Citalopram To Mirtazapine

Treatment and medication
1

I wonder if anyone could relate to my experience coming off 40mg Citalopram a night for about 5 years and switching straight to 30mg Mirtazapine a night?

Citalopram worked well for me for many years treating my depression and anxiety and virually elimintaing the almost regular nightmares I suffered from. It weaken my eyesight slightly and totally killed my sex drive but I felt they were side effects worth putting up with to feel better generally. Suddenly this year though it seemed to stop working as far as controlling my anxiety and helping me to sleep goes. I started to get palpitations, chest pain (I even got referred for an ECG as they were so bad but that was clear), anxiety and couldn't sleep (where I was at before starting to take Citalopram) without the aid of Zopiclone (which was a vicious circle as although it knocked me out well it made me feel depressed the next day) My doctor switched me to Mirtazapine 30mg a night. As soon as I switched I felt quite heavily sedated mostly all the time and when I take them of an evening they very quickly knock me out but as soon as I fall asleep the vivid, nasty nightmares start and just seem to go on and on until I have to get up the next morning. Some mornings I feel almost drunk and worry people might think I've been drinking hearing my slurred speach. On the positive side they have got my depression and anxiety under control very well but on the negative side I feel heavily sedaated all the time, have constant vivid, nasty nightmares all night every night and have no sex drive at all. Is this something that will get better with time? The things that worry me most are the constant feeling of heavy sedation and constant vivid, nasty nightmares. I feel like I'm in a catch 22 sitaution as if I stop taking them the anxiety and insommia will return but if I carry on taking them will these negative side effects persist?

2

Hi c2m,

I came off the same dose of citalapron and moved to 30mg of Avanza. I weaned off the first drug far too fast (over three days) and so was coping with withdrawal effects as well as side effects from the new med. I am now into week three of the new treatment and am now starting to feel much better. I now take Avanza at 6.00pm and am not drowsy the following day. If for some reason I need to take it later, I have difficulty the following day. The vivid dreams have also settled to some degree, certainly they are no longer of a nightmarish quality. I really struggled to persevere with this medication as there were days where I felt I was losing total control and was so irritable and explosive. However as the side effects are settling, I am feeling much more my self and able to function well. I have seen my GP up to three times in the one week in an attempt to manage this process, but it has been worthwhile.

3

This site seems to be working as a support group at the moment as there are several of us experiencing mirtazapine for the first time. The side effects are quite severe but mirtazapine is worth persevering with as the benefits are good. My psychiatrist wants me to increase from 15mg to 30mg but I'll wait and see how I am over Christmas. The sedative effects have been quite significant for me.

4

Hi.

I've been on Citalopram for a couple of years and recently started taking Mirtazapine too.

I had all the usual side effects for about the first 8 weeks (fatigue/vivid dreams/eating like Pac-Man), but they gradually subsided to a manageable level. The dreams are fantastic now - very vivid, but never nightmareish- I look forward to sleeping now!

I think I got to the same point as the person above with Citalopram- I just felt it had served it's purpose and was no longer helping. It was a revelation when I first started it but the benefits gradually lessened- not knowing what was actually wrong with me had also made the prescription lottery more of a gamble. I also thought it was possibly responsible for the Akathisia I was experiencing- I think a lot of people would agree; the worst side-effect you can imagine!

I stopped my Citalopram 2 weeks ago when my prescription ran out. So far, I think it was a good decision- time will tell.

This may be useful to someone- when I started the Mirtazapine, I instantly became much less irritable and snappy. I became the sort of person I always felt was underneath but couldn't fight to the surface. I noticed that, after a few weeks, I was back to being really irritable again. That's when I thought maybe the Citalopram was having a negative effect. I'm now hoping that my irritability levels will decrease again- the 2 weeks where I was relaxed and able to talk without second-guessing myself and others was pure heaven!

Incidentally, my background to all this is catching Leptospirosis when a dog licked my face, causing renal and immune shut-down. The doctors told me I'd had pneumonia so I had recurring unexplained physical and mental symptoms for years- CFS/Major Depression/Anxiety/Akathisia and so many other things that no-one has managed to categorise me. The best guess seems to be some form of Post Traumatic Stress Disorder.

Unfortunately, the symptoms come and go in waves and change month to month, which is difficult to deal with- even feeling better gave me a sense of dread because I knew the next phase of pain was getting inevitable close.

I eventually found out i'd had Leptospirosis when a doctor mentioned it, inadvertantly. You can cope a lot better when things make some sort of sense!!

Anyway, Mirtazapine is definitely keeping me alive for now :-D

(Sorry for rambling- don't get to explain this very often)

Ian