Mirtazapine Causing Anxiety/agitation?
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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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Re: Verwon (# 1)

Hi I'm on mitrazapine 15mg and take 150mg of sertraline, I feel more anxious more anxiety and panic attacks that's the first week of and I'm shaking and feeling cold, they are wondering if I have too much sereotin in my system, now I have to stop both tablets to see if it helps. Hope u get sorted.

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This is the first time I have heard someone complain that remeron does not make them sleepy. Perhaps remeron is not helping with the anxiety.

If you want my crazy theories...

It is most likely that they messed up the "enantiomers. The (S)-(+)-enantiomer is known as esmirtazapine" from Wikipedia.

I am currently dealing with a similar issue. Again, crazy ideas; a histamine such as Vistaril (Hydroxyzine) may work. Even crazier, small doses of seroquel (like 25mg) or Abilify (Aripiprazole). This may help with the serotonin 5ht1a and D2 as a partial agonist. These drugs are antipsychotics so the side effects may be worse than the cure.

If you want a crazier idea maybe Modafinil when taken in the morning may help you sleep better at night and make you less sedated during the day.

And of course, the worst idea I can think is trying ambien for sleep. I am not familiar with TCAs.

these are my crazy ideas at the moment. please feel free to complain :)

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I know exactly what you're talking about. I just found this site and saw your message. I was looking for others experiencing anxiety while taking Remeron. I increased my intake of the drug hoping it would help my insomnia and depression. It all went down terrible for me. Night sweats and anxiety were out the roof. My doctor didn't seem to know what had caused this. Anyway I finally stopped altogether and I'm finally starting to feel better.. that drug I've experienced works better with Clonazepam (for anxiety)... So glad you posted this... I thought I was losing my mind!

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Re: Alex (# 6)

It is a grim drug. It has over time ramped up anxiety to intolerable levels. Totally inappropriate prescribing for me, feel totally wired and exhausted. Hard to come off too, down to 30 and struggling very badly. Hope you managed ok.

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So is the weight gain from increased appetite or is it because you feel that the pill itself is making you gain weight?

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I forgot to take my remeron (mirtazapine) 15mg for the last two nights and I am feeling a little jittery. Can I take it now?

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

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

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

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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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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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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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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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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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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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