Mirtazapine Question - too much sleeping

Treatment and medication
1

Hello,

It's my first time on here and I'm seeking advice.

I'm 60 and have a few health problems, mainly M.S. and FBSS (failed back surgery syndrome) and I manage pretty well with the pain involved with these.

I also have a pysch hsitory. Anxiety and agoraphobia cost me 26 years of normal life. However, after a diagnosis of borderline personality disorder and a long course of a new talking therapy, these things are much, much better.

The problem is that I'm going through what feels like the world's longest divorce. Reactive depression has been a consequence to be expected. After struggling with Prozac, I was given Mirtazapine and have been taking 15mg/day for about eight months. 

The snag is that I'm sleeping too much. I habitually settle down to sleep at about 3am. I set my alarm for 10.30am. Come the morning, I hear the alarm, and will rise if something must be done. But most days, I'll let the alarm (music on my phone) keep rolling on. I then tend to surface at about noon, or later.

Being self-employed, I don't need to follow a normal pattern of work. A rude awakening, such as a phone call or postal delivery, can have me feeling dozy all day long.

I've read about Mirtazapine's being used for insomnia and the situation begs a question. I've never felt good in the morning anyway but...

* Is the Mirtazapine dose enough to make me somnolent like this?

or

* Am I avoiding facing the day because of the depression, and I need to take more Mirtazapine?

I have no strong feelings about Mirtazapine. I don't feel dependent on it and it seems to make me generally more cheerful.

So, I'm considering dropping the dose to 7.5mg/day. I usually take it at midnight. I usually drop off to sleep fairly easily and, apart from some spectacular dreams, I sleep well enough. 

There's no hurry on this - I've to have an operation soon (trapreziectomy) and a significant change before this probably isn't a good idea. But constructive thoughts, and/or experiences, would be welcome.

Thank you.

2

Am I getting this right, that you go to bed at 3 AM and try to wake at 10:30 AM for 7.5 hours of sleep?  Surfacing at noon would put you at 9 hours. Why do you go to bed so late?

I tend to go to bed at 11, and am woken up when my husband leaves for work at 7:30.  If I allowed myself to go back to sleep for real, I could keep going until 9, which would be 10 hours!  Yes, this stuff definitely helps with getting you down and keeping you down for the count!  I usually make myself get up at 7:40, which is 8 hrs 40 minutes give or take.  I'm taking 20 mg right now, but even when I first started taking 7.5 mg I could sleep like that.  I don't feel groggy, though, when I do get up, even if I could keep sleeping.

3

I am in the same position as you but solve it differently.

I was taking 15mg at night but it was trying to make me sleep for 13 hours!

I could probably reduce that by taking either more or less.  I tried less (7.5mg) but that stopped me getting to sleep, so I now take 11mg.  That still wants to make me sleep for 11 hours but is probably the optimum.   I am retired so can get up at 8.30am. I take the mirt at 9pm.  Unlike with some people it does not knock me out, so I can go to bed when I like.               

4

Thank you for your responses.

Betty, going to bed late is an entrenched habit, from when I was a magazine editor. I had to take phone calls during the day so I would write at night. It's suited me for decades!

Oldboy. I assume you have Mirtazapine in liquid form so you can measure out 11mg. I have the 15mg tablets so 7.5mg would be easy to prepare.

I bedded down at 3.30am last night. A postal delivery arrived at 11.30 am, then I let myself doze on, surfacing at 12.30. So, I'm a bit dozy now...as I mentioned, rude awakening!

One thought I had: I'm no insomniac but does reducing Mirtazapine cause sleep problems as a rebound thing?

5

davhillm, some people have a lot of trouble making a 50% cut like that, especially when they have been on Mirt as long as you have been. WD symptoms, especially digestive upset/gut issues, headaches, are common.  If you could do a 25% cut, that would be better.  Some have reported emotional symptoms as well, worsening of anxiety, depression, and some even have their sleep messed up by WD.  I have been doing 10% cuts, using a jeweler's scale that measures milligrams, cheap through Amazon.  Just be aware that this could occur, and reinstate if it is too bad.  Some can tough it out until the symptoms subside, while others find it so horrible as to have to reinstate and then do the much smaller cuts, as I am doing.  If you can get your doc to prescribe a liquid through a compounding pharmacy, that is the easier way to go than messing with breaking down tablets into bits to get the right dosage!

6

No I have 15mg pills.  I bite off about a quarter and discard it.

Mirt in low doses (7.5 or 15mg) usually helps sleep.   More or less mirt does not (usually).    That is not a rebound - just that the help has been removed.  

 

7

Thank you again, lady and gentleman,

First, I tried a new tactic. I was feeling very tired indeed yesterday so I decided to have a lazy day, doing only essential tasks. I took my Mirtazapine at 11pm, and took a 2mg Diazepam at midnight.

The next thing I became aware of was a phone call (which I ignored) at 9.30am. The alarm started playing at 10.30am. I dozed on, finally achieving full consciousness at 12.30.

In the event, 12 hours' not-quite-undisturbed sleep has made me much more wakeful today - I've done a lot of 'office work' and will be going out later.

This suggsets that I have some 'sleep debt' anyway. In addition, there have been developments on both the divorce and operation fronts; both seem positive. 

My plan is to stay with 15mg of Mirtatzapine for now. The operation is planned for the 19th October and progress with the divorce may have occurred by then. At this point, I plan to go down to 7.5mg of Mirtazapine nightly, secure in the knowledge that I can reinstate the original dose if need be.

 

8

A low dose of Mirtazapine works in a similar way that some antihistamines do, you tend to feel groggy the next day and can sleep long hours. I was sleeping for 12 hours when I started on 15mg and had to force myself to get up after 8 hours. I am on 45mg now and sleep only about 7 hours.

9

I find it very difficult to get up less than 12 hours after taking my mirt at night.  However I do not feel groggy during the day.

I am interested in your solution - to take more mirt.  Did that make hunger, or any other side effect worse?       

10

I can only go on my experience and would suggest talking to your Doc first about your sleep. I certainly wouldn't recommend upping your dose just to get better sleep as that might make your symptoms worse.

​