Lexapro and Mirtazapine - Awful Side-Effects

Posted by odi @odi, May 24, 2025

Been taking 10mg Lexapro (Escitalopram) in the morning for 1 month for anxiety and depression, but I was not feeling like it making any better. I was feeling nervous and restless whole day with no motivation to do anything.
Doctor said to bump Lexapro to 15mg and added 15mg Mirtazapine at night. Did it for 10 days and I felt more anxious and restless.
Went down to 10mg again. It's been 5 days and I feel like I'm losing my mind. I'm having anxiety crisis, feeling hopeless, feeling like I'm losing control, I can't stop having negative thoughts in my head. I am also feeling tired and sleepy all day, but no matter what I do I can't calm myself down to sleep. I am also taking Xanax 0.25/0.5mg when needed, but even that is not working sometimes.
I could not find any info regarding Mirtazapine being able to cause this type of side-effects. Doctor is not really helpful to determine the problem. Could the restlessness be caused by Lexapro? Should I try a lower dose? I am also scared of lowering the dose having even worse side-effects.
Please, any guidance is welcomed.

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I’m tapering off Ativan. My new PCP- because I moved states-wanted me to start taking Lexapro during this process. But I was resistant and I’m doing just fine with a slow tapering. She wanted me to go from .5 mg Ativan to .25 for a week and then quit; from all I’ve read on this site that could be pretty dangerous, and reading all the comments about side effects of Lexapro and other drugs and combining them. I think I made the right decision we need to be our own best doctors!

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Profile picture for berekann @berekann

I’m tapering off Ativan. My new PCP- because I moved states-wanted me to start taking Lexapro during this process. But I was resistant and I’m doing just fine with a slow tapering. She wanted me to go from .5 mg Ativan to .25 for a week and then quit; from all I’ve read on this site that could be pretty dangerous, and reading all the comments about side effects of Lexapro and other drugs and combining them. I think I made the right decision we need to be our own best doctors!

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@berekann How are you doing now?

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Doing well - at .375mg Ativan for a week with occasional mild anxiety & insomnia, but otherwise, feeling good. My brain is clearer, and I’m walking more. Happier.
See a new doctor tomorrow and will get his guidance for next taper step.
The Ativan had some negative side effects, especially at 1.5mg, so I’m glad to be getting off it.

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Sounds like you need to find another doctor. One who really listens to your concerns. And maybe try to lower the dose with their help. I know I feel so much better after decreasing Ativan. It was causing numerous side effects that I ignored and/ or just increased the dosage on my doctors suggestion.

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Lexapro caused horrible reactions for me sending me to the emergency room. I was overly anxious and could not handle the drug. I’m now off of it and am returning to Paxil which worked for many years. The only way I could tolerate Lexapro was to take Clonazapam and needed to increase it to 3 mg. It was a horrible drug for me.
Mjdennis

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