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has anyone tried Mirtazapine for sleep?

Discussion in 'General Treatment' started by outdamnspot, Oct 20, 2013.

  1. outdamnspot

    outdamnspot

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    due to my severe insomnia, I've been thinking about trying Mirtazapine .. I was in fact on it a few years ago at 30mg, but found it provoked a severe increase in anxiety; I'm not sure how the pharmakinetics change with dosing, but I believe lower doses are far more sedating, so wasn't sure if I'd have an issue ..

    anyway, I was wondering if a) tolerance develops to the sedative effects and/or hangover, b) if there's cross-tolerance with antihistamines (50mg of Doxylamine is like a sugar pill at this point), and c) if there's a risk of next-day irritability (something I get with Doxylamine)?

    the only other thing I haven't tried is Lyrica, but I hear it can cause rebound anxiety and that tolerance develops ..

    thanks!
  2. outdamnspot

    outdamnspot

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    by the way, I've tried herbal supplements, melatonin, etc. all without success .. so it's going to have to be something pharmacological at this point. I'm been experimenting with amitriptyline the past two nights, but I took 20mg two hours ago and feel totally out-of-it and slightly sedated, but not the point where I can sleep, which is frustrating because it doesn't really leave me able to do anything
  3. Hugocfs

    Hugocfs Senior Member

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    When I started relapsing in the Fall of 2011, I developed severe insomnia. Eventually in January of 2012, I was put on 30 mg of mirtazapine. I didn't have any of the side effects you experienced. My main complaint was that it was too drying. I developed hard stools which gave me a prolapsed internal hemorrhoid. I cut back my dose to 15 mg, but it was too late. I ended up getting the hemorrhoid rubberband ligated. I also added 400 mcg of melatonin. Most people try too much melatonin, so it might be something you might want to reconsider. I was advised to try between 300 and 500 mcg. Higher doses can actually be counterproductive and make your sleep worse. Give the low dose of melatonin at least 3 weeks to work. Eventually I was able to cut the mirtazapine down to 7.5 mg and most nights I sleep pretty good now. Good luck.
  4. Hugocfs

    Hugocfs Senior Member

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    Ps. A lot of people complain of weight gain with mirtazapine. I never had any issues with my weight since I have been on it, but then again I am an ectomorph.
    minkeygirl likes this.
  5. outdamnspot

    outdamnspot

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    thanks for the suggestion, but melatonin makes me profoundly depressed, so it a no-go
  6. minkeygirl

    minkeygirl Senior Member

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    Nothing over the counter helps me sleep. The only thing I can take right now is Trazodone (which I've been taking for years).

    I have tried Doxepin, Seroquel, Baclofen, Elavil and more and they either totally drug me out or make me feel "speedy".

    I am working on finding a few other things so I can switch off but I can tell you it's all trial and error. What we know is that what works for one does not for another.

    I also have heard that Remeron causes major weight gain by making you hungry all the time. If I was going to take it it would be to switch off with other meds.
  7. alex3619

    alex3619 Senior Member

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    Be careful with your first dose of Mirtazapine. Take a minute amount, a scraping, and have someone with you. I think this is the drug (Avanza) that almost killed me as I am a hyper-responder. That can happen with any drug, its not specifically about this one (except to me), but its worth being cautious with ME or CFS on the first few doses of any new drug.

    In my case I was asleep in under a minute. Sounds good so far. The problem is for the next four days I could only wake up momentarily if at all (and not sure when, probably day three and four) and even after that I was groggy and sleeping almost all the time for some more days. If this happened in the middle of our summer here, I would have died of dehydration in my sleep. If I had taken a full tablet, I don't know that I would ever have woken up. I took only a scraping from the side of a minimum dose tablet.

    So be careful on the first dose, start at a tiny tiny dose, and build up over several days if you respond OK. Also, as I said, make sure someone is going to look in on you to ensure you are OK.
    Valentijn and Hugocfs like this.
  8. outdamnspot

    outdamnspot

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    That's interesting, minkeygirl. I actually feel 'speedier' after taking 20mg of amitriptyline two hours ago .. I'm more mentally anxious and have slightly more energy than usual (though it isn't very comfortable), and am not noticeably sleepy. In fact, none of the TCA's have worked for sleep.

    I have a lot of paradoxical reactions and was beginning to resign myself to the fact that maybe I'm just bipolar or something, but I guess it could be a sensitivity.
  9. outdamnspot

    outdamnspot

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    Thanks for the warning alex and sorry to hear about your awful experience! What's interesting is that Mirtazapine actually becomes paradoxically sedating the lower you go, so taking a tiny 'scraping' will be far more sedating than starting on 7.5 or 15mg.
  10. minkeygirl

    minkeygirl Senior Member

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    I have that reaction to a lot of things, meds and supplements. I never once thought I was bi-polar (at least not from the meds LOL).

    It's just one of those things that happens so I move on to the next thing. Like I said, it's all trial and error. There are people here who trade off with about 10 different things to not build up tolerance or get addicted.

    That has been my plan I just have not found anything that works for besides Trazodone and with that there are only 2 generics I can take since I have problems with the inactive ingredients in the others.
  11. Azrael

    Azrael

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    A) Sure tolerance might change, what can happen is that you sleep good in the beginning but after a few months not so good, or there wont be a problem at all.

    But you should be extra careful due to the anxiety you experienced before on the same meds.

    Hangover: Some patients have reported heavy hangovers the day after and especially the first few starting days. If you're lucky it could disappear overtime or not so, stay with you for longer.

    I would look for something different.

    I don't know you - but due to your severe insomnia you feel desperate, so desperate anything that is sedative makes you feel it is worth trying?

    Some suggestions:

    A good b-complex might balance you within a few weeks, along with daily activity. Have helped many I know with both depressions and problems sleeping.
    Have you ever tried 5htp ? It's a precursor to serotonin. Could help!
    If you already have a high histamine problem sam-e could be beneficial. Could help depending on your brain chemistry

    That's all advices I have for now

    b) No idea

    c) Like with all mental meds there's a risk of irritability, but the heavy hangover might be a bigger problem.

    I hope to hear more from you if it's getting better or not.
  12. minkeygirl

    minkeygirl Senior Member

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    @azreal I WILL not sleep without a med. NOTHING I do helps. B-complex doesn't help, I am too ill to exercise. 5HTP is like speed. Melatonin may help but it doesn't put me to sleep.

    For me when I ask for help I have exhausted all other options.

    SAM-e no, Tryptophan gives me a headache. The list of things I have tried is too long for me to even remember.

    After all that, he only thing that puts me to sleep that I have not built up a tolerance to is Trazodone. If that stops working I am royally screwed which is why I, like outdamnspot try things to help us sleep.

    I did just try Tizanidine. It put me to sleep at 10 but only for 3 hours. When I took at at 3 when I always wake up, it did not work.

    outdamnspot We all have different reactions to things. Take what others say into consideration but move on with your quest to find something to help you sleep.

    Only someone who has severe insomnia and has problems with meds knows what it's like to try to find something to sleep.

    Feeling drugged for days or like we are on speed is the price we have to pay to find something to help us sleep.

    BTW, I heard Lyrica also causes huge weight gain.
  13. Hugocfs

    Hugocfs Senior Member

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    This is extremely good advice from Alex which I forgot to mention. When I started on mirtazapine, I was extremely starved for sleep. I think my initial dose was 7.5mg (which I slowly built up to 30 mg). The first night it knocked my socks off. And I dreamt like crazy. I took my first dose on a Thursday night which was a mistake as I was still working then. Somehow I made it to work but I really did not wake up until about 1P the following afternoon. As they always say, start low and go slow.
  14. outdamnspot

    outdamnspot

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    I ended up getting a script for Mirtazapine. I'll report back on how it goes!
  15. Grigor

    Grigor

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    My GP wants to prescribe me Mirtazapine.

    I tried amitriptyline. I was sedated but fel tlike I was awake all night. A weird feeling. Plus I felt awful the next day. So a bit scared to try Mirtazapine. Or people who tried it feel that it has a different effect???
  16. Valentijn

    Valentijn Activity Level: 3

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    I haven't tried it, but it's one of the drugs which suppresses ADRA2A. ADRA2A has been shown to be over-expressed in ME patients after exertion. I take Yohimbe for the same effect, however, because it's much more specific - basically it only has a strong effect on the ADRA2 receptors.

    But Mirtazapine does a lot of stuff with the serotonin receptor as well, and I have done very badly with SSRI's in the past so prefer to avoid that. But it also has a big impact on the histamine receptor, which might be nice.

    It seems a bit weird to use it for sleep, since that's not an intended function, but rather a side-effect. It's primarily intended to be an anti-depressant - not that that means a damned thing.
  17. Azrael

    Azrael

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    Hi Minkeygirl

    I see it's over half a year since i wrote that to you

    I understand your situation a little better now.

    Do you sleep better today?

    That you expereince 5htp as speed is worrying. I have experienced that as well but it went away pretty quickly and i was able to sleep after 3 hours from that speeded feeling. I see this is alot tougher for you. I would make a qualified guess and say you have severely high nor adrenaline. But I also wonder if you could have high serotonin, if both are high serotonin and NA - choline pre cursor to acetylcholine might be low and trying that carefully on low dose could be helpful.

    So im asking you:
    Do you have dry mouth?
    Do you feel hot?
    Do you have allergy symptoms?
    Any Constipation?
    Are you sensitive to garlic and onions?

    Dry mouth and being unpleasantly hot is a clear marker of high noradrenaline

    Have you gone through any genetics to see what is wrong?

    Both bcaa and b3 niacineamide do lower catecholomines like noradrenaline and serotonin, which one works better depends on who takes it so you would have to try them and see what works the best. But i think b3 has more punch and is cheaper. I have both taking them on different days. But I doubt that is the only thing that should be done.

    Taurine should balance noradrenaline perhabst you have way to low taurine levels and taurine is manufactured in the body by methionine and cystein. But you should stay away from methionine as that will create even more NA. But taking taurine directly CAN make things worse but it depends on your specific brain balance.

    Im thinking if glutamine can help you but im not sure I know too little at this point about your other symptoms apart from not being able to sleep.

    I have high nor adrenaline too so I recognise your problems.

    Stay away from coffee or any caffein product as that will keep raising NA
    Try to avoid cheese (hard chesse) as that contain tyrosine precursor to dopamine
    As you said avoid everything with serotonin as long as you feel like this.

    What's it like after eating a dinner? Is your stomach upset, cramps or just feel awful in your stomach area?

    Or just sometimes or often?

    Would love to hear from you again.
    Last edited: Apr 10, 2014
  18. wastwater

    wastwater

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    It made me sleep then induced what I call depression,couldnt take it more than two days,but it might be completely different for you.
  19. adreno

    adreno 3% neanderthal

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    Yes, I've tried it. It's like an off switch.
    ggingues likes this.
  20. minkeygirl

    minkeygirl Senior Member

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    @Azrael I am seeing a NP who has my 23andMe results. She is aware of my sleep issues and is in a better place to figure out what is going on with me in general.

    What I will say is high adrenaline is NOT my problem as I am pretty much flatlined below normal starting at 7 a.m.

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