Can't think of the correct word that i wanted to use but basically what i'm trying to say is can you become immune to the sedating effect of mirtazapine? Been taking it for nearly six weeks now and it has been great for my sleep, (helping me to fall asleep quickly), but lately i have been having difficulty falling to sleep again, i have found a few times that i feel wide awake late at night making it difficult to fall asleep. So wondering if a person gets used to the sedating effect of mirtazapine? I have previously suffered severe insomnia from depression and anxiety and i dread to think that it is coming back.
Hi itssofluffy, absolutely yes tolerance to any drug can develop.
Mirtazapine exerts it's (slight sedation in my opinion) via its antihistaminergic and serotonergic properties.
In my experience, Mirtazapine barely had any sedating effect compared to my primary antidepressant
Amitriptyline. Remember though everyone has physiological and psychological differences which in turn
means you should never take generalisations about any drug you are prescribed. Under a doctors
supervision it is generally trial and error until you find a breakthrough and combination which gives you relief of your symptoms whatever they may be.
I suffered terribly with insomnia due to having severe ulcerative colitis. This caused anxiety and mood problems. It was my Gastroenterologist that introduced me to Amitriptyline. In my opinion the best antidepressant and sleep aid available today. Maybe discuss with your doctor if your issues can be addressed with the minimal amount of meds.
May I ask what Mirt was prescribed for initially, also are you taking anything along side it?
Hi, yes i am taking mirtazapine for depression and anxiety. No other medicines just 30mg mirtazapine. Did try citalopram for 8weeks before doctor changed me to mirtazapine because citalooram wasn't improving anything and dr thought mirtazapine would help my sleep. Didn't sleep for 3 days at one point whilst taking citalopram.
How long have you been on the Mirtazapine if you don't mind me asking?
I have stopped my own Mirtazapine with no ill effects at all, in fact I feel better without it. My Mum uses Citalopram with great results. However that is generally a gp's first line of treatment. My current meds I have listed below, any questions don't hesitate to ask. I was where you are once and you will find a solution don't worry.
Current Meds: Amitriptyline 150mg
Buspirone 60mg
Pregabalin 400mg
Discontinued Meds: Mirtazapine 30mg
Propanolol 80mg SR
I have been on 15 mg Mirtazipine for over 12 months and with 60 mg of Duloxetine I am doing very well. Came off all benzodiazepines, thank goodness. I sleep reasonably well, better in fact, than I have in years.
I am in Australia, new to this forum.
I have been on mirtazapine now for two years. For me, it has been a godsend. It has stopped my frequent migraines, my constant skin hypersensitivity, and my insomnia. The initial heavy sedating effect of the drug wore off after a couple of weeks, but it has left me with a natural sleep better than I have had in twenty years. It helped me come off temazepam and reduce my alcohol consumption. However, I would say that it is no help if you cannot sleep through severe anxiety caused by noise. I am a very light sleeper and I remain so on mirtazapine. I will wake if a pin drops and this has not changed one bit since taking it.
Been taking mirtazapine for nearly six weeks now. I have been overall pretty happy with how it has been working for me, I much prefer it to citalopram which I tried first. The best part has been that I have been able to sleep, but been having a little difficulty again on a few days lately, it's not anything near how bad it was though, I do want to try and stick with mirtazapine.
Hi elizabeth, Australia nice 
. Glad to hear it's working out for you.
Hi evergreen, yeah I have always been a difficult sleeper, can remember struggling with sleep since my mid-teens, often getting up in the middle of the night, but it wasn't a severe problem. Only had severe difficulties from suffering with depression and anxiety. Overall Mirtazapine has helped my sleep immensely, maybe these current difficulties are just me going back to my usual way.
Hey good afternoon everyone, great to hear such positively.... I was on mirt 30 for three years and got through a nursing degree with distinction and I was clinically depressed with bad anxiety and recovered... came off my med with no prob at all and gt a great 6 years well ... unfortunately have become unwell again since Nov... back on my med 30 mirt and doing good... sleeping well after surviving on only an .hr at at a time and eating again and anxiety virtually gone.. this med has done wonders for me ... nice talking to u all ... .kp the positively going... remember it's good to talk
To itssofluffy : 6 weeks is certainly long enough to achieve a clinical response for what the Mirtazapine was designed for. If it works it works and you should be thankful your chemistry accepts this med. Mirtazapine is a NASSA - Noradrenergic and specific Serotenergic Antidepressant. This means it acts slightly differently to an SNRI where they just inhibit the reputake if the neurotransmitters it targets, Mirtazapine actually encourages more production. It's specifically targets the blockade of certain 5ht receptors via an antagonistic/Inverse agonistic method. In my experience I am not sure of its efficiency alone as I was ready going full steam ahead on Amitriptyline which as mentioned earlier has been a live saver to me.
I found my vicious circle started when I became sleep deprived through having uc which I mentioned earlier. I had social anxiety before which was magnified with getting little sleep and then General anxiety on top sent me into depression and the circle continued, no sleep more anxious, worrying about no sleep even more anxious and so on.
Anything you need to know Donny hesitate to ask.
Kind regards,
Stuart.
Thanks stuart. Yeah it does get like a vicious circle..... with me it started as depression, led to anxiety, led to insomnia, and insomnia just makes everything a whole lot worse! Have been doing ok generally lately, I do think mirtazapine has started to have a good effect on me. I feel much more relaxed and laid back about stuff now, things that used to bother me just go straight over my head.
That's great, the sooner you find an antidepressant that works the better as the more you try the less possibility of complete remission of symptoms. You have probably built a tolerance rather than immunity as if you stopped for a while it is likely to have the same effect it did at first. Regarding the insomnia the Amitriptyline for me is the best thing on the market. I also find the Pregabalin has a great effect on both anxiety and my sleep architecture. If you read up on it, it is clinically proven to help you achieve sleep 3 and 4 (deep restorative sleep)
Maybe have a chat to your Doctor. I see no reason why you cannot augment with something for your sleep problems.
Stu.
Yes a tolerance, that was the word I was looking for. Yeah I'm due to go back to the doctors in a couple of weeks, so will mention it if my sleep problems continue. It has only been on a few days, I am just worried about falling back to how it used to be, hopefully that won't happen!
We all dread going back to square one don't worry. Also something I have learnt online is, the successful patients do not generally post as their lives have improved to a point they do not need to search forums etc. the people with no success or side effects moan like everybody will react like they have. I am sure you have come across a few lol.
One more thing is that the higher the dose of Mirt, the more stimulating it becomes. This is a novel action which is completely unique still to this day I think. Maybe Mianserin which is also in the same class may also do this. With that in mind maybe discuss with your prescriber about this. Please look for long term safe relief from insomnia and not quick fixes of z drugs or benzo's. Have you ever tried melatonin?
Yeah I do know what you mean lol. Yeah I heard that about mirtazapine. I was prescribed zopicline for just 7 days back in november when I started taking citalopram, but there's no point in it for insomnia because it just meant that I slept well for a week but then went back to the beginning again when finishing the course. No I haven't ever heard about trying melatonin.
Exactly yes, that isn't a solution it just adds to the problem long term. Melatonin is the hormone that controls your body's sleep cycle. It is converted from Serotonin late in the day when serotonin release is increased.
I am not sure if you are in The Uk or not but I believe here you can buy it in health food stores.
Stuarto are you a doctor? You seem very knowledgeable on this topic.
Yeah I'm in the UK, I might have a look into it, just been reading about melatonin, I find it all quite interesting.
Hi Jacqueline, a pharmacology student so not quite yet lol.
Melatonin does work for some but not for others of course.
It is worth a try and is relatively cheap, if your insomnia is chronic and debilitating I would discuss with your doctor options open to you. In my opinion he will feel that the Mirt is taking care of your primary reason for taking it, and should be open to letting you augment with a non habit forming sleep aid. Most of the tca's have a aesedating effect, the only slight risk your doctor may hesitate on would be the slight risk of developing serotonin syndrome (very very rare) and is usual from an SSRI not a tetracycline you are on or a trycyclic like myself.
I have been on Amitriptyline for a year now and I still get good results from 100mg at night. I started on 50mg. The Lyrica (Pregabalin) I find stops that racing mind and oh my God I can't sleep again, it steady's you for the Amitriptyline to come along and sweep you off to sleep lol.
Hope this helps anything else do not hesitate to ask.
Stu.
Thanku stu ... I think u may b rite in questioning mirtazapines ability to work on its on... whilst I was on mirt 30 many years ago my gp also introduced escitalopram as well and I totally recovered on this combination... I am presently on mirt 30 and this time hope it may b enough but may have to have the e escitalopram as well... so far so good ....
Only had a quick read about melatonin so I'm not an expert, it seems like it's not usually recommended to treat insomnia in people under the age of 55 and shouldn't be used long-term, so doesn't sound as though it will be suitable for me. I have slept better again the last few nights, think maybe I must have just had something on my mind on the few troublesome nights that I had.
Stu, is amitriptyline taken to treat insomnia?