Reports of use of mirtazapine

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Thomas
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Re: Reports of use of mirtazapine

Unread post by Thomas »

Calm Amygdala wrote: Tue May 25, 2021 2:27 pm What benefits did you experience in regards to both depression and pssd? I'm consideringtrying 7.5 mg for help with depression/pssd
I wasn't depressed but suffered from some anxiety / sadness, low libido and insomnia. Doc gave me low dose mirtazapine for insomnia, but it was 100% effective on anxiety and sadness. I was doing wonderfully. Somehow effective on insomnia.
This is quite the opposite of what was supposed to happen (antagonism of the H1 receptor is by far the strongest activity of mirtazapine, thus theoretically sedative effects are supposed to happen at lower dose than antidepressant effects)
Escitalopram, 10mg/day, Jan-May 2019. Fluoxetine, May-Sept 2019. Mirtazapine 7,5mg/day, November 2019-January 2020. Escitalopram, 5mg/day, Feb-May 2020.
Symptoms: sexual & emotional numbness
sovietxrobot
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Re: Reports of use of mirtazapine

Unread post by sovietxrobot »

Calm Amygdala wrote: Tue May 25, 2021 2:27 pm What benefits did you experience in regards to both depression and pssd? I'm consideringtrying 7.5 mg for help with depression/pssd

Also, have you experienced any rebound depression/pssd since coming off? Did you switch to something else or just stop mirtazapine?
No benefit to depression or anxiety. It modestly boosted my sexual function across the board, but that effect didnt last very long. I didnt replace it with anything.

Oddly enough, coming off of mirtazipine gave me a big boost in mood and function. When tapering off of Effexor (several years ago) I had tremendous gains towards the end of the taper and for 3-4 months afterwards- sexual function was almost completely restored. Unfortunately it didnt last and I drifted back to baseline. The only time I get rebound depression/pssd is after ketamine treatment.
Calm Amygdala
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Re: Reports of use of mirtazapine

Unread post by Calm Amygdala »

really, that is fascinating. i am undergoing ketamine treatment right now and am noticing a worsening of symptoms. Does your ketamine doc give you ondansetron before sessions? I have found 5ht3 antagonists worsen my symptoms substantially and i think the worsening of symptoms may be due to the ondansetron rather than the ketamine. i can post clinical studies where 5ht3 antagonists induced sertonin syndrome (huge increase in serotonin) and i think they may aggravate pssd as well.

so you noticed no rebound in depression after coming off mirtazapine?
Calm Amygdala
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Re: Reports of use of mirtazapine

Unread post by Calm Amygdala »

My hope is i can get good improvements in depression/pssd from mirtazapine without anxiety. Its noradrenergic activity can cause anxiety in me, as it has in the past. but ive never tried low dose. Looking to capitalize on its activty at 5ht1a, 2a, and 2c for depression/pssd
sovietxrobot
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Re: Reports of use of mirtazapine

Unread post by sovietxrobot »

Calm Amygdala wrote: Thu May 27, 2021 3:33 pm really, that is fascinating. i am undergoing ketamine treatment right now and am noticing a worsening of symptoms. Does your ketamine doc give you ondansetron before sessions? I have found 5ht3 antagonists worsen my symptoms substantially and i think the worsening of symptoms may be due to the ondansetron rather than the ketamine. i can post clinical studies where 5ht3 antagonists induced sertonin syndrome (huge increase in serotonin) and i think they may aggravate pssd as well.

so you noticed no rebound in depression after coming off mirtazapine?
No, I haven't heard of ondansetron. I just get the nasal spray. I'm not sure I will continue on it, I don't feel much of a boost after the rebound depression resolves. I'm curious about the long term effects though.

I have never experienced rebound depression. Tapering off of Effexor, trazodone, and mirtazipine all provided very substantial benefits. Trying to taper down escitalopram or buspar has been a disaster every time. As soon as I lower the dosage my anxiety goes into overdrive and I can't function. That could also be a rebound effect.
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