L

L-L

-
Nov 14, 2019
128
Hi everyone. First time I've posted my own thread despite being around for a while.

I had my psychiatric assessment yesterday and I didn't get sectioned despite being very open and honest about having acquired SN and anti-emetics. However, he did suggest some new medications to replace the Citalopram that I am currently taking and I wondered if any of you guys had any experiences - both positive and negative - that you would care to share before I make a decision on which one I'd like to go with.

As the thread title suggests, the two that he was keen for me to try are either Mirtazapine or Venlafaxine. I've done a bit of searching around for studies done on their tolerability, side effect profiles and interactions that I'll post below if anybody else is interested, but any experiences you have to share would be welcomed.

Thanks for taking the time to read. :happy:

Mirtazapine vs Venlafaxine:

Info on Mirtazapine:


Venlafaxine:


And finally, a very niche study into the possible effects of combining MDMA with Venlafaxine - one of the few things that I enjoy is rolling every now and then - full article accessed by clicking pdf:
 
Nanami

Nanami

Global Mod
Nov 20, 2018
110
From my own experience, Mirtazapine will make you sleep a lot and Venlafaxine will make you struggle to sleep.
They're often combined because of how they affect sleep (California Rocket Fuel).

Personally I preferred just Mirtazapine as I already have severe insomnia issues, and it also acts a bit as an anxiety reducer. Though weight gain is a serious issue of it.

Also, if you ever plan to stop them, mirtazapine withdrawal is uncomfortable but venlafaxine withdrawal is pure hell for a few weeks.
 
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L

L-L

-
Nov 14, 2019
128
From my own experience, Mirtazapine will make you sleep a lot and Venlafaxine will make you struggle to sleep.
They're often combined because of how they affect sleep (California Rocket Fuel).

Personally I preferred just Mirtazapine as I already have severe insomnia issues, and it also acts a bit as an anxiety reducer. Though weight gain is a serious issue of it.

Also, if you ever plan to stop them, mirtazapine withdrawal is uncomfortable but venlafaxine withdrawal is pure hell for a few weeks.

Thanks, @Nanami. I did come across the California Rocket Fuel concept when reading about them, but I'm not sure it's on offer to at the moment.

Even though there are horrendous withdrawals I'm leaning towards Venlafaxine - one of the things I don't like about the Citalopram is that I'm a lot more tired than usual.

Really appreciate your input.
 
N

nonamegirl

Student
Jan 6, 2020
183
I was on Venlafaxine for a few months, didnt help my anxiety or depression, just made me fell sorta "weord" and gave me horrible sweats. I couldnt walk up 10 steps on stairs without getting so sweaty it nearly ran down my face. It was not something I ould live with and seiing as I didnt really feel any effect on my depression and anxiety I tapered off. It was fairly easy and my symptoms during withdraval was managable. Took only a couple of months.

Mirtazapine I have been on 2,5 years. In the first couple of years it was by far the most effective antidepressant I have tried. Amd worked like a charm on sleep (I have tinnitus which makes it very hard to fall asleep) BUT now after 2,5 years my depression and anxiety is back with a vengance. it still works on my sleep but not as effectively as in the beginning. Actually Mirtazapine has worked 10x better on my sleep, then when I was on benzo's. I used to lay awake 1½-2 hours before falling asleep on benzo's. NOT with mirtazapine, it knocks me out.
 
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L-L

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Nov 14, 2019
128
I was on Venlafaxine for a few months, didnt help my anxiety or depression, just made me fell sorta "weord" and gave me horrible sweats. I couldnt walk up 10 steps on stairs without getting so sweaty it nearly ran down my face. It was not something I ould live with and seiing as I didnt really feel any effect on my depression and anxiety I tapered off. It was fairly easy and my symptoms during withdraval was managable. Took only a couple of months.

Mirtazapine I have been on 2,5 years. In the first couple of years it was by far the most effective antidepressant I have tried. Amd worked like a charm on sleep (I have tinnitus which makes it very hard to fall asleep) BUT now after 2,5 years my depression and anxiety is back with a vengance. it still works on my sleep but not as effectively as in the beginning. Actually Mirtazapine has worked 10x better on my sleep, then when I was on benzo's. I used to lay awake 1½-2 hours before falling asleep on benzo's. NOT with mirtazapine, it knocks me out.

Thanks, @nonamegirl. With your Mirtazapine is there any lingering effects on sluggishness or somnolence in the morning?

Mirtazapine does interest me as it's not your typical treatment - most are SSRI's or SNRI's like Venlafaxine.
 
Susannah

Susannah

Mage
Jul 2, 2018
530
I used Venlafaxine (Efexor) for 4 years (3 y at 300mg), and it didn't do me any good. I was depressed, but never suicidal when I started taking it. I remember thinking it helped a little bit in the beginning, but after a while, I got worse and started having suicidal thoughts. I wanted to get of meds, but the withdrawel was awful, even though I "followed the book". I actually ended up at the psyc ward. I've talked to others about Mirtazapine, and then felt ok about this med (except maybe gaining some weight).
 
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CynicalHopelessness

CynicalHopelessness

Messenger of Silence
Jan 9, 2020
940
I used venlafaxine for several months. It made me functional, and the only observable side effect was loss of any sex drive. Withdrawal was very heavy for about 3 weeks, even though I've been gradually reducing the dosage, felt stressed and in the fog all the time.
 
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N

nonamegirl

Student
Jan 6, 2020
183
Thanks, @nonamegirl. With your Mirtazapine is there any lingering effects on sluggishness or somnolence in the morning?

Mirtazapine does interest me as it's not your typical treatment - most are SSRI's or SNRI's like Venlafaxine.

I am drowsy , I can't deny that, but not all day long. Mostly the first 3-4 hours of my day. But I have always been a slow starter and drowsy several hours after waking, so I don't feel the mirtazapine makes that much difference to me in that area. I get most of my energy in the evenings and mirtazapine has not ruined that for me.
 
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L

L-L

-
Nov 14, 2019
128
I used Venlafaxine (Efexor) for 4 years (3 y at 300mg), and it didn't do me any good. I was depressed, but never suicidal when I started taking it. I remember thinking it helped a little bit in the beginning, but after a while, I got worse and started having suicidal thoughts. I wanted to get of meds, but the withdrawel was awful, even though I "followed the book". I actually ended up at the psyc ward. I've talked to others about Mirtazapine, and then felt ok about this med (except maybe gaining some weight).
That really doesn't sound pleasant! Would you attribute your stay in the ward to the Venlafaxine?

I used venlafaxine for several months. It made me functional, and the only observable side effect was loss of any sex drive. Withdrawal was very heavy for about 3 weeks, even though I've been gradually reducing the dosage, felt stressed and in the fog all the time.
How bad was the loss of sex drive? Sounds terrible but having sex is one of the few pleasures I have left.

I am drowsy , I can't deny that, but not all day long. Mostly the first 3-4 hours of my day. But I have always been a slow starter and drowsy several hours after waking, so I don't feel the mirtazapine makes that much difference to me in that area. I get most of my energy in the evenings and mirtazapine has not ruined that for me.
It's good that you still got your energy left. I used to be pretty active in the morning but the Citalopram I take has made me more drowsy as I have moved the dosage up, so I'd like to minimise the risk of it.


There's such an issue with treatment of depression. So many different modes of action for different drugs, and no one drug will work for one person. Can be so disheartening and frustrating when you're trying so hard for the people around you, or even yourself, but everything seems to be stacked against you.
 
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CynicalHopelessness

CynicalHopelessness

Messenger of Silence
Jan 9, 2020
940
How bad was the loss of sex drive? Sounds terrible but having sex is one of the few pleasures I have left.
It was pretty absolute. Nothing aroused me at all, but I didn't feel like I was missing something. It also fully recovered after I stopped.
Then again, I was in despair back then, and pills made me zombie-like, neither of which are a satisfactory state for me. I probably won't be using any ADs anymore.
 
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SonOfSam

SonOfSam

Member
Jan 15, 2020
11
I was on venlafaxine at 300mg for over a year and it was the most effective anti-depressant I've been on. After about a year though it lost it's ability to keep me stable. Coming off of it, being tapered down while in the hospital was really uncomfortable. Although they tapered me, I still got "brain-zaps", which are like shocks inside your head.

I was also on mirtazapine a long time ago. I took it at bed time. It's definitely a sedative medication. If I remember correctly I gained some weight on mirtazapine but not as much as some other meds.
 
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nonamegirl

Student
Jan 6, 2020
183
I was on venlafaxine at 300mg for over a year and it was the most effective anti-depressant I've been on. After about a year though it lost it's ability to keep me stable. Coming off of it, being tapered down while in the hospital was really uncomfortable. Although they tapered me, I still got "brain-zaps", which are like shocks inside your head.

I was also on mirtazapine a long time ago. I took it at bed time. It's definitely a sedative medication. If I remember correctly I gained some weight on mirtazapine but not as much as some other meds.

But it doesnt have this effect on anybody. I have talked to some people who didnt get this effect on it.
 
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SonOfSam

SonOfSam

Member
Jan 15, 2020
11
But it doesnt have this effect on anybody. I have talked to some people who didnt get this effect on it.

Medications will effect everyone differently. Brain chemistry varies greatly and you shouldn't base the effectiveness of a medication off of someone else's experience. If you want the best chance at getting the most out of an anti-psychotic, anti-anxiety, or anti-depressant, you should do your research, but take it with an open mind and record your feelings while on said medication.
 
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nonamegirl

Student
Jan 6, 2020
183
Medications will effect everyone differently. Brain chemistry varies greatly and you shouldn't base the effectiveness of a medication off of someone else's experience. If you want the best chance at getting the most out of an anti-psychotic, anti-anxiety, or anti-depressant, you should do your research, but take it with an open mind and record your feelings while on said medication.

Exactly! :)
 
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BPD Barbie

BPD Barbie

Visionary
Dec 1, 2019
2,361
Mirtazipine at low dose is very very sedative. The higher the dose, the less sedative it becomes. Its a funny drug in that sense.
 
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nonamegirl

Student
Jan 6, 2020
183
Mirtazipine at low dose is very very sedative. The higher the dose, the less sedative it becomes. Its a funny drug in that sense.

But again, not for everybody. And for me the low doses didnt sedate me much. I am on 30 mg. and that worked the best for me in all areas, including sleep. Drugs work differently on people,
 
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RealLifeTamagotchi

RealLifeTamagotchi

memento mori
Dec 15, 2019
29
I'm quite satisfied with venlafaxine right now, but one does have to watch out for serotonin withdrawal syndrome. A month ago my psychiatrist decided to change my medications, and he did it without tapering. I ended up suffering from nausia, dizziness, diarrhea, insomnia. etc. Got back on venlafaxine and the symptoms were gone. I didn't suffer like this when I stopped taking vortioxetine or desvenlafaxine...
 
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Emily_Numb

Emily_Numb

Wizard
Jan 14, 2020
654
Mitrazapine has to be my least favourite psychiatric mediation. It makes you want to do nothing but eat! I would take it at night and within 30 minutes I'd be out of bed and making myself food in the kitchen. I've never been on a drug that had that strong of an effect on me. I put on about 8lbs in 28 days. I stopped it for this reason. There is no way I would ever recommend this drug to anyone.

I am on Escitalopram now which is totally weight neutral and almost appetite suppressing with me which I like. I haven't been on it long enough yet to see any marked benefits but I need to give it time.
 
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Little Mook

Little Mook

Member
Oct 20, 2019
88
I was put on Mirtazapine a few months ago and my moods significantly improved. I'm eating more , but no massive weight gain and I'm sleeping better. No serious side effects so far .
 
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mathieu

mathieu

Enlightened
Jun 5, 2019
1,090
I've used them both, together and separately. Neither helped my depression that much. Maybe a little numbing. Mirt is very sedating so good if you have insomnia. It gives you the munchies but I personally didn't gain any weight.
 
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TotallyIsolated

Mage
Nov 25, 2019
590
Mirtazapine made me extremely sleepy within minutes of taking the first dose! I gained a noticeable amount of weight but then my weight tends to fluctuate anyway.

Currently on Venlafaxine (225mg for a few years and just recently up to 300mg) and I find it *FAR* more effective, though I'm concerned that it disrupts my sleep. Plus the withdrawal is super nasty. I was late getting a refill once... by the fourth day I was shaking and crying all the time. It makes me a little nauseous, but you get used to it quickly.

You need to be on a high dosage of Venlafaxine to get the secondary effects which make it so effective. In the UK you need to speak to a psychiatrist or a GP who specialises in mental health to get the higher dosage.
 
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L

L-L

-
Nov 14, 2019
128
I've used them both, together and separately. Neither helped my depression that much. Maybe a little numbing. Mirt is very sedating so good if you have insomnia. It gives you the munchies but I personally didn't gain any weight.
Mirtazapine made me extremely sleepy within minutes of taking the first dose! I gained a noticeable amount of weight but then my weight tends to fluctuate anyway.

Currently on Venlafaxine (225mg for a few years and just recently up to 300mg) and I find it *FAR* more effective, though I'm concerned that it disrupts my sleep. Plus the withdrawal is super nasty. I was late getting a refill once... by the fourth day I was shaking and crying all the time. It makes me a little nauseous, but you get used to it quickly.

Thanks guys. I went for the Venlafaxine in the end, for better or worse. Don't think I'm going to be able to roll whilst on it, as the withdrawal is too bad to justify it by the sounds of it; but Mirtazapine with its sedation just doesn't seem to be worth it. Difficult to keep up the motivation to carry on sometimes when you consider all of the different variables in the scenario.

Thank you to all for your input, I genuinely appreciate all of you for your inputs.
 
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Deleted member 1465

_
Jul 31, 2018
6,914
Mirtazapine also affects your metabolism. There's a reason why it makes you hungry and gain weight, my endocrinologist told me it can induce the onset of diabetes.
 
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Susannah

Susannah

Mage
Jul 2, 2018
530
That really doesn't sound pleasant! Would you attribute your stay in the ward to the Venlafaxine?

Yes! My psychiatrist had diagnosed me (blood test) with something called serotonin syndrome. My serotonin levels were way too high. This syndrome

How bad was the loss of sex drive? Sounds terrible but having sex is one of the few pleasures I have left.


It's good that you still got your energy left. I used to be pretty active in the morning but the Citalopram I take has made me more drowsy as I have moved the dosage up, so I'd like to minimise the risk of it.


There's such an issue with treatment of depression. So many different modes of action for different drugs, and no one drug will work for one person. Can be so disheartening and frustrating when you're trying so hard for the people around you, or even yourself, but everything seems to be stacked against you.
That really doesn't sound pleasant! Would you attribute your stay in the ward to the Venlafaxine?

Yes! My psychiatrist had diagnosed me (blood test) with something called serotonin syndrome. My serotonin levels were way too high. This syndrome is caused by meds like SSRIs. Nobody at the psyc ward had heard of it, and they thought I was making it up:(

How bad was the loss of sex drive? Sounds terrible but having sex is one of the few pleasures I have left.


It's good that you still got your energy left. I used to be pretty active in the morning but the Citalopram I take has made me more drowsy as I have moved the dosage up, so I'd like to minimise the risk of it.


There's such an issue with treatment of depression. So many different modes of action for different drugs, and no one drug will work for one person. Can be so disheartening and frustrating when you're trying so hard for the people around you, or even yourself, but everything seems to be stacked against you.
 
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Little Mook

Little Mook

Member
Oct 20, 2019
88
Mirtazapine also affects your metabolism. There's a reason why it makes you hungry and gain weight, my endocrinologist told me it can induce the onset of diabetes.

Maybe that's why my gp is already talking about when I start coming off it , which worries me , as whenever I've been med free I have become really delusional with my bdd and severely depressed!
 
Sadddd

Sadddd

How did I end up here
Jan 26, 2020
57
Catching up on this thread after posting a similar question today.

Been on Mirtazapine for 8/9 months. A lot of food cravings (especially carbs) and get very drowsy taking it. Started at 15mg which for me was like a sleeping tablet (hadn't slept more than 3/4 hours for 2 months by that stage tbf) so great that i started sleeping again. then went up to 30 which helped with the anxiety and eventually 45 which was a bit too much.

do find that i am struggling getting up and generally a bit confused and having vivid dreams (nobody else has mentioned this it seems) but situationally i am in a bad place atm so tough to know how much that is effecting it.

Been offered venlafaxine or they will let me go back onto citalopram if i want. The side effects of V have put me off but as @L-L mentioned he has been generally ok and better off on V so it does depend on the person
 
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Moonomyth

Student
Feb 6, 2020
195
I am on a low dose of Venlafaxine presently and I have had mostly good results. My mood has improved and I haven't had any serious side effects that would make me want to stop taking it - no weight gain, sexual dysfunction, anything like that.

The most significant side-effect has been that my dreams have become increasingly strange and vivid since I started taking them. This is not normally a big deal but it can make the nightmares very nightmarish.
 
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Sadddd

Sadddd

How did I end up here
Jan 26, 2020
57
Can I ask how much a low dose is?

Sorry to hear about the dreams/nightmares :-(
 
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Moonomyth

Student
Feb 6, 2020
195
I am on a 75mg dose, which is the lowest I can reasonably get. I am told that there are half-doses of that but you may need to negotiate with your psychiatrist; most research I've seen does increments of 75mgs.
 
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L

L-L

-
Nov 14, 2019
128
Glad you found this thread, @Sadddd - I came on to link you to it now I'm home.

I am on a 75mg dose, which is the lowest I can reasonably get. I am told that there are half-doses of that but you may need to negotiate with your psychiatrist; most research I've seen does increments of 75mgs.

I was one of the people who started at 37.5mg, @Moonomyth, because I was cross-tapering with Citalopram. Today will be first dose of 70mg.

@Sadddd, I don't see why you couldn't request to start at the half-dose I started on, if you're still worried. I saw my Psychologist this morning (not the Psychiatrist who does the prescribing) and she said she thinks I need to go up to 225 as soon as possible. I imagine it'll take a while of increased dosages but I'll let you know how I get on.
 
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