Mirtazapine

[Katze]

About 3 months after my son was born I started to have difficulty sleeping. At first I put this down to my sleep patterns being disturbed because of his waking in the night but my sleeping gradually got worse as his sleeping got better. I tried acupuncture, homeopathic remedies, flower essences - these all worked for a bit but the insomnia always returned. After about 6 months of bad sleep I was diagnosed with depression and was prescribed mirtazipine (15mg.) Within a few days I was sleeping solidly through- 8 hours a night - it was amazing after such a long time without proper sleep. After about 4 months of being on it I reduced the dose to 7.5mg and gradually stopped. However within 3 weeks the insomnia returned - I couldn't get to sleep or if I did I would wake up at 3 in an anxious state and not get back to sleep. I desperately want to come off the mirtazapine as I want another baby but I can't cope with the insomnia. I think I have a hormonal imbalance as I definitely haven't been feeling depressed. Does anyone have any tips for coming of mirtazapine so as to avoid the insomnia and/or has anyone had a baby while taking mirtazapine?
Hope someone can help.

hi girls - im ok today yesterday was awful the kids were all fighting and bored so i was very stressed not too bad today - so now im off 45mgs yay me !!! down to 30mgs now so give them a go for a few months then get down onto 15 mgs - how is everyone else doing ?
hoping you are sleeping a bit better becky

Well done candyfluff. Hi BeckyBendyLegs hope you're on the up again. I'm not sleeping too badly but feeling stressed out, just all seems relentless, feel I'm not cut out for this baby business, it's wearing me down. Baby has first cold and not been well so that's been a bit stressful. Also fed up with noisy neighbours. Also feel I'm paying the price for asking family for help as they feel free to make 'helpful' comments and suggestions about my parenting! Just keep telling myself it will get better!

how old is your baby arcadia ?
i have 3 kids aged 11,9 and 3 so i know how your feeling - it does get better of that i can be sure xx

Only four months so quite hard going. But only one to deal with ! Feel guilty I am wishing she was older as she is really quite cute ....

Arcadia small babies are hard. I find them hard. DS3 is now five months (well nearly) and I feel so much happier in myself because he is more content, more smiley, etc. It does get easier but there are ups and downs with illnesses, teeth, etc. My sleep is much better than it was but I still feel anxious when I go to bed which is just so silly as that stops me sleeping sometimes. I think the hypnosis I use overrides that most nights as I often fall asleep and wake up and think 'oh I've been asleep!' I also just feel anxious about nothing in particular, just life and the chaos of family life, wish is really annoying because I feel fairly happy most of the time. I'm sure you are doing a great job. When I had DS1 I was so insecure and felt as if I was doing it all totally wrong (and I used to get those 'helpful' comments from family too). Keep positive though, it really does help if you can and it really does get easier.

have you two been diagnosed with pnd ?
ive had it twice ,bloody miserable!!

The truth is I don't know if I've been diagnosed with PND, nor do I know whether I actually have it! My GP seemed to agree with me that I wasn't depressed but whilst we were speaking I saw her typing 'PND' into my notes. I've been given antidepressants twice but the first time I stopped taking them and the second time I didn't take them at all (with my doctor's agreement). I don't have much faith in GPs or the medical establishment generally. I don't want to take pills that alter my brain chemistry on the basis of a five minute conversation with a doctor who has already made up their mind about me. On the other hand, it is hard to know how much I can do on my own. Sometimes I feel fine and sometimes I don't.

Arcadia I feel exactly the same way. I spoke to my GP for about five mins and he prescribed me ADs and mentioned 'postnatal depression'. I took them for three days and hated them. They made me feel absolutely awful. I feel 'better' without them. I have good days and bad days but my main symptoms are anxiety and sleep. I am so fed up of the sleep thing now, it's just boring. I want to get back to normal now. Last night it took me a while to get off to sleep but I put that down to watching a rather excited recorded episode of Dr Who before bed, which I know I shouldn't do (as Paul McKenna says in his book: some people can cope with exciting TV before bed, others can't!).

have ypu tried herbal sleeping tablets kalms nigh time ones helped me also a few drops of lavender oil on your pillow before you go to bed might help.
try to unwind with a hot bath and a book before trying to sleep too xx

Candyfluff I do try many things (I have a lavender thing by my bed), and have some herbal sleeping tablets but I am so bad about taking tablets. I hate taking pills! I'm the world's worst patient. I don't even like taking parocetomol. I'm just going on the hope that this feeling will pass with time. It did with the other two DSs (although wasn't this bad).

god my spelling was awful lol !!
apologies
i found cbt really helped my anxiety maybe ask your gp for a referral ,no pills involved

I just feel totally crap today (slept ok after struggling to get off but had dreams all night and DS3 waking about 4 times a night on average at the moment). Anxiety is constant about DS3's skin (eczema), DS3's sleep, the worry of anyone being ill, about my sleep too. I'm fed up of being obsessed with sleep. I've lost faith in my GP but may need to go back as I can't go on feeling like this. I've just done an Easter Egg hunt with DS1 and DS2 and tried really hard to find enjoyment in it, but couldn't. So feel guilty about that!

Hi Haven't had a chance to look at mumsnet till now - back at work and functioning like a normal human being. I went back on the mirtazapine and am taking 7.5g a night and sleeping deeply for 8 hours. I fell so much better. Will reduce it much more slowly than last time...but time is running out. I'm 39 this year and want another baby soon. I don't think its fair to get pregnant while on the pills - as this is against medical advice.... So still in a dilemma about it all. Thanks so much for all your replies - its so good to share this stuff (I'm crouching over my laptop at work ready to hit minimize screen as soon as anyone comes to my desk!)

Hi Katze at least you know there are others of us with similar issues. The insomnia thing is a total pain isn't it? Glad you're doing OK anyway.

Arcadia hi! How are you doing? I'm still the same really, up and down. I took DS1 and DS2 to my dad's caravan for the weekend and thought I'd be fine but woke at 1am on the first night and couldn't get back to sleep so on the second night panicked when I went to bed! I rang DH in a mad panic and he had to calm me down, made me take two parecetomol to relax me and I then did fall asleep. But felt so ashamed of myself for getting in such a tiss on wht should have been a lovely weekend away. Ah well. But besides that I'm plodding on, more good nights than bad nights but the bad nights are horrible. I hope you are doing ok Katze I'm sure the slowly does it approach is best. I had DS3 aged nearly 38 but you still have time yet. You could try things such as hypnotherapy to help you while lowering your dose?

hi bbl typing one handed dd on knee! still quite bad am going to gp tomorrow really tempted to ask for mirtazapine as i feel i could sort myself out if could only sleep well! like you up and down still - got better for a while bit worse again now. also DD sick over weekend and I was up all night fri and some on sat so got even less sleep. hypnotherapy didn't have lasting effect for me. want to get back into yoga - may help. have started swimming too. i don't really get panicky just feel crap and tearful in the days after bad sleep and do get quite worried and upset about it.

Arcadia I think that every week: I need to go back to GP and ask for some ADs that help with the sleep but then I feel better and I think I can cope. I might end up doing this for months yet! I'm convinced my symptoms are PMT related so not sure ADs would help. Who knows. DS3 is attached to me in the baby carrier while I am typing this! The joys of babyhood. Sorry to hear your DD was poorly. It's hard when they are ill, I find it really hard.

Hi again
I do recommend mirtazapine to help with sleep - it really worked for me. I just take the lowest dose (15mg).

I am at the point now where I am considering coming off. But it did really help me and would be my AD of choice if I have to go back on them at some point in the future.

x

Hello GetDownYouWillFall!

Waves to becky !! How are you doing?
x

So-so. I have more good nights than bad nights but as before every bad night sets me back down to the bottom again (like this weekend when I decided I would be able to take the DSs away on holiday to Wales for two nights and slept 3 hours the first night and panicked the second night). The sun is shining today though, which helps, as it is school holidays and three DSs all day is hard work. I'm going to take them to the park later. DS2 has already hit DS1 this morning, sigh. I hope you are doing ok and feeling better. Arcadia how is your DD today?

Hi BBL and GetDownYouWillFall if you are there! My DD is getting better thanks. It has been like having a new born again - feeding all the time, getting up in the night, her falling asleep on me a lot - in a way it has been quite nice bonding for us. Also I have had to stay at home which has actually been quite restful - I was overdoing the mother and baby activities and tiring myself out I think!
Went to the GP yesterday. She refused to give me mirtazapine. I don't think GP's appreciate self-diagnosis let alone self-prescription! She seems to have something against that drug and instead suggested I try the citalopram (still unopened in my bag). I said I don't want to because of poss bad effect on sleep. She gave me some amitriptaline (very low dose) just to take as an occasional sleeping tablet. Feel a bit fobbed off.
However my sleep seems a bit better again. I find the best thing to take is the Nytol anti-histamine (not the herbal one). I still wake up but easier to get back to sleep. I asked about counselling/CBT and there is a six month wait - rubbish!!!
Everyone says 'go to your GP' but what can they do? Nothing!

Hi arcadia - gosh that sounds a bit frustrating. GPs seem to vary so much. Some have their bug bears about certain drugs - doesn't help us patients much does it!!

I think citalopram is the AD of choice for GPs. A psychologist friend of mine rather cynically told me it was because it was cheap (whether that is true or not I don't know).

It's a shame you can't get referred to CMHT then you would get to see a psychiatrist who is much more skilled and knowledgeable about all the different ADs (and there really are LOADS of them!)

I can see why they wouldn't much appreciate self-prescription, but actually you weren't doing that, you were really just asking her advice about whether it could be suitable for you. I am no doctor, but much of what you've described in other posts rings so many bells with my experience, and mirtazapine really has been the best thing for me. Citalopram was the nail in the coffin for me in terms of being admitted because it sent my anxiety sky high and made the insomnia so much worse.

It's good that your sleep has improved a bit again though. I really think it will sort itself out over time. I never thought I would sleep properly again after everything that happened to me, but I do now. It's good the nytol is helping, I never found that one particularly helpful.

One thing that helps me, don't know if it will you, but here goes. When I get into bed I play out in my head the same "story" every night. This is going to sound a bit weird but basically I imagine I've been travelling on a very long journey, and it's time to stop for the night. I am in a forest by a river. I unpack my bag and in it I have a thick grey woollen blanket. I imagine laying out the blanket, choosing the right spot, by the river etc. And play out to myself all the details e.g. how tired my legs feel, the sound of the river, the warmth under the woollen blanket. I embellish with as many details as I can, and then eventually - usually - I fall asleep!

I'm not saying this would have particularly helped when I was really "ill" as I believe that was a chemical imbalance. But it helps me now that I am just left with a kind of residual "anxious" insomnia IYSWIM? Anyway! As you were!

A quickie from me as I am about to feed DS3 but I also play a story in my head before I drop off and it does work most of the time for me. When I was little I used to play this story in my head pretending I was a caterpillar and making my cacoon and going to sleep until I woke up to be a butterfly!

My sleep is much better at the mo. too and my period has just arrived (my symptoms seem to be far worse before my period and around ovulation).

Arcadia GPs are clueless. I was also perscribed an AD that gave me worse insomnia. I only took it for 3 days (fluoxitine).

Glad your DD is better

Thanks you two! Us three always end up on the sleep threads, don't we! Wierdly Becky I have started my period today too - so maybe my next couple of weeks will be better too? I am much better than I was a couple of months ago GetDown so I really don't think the sleep will deteriorate much now but I'm just keeping an eye on myself. Now I feel over the birth physically am starting gentle exercise, and getting out into the fresh air is really helping too. I've basically got over the real anxiety about sleep because I'm coping with DD on the days when I'm tired, even when she's ill, so although I feel a bit more emotional I'm basically OK. Generally get 5-7 sleep a night (but never in one stretch), can't remember the last time I had less, and it is definitely copeable with. Nightmares have decreased too and feel bit more relaxed. Touch wood things are better but still feel like I'm working at it!
GetDown my GP doesn't seem to think it's serious but I think that anything other than very mild depression should be referred on as they are messing with people's brain chemistry! They don't seem concerned about following up either - I think it's a bit poor.