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What Causes Agitation While On Mirtazapine?
Question: I have been taking Mirtazapine for 1 week. Today has been the worst day. I was so angry & agitated then I just got really emotional. Sick of changing antidepressant because of the side affects or not working. Feeling extremely down, wanting to give up on life.
Should I stop taking them?
Should I stop taking them?
Brief Answer:
do not stop right now, let me know your illness symptoms and more history
Detailed Answer:
Hi,
Thanks for writing to us.I can understand your sadness and frustration.
Mirtazapine in rare case can cause agitation as a side effect.But in depression anger outburst can also be caused by depression itself. From your history it seems that you are suffering from depression.
Please do not take any step that can harm yourself. Depression can be treated.No need to think about giving up life .
Let me know your illness history with symptoms and detail of medicines(dose, duration and effects) so I can give more comments about treatment aspect.
Right now do not stop mirtazapine without consulting your doctor.In any case if your anger continues consult treating doctor and then stop mirtazapine.
I will be happy to help you further.
Regards,
Dr.Chintan Solanki.
do not stop right now, let me know your illness symptoms and more history
Detailed Answer:
Hi,
Thanks for writing to us.I can understand your sadness and frustration.
Mirtazapine in rare case can cause agitation as a side effect.But in depression anger outburst can also be caused by depression itself. From your history it seems that you are suffering from depression.
Please do not take any step that can harm yourself. Depression can be treated.No need to think about giving up life .
Let me know your illness history with symptoms and detail of medicines(dose, duration and effects) so I can give more comments about treatment aspect.
Right now do not stop mirtazapine without consulting your doctor.In any case if your anger continues consult treating doctor and then stop mirtazapine.
I will be happy to help you further.
Regards,
Dr.Chintan Solanki.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi
Thank you for replying.
I've suffered depression on & off over the past 10 years. I've tried talking to councillors but never really helped.
I've tried lots of different antidepressant pills but never end up staying on them due to side affects. I put in a big effort last year to loose over 20kg but now it's all just creeping back on.
I recently tried Prozac which I really liked because it didn't make me want to eat, BUT I couldn't sleep and was having anxiety attacks.
At the moment all I do is eat, constantly looking for something nice but nothing satisfies.
Wish I could just find an antidepressant that didn't make me suffer with side affects.
Just feels like a constant struggle.
This morning I took my previous antidepressant Coperin 60mg as well as taking the mirtazapine 15mg.
Is this ok?
I was prescribed the mirtazapine as I have great difficulty sleeping. I try listening to meditation & generaly fall straight to sleep, but that only last a couple of hours then I'm awake.
When I don't sleep makes my depression worse. I end up not going to work & end up quitting my job. I can't afford to leave another job, I'm getting older (40yrs) & jobs are getting harder to find.
I'm really over the rollacoaster.
I don't really just have one doctor I go to. I go to a medical centre & see whoever is available. Please help me .
Thanks XXXXXXX
Thank you for replying.
I've suffered depression on & off over the past 10 years. I've tried talking to councillors but never really helped.
I've tried lots of different antidepressant pills but never end up staying on them due to side affects. I put in a big effort last year to loose over 20kg but now it's all just creeping back on.
I recently tried Prozac which I really liked because it didn't make me want to eat, BUT I couldn't sleep and was having anxiety attacks.
At the moment all I do is eat, constantly looking for something nice but nothing satisfies.
Wish I could just find an antidepressant that didn't make me suffer with side affects.
Just feels like a constant struggle.
This morning I took my previous antidepressant Coperin 60mg as well as taking the mirtazapine 15mg.
Is this ok?
I was prescribed the mirtazapine as I have great difficulty sleeping. I try listening to meditation & generaly fall straight to sleep, but that only last a couple of hours then I'm awake.
When I don't sleep makes my depression worse. I end up not going to work & end up quitting my job. I can't afford to leave another job, I'm getting older (40yrs) & jobs are getting harder to find.
I'm really over the rollacoaster.
I don't really just have one doctor I go to. I go to a medical centre & see whoever is available. Please help me .
Thanks XXXXXXX
Brief Answer:
Benzodiazepine should be added to prozac for sleep disturbance
Detailed Answer:
Hi XXXXXXX
Thanks for follow up and information.
Coperine(duloxetine) and mirtazapine work almost with same mechanism. So there is no specific advantage of taking both simultaneously. It is ok if you have taken today but do not take it further on your own.
You mentioned that you were better with fluoxetine and due to sleep problem you did not take it. In my opinion you should be given benzodiazepine like clonazepam for sleep with prozac. We use this combination in lots of patients.Prozac initially can cause anxiety attacks but later it can treat anxiety actually.
For this much chronic problem you should consult a psychiatrist regularly so treatment strategy can be applied successfully. In depression any medicine must be taken for at least 4-6 weeks before considering it ineffective.
Depression in current medicine practice is treatable condition as lots of medicines and other options are available.
Medicine from SSRI group(Fluoxetine, sertraline, escitalopram, paroxetine),SNRI group( Desvenlafaxine, Mirtazapine, Duloxetine) , NRI (Bupropion) or TCA(Imipramine) can be combined in suitable combination when one is not effective alone.
If combination is not effective lithium or lamotrigine can be used. Another option is combination of olanzapine with fluoxetine.
ECT (elctro convulsive therapy ) is also very safe and effective treatment approach and when depression is not responding to medicines.
Psychotherapy - Cognitive behavior therapy should also be applied simultaneously.
Go for your serum thyroid and vitaminn B12 level also(if not done yet). Deficiency of the same is also associated with resistant depression.
In conclusion you should consult a good psychiatrist regularly.
Hope I have answered your concern.
Feel free to discuss further.
Benzodiazepine should be added to prozac for sleep disturbance
Detailed Answer:
Hi XXXXXXX
Thanks for follow up and information.
Coperine(duloxetine) and mirtazapine work almost with same mechanism. So there is no specific advantage of taking both simultaneously. It is ok if you have taken today but do not take it further on your own.
You mentioned that you were better with fluoxetine and due to sleep problem you did not take it. In my opinion you should be given benzodiazepine like clonazepam for sleep with prozac. We use this combination in lots of patients.Prozac initially can cause anxiety attacks but later it can treat anxiety actually.
For this much chronic problem you should consult a psychiatrist regularly so treatment strategy can be applied successfully. In depression any medicine must be taken for at least 4-6 weeks before considering it ineffective.
Depression in current medicine practice is treatable condition as lots of medicines and other options are available.
Medicine from SSRI group(Fluoxetine, sertraline, escitalopram, paroxetine),SNRI group( Desvenlafaxine, Mirtazapine, Duloxetine) , NRI (Bupropion) or TCA(Imipramine) can be combined in suitable combination when one is not effective alone.
If combination is not effective lithium or lamotrigine can be used. Another option is combination of olanzapine with fluoxetine.
ECT (elctro convulsive therapy ) is also very safe and effective treatment approach and when depression is not responding to medicines.
Psychotherapy - Cognitive behavior therapy should also be applied simultaneously.
Go for your serum thyroid and vitaminn B12 level also(if not done yet). Deficiency of the same is also associated with resistant depression.
In conclusion you should consult a good psychiatrist regularly.
Hope I have answered your concern.
Feel free to discuss further.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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