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Any success with lithium+mirtazipine?

Posted by silkworm on December 5, 2006, at 1:52:27

Hi all,

This may have already been discussed somewhere in the archives, sorry if it's a repeat. Just can't find the motivation to go looking.

I'm taking 60 mg mirtazipine at night and 250 mg lithium (not slow release) twice daily. Initially this combo went well, but have recently crashed following major stressor. It's been several weeks and despite me eating well, getting plenty of sleep, going to the gym, etc, I'm still not bouncing back. Very flat, numb, couldn't care less about anything.

So, my question is this: is 500 mg a subclinical dose for lithium? Even though it was prescribed for treatment resistant depression (not bipolar), should I be on a higher dose? I've been seeing a public mental health service pdoc (Aust.), but that is easing back now. The services are really only appropriate for the critically ill, and I'm no longer that unwell. Last time I spoke to the pdoc registrar, she was reluctant to increase lithium. I plan to get a referral to a private pdoc soon, but in the meantime be good to hear any ideas about theraputic dose or personal experiences with lithium. The good, the bad and the ugly..can't be any worse than how I'm feeling atm,

Thanks,
Sw

PS./ She may have been reluctant to increase lithium because of ongoing S/E which are only now easing (6 months later). Those being diarrhoea+++++ and sedation. I'm really not sure how much of the spacy feeling is depression and how much is sedation. Mirtazipine also knocks me out at night, have no trouble sleeping.


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poster:silkworm thread:710484
URL: http://www.dr-bob.org/babble/20061129/msgs/710484.html