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Thread: Best mirtazapine dose

  1. #1
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    Default Best mirtazapine dose

    I know this will differ for everyone, but Iím wondering if anyone saw an improvement in flushing when moving above 15 mg? I have been on it maybe 3 weeks now and I think itís helping some, but Iím not seeing huge differences. I donít know if I just give it more time to get the best result or if a slightly higher dose is more likely to work better. I am also taking it for antidepressant/antianxiety effects and I guess would say the same about that- itís better I think, but not a huge change yet.

  2. #2
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    Default Anyone?

    Just curious if someone had 15mg not really work much for flushing, but a higher dose work. I know too low or too high seems counterproductive for the flushing control...

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    Quote Originally Posted by Chai View Post
    Just curious if someone had 15mg not really work much for flushing, but a higher dose work. I know too low or too high seems counterproductive for the flushing control...
    I'm about to start Mirtazapine 15mg. Curious- did you seen an improvement at 30? Just researching this drug and trying to get as much info as I can while I'm trying it out.

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    Quote Originally Posted by Jamoverton View Post
    I'm about to start Mirtazapine 15mg. Curious- did you seen an improvement at 30? Just researching this drug and trying to get as much info as I can while I'm trying it out.
    Some people have found a very high dose can increase flushing with mirtazapine. Doses of 22.5mg or 15mg seem to work well for most people, where mirtazapine works - issues such as body weight will be relevant here as well. It is not necessarily the case that increasing the dose will reduce flushing further above a certain point, and side effects can also increase with this drug as you increase the dose (it is not regarded as a first option anti-depressant due to possible side effects in some people).

    If mirtazapine does not work well for you, hydroxychloroquine is another option, which I found better (although mirtazapine helped me a bit).

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    I moved to 22.5. So far no help ok either flushing or depression.

  6. #6
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    Quote Originally Posted by antwantsclear View Post
    Some people have found a very high dose can increase flushing with mirtazapine. Doses of 22.5mg or 15mg seem to work well for most people, where mirtazapine works - issues such as body weight will be relevant here as well. It is not necessarily the case that increasing the dose will reduce flushing further above a certain point, and side effects can also increase with this drug as you increase the dose (it is not regarded as a first option anti-depressant due to possible side effects in some people).

    If mirtazapine does not work well for you, hydroxychloroquine is another option, which I found better (although mirtazapine helped me a bit).
    Mirtazapine did not work very well for me so Im decided to try hydroxychloroquine, however it is very difficult to get the prescription here in brazil
    just out of curiosity: when you are on treatment with hydroxychloroquine is it necessary to leave any SSRI aside?

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    Quote Originally Posted by Douggx View Post
    Mirtazapine did not work very well for me so Im decided to try hydroxychloroquine, however it is very difficult to get the prescription here in brazil
    just out of curiosity: when you are on treatment with hydroxychloroquine is it necessary to leave any SSRI aside?
    I'm not aware that you can't take an SSRI alongside hydroxychloroquine although this is not a very common combination necessarily - I've seen studies where people are on both. A more common combination is a blood pressure medication (e.g. moxonodine, clonidine or propranolol) and an anti-inflammatory (e.g. hydroxychloroquine or an SSRI).

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    Quote Originally Posted by antwantsclear View Post
    I'm not aware that you can't take an SSRI alongside hydroxychloroquine although this is not a very common combination necessarily - I've seen studies where people are on both. A more common combination is a blood pressure medication (e.g. moxonodine, clonidine or propranolol) and an anti-inflammatory (e.g. hydroxychloroquine or an SSRI).
    Thank you for the informations.
    Are you a post accutane sufferer too? By the threads I read I believe it's my best shot at the moment since nothing really worked out well.

  9. #9
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    Quote Originally Posted by Douggx View Post
    Thank you for the informations.
    Are you a post accutane sufferer too? By the threads I read I believe it's my best shot at the moment since nothing really worked out well.
    Yes, I do think hydroxychloroquine helped me with post accutane flushing. Quite a lot of people have found this with hydroxychloroquine.

  10. #10
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    Mirtazapine seems to work really well for me. I get bad nose flushing. I was on 22.5mg for about 9 months and things calmed down a lot. I then tried stopping for 2.5 months, because it was the summer time and I usually suffer more in the winter months when the central heating comes on, and it became bad again. I started back on 15mg and it's back under control.

    It's not perfect, but it's a massive improvement. I've also learnt that prevention is better than cure; if I can sense a flush coming on I need to get up, walk outside, splash cold water on myself or get a fan on my face. This now usually does the trick, but without mirtazapine this was slightly less effective. I have a fan at my desk at work which I switch on most afternoons because I can tell I need to prevent it.

    I've now been a week or two without any major flush, which is amazing. At it's worst it would happen 3 times a day, with some of them lasting hours.

    The big test, however, is around October when the central heating season starts. That's usually when I struggle.

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