Mirtazapine and sleep

[Dawn1965]

I started taking 15mg Mirtazapine 6 weeks ago to help with getting off to sleep and it worked wonderfully, too good! However it's suddenly stopped working. Has anybody else experienced this? I'm wondering if increasing the dose might help?

[Hidden]

You should contact your doctor before you ever decide on increasing dosages of medication prescribed. This medication is less effective than at higher doses for slerp, you should ask you doctor the best course for you to take.

Maybe this will help explain why it’s not a good idea to increase:

“Mirtazapine is a noradrenergic and specific serotonergic antidepressant and has an unusual dose-dependent effect on sleep. At low doses below those needed for antidepressant efficacy, mirtazapine binds more avidly to the histamine site than to the adrenergic sites, leading to increased daytime sedation. Sedation is inversely related to dose and may be excessive in older adults on the 7.5 mg daily dose. So if you are older, it’s suggested doctors avoid 7.5 mg dosing of mirtazapine in and start at 15 mg instead.

The medication is not as overly sedating at 15 mg because the norepinephrine effects moderate the sedating effects of serotonin, while still maintaining its soporific properties. However...

At higher doses (when used as an antidepressant) the norepinephrine effects may interfere with sleep. In such cases, switching the administration from bedtime to the morning can correct a patient’s insomnia.”

[Starrlight in reply to Hidden]

Ooooh great info thank you so much Roxie! How are you doing?

[Hidden in reply to Starrlight]

Hi Starlight! I’m doing okay. Working on my new house quite a bit, it keeps me out of trouble. 😁😁😁

I hope you are doing well. 🌺💜🌺💜

[Dawn1965 in reply to Hidden]

Thank you for that. Although I knew Mirtazapine was only effective for sleep at a lower dose I didn't understand the science behind it. So effectively I should be potentially looking to reduce the dose, especially as I am 55, so perhaps in the "older" person category! I have an appointment with my gp next week so will discuss with her then.

[louielou]

Hi Dawn, I have been taking mirtazipine as an antidepressant for a few years now. Part of my anxiety was lack of sleep amongst others. I'm on 30 mg. I did start on a low dose, like yourself, but in consultation with my doctor the dose increases over a long period of time. Whilst I do take the tablet a good bedtime routine does help. No phone 1/2 an hour before bed. A warm bath/shower & relax before bed and of course any other regime that would help promote relaxing the mind and body. Definitely speak with your GP. Hope this helps x

[Dawn1965 in reply to louielou]

Hi Louielou

Thanks for your reply. Funnily enough I am also in the middle of the Sleepstation course (NHS specially designed sleep CBT course) and it is helping with my sleep habits. The most important factor I have found is to keep a strict to bed and wake up time. The next part of the course is "sleep restriction" where your sleep is restricted by an hour or so each night for a week or so. This is to reset your sleep body bodyclock. I can't say I'm looking forwards to it as it will really make me even more anxious about my sleep but I'm sure it will be worth it.

I've also stopped having the TV on in my bedroom at night and reading until my eyes start getting heavy. It is all starting to help!

Good to know I'm not the only one out there with anxiety about sleep.

[Cubs092011]

You have to talk to doctor before you raise your dose.