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LucyH

'start Up' Side Effects On Mirtazapine - Is This Normal!?!?

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Hi All,

I am new to mirtazapine - just been prescribed it to mainly help with sleep, though i have depression too, just never taken anything for it, so am hoping for improvements on all levels. I took lorazepam (ativan) for the last 4 months, so the doctor also wanted me to come off that, and thought this would help.

I have taken it for 2 nights now, 15mg per night and am suffering some side effects which have really made it impossible to function the next day.... I cannot even get out of bed until 1pm (took the pill at 11.30pm the first night and 9.30pm last night), have headaches in the morning, completely groggy, spaced....... both nights I have also had REALLY vivid dreams, not nightmares, so OK, but just non-stop totally real feeling dreams. I think I will try to eat much earlier tonight and see if that improves (after reading some posts on this site - very useful, thanks!).

I guess I just want to know that these side effects are normal and will pass..... and roughly how long it will take for them to pass. I have been unable to work the last 2 days (kind of the least of my worries just now, but still, it does not make me feel good about myself to have to cancel workplans), and also have to move flats next friday.... cannot even imagine having the strength for that the way I feel today :-(.

I have not been able to speak to my doctor due to being in bed the last 2 mornings and its now the weekend and I just am not sure whether I should stop taking the mirtazapine or whether to persevere..... I am also aware of the fact that of course these side effects could also be related to the fact that I have stopped the ativan......

I would really like to hear the experiences of others!!!!

Many many thanks!!!!!

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Guest Mogwai

Hi Lucy,

From what i've heard other people say about antidepressants the side-effects, and their severity, are dependent upon the individual. So the side-effects you are suffering from might be normal for you, and it might be that they will subside after a couple of weeks or so. Your doctor should be able to ease your concerns about this more than me, so i would definitely get in touch with him or her as soon as you can.

It may be that this drug is not suited to you at all, which would be a shame considering its been prescribed to help you sleep - i don't think there is another AD out there that has a similar effect.

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Hi All,

I am new to mirtazapine - just been prescribed it to mainly help with sleep, though i have depression too, just never taken anything for it, so am hoping for improvements on all levels. I took lorazepam (ativan) for the last 4 months, so the doctor also wanted me to come off that, and thought this would help.

I have taken it for 2 nights now, 15mg per night and am suffering some side effects which have really made it impossible to function the next day.... I cannot even get out of bed until 1pm (took the pill at 11.30pm the first night and 9.30pm last night), have headaches in the morning, completely groggy, spaced....... both nights I have also had REALLY vivid dreams, not nightmares, so OK, but just non-stop totally real feeling dreams. I think I will try to eat much earlier tonight and see if that improves (after reading some posts on this site - very useful, thanks!).

I guess I just want to know that these side effects are normal and will pass..... and roughly how long it will take for them to pass. I have been unable to work the last 2 days (kind of the least of my worries just now, but still, it does not make me feel good about myself to have to cancel workplans), and also have to move flats next friday.... cannot even imagine having the strength for that the way I feel today :-(.

I have not been able to speak to my doctor due to being in bed the last 2 mornings and its now the weekend and I just am not sure whether I should stop taking the mirtazapine or whether to persevere..... I am also aware of the fact that of course these side effects could also be related to the fact that I have stopped the ativan......

I would really like to hear the experiences of others!!!!

Many many thanks!!!!!

Ativan is a drug of addiction you need to wean off of it to avoid the withdrawal effects. The symptoms you describe seem to be typical Mirtazapine type. My experience was that the first 15mg flattened me. This effect quickly reduced but there is still permanently a sleep inducing effect. I must take it before bed or I will want to fall asleep where ever I am.

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Thanks Mogwai and Old friend for your replies. I am doing better now (its sunday, and i'm now on my 4th day of Mirtazapine). The ridiculously groggy/spacey effects which meant I could not even leave the house lasted only 2 days, and yesterday I was fully of energy! Its only 10.30am here in Amsterdam on sunday morning, but already I am feeling like it will be another good day!

I am still not sleeping too well..... certainly can stay up a few hours after I have taken my 15mg... and find when I do fall asleep, I wake up one hour later and then continuously throughout the night, and the vivid dreams continue. But, despite this, I am feeling better. Forgot to mention it in my first post, but I have also been suffering chronic fatigue, and am hoping this will be less on Mirtazapine.

I will discuss with my doctor again soon.... I am surprised now I have researched more that she did not cut down the ativan dose; but instead replaced it with mirtazpine. I was taking 1-3mg per night of ativan, which is maybe also not the way you are meant to take it?? I was basically varying the dose depending on whether or not I was sleeping on it. Some nights I'd sleep 3 hours then get up and take another pill.

Anyway, thanks again, and I'll keep on the Mirtazapine and see how I go!!!

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LucyH,

Only just joined so picked up on this thread a bit late. I have been on Mirtazapine (M) for about ten weeks now and for me at least, the sedating effects you are describing did fade after a week or two.

I have read somewhere (and my doctor has confirmed) that ironically, M can be more sedating at lower doses (ie 15mg) due to its antihistaminergic properties. Higher doses are generally less sedating as this sedating effect is thought to be offset by the increased noradrenaline release at higher doses (ie 30mg - 45mg). My doctor started me on 15mg for five days to be upped to 30mg thereafter. Once I had been on the 30mg for a few days, the sedating effect had almost completely disappeared.

Far be it from me to give any prescription advice but it may be worth discussing with your doctor upping the dose from 15mg.

Incidentally, a good friend of mine is a vet and and he said that M is indicated as an appetite stimulant for cats!

Just thought I'd throw that into the mix.

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I just joined, so maybe it's too late for peopole to see this in the thread. Anyway, yesterday I got prescribed mirtazapine. I have been on fluoxetine for a while but it wasn't helping that much at all. I took 1 15mg tab last night. Had a broken sleep, woke in the night with a rging headache, vivid dreams (though not nightmares) and couldn't get up this morning. It's not 5:00pm and I still feel totally spaced out, almost drunk-like. I'm going to take 1 15mg tab tonight and see how it goes. I don't like these additional feelings, they are not welcome and if today is anything to go by then they are going to upset my routine, which I don;t see as good.

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Took my dose last night and slept well. It's only Day 2 but the difference in sleep is that I feel I have rested, so big tock in the box. Lots of dreams again, though not nightmares. I woke late again and still difficult to get out of bed on time, although now I am up (at 10:00am) I feel slightly weary but a lot better than yetsreday - not nearly as spaced out.

I'm also working today, which is great. Hope it lasts!

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Lucy H,

I have been taking Remeron for 2 days now. The first night I took it I slept very deeply and for a long long time. I was very tired and lethargic all day. The second night I took it I did not fall asleep until 12am despite having taken it at 9pm. My sleep was very light and I woke up often. I also had very vivid dreams. On the plus side I am not nearly as lethargic or tired today, so that is good.

You commented that:

I am still not sleeping too well..... certainly can stay up a few hours after I have taken my 15mg... and find when I do fall asleep, I wake up one hour later and then continuously throughout the night, and the vivid dreams continue. But, despite this, I am feeling better. Forgot to mention it in my first post, but I have also been suffering chronic fatigue, and am hoping this will be less on Mirtazapine.

I will discuss with my doctor again soon.... I am surprised now I have researched more that she did not cut down the ativan dose; but instead replaced it with mirtazpine. I was taking 1-3mg per night of ativan, which is maybe also not the way you are meant to take it?? I was basically varying the dose depending on whether or not I was sleeping on it. Some nights I'd sleep 3 hours then get up and take another pill.

That was back in May. I wondered what your experience has been since then in terms of sleep. I am a bit dismayed that this drug is supposed to help with sleep but didn't help me last night. I am curious to see what it does tonight. Does it take a while for the sleep part to take? It seems to work on sleep for everyone and I find so little from anyone that said it didn't work except you. I would love to know what happened next for you!

AZ

Edited by az8zs

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Hi All,

I am new to mirtazapine - just been prescribed it to mainly help with sleep, though i have depression too, just never taken anything for it, so am hoping for improvements on all levels. I took lorazepam (ativan) for the last 4 months, so the doctor also wanted me to come off that, and thought this would help.

I have taken it for 2 nights now, 15mg per night and am suffering some side effects which have really made it impossible to function the next day.... I cannot even get out of bed until 1pm (took the pill at 11.30pm the first night and 9.30pm last night), have headaches in the morning, completely groggy, spaced....... both nights I have also had REALLY vivid dreams, not nightmares, so OK, but just non-stop totally real feeling dreams. I think I will try to eat much earlier tonight and see if that improves (after reading some posts on this site - very useful, thanks!).

I guess I just want to know that these side effects are normal and will pass..... and roughly how long it will take for them to pass. I have been unable to work the last 2 days (kind of the least of my worries just now, but still, it does not make me feel good about myself to have to cancel workplans), and also have to move flats next friday.... cannot even imagine having the strength for that the way I feel today :-(.

I have not been able to speak to my doctor due to being in bed the last 2 mornings and its now the weekend and I just am not sure whether I should stop taking the mirtazapine or whether to persevere..... I am also aware of the fact that of course these side effects could also be related to the fact that I have stopped the ativan......

I would really like to hear the experiences of others!!!!

Many many thanks!!!!!

As with all psychotropic medications, it takes time for our bodies to get adjusted to them.

Benzodiazepines ( Ativan, Xanax, Valium) are so far the safest medications in terms of their wide marginal safety profiles, also Benzos are not cardiotoxic (doesn't affect heart fuctions), no anticholinergic effects ever noticed, and work on the first day it is being taken. Although our bodies develop tolerance to its sedating and "re-inforcing effect" (things that make us feel good in the brain system, through GABA-A/Benzodiazepine receptors), research shows that our bodies do not develop tolerance to its antianxiety effect.

With Mirtazapine, it laso lacks anticholinergic effect, does not affect heart function as Tricyclics or SNRI ( Effexor, which raises blood pressure), does not impair sexual performance.

Mirtazapine works by releasing noradrenaline and serotonin from the synaptics, but unlike SSRI's (Prozac, Zoloft etc), it blocks Serotonin (5-HT2) type2, Serotonin (5-HT3), as well as Histamine (H1), and alpha-adrenoceptor, therefore it does not cause nausea, nor akathisia ( a form of restlesness ), and it improves sleep, and considered as being a 'nootropic agent' ( improve cognition on the next day, when researches being conducted had shown that it improve driving performance compared to placebo).

It takes time for our bodies to get adjusted to this medication. It has a half life around 20-40 hours in the body, and if sedation still persists even with a low dose, maybe another form " The Soluble Tablet" would be appropriate, as it is absorbed faster into the blood stream, and entirely metabolised during sleeping, reducing the hangover the next day.

A couple of my friends are taking the SolTab, found that it sedates them for 20 minutes, then they wake up again, unable to continue to sleep.

I guess everyone has a different reaction to Mirtazapine, mainly we have different genetic and different level of the amount of the enzyme to breakdown Mirtazapine, that is Cytochrome P450 2D6 and 3A4. Some medications induce the enzyme in our liver, such as Carbamazepine, Sodium Valproate, Phenytoin, Phenobarbital, making it faster to breakdown the substrate ( in this case the Mirtazapine), some other medications inhibits the breakdown of the substrate, making it longer for Mirtazapine to stay in our body system.

So far, Ativan does not have an active metabolite, neither does Oxazepam ( SEREPAX, SERAX, MURELAX in Australia), but when Mirtazapine is taken together with Xanax ( Alprazolam), which is also a substrate of CYP 450 3A4, the level of either drugs could be raised double, even triple in the blood stream, leading to a feeling of severe drowsiness.

In my own experience, I used to take Xanax 2mg daily, but when my Psychitrist added Mirtazapine, a quarter of a tablet of Xanax ( 0.5mg) produces the same effect as though I am taking 2 mg of Xanax on its own. So I cut down on Xanax to 0.5 mg.

I think in your case, it is best to give it a time for Mirtazapine to get adjusted in your body system, meanwhile, if sedation still persist on the next day, maybe you can discuss it with your doctor to switch it to the SolTab form. Good luck.

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Hi, I just started on mirtazapine about a week or 10 days ago, to battle insomnia mostly but also depression. I have that weird sleep cycle that seems to be reversed or gone, I fall asleep only when I'm so exhausted I can't go on. I have noticed the headaches and vivid dreams, also a different mental state after taking this med, in the last couple of days my sciatic nerve has started really bugging me, I didn't make it to work today because I could hardly sleep last night it was so annoying. Is this possibly a side effect of the mirtazapine? I also have been taking buproprion for 9 years and was prescribed oxazepam as a backup in case the Mir didn't put me to sleep. Thanks

Ryan

Also taking the mirtazapine for anxiety, forgot to add, I have very high anxiety.

Edited by awakentired

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. . .I have taken it for 2 nights now, 15mg per night and am suffering some side effects which have really made it impossible to function the next day.... I cannot even get out of bed until 1pm (took the pill at 11.30pm the first night and 9.30pm last night), have headaches in the morning, completely groggy, spaced....... both nights I have also had REALLY vivid dreams, not nightmares, so OK, but just non-stop totally real feeling dreams. I think I will try to eat much earlier tonight and see if that improves (after reading some posts on this site - very useful, thanks!).

I guess I just want to know that these side effects are normal and will pass..... and roughly how long it will take for them to pass. I have been unable to work the last 2 days (kind of the least of my worries just now, but still, it does not make me feel good about myself to have to cancel workplans), and also have to move flats next friday.... cannot even imagine having the strength for that the way I feel today :-(. . . .

Hmm, those side effects never really go away. Well, they lessen over time, but some remain indefinately, speciffically having a hard time dragging yourself out of bed (i have a dual alarm clock at the other side of the room). Groggyness should lessen, as should feeling spaced. Headaches should go away completely. This drug will slow you down.

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Hi All,

I am new to mirtazapine - just been prescribed it to mainly help with sleep, though i have depression too, just never taken anything for it, so am hoping for improvements on all levels. I took lorazepam (ativan) for the last 4 months, so the doctor also wanted me to come off that, and thought this would help.

I have taken it for 2 nights now, 15mg per night and am suffering some side effects which have really made it impossible to function the next day.... I cannot even get out of bed until 1pm (took the pill at 11.30pm the first night and 9.30pm last night), have headaches in the morning, completely groggy, spaced....... both nights I have also had REALLY vivid dreams, not nightmares, so OK, but just non-stop totally real feeling dreams. I think I will try to eat much earlier tonight and see if that improves (after reading some posts on this site - very useful, thanks!).

I guess I just want to know that these side effects are normal and will pass..... and roughly how long it will take for them to pass. I have been unable to work the last 2 days (kind of the least of my worries just now, but still, it does not make me feel good about myself to have to cancel workplans), and also have to move flats next friday.... cannot even imagine having the strength for that the way I feel today :-(.

I have not been able to speak to my doctor due to being in bed the last 2 mornings and its now the weekend and I just am not sure whether I should stop taking the mirtazapine or whether to persevere..... I am also aware of the fact that of course these side effects could also be related to the fact that I have stopped the ativan......

I would really like to hear the experiences of others!!!!

Many many thanks!!!!!

Hi I took mirtazapine and it took around 2 weeks for my body to get used to it. The first 3 days where the worst and then it got slowly better. I had to get used to the groggy feeling as well but it does go away. Although I should mention I didn't sleep for 4 days straight before I started the meds. I can't sleep when I am depressed. So the second night I slept for almost 20 hours. I'm guessing the 15mg are just the starting amount as they where with me but don't worry if you up your meds later you won't go through the same symptoms as when you started, your body will already be used to the drugs. I also agree with the others that you could also be experiencing side effects from ativan but the drowsiness of the mirtazapine should help it a bit, it did with me, although I was stopping another med not ativan. I hope you start feeling better soon xoxo

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Hi All,

Benzodiazepines ( Ativan, Xanax, Valium) are so far the safest medications in terms of their wide marginal safety profiles, also Benzos are not cardiotoxic (doesn't affect heart fuctions), no anticholinergic effects ever noticed, and work on the first day it is being taken. Although our bodies develop tolerance to its sedating and "re-inforcing effect" (things that make us feel good in the brain system, through GABA-A/Benzodiazepine receptors), research shows that our bodies do not develop tolerance to its antianxiety effect.

With Mirtazapine, it laso lacks anticholinergic effect, does not affect heart function as Tricyclics or SNRI ( Effexor, which raises blood pressure), does not impair sexual performance.

This was not the case with me, after a few months my sex drive slowly decreased and after 10 months it was practlicaly gone and that is when I quit. Advise to others if you are lossing your sex drive talk to your doctor the meds might be at a wrong dose

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I started Mittazapine almost a week ago. I slept heavily through the first night. After that, my sleep was more "normal" for me (waking up throughout the night) but I have been having vivid dreams throughout the night. I tend to get tired very quickly after taking it but I don't feel very groggy in the morning. In fact, today I was far more alert than I'd been in a while.

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Hi mauers,

It can take up to 8 weeks for your med to have it's full effect, it seems that at least you are able to sleep better and not feel groggy in the mornings. Some people after given the time for the med to take full effect the vivid dreams seem to go away but every individual reacts differently to each med. It's good to hear that you are feeling more alert now as that is important to make it through each day.

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hi. thought id add my experiences of the side effects of mirtazpine. i started on 15mgs 6 nights ago. it still takes me ages to get to sleep and then its only very light and i keep waking. i also have very vivid dreams. i feel spaced out all day. im not tired in the mornings but still cant get out of bed because of the groggy feeling. due to see the doctor tomorrow so i will see what he has to say. sandra

forgot to say i dont know if this is a side effect but my temper is a lot worse. i snap at the least little thing.

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Hi sank,

It really does take time for the medication to work it self into your system and many people do have vivid dreams with remeron, some people do better on the higher dosages and some do better on the lower dosages as everybody reacts differently to meds. I would bring up the fact that you feel your temper has gotten worse with the remeron with your pdoc. I haven't heard of any side effects of tempers rising with remeron but like I said everybody is different. Let us know what your pdoc says.

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Hi Sandra,

I'm on day 4 of treatment with mirtazapine, and I can say I feel just as irritable as you do. On Day 2 I felt quite violent, like I wanted to attack anyone who pi**ed me off. This is out of character for me, and my girlfriend is very worried. I am also getting vivid nightmares, but at least I am sleeping quite well, during the day I feel quite groggy. I am also taking 3 x 1000 mg per day of L-tyrosine to help with mood, energy and concentration, we'll see how it goes...

Cheers,

IB

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Hi All,

I am new to mirtazapine - just been prescribed it to mainly help with sleep, though i have depression too, just never taken anything for it, so am hoping for improvements on all levels. I took lorazepam (ativan) for the last 4 months, so the doctor also wanted me to come off that, and thought this would help.

I have taken it for 2 nights now, 15mg per night and am suffering some side effects which have really made it impossible to function the next day.... I cannot even get out of bed until 1pm (took the pill at 11.30pm the first night and 9.30pm last night), have headaches in the morning, completely groggy, spaced....... both nights I have also had REALLY vivid dreams, not nightmares, so OK, but just non-stop totally real feeling dreams. I think I will try to eat much earlier tonight and see if that improves (after reading some posts on this site - very useful, thanks!).

I guess I just want to know that these side effects are normal and will pass..... and roughly how long it will take for them to pass. I have been unable to work the last 2 days (kind of the least of my worries just now, but still, it does not make me feel good about myself to have to cancel workplans), and also have to move flats next friday.... cannot even imagine having the strength for that the way I feel today :-(.

I have not been able to speak to my doctor due to being in bed the last 2 mornings and its now the weekend and I just am not sure whether I should stop taking the mirtazapine or whether to persevere..... I am also aware of the fact that of course these side effects could also be related to the fact that I have stopped the ativan......

I would really like to hear the experiences of others!!!!

Many many thanks!!!!!

Hello - new to this forum - in fact new to any forum!

I have just started on mirtazapine 15mg 4 days ago (this is my first time on anti depressants) and I have become a complete zombie! My concentration is gone, I have no motivation, everything is an effort I feel hungover and dizzy/vertigo symptoms... i just cannot function or socialise even. i am taking it at night and i sleep really well but am so groggy in the morning, I have had to cancel work for the past 4 days and I am getting to be really worried that the symptoms aren't subsiding much.... I know you started a year ago in May 2009 but I wanted to ask you did these effects go away after the first week or 2.... i would rather feel the way I did before taking the meds than the way I feel right now!! This is just Hellish, I will push through if I knew there was a light at the end of the tunell, I dont see my doc again until Wed - it's now Sat. There is talk of upping the dose in a couple of weeks to 30mg and that thought petrifies me right now thinking I will be feeling twice as worse! Please tell me your symptoms subsided dramatically after a week or 2? Thanks :)

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Hi holmesy76,

for most people these side effects do go away in time, do talk with your doctor about your symptoms though if this is causing you too many problems. There is a pinned topic at the top of this page " Remeron FAQ's " here is the link for it as it will give you a lot of information along with the side effects that Remeron may cause.

http://www.depressionforums.org/forums/Rem...AQ-s-t1663.html

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Thank you secret Mist, I really appreciate your reply - I have been on 15mg of Mirtazapine for 8 days now and alot of the side effects have subsided, although I still feel very anxious and dizzy/vertigo alot of the time, especially whilst working in front of the computer or trying to concentrate on something like reading etc I hope these side effects eventually go away as well - I understand these symptoms are also symptoms of the actual depression they are trying to prevent but they feel quite heightened whilst on the medication- hopefully another week and all will be good regarding the side effects.

Hi holmesy76,

for most people these side effects do go away in time, do talk with your doctor about your symptoms though if this is causing you too many problems. There is a pinned topic at the top of this page " Remeron FAQ's " here is the link for it as it will give you a lot of information along with the side effects that Remeron may cause.

http://www.depressionforums.org/forums/Rem...AQ-s-t1663.html

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Your most welcome holmesy76, Yes I would say that if after another week if your dizziness/vertigo doesn't ease up then chat with your doctor. Although it does take time for the meds to get into your system and work and for the side effects to ease up you really don't need that dizziness/vertigo especially if you drive. Do let us know how you do on it.

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Hi all,

I thought I would chime in. I really appreciate hearing everyone's experiences. I am very sensitive to medications and am in the process of getting back on remeron again after being on it several years ago. Unfortunately, the start up has been complicated by lots of nausea and being physically ill since I was already on a tricyclic (nortriptylene). My doctor was adding in the remeron for recurrent depression. So, I have had to taper off nortrip and am slowly going up on the remeron.

Because I am so sensitive to medicines, my doctor has the remeron "compounded" so I can go up in smaller increments. I literally started on 1 mg and have increased by 1 mg every 4 days. I am now on 6 mg and will go up to 7 mg tomorrow. . This seems to really help with the extreme sedation i get from the remeron start up.

Anyway, it is very slow going and I am having lots of woozy head and grogginess, but will hang in there. Woozy head and balance issues seem to be part of my depression symptoms anyway, so I have to remember that. It is really encouraging to hear others who had a hard time with the start up of remeron but did eventually do well on it.

all the best!

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I am coming up to the end of my 3rd week on Remeron and i must say i am loving this stuff :)

My probs are anxiety, went thru decreasing intesity but 3yrs of anxiety/panic attacks when i quit drinking in Sept 2007.

The 1st yr and a half were the worst

my problem now is mostly depression and with that bad sleep. Just was not sleeping. Getting to sleep was ok most times it was

staying asleep. kept waking up ever hour. Was exhausted all the time. I also get acid reflux many nites. some nites i even wake up choking.

been on various formulations of St Johns wort for years. Tried Cypralex and Paxel but could not take the side FX. Tried Trazodone but wasnt for me.

Tried Zopiclone for sleep and it worked for a while but one of the side fx of that was bad for me. (worsening depression) Even tried drinking again(ya i know - bad idea) was given a proton pump inhibitor for the acid reflux and that helps but dont like taking it for too long so i only take it when it gets really bad.

I finally got around to giving Remeron a go (was prescribed in Feb 2010) .. i am chicken to try new meds after reading all the sideFX.

The first day i took it, about a quarter of a 30mg.. and omg i was sooooo farging tired. i took it at 5pm and it was a struggle to stay awake

until 11pm. but that overwhelming tiredness was only really the first nite. I sleep great now and the dreams are wild and fun.

the first week i was kind of groggy for the morning but now its nothing. I take 15mg at 9pm and in bed at 11pm and up at 6am.

so far i really do not have any of the side fx. i had a blood test last week to check my white blood cell count and that was normal. no sexual sidefx.

none of the weight gain or bad cravings. Well maybe a bit :) i do notice i wanted potato chips and icecream lately so i have to becareful about that.

One good sidefx is i have more energy now and am working out more than i could before.

i notice anxiety is about gone. i am relaxed and while not a giggling ***** happy..i am happier and less gloomy. I notice i can actually feel things now. Instead of being on autopilot and feeling nothing.

so for me - so far - looks like remeron and me get along just fine :)

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This is an old topic, but though I'd reply anyway.

I started Remeron a week ago Monday after coming off Lexparo (4 weeks on). My first night of Remeron I took 7.5mg. I got a little drowsy maybe, but nothing out of the ordinary. I slept 8 hours and felt refreshed in the morning with a positive mood. First time in months. I thinking coming off Lexapro helped my mood since it had flatlined all my emotions. Anyway, I slept pretty good the next couple of nights, very vivid dreams, mood decent, then after 3 nights I increased my dose to 15mg. Didn't cause any more drowsiness, still sleeping okay, vivid dreams, mood decent, a couple of days later my mood was really good in the morning but in the afternoon it kind of tapered off, but still felt content. But then last Wednesday, I woke up still feeling a decent mood, but by the afternoon I tanked, and had anxiety, depression, awful thoughts/feelings were back. I have anxiety, depression, and insmonia. Lexapro started to help with the anxiety but flat lined my emotions. Not sure if this relapse was Lexapro withdrawal or what. My anxiety increased, I couldn't sleep, it was awful. The next couple of nights I slept a little better, the bad thoughts/feelings were still there, but then the next night I tried 30mg of Remeron thinking that this might help incase the 15mg pooped out already, but I didn't sleep that much better but the next day I didn't have all the bad thoughts, just anxiety. I went back to 15mg last night, and didn't sleep that well, still have anxiety, but the bad thoughts aren't there.

I think I might be experiencing Lexapro withdrawal, although I was only on it 4 weeks, but I had only tapered off it for 3-4 days. Maybe that wasn't enough. Not sure why it took about 9 days to finally have withdrawal side effects. Or, maybe this relapse was actually start up side effects of Remeron that took 10 days or so to rear it's head. Has anyone experienced ups/downs when starting up remeron, or had increase in anxiety for a bit? I know that it can take time for Remeron to kick in, and I'm still under 2 weeks, so I'm sure I need more time to feel any anxiety/depression benefits. I just wonder if 15mg will be enough? My MD said I can try 30mg. My Pdoc things I should go back to 7.5mg for a few nights to see how I do, since I'm senstive to meds. I just wish I knew why I was feelings so good and then had a relapse, was it lexapro withdrawal or remeron start up, or some of both?

How long has it taken Remeron to kick in for you, for either Anxiety ,Depression or both? Did you have good sleep to start, then not? Did sleep re-improve over time?

Thanks

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