About Us Nine studies involving a combined 1, participants showed St. In head-to-head comparisons of exercise alone versus antidepressants alone, antidepressants yielded better results. Plus, people stuck with exercise more often: Its goal is to change patterns of thinking or behavior that contribute to people's difficulties. CBT has been in use for decades, and the goal is to treat people with a wide range of mental health problems, most especially anxiety, depression, substance abuse, addiction, and post traumatic stress disorder.

Third-wave cognitive behavioral therapies extend traditional cognitive therapy into alternative and holistic medicine. They emphasize promotion of health and well being as well as reducing psychological and emotional symptoms. This makes it less likely that your symptoms or problems will return. How effective is CBT? It is one of the most effective treatments for conditions where anxiety or depression is the main problem. It is the most effective psychological treatment for moderate and severe depression.

It is as effective as antidepressants for many types of depression. What other treatments are there and how do they compare? CBT is used in many conditions, so it isn't possible to list them all in this leaflet. We will look at alternatives to the most common problems - anxiety and depression. CBT isn't for everyone. Another type of talking treatment may work better for you.

CBT works as well as antidepressants for many forms of depression. For severe depression, CBT should be used with antidepressant medication. When you are very low, you may find it hard to change the way you think until the antidepressants have started to make you feel better. Tranquillisers should not be used as a long term treatment for anxiety.

CBT is a better option. A therapist is like a personal trainer that advises and encourages - but cannot 'do' it for you.

If you are feeling low, it can be difficult to concentrate and get motivated. To overcome anxiety, you need to confront it. This may lead you to feel more anxious for a short time.

A good therapist will pace your sessions. I have been 6 months off, but I quit cold turkey after 8 years. I, like you, would like my appetite and about 20 pounds of my weight back.

I am one of those folks that you read about that are unfortunate and have withdrawals longer than usual. Good luck to you. A little advice, grab your sleep when you can, short naps during the day adds up. I hope your trip down a road that for me has been hell is quick and as pain free as possible.

David Reply Link Amanda August 28, , 8: I have been on and off mirtazapine for at least 6 years. Reply Link jan August 29, , 2: BUT… still even with my slow withdrawal after 10 days I started feeling crummy. Chills, nausea, trouble sleeping. My doctor prescribed Zophran for the nausea but feel that trying to eat a bite of banana or oatmeal is almost as good. Talked with a pharmacist about this and he said because I was on it so long it would probably take me longer.

He also said to my surprise that they are prescribing this for people with sleeping problems more than an antidepressant now. They will sleep but at what expense. This board is what keeps me going though. I look at this frail old body and it scares me. My doctor wanted me to see a gastro but I know they would put me through a lot of horrid tests and find nothing. I had something similar 20 years ago also caused by another med. They did all their tests, found nothing so decided to do an exploratory operation.

They just about killed me. Wound up in the hospital for 3 weeks. I did finally come out of it but it was rough. Know now not to have those tests that I just have to tough it out.

I am so concerned about this weight though. Last time I got down to 89 lbs. Found that oatmeal and banana set well in the stomach although I am not fond of either. Thank you for answering David.

My thoughts and prayers are with you all of you on this board that we will all come through this and feel good again. I should say that since starting this milk is a problem for me.

I love milk but now buy almond milk. I am not sure what foods have histamine. Reply Link David August 31, , 1: I am at 6 months, have lost over 30 lbs. I weighed this morning, and weighed when this started. Reply Link jan August 31, , It doesnt help matters that I am not taking in enough calories to keep a bird alive. Tried to eat a salad with a chicken breast on top today.

Just sat with a heating pad on my stomach until I felt better. Of course I have no appetite now and it is almost dinner time. I tried to count my calories one day and it added to about In order to gain I have to take in about a day.

Stomach just wont allow that though. Picked up some more Boost today. Will try some of that later. I am having problems with milk too and Boost says it is lactose free. Will see how that goes. Hope we can both weather through this and gain some weight.

I think my weight started to decline about January but has gone faster since I cut back and finally off completely. It will be one month tomorrow since last bit of mirtazapine. Reply Link Mary September 4, , 2: He also instructed me to stop taking my 10mg of Abilify.

I am also noticing a sharp change in my mental state, but that could also be influenced by the fact that I feel bad physically. I feel strange — that is the best way I can describe it. The symptoms I am feeling are similar to how I feel when sleep deprived.

Should I expect my symptoms to get worse before they get better? How long should I expect to feel bad? Any bit of information anyone has for me would be greatly appreciated.

Reply Link David September 5, , 4: I stopped abruptly after almost 8 years at 45 mgs. Get as much sleep as you can, regardless of how you feel. I am at over 6 months, and still having withdrawals.

Does that mean that you will go that long? No, it could be less or more. As far as withdrawals, mirtazapine is one of the worse. There are a number of symptoms, and they can come and go. Mine have been mostly GI pain and spasms, weakness, fatigue, nausea, weight loss, loss of appetite, and of course elevated anxiety. Read these posts, you will get an idea of what to expect.

No two people have the same experience, some that I have read about have gone over a year, while others are short and not too bad. I have been sick from this since Feb 27th, and still have miserable days. I have learned to expect this to end whenever it ends.

It has gotten bad enough to have me considering going back on the mirtazapine, but then I remember what I wanted off of it, and fought of the temptation. I wish you luck, and a quick withdrawal. I guess you see why this is so hard to go through. Reply Link jan September 8, , 2: I have been totally off mirtazapine since Aug. I can definetly see that I am improving as time goes on. I was put on Mirt. I tried just stopping and was violently ill and wound up going back on it.

So, realized I would have to wean slowly. I have been doing this. Taking crumbs and shavings at the very end in July. Even going this way I still was uncomfortable for most of Aug. I say uncomfortable because compared to what happened to me the first time it was nothing. Now I am more than a month out and beginning to feel I am coming around. As David said though each person is different and it is important to let your body determine how you go about this weaning off.

The past two nights I have slept well. I woke up only once each night but went right back to sleep. I have been going to bed a bit earlier than usual The itching has stopped and stomach is starting to feel more normal. No diarreha or constipation. Think my gut is beginning to work on its own. I am also starting to get a bit of appetite back. Not every day but try to force myself to eat realizing I need it and not the trash can. I think my weight may be stablizing.

Just wanted to write and encourage all of you that are deep in this. Keep working on it and be kind to yourself. Yamamoto September 13, , 8: I began my taper of 15 mg. My plan was to proceed to 3. So I completed the 5th week at 7.

I tried melatonin for sleep with my taper and found it useless in giving me a sleep. I have tapered off Zoplicone in 6 weeks, but tapering off mirtazapine is a very lonely and uncomfortable experience. Please advise as to my titration rate, and dangers. Reply Link jan September 17, , 2: Either that or I have some kind of bug. Last Monday night I was so nauseated and sick I called my kids to take me to the hospital at 9 at night.

Of course, considering how I have been feeling and worrying about my weight and all of this. They gave me fluids as I was dehydrated, checked my blood low sodium and gave me Ativan for anxiety.

I panicked at that because I have never heard of Ativan and thought oh no, here I go again. Another drug to be addicted to. Have any of you had any experience with Ativan? What is your opinion of it? When telling ER doc about mirtazapine her response was typical of what we all hear. I am wondering what planet these doctors practice on. How could their knowledge on this and our real life experience be so far apart?

I have had eye issues for many years but the past two weeks have been terrible. Double vision making most days impossible to drive. I think I scared the dickens out of my daughter and son. They both drove me to the hospital and were quite sympathetic which is not normal for either of them.

I guess they could see how sick I really felt. So, I am back struggling again. Scares the dickens out of me. Still, I will not under any conditions go back on that poison just to have to start over again.

David, are you doing any better? Reply Link David September 18, , I mean it, the same boat. I feel as bad right now as I did early on in the process. It is call protracted recurrent withdrawals, when the very thing that happened to you happens during, or right at the end of withdrawal from any drug or alcohol.

I am very sorry to hear of your misfortune, and wish you a prompt recovery. I have all the same symptoms that you have, and some more besides. I just had a prayer for you. Again, I am so sorry that this has happened to you. I wish that I knew something to say or do to help you, but prayers, and knowing that someone else cares, and shares your grief, anxiety, pain and suffering is all that I can offer.

For a few weeks, about the only time I get out of bed is to shower, bathroom, and eat, although I still have no appetite. I am just too weak and fatigued. I never once said a single thing to the family doc I had, because I knew he would only say I was depressed and pull out the prescription pad. Ativan can be addictive and quite hard to come off too.

Changing diet made a very big difference for me in terms of reducing symptoms. I am just over a year off the drug and am doing reasonably well. Most symptoms are minimal or non-existent. I ended up seeing an acupuncturist for my digestion and found great relief through that. I still have occasional nights of poor sleep, or bouts of increased heart rate, but for the most part, am doing miles better than I ever was on the drug.

Hang in there…things get better in time. Reply Link jan September 19, , It is comforting to know there are people that understand your plight. I went to an ER follow up with my doctor on Thursday. She asked me if I would consider Paxil. I had to grin because when I read my chart online that is just how she wrote it. Guess I will have to be a bit more careful with my language. I told her I wanted my body clean.

I have taken fluerazepam for years seldom only on no sleep nights. My gp asked me if the ER doc knew I had that because that and Ativan could have been a real problem if taken together. All my records are there on their darned computer. Fortunately I didnt take it. I am very cautious about mixing stuff. I discovered too that if I take fluerazepam the next day i feel really great, but watch out the next day.

I am thinking wondering if those drugs give you a shot of serotonin and so you feel better but then when it is gone bam you are back in the soup again.

David I think you are in worse shape than I am. I can still move around and function most days. Not great but at least moving. I live in an apartment now and have started walking up and down the halls for exercise in the evening.

My balance is not good so I just push my little granny cart in front of me. While I am out there and out of my familiar surroundings it kind of gives me a different mindset. I live in Minnesota so we are gearing up for winter by mid November. That in itself is depressing. Keeps a person more housebound and none of us need that when we feel so lousy. My prayers and thoughts are with all of you going through this.

As you said David we are in the same boat. We will come out of this sooner or later if we just keep at it. Thank you again for taking the time to write. It helps me more than any doctor ever could. I am still with weight loss, today, down from , fatigue, weakness, and bad abdominal symptoms. I even feel like where my abdomen meets my ribs has spasms. Right now pain and appetite are issues.

I hope that things improve for you. I am so tired of being sick. I guess 8 years at 45 mgs is hard to shake. I was on this drug for over a year now and was up to 30 mg. I am a wreck! I have to force myself out of bed, go to the shower and immediately start throwing up. I come out, lay down and then try to drink a protein shake. I have all the symptoms you are describing. Headaches started last night. I too am thankful for all of your comments! I hope we can all get relief and come back later to let everyone know how we are.

Prayers and best wishes to you all. Hang in there and get out as much as you can. Reply Link Rain September 24, , 4: I finally feel completely free of the side effects. I had been on 30mg for 6 years. I had severe anxiety and depression caused from a misdiagnosis from a young doctor that totally freaked me out.

I also had started going through menopause which in itself created anxiety. With mirtazpine my life returned to normal however I was never able to feel any real highs or very happy moments.

To start my reduction I went from 30mg to 27mg for one week, then down to 20mg for a few days, down to 15mg. At 15mg I felt my worst. Withdrawal was awful with not being able to sleep for longer than an hour and when I did sleep there were nightmares. I had sweats, nausea, headache, body shakes, brain zaps. I was edgy and scared but at the same time I tried to keep positive and reminded myself this is withdrawal and not illness.

At 7mg I felt better than I did with the stronger dose so after 2 days I dropped to 3mg. I had weeks of over the top happiness which has now balanced out to highs and lows. If you have managed to go 12 months without the symptoms that put you on mirtazpine in the first place, then that is the time to consider coming off. The important part of the whole process is understanding that it is the right time to come off. You have to be totally committed to it and not panic with the withdrawal effects.

I knew my time for mirtazpine had come to an end. My cholesterol was rising and I was having stomach issues and bleeding under the skin on my arms. I was also experiencing restless legs constantly. Since coming off mirtazpine the restless legs and bleeding has ceased. I hope this helps anyone with their weaning off.

Good luck and be positive. Rachel May 25, , 5: Reply Link David September 24, , 5: Anyone following my posts knows that I went off cold turkey, which was an awful mistake.

I am still having withdrawal symptoms. They are painful at times and interrupt my sleep, so sleep problems are on the list as well. I am still losing weight, over 30 pounds so far, and appetite reduced. I feel that I may be slowly improving, and was doing better but had an episode of protracted withdrawal, and lost ground with my progress. There has been times when I almost went back on the mirt, and times when I thought that I was going to die. I am very serious about this.

I am sharing this because I want others to know that these symptoms can last a very long time. I have been to the Emergency Room a number of times, thinking something serious was going on.

I wish you all the best in your healing progress. Initially, I had every symptom of withdrawals, but now what is left are the ones that I have listed. I am off since Aug. Dizzy head, fatigue, tired eyes. Last night I could feel the anxiety edging in on me like when I wound up going to the ER. I took an Ativan at bedtime and slept for 7 hours. Have some screwy dreams but at least sleep. Today have felt crummy most of the day.

Hoping they can give me some positive suggestions for coping with withdrawal. If we can stand firm and not slide back in with the devil mirt we will make it. I know I will not under any circumstances take it again. Either I will come out of this clean or it will kill me. As many of us have said it feels at times that is what it is doing, killing us.

We just have to be there for each other and we will get through this. Thank you again Rain. Please keep us up to date on your recovery. It is so encouraging. Jan Reply Link David October 2, , 1: I am still having symptoms at over 7 months. I am depressed, feelings of doom, no hope, trying hard to maintain my weight, I have lost 30 pounds.

I went cold turkey, and have paid dearly for it. Every day is a struggle to keep from giving up. Also headaches and a general feeling of being sick. I have a good day every now and again, but right now just making it a day at a time. Maybe it was too short. No matter, I wish you a full recovery, and the rest of us as well. David Reply Link Rain October 13, , I was so scared of the withdrawal but kept telling myself that my symptoms were a normal response to my body trying to adjust without the mirt.

I have been free now for over 3 months and I still have problems with sleep. Taking it at the same time each day will help you remember when to take it.

If recommended by your doctor, this medicine may be taken in sub-doses equally divided over the day for example, once in the morning and once at night-time before going to bed. How long to take Mirtazapine Sandoz Continue taking your medicine for as long as your doctor tells you.

For depression, the length of treatment depends on how quickly your symptoms improve. Most antidepressants take time to work. Some symptoms may improve in 1 to 2 weeks, but it can take up to 2 to 4 weeks to feel the full benefit of the medicine.

It is important to keep taking your medicine even if you feel well, usually for about 4 to 6 months or even longer, to make sure the benefits will last. If you forget to take it Once daily dosing: If you forget to take the tablet before you go to bed, do not take the missed dose the next morning.

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