Suggest alternative for mirtazapine
try venalafaxine and etizolam
If mirtazapine is not helping but making the situation worse, then I think you should try venalafaxine. You should also take etizolam along with it in morning and afternoon for one to two weeks and later taper and stop it.
The usual dose of venalafaxine - 37.5-75mg & increase it upto 225mg as needed by increasing 37.5mg each time. Dose is increased prefrably after a week.
Etizolam is given in in dosage of 0.5mg twice a day.
You should also taper and stop mirtazapine by reducing 7.5mg at a time after every three days.
Dont worry, it is a common problem that patient has difficulty in responding to one drug. Mirtazapine is a right molecule but not suitable for your body type.
Also taking zanax on and off disturbs bodily mechanism and then main drug has difficulty in giving results. so, dont go back to zanax please, it is addictive and habit forming and not the proper drug. It is quick to response but wrong.
Wish you good health.
Dr. Manisha Gopal