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

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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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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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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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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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