I have started 15mg mirtazapine for depression and Insomnia about 4,5 weeks ago. Initially with 3,75 and then 7,5mg now on 15 for over 20 days. Before I had issues falling asleep (some nights now sleep at all) and waking up around 3 or 4am with no way getting back to sleep. Falling asleep has been improved since on this, but I am still not sleeping more than 4-5 hours. When is there a lift in depression, as I am thinking of asking my psychiatrist for help/ change in medication.
Initial side effects where dizziness and change in hunger. Slight increase in weight since taking.
Would it make sense to combine it with/ or change to Lexapro/ or Fluoxetine to ease the depression?
Never used AD before, treated issues with St. Johns in the past. Any suggestion would be helpful
4/5 weeks of mirtazapine 15mg still no big changes/ what to do?
Question posted by Anonymous on 27 Feb 2023
Last updated on 16 August 2023 by OnAMission
Started also CBT a week ago, which I havent mentioned.
Answers
Hi Tisdart,
Has the increased dose been working you?
Hi, Tisdart!
This is my answer posted on your comment on grape's question:
"Talk to your doctor! It may be a matter of essence of time but if you've felt no improvement at all it might be time for a dosage increase.
What dose are you taking? 15mg is the initial dose and the low end of the maintenance dosage. The maximum dose is 45mg/day.
Wildcat"
Hello Wildcat,
thanks for the fast response, I am talking to the doc in a few days and will see what his opinion is, but we have had discussed a second medicine previously (liek adding Lexapro/Fluoxetine) in the morning, I guess its a matter of patience as well, as I seem to have had some slight improvements in mood and been more sociable. I am just surprised that I haven't had bigger changes with my sleep, because this was the reason we started on Mirtazapine and some people here have reported major sleep improvements, like 8-10 hours...
Going up to 30mg for the last three days, will see if there are any improvements. In regards to sleep I haven't noticed any real changes(still around 4-5 hours). Is there usually mood changes whilst upping the dose? I seem to me more anxious atm.
Changed to 30mg now and was wondering how long I should wait until I can really say that its not really the medication I need?
You should start getting better sleep rather quickly but overall it can take a few weeks to reach therapeutic levels. I wouldn't wait more than two weeks before getting advice from your doctor if you're not feeling improvements by then.
Mirtazapine works fast for most people as far as sleep goes. Hopefully this increase will help but if it doesn't you may be fairly resistant to this medication. Also, mirtazapine has a 6.6 rating out of 10 for anxiety by User Reviews.
Tbh, the sleep has not been better on the 30mg dose. I will give this med another week or so, as I am losing any hope in regards to it being the right medication.
It really sounds like it's not doing much good. Time to start thinking about options?
Good luck and I hope you get some relief soon.
Hello, how’s it been going on 30mg of mirtazapine? Thanks
Related topics
depression, insomnia, mirtazapine
Further information
- Mirtazapine uses and safety info
- Mirtazapine prescribing info & package insert (for Health Professionals)
- Side effects of Mirtazapine (detailed)
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