Still having difficulty sleeping! Don't know where I goo from here?!

Back to having awful insomnia again. It's 4am and i haven't been able to fall asleep at all yet. Been taking mirtazapine for almost 8 weeks now and it has been great at helping me to fall asleep, but now i have suddenly gone back to this dreadful insomnia, i feel like it's impossible for me to fall asleep. Has this happened to anyone else after a couple of months? I don't know where i can go from here now what else can i do? I don't want to go through the whole thing of changing meds again, i can't go through that again, but being able to sleep was the only thing keeping me sane and now i've got this shi**y insomnia again, it's frustrating after feeling well for a while. Any advice please?

I don't know if you have sleep clinics in England but I went to one on Long Island, New York where I live. I had an excellent psycholigist as therapist who taught me relaxation exercises, and meditation techniques which helped greatly. As a psychologist he wasn't permitted to prescribe medications but by learning to tighten and then relax my muscles from my forehead down to my toes I did get relief from insomnia. It takes time but it's better than medication.

I don't know if we have sleep clinics here, maybe in the big cities but i have never heard me one locally to where i live.

Hi Vicky sorry to hear about your troubles.

Have you had it increased since you began the Mirt?

Stu.

Hi Sunset, I am on 45mg Mirt for 18 months still have the sleepy affect, but my psych already had me on a. Xanax at night as they don't really like long term sleeping meds.

If you talk t your Dr maybe an increase in mirt or add something for you at night to relax your mind.

Maizie

Ok thanks maizie.

I have been on 30mg the whole 8 weeks.

As I mentioned before, the lower the dosage of Mirt the better chance of a sedating effect. This is due to histaminergic action plus tolerance not serotonergic action. The higher the dose the more it becomes activating and weirdly the less side effects become apparent.

I take Amitriptyline for sleep issues which still a year on puts me to sleep magnificently. Quite a few of the tca's have this effect and will also boost your Mirt's antidepressant action.

Stu.

Thanks, I guess I should just discuss it all with my doctor, I am just worried about them changing my medication again, I do feel like mirtazapine is right for me. When I changed from citalopram it felt like starting all over again. Maybe a change in dose might help if the lower doses have a greater sedating effect. I have an appointment at the doctors next week, but with a nurse from the cmht so don't think she will be able to make any changes to my medication, but I might still be able to discuss it with her, she keeps in contact with my doctor. Probably not though, I turn into a nervous wreck.

I am sure she will have information if you ask. I personally think the sedation aspect of Mirtazapine is overplayed and there are far better drugs that combine an antidepressant effect with helping insomnia.!you always have the option of adding something to your Mirt if need be.

Keep working with your doc and you will get there I am sure.

Stu.