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Dr. Bob is Robert Hsiung, MD,
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Posted by mtom on July 7, 2019, at 9:53:07
Last year started Escitalopram (Lexapro, Cipralex) at very low dose due to past hypersensitivity to AD adverse affects. Got these on Escitalopram also (increased anxiety, tinnitus, others) which escalated when I increased dose to 7.5 mg. At that dose I also started having very vivid dreams and nightmares. So gradually reduced dose to 5 mg, dreams became less frequent and intense (other side effects lessened only slightly).
Recently started Mirtazapine (Remeron), again at very low dose, as an add-on (and possibly considering a cross-taper and switch), as in addition to side effects, Escitalopram had minimal effect on depression. And there seems to be a lot of reports of Mirt helping anxiety. After 5 days of Mirt, vivid dreams & nightmares returned. After about 3 1/2 weeks seemed to have lessened, so increased dose very slightly 3 days ago, still very low dose. Really bad nightmares that night, not as intense next 2 nights but still had vivid dreams.
Product monograph reports abnormal dreams as "infrequent" about 4%. But a number of reports of nightmares in post marketing Publications and by users on websites, but none put a number to incidence and it seems not much studied.
At least Mirt hasn't increased my anxiety, maybe improved slightly. But the nightmare issue if it continues may not be tolerable. And I have to increase dose further as my dose is, supposedly, sub-therapeutic (but again, I'm hypersensitive).
Any experiences with abnormal dreams with Escitalopram, Mirtazapine or other AD's?
Posted by linkadge on July 7, 2019, at 13:09:43
In reply to AD induced nightmares: do they go away?, posted by mtom on July 7, 2019, at 9:53:07
Hmm. I have been on these two meds together and did have sleep disturbance (more so on the escitalopram). Mirtazapine may cause more abnormal dreams at higher doses (as it can raise norepinephrine). For sleep, I wouldn't take more than 7.5mg. Really, it can help sleep at much lower doses (1-2m). I dissolve a tablet in an eyedropper bottle and use drops to get up to the desired dose. I think you may be able to get mirtazapine as a liquid as well.
You may be able to keep the escitalopram at 5mg. I'm not sure if some supplements may help enhance the effect (i.e. magnesium for anxiety, folic acid for depression).
Linkadge
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