Experiences on upping doze of mirtazapine

Hi. Can anyone tell me if upping doze of Mirtazapine causes more anxiety.  Went from 15mg to 19mg (1-15mg + 1/4 of 15mg) had more anxiety for 2 days.  Now from 19mg to 22.5 more anxiety.  Feel like going back to 19mg.  Doc says to keep upping to 30mg.  Help please.

I wonder whether your increased anxiety is caused by you worrying about what effects the increased dose will have. Personally I went from 15mg straight to 30mg with no problems, but it will be interesting to see if you hear from anyone who has found that mirtazapine causes anxiety itself.

it doesnt cause anxiety, it takes it away, its like a sedative, i take 15mg a night, and it keeps you calm, but of course it may be different for some people.

Sorry, Ruth, to butt in but I am interested in Pixie's reply. Pixie, what effect did upping the dose have (sleep pattern, weight gain etc.)?

I ask because I have been taking 7.5 or 15 mg and I do not like the fact that I need 12 hours sleep and get very hungry.   I wondered whether to up the dose as you did.  

Best wishes.     

Mirtazapine, like any AD, can cause anxiety when upping or dropping dosage. But Mirtazapine seems to be a little more gentle when it comes to that than SSRIs like Paxil.

You may experience a little more anxiety for a few days but it passes and then you get the benefits of a higher dose with less sedation. You just have to be patient and know that it usually does pass rather quickly.

Of course don't change your dosage without speaking to your doctor first, but yes, Mirtazpaine side effects, especially hunger and tiredness, lessen once you get to 30mg and at 45mg are dramatically reduced. I was too tired and hungry on anything up to and including 30mg. Once I went to 45mg I felt as close to normal as I've ever felt. 

Good luck!

Hi Ruth, I started on 30mg felt great for a month then bad anxiety again, dr suggested changing meds so reduced me to 15mg ready for a change over, suddenly I felt great again, no anxiety at all... Unfortunately now I'm falling flat again..anxiety, chest pains etc...I hope you get some answers x

When I went from 15mg to 30mg I felt really rough, depressed, anxious just not well and quite aggressive and started swearing at myself and the cats a lot which I know sounds funny.  When I said to psych, she came out with some feeble excuse and said she would be worried if I was swearing in public.  Anyway, I thought blow this, and I went back to 15mg and then cut back to 7.5mg.  Problem is as soon as I dont feel well for whatever reason it makes me nervous and then I cant tell if I have something physical like a bug or if it is anxiety.  If you were okay on 15mg, stick with that.  These doctors make me so annoyed, I dont suppose any of them actually investigate all the side effects etc.

I'm on 15 mg but having bad time at the moment with feeling anxious àlso pre menopause always tired cant sleeping at night feeling trapped and when I go out get awful feeling of not being normal don't know what to do for the best

Funny you say about aggression. I've been on 15mg for 7 weeks now, I tried going to 30mg as suggested by my doc but I got terrible insomnia and restless legs. The 15mg has helped me a lot with my anxiety and depression but I'm so angry and grumpy I don't know if I can stay on it. Have you been angry on all doses?

Ruth, if you feel 19mg is best for you, or even 15mg then maybe stick with it.  Are you taking Mirt for depression or insomnia/anxiety?  I've read of many saying 30mg brought on anxiety, but 15 mg too sedating, akthough the latter best for anxiety. BUT, if you are treating anxiety - once the sleep improves maybe 15 is enough?  

Steve, yes that angry feeling is common I think, also the RLS.  I think sugar plays a part with both ... I mean eating rubbish, chocolate/sweets/cakes etc - it seems to multiply my anger, and patience... ugh !

I have read on other posts here that it can cause aggression.  To be honest I am still irritable and impatient on 7.5mg but not as bad as before.

Upping to 30mg made me depressed and anxious and I started dwelling on my father's death.  I do actually feel anxious about all the long term side effects of this drug particularly the possibility of bone marrow depression when I already have severe osteoporosis.   I went from 8 stone 3 (which was too light for me really but wish I was back there) to 9 stone 12 and I hate it, despite dropping down to 7.5mg got a huge stomach  but the same scrawny old top half.  Apparently fat stomach is a well known side effect.  Obviously there must be some people who are not affected by that.  Glad to hear you are okay on it.

Well I was probably lucky. Increasing from 15 to 30mg mirtazapine reduced my anxiety levels and helped to lift my depression. Also I haven't gained any weight on it, over several years.

Hi Ruth. I've been on Mirtazapine for many years. I was started on them for insomnia, with Venlafaxine for anxiety and depression. Sadly my psychiatrist died and I was discharged from the psychiatric services to the care of my GP. When my depression reoccurred my Mirtazapine was gradually increased. It's taken me years to realise that the increases were making my anxiety worse. Added to that I've put on about 4 stones. I wish I'd known at the start where the Mirtazapine would take me. It's fine for insomnia at 15mg but think seriously about the consequences of increasing it for anxiety. Discuss it with your GP if you can. Good luck.

Hi again everyone and thanks for replies.   Went back down to 19mg was slightly improved.  Things today not good.  Could not sleep last night.  My anxiety was very bad before but seemed to be getting better.  I have propanol to take which lowers my anxiety.  Do you think I should try 22.5% for 4 days to see how it goes. Oops forgot to say had a half of lager yesterday which knocked me.  Could that have been the cause.  Any views on this

Hi pixie22, I have now had to completely stop mirtazapine as it increased my anxiety to an unbearable level.

Hi Caroline, it's such a nuisance that we don't know how we will fare with these drugs until we try them. There's too much trial and error involved in finding the best one, because we're all different. I hope you find what you need. Pixie.

Hi Caroline

Ive read your 3 posts on this page; you know what I'm reading is at 

30mg Mirt increased your anxiety (many folk have said 30mg does this)

so then the doc said to go to 15mg & you felt fine ... initially ...

then suddenly your anxiety increases again, along with chest pains - 

the latter (50% reduction - a massive 50% drop) in mho, is too quick a drop (from 30 to 15) - most doctors don't realise you cant do this with Mirt  (or any AD's) it causes a discontinuation syndrome which is the wobble you have now.

So you have now STOPPED at 15mg ... no taper, just off ... I don't want to frighten you, but I think your doc is playing Russain roulette with your AD's, docs' just add another if one doesn't suit without tapering slow advice.  

Anyway, all is not lost, has your doctor prescribed another AD?  Do you still have some Mirt?  Don't flush them away, hang on to them just in case.  

Hi Caroline. After quitting mirtazaphine, did you have to go on anything else?