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[GalwayGirl]

Hi all

I posted before re: Mirt. I am 10 days in and started on 7.5 with a couple of nights of a bit more- meddling with taking a little bit off then not being able to do it the next night… I saw my psychiatrist yesterday for first time and he wants me to either start on 15mg asap or taper to sertraline. I did something very stupid last night and took half at 7.5 then woke at 4am panicked that I should be just taking it so took another bit - not the actual full half as couldn’t find it - and now feel dreadful and strange and a bit tripped out. I didn’t get back to sleep either.  I have also had this very dark mood whilst I have been on Mirt that I haven’t had before - anxiety +++ is my usual issue with desperate suicidal thoughts. But this is very strange like I am fighting a dark rising panic and I want to flee and get this drug out of my system . But in another way I feel a bit  better and more like me - although I am still not sleeping - it has not given me a full nights sleep - only on 3 occasions. I am so conflicted whether to carry on as I’m also scared by what I have read about Mirt and how hard it is to come off and how people feel worse after a few months in- I’m so reluctant to commit because of fear of this dark mood and irratibility- but i am also not getting any sleep - even my insomnia is beating Mirt . So if I carry on and it’s awful then I fear the awfulness of having to come off and try again which I just cannot face either. So questions:
- have I messed up the balance of things by my stupid 4am meddling? Will this settle?
- had anyone else had the dark mood and feeling weird and surreal which is out of character and does it get better?
I find it so hard to stick things out and accept the long haul - I wish they were like paracetamol- 2 weeks and your better ….. does anyone else also mess with their meds like this out of desperation as I do and have managed to recalibrate ? So worried about takin the dose like this - they are not to be messed with and I can’t understand why I do when I know this ! I’m sure no one else is as stupid as me.
I have rang me team this morning also to ask for advice fyi.

[CrispyChick]

I don't have advice on the mirt. But be assured, I'm just as stupid. I mess all the time, esp with hormones.

As you know, any antidepressant is a short haul pain for long term gain. But that first month can feel hellish.

So. Rather than beat yourself up about what you've done, I think you need to make your decision. Your phsychiatrist has given you a choice. There must be a reason for this.

So, after last night, your 3/4 of the way towards 15mg!

Or u swap now to sertraline. And stick.

I know how brutally hard it can be. I really do. But if you make the decision, backed by your expert, then hopefully they'll help get you through it  xx

[Nik2502]

Hi

I was on Mirtazapine for years. It helped me sleep but I put four stone on! No problems at all coming off it.
It did make me feel low at first but it passed after about a month.

Nik x

[GalwayGirl]

Thanks Crispy- you are so supportive and helpful. I agree I need to do something but I just have this lurking feeling that this isn’t for me - very dark thoughts and panic which isn’t my MO. Equally I can’t face another switch but my gut is telling me that this ain’t good for me. It’s all very frightening. Ive taken a Diazepam to help which I usually hate doing but just felt so desperate. It’s a good insight into how much my issues are anxiety related rather than depression hence my desperation to find something else to manage it. When it’s under control life feels so much better and manageable but it’s been so long since I have felt that. I’m so sensitive to ADs I just feel trapped and have never got to therapeutic dose. All a bit of nightmare xx

[GalwayGirl]

You are lucky Nik ! Wish I could say the same. I don’t even sleep on Mirt as everyone else does xx

[Emmia49]

Hi GalwayGirl!

I feel for you and I am so sorry you have such a hard time.

Unfortunately ADs are nightmare when you start and a real hell to stop.

BUT when your mind is in a total dark place and you feel you cannot function at all, well, you have to decide.

If you have a doctor you can really trust, then follow his advice and let him guide you.

The Ad road is hard to walk alone. ADs take time, time and time. 12 weeks is a minimum time for one to feel better.

For me it was 4 months when I could really say I am ok. I thought I will never survive this.

Mirtazapine can help you with sleep, but is your dose high enough? I take 30mg and it helps. At first, I took 15mg for 2 weeks and it didn t help. 30mg is where I feel ok and don t have perimenopause symptoms.

Switching too soon will not help, you will have to go through side effects again and you will still have to wait for weeks to feel any better.

So, please, be strong and try to preserver....I believe you have the strenght ....

My prayers and thougths are with you!

Emma

[CrispyChick]

Did you get to a therapeutic dose on citalopram???

I wonder if you're putting too much pressure in the sleep issue. You're only on low dose mirt and the others like ssri do not make you sleepy. But, overtime, that should improve as your anxiety calms.

Are there other options to help you sleep on the short term??? Some antihistamines make folk sleep???

I don't think you've been happy since starting mirt. So I'd probably consider the sertraline. But it will not sedate you or maybe you sleep. You need to be prepared for that. What dose dies your phys suggest?

[GalwayGirl]

Thank you both so much for your replies.

No I didn’t get to a therapeutic dose for CT- couldn’t go above 10. it sent my insomnia wild and i did not sleep for 12 weeks- many nights of no sleep and then 2 or 3 hours on other nights- it absolutely killed me. I tried to increase the dose but i just felt like i was on speed and it made me just manic and constantly clenching my jaw but i only did it for a couple of days i could never try again as i was too fearful. I think part of the problem is that i was in such a state when i started them had only been on hrt for 6 weeks and wasn’t absorbing which i didn’t know - my estrogen was 18pmol when i started! I had heightened sensitivity and still do.

CC- Mirt is used to treat insomnia at 7.5 as it has strong anti histamine blocker but even my insomnia has beat it.

Emma i know you are right it will be a nightmare to start again and I can’t bring myself to do it but  also just can’t face the long haul of this in my system it already feels awful 10 days in- i never got used to citalopram it made me feel awful every single day and i dread the same again - but a huge part of it was lack of sleep. The only thing it did do was help my concentration and i feel that all that has gone and im all over the place, not working and back to not caring about my appearance. It just knocks my motivation and i can’t sleep again. My psych said i just cannot let go and accept that i need treatment but i have to somehow have a leap of faith. I know he is right but i just have this block and cannot relax and accept that i need this and that it is changing my mood - did it do this for you? Cit just made me so anxious and enhanced all my existing problems- i just obsessed over what it was doing to me physicallly and didn’t always feel so concerned about what it is doing to me mentally. This is all so different and odd. Harder also cos im on my own- 20 year marriage ended so feel just lost in trying to make good decisions for myself. I think if i switch i will find issues on the next one- i just want the old me back without having to go through this pain- and deep down i can’t help but feel i dont need them but then i know the reality if my anxiety isn’t contained. I haven’t worked or seen friends for 6 months so have to get real. Just wish could take diazepam long term!
Sorry for the long rant but it really does help to share. Emma what side effects did you have and how did they fair over time ? Im so hugely sensitive this is half the problem. I can’t even take caffeine as it makes me feel like im on speed.
I feel utterly wiped out on this, pale with blood shot eyes and headaches - none of that on Cit but did generally feel like shit with racing heart and constant jitters. I only wish I could sleep every night for 7 hours as that is no doubt part of it.
Thanks for all your support xx

[Kathleen]

Hello GalwayGirl


I am sorry that you feel so bad.  I haven't been troubled by insomnia but I can relate to all the mental struggles that the menopause brings.

I am currently on 50 mg of oestrogen and 100 mg of Utrogestan taken orally and I still have physical symptoms so I know the dose isn't adequate but I don't want to change anything and risk more episodes of breast pain and bleeding.
I am also on the AD Venlafaxine which I was told would help me sleep and this may be the reason I don't have insomnia.

I am still plagued by mood changes and I was recently prescribed Pregabalin,  25 mg. I was told that this is a starter dose to see if it is well tolerated and if so I could increase to 50 mg. I believe that this drug is often used to treat nerve pain and anxiety.   Like you I have used Diazepam on occasion.

Perhaps you could ask about using Pregabalin instead of an AD? My menopause nurse tells me that this drug is available to treat menopause problems.

Wishing you well and take care.

K.

[Gnatty]

I am sorry I don't have time for a longer reply but Mirtazapine only sorted out my insomnia at 15mg. 7.5mg didn't work at all. x