all new to me and confusing!-mirtazapine

[davefarmer]

hello all hope everyone is ok

 i could really do with some advice as im really rather new to this and i dont seam to be able to get the answers i need from my GP-that could be whole entire page full on its own!

 im 30yr old guy with condition called cystic fibrosis of late its been hard hard work keeping on top of it, which in its self brought me down bit plus one of the medications i had to take occasionally, for three or fours weeks maybe twice year would also make me feel very low and depressed but once i finished the course i would usually go back to normal.

 but my issue is this christmas time was very very low due to health being bad not responding to treatment and taking the antibiotic that made me feel depressed. so was perscribed 15mg mirtazapine which really helped took while to get used to but soon lifted my mood and sleep greatly improved my speach improved was far less irritable.
 but of late my mood had been fine but other symptoms seam to be coming back mainly taking ages to get to sleep at night and my speach being slurred feel quite sedate in my self to,
 GP said to up to 30mg which i did and just felt very zombiefied and seamed to stutter and slurr my words more over slept. so since gone back down to 15
 i do find that moderate amout alchol seams to put me right my speach goes back to normal and i feel more my self.
 i just dont know what to do with my self im usually quite good at working these things out,
 my biggest gripe is that no one in the health proffesion seams to have the time to give me advice or just sit and talk things through none of them inspire me with confidence that they know what there talking about
 so really wondering if any one has had similiar experience or can offer advice.
 ide like to try coming of the mirt but dont know how it would go

[Zaf]

Hi and welcome

I have no experience of that drug so cant advise you on it but mixing alcohol with depression is not a good idea in my experience.  Is it possible for you to see a different GP at your practice?

Z xxx

[davefarmer]

hay Zaf

 i dont drink on regular basis i know its not great to mix the two as is the same for all the antibiotic im on but way i look at it is you have to live your life so figure on occasion and nothin to excessive ought to be ok. on average i drink once a month if that.
 im looking into moving to different GP trouble is only one surgey in my town and all the other surgeries i live to far out of there catchment zone.
 all the times iv had contact with my local GP surgery iv seen different GP. asking to see the same doctor puts the reception staff into melt down either not possible or have to wait three weeks. i really hate my local surgey always had bad service from them.
 i was once perscribed a drug from my consultant at the hospital went in to have it put on my repeat prescription as it was long term thing but was told "im not putting that on there you can go buy it from holland and barrett"
 i find it very strange i get great service out of the NHS as regards looking after my cystic fibrosis the team at the hospital are great but this lot are something else!!

[Sweetpea]

This seems to be a common problem. I am very lucky with the surgery I am with thankgoodness. But I have had problems in the past. Its very frustrating when we don't get the help we need and deserve. S x x x x

[Zaf]

It doesnt sound the best service, it really does seem pot luck sometimes with the care and treatment we get

Being told to get something from Holland and Barratt might have been a kindness however as on more than one occasion my GP has recommended something from the local chemist thats cheaper than the (extortionate imo) prescription charge and does the same job.

Z xx

[davefarmer]

it is very frustrating the care you receive is based on your post code! but there thats the system just need to figure way round it!
 
 i have a prepayment certificate for my repeat as i do get though vast quantity of meds to keep my CF side of things right. i pay bit over £100 year which i dont mind as it entitles you to what ever and how ever much you need so no issue with cost if i need anything else. i should of asked why really but i just got the hump with this GP and went with it. told my CF team about it and they now supply me with the things my GP wont put on repeat.

[Got]

Hi mate,

Firstly, i have no experience with cystic fibrosis and I know little about it, so I have no advice on that front, but I do know about depression and medication for depressive illness. It does sound like you are suffering depressions whether they are caused by medication or not. Your physical health problems are certainly not helping you.

In my opinion it sounds like you should be on an anti depressant to help combat your low mood. It sounds very promising that you responded to mirtazapine but it is unfortunate that you are experiencing solmnolence. The only time I have heard of mirtazapine causing slurred speech was in a case of serotonin syndrome induced by the medication, but I am not a medical doctor. Do you know of any other reasons why you may be experiencing slurred speech?

In terms of solmnolence, mirtazapine is considered to have its greatest sedative effect at about 7.5 mg (if I remember correctly) so increasing the dose should not make you feel more sedated. However, I have heard of people complaining that increasing the dose made them feel tired all day and I had a similar experience myself (although I am not sure if it was caused by my depression). The fact that you are finding it difficult to sleep at night suggests that perhaps you are depressed, although you claim to not be experiencing low mood. Perhaps it may be caused by some of your other medications, I do not know.

Are there reasons other than unwanted side affects, that make you wan't to stop antidepressant medication? Would you consider taking another kind of anti depressant medication?

Best wishes,

Steve

[davefarmer]

hi steve

 i cant really think of any reason why my speach is the way it is. when i used to take meropenem which is the antibiotic that made me feel low my speach would play up then but return to normal once i was of it.
 this is why im little confused really starting of on the mirtazapine everything was improving but these past two three months i feel my mood has been ok but other symptoms have slipped though of late sleep been ok.
 i just feel bit nautral at the minute im not un happy but i dont feel particularly whoop whoop either!!
 i wouldnt object to being on other anti depressants, my only reason for thinking it could be time to stop the mirt was having my mood greatly improved with the other symptoms coming back bodys way of saying its had enough mirt and if coming of the mirt made me feel less sedated things would then pick up of there own accord be be back to "normal"
 thing is my knowldege of depression is very very limited and getting proffesional advice seams vary hard to come by, ile try my GP again this week see what they have to say. i have been in touch with organisation called well being service who offer councilling and advice had one half hour meeting with guy and hes was talking about guiding me though some self help techniques and cognitive behavioral therapy. see what comes of that,
 thanks for your advice steve much appreciated

[Catbrian]

Hi!  I’ve just read your posts since 20th July and can completely understand being frustrated with NHS services and GP.

In the last few weeks, I’ve been on Mirtazapine 30mg.  I specifically requested because of its renowned sleeping aid effect.  Unfortunately, it didn’t do that for me, but it seems to be going okay otherwise.  It just demonstrates that everyone reacts completely differently to AD’s.  As Stevie suggests, perhaps a trial of something else might help.  And I suppose you’re aware that you shouldn’t suddenly stop taking AD’s.  This could further exacerbate your depression.

Perhaps you could specifically go see your preferred GP.  If the Doc’s up to much they will understand your need for consistency rather than continually switching GP’s.

It sounds like you’re in a bit of a remote area, but I’m sure some sort of Counselling might help, if you can find it.  The Well Being Service sounds a good start.  Is there a NHS Community Mental Health Teams or Psychotherapy Dept you can tap into in or near your area?  Also, there is the organisation, MIND. 

If the services are slow or poor it can make you feel very alone, I remember it very well.  In the meantime, you’ve found this Forum; an anonymous space with understanding people.  Hope you find it as supportive as I do.

[movingtables]

hope you feel a bit better soon davethefarmer.
i've been on 15mg mirtazapine for a few months.
going to try and get it doubled this week.

hang in there buddy  $%$