How Do I Know If Meds Are Working?

[Solstice]

I started on mirtazapine for depression about 5 weeks ago. Aside from sleeping better than I ever have in my life, some really weird dreams, and a slight weight gain (which could just be because I've been more lax about my eating habits than usual), I don't feel any different. Still deeply sad, still feeling hopeless, still overly emotional at the drop of a hat -- in other words, same old me. I started on the drugs reluctantly, as I'm not much of a believer in throwing a pill at a problem, rather than getting down to the root cause. However, I was (and still am) so desperate to change my life that I decided to go with it. But I don't want to waste my time taking something that's not doing anything.

I will ask my psychiatrist about this when I next see her, but I was just wondering whether anyone here has any insight on how I will know when and if the meds are working for me...

[LaLa]

Hi, Solstice,

I take mirtazapine, too, that's why I'd like to answer your question.

I'm sorry you don't feel better yet... And I'm sorry I don't know you from another threads, so I'm not aware of your situation, thus I will probably ask about something you've already mentioned somewhere...

My question is if you only take the med or you also go to psychotherapy. Because the therapy is very important, too...

And mirtazapine: I have very good experiences with this med. But my doc gave me it for anxiety, not for depression. I didn't believe that the med would change me, so I think there was a small chance for a placebo-effect, but... I felt differently since the 1st day. "Differently" means relaxed and not so anxious. I had never realized before that I had been anxious! I was surprised when the doc told me I was! But then, the med changed me completely in this regard and thus I realized there had been an anxiety! BUT: Don't feel bad now that you don't feel much better even after 5 weeks!!! My "story" continues: The initial change was about the relaxation and anxiety. And you also wrote that "I've been more lax about my eating habits than usual" - this might just be a sign of change (together with your better sleep!)! So... in my case, I came to the p/doc because of longterm suicidal ideations. And the med didn't change this in the first weeks! I felt better overall, my bad moods were less frequent, but were still there. But I was much more "prone to" the therapy! An I think, then the therapy made the bigger difference (=I definitely stoped to feel suicidal and my ideations were gone!!!), thanks to "the med in my head".

Moreover, after several months, I realized a difference probably due to the med: I began to feel "emotionless"! It was a bit stragne, but I considered it to be fine, because... it was much better than all the bad moods and so on. I wondered if it would take "forever" (-all the time I take the med), but... it took only about 2 months and I somehow "habituated" or how to say it - I started slowly to have my emotons back, but not the very strongest, worst, most painful ones. Now... I feel "normal" (I know; it's hard to say what "normal" is ) and I like it. I still take the med and go to therapy.

And there is another important aspect of antidepressants! They stimulate formation of new neurons in the brain, what's wonderful, because it gives you a "physical/anatomical support" for you psychic change! That's also why the therapy is importnat: It learns you to change your thinking at the same time as your med allows you to build up new connections in your brain, which support and "fix" the changes.

I hope it helped a bit

Take care!

L.

[Luna-]

You may need a different dose. A so-called "fair trial" of a medication includes going up to a dose level that is considered to be the optimum for you. So if you are on the introductory dose of 15mg (which you will probably be for the first several weeks) you may find you get results at 30mg (or you may not, it's so very individual). Of course this is completely up to the pdoc who is treating you.

[LaLa]

Thanks, Luna, for reminding me this!

My dose was 7,5 mg the 1st 4 days and since then 15 mg. (But my weight was around 50 kg (now 55), so... this is also important to consider, as well as the needs of the brain, of course....)

[Solstice]

Thanks to you both. As to Luna's comment on dosage, my pdoc put me straight onto 90 mg, since she's found that side effects with mirtazapine actually decrease as the dosage increases. So, I don't think there's much wiggle room there...LaLa, I am in weekly therapy sessions as well, since I agree that's very important. I'm not wild about my pdoc as a therapist -- but that's a story for another time. Now that you mention it, though, I think I have become less anxious over the past weeks. I've always been a worrier, constantly fretting about even the smallest things, but those nagging thoughts don't seem to have as much traction in my mind as in the past. I've been so focused on waiting for my misery to lift that that small change really didn't register with me until now. So, perhpas the meds & therapy are working.

Feeling "normal" would be amazing, but I'd gladly take the "emotionless" state you describe as well. I've been so unhappy for so long that an absence of emotion could only be a good change...Anyway, thanks again for the insight.

[LaLa]

Hi, Solstice,

I'm glad to hear that you've noticed the changes!! I think it's important to focus on the positive changes and not to expect "too much" in a relatively short time. We all would like to feel much better as soon as possible, but... it's like with every other illness: it takes it's time, in some cases, several months, in others also some years ... But imagine the time before therapy: How long did your prombles "evolved"? Your present state is the result of many years, so... it's, sadly, logical that it will not change in some weeks. The most important thing is that you are recieving help and you are working on yourself to get better . I wish you good luck!!!