Posted by mtom on June 21, 2019, at 9:36:48
In reply to Re: Many comment Mirtazapine for sleep.But AD/anxiety?, posted by plenair on June 20, 2019, at 22:00:46
Hi Plenair,
I've had tinnitus problems with SSRI's also, specifically citalopram and escitalopram. Also sometime difficulty urinating, mostly in morning. But a ton of other side effects like anxiety, agitation-jitteriness (was worse with citalopram), and vivid dreams, even nightmares. A few years ago I tried very low dose Trazodone for middle of the night insomnia, and it caused even worse tinnitus (and other side effects) so had to stop that after a couple of months. My insomnia improved, but my depression & anxiety kept getting worse, so last year starting trying SSRI's as menntioned above.
I had already been gradually cutting back my escitalopram (Lexapro-Cipralex) to a very small dose with some tinnitus improvement, but the SSRI's helped very little with my depression and although side-effects lessened slightly on lower dose, they didn't completely go away. So 11 days ago my Doctor started me on very low dose Mirtazapine as an add-on initially, and may start cross-tapering to just Mirtazapine depending on how things go.
Because I'm so sensitive to Antidepressants side effects even at very low doses, my doctor started me on a 1/4 of a 15 mg Mirtazapine pill, i.e. 3.75 mg, and I'm still taking this 11 days later. The Pharmacy cut the pills for me (although the prescription specified "take 1/4 pill - I don't know if they would have done it otherwise). They're small, might be tricky to do yourself - you might discuss with your Doctor starting on 1/4 and have her ask the Pharmacy to do this? Upon starting Mirtazapine I reduced my Cipralex dose further. I think the tinnitus has improved a bit, but dreams have been increasing again, last night very vivid. My anxiety may be "slightly" improved, but it may be too soon to attribute this to the Mirtazapine, could be the lower dose of Cipralex that has helped this.
Mirtazapine is known to be very sedating, sometimes causing intense somnolence - and some say worse at lower doses (more of an antihistamine effect at lower doses). The first morning I felt some of this and a bit groggy through the morning, but that seems to have passed since. I think the very low dose I'm taking may not be enough to produce much of a somnolence effect, I'll see what happens as I titrate (increase) gradually.
For people like me who are very sensitive to AD side effects, I believe it might be worthwhile to start very low and increase gradually as tolerated. And stay in touch with your Doctor about Side Effects.
> I'm really interested in Mirtazipine as well. I have a filled prescription for it and have been debating taking it for my horrible anxiety and insomnia.
>
> SSRIs cause me a boat load of side-effects with the intolerable ones being louder tinnitus and difficulty urinating. I understand that Mirtazipine may not produce these effects.
>
> For people who split pills - I was under the impression that 7.5mg was the lowest dose, as it was half of the 15mg (smallest) pill. Is it safe to cut pills smaller than the half-pill score line? I would rather start Mirtazipine at a doseage lower than 7.5 mg.
>
> Thanks.
poster:mtom
thread:1104640
URL: http://www.dr-bob.org/babble/20190513/msgs/1104932.html