I've had really bad insomina where I sleep for only an hour and then wake up. I'm able to get back asleep but I always wake up after an hour. My psychiatrist prescribed mirtazapine 7.5 mg/15mg for it but only as needed. Does this sound right? My pharmacist says you have to take it every night but when I asked my psychiatrist she said because it's such a low dose I don't have to. Has anyone else heard of mirtazapine being prescribed only as needed?
Has anyone else heard of mirtazapine being prescribed only as needed for insomina?
Question posted by Masheeko on 7 Dec 2018
Last updated on 13 February 2021 by Todd G
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
3 Answers
I've been using mirtazapine for just over 2 weeks for insomnia and even after only 2 nights of 15mg dosage I felt withdrawals on night 5, where I lay awake with anxiety (something previously foreign to me), after the previous 2 nights sleeping without the drug. It stays in the body for a few days before being eliminated so it may be easier to develop a dependence than you realise. Best to try sleeping drugs that have no physical dependence issues before going on to something like mirtazapine, in my view. Others may have a different experience.
Some doctors now prescribe it off label as a sleep aid. The idea is to knock you out so it should only be taken as needed in this case. It is usually prescribed daily for depression. Due to the dependency psych drugs cause, you should only take it as needed unless you are treating depression. Taking it daily will drastically increase your chances of having withdrawal when you no longer need the drug.
Yes. Mirtazapine is often prescribed off label just for insomnia. It is a powerful sleep aid. The lower doses are more effective for insomnia (it's counter intuitive) I'd start off with the 7.5 mg first or even lower ( get a pill splitter) at 3.5 mg. Give it a couple of weeks. If the lower dose doesn't help increase it but I would not go above the 15 mg. At 30 and 45mg it has much more antidepressant effect and if you aren't depressed you don't need or want that.
One of the disadvantages is that some people have a difficult time stopping. Rebound insomnia is common with cessation. But it it's better to sleep than not and if this helps you get the rest you need it's worth it in my opinion.
I am not a physician so if you have any questions please talk to your doctor. Good luck and I hope you get well.
Thanks. I do have some depression because of the insomina and took the 7.5 mg which helped. I was surprised that it could be used as needed and days can be skipped. The sleep the first night felt the same. I felt like I was still waking up every hour but I didn't worry as much about it like usual so maybe it is helping in a way.
Yes! I had that happen to me! It took me YEARS to find something strong enough to get me to sleep and stay asleep but not to strong and cause me to be a zombie the next day. I started at 7.5mg as needed for years. Now my dose increased but it is magic. I would try it and if it works that’s great if not than you can try something else. From my understanding, you take it as needed which can be nightly because you take it to go to sleep but sometimes you are so exhausted you don’t need help to fall asleep so those nights don’t worry about it. I hope it helps you like it has helped me.
Related topics
depression, post traumatic stress disorder, anxiety, insomnia, mirtazapine, sleep, prescription, psychiatry
Further information
- Mirtazapine uses and safety info
- Mirtazapine prescribing info & package insert (for Health Professionals)
- Side effects of Mirtazapine (detailed)
Similar questions
Search for questions
Still looking for answers? Try searching for what you seek or ask your own question.