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  • Q&A with Australian Health Practitioners

    Mirtazipine 15 mg recommencement - why isn't it working?

    I used mirtazipine 2 years ago for anxiety disorder treatment(with some symptomatic depression),insomnia, poor appetite/weight loss. it worked well with good results immediately. I went off them over a long period of time, and even though id gotten down to 1 8th of a 15 mg tablet at night, i still experienced withdrawal symptoms once i completely stopped.

    I was put back on mirtazipine at the end of november because my anxiety and panic attacks returned after a long period of stress. started at 7.5, then to 15 mg after 3 days. Im finding that it is a very different result from the drug this time,its helping sleep, but the nightmares are bad, waking me into extreme flight or fight panic in the early mornings, which involve diarrea and gagging/vomiting,& they cycle for hours. Im pacing for most of the day, it seems to relieve the rising hot feeling and the urgency to move move move. Im exhausted.

    Shouldnt the mirtazipine be working better than this if I had such good results last time?
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  • 1


    Dr Paul McQueen

    Clinical Psychologist, Psychologist

    While I can't explain why mirtazipine isn't working for you this time around, I can say that this is not an uncommon experience. I have had clients who were recommenced on a medication that once worked wonders for them only to find it does nothing for them the next time. Sometimes a change of medication, even to another in the same class, brings about results. However, bear in mind that a medication like mirtazipine needs to be taken consistently for 4+ weeks before its effects really kick in.

    If you haven't already, I would recommend you investigate additional treatment options, such as cognitive behaviour therapy, which have been shown to be effective for treatment of anxiety. An advantage of psychological treatments is they teach you that you can master your anxiety and depression with your own resources, and provide you wil strategies you can apply at the first warning signs of anxiety in the future.

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