Effects of increasing Mirtazapine dose? - Mental Health Sup...

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Effects of increasing Mirtazapine dose?

Knittedbunny profile image

I started on 15mg mirtazapine for depressive symptoms (of complex ptsd) just over a week ago, and I've been so anxious, to the point where I'm almost constantly dissociated, and instead of 4-6 hours of restful sleep, I now get closer to 8 hours but I wake up anxious several times in the night. However, I have been more functional since starting (possibly because of the mirtazapine and possibly because of the structure of being back at uni). It's hard to know how much of this is because of the mirtazapine because I started taking it around the start of the new semester, but I'm pretty confident that it's made at least some contribution to the increased anxiety. I also had a mini breakdown yesterday because I'm still not functional enough to keep up with uni work, and the strength of my self harm urges and suicidal thoughts kind of scared me, even though I get them quite frequently.

I was prescribed 2 weeks of 15mg then 2 weeks of 30mg then 2 weeks 45mg. I understand 15mg is kind of a borderline dose between sleep aid and antidepressant effects, so I don't want to give up too soon, but I'm concerned increasing to 30mg is just going to make me more anxious.

Has anyone had issues on 15mg but found 30mg beneficial?

5 Replies

Follow your Doctors advice it take up to five weeks to become used to the drug and get some form of relief, your Doctor has been increasing dose over an extended period, we do not know what your Doctor is thinking or trying to achieve so hopefully you will soon feel much better,

Remember your Doctor is in Partnership with you regarding conditions and medications, Trust your Doctor and Health Professionals They have your interests and Health at Heart


I'm not going to change anything without speaking to my doctor, I just wanted an idea of whether I should consider making an appointment to talk about the effects it's having. 5 weeks is a very odd/specific time frame for you to choose, and also you should be wary of telling people to continue for x amount of time no matter what because for some people that will be dangerous.

It's true that my doctor prescribed an increasing dose over a period of time (although I wouldn't say an extended one, I'm going up pretty quickly) he wrote it all as one prescription, without knowing how it's working for me, because there simply isn't enough availability for me to see him within 2 weeks of my last appointment to check before increasing the dose. Hence I was hoping to hear other people's experiences before I try to see him again so soon.

Whilst I'd like to say I agree with you that doctors work in partnership with patients and have our best interests at heart, sadly with the current strain on the healthcare system they're more concerned with getting you able to be discharged than helping you fully recover, or I would've been given access to therapy (the recommended treatment for cptsd, since medication will never cure it) months ago instead of being told they won't refer me because there's a waiting list.

You were given what most patients have worked out for themselves. I have been on my medication for over thirty years and now will be on them till My Death. I am sorry you feel my suggestions would not work for you given that anything I suggest always bows to your Doctor, He knows you and your condition. I am only given the bare bones of you condition however medications and treatments are not infinite in number

It is always a good idea that you understand you own needs and expectations especially at this time where Covid is affecting many patients with deep worries and concerns. I know by experience how difficult it is to get Doctors appointments and treatment plans. So I wish you well this site gives support and an understanding, Given that only your Doctor can advise. None of those on site are professional, if you looking for that you will not find that here, it is support and recommendations people have learned over an extended period


Missy_D profile image
Missy_D in reply to Knittedbunny

If your going to post on here and then be rude and accuse people of misinformation when someone bothers to take the time to reply then perhaps this isn't the site for you. All Bob did was point out exactly what everyone else will and that is it will take a number of weeks for the medication to start working. Around 4 to 6 weeks is considered normal. Bob did not say or recommend that you carry on taking a new medication without talking to your GP or Mental Health Team. If you think the side effects are down to the medications then you really shouldn't be wasting time posting on a forum which has no medical professionals and should be trying to get at least a telephone consultation with your GP.Have you read the PILS leaflet? I fairly sure that it will tell you that there is always the possibility that you will feel worse before you feel better and should you have thoughts of self harm or suicide then you should seek professional help immediately.

I am on Mirtazapine but I am not prepared to give you my opinion as I fear you will either make wild accusations or throw it back in my face.

Knittedbunny profile image
Knittedbunny in reply to Missy_D

I honestly wasn't trying to be rude, maybe it came across that way because tone is difficult to identify in writing, and I'm genuinely sorry that it came across that way.

I thought in my initial post I was fairly clear that I was hoping for others to share their experiences, but evidently that wanls not the case.

I think I should have been clearer that I am working with my doctor as much as possible on this, but it's difficult to get an appointment.

Before I take up more of his time I was hoping to gain some insight into how increasing the dose affected other people, information not in the leaflet PILS leaflet, which I have read, but I'm not going to see a doctor because I want to self harm after starting a new medication when I've wanted to self harm every day for as long as I can remember. This was never meant to replace the advice of a medical professional and I never asked for professional advice. I just asked to hear people's experiences, but I now regret that

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