Mirtazapine Causing Anxiety/agitation?

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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REPORT

It is possible that it just isn't the right medication for you.

It is well known and usually reported in the monograph, that these types of medications can cause the opposite of their intended effects in some people. When this happens, it can result in increased anxiety, nervousness, depression, weight loss and insomnia.

(I am not certain if these details are required in the monograph in the UK, they may not be.)

You may want to try to Citalopram again, or use a different medication entirely and stay away from this one.

Are there any other questions or comments?

Learn more Mirtazapine details here.

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Thanks Verwon for taking the time to reply, and for your perspective on this. The anxiety has subsided a little again
now. My Doc has assured me by telephone that the mirtazapine could not possibly cause anxiety to worsen, even though nausea and agitation are listed as possible side effects. So I don't know who to believe. She thinks the dosage isn't high enough and should be taken up from 15 to 30mg, which I did for the first time yesterday. I figure as I've started as might as well go all the way and see if it works. There is always the possibility that she's right, and I wouldn't want to miss an opportunity for recovery. I have tried a couple of times to get back on to the citalopram, but even a quarter of a 10mg tablet makes my anxiety levels go through the roof for a couple of days.

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Hi I am curious at to whether you continued on the mirtazapine? Did you stay at 30 mg. I am on day 23 of 15 mg and still feeling very anxious and quite agitated. I have spoken to my gp today who said the same as yours that to get the benfit I need to increase to 30 mg. I am already struggling with the sedative side effect next day which lasts almost all day aswell as the anxiety and panic.

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My experience is nearly the same. Especially the broken sleep part - I was pescribed Mirtazapine for sleep, initially 30 mg, but instead of letting me sleep I typically woke up all the time and seldom felt that I had gotten any sleep at all. After five weeks I had enough and started on Zopiclone which obviously work much better.

I think our problems are definitely linked to the noradrenaline levels. Before taking Mirtazapine I slept much better.

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Started mirtazapine drowsy and dizzy but couldn't sleep. Why?

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I began taking mirtazapine last year after trying sertraline, citalopram, and duloxetine. I started with 15mg, then went up to 30mg shortly after. I've always struggled with insomnia and it helped me sleep, and the reduction in my anxiety absolutely blew me away. The worst thing about it was the increase in appetite, and some related weight gain (nothing major). I was on it for about 6 months, I think. For the last few months, I began to have gut problems - Excruciating cramps and bloating, gas and diarrhoea. I was feeling pretty good emotionally at this point, so I came off it. Long story short, a month later I was back on it. My experience is currently COMPLETELY different to how it was the first time. My anxiety is through the roof, I get so agitated at night that I can't sleep, I'm suicidal, restless and generally incredibly unhappy. I have gut problems at the initial 15mg dose but not any more at 30mg. I'm thinking about trying 45mg, but honestly, I'm scared.

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Hi. I have been on mirtazapine for about a year, and the highest dose I got was 22.5 mg, in which I started feeling very anxious to the point I thought I was walking on cotton feet...I reduced the dose and started feeling better until I came out completely. The second time I had to take it was 3 years after. But I stayed at the minimal dose I could cut the pill to: 3.75 mg. On this dose I can sleep much much better and have a better apetite and cope with anxiety issues. My recomendation is that you stay as low as possible just to use the hipnotic properties of mirtazapine at that level. If not, go on to 15mg but stay there. Some doctors have told me that if you start to feel better after months of being on a pill, then you're probable better at your depression, but not necesarily on your anxiety.

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Been on 30mg mirtazapane since november. Dr upped my dose to 45mg five days ago. My anxiety levels r through the roof. Could it be the increase

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I've been on 15mg Mirtazapine since middle December 2014. I've tried raising dosage to 22.5mg .( doctor wanted me to try 30mg) I lasted a week & a half. Anxiety & agitation went through the roof !
I don't really know whether or not this medicine is helping, completely confused what to do next. So I would say Yes it's the upped dosage. Scary stuff .

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I suffer from anxiety and anxiety attacks and was on citalopram for 2years. They stopped working and doctor has put me on mirtazapine.15mg. I got usual side effects like feeling dizzy, tired during the day and thirsty. My anxiety did not improve so I have been put on 30mg. I take them at night but by mid day I feel as if I am struggling. I do not have trouble sleeping and never have had. I was wondering if i should maybe take them in the morning instead as I am not using them to help me sleep. I was wanting to know if anyone else was not using them to help them sleep and just for anxiety and when u take them.

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Been on martizipine for 4months then went cold turkey I was on 30mg I feel terrible so I went back on it hopefully I get bettrr I felt very anxious going into a shop

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Dont take them in morning you will feel relay tired I tried it on 15mg and felt tired all day you will feel like a zombie

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Hey Gary,

I was on Mirtazapine for about 5 months from about Xmas time. Made me feel terrible , I think they've helped my depression but the side effects & general effect of being on them was intolerable. I was on 15 mg & tried on a couple of occasions to increase the dosage. Couldn't bare it, lasted about a week.
So I just decided I couldn't deal with it & needed to get off them. Went down to 7.5 mg for about 3 weeks. Had a few really bad days were I could barely get out of bed. But I just kept telling myself it was the withdrawal & not the underlying depression.
I've now been tablet free since last Thursday (4 days) . Best I've felt since I was introduced to Mirtazapine. Mind is so clear & don't seem to be getting agitated about the smallest things anymore. I know that I'm not
out off the woods yet, but I'm never going back on that drug again. I've taken a few different AD's but this one was the worst for side effects for myself . I know everyone is different, but there seems to be a certain type of person that just isn't suited to Mirtazapine & I was certainly in that group.
I'll post back in a week or so, hopefully things are still positive

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Hi, I was diagnosed with social anxiety and prescribed Citrolapam (Spelling??) which caused a lot of side effects not sleeping, weakness etc so i returned to the doctors who weaned me off and prescribed me mirtazapine 15mg initially i had some tremors and vivid dreams but it settled a little after a few weeks my dose has now been increased to 30mg having taken these for a week i have began getting similar signs of my anxiety become agitated, defensive and withdrawing etc has anyone else had this experience or know if you can have his wobble when increasing or messing with the dose as it is quite concerning and causing a lot of stress not knowing wheher i should plough through or go back to doctors to look at alternatives.

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Hi my name is gary I was taken 15mg of martizipine for a month then put up to 30mg been on them for 4 months feel agitated at times im scared I will hit someone for no reason and cant sleep what shall I do

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Hey Gary,

I understand completely were you coming from . I also posted below when I just stopped Mirtazapine. The agitation was one worst experiences ever. I've been of all AD's for almost 5 months. Suffering badly from withdrawl . But the symptoms you're describing put we off AD's for life.
Just remember it's 100% the tablets doing this , you're not going mad it's s major side effect of Mirtazapine .

Try to relax if you can

J

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I started taking the remeron 15 mg just last night. Today I'm so anxious I can't stand it. Could it be possible that just that 1 pill did this?

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I've been on Mitazapine for almost 3 years and I really think it's making my anxiety worse right now. I started on 15mg, went up to 30mg. My body cannot handle 30mg or even 22.5mg. My dr told me that as you go up the sedating effect goes down and you're not getting the proper REM sleep needed which causes that groggy bone tired feeling next day. So I've been on 15mg for past 2 1/2 yrs. I've always seemed to have anxiety in the am but it goes away by noon. Not in the the past month though. Anxiety almost all day everyday. Time to go off but not sure what else to take. Dont like many of the side effects with these kinds of drugs.

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Hi Nicole,

I took AD's for almost 20 years. Prozac & then sertaline for nearly 2 years. I was put on mirtazapine just before Xmas last year. I can assure it definitely made my anxiety worse. The agitation it gave me was unreal and honestly quite scary. I stopped taking them May last year & my experience was so bad I don't think I could ever take this kind of medication again.
Everyone is different & are affected in different ways. But don't just stop taking them as the side effects can be awful. See your GP.

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I am on mirtazapine 30mg and also valdoxon 25mg at night for the last 2 months, I feel extremely agitated all the time to the point were I feel my chest is going to explode , everything and everyone has me so uptight that I just want to crawl under the covers away from everyone .have tryed a lot of ad over the past 5 yrs , don't know Wat to do any advice would be great

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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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