Mirtazipine, insomnia and nightmares

Saluki · September 19, 2023, 01:33:36 PM

I finally got prescribed 15mg mirtazipine to take at night for CPTSD and insomnia. Prior to that I was prescribed promethazine 50mg which took at least 6hours to just about kick in, followed by vivid recurring nightmares and feeling drowsy all day. I feel exhausted all the time anyway, but they made nightmares worse. Prior to starting promethazine I'd been taking over the counter antihistamines (nitol type) which really did nothing. I wasn't sleeping much at all and when I did, I couldn't wake up in the morning due to absolute exhaustion. So I was very excited to try mirtazipine again after around 12 years as I remember they helped with nightmares.

Well, I must have remembered the wrong meds because my nightmares are worse than ever and every night. But the bonus is that I'm now not laying awake until it gets light every night, panicking and flashbacking and scared to fall sleep.

My nightmares have woken me up a few times but I've been eventually able to get back to sleep. To more nightmares.

The nightmares are more abstract than they have been previously: no actual abusers present, though representations of abusers are a thing. Which is a good thing considering I previously had a lot of nightmares involving my mother being abusive towards me in my childhood home and my psychopath ex chasing me. So it's a relief those nightmares seem to have stopped.

I'm not noticing the mirtazipine making me drowsy at all though after just over a week, starting to worry they're going to stop working like everything else always does. Last night I managed to get to sleep around 4am (which is actually good going for me) and managed to wake myself in the morning and not fall back asleep, which is unusual: I normally get trapped in nightmares I end up unable to wake myself up from because I'm convinced they're real and the need to escape overwhelms my brain's awareness that it's just a dream.

Hmmm.

I don't want to end up on higher and higher doses of any meds as I'm an ex heroin addict and obviously I have a very addictive brain. It seems to get used to meds after 3-7 days and ask for more 😔

Has anyone had any success training their brains to stop having nightmares?

The mirtazipine seems to have dried up my ability to cry easily, which is good in one way as I was crying over everything and anything, but bad in another way as now it feels trapped and unable to find an outlet (which I was struggling with for years, unable to cry, and my anger overwhelmed me)...

Now I just seem to feel slightly on edge, not understanding how I'm feeling. It's confusing.

I think it's helpful in some ways and not in others.

I can't handle SSRIs. They make me psychotic.

Kizzie · September 19, 2023, 04:36:20 PM

Having been on and off meds for decades now, I've found that it's hit and miss frankly. The most important thing IMO is to work with a psychiatrist not a GP as they know medicine and mental health much better. I ended up in hospital in 2022 because my SSRI pooped out, I had a really rough time going off it, and ended up getting hooked on benzo's and a sleep med (Zolpidem I think it was?).

It was such a bad time but I got a psychiatrist who has me on two meds that work pretty well albeit not 100%. I'm almost afraid to try anything else as I do react a lot, so feel like I need to just be content with what I'm on.

I hope you get yours sorted to where you are feeling better. I don't know what works well with nightmares (I have anxiety dreams versus nightmares), but I know some members have them and have tried various meds. Hopefully they'll see your post and have some info to pass along.

Saluki · September 20, 2023, 12:45:03 AM

Benzos are so difficult aren't they? I had a fight on with the anxiety they caused me, I very much empathize. I honestly don't know how I didn't end up in hospital with my psychotic behaviour on SSRIs. I think it was probably because I was in a big city and also an IV addict. That seems to help towards not getting help...I guess I just blended in as another crazy addict at the time. Not sure if hospitalisation would have made things better or worse to be fair: it was a terrifying time and I ended up in rehab so it kind of worked out, for a while at least...
I get a lot of anxiety dreams too. They're really scary. Not sure where the line is between the two...
Thanks for your reply, Kizzy. Ugh, I've been on and off meds since I was 18 or 19 I think. I hate having to go back to them because of side effects and fear of dependency and them stopping working and having to come off them and the fear I will end up worse off than where I started before I took them...

Kizzie · September 20, 2023, 04:33:26 PM

I totally relate to how you feel about meds and why. I think the fact that so many of us have problems with meds is very much due to how trauma changes out brains and nervous systems. This might be a topic to include in the book members are writing. The final section of the book is about what we need/want so it's certainly the right place to talk about this.

Saluki · September 21, 2023, 01:10:07 AM

That's a good idea and well needed. I will have a think about that.

2.08am and again, not sleeping, took meds 3 hours ago... it's infuriating it really is.

blue_sky · September 21, 2023, 10:52:15 PM

Saluki, I have been on/off so many meds as well to find out which combination works best for me with lease side effects.

In terms of good sleep and (less) nightmares, Prazosin worked pretty well for me. Although I would suggest to please see a psychiatrist for recommendation because even slight changes in dose can have an impact. It is traditionally used for people with high blood pressure so it does lower your BP slightly. But it has definitely helped me with either not having a nightmare at all, or even if I do get them, it helps me sleep better.

Good luck and hope you get good sleep.

Saluki · September 22, 2023, 09:59:11 AM

Thanks Blue Sky,
I have a feeling my blood pressure is already too low so probably not a possibility, but I will look into this. Though since I no longer smoke maybe blood circulation isn't awful any more so that might have been the problem I had with beta blockers which gave me sleep paralysis and blackouts which was scary!

Flitzi · October 31, 2023, 12:15:32 PM

I have cPTSD and also take Mirtazipine to sleep when my chronic lack of sleep affects my mood. The dose is very low. For me it's just about calming down enough so that I can fall asleep and have a somewhat normal sleep cycle.
It doesn't protect against nightmares and doesn't let me sleep longer than my usual 3-5 hours.
If I take a higher dose, I sleep a little longer, but then I can't think clearly until lunchtime. That feels unpleasant. Even with a higher dose I have nightmares.

I'm trying to find my way. Preferably without medication, or if necessary in as low a dose as possible.

Saluki · October 31, 2023, 03:04:43 PM

I started breaking my tablets in half and only having half my prescribed dose of mirtazipine because of feeling so fuzzy and also because of feeling very bloated (I think it's water retention). They seem to be working more or less okay to let me wind down so I can sleep but yeah me too re. nightmares. and I forgot to take my meds last night and only realised I was laying wide awake until 5am because I forgot to take them...oops...