Mirtazapine 30mg

[DSTJ]

I need advice.....

I wasn't sleeping for days, and my depression was getting worse. So my doctor changed from 150mg Sertraline to 15 mg and then 30mg Mirtazapine. But once I went up to 30 mg, I feel like I am a bit of a zombie. I am so drowsy, I can't seem to function. I am still crying loads and I keep feeling so anxious, it feels like I am scared andas if something bad is going to happen. My depression scares me.

Can anyone advise me if they feel like this, as I am worried.

[MAS_Nurse]

Hi DSTJ,

Okay so in the UK Sertraline which is an SSRI (Selective Serontonin Reuptake Inhibitor) antidepressant, is a first-choice antidepressant. However, other SSRI's may be used such as Mirtazapine. There are no one-size-fits- all when it come to medications, and so if one doesn't suit, then another may. Your GP should have weaned you down very slowly from Sertraline, before initiating Mirtazapine, so you maybe experiencing the lasting effects of the former. Check out this information on the Electronic Medicines Compendium and Patient Information Leaflet: medicines.org.uk/emc/produc... and medicines.org.uk/emc/files/... I would suggest that you go back and talk to your GP and/or pharmacist about the symptoms you are experiencing, as your dose may need adjusting. As with all AD's you need to give it time to work and settle in. Below is more information about the UK NHS guidance in prescribing AD's:

According to the UK NICE (National Institute for Health and Care Excellence) Guidelines on Depression in Adults and Common Mental Health disorders, in the first instance treatment options for mild to moderate depression is:

NICE Guidelines First-choice antidepressants:

nice.org.uk/advice/ktt8/cha...

“NICE advocates a stepwise approach to managing common mental health disorders. It recommends offering, or referring people for, the least intrusive and most effective intervention first. Therefore, non drug interventions (such as cognitive behavioural therapy [CBT]) should be the mainstay of treatment for many people with depression or GAD, with drugs generally reserved for more severe illness or when symptoms have failed to respond to non drug interventions.”

“If an antidepressant is indicated for an adult with depression, the NICE guideline on depression in adults recommends that it should normally be a selective serotonin reuptake inhibitor (SSRI) in generic form. SSRIs are equally effective as other antidepressants and have a favourable risk–benefit ratio...”

“The full guideline on depression in adults concluded that antidepressants have largely equal efficacy and that choice should mainly depend on side effect profile, people's preference and previous experience of treatments, propensity to cause discontinuation symptoms, safety in overdose, interactions and cost. However, a generic SSRI is recommended as first choice because SSRIs have a favourable risk–benefit ratio.”

See also these guides below:

NICE Guidelines: Depression in adults

nice.org.uk/guidance/cg90/i...

NICE Guidelines – Common Mental Health problems:

nice.org.uk/guidance/CG123/...

Hope this helps you to make informed choices about your treatment, that you can discuss with your doctor.

Best wishes,

MAS Nurse and Moderator.

[DSTJ in reply to MAS_Nurse]

Thank you for this advice.

I was on 150 mg Sertraline and then the next day on 15mg Mirtazapine. I didn't think this was normal. But since my depression has come back and got worse, I feel like I have lost the fight in me. I did tell my GP that I was self harming, but he just said "take these and they will also help with the sleep". It seemed as if he didn't recognise that I was crying for help and struggling mentally. Everyone says that if you are struggling, your GP is your first port of call. But I don't really feel like going back because it seems as if I am going for a check up, and he just notes that I have attended and that I'm still alive. It's a horrible feeling when you feel so scared about how bad you feel, and it's like he's not listening😢 I might as well order my meds on line🤦🏾‍♀️ and whatever.....

[Hidden in reply to DSTJ]

Sorry if I missed it but have you tried getting a second opinion from another doctor. I I think sometimes we are too quick to give our loyalties to a doctor that as you say is not listening. That doctor may not be the right one for you. It sounds very frustrating what you're going through. I have the same issue and have been on numerous medications for depression and I also have a genetic issue where my body metabolizes drugs differently than other people. So it's very frustrating I start an SSRI and it tends to make me feel on edge anxious then I can't sleep and as you say it just perpetuates from there it gets worse the lack of sleep makes things even worse. So these drugs do not help me and it's been hard trying to find one that does I'm still on a path to try and figure something out. I found a doctor that is not in my insurance but have a friend who said he did wonders for his mother and he seems to get good reviews online. So I'm going to try him out even though it may be a bit pricey. You are your own best advocate so you have to speak up for yourself and be pushy if you have to it is your body and your mind and whatever you have to do to get things right and be heard. If that doctor will not listen to you and not hear you you may want to think about trying somebody else. I know that feeling that you're speaking of this feeling of Doom like something's going to happen something awful. It's a horrible feeling and I almost feel better off of drugs right now I'm trying to use acupuncture to get me through and trying to adjust my sleep but it's hard.

And I I'm fine right now but I tend to have dips down and that's not pleasant so I really need to find a medication that works and I hope you can find one that works for you! As the other reply noted there are so many drugs out there and it is a very individual thing. Everyone responds differently to different drugs and there may be different side effects for different people. I really hope everything works out for you!❤

[DSTJ in reply to Hidden]

Lasouris,

Many thanks for your response and advice. I live in England, and am blessed that I don't have to pay for my medications because I am registered disabled. Our National Health Service does not charge for certain medical services/treatments. I may discuss this with my Psychotherapist when I go for my session at the hospital this week. I am.a bit reluctant to change doctors because of all my physical conditions. My Doctor's practice has 4 doctors. But I had a bad experience with one of them when they accidentally prescribed me the wrong medication (an anti psychotic!) which had a similar name to one of my other medications. Fortunately before just before I swallowed it, I noticed the colour change. I rang for emergency advice. It turns out there could have been serious reactions if I had mixed it with my other meds. So the practice insisted that I only be seen by the senior doctor. It just seems as if there is inexperience when it comes to Mental Health. I will let tou know how I get on when I go to the hospital this week. I have been told that it may take time to work, but I think one of my issues is the overlap between the two has made my depression, self harm and suicidal thoughts worse😢

[Hidden in reply to DSTJ]

I hope things went well at the hospital!

[DSTJ in reply to Hidden]

I had my therapy appointment. But I felt like running out of the room. I felt like my chest was getting tighter and tighter!😢

I am trying hard to pick myself up, but feel like I'm getting worse. A big childhood secret came out in my session which were very painful. So much to deal with...I'm struggling to keep going

[Hidden in reply to DSTJ]

awww I'm sorry.

So this was therapy not for medicine? Do whatever you can to comfort yourself I'm so sorry you're going through this. Take a warm bath maybe some Epsom salts or something calming the help you some nice chamomile tea or I'll tell you what works for me is ashwagandha tea. Do you have access to someone who does acupuncture? That helps me immensely with anxiety I can't even tell you how much it helps.

[DSTJ in reply to Hidden]

I appreciate your advice and suggestions. I will try them. At one point, I was filling up my pill box, and there they were...all laid out in front of me. I just wanted the pain to stop😢I picked them up and my mind started racing and I was crying. It felt like I was there for hours but it was minutes. I grabbed my phone and started playing music to block out the thoughts. I'm seeing my GP on Monday as I don't feel good😢😢😢😢