Is Remeron really anxiolytic?

[BouncingMind]

I am curious about using remeron for refractory anxiety. The problem is that i'm not sure if it really does reduce anxiety or if it just makes you so so sedated that its hard to feel anxious.

see ssris pooped out for me a long time ago. i feel like i still need to tweak my serotonin system and i like how remeron is "supposedly" a 5ht2 antagonist. anyway it sounds like for most of the negative reviews no one stuck on it long enough just because they hated sedation

[tryp]

I was on Remeron for about a year and I found that it really did help with my anxiety, and not because it made me so tired I didn't care. I felt a lot calmer while I was taking it and I had a great deal less in the way of social anxiety, especially. I would have stayed on it except that it crapped out in terms of depression and since anxiety isn't really my most major concern, I moved on.

[The Emperor]

If I remember correctly, I was okay anxiety-wise on the Remeron, but unfortunately it also made me an irritable bitch so I had to stop it. I wasn't even tired on it. I mean, sure it knocked me out at night, but I wasn't sedated at all the next day. I was actually getting by on LESS sleep on Remeron. YMMV, of course.

[hallowedink]

I know people who have used mirtazipine for anxiety. Personally, I found that it had a completely opposite effect: it made me a lot more anxious and prone to panic attacks. Then again, it also didn't sedate me at all. Obviously, that doesn't mean that that's how it will work for you, though!

[Seniortooold]

Worked great for me for anxiety! However, the sedation and weight gain were too much. I also wondered if the reason it helped my anxiety and depression was that it gave a good 8-9 hours sleep which made it easier for me to cope with difficult situations.

[chimpmaster]

Remeron has been good to me so far. Ive only been on it for around 3 weeks. I have also just come off prozac, which I was on for several years.

For me, the remeron is less sedating than the prozac was; I take it in the evening and it helps me sleep at night but I feel alert during the day> A good compromise I guess - for me at least.

I have nothing negative to say about it at this point.

[Closure]

Remeron (mirtazapine, I like non-proprietary names) has worked well for me as an anxiolytic. Before I went on it, I was getting really bad anxiety, but pretty quickly that (both related to my OCD and in general) did get taken down quite a few notches. It is still present to a degree, particularly when related to my OCD, but it is still much better than before, to an extent that this in itself has been reason to stay on the mirtazapine.

About sleepiness, in the several hours after I take mirtazapine, which only take at night, it does makes me more tired than before. However, after having settled being at a a given dose of mirtazapine this is so minor that I can essentially ignore it, and except when I just started on mirtazapine it has caused no tiredness at any other times of the day. The big effect in this department that it has had, much for the better, is that it has allowed me to actually sleep normally, whereas both my depressed moods and mixed moods that I have been getting make it very difficult for me to both get to sleep (or to feel like I should go to sleep) and get any reasonable quality of sleep (without waking up before I want to wake up). It does seem to sometimes extend the length of my sleep, and I am trying to see if I can avoid that by taking my mirtazapine well before I go to sleep, so I am at a lower blood level when I would want to wake up (i.e. more like the rest of the day).

The mirtazapine does increase my appetite a good bit, but for me personally this has not been a problem because my depressed moods would reduce my appetite to thoroughly unhealthy levels, at which I would sometimes have to actually forcefeed myself. For others this might be an issue, though.

As an antidepressant, though, mirtazapine is clearly not going to work for me. I am only at 15 mg right now, and it has had no real antidepressant effects at this dose. I did accidentally end up at a 30 mg dose one month, and it started to clearly destabilize my mood, with there being breakthroughs of mixed moods and restarting cycling, which made things worse in general, but as soon as I went back to my 15 mg dose I had been on before things started settling down, albeit without doing anything about my depression.

Even without being suitable as an antidepressant for me, the other effects have far outweighed switching off of being on a 15 mg dose of mirtazapine. My pdoc on a couple occasions mentioned possibly adding a benzodiazepine, which I shot down due to what I know about them (and especially their lack of suitability for long term treatment of anxiety), and this seems to be so much better than if I had chosen to take one of them.

[chimpmaster]

I think we are getting off topic a bit right now. Mirtazapine or remeron is an anti-depression medication - not a mood stabiliser.

It is definitely more attuned to anxiety than depression, though I have found it really good for depression also. Most anti-depressants are not effective for those with bipolar disorder.

[Closure]

I think we are getting off topic a bit right now. Mirtazapine or remeron is an anti-depression medication - not a mood stabiliser.

It is definitely more attuned to anxiety than depression, though I have found it really good for depression also. Most anti-depressants are not effective for those with bipolar disorder.

That I do know, and note that I was not speaking of mirtazapine as monotherapy. I was originally trying it because my mood stabilizers (lithium, and carbamazepine) had not been touching my depressed moods, which were getting quite severe at times and were clearly not slowly going away as they had with that combination in the past, and the usual bipolar depression option, lamotrigine, was clearly contraindicated (horrible, horrible mixed episode) for me, as were SSRIs (ultradian cycling at very low doses even when with lots and lots of mood stabilizer).