Why don't we just call it 2 per cent. Then we will know precisely what we are talking about. I wrote statistical publications for 15 years trying to think up different ways of saying things, eg where writing separate descriptions of the 33 London boroughs.
Although Partridge in "Usage and Abusage" says don't use "substantial" where you would use large or big, I get the impression that this is more stylistic. Substantive=tangible - in that sense an atom is substantive. In the OED (1980ish edition) all but one of the definitions of substantial refer to considerable in number or of size, only one refers to the more chemical definition.
Jetchan/Jimmy, Lithium isn't as scary as bad aspeople make out and I can say that after suffering from accidental severe lithium poisoning due to excess prespiration on a walking holiday, but you really need regular blood test and it is best if you have a good grip of the technical issues associated with using it (half lives, why it is important to take it at night, why it is important to have blood levels done at the same point of the day, what happens when your body looses to much sodium through perspiration etc as many emergency doctors have no experience of lithium posoining). I took Lithium for 6 years and it really helped but I struggled to tolerate it again after the poisoning episode so I am looking at other alternatives hence the move from velafaxine to mirtazapine which looks to be the more effective drug.
Jimmy, I have a fundemental belief that modern day pysc meds are aimed at making your brain work the way it was designed to i.e. they are returning an incorrectly functioning brain back to the way it was designed to function. The deficiencies in modern pysc drugs is a reflection that we have not yet get to the real root cause of the malfunctions but this like cancer is a battle we will win. There should be no shame in taking psyc meds. Decisions on choice and dose of pysc meds should be made on the best quantative evidence available. I understand there is general antipathy to taking medication in the media and in particular there is real antipathy to pysch meds .I firmly believe that this an unhelpful perspective and that it would be better if we got everybody agreeing that "evidenced based medicine" is the best way forward.
Lithium how so scary? You have blood tests every 4 months. After 15 years I have had to come off it because it has been effecting my kidneys. You take it each night, you don't take double the dosage as I once did by mistake.
I have taken many of the drugs for my depression - every SSRI's and other, and I think the main problem if serotonin drugs don't work is becouse of prefrontal cortex dopamine shutdown by 5-HT2c agonism in VTA. In that cases drugs like mirtazapine, that don't increase serotonin so much, and increase dopamine release in prefrontal cortex could by more effective (http://www.ncbi.nlm.nih.gov/pubmed/15033381). In my case mirtazapine is most effective drug (but don't work second time) - it had worked for my anhedonia, elevates my mood, changes my perception.
Sorry MM3 if I can answer myself - for once I agree with you, I was responding to Jimmy-UK-Lancs.
But can I say, my sister is a GP and she doesn't treats her children. They have another GP and if they are sick she takes to their GP or in emergency she takes them to the hospital. She is too involved with their own care and therefore needs to obtain the help of others. She is an extremely competent GP but she hands over the care of her children to others. Likewise it is a good thing to be able to take the responsibility off our own shoulders and where possible to give that to others. On the other hand I recently changed GPs because I didn't think that I could rely on the previous one. I decided in effect that he was not being proactive in reminding me when my next blood test was needed, suggesting that I was getting side-effects from my meds and not going by everything that my pdoc said.
It was 2% but it wasn't a small number. There are (for the lack of a better adjective, we can agree on) a significant number of patients acroos the country on this dosage. I guess its time to email Suzy in dictionary corner about the usage of the word substantial, she seems to love it when she is talking about a word whose meaning is in a state of flux from it's original meaning to a different, more modern meaning.
I've heard of higher doses of 60-90mg prescribed in USA but I'm not sure if they do in the UK. My doctor told me that 45mg is the max dose and if I don't get well on it then he may add a small dose if another antidepressant rather than take me off Mirtazapine and have to start all over again.
Ive been on Mirt almost 12 weeks,8 weeks at 45mg and although I'm still not totally better,I am better than I was at thus stage with the antidepressant I was on previous to it.
Some peoples doctors add a mood stabiliser to there antidepressant for depression that seems resilient and others add a low dose of a antipsychotic.
Perhaps discuss your options with your GP. I think if Mirt has worked for you in the past then it would be worth going on that with a add on of something else xx
mirtazapine is the best anti depressant out there side effects vs results, dreams were bad at first but now they are great, fluoxetine made me a zombie.
Yes, I agree, for me it's the best antidepressant. SSRI are making me apathetic, unmotivated and flat (this drugs don't elevate my mood, or cure my anhedonia). I like dreams on mirtazapine - very vivid and fantasy (not nightmares).
I am on 45mg to stave off psychosis during my 'annual' major depressive episode and normally worked in the past, but I'm afraid this year it has failed and started hearing voices yesterday "stephen is ill again, stephen is ill again", so got my GP tomorrow and psych assessment next week. I am probably going to move to anti-psychs. Apart from the horrendous weightgain (3 stone for me), I actually think Mirtz is overall a good drug. At 15mg, probably fixes 80% of patients with mild (short-term) depression and poor sleep (the great sedative nature at 15mg!), 30mg...less sure, 45mg...not sure.
But that's my personal opinion and everyone is different...
I have been on 60mg for about 3 years. It's been a very effective treatment for me, although dosage does need to increase every, say, 2 years-ish. Like many others I started on 15mg (in 2007).
After reading all the replies, I just took another 45mg pill of Mirt. I took 45mg last night before bed. I'm desperate. I'm in the depths of Hell. 15mg worked for me with Cymbalta. 15mg stopped working. 30mg started working again. It stopped after 10 days. An increase to 45mg did nothing. Not sure why 45mg is the recommended max in US.
In the past, high doses of Parnate, an MAOI worked extremely well for me, but my current doctor won't do that. I've been treatment resistant for 20 years. I've had 7 ECT treatments. The first 4 brought me back to myself. I felt like I was 12 yr old again and wanted to go out and build treeforts. LOL I dropped like a rock after 3 months. 3 consequetive ECT treatments on 3 consequetive Fridays only made me worse.
I was on Tramadol as an anti-depressant for 5 years. It worked wonderfully but it was a constant nightmare trying to keep my tolerance down. Tramadol has gained recognition as a viable anti-depressant over the years, but now it's controlled. Well, just rambling now.
I wish you all the best in your plight and God bless.
Hi I know this is an old post but I've dealt with depression for my entire adult life and mirtazapine was semi-miraculous for the short time it worked really well. Bupropion is the 2nd best antidepressant I've ever taken and I saw you mentioned taking that as well. I guess my question is did bupropion help you out at all and if so are there any other drugs that have helped you?
I've taken a lot of other ssri, snri and mao-I's and none of them work half as well as mirtazapine and bupropion.
I would greatly appreciate any insight you might have. Thanks
Hey. Yes I have some reaction to wellbutrin but not the same as with mirtazapine + SSRI. The problem is the effect is short term. I'm trying now some neuroleptics like abilify, seroquel or zyprexa. We will see...
I have been on mirtazapine 30-45mg for the last couple years and my panic attacks have become worse due to problems in life. I also have been on xanx 0.5 and cymbalta 60mg for the past 20yrs. I have just come off of cymbalta (which is a nightmare) in exchange for Buspar. Back to mirtazapine, I am considering doing 30mg in the morning and 30mg in the evening. I used to only take it at night because it made me tired. But I have tried this 30-30 just this week and I feel much calmer. I will continue to walk and swim to avoid any weight gain. But I feel whatever works to get me away from feeling afraid of life (panic) I will take anything!
I used to be on 60mg but I deliberately stopped taking them because they made me tired all the time. I only just stared my medication again, this time on 30mg, two days ago