Is mirtazapin a good choice as antidepressant?

[grifs]

Hi,
I found this forum looking for mirtazapin and cortisol.
I suffer from depression and anxiety. I also have low testosterone but wasn't treated for it cause the damn docs always said it's still normal.
I am planning to go on TRT but first I have to do more tests to find out if I'm primary or secondary and who. This means I will need to go some HTPA stimulation tests.
And that's already a problem. If I start with mirtazapin now and go to an endocrinologist in a few weeks and possibly get a LHRH test or GNRH test then could mirtazapin interfere with these tests and cause false results? After all I read that mirtazapin lowers cortisol this shows that it affectes hormones. I worry now that this stuff could make the test results unusable by distorting them.

And what I also worry about is that mirtazapin causes weight gain. I cant afford to gain weight I have already gained a lot due to being depressed and eating too much.

And I also wonder if mirtazapin lowers cortisol then does this always have to be good?
What if you end up having a lack of cortisol due to it?

Damn I really wish I knew what to do. I already declined to take effexor out of fear because this drug has a bad rep and if I now also decline to take mirtazapin the doc will be pissed.

 

[Omen88]

In my experience mirtazapine is a very effective anti depressant. I have gained lots of weight on it though, but nothing that can't be overcome with exercise and common sense. I am however hungry all the time, and crave carbs. But since I suffer from insomnia as well, and mirtazapine is quite effective for that as well, I am happy with it.

Do keep in mind that everybody responds differently. It could very well be that due to lifting your depression you become more active and do not need to comfort eat anymore.

I do find it odd that your doc actually prescribes two (kind of) SNRIs. Do you have a problem with attention disorder? Otherwise, most commonly an SSRI is prescribed, such as escitalopram (lexapro).

I do not know about hormonal influences of these medications though.

Good luck with your treatment

 

[grifs]

Hi, what do you mean with 2 kinds of SNRI? He only suggested effexor. But remeron isn't a SNRI.

I don't know if I have ADD. I think there is a chance I might have it but haven't really been tested for it. Maybe effexor would have worked but I read so many bad things about it that I was too afraid to take it.

I'm also scared of gaining weight. I already weigh too much. I absolutely must not gain more fat.
I also read some people got fat on remeron even though they didn't eat more. Is this possible that it slows down the metabolism or something like that?

ps: I already tried celexa 20mg for 1 month but this stuff did nothing for me.

 

[Omen88]

Well technically it isn't an SNRI, it is a TCA. However, it makes you produce more serotonin and at dosages of >= 30mg also norepinephrine. My doctor does refer to it as SNRI though. To be more precise it acts as an antihistamine at 15mg and SNRI at 30 and above

 

[grifs]

@ omen

Can you confirm that the effect you get is different at 15mg and at 30mg or higher? Does this mean if you take 15mg at night you become tired but if you take 30mg or 45mg at night then it will make you more alert? That would also suck cause at night you don't want to take something which stimulates you.

 

[Omen88]

There is indeed a difference. I notice falling asleep pretty well at 30 and being active in the morning. At 15 I sleep even better, but then I'm tired all day.

Citalopram is the same as escitalopram, where escitalopram only contains the active isomer. So that explains your doctor's reasoning to try mirtazapine.

 

[grifs]

so is remeron working out for you? i worry that it might not be strong as antidepressant or that i gain weight.

what's also weird is that it says you can also take it in the morning and evening. now if you took 15mg in the morning then this would make you totally tired wouldnt it?

and what also suck is that it says no alcohol and no benzos. i like to drink beer or wine at night and sometimes i also need a benzo before exams.

 

[Omen88]

It has gotten me out of the deepest of misery. I would even say it makes me border on mania
Taking it in the morning would be a very bad idea. Just take 30 mins before sleep. It also combines very well with classical SSRIs as it will blast your receptors with noradrenalin and serotonin, while the SSRI will prevent the reuptake, meaning it will drain in serotonin.

Mirtazapine is the best AD in my book, you'll just need to vigilant on your weight.

I never experienced any probs with combining with benzos or booze. But be very careful the first times. Your mileage may vary.

 

[grifs]

Your experiences suprise me. From what I read most people dont seem to like remeron.

What's weird is that in the leaflet it says not to combine it with a SSRI because of serotonin syndrome.

It also says if you feel euphoric you should call your doctor, lol. How do I know when it's time to call the doctor? Then you even have to be worried in case you feel better that feeling better is also a side effect.

And do you have experiences with alcohol? Can you still drink something in the evening or better not?

 

[Omen88]

I know about the serotonin syndrome and it is indeed a risk, however the symptoms are quite easy to detect. If I were a doctor I would say, no don't combine with alcohol. But I also like a glass of wine in the evening, without any troubles.

And again you might react totally differently. You could check out www.crazymeds.us for a lot of anecdotal reports on ADs.

I hope the best for you. And trusting you med is already halfway the battle won.


pS: I hated Effexor, gave me panic attacks