Switching from fluoxetine to mirtazapine – Have been tak...

Treatment and medication
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Switching from fluoxetine to mirtazapine – Have been taking prescribed antidepressants for about 6 years. First venlafaxine, then citalopram, then fluoxetine. For me, all of these were effective – especially fluoxetine – but all had more or less undesirable side-effects. After about 2 years on fluoxetine, these included: excessive sweating (eventually almost constant); breathlessness on exertion (increasingly); fatigue and drowsiness; and sexual dysfunction. Having come off antidepressants at various times, I know that I don’t cope well without them so I asked GP about an alternative to SSRIs – hence mirtazapine. Over past 2 weeks been weaning off fluoxetine and onto mirtazapine. Effects obviously arise from both those events and thus far only taking a half-dose (15 mg) of mirtazapine (30mg as of tomorrow). However:

:D Sweating has stopped - hooray!

Breathlessness the same

Even more fatigued and sleepy than before

:yikes: Vivid dreams (consistently)

:? Have been putting on weight anyway – apprehensive

:ill: Irritable and aggressive (when awake)

Low mood

:headhurts: ‘Churning’ thoughts returning

:wink: Sexual dysfunction – chance to find out would be a fine thing!

A lot of this is withdrawal from the fluoxetine. There is also a tendency to ascribe everything to depression and/or antidepressants, whereas there are always other things going on as well. Going to see how the mirtazapine pans out after a few weeks, then reassess.

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It was interesting to read your comment, I have also been on prescribed medication long term (on and of for 28 years) currently continually for 11 years). I started on fluoxetine in 11yrs back which suited me fine at first. Most of the time I was was on the level, no real side-effects (apart from severe shaking if I didnt take my tablets exactly on time),very happy and no lack of sex drive! After about 18mnths the problems started, I would feel brilliant one minute and then BAM, straight back down to earth with a bang. Erratic behaviour, severe depression, suicidal thoughts often followed by an overdose. I'd go back to the psyc for a reveiw, sometimes a dosage increase, until the next episode. Unfortunately the time between each BAM was decreasing rapidly and I was finally taken off fluoxetine in 2002 because they couldnt increase the dose any further.

Next I was given venlafaxine 75mg, no lapse in the depression so dosage increased over time to max 300mg within 8mnths, still depressed. The side-effects were horrendous, suicidal thoughts constantly,(I have planned so many ways), mood swings, constipation where laxatives dont even work, vivid nightmares (often watching my children die so I'm scared to sleep), maybe getting about 15 hours a week avg.,lightning bolts shooting through my head when I doze, night sweats, fatigue, paranoia, amnesia and the sex disappeared overnight, to the point of total fridgidity.

Boyfriend dumped me 2wks ago after 7yrs, prob frustrated, so I paniced and went cold turkey out of sheer desperation and feelings of guilt. No medication now, side-effects ebbing, the last one gone :magic: but suicidal thoughts, depression and tearfulness still there.

Seen psyc today and prescribed mirtazapine 15mg(no leaflet included so checked online), told of drowziness but not weight gain, as a previous size 22 and now size 8-10, if I put on a lb I go into panic. I have an eating disorder and I'm alcoholic(under control but dont intend to go dry)I really dont think this drug is for me.

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I have also been on fluoxitiine for while with no discernable improvement.

Have been taking 15mg mirtazipine for just iver a week now and feel a significant improvement! Not as anxious or tearful! Sleeping SOO much better - though drowsy in the mornings. Fantastic dreams - takes a while to discern betwen dreams and reality when waking! Have suffered with very jumpy legs but as I fall asleep quickly I think it bothers my partner more than me!

I have had to take time off work just now to try to deal with the fatigue and drowsiness but this is far better than just sitting in a black hole as I was before!

Would love to hear more positive comments from people who have taken mirtazapine?

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I´ve taken many antidepressants over the past 9 years. Mirtazapine was surely the best one. The one drawback to me was a major increase in appetite and weight gain. It basically turned me, a 23 year old at the time, from a slender, seductive but very depressed and angry man into a fat happy man. I had to stop after 10 months because I gained too much weight. I did not mind having everyone telling me how drastically I had gained weight and how I should loose some to be handsome again, as I was feeling I was living life truly for the first time. But one day it got me, after some girls turned me down because I was fat, I looked in the mirror and remembered how more good looking I had been so I decided that I couldn´t live without women and sex even though I was happy like in heaven, at peace, clever, positive, and every sense seemed to be enhanced by Mirtazapine, music sounded wonderful, smells, tastes, touches, it was all wonderful. Mirtazapine should be more studied. It is by far the most potent antidepressant I have ever taken and I´ve taken more than 10. One thing which would hit me sometimes was exactly this thing about not knowing whether I was awake or still dreaming, as I had interesting dreams when I would 'wake up', get off bed, go to the bathroom and then bang, I really woke up in my bed wondering, wasn´t I in the bathroom? Sometimes I tested reality to see if it was really real. But just as you said after some 2 hours this feeling usually goes away and you know for sure you are awake.

Mirtazapine is great. I wish there was a version which did not cause so much increase in appetite. Now Im going from Sertraline to Fluoxetine again as Sertraline is way too weak for me.

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you no fredonmed i agree in some parts with you about mirtazapine the bad thing is the nightmares or bad dreaming and the weight gain is just plain horrific i have been on mirtazapine 2 times the first i came of cuz of the weight , then went on another anti-d (cant remember what name as i must of been on them all) but they didnt suit me , so i had a word with my dr and i thought i would give them another go with me eating more healthy things when i need to eat , but the second time i went on them i just had panic attack after panic attack and my anxiety was so high i thought i was going to die every day i couldnt handle it so i stopped them the other good thing about mirtazapine is it dont mess up your sex life but who wants sex feeling that ill , now for me the best anti-d ever to stop the depression and to calm me down is Fluoxetine but although i felt like anyone else in the without our problem you no \"normal\" it completely kills your sex life im talking from a males point of view here , you just dont care for sex there was no desire , and when i was in a situation where sex was going to happen i just couldnt get it up went to the dr told him i had no desire for sex and when i tried it i couldnt get it up so he gave me some viagra , so i took a viagra then i found i couldnt ejackulate even after hours of trying went to see another dr he said Fluoxetine is well known for all 3 failures i had with the sex thing , so as its great in making you feel completely normal and calm without a care in the world it kills your sex life , im not trying to put you or any others of just something you might want to think about good luck.

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Been on paroxetine for 15 years and suddenly stpd working. Fell t pieces having constant anxiety attacks and anxious thoughts. Now started Mirtazipine 3 weeks ago and just 1 wk ago was increased to 30mg of the drug, still feel really low and anxious. wondering if this is the right drug for me. hoping some one can give me positive feedback about mirtazipine. :?

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Hi Shona, I too started to take mitzapine 3 weeks ago. I have found them to be really effective. They have stopped my anxiety and panic attacks. The only problem is the weight ive put on already, im constantly hungry!! jupes :roll:

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Hi jupes , ive been on mirtazapine before for a week and half i had to stop taking them because i had terrible anxiety and panic attacks all day everyday my nervous system was shot to pieces and my depression was no better so i thought they was not the right tablet for me so i stopped , my question for you and ofcourse anyone else is , do they make you feel so bad such as bad anxiety terrible panic attacks bad depression , until your body is used to them if so how long does it take for your body to adjust ? i know everyone is different , i suffer from bad anxiety and panic attacks anyway so im wondering if i had of kept taking this medication longer than a week and a half would my depression anxiety and panic attacks have gone , or will it just cure my depression and still leave me a total wreck with my anxiety and panic attacks , or would it not do anything at all for me , is it completely the wrong medication , im so confused and scared , i remember having very bad dreams and eating loads too but i would put up with that if i knew this tablet would help my depression anxiety and panic attacks , any feedback is so welcome thanks for reading

Ricky.

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update , can anyone give me any advice on the last question ?

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To Woody31, I would have probably tried to put up with them for at least 4 weeks. Some tablets do exagerate your symptons at first. All tablets that ive taken in the past made me feel worse at first but I persevered with them. Everyones got different tolerance levels so I can only speak for myself. You could try them again for longer, see how you go.

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My psych tried mirtazapine for three weeks and then I went back for a review. It has taken at least six weeks for my mood to lift significantly and to stop feeling so sleepy and ravenous. In my case as he had increased my lithium he did not increase the prothiaden. I felt a lot worse before I started feeling any better.

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cheers for that info pooh bear x

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Hi Woody I was just wondering whether you had persevered with the mirtazapine or whether the docs or psych switched you to something else? I remember trying to switch from prothiaden to seroxat once but the side effects were too dreadful to continue. It's hard if you are in an acute phase of illness like you and I have been in to make these decisions for ourselves. I hope that your depression and anxiety are better if not from tne mirtazapine from something else.

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hi im now on lustral dont no the other name for it , been on them for a while but they are useless i hate them its makes me feel like im on whizz or something cant stop moving cant relax and they do nothing for my depression and anxiety , got told to keep taking them for at least 6 weeks but i just want to try mirtazapine again tho

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Im just about to switch from FLUOXETINE to MIRTAZIPINE, is there anything I should know straight away about the side effects, especially with Xmas coming up.

Thanks

BJ

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Hi Guest I am changing over as well second day of 30ml and no venaflaxine and I feel drunk but no panic just want to get on feel positive for the first time in months but my body won't work. Phoned phsy she said cut back to 15ml but I don't think I have come off the venaflaxine long enough. I can put up with feeling drunk for a while as long as it goes eventually, don't want to go back to the black hole, didn't want to live. Think I will try a bit longer and keep my fingers crossed that it is a side affect that will go in time. Good luck