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Re: Depression anger and ADs (Mirt and Esc)

Posted by Mtom on August 18, 2020, at 10:10:09

In reply to Re: Depression anger and ADs (Mirt and Esc), posted by creepy on August 18, 2020, at 3:01:14

> sounds a lot like me except that max dose of escitalopram actually killed the usual SSRI anger 100% it was great, except for the apathy.
> citalopram made me very very irritable. fluoxetine as well.
> sertraline was pretty good. vortioxetine causes irritability and apathy its very strong in that regard Im taking the smallest amount possible to stave off depression and keep the apathy from getting too bad.
> Ive never found a fix for the irritability but I bet it has something to do with getting away from SSRIs which I am trying to do.

I was already getting increasingly irritable as my depression worsened, before starting ADs. At some point on ADs the temper flares stopped and much less easily irritated. Im sure this was after I added Mirtazapine and at the same time lowered my Escitalopram dose. Escitalopram on its own made my anxiety bad and other side effects, adding Mirt helped anxiety and also helped depression and motivation, something Esc never really did much. But the improvement was inconsistent, still ups and downs and could still feel Esc side effects, even on low dose. I felt the Escitalopram could be intefering with the positive effects of the Mirtazapine.

I was still taking fairly low doses of Mirt when I tapered and stopped Esc and irritation with temper flares returned. Depression worsened, so did ruminating which had stopped when I added Mirt (Esc on its own had not helped with ruminating or much with depression adding Mirt helped both to a noticeable although inconsistent degree).

BUT, I had also reduced my Mirt dose while tapering Esc (reasons too long and complicated to explain).

I think I maybe went too low on Mirt, especially as I was also stopping Esc. Dont want to go back on Esc because I felt out of it a lot when on it, anxious, demotivated, brain fog and other things.

Talked with my Doc and am now increasing Mirt dose. I actually never quite got up to the usual starting dose really sensitive to all ADs so always start low and go slow. But think I need to get Mirt dose up to therapeutic level now that Ive stopped Esc. And it's still possible my recent issues have been withdrawal effects as I tapered then stopped Esc and decreased Mirt around same time.

You liked sertraline but I tried long ago, was awful, over the top anxiety and agitation. Were all so different. Tried Citalopram before Escitalopram, also intense agitation, anxiety, jitteryiness. Esc had slightly less intense adverse effects but still not good, just cant seem to tolerate SSRIs. Adding Mirt had improved things and Ill see how it goes with higher Mirt doses.




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