psychiatrists. They usually get around to prescribing it where there’s treatment resistance/ other things haven’t worked. Partly because it often comes with side effects that can affect quality of life (weight gain/ increased appetite/ fatigue/ poor concentration/ brain fog etc) so it needs to be “worth it” so to speak and partly because it doesn’t work like other antidepressants, it usually works best in a “cocktail” with other meds. I had never heard of anyone being on mirtazapine alone until fairly recently and then it’s always a GP prescribing.
Is there any chance you could a referral to see a psychiatrist?