Mirtazapine and feeling...empty (mixed with fluoxetine)

Treatment and medication
1

Hi, first time poster but I really wondered if someone could analyse this for me.

im taking fluoxetine and mirtazapine together. i took as a result of severe OCD plus insomnia and mild depression\anxiety. With the help of CBT i am extremely fortunate (and grateful) the OCD and insomnia are no longer issues and i hope never will be. the mood side of things though remains.

as a result of this, i was given mirtazapine (first 15mg, now 30mg) and i just don't know if it's doing anything. I feel flat 99% of the time. i don't enjoy things i used to enjoy. simple pleasures such as watching a film, seeing friends etc, don't hold appeal to me like they used to. i feel neither highs nor serious lows (of course no-one wants the latter, but in this respect i feel like i 'can't' become emotional) i was told a potential side effect of mirtazapine is the fact it can infact make you feel 'numb' and this is what i'm feeling at present. recently, i've also been thinking highly negative thoughts about life- how miserable i'll be when im older, what happens after death, etc etc (but i stress no suicidal thoughts), what's the point in things such as love, happiness etc- depressing thoughts,no?

despite all this, if you'd have said to me a year ago i'd have no OCD\insomnia i'd have bitten your hand off, it was such a large part of my life. but now the next battle is this: i want to enjoy things again like i used to, and to look forward to things. i'm not sure if the mirtazapine or even the fluoxetine now is helping (would i actually feel continously depressed without it) or hindering (is it just cutting off any positive emotions)

sorry for the rant, but any advice\input would be greatly appreiciated. thanks.

2

Hi there Tony and a warm welcome to PUKE.

You don't mention how long you have been taking the medictions. They can actually take a few weeks to really 'kick in' so that you feel the benefits of them.

However, if you feel they are no longer working ask your doctor if it would be possible to take a higher dose.

Posting here 'ranting' can most definitely help as it relieves our pent up feelings. So please don't hesistate to rant away until your hearts content. We have all done it and still do, so don't be apologising for your rants.

Let us know how you get on.

Melbi x

3

Hello Tony I dont think that I can analyse your post only to add my own experiences so that you can get some benefit from them. I am also on 'cocktail' of drugs. It seems very fashionable to do this type of combo. I am currently taking mirtazapine 30mg reducing to 15mg, lithium 1,00mg and prothiaden 150mg. You describe your feelings about being on 30mg of mirtazapine perfectly. That was me about two weeks ago. I was waiting for the mirtazapine to give me that 'lift' but it just wasn't hasppening. I felt numb emotionally numb unable to receive or give anything to anybody. I didn't want to go away on holiday, small tasks were a big effort. I guess that your doctor/psychiatrist has put you on mirtazapine for the insommia and depression. I'm only guessing but I expect that the fluoxetine takes care of the ocd. Are you still receiving cbt ot some counselling? This would be a good time to talk out some of these negative and low mood feelings. If I were you and with support I would still try to attend some social occasions but avoid anything that will make you feel more stressed. Your feelings and emotions are still there it's just like they are in a memory bank. They will return. The thing that has most helped my upturn in emotion this time is a return to some physical exercise namely swimming. If it is at all possible for you to try some physical exercise it will help to lift your mood. Talk to your psychiatrist because if the mirtazapine isn't working he will try another anti depressant that will. If you are thinking about death even if you have no suicidal intent your doctor needs to know about it. These feelings can easily turn into suicidal despair and there is help 24/7 if you are feeling as if you want to take your own life. The other main point of this post is to say that there are many of us who feel as you do. People will pass by and add their comments to your posts. You need not feel alone. we try to help each other. Pooh.

4

Hi Tony,

Would be interested to know if you think cbt has helped. I am going for my 5th session tomorrow, although my problem is social phobia and anxiety, Im not sure its helping at the moment or is it a bit early to tell.

Your views much appreciated.

Danielle.

5

thanks for the replies guys, genuinely.

Melbi- i've been on Fluoxetine for probably about a year now, and on my current dosage (60mg) for about 9 months. The mirtazapine i've been taking for about 4 months, and doubled it to 30mg about 5 weeks ago. When i first started taking the latter i did notice an improvement in mood, but that's kind of been numbed away now.

Pooh Bear- you hit the nail on the head about feeling emotionally numb. it's difficult to describe to someone- just to not get that feeling of excitement or optimism is part of it. i go to the gym twice a week (i work in 1) but only for like 30 mins each time (though i am thouroughly knackered at the end of it!) so perhaps going more frequently or spending more time per session would be of benefit

Danielle- I was very sceptical of CBT and remained so for a good few sessions in. mine was mainly about making pledges\doing things that would take up sometimes hours of my day. i was told to mark down out of 10 how anxious i was each time, and then bit by bit chip away at it (for example if i 'had' to do a message 10 times, try only doing it 9 times) and to my surprise, it worked. it helped that the guy who i saw was amazing, we gelled and it was very relaxed to go and meet him. so i'd say keep at it, but tell the person who you are seeing for CBT your concerns- it probably is still to early to tell, i had loads of sessions. when i look back, it's amazing as to how much better that aspect of my life is, and i'm thankful for that.

i just feel that i'm in the best years of my life- i'm 22, got a great job, great friends and family, health is good- so i'm just annoyed with myself that i'm not savouring these years. anything that i used to think would help me once i got it (ie, a relationship, going travelling etc) is now met with, for example: 'what's the point in going travelling? i'll just come back and i can say i've seen places, but big deal' instead of realising how lucky i'd be to do something like that (if that makes sense).

sounds daft but i often rank whether i'm emotionally 'numb' or not by how i react to watching films. before i started feeling like this, i got really immersed in them, heart beating, feeling sad at scenes etc. now, i just...watch them. a scene that i previously would have laughed\got upset at now just doesn't register. (which kinda sucks as i'm aiming to be a film reviewer) it's just the mindset i've got myself in. i've learnt to feel like this, hopefully i can re-learn to appreciate things, cuz i know i've got it good, i just need to start thinking that way.

6

Hi Tony_S,

I had the same feelings when on Citaloprim, except I'd describe it as a dumbing, not numbing experience. To explain, I had no pleasure in anything but also little time for depression, as my brain was dumbed down to think of nothing. Needless to say it was a terrible time for a long while as every thought had this throw-away feeling of uselessness, each thought was so fleeting that it was gone before I could enjoy/agonise on it.

As for travel etc, in my line of work I travelled about 1/4-1/3 of the year each between 2000-2006. It was agony not to be able to enjoy this, but I'd advise you to try and seek a psoitive experience each time you go abroad, this was my lifeline. Either see some new and extraordinary sights or better yet take the time to meet new people, try to get into their mentality and enjoy their country, culture and company. The key thing I realised is that we're all the same the world over, but the little differences are really cool to experience.

I really hope you'd be better equiped to enjoy travel much more now that your OCD is under control, it must have been a great barrier to you mentally having to endure this and could have been one reason why you seem to have been scared to travel in the past. I know for me that my depression was/still is a major burden when travelling as it is not under control (yet!) so has cost me a lot of missed enjoyment as a result.

Good luck to you and thanks for sharing your experience here. It's an asset to anyone reading who has similar problems and anxieties.

Best to you,

Silent..

7

Hey, Just wanted to let you know that your not alone. I'm on only 7mg of (mirt) and when the doctor increased it by half I had thoses same thoughts. So empty and nonemtional feeling made me numb to anybody and anything. So I reduced it by half a tab and withdrawl was no pleasant. But those feelings of emptiness are going away. But my insominia is back a little bit. I have to find the right combination too. So we are all in the boat. Just hang in there things will get better.