Hi friends, before being diagnosed for PD almost three years ago,my primary doctor has always been treating my anxiety symptoms with xanas.After PD diagnosis my Neurologist/Mds switched my medication to mirtazapine,which has helped with managing my anxiety symptoms,but it's effect is now declining gradually,and according to my Mds,it is time to increase my dose from 1/2 of 15mg tab to whole.But recently,I had an appointment with my pry Md,who wants me to continue with Xanas.I am kind of confused now because I am trying to avoid using too many drugs.If you have ever been in this kind of situation,I could use your advice,please respond.My Mds also double as a psychiatrist.Sometimes,it is hard to know who really have your best interest among these doctors.
When primary MD contradicts MDS over the ... - Cure Parkinson's
When primary MD contradicts MDS over the choice of Medication for anxiety in PD ,what to do?
Since you already have experience using both medications, I believe you are already the best expert as to what will work for you. What do you think is best?
Do they each know they have prescribed differing meds? Your situation will be complicated by your desire to not have too many meds.
Personally I would follow the MDS (which I presume is the movement disorder specialist) as he should be aware of recent trends and treatment. Otherwise why see an MDS who is a specialist, if you want to follow your primary doctors advice
I was in a similar situation with my primary care doctor and she stopped treating me for depression once I told her that I was now being treated by my psychiatrist and that the psychiatrist would be “taking over”. I was instructed by my psychiatrist to say so to the primary care doctor.
I guarantee that if you tell your primary care doctor the same way that I told my doctor, he or she will back off. They have a professional obligation to defer to the specialist and they will follow protocol.
I suggest that you follow the etiquette and gently but politely inform your primary care doctor.
I’ve used mirtazapine with good results. It has the advantage of not being a benzodiazepine class drug, which can cause dependence, and lose effectiveness over time, and be very hard to discontinue. Benzodiazepines are also linked to an increased risk of dementia. In general it’s not recommended to use them for more than 2 weeks, although there are exceptions as with everything.
Mirtazapine is a “good” drug for people with PD, not addictive, often effective for both anxiety and depression, doesn’t cause or worsen motor symptoms like some SSRI’s. 15mg is not a high dose.
Xanax is a benzodiazepine.
Hi rebtar,
Are you still on Mirtazapine?If so what dose are you on,and how long has it been working for you?
Yes, I’m on mirtazapine still. At one point I was at 30 mg, now I’m down to 7.5. My depression and anxiety improved immensely when I started C/L and I was able to reduce depression meds.
Do you take it only at night before bedtime?The reason why I am asking is because I have been taking 7.5mg for the past 7 months,and it worked for sleeping and my anxiety for about 6 months but its effectiveness is waning now most especially for sleeping,that I now have to add 1.5mg melatonin supplement.I noticed that If I sleep well a night,I get less anxious the following day,even when my c/L wears out.
Sleep is essential for stopping anxiety. I've had a lot of insomnia in my life and when I couldn't sleep my anxiety increased. I actually use the mirtazapine in the AM now but I have taken it at night as well in the past. My doc added it for depression/amxiety rather than for sleep, so the time of day wasn't so important. I found that when I took it at night I was groggier in the morning.
A lo of people take it for sleep at night, 7.5-15mg. At a higher dose it can help for depression and anxiety but less for sleep.
There's nothing wrong with adding melatonin if that helps you sleep, and the mirtazapine helps with anxiety.
Thank you. My sleep doctors keep suggesting clonazapam which is a benzo for my REM sleep disorder. I keep telling them no way. I've seen people destroyed coming off benzo's though admittedly, they weren't doing it with their doctor. I do take melatonin which I am guessing is somewhat effective. Better somewhat effective than addicted.
I’m not against benzodiazepine in all cases. I still take lorazepam very occasionally for sleep. I took it for several years fairly steadily at a low dose for anxiety and sleep, and was able to come off it by tapering very slowly, which works for many. I’m not totally against it but it should be used with caution and clarity of the potential consequences. If something else works, better to use the alternative.
i have taken xanax and clonipin. i no longer take clonipin but it helped me through a difficult period. dr. told me to just make sure i didn't take these two meds at the same time of day. only used the clonipin at night. they are both suppose to be "addicting". personally i didn't have a problem going off the clonipin. i was so worried about what i would go through when decided to stop the clonipin yet was fine. i think each of us are different, have different illnesses/ailments in addition to pd so guess we handle meds differently. i have found xanax to be a huge help but also know it is a benzo so need to be careful. think the mirtazapine might be a great alternative to xanax so am going to talk with my gp about it.
My husband has been on mirtazapine. I found it made him very dozy and I believe it caused a lot of his PD type symptoms. It made him very apathetic, froze his face and made him not want to talk to people, in fact he was sitting in a chair all day watching tv if he did get up with a blank look on his face. He is 59. I am gradually weaning him off and have him down to about 2 mg. He had been on up to 30 mg and tried to get off it before but a few months later he had severe withdrawal reactions and became so agitated and suicidal they put him back on it along with sertraline/Zoloft.
None of it really controlled his anxiety in fact the Zoloft made it worse.
The only thing that noticeably helped was when he started taking Hardy’s daily essential nutrients. In 3 days he was feeling so much better. Now I am trying to wean him off the other 2 again but instead of over 3 months we are decreasing only a minute amount every couple of weeks. He is now on 90% of his Zoloft but only 2mg/ 15 of his mirtazapine. I had the mirtazapine compounded and put into capsules and now I use a jewellers scales to take a tiny bit out at a time. I tip it onto a post it note to weigh it then put the required amount back into the capsule and storing the remains so when he gets down to that amount I can use it.
Before increasing try the Hardy’s den. Talk the the product specialist on the free help line and they will talk you through it.
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