Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[discogirl]

i completely hear you there. i grieve for the way i used to sleep.

how long have you been on your current hrt regime xxxx

[Nicodemus]

Hi - I've never stopped Mirtazapine so don't know about the withdrawal. But I have gone down from 45 to 30 and from 30 to 15 (and back up) at various times without any problems - no tapering just stopped 45 and started 30 the next night.

Amitriptylline: I had the type of insomnia where I would get off to sleep easily but wake at 2am worrying about stuff and be unable to get back to sleep. It helped for a while but then didn't any more and so I stopped it as it also made me incredibly constipated - it dried me out basically. Sadly it did nothing for my migraines either. Beware - I stopped it dead which I later found out you are NOT meant to do and had quite a nasty withdrawal for a few days.

I can't really compare the two - I was taking Mirtazpine the whole time I was on amitriptylline, I didn't get particularly bad side effects with either and didn't mind taking them when they worked for sleep. I'm only still on Mirtazapine as the last couple of times I tried to go down to 15 my depression worsened so it obviously is doing something on that front, and without a doubt it saved my life as I was near suicidal when I first went on it.

I wouldn't really recommend amitriptylline, I personally would not take it again.

If your anxiety and insomnia has come about because of menopause then you might be better off following the advice about not splitting the oestrogel first. I see a lot on here about GPs chucking anti depressants at a problem that sounds hormonal and I think it's probably better to not embark on anti ds without tweaking the hormonal side of it first- it just feels like fixing the wrong problem to me.

[nattyd]

started feb 2021 and upped my oestrogel about 8 weeks ago
feels like a very long time since I felt normal!
xx

[discogirl]

hi nicodemus

i take amitrypline as it helps my tinnitus.

it intially helped my sleep then the sedating effect wore off so i take it in the morning now. i was trying to wean off it but when i do my tinnitus increases so im stuck on it i guess.

do you mind me asking why you wouldnt recommend amitrypline. im just curious about other peoples experiences on it.

i hope you dont mind me asking xx

[nattyd]

when i mentioned checking my hormone levels to my GP he said that it was pointless as the levels fluctuate so it would not tell us anything meaningful!  What's the best route for me to go down to properly investigate the hormonal side?
Do I need to go private?

[Gnatty]

I have had no trouble coming off the mirtazapine but I do feel quite sorted hormonewise so that probably plays a part. Also just to throw another idea out there (!!!), has anyone heard of Alpha Stim? It's a device available on the NHS or you can buy your own for the hefty sum of £500. I used it to great effect the other week when I was beside myself with worry about a health issue. All fine btw but had a few days of waiting. The device had a real calming effect and it's supposed to be very good for sleep too. I had never heard of it but it came very highly recommended from a therapist.

[Nicodemus]

I've heard of Alpha Stim - I think in relation to migraines but don't know much about it.

discogirl I wouldn't recommend amitriptyline because of the bad withdrawal (which was totally my fault) and the constipation and because I don't think it's particularly effective for sleep. But if it's working for your tinnitus and not giving you any problems then there's no reason to stop it. I guess with any drug you have to weigh up whether it works vs any side effects you have.

[discogirl]

hi nicademus

your right it only works for sleep the first few weeks.

and you have to withdraw very carefully off it.

did you find it disrupted your sleep at all. thats part the reason i take it in the morning xxx

[Nas]

Hi again nat,
I took 15mg mirtazapine for about a month ( anxiety and insomnia).
I work in a busy school, so did the mirtazapine experiment during the holidays. Side effects were that I became constipated, dry mouth, numb ( mentally) and vivid dreams. I couldn’t wake up at all. Maybe had I given it a few more weeks, things would have gotten better.

I then swapped to Amitriptyline 10mg. At first it helped with sleep, then the effectiveness wore off. I upped to 25 mg and whilst it helped  for a few months, it doesn’t now. Also, if I didn’t  take it early enough, I become constipated the next day! Whilst I can cope with most things, constipation is not one of them! Not really conducive with an early start and getting ready for work etc. So now I take nothing. My sleep is atrocious tbh.

I don’t know what the answer is. I run on adrenaline during the week, collapse at the weekend and live for the school holidays! Not ideal but hey ho that’s  where I’m at.  CBD Is hit and miss. Again,if you take that too late in the evening, it can have an adverse effect. Plus, there are a ton of products, all claiming to possibly help with sleep!

Some say reaching the optimum dose of HRT is the answer. It hasn’t worked for me. I use a 75 patch and coil and feel vile on the 100 dose, even if I do need it.

Hope you can get some sleep soon. Cbd tea at night is good, or valerian tea.
There’s a cure in nature for everything they say! Also CBD gummies for relaxation.

Xx

[Gilla999]

Nat withdrawal is a very real thing from Mirtazapine, although some people are lucky and don't seem to exeprience it. From experience I know I need to taper down at 10% a month otherwise I get rebound insomnia. But that's fine - there are worse things in life! (I experience this with all ADs not specifically Mirt).

I agree with the earlier comment about not splitting your dose of HRT - I've seen several ladies here comment that it gives them insomnia if taken in the eve (though again not everyone!).

All sedating ADs will "stop working" after a while, but (in my opinion) in the sense that they still send you to sleep faster than if they weren't there, but that if there is an underlying reason why you're not sleeping, they won't get rid of it (which is what I was referring to when I said a two pronged approach is best, to address any underlying hormone imbalance).

If I were in your shoes I would try Mirtazapine (starting at a 7.5mg dose), stop splitting my HRT dose and get a blood test to understand your hormone levels. I have had blood tests done almost monthly for nearly 2 years and I have found them invaluable, despite the line peddled that there is no point. They do fluctuate a bit - eg to within 100pmol - but there isn't these wild swings from day to dat that make the data unusable. I use Medichecks who are very good - you'll need a venous blood test if you're using HRT (not a finger prick test). Do the test around day 21 of your cycle (and if you test in future months, test at the same time of your cycle). If you need any more help on the test / which to choose etc, just shout  This will at least give you a baseline of where your hormone levels are and if you decide to increase your HRT dose, you can monitor.

xx

[nattyd]

Hi Nas, thanks for sharing your experience - after the month of trying mirtazapine at 15mg and deciding to stop, did you have any withdrawal symptoms?
I woke about four or five times last night, though thankfully managed to get back to sleep until 5.30am this morning, which is a good night for me these days.
Hope you slept last night, have a great day
xx

[nattyd]

Hi Gilla, thanks for the advice about the blood tests. I am post menopausal so no monthly cycle.
Yes please, any advice on how to find the right tests is appreciated, I think I've only seen a fingerprick one but it didn't seem to be checking all the levels.
Thanks for your help
x

[Gilla999]

Nat if you're post meno then there's even less reason why your levels would be fluctuating and even more reason to get a blood test. Even my GP (who is generally useless) wants to check my levels once a year while on HRT.

This is a link to the Estrogen only blood test on Medichecks. There are lots of others to choose from, depending on what else you might want to get tested, but I would personally start with just Estrogen.

https://medichecks.com/products/oestradiol-blood-test

You need to choose the "visit a clinic to have a venous blood test" option (which is an extra £30). You put in your post code and it gives you the nearest clinic you can go to. Medichecks send you the box, which you take to the hospital, they do the test and then you post it Medichecks. Results usually take 2-3 days. If you don't yet know what Estrogen level you need to feel "well" the first blood test you get might not be super helpful in itself, but it will give you a baseline from which to potentially try increasing or decreasing (under the guidance of your GP) and correlating with how you feel. It could be that it's not enough (I've observed a lot of ladies here not absorbing well) or it could be that it's too much, but in either case I think understanding your baseline will be useful for you.

I would also echo again what others have said in terms of splitting the dose - it may be that taking two pumps of it at nighttime is contributing to the problem. Keep us posted! x

[nattyd]

that's super helpful, thanks so much.
will let you know how I get on
xx

[Noestrogen]

I dont know if its MORE sedating at lower levels but its AS sedating. I take it (very effectively) at 7.5mg (by using pill splitter. This might be because of my low weight though, needing less?) I prefer to consume as little as possible. I was prescribed 30mg per night, but gradually reduced it over few weeks to get to 7.5mg. I even get a sleep-benefit from 3.75mg, but the tiny bits of pill were impractical.

Ive taken it for 15 years. It made me put on a little weight at beginning (which I needed) but unfortunately the weight went again. I havent seen any benefit to mood during day (I only take it at night. Tried during day as experiment but just felt drowsy.)

It makes me sleepy 1 hour after taking and I usually sleep right through night. If I forget it one night, I go back to not getting sleepy until 2 am then sleeping for couple of hours, then being wide awake till I need to get up. (Before this, I had extreme insomnia for 10 years and tried everything possible to no effect.) If I dont immediately switch of light and settle in bed during the sleepy 'window' of opportunity, I end up awake all night, or just take another tablet and wait for the next 'sleep window'...

If you are tired following day after taking it, try going to bed earlier (scientifically proven 1 hour of sleep before 10pm is at least twice as beneficial than 1 hour after 10pm.)

If you are prone to weight-gain your GP might resist prescribing it for you. Mine confirmed what I already knew- that its one of the few anti-depressants that actually works (most are no better than placebo) but because it usually causes weight gain, that have to balance the benefit against the side effects.