Posted by mtom on January 4, 2019, at 18:03:48
After 10 weeks of low dose Citalopram, I was switched to Escitalopram due to continuation of intense side effects (including agitation and anxiety). The same occurred to a lesser degree with Escitalopram, but have not completely resolved after 3 months (I started very low dose and titrated up gradually to 7.5 mg as of about 8 weeks ago). Also poor sleep with vivid dreams and muscle aches. And there has been at best very minor improvement in depressive symptoms. I have not titrated up further because of the side effects, and I am a very small person anyway.
My Doctor is thinking of augmenting with low dose mirtazapine. Weight gain is not a concern as I had already lost weight before starting escitalopram, and it has decreased my appetite further. However other side effects are a concern, including sedation and possible increased anxiety which I read is common at least initially. I am hypersensitive to AD side effects.
Can anyone share experiences with low dose mirtazapine augmentation to escitalopram or other ssri?
By the way, for those who are familiar with Pharmacogenetic testing, my P450 CYP2D6 alleles make me an "intermediate metabolizer" of medications metabolized by this enzyme. Escitalopram is thought to be mostly metabolized by other enzymes, although some research does say CYP2D6 is involved. CYP2D6 is definitely involved in Mirtazapine metabolism (along with other enzymes my Genetic report did not include analysis of).
poster:mtom
thread:1102691
URL: http://www.dr-bob.org/babble/20181024/msgs/1102691.html