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Powerful Sedative, Then Numbing of Emotions
Mirtazapine & Fluoxetine
Citation:   James1987. "Powerful Sedative, Then Numbing of Emotions: An Experience with Mirtazapine & Fluoxetine (exp111522)". Jan 6, 2019.

20 mg oral Pharms - Fluoxetine (daily)
  30 mg oral Pharms - Mirtazapine (daily)
I was prescribed Mirtazapine in April 2017 after not having much success with Fluoxetine (it was my third time with Fluoxetine and though it had helped a lot previously it didn't seem to be working well this time). Unusually I was taking both drugs together for a short time until I had a bad reaction that was possibly mild serotonin syndrome and had to stop the Prozac but we will get to that later.

So back to April last year and after a particularly bad few days mental health wise (long story short I was getting virtually no sleep due to nightmare neighbors and had pretty much had a breakdown) I ended up with an appointment to see a psychiatric nurse who passed on my details to the psychiatrist at the hospital and he prescribed me Mirtazapine. I will point out that I had been taking the prozac for 2 months at this point. I didn't even see the psychiatrist myself, the nurse relayed what he had said and it was as follows. Unusually, a) he told me to continue taking the prozac which I had been on for a couple of months prior (20mg) and added the Mirtazapine to the later amazement of doctors at my surgery who said they would never usually prescribe both together and b) Started me on the full 30mg dose with no titration up which initially knocked me for six. This is a really powerful sleep agent when first taking it.

The first pill was taken at 9pm that night and by 9:30 I could feel the effects, walking had become more difficult and I started feeling very drowsy. By 10 I could hardly keep my eyes open and a phone call with my mum was basically useless as I could barely find the words to say. I felt almost drunk and walking nigh on impossible, more like a stumble close to the walls so I didn't fall over. I fell asleep almost instantly and woke up at half 8. I would have stayed asleep a lot longer but I was staying in a youth hostel and breakfast was at 9.

I quickly realised I was no where near sober - 12 hours after dosing; and managed to make my way downstairs and just about keep it together, the staff and other there probably thought I was hungover or still drunk. This feeling persisted for another couple of hours until I walked home and felt normal around lunch time. That day I went to an outpatient psychiatric facility due to the suicidal ideation I had been having, kinda of like a halfway house between being sectioned in a hospital and being at home.
We had freedom to do what we wanted and could come and go but were required to give medicines to the staff and had check ups to see how we were doing and some group sessions, things like that. In total I spent a week there. So the second and third night I took half a pill (15mg) due to being totally knocked out the night before and all in all coped pretty well with it. Day 4 in the mirtazapine and I went back to the full 30mg and fared considerably better this time though still made me very sleepy.....

This sedative effect lessened over the next few weeks and now, having been on it (8 months), it's barely noticible. About 4 months into my treatment (August) a strange thing happened. By this point I was still taking the fluoxetine one afternoon I started to feel anxious and unable to sit still. Over the coming hour my heart began to race, I was pacing up and down and felt like I had had 10 cups of coffee. I was literally clenching my fists, grinding my teeth, sweating and shaking. I called the ambulance who came out, checked me over and told me it would be a good idea to stop taking one of the drugs immediately as taking both together was not advised (thanks psychiatrist). They also asked if I wanted to go to hospital but I declined and thankfully a couple of hours later I started to feel more normal. I stopped the prozac and have been continuing with the Mirtazapine and luckily have had no more ill effects.

Fast forward to today (January) and to summarize I would say it has helped to some extent with depression and anxiety. I have noticed that it has dulled my emotions. Though I no longer feel the almost instantaneous tiredness I did when first taking it I do feel a bit numb, which I guess in a way is the point. The other noticeable side effect is a huge increase in appetite. I've gained 3 stone while on it however being an atypical antidepressant it doesn't have the dreaded sexual side effects of SSRI's.

Taking this for depression/anxiety, I would avoid alcohol at all costs until not affected by the sedative side of things. I gained weight. The experience when I had to call out the paramedics was particularly scary. I later learned that taking two drugs that both increase serotonin can be a recipe for disaster. Peace.

Exp Year: 2017ExpID: 111522
Gender: Male 
Age at time of experience: 29
Published: Jan 6, 2019Views: 2,249
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Pharms - Mirtazapine (311) : Combinations (3), Retrospective / Summary (11), Medical Use (47), Not Applicable (38)

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