First what are your side effects?? Does it help with the fibro?
Mirtazapine is typically prescribed in doses ranging from 15 mg to 45 mg. However, in severely depressed individuals, doses as high as 120 mg have been used with success. Mirtazapine has a half-life of approximately 20–40 hours. Like most other antidepressants, because of the "therapeutic lag" mirtazapine may require as long as 2–4 weeks until the therapeutic benefits of the drug become manifest. Mirtazapine can be sedating at lower doses in the 15–30 mg range mainly because of its antihistamine action, but at higher doses in the 45–90 mg range the enhanced adrenergic activity partially counteracts these effects and it becomes more stimulating.
Have you ever tried elavil?
What I suggest is you start lyrica. It can be very beneficial with few side effects. Did you gain weight on the nortriptyline/pamelor??
I started lyrica in mid Dec for severe phantom pain and in 14 years of 40 different meds opiates incl. This has helped me the most. Unbelievably has changed my life. My vision is a bit blurry in the morn while on comp. I have not gained weight like some say they gain just 3 weeks. The meds in your class have weight gain as a major side effect. I tried elavil in 1996 combined with some others for the PLP and got serotonin syndrome. The docs didn't know much about that then. Also the elavil caused excessive appetite. I hated it but when I took it at night it knocked me out?
Are you seeing a pain doc for your fibro or a psychiatrist?
What I suggest is lyrica and if and only if you are not on opiates and CNS Depressants the drug xyrem is very effective for sleep and is about to be approved by the FDA for fibro because of what happens when people with fibro get this type of deep sleep.
copy and paste into google and will see so many with fibro and hpow much xyrem has helped them.
So again you need your doctor to look at what I suggested and you can research it and decide for yourself. Nortriptyline is just so ancient and if it;'s the sleep you are more concerned about and want less side effects I would do the lyrica with xyrem. Both will help your pain significantly. Also you don';t build up a tolerance to xyrem and keep needing higher doses. You will have your own personal nurse and talk with the pharm if you have any questions. It comes from a regulated central pharmacy fed ex overnight and has to be signed for.
Now because I am on opiates,lyrica and benzo as needed my psychol should never have prescribed xyrem nor should Jaxx Pharma-xyrem pharm prescribed all knowing what meds I was on. When I went up to 4.5 gm in my first month of taking my husband found me with no pulse slumped back in my wheelchair. EMS did CPR and were trying to intubate me unsuccessfully, I just got my med records yest.My pain doc said I was toe tagged and he was so frustrated he dumped me and I was devastated because it took me 14 years and over 1000 hours research to finally be in a position of aggressive treatment with doing a spinal cord stimulator,if failed pain pump-if failed poss deep Brain Stimulation. One gets consumed by excruciating, crushing,gnawing,burning,life draining pain that effects every aspect of ones life. i had already endured 68 operations,23 broken bones then above knee amputation.
Please don't be afraid of the xyrem. It has helped thousands with fibro, many have now been able to take less pain meds and some stopped them all together because of what the xyrem does. Google that link above. Sorry so long