Mirtazapine Causing Anxiety/agitation? (Page 3)

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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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41

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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42

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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43

Re: Alex (# 6) Expand Referenced Message

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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44

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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45

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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46

Re: Verwon (# 1) Expand Referenced Message

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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