Psycho-Babble Medication Thread 1108071

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

How to maneuver Mirtazapine?

Posted by Prefect on January 19, 2020, at 12:54:05

I've been on no meds for the last 2-3 months as I wasn't responding to any (anxiety, agitation, depression, etc) and currently reviewing options.

I began having severe insomnia over the last month, and after not sleeping for 4-5 days straight this past week I began having derealization, abnormal thoughts, etc, so severe that I went to psyche hospital emergency.

They put me on 15 mg Mirtazapine /night. Well it almost works too well. I love the sleep it gives me, but I can't get out of bed after 10 hours sleep. I could sleep for 20 hrs straight on this med. I took my third dose last night and it's 2 pm now, and I've had close to 15 cigarettes trying to increase alertness. I don't have caffeine due to anxiety it causes.

What strategies have you used to offset the severe next day grogginess? Do you augment it with something else? Should I just stick to the 15 mg dose until I adjust and hope next day grogginess may subside in the upcoming weeks? Should I up the dosage, but I don't want to because I'm taking this drug to help me sleep.

Any experiences, suggestions?

 

Re: How to maneuver Mirtazapine?

Posted by linkadge on January 19, 2020, at 13:03:39

In reply to How to maneuver Mirtazapine?, posted by Prefect on January 19, 2020, at 12:54:05

If you're taking it for depression, you might need 15mg. If you're taking it for sleep, then less is sometimes better i.e. 7.5mg or less.

Trying to offset the effect is tricky (from experience). It has a long half life and there really isn't a substance to directly counter histamine blockade.

You might find something like Provigil helps.

Another suggestion is to not take the med right at bedtime. Take it in the early evening (if possible) - say 6-7pm. It will then be out of your system a bit earlier.

Linkadge


 

Re: How to maneuver Mirtazapine?

Posted by undopaminergic on January 19, 2020, at 13:12:12

In reply to How to maneuver Mirtazapine?, posted by Prefect on January 19, 2020, at 12:54:05

>
> Any experiences, suggestions?

I tried mirtazapine myself, but it's not helpful to recount my experience here.

My suggestions are pretty basic. You can try adding a stimulant in the mornings, eg. methylphenidate (Ritalin), dextroamphetamine (Dexedrine), or modafinil (Provigil). You can try to lower the dose. You can switch to another drug, eg. cyproheptadine (Periactin) or quetiapine (Seroquel).

-undopaminergic

 

Re: How to maneuver Mirtazapine?

Posted by Lamdage22 on January 19, 2020, at 13:29:49

In reply to How to maneuver Mirtazapine?, posted by Prefect on January 19, 2020, at 12:54:05

I think you will get used to it

 

Re: How to maneuver Mirtazapine?

Posted by sigismund on January 19, 2020, at 13:36:36

In reply to Re: How to maneuver Mirtazapine?, posted by Lamdage22 on January 19, 2020, at 13:29:49

I have been told the next day grogginess passes in a couple of weeks.

I couldn't take it because of the next day thing, even though I loved the sleep

Trimipramine was good for sleep too and not so long acting.

 

Re: How to maneuver Mirtazapine? » Prefect

Posted by phidippus on January 19, 2020, at 14:17:11

In reply to How to maneuver Mirtazapine?, posted by Prefect on January 19, 2020, at 12:54:05

I found the groginess went away after a while. Higher doses caused less sedation. Don't give up on it just yet.

 

Re: How to maneuver Mirtazapine?

Posted by Christ_empowered on January 20, 2020, at 14:44:13

In reply to Re: How to maneuver Mirtazapine? » Prefect, posted by phidippus on January 19, 2020, at 14:17:11

going higher might be an option. in some countries, doctors use 60, i think even 90mgs/daily...

in the US, from what I understand, its used at lower doses, as a sedative and with other Rx drugs.

 

Re: How to maneuver Mirtazapine?

Posted by Lamdage22 on February 17, 2020, at 0:39:13

In reply to Re: How to maneuver Mirtazapine?, posted by Christ_empowered on January 20, 2020, at 14:44:13

Bupropione in the AM?

 

Re: How to maneuver Mirtazapine?

Posted by SLS on February 18, 2020, at 12:21:13

In reply to Re: How to maneuver Mirtazapine?, posted by Christ_empowered on January 20, 2020, at 14:44:13

Hi, C_E.

> going higher might be an option. in some countries, doctors use 60, i think even 90mgs/daily...
>
> in the US, from what I understand, its used at lower doses, as a sedative and with other Rx drugs.

From what I've seen, Remeron is woefully underutilized. The dosage range effective for treating depression is 45-90 mg/day. So, that means that doctors in the U.S. who stop at 30 mg/day have wasted their patient's time and possibly squandered a rare opportunity.


- Scott


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