Mirtazapine Causing Anxiety/agitation? (Page 2)

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I have been taking 15mg of Mirtazapine for three weeks. This was prescribed after suffering from insomnia and anxiety, with moderate to severe depression, for three months following complete withdrawal from the SSRI Citalopram (which I did very gradually, over three before this months as I thought I was stable enough to stand on my own two feet).

My sleep improved immediately and I started to have some better days over the first two weeks. I know recovery should take time, and that the Mirtazapine takes at least 4 weeks to show its beneficial effects. On that basis, by the end of the second week I was feeling in a pretty good frame of mind and quite optimistic that I had finally turned a corner out of my anxiety.

This third week has been a real disappointment though. My anxiety has got worse each day. My sleep is typically very broken, with patterns of waking and sleeping for 10 minutes each for some periods of the night. Even before I started the medication I hadn't experienced this. I take the 15mg at night, and I do feel very sleepy in the evenings, but then why I go to bed and get off to sleep I keep waking up again and again. In the mornings my anxiety levels are very high, but they drop down to more moderate even, if I'm lucky, sometimes mild levels by the late afternoon.

Like so many others, I initially noticed an increase in appetite, which was a nice relief from feelings of nausea, but yesterday I felt sick again in the morning and really struggled to eat anything until later in the afternoon.

I don't know why things are going backward rather than forward and am confused and concerned. Is it possible that the drug's activation of noradrenaline is just starting to kick in? Would I be better to drop the dosage a little so as get the benefits of it in dealing with insomnia? Do I stick it out at this dose and hope for things to rebalance themselves or might a higher dosage be the answer?

Of course I will speak to my Doctor when I can, but it take (in the UK) around 3 - 4 weeks to get an appointment for a face to face 10 minute session. So, any thoughts, comments or suggestions would be very much appreciated.

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21

Hi, I have been on Mirtazapine since Jan 2013. My psychologist put me onto it when I told him about my decades long insomnia. Even it's not the magic bullet it has had beneficial effects. I find Edwin's (Aug14) experience interesting, where actually decreasing the dose improved the sleep aspect. In my use of Mirtazapine I found that I would feel like a ton of lead with a 30mg dose so I reduced it to 22.5mg per day. I noted an improvement. However since the beginning I have found that approx 1-2 hours after taking it even though I get drowsy I also get restless legs so taking it at night has me hyped until the restless legs wear off. Has anyone else experienced the restless leg syndrome with Mirtazipine? Meanwhile I might reduce the dose a little more and monitor the results.

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22

I am 38y/o F.

Would like to say this first; I think it is really important to find the correct antidepressant type, however that can be very difficult. I have been quite lucky that it didn’t take me long to know that SSRI’s are right for me. So that is only 3 antidepressants throughout my history I have tried and 2 being the SSRI’s.

Began Mirtazapine after my initial complaint of insomnia. Going onto this medication seemed to be quite pleasant compared to having been on Peroxetine previously. For my insomnia it helped immensely. Also began to gain weight which for me wasn't totally a negative as I was underweight. 47Kgs. But in the end I put on over 10kg! On Mirt for about 4 years. Earlier in my treatment I was taking the max dose of 45mg! After 2 years on 45mg lowered dose back to 30mgs due to feeling really groggy in morning, difficulty in trying to wake/get up and weight gain. It helped a little and my weight went down slightly.

2 more years on Mirt I thought I was going to have a meltdown! Was working but really struggling with it. Worked in aged care home in housekeeping. Very physical job, mentally demanding and stressful environment. Not a great place for my mental well being. Had been there about 6 years and blacked out once at work. During 4th year on Mirt it was time to get off it and go onto something more suitable. I felt it never really worked to help with my anxiety and depression. If anything prob made it worse. Was unable to function daily, could no longer drive as I kept having major panic attacks and became agoraphobic. Never been like that before. Always had mild anxiety though. After seeing a psychiatrist (rather than taking the word of my GP) he prescribed me escitolopram (SSRI). Thank goodness I sought his opinion. I am so much better now, can drive again without panic attacks.

My GP wanted me to stay on Mirt and take Venlafaxine as well! Would have been a disaster. It was very difficult during the transition of going off Mirt and taking escitolopram at the same time. My head felt empty and my thoughts could do what they liked! After a few days of changing medications I began to have more severe panic attacks and felt very paranoid. My body could not relax, I was shaking quite a lot. Could not sleep and lost appetite. Took more than a month to begin to feel sort of ok. Had difficulty functioning and just doing basic things like showering, dressing, getting food, going to the toilet was all a real challenge. 6 months on escitolopram and virtually have no anxiety, my head feels better and can control the thoughts better. Side effects I have are the night sweats, some sexual dysfunction and often waking in middle of sleep. Still have a lot of difficulty with winding down/sleeping, energy levels and getting up early, but think that is just how I am since have always had problems with that regardless of medications. For me Mirtazepine didn’t really work for me whereas the simple SSRI types do.

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23

I did the same thing, Upped to 45 after several months of feeling great. Ever since I upped it to 45 I feel horrible with anxiety through the roof. I am wandering if you got better? I went back to 30 the next night and my Dr said it would take 4-5 days to clear the extra dosage.

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24

14 months on meratzapine 15mg for sleep and anxiety. All good until the end, then I had a constant base line anxiety which was not good. I had massive spikes of anxiety throughout the day, not through external stimuli. In the end I was experiencing psychosis like symptoms, nausea, loss of appetite. The doctor didn't want me to stop, recommended I increased. Tried 30mg and felt worse. Feeling annoyed I went cold turkey knowing fully what was was in store. Almost no sleep for 2 days, hypnopompic hallucinations. Chronic pain sufferer..... all kinds of back, head and neck pain, tinitus. Almost NO anxiety soon as I stopped ! Sleep was rubbish for weeks after stopping. Months pass and I still get the odd hypnopompic episode. Pleased I did cold turkey. I still get anxiety but I use CBT, exercise and other methods to cope.

Iv'e had great help from these forums.....thank you all and good luck :)

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25

Any more people out there with mirtazapine related problems? I have been trying for two years from 7.5 to 22.5mg, still depressed..very anxious and having to take diazepam to calm it. What should I do - tried duloxetine, zombie; tried pregabalin, felt terrible. Seems no way out of this mess. Just want to be well and normal again.

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26

does anybody else get bloating gas and stomach cramps when coming of mirtazapine

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27

Hi i have takinf effexor for years but stopped working. Doctor changed to wellbution but i got insomnia so put me on 45 mertazapine. Been on it for a month but I feel intense anxiety. Im cuttind dose in half and then stopping. Im afraid of what might happen.another problem is my hair has been falling out.
Anyone else having these symptoms?

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28

Alex, how are you doing? I see this is a post from a while back. Have you have luck with any changes?

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29

I have been taking Mertazipne for 5 days, it has helped with sleep, but I wake up very agitated and more anxious. I'm taking 7.5 mg. It takes me up to 3 hours to calm down and not feel as agitated. Is the agitation aside effect? And as the medicine wears off the agitation lessens?

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30

On mirtazapine at 7.5mg for months, each time tried to increase got increased anxiety. Dr gave me diazepam to help. Now cannot get through day without 2mg. Go from feeling nausea to diarrhoea. Dr tried to use several different ssris but they made me worse. Stuck now and dont know what to do. Neither does psychiatrist. At least i can sleep on mirtazapine but need an anti dep to work for me.

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31

I had started mirtazapine for depression from 7.5 to 15 to 22.5 to 30. It had worked me fine and reduced dose to 22.5. I left medicine myself for almost a month which made me feel much better. But all of a sudden anxiety and panic attack hit me and again started dose from 7.5 to 15 to 22.5 again. My doc says it is side effects of the medicine and again reduced to 15mg now. But anxiety and panic attack still seems to not go away. What can be done to get off anxiety..??

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32

I've been on Mirtazepine 15mg for about a month, this drug has made so much difference to me, I'm like a new person and feel like I want to get out of bed and do things! I've never felt like this for years! Have been on loads of antidepressants and just been weaned off Fluoxetine, I felt better when I was starting Mirtazepine and still on low dose of Fluoxetine so I think GP will up dose on Monday when I see him. Hasn't done much for my insomnia and still have little anxiety so been taking Propranolol which helps, not getting much side effects apart from little weight gain which i am watching! But don't feel sedated. I really wouldn't want to be taken off this drug as it has helped so much for my severe depression, everyone has noticed such a change in me, so it's definitely seems to be the right drug for me.

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33

Severe agitation when I go to bed taking 15mg of mirtazapine. Goint to stop it after 2 months

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34

My Dr said it takes about 6 weeks to feel the effects she stated me on 1/2 of a 15 mg pill for 3 weeks and I upt it to 15 mg a week ago I'm feeling the same as you edgy impatient and so on I wake up and go back to sleep I'm thinking that the 1/2 dose worked better than the 15 mg but my Dr did tell me to hang in there because it does have to work into your body and a lot of people just give up on it too soon so I would do exactly what your Dr ordered because my doc told me to take 1/2 of my 15 mg pill for 30 days then up the dose but I upt the dose at 21 days and now my anxiety is mild but I can feel it again where as I have to really work at it to control it it sucks I really should have listened

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35

Since I posted, my dose has been increased to 30mg which does make me sleep, but like other I tend to have a couple of hours and then wake up. I still have slight anxiety and still take Propranalol, but over all I still think it is the best medication I have been on. I've lost weight now, initially I gained a few pounds only

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36

Does a lower dose of mirtazapine work better than a higher dose because if you don't need that much of what the drug does for your brain I could see how it would overload and cause a person to have anxiety it just st like melatonin it works its best at lower doses for sleep

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37

Try 1/2 of that for a few weeks but first check with your dr

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38

I am full of anxiety after two years on this mirtaz, low level just cant increase. What di i do

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39

Mirtazapine for two years, cant stand anxiety on increasing, dosn to 7.5, dr says drop down again then offf. Anxiety and depression going through roof, what now?

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40

Liza,

I have been prescribe the exact same.. and have found that it doesn't help me sleep that much at night and I'm waking up all the time and the agitation the next day is very high.. but I have only taken it two times..all at night.. I don't like the agitation it makes me feel like I want to crawl into bed and stay there.. I don't know if people react as quickly to it or not I was wondering if you had any answers or responses?

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