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Mirtazapine for insomnia -- concerns
I am 74, have had DIABETES and HIGH CHOLESTEROL and hi BP controlled since 2000 (A1c 5.7) with lifestyle, Metformin 2000mg, Lipitor 40mg, Amlodipine 10mg and Telmisartan 80mg, but I take a variety of close to 20 meds altogether for other conditions. I have suspected IBS.
I am prone to anxiety and depression, but usually only episodic responses to life triggers, during which I had experience with Norpramine (awful), Xanax and Zoloft (a bit better) and developed an abhorrence for psychotropic drugs. Luckily the last impairing episode occurred years ago. Since then I reacted preventively to occasional triggers with Temazepam 7.5/15mg for 2-3 nights which was both effective and without side-effects.
It's been very hard to sustain my physical and mental health profile and med regime stable and it's very easy to mess it up.
Three weeks ago I had a sudden onset of insomnia that extended beyond three days, it triggered anxiety for having to stretch the benzo or take some other psychotropic drug (non-pharma options don't work for me).
My GP recommends Mirtazepin 7.5mg. I have researched all the online sources I could find on both this medication, including in this group. I understand what it does and how and I have serious concerns which I expressed to my GP, but he is convinced. Because my access to healthcare and specialists is quite limited, I pay particular attention to health professionals present online.
1. Given my profile and the potential weight gain, should I take it? Is the gain equally likely for 7.5mg as for the larger dozes?
2. A core concern of mine are mind-dulling and lethargy, which doctors admit but say that if the drug is ineffective or side effects intolerable, it can be discontinued. However, many users describe a very long and difficult tapering process possibly worse than the insomnia.
3. It's supposed to be sedative at 7.5/15mg and antidepressive at 30/45mg. But there are users who say that 7.5mg-15mg is too sedating (they break the pills in quarters to tolerate). Given my primary objective is sleep, it may be difficult to find a doze that puts you to sleep but does not affect your cognition.
4. There are many claims that the sedative effect wanes, but the timing varies from days to years.
I would appreciate comments from any doctor if present here, particularly if they prescribed it.
Thanx.
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Has your Dr mentioned trying Trazodone before Mirtazapine? I've been taking Trazodone for sleep for over a year. I started at 50mg and now take 100mg. It's an anti-depressant with a side effect of sleepiness. I was waking up frequently during the night, so tried switching to 7.5 mg of Mirtazapine but only took it one night. It helped me sleep through the night but I felt groggy and tired for the next 3 days so stayed with Trazodone. Trazodone has a half life of 5-13 hrs, while Mirtazapine's half-life is 20-40 hrs. My routine now is taking 2.5mg Melatonin before bed, which helps me fall asleep. I wake up 1-2 hrs later and then take 100mg Trazodone which helps me sleep a few more hours. A helpful website with user reviews on both drugs (and other sleep meds) is Drugs.com. Google the name of the med you want to research and add "for sleep reviews" after it and the website should come up.
I had a sudden unset of insomnia 3 weeks ago -- could not fall asleep. My dr had addl reasons to recommend Mirtazapine, I have been uncomfortable given my research (half-life is one reason, they say 16hrs) but he pushed it and I am not in a position to refuse (complicated).
I have taken 7.5mg at bedtime for the last three nights. While I do fall asleep, I wake up more than once and every sleep episode comes with a dream. It's not healthy sleep. I felt sleepy only the day after the 1st pill.
The advantage I see is that at the low doze it's not anti-depressive. I only looked superficially @Trazadone and it did not attract me, don't recall why. What side-effects did u experience?
If there is no improvement I may try Trazodone -- starting with 25mg.
I was on Lyrica for a while and had similar symptoms as you are having with Mirtazapine. I went to 3mg of melatonin 60-90 minutes before bedtime, and 7.5 mg at bedtime. Melatonin helped get to sleep, the Mirtazapine to help to get back to sleep quickly when I have to get up due to chronic pain/bathroom habits. Both work for me, but my goal is to get the chronic pain managed better so I don't need the sleep meds. One other point, I do use a CPAP for mild apnea.
Unfortunately, meds work differently in people, dosages need customization, time when you take the meds need adjustment as well. If what you're doing doesn't work or has side effects, explore options with your physician's advice.
With Trazodone, I didn't notice any side effects, except that sometimes I would build up a tolerance and need to increase the dosage. Now I'm slowly reducing my dosage by 25mg every few weeks to see if I can sleep without it. I was at 150mg/night and am now at 75mg at night with no effect on my sleep quality.
My Dr also prescribed Mirtazapine, I didn't like what I read when I looked it up so I didn't take it. I took Trazodone for years. I also had pretty severe leg and feet pain every night. When the Trazodone stopped helping with sleep and I went off of it all the pain stopped. I took a Trazodone a few months later and again horrible leg and foot pain all night. I now take Quetiapine which helps me sleep pretty well with little problems. I don't respond well to antidepressants and psych meds and really don't like taking them. In fact there are very few I will take for my chronic depression and anxiety, I don't want to be forced to take them in order to sleep. I think they can cause all kinds of problems
I use 10 mg Melatonin tabs and they work great as well as mirtazapine - I have nocturnal seizures so it's very important that I get enough sleep.My family always caused my depression and seizures so I steer clear of them . Have your potassium levels checked as I did and mine were quite low so I was put onto a potassium supplement and my mood changed within a month. For the first time in my life I'm quite contented ( I'm 65)