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Temazepam to Mirtazepin?
I am reading the posts here on this subject but in the interest of speed I am asking a question before I finish:
74yo man with a variety of health issues and limited access to quality care.
Before I go into any more complex details, the basics.
I have usually been able to keep depression and anxiety at bay without meds or therapy, except during triggers life events, for which Temazepam has been
effective (15mg 2-3 days, few times/year).
A recent trigger has induced insomnia. Even though I have decent sleep hygiene, I walk briskly 1hr/day and do not sleep/nap during the day, for the last two weeks am unable to fall asleep without at least 7.5mg Temazepam daily and that gives me
only 3-5 hours of sleep.
My GP recommends the tetracyclical Mirtazepin for its dual action on both depression and sleep, I researched it and:
* don't like what I read about it;
* I took a tricyclical decades ago and hated it
* withdrawal and rebound.
I researched all AD and sedative options available and found none attractive, to put it mildly.
I realize it's no substitute for medical advice, but it may take time to get access to a good specialist -- if at all -- so I would appreciate any help/comments.
* How long can I expect daily Temazepam 7.5mg to be effective and safe?
* Is Mirtazepin the least bad option?
Thanx.
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Hello @sgeneris, Welcome to Connect. I'm tagging a few members who have posted about Mirtazepin that may be able to share their experience to help answer your questions. @faithshouse, @doorman, @jimhd, @ripley, @sherryann48 and @athomkat2u have posted about using Mirtazepin and may be able to share their experience with you.
It is good to do your homework. What worries you the most about switching to Mirtazepin?
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1 Reaction1st, I know this is a tetra, but see my references to tricyclics in my msg.
2nd, I am not fully convinced that depression is a core factor in my case and the doze-dependent sedative/antidepr ratio may prove problematic for me.
3rd, I generally prefer to avoid the kinds of side effects of psych drugs and the potential LT damage (the profile of and experience with are not very convincing to me, including what I read about this one), particularly @74.
Several side effects will exacerbate problems I already have.
4th, I take 16-17 meds and it's impossible to figure out the interactions and impact of any change.
Unfortunately, don't see any better alternative.
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1 ReactionI started Mirtazapine at 15mg.. taken at bedtime. For the first time in months, I slept 8 hrs. straight. That was 5 yrs. ago. I now take 45 mg. at bedtime and usually sleep 6-7 hrs. straight. It has had little effect on my anxiety that I notice. Or my depression . It is basically my sleeping pill. No side effects. Just my story.
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2 ReactionsThank u.
How old were you when you started it? I am 74 and there are warnings for the elderly.
Given the way it works, why the doze increase? Too sedative? Was it direct from 15 to 45 and after how long?
By "without any effect" you mean the sedative effect is not VIA anxiety and depression -- you take smtg else for them?
Any weight gain? Other conditions preclude that for me.
No side effects AT ALL?
I had some bad reactions to anti-depressants of various types over the years, and decided years ago I'd never take them again.
Fast forward to about 6 months ago, and I wasn't sleeping due to pain. I talked to my PCP about it, and she suggested trying mirtazapine. She said it was a very bad anti-depressant, but a very good sleep sedative. I've been taking 7.5mg, and up until the past week or so, I've been sleeping well. No negative side effects. Today I'll be asking her about a small increase.
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1 ReactionThe dosage was raised slowly over the years. 45 is the max dose. It still works for 7hrs. of sleep, but I’m lucky. It helps with my poor appetite, but I’ve actually lost weight over the years. I am 68, and started about 5 years ago.
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1 ReactionBy the way, I take Klonopin for anxiety.
Same here: decades ago the 1st AD I took was a tricyclic and I promised myself I won't touch any again. Hard to believe a tetracyclic is fundamentally different, hence the concern. Age (74) is another -- there are warnings (that's why I asked your age). And the rebound if stopped.
I've read exhaustively about it and the effect on people are so widely different -- extreme differences -- that the only way to know is to take it.
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2 ReactionsKlonopin alone does not help sleep too?
Sorry, @sgeneris. I meant to tell you my age. I'm 69.