Mirtazapine Causing Anxiety/agitation? (Page 3) (Top voted first)

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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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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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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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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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 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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