Mirtazapine Weirdness

[theshade89]

In response to a long standing problem with insomnia and a somewhat more recent problem with depression my pdoc decided that it might be worth giving an AD a shot in addition to the other meds I take for sleep (Lunesta and Seroquel IR). I've taken mirtazapine before, although this was strictly for insomnia and not necessarily in an attempt to help with depression. I fared well taking it previously, but had to stop because of a significant drop in white blood cell count (it was later determined by a hematologist that this was probably not medication related). A few months have passed and I've since resumed taking it as of about 2 weeks ago.

My sleep and (some) depressive symtoms seems to have improved appreciably, however I have found that it has caused some rather unfavorable changes to my personality and temperament. Since starting on the full dose (30mg) prescribed by my doc I have become extremely short-tempered and highly reactive to situations and people that have never bothered me in the past. I also am having difficulty enjoying doing anything or being around anyone, and my interest in sex has plummeted significantly. I'm to the point where I can't even see my significant other and feel like there is any love or connection there. If my fiancee so much as tries to be physically suggestive or close to me my first reaction is acting like it's just bothering me and I'd rather not "go there".

So my question is mostly in regards to seeing if anyone else has experienced something like this on mirt and if it ended up going away eventually. I am sort of stuck if this doesn't work for me cause Wellbutrin makes me even more agitated and made my anxiety spin out of control and the SSRI's have historically worsened my insomnia and made me so tired I needed to sleep 15 hours a day to function at all (not to mention pinning me down with every possible sexual side effect possible). I've tried Elavil (insomnia, bad SSEs) and trazodone (so so, but very little AD effect and too stimulating for sleep at higher doses); my pdoc is concerned with trying some of the other TCAs (pro/nortryptiline) due to their cardiac side effects when taken with Seroquel.

Any comments, suggestions, or thoughts on the topic would be highly appreciated. I've brought this all up with my pdoc, I just want some additional opinions and possibly insight into other people's experiences and if there is perhaps a medication route that I've missed along the way.

Thanks in advance

[Moody]

Have you tried remeron at a lower dose, like 15mg? It will still help with sleep, and might still help with depression. I was on remeron for a long time, and I could never take more than 15mg. I was happy and relaxed on 15mg, when I went any higher I would get really agitated.

[The Emperor]

Hi! I was on Remeron for a few months and it REALLY helped the depression. I was on 15mg and it knocked me out like nothing else ever has, even RX sleep meds, so it did really well with that. And I was happy as a clam! I was running everyday and the weird thing was that even though it knocked me out, I'd feel well-rested after just five hours of sleep. Weird. but that has nothing to do with this.

YES. It made me VERY irritable. I hated that. Because it worked so well for the depression and sleep, I wanted to stay on it, but I just couldn't because I was such a raging BITCH that my family couldn't stand me. Even my benzos didn't help this. So yeah, I've experienced the irritability on it, definitely-it's the reason I came off of it. I really thought that sucked.

I don't recall it having any effect on my sex drive, but then I'm one of the lucky few that really don't get sexual side effects.

[theshade89]

Have you tried remeron at a lower dose, like 15mg? It will still help with sleep, and might still help with depression. I was on remeron for a long time, and I could never take more than 15mg. I was happy and relaxed on 15mg, when I went any higher I would get really agitated.

Yeah I actually did start it at 15mg; it did help with sleep but unfortunately didn't have much of an antidepressant effect (I just noticed that it made me exceptionally tired/fatigued most of the day). My energy levels have improved on 30mg and the depression is going away but the agitation is definitely a deal breaker. Think I'll give it a little more time before I make any changes but it might be worth dropping back down to 15 to see if there is any improvement if 30 doesn't work out.

[scatty]

I hope you and pdoc figure something out. I am on zoloft and remeron and pdoc raised my risperdal on Tuesday becasue I am in a mixed episode.

[theshade89]

Hi! I was on Remeron for a few months and it REALLY helped the depression. I was on 15mg and it knocked me out like nothing else ever has, even RX sleep meds, so it did really well with that. And I was happy as a clam! I was running everyday and the weird thing was that even though it knocked me out, I'd feel well-rested after just five hours of sleep. Weird. but that has nothing to do with this.

YES. It made me VERY irritable. I hated that. Because it worked so well for the depression and sleep, I wanted to stay on it, but I just couldn't because I was such a raging BITCH that my family couldn't stand me. Even my benzos didn't help this. So yeah, I've experienced the irritability on it, definitely-it's the reason I came off of it. I really thought that sucked.

I don't recall it having any effect on my sex drive, but then I'm one of the lucky few that really don't get sexual side effects.

It's interesting that you note it knocked you out but you felt rested after just 5 or so hours of sleep--my experience this time around has been exactly in line with that although I typically try to sleep longer anyways because I pay for it if I only sleep that much later on in my day.

Much like yourself I do like the antidepressant and sleep enhancing effect of the med but it's hard to try and balance doing well in those areas with being totally depersonalized and weird toward people that only want what's best for you and don't even do anything that would normally irritate or annoy you. Interestingly my brother also takes this med at 45mg for sleep (maybe depression, I don't know about that part) and he is constantly in a highly irritable state so it may stand to reason that I may not be genetically predisposed to respond well to this AD.

Think I'll give it a little more time to see if this particular side effect calms down, but if not I will probably have to axe it and look another direction.

[theshade89]

I hope you and pdoc figure something out. I am on zoloft and remeron and pdoc raised my risperdal on Tuesday becasue I am in a mixed episode.

Thank you for the support . This drug thing is definitely a work in progress, trying to find the right balance of everything can be a nightmare sometimes.