Does anyone have experience with Mirtazapine?

Wondering if anyone has had similar problems with sleep and trying to reduce zopiclone sleeping pills.
The last few weeks have been stressful as I became extremely anxious due to worrying about my health. I I was prescribed Amyitryptiline (Now 60mg) but over 4 weeks the sedating effect wasn’t enough to put me to sleep so continued taking zopiclone (Actavis) every night. I’ve used this sleeping pill on and off for years but at smaller doses.
Now I’m gradually coming off the ineffective Amitriptyline and over 3 nights have taken 15mg of mirtazapine. I take it 20 minutes before I go to bed . But by midnight I’m still awake so resort to a whole zopiclone. 7.5mg . Half an hour later I’m still awake so take another half zopiclone ... and finally I fall asleep!. Ideally I want to get off the zopiclone and stay on mirtazapine. Next week I’m to start taking 30mg of mirtazapine . Is that more effective and likely to get me to sleep? The anxiety is now worrying about sleep! Love to hear from anyone who has similar experiences or advice on what I should do. Thanks.

Hi, @carolcs - welcome to Mayo Clinic Connect. That sounds like quite a sequence to get some sleep at night.

You will note I've moved your post here to this discussion of mirtazapine so you can talk with others who have addressed some of the same issues. Hoping they can provide some input on the anxiety with worrying about sleep and trying to reduce zopiclone and increase the mirtazapine. Please meet @sandifl @gettingbetter75 @contentandwell @faithshouse @artscaping and others here.

When will you be done with your taper off the amitriptyline, carolcs?

Thanks Lisa. I’ll be off the Amitriptyline by Wednesday this week. 2 tonight (Monday here in NZ) , 1 Tuesday. I will increase the mirtazapine from 15mg after a week to 30mg. Hopefully it will have a sedating affect by then!

@carolcs. Good morning. @lisalucier has suggested that I jump in here. I am currently getting off Nortryptilene. The first 30 days went reasonably well. The next 30 days may be more difficult...down to 10 mg per day for the next 30 days. It is a little scary. We seem to treat some of these medications like crutches.....to help us get through our day. And I am like a detective watching every possible incidence of depression or anxiety. However, Nortryptilene is an older medication and I have already ramped up the duloxetine with my clinician's support.

I should tell you that I use Medical Cannabis for sleep aid and pain management. One dropper of CBD/THC and I am able to rest without waking during the night because of electric shocks or the burns inside my skin. Good luck and be free of suffering. Chris

Thanks Chris. Fortunately I haven’t been on the Amitriptyline for long (3 weeks) but it just wasn’t helping me sleep - hence the change to mirtazapine. I’ve only had 5 nights using this but still seem to have trouble getting to sleep without the zopiclone! I’m also taking magnesium at night (2 nights so far) and last night got to sleep but was half awake all night! Weirdest feeling as I was in and out of sleep and by 3am when I became more awake it was too late to take the zopiclone. So today I feel like I have major jet lag! If only we had a switch on our heads we could turn off!

Hi again, Have just increased my 15mg mirtazapine to 30mg last night as my GP prescribed this increase after a week of being on mirtazapine. (for Anxiety and related insomnia) . Had had two good sleeps prior with 1/4 lorazepam , 15mg mirtazapine and 7.5 zopiclone.
So....the new regime started last night. Got to sleep after an hour of taking it but woke an hour later, dozed and woke another hour later. Because I didn’t want to go thru the terrible in and out of sleep all night that I experienced 3 nights ago I got up and had 1 zopiclone (imovane). An hour later still awake! Up again Feeling dizzy and another half zopiclone. Waited to no avail! Up again feeling dizzy and took another half so two in total. Finally slept! But now what do I do tonight! Take the 30mg mirtazapine again and just try sleeping thru if I wake? Appreciate any advice...thank you...

Dear Faithshouse: I was given Mirtazapine a long time ago by a Psychiatrist. That was when I was having trouble with another antidepressant wearing off. She said I could try it, but it did nothing to help me. I believe you can gain weight on this and that it is an older antidepressant.

My doc prescribed Remeron as an alternative to the Zoloft I’d been taking for years. I do not have sleep problems. I had some of the deepest sleep with vivid, positive dreams the first week taking 7.5mg. Really solid sleep with some grogginess in a.m. As the Remeron increased the Zoloft was decreased until I was at 30mg Remeron and 25mg Zoloft. The side effect of this switch — I had a depression unlike any I’d felt in over 30 years. Despair and anguish. The total weaning time from one to the other was six weeks. It was all a huge mistake. Another doc and psychiatrist agreed 1) no need to come off Zoloft and 2) the titration period was not long enough. I’m now reversing back to Zoloft. Felt my depression lift within a couple of days.

@faithshouse

I just happened on to this discussion, and thought I'd tell you what my experience has been with Mirtazapine.

It was maybe a year ago that I was feeling that my long term antidepressant, Wellbutrin, wasn't quite keeping up with my depression. I met with the psychiatrist, who prescribed Mirtazapine to enhance the effects of Wellbutrin. I raised the dosage until I started seeing a lifting of my depression, at 45mg. I was already taking the maximum dose of Wellbutrin, so I couldn't add to that medication. I don't recall any side effects. I have sleep apnea and use a Bipap machine, and with the help of the BIPAP, I sleep well perhaps too well, as my sleep doctor told me to work on sleeping for only 9 hours and avoid naps.

I haven't read through this discussion, so I don't know if a sleep study has been suggested. Back in 2000, I told my PCP that I was feeling poorly, and the symptoms indicated possible depression, but I wanted to rule out any organic problems I might have. I had a bunch of tests that year, one of them being a sleep study, where sleep apnea was indicated. During the first month or two, I slept at least 12 hours per day - I was really sleep deprived! When I told my mom, she said that when I was a child, she noticed that I'd stop breathing and she wondered if I would take another breath. She had never told me that. Anyway, I felt immensely revived.

Another series of tests revealed that my gall bladder was hardly functioning, and I had it removed. Again, I felt much better. And on it went until I was feeling increasingly depressed and attempting suicide.

My journey has been an interesting one. I'm glad I asked the doctor to look at all of the possibilities of why I was feeling so bad. I found that depression wasn't the only thing going on in my aging body. It seemed like I started falling apart when I turned 50. I wasn't ready for it. The next milestone is #70, next year. That is making me feel old.

Where are you by now with Mirtazapine? I hope sleep is going better.

Jim

I’ve had awful insomnia over the last several years. Was relying on lorazepam for sleep (prescribed for anxiety but no longer need for that) but am weaning from it. Tried lunesta but can’t be on that long term and trazadone affects my liver enzymes.
Would like to hear others’ experiences with mirtazapine. Tried for the first time last night (7.5 mg) and knocked me out but very groggy today. Thanks!