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[flutterby]

Hope it’s ok to pop back on here seems a long time
3 years ago I started to suffer from really bad insomnia after several months the doctor gave me mirtazapine 15mg. This has worked well for my anxiety and reasonably so for the insomnia.
However, before Christmas, I started sleeping badly again but thought it was just Christmas stress.
However, it is has continued and now it’s just as bad as before. Real problems getting to sleep and then very little sleep.
I think if I wasn’t still having hot flushes, I’m 72, at least getting to sleep would be easier. I start to fall asleep and then feel a bit of doom/ panic and I’m wide awake
Am I right in thinking that increase in the dose would take away the
sedating effect?
Has anybody else experienced this?
Can you take anything else for sleep with Mirtazapine ( it still seems to be working for anxiety)
Need to be informed before going to GP
Thank you in anticipation
Flutterby x

[CLKD]

How bad are the flushes?  There is a AD which apparently eases those symptoms rather than full on HRT.

I hate that sudden waking as I drop off, usually I fall up a kerb 

[flutterby]

Hi CLKD
I can manage them well during the day. It is this feeling of dread and then hot flush that wakes me
Don’t have too many during night
I’ve tried the sleep hygiene techniques, emotional freedom technique, increased magnesium intake
I’m at a loss and worried about rising anxiety level
Flutterby x

[CLKD]

My anxiety rises for no apparent reason  .  Could U speak to a pharmacist to C what else is appropriate with your regime?  I found Bachs rescue remedy throat spray helps, two squirts and don't think whether it works/ not. 

[Gnatty]

Hi there I think in answer to your question about a reduction in the sedating effect, the higher the dose - I think it depends on the individual. So for some they sleep better on a lower dose and for others better on a higher. See what your doctor says. You could always try a  higher dose and see if it makes a difference before you see the GP so you know if it is worth increasing.  Could you suddenly have become sensitive to coffee? Try and think if there are any other changes that might have had an impact. Maybe your oestrogen levels have taken another dip? Something to consider.

[flutterby]

Hi Gnatty
I’m going to make a GP appointment
When I was on HRT I slept really well as soon as I came off 9 years ago I noticed the difference. 3 years ago after a close younger friend died suddenly and Covid the insomnia started and 6 months later I went on Mirtazapine with good results until now.
HRT would solve it but I don’t think they would allow me to go back on it at 72 ☹️
CLKD - I’ll get my Rescue Remedy out 😊
Flutterby x

[bombsh3ll]

I also take a low dose of mirtazapine for chronic insomnia, 7.5mg.

For me there is no hormonal component as I have had it for years and am not deficient in ovarian hormones.

You are correct that at higher doses the sedative effect is lost.

Regarding hormone therapy, it's your body, your health and your money, nobody else gets to say whether you're "allowed" hormone therapy.

This paternalistic attitude among clinicians is now thankfully dying out, and I would say if one provider cannot meet your needs, go somewhere else, don't just give up!

[flutterby]

Hi bombsh3ll
I will mention HRT when I go and maybe very gradually decreasing the Mirtazapine to 7.5 mg
Flutterby x

[Gnatty]

Just to reiterate, not always the case that less is more. When I reduced to 7.5mg my sleep was worse. So if that happens to you try 22.5mg instead. Hopefully one will suit!

[flutterby]

Interesting to hear of your own personal experience with the increased dose, Gnatty
It least I have options
Thanks

[dawncowp44]

I started on 15mg of mirtazapine and after 10 - 14 days of unpleasant side effects I started getting of to sleep much more easily and seemed to sleep more deeply.

2 weeks ago I increased my dose to 30mg which only lasted 2 nights then I reduced to 22.5mg.  Again, another 10 days of unpleasant side effects and my sleep has got bad again although I do have a nice clear head, i have also been very jittery & unsettled, I guess the higher dosage just doesn;t work for me.  I'm reducing my dosage back to 15mg tonight & when I next talk to my GP I'm going to ask about a combo which may help my insomnia & anxiety.  I have heard that 7.5mg is actually the best dosage for insomnia but that doesn't seem to be a typical dosage in the UK.

[flutterby]

Hi Dawn
I have been taking magnesium just before bed as well as the 15mg Mirtazapine. It helps some nights but last night it was 3pm before I went to sleep ( however I was rather worked up after watching Trump and Vance on the news)
I am still going to pursue some relaxation techniques
If I may ask, what was the reason for upping your dose to 30mg
Flutterby x