mirtazapine

[little_debs]

hey all,
I've been taking citalopram for the last 6 months or so but it stopped working so my doc has me changing to mirtazapine. At the minute I'm on 20mg citalopram until this coming Wednesday, and 15mg mirtazapine which I started last Wednesday.
At the minute I feel really doped up; I've been losing hours everyday in kind of a trance, I can't follow conversations, I'm forgetting everything and losing things.
Is this normal and if it is, how long will it take to settle?
In the past I have given up at this stage. I hate not feeling like myself but I have to push through it this time.
Thanks for your help

[Amanda_George]

I'm far from being a doc, but did s/he want you to slowly decrease your level of Citalopram when you started on the Mirtazapine or anything like that?   

[little_debs]

Yes I've reduced and overlapped the two as she told me to. I come off the citalopram completely this week.

[Amanda_George]

Okey dokes, I'm all out of ideas then... maybe go back to the doc who prescribed the changeover if you're still feeling grotty at the end of the week?  I'm just thinking it might be side effects or something?   

[Sweetpea]

If you are still concerned then you should contact your Dr and tell him/her how you are feeling. They may be able to give you something to help during the changeover.

[SteveW]

Feeling completely out of it on Mirtazepine as you describe is very very common. Of all the 30 anti-depressants I think Mirtazepine is easily the most sedative. It also behaves in a very odd way. With most sedative drugs the more you take the more out of it and sleepy you get. Not so Mirtazepine. If you take 30 mg you should feel less sleepy than on 15 mg.  It is at its  most sedative at 7.5 mg which isn't an anti depressant dose.

As with all anti-depressants side effects of Mirtazepine do tend to wane over a period of a few weeks. 3-4 weeks and things should be moderating. There is a second side effect that you should be aware of. A number of anti-depressants cause weight gain but once again Mirtazepine is the number one. People who take it for a year have been known to gain up to 17 kilograms. I would suggest that you should weigh yourself now and every month or so. Putting on weight with Mirtazepine is really easy, getting it off again is not so easy.

I wouldn't suggest going back to your doctor yet. A month on Mirtazepine is a fair trial. Of course if you were to find yourself so wiped  out that you couldn't function at all  you would have to go back.  Good luck.

Love

Steve

[SteveW]

There isn't really much a doctor could give you. I don't think you have a change over problem, more a classic Mirtazepine problem. Stimulant drugs might assist but no GP is going to give you Dexedrine or Ritalin. I wouldn't even waste my
time asking.

[rjs]

Hi Debbie

I found citalopram to be quite effective for a while, but as you've found, the effects can wear off. I found mirtazapine to be really good at making my depression go away, but it does come with a sedative effect (the opposite of citalopram) and as Steve has said, there's the possibility of weight gain. I gained a fair bit of weight on mirt. which I'm still struggling to shift. Coming from citalopram to mirtazapine, from  a stimulant to a sedative might take a bit of getting used to, but persevere, it might be very effective for you. I found that the mirt. helped me sleep where I wasn't before and gave me a more positive mindset. I found that I couldn't get going though so whilst the mind was willing, the body wasn't. (I used to do triathlon, but haven't swam, run or cycled in a number of years because of depression). Hopefully, mirtazapine will work for you too. Give it a go, the side effects should dissipate over time and if your dose is increased as you come off citalopram, you should find the sedative effect is reduced too. If you're still feeling out of it after a month or so talk to your GP/psych again and see if they can offer any alternatives.

[Sweetpea]

I also found that Citalopram stopped working for me after a time. I was then put on Duloxetine and have found this to be very good for me.

Normally your Dr would want to see you regularly, to check on how you are doing.  I still say that if you are concerned have a talk with your dr.