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Author Topic: Mirtazapine (Avanza, Axit, Mirtaz, Mirtazon, Remeron, Zispin) Question  (Read 764 times)

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Offline raggamuffin

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Hi all,

Briefest of summary's. Been a worrier since about 12 or so (i'm 27 now). Depression since 15 or 16 and severe anxiety with pains every hour of every day for over 4 years solid without relent. Tried SSRI's and I couldn't deal with feeling wired, being unable to sleep and the sexual dysfunction. Lasted about 2.5 weeks at the most with these medications (tried 4 in all). So now i'm on Mirtazapine. In terms of side effects there's more than the SSRI's but they're more manageable. I'm at the 3 week mark and feel a bit happier when i'm not in pain from anxiety. When I am the anxiety feels just as strong. Upped the dose to 30mg after 7 days lik ethe Dr recommended. Also 40mg propanalol per day up to 3 a day but i've never needed that. In all honesty I feel no benefit from it either.

Just wondering how people have faired with this medication? My GP said he'd never known any of his patients needing 45mg but said I should notice improvements at around this time. To be honest things feel the same. Pains never come with panic attacks, they just come and go. I know all the lopgic behind anxiety like the back of my hand but it doesn't help. Pains will come and go as they please. I can rationalize but they wont' go away. You worry they last longer and get worse. There is the sensation of impending doom. To be honest, since being on this medication that sensation has felt more pronounced, like death is about to happen any moment from now. I know upping a dose can heighten anxiety etc but to be honest it's 2 weeks of 30 mg from now.

When I spoke to my GP about SSRI's he said 3 m,onths before I notice considerable benefits. Could the same be said for this medication? I'm not sure what i'm expecting from it. 4 years of living with constant pains all over my body and unnerving sensations has entrenched me so much in this anxiety that I wonder if popping a pill a day would be of any benefit.

Ed
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Online Cuchculan

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I've been on 30mg for a good few years now and I love it. Knocks me out at night. Other than that I have no side effects at all. Never have done. It is one form of medication I love. But people differ. What works good for me may not do the same for you.
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Offline MamaLouie

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I took Remeron 30 mg for 1 year and for the most part worked great! Was very effective for my anxiety, however it made me eat, eat, and eat. Was up 25lbs and all I could think about was food lol.
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Offline Andrew90

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I've tried many of the SSRI's and an SNRI at one point or another, but they all had unsettling side effects that made me feel lethargic, mentally dull, and sexually dysfunctional. The nice thing about Remeron is that it works well for many in regards to depression and anxiety and it tends to have less of the side effects that the SSRI's have (especially the sexual dysfunction). However it does cause weight gain for many people. That being said, I've found it to be the most tolerable antidepressant that I've tried. I'm currently on my 2nd try with this medication, which I am now on 15 mg. It's worth riding out for at least 8 weeks, because it can take that long for it to fully take effect.

These pains that you mention, are they centered around a particular area of your body? I get intermittent chest pains/aches which come and go...this has caused me a great deal of anxiety, and I have had many doctor visits and tests done to get some assurance that I don't have anything serious. I have been told that it's all a symptom of my anxiety, and that there is nothing wrong physiologically (I'm an otherwise healthy 23 year old with no history of any health complications). Anxiety is one of those psychological illnesses that is truly painful. It affects everyone differently, but it so commonly produces unpleasant sensations that magnify the severity of the disorder. I can relate to your situation. It sucks, but we push on and try to make things better for ourselves. And we can overcome it. It just takes time and effort.

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Offline raggamuffin

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Pains are anywhere and everywhere. Every hour of every day for over 4 years. Sometimes it's every minute of every day when it's very bad. Anywhere in upper torso and limbs has been affected by pains, aches, sensations etc. Favourites as with any anxiety sufferer - chest, left arm, jaw, head. Had a bout of what I suspected was epididymitis lasting over a year until a consultant urologist said there's no sign of infection - it's anxiety. Symptoms disappeared within 2 weeks after accepting it was anxiety. 3 month stomach ache convincing myself it was IBS tried 6 medications. Then I accepted it was anxiety and it disappeared. Dizziness, derealization etc etc.

I'm not sure I enjoy this medication. Sleepy all the time, slept 9 hours during the daytime on Sunday. Hungry constantly. Put on a stone and a half. I've never put on weight on 14 years so this sucks. I feel nasal congestion, like I can't breathe properly since being on this medication. Even deep breathing doesn't feel like enough. Obviously it is. I'm not out of breath. When i'm not thinking about breathing I feel fine so there's no physical issue other than congestion. But tell that to someone with anxiety when you're thinking about collapsed lungs or pneumonia, fluid in the lungs etc etc. It's really unnerving. Been getting mouth sores from this too, ulcers and all sorts. Stomach aches, nausea. Who knows what's anxiety and what isn't. 4 weeks into this (3 weeks on 30mg) and I feel no different, no benefits just side effects. More side effects than the SSRI's. First I thought it was manageable. Now I'm starting to realize, like lal the others, this is just a poison. It's not meant to be in my body. Chemical imbalance or no, why on earth am I taking this anymore?

Ed
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Offline insights

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I'm not sure I enjoy this medication. Sleepy all the time, slept 9 hours during the daytime on Sunday. Hungry constantly. Put on a stone and a half. I've never put on weight on 14 years so this sucks.

Sedation and hunger/carbohydrate craving are both known issues with mirtazapine, Ed. The nasal congestion is more of an oddity, though quite possible.

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Now I'm starting to realize, like lal the others, this is just a poison. It's not meant to be in my body. Chemical imbalance or no, why on earth am I taking this anymore?

It is not a poison, but as with all medications, including over-the-counter ones such as aspirin or even vitamins they sometimes have unwanted side-effects. It seems that this isn't the right med for you and there probably needs to be a review of your progress, or lack thereof, and perhaps a rethink on how the anxiety is treated.

I understand you've tried 3 or 4 SSRIs and stopped taking them within a week or two, I assume because of the side-effects. Have you considered therapy instead on antidepressants? Your GP should be able to prescribe access to the FearFighter CBT based online therapy provided free by most NHS trusts. By all accounts it is very effective provided patients are willing to put in the time and effort.

Alternatively, perhaps you'd have better results with the older tricyclics. They usually produce fewer initial side-effects, though at the expense of more ongoing ones such as constipation and dry-mouth. But crucially, they can be started on very low doses relative to their therapeutic dose range. Most come in 10mg tablets which is tiny compared to the typical 75 minimum effective dose. Given the difficulties you'd had with SSRIs I suggest you start of at only half a tablet to reduce the possibility of experiencing the initial side-effects even further. Desipramine (Norpramin) is less likely to produce the ongoing side-effects than the others.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline raggamuffin

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Hello,

Thanks for the response. I guess I could try another medication. Can't get a dr's appointment anytime soon. Next one is 23rd of this month. So another 2 weeks. Might as well see how I am at the 6 week point of this medication. I've done CBT, therapist wasn't very helpful. But like medication, it takes time to find the right one. But I had free private healthcare where I work and i'm losing my job in 2 months so i'd have to be put on an NHS waiting list to see another therapist. From the first session my therapist was surprised how much I understood about anxiety. We had 4 sessions before she literally told me "there's nothing more I can teach you". I've read countless anxiety webpages, self help books etc. I understand the logical side of anxiety like the back of my hand. In a way I think it's a bit of a curse knowing so much about anxiety because at this point I know that if I don't help myself get out of this hole then it will one day cause me very real health problems and not simply restricted to the aches and pains I get every day at the moment.

I don't mind trying another therapist, or another medication. But all the waiting for a medication to work is somewhat troublesome for me. Seeing as it's some time until my next GP appointment i'll curb wat I eat and get my weight back down to where i'd like it to be. Drowsiness I can tolerate, as you can always keep yourself awake even when you do feel tired. Plus I know it's just in my mind, because when I am really drowsy due to lack of sleep my anxiety symptoms kick up tenfold to the point of being utterly unbearable. But i've heard mixed things about medication waiting times - 2, 3, 6, 8 weeks. Or 2 or 3 months. So I don't really know, I guess everyone is different. SSRI's did have a more noticeable reduction in anxiety, but the inability to sleep added a different element of anxiety. I've never had issues with sleeping, and if I can't sleep properly, as stated above, my anxiety just goes nuts.

Ed
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Offline insights

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But i've heard mixed things about medication waiting times - 2, 3, 6, 8 weeks. Or 2 or 3 months.

It is usually anywhere from 3-12 weeks once you're on a therapeutic dose, Ed. Antidepressants work by stimulating the growth of new brain cells to replace those killed or prevented from growing by chronic stress hormone exposure and this takes time.

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SSRI's did have a more noticeable reduction in anxiety, but the inability to sleep added a different element of anxiety.

SSRI induced insomnia is a well known problem with an effective fix, small doses, 25-50mg, of the sedating antidepressant trazodone (Desyrel). At those doses it acts only as a powerful antihistamine so won't affect the actions of the SSRI. It is also a pretty good antidepressant in its own right with fewer side-effects than most others, especially in its effects on the libido (it is the only antidepressant which enhances it). Its main problem is the sedation, but this diminishes at the high doses required to initiate the antidepressant effect, usually 225mg plus, especially with the new slow-release formulation.

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline raggamuffin

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I don't mind the drowsiness so much. It's bearable and I don't really want to be taking any more pills than I need to. I'll stick with 30mg until I start seeing improvements. Then in 2 weeks time I can speak to my GP and discuss what i've been experiencing. I think the most annoying side effect is this nasal congestion.

Ed
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Offline raggamuffin

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I think I forgot to take my medication. I can't remember as i'm terrible with remembering to take pills. So either that's what's causing me to feel like crap today, or the suggestion and fear that I forgot to take it.

I'm almost positive I did forget though. Nothing feels real this morning, it's really unnerving. might go back home on my lunch break and get it. But that'll mean i'm faced with unbearable dizziness for the rest of the day.

Might be best to just grin and bear it until I finish work and then take it when I get home.

Ed
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Offline insights

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I think I forgot to take my medication. I can't remember as i'm terrible with remembering to take pills. So either that's what's causing me to feel like crap today, or the suggestion and fear that I forgot to take it.

It is probably a bit of both, Ed. The mean half-life for males is about 26 hours (~36 for females) - range 20-40, so there isn't much margin for error, especially if you're a fast metabolizer, but withdrawal effects usually take a while to become noticeable.

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But that'll mean i'm faced with unbearable dizziness for the rest of the day.

I'm surprised it takes that long. Mirtazapine is absorbed into the bloodstream fairly quickly usually reaching peak plasma levels within 2 hours.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline raggamuffin

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My metabolism is stupidly fast. I have put on a stone on this medication. But in general, I eat constantly and never put on weight and i'm always hungry. So when I went on this medication my body just went nuclear in terms of hunger.

I meant drowsiness. Half an hour after I take the medication I get hit with the worst drowsiness and it doesn't go away.

Ed
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Offline insights

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I have put on a stone on this medication.

Some can develop carbohydrate cravings so bad when taking mirtazapine that they will literally eat sugar straight from the bag.

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Half an hour after I take the medication I get hit with the worst drowsiness and it doesn't go away.

Small doses of mirtazapine are often prescribed to counter SSRI induced insomnia, so this isn't surprising. It's because it is a far, far better antihistamine than a serotonin and norepinephrine reuptake inhibitor. I'd like to tell you that this diminishes over time, but it won't.  :(

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline anxious J

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Can Mirtazapine lead to growth of new brain neurons that are damaged by stress Hormones ? Also does anyone no if benzo's can encourage the growth aswell ?
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Offline insights

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Can Mirtazapine lead to growth of new brain neurons that are damaged by stress Hormones ?

Yes.

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Also does anyone no if benzo's can encourage the growth aswell ?

No, they don't and there is some recent evidence that when taken with antidepressants (ADs) they may impede initiation of neurogenesis to an extent. But it is still better to use benzodiazepines to ease the initial antidepressant induced increase in anxiety than have patients stop taking the AD because of it.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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