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On avanza mirtzipine for nausea and anxiety. Help?

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Practicing since : 2004
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Hi have been on avanza mirtzipine for 33 days on 30 Mgs was prescribed for nausea and anxiety. Doesn't really help me much am going to come off them what is the best way.
Posted Sun, 20 Oct 2013 in Mental Health
Answered by Dr. Ashish Mittal 1 hour later
Brief Answer:
Need to find out cause of poor response.

Detailed Answer:
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     49 year old male
•     Known case of anxiety and nausea.
•     Currently on Mirtazapine for 33 days.
•     Complaints of: poor response to treatment.

Mirtazapine is good drug for anxiety specially in presence co existent gastric symptoms like nausea in your case. This drug take 4 to 6 weeks to show improvement after achieving the optimum dose for patient.

Apart from that common causes of poor treatment response:
•     Vitamin deficiency: Start multi vitamins (Specially vitamin B1, B12 and vitamin D)
•     Side effect of substance use (stop use if present)
•     Thyroid related problem: get thyroid hormonal assay done
•     Concurrent stress in life

In your case following steps will be helpful:
-Wait for 10-15 days for response
-Increase mirtazapine doses to 45 mg per day, if there is no response with current doses after 2 week, under your psychiatrist supervision.
-You can also start some benzodiezepines medicines (like clonazepam) for short term which immediately relieve anxiety symptoms under your psychiatrist supervision.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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