• Tara Vaughan

The Drugs Don't Work



The two drugs that I have taken are Cipralex and Mirtazapine. Cipralex (otherwise known as Escitalopram) - I have been on for six years with a nine month break between the first and second year. Mirtazapine - I was put on in September (2017) after my boyfriend broke up with me. I had serious insomnia, it could take me hours to fall asleep and then the slightest noise would wake me. Pretty much for all of August my mother was drugging me with Night Nurse. I couldn't sleep by myself, I either had to have my dog in my arms, my mother sleeping next to me and sometimes even both. In the trauma clinic I started to ween myself off them. It could still take me hours to fall asleep but once I was asleep, I stayed asleep - most of the time.

On New Years Eve my dog, Ziggy, came into season which meant she couldn't sleep in bed with me. The insomnia came back - my doctor said it was my attachment trauma, so he prescribed Mirtazapine again. I have now weened myself off, hopefully for the last time. I'm still not sleeping well but this was an easier one to kick as I hadn't been on it for a long time, I could go cold turkey. I still have to have Ziggy in my arms and on really bad days I have to ask my mother to sleep with me.

I am now trying more herbal remedies such as Jan de Vries Night Essence and Melatonin, which help me get to sleep within an hour. The Night Essence is a combination flower remedy which can also be used by children. Melatonin, I have to admit I have only used a handful of times but when taken early enough - two hours before bed - it did help me to fall asleep faster.

About the drugs

Cipralex

Cipralex contains the active substance escitalopram. Cipralex belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These medicines act on the serotonin-system in the brain by increasing the serotonin level. As with many medicines, combining Cipralex with alcohol is not advisable, although Cipralex is not expected to interact with alcohol.

Used To Treat:

  • Depression (major depressive episodes)

  • Obsessive-compulsive disorder (OCD)

  • Generalized anxiety disorder (GAD)

  • Panic disorder

  • Social phobia or social anxiety disorder

The side effects in bold are what I have or have had.

Very common side effects (affect more than 1 in 10 people)

  • Feeling sick.

  • Headache.

Common side effects (affect between 1 in 10 and 1 in 100 people)

  • Decreased or increased appetite and weight gain.

  • Feeling anxious or restless.

  • Difficulty sleeping (insomnia).

  • Feeling sleepy or tired.

  • Abnormal dreams.

  • Yawning.

  • Feeling dizzy or shaky.

  • Increased sweating.

  • Pins and needles sensations.

  • Inflammation of the sinuses (sinusitis), congested or runny nose.

  • Disturbances of the gut such as diarrhoea, constipation, vomiting.

  • Dry mouth.

  • Aching muscles or joints.

  • Sexual problems such as decreased sex drive, difficulty achieving orgasm, erectile dysfunction or problems with ejaculation in men.

Uncommon side effects (affect between 1 in 100 and 1 in 1000 people)

  • Weight loss.

  • Teeth grinding.

  • Feeling nervous or agitated.

  • Confusion.

  • Change in the way things taste.

  • Fast heartbeat.

  • Dilated pupils and visual disturbances.

  • Sensation of ringing or other noise in the ears (tinnitus).

  • Bleeding, eg nosebleeds or bleeding in the gut.

  • Rash, itching or hives.

  • Hair loss.

  • Heavy periods in women.

  • Fluid retention.

Frequency of side effects not known

  • Difficulty passing urine.

  • Decrease in the number of platelets in the blood (thrombocytopenia).

  • Irregular heartbeat or abnormal heart rhythm seen as a 'prolonged QT interval' on an ECG.

  • Low level of sodium in the blood. This can cause symptoms such as drowsiness, confusion, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect.

  • Seizures.

  • Mania.

  • Inflammation of the liver (hepatitis).

  • Persistent painful erection of the penis (priapism).

  • Bruising under the skin causing red patches (ecchymosis).

  • Thoughts of suicide or hurting yourself.

Mirtazapine

Mirtazapine is an antidepressant. Mirtazapine affects chemicals in the brain that may become unbalanced and cause depression. Mirtazapine is used to treat major depressive disorder.

Drinking alcohol can increase certain side effects of mirtazapine. Mirtazapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Very common (may affect more than 1 in 10 people)

  • Increase in appetite and weight gain.

  • Drowsiness or sleepiness.

  • Headache.

  • Dry mouth.

Common (may affect up to 1 in 10 people)

  • Lethargy.

  • Dizziness.

  • Shakiness or tremor.

  • Nausea.

  • Diarrhoea.

  • Vomiting.

  • Constipation.

  • Rash or skin eruptions (exanthema).

  • Pain in your joints (arthralgia) or muscles (myalgia).

  • Back pain.

  • Feeling dizzy or faint when you stand up suddenly (orthostatic hypotension).

  • Swelling (typically in ankles or feet) caused by fluid retention (oedema).

  • Tiredness.

  • Vivid dreams.

  • Confusion.

  • Feeling anxious.

  • Sleeping problems.

Uncommon (may affect up to 1 in 100 people)

  • Feeling elated or emotionally ‘high’ (mania).

  • Abnormal sensation in the skin e.g. burning, stinging, tickling or tingling (paraesthesia).

  • Restless legs.

  • Fainting (syncope).

  • Sensations of numbness in the mouth (oral hypoaesthesia).

  • Low blood pressure.

  • Nightmares.

  • Feeling agitated.

  • Hallucinations.

  • Urge to move.

Rare (may affect up to 1 in 1,000 people)

  • Yellow colouring of eyes or skin; this may suggest disturbance in liver function (jaundice).

  • Severe upper abdominal pain often with nausea and vomiting (pancreatitis).

  • Muscle twitching or contractions (myoclonus).

  • Feeling aggressive.

Not known (frequency cannot be estimated from the available data)

  • Signs of infection such as sudden unexplainable high fever, sore throat and mouth ulcers (agranulocytosis).

  • Epileptic attack (convulsions).

  • A combination of symptoms such as inexplicable fever, sweating, increased heart rate, diarrhoea, (uncontrollable) muscle contractions, shivering, overactive reflexes, restlessness, mood changes and unconsciousness. In very rare cases these can be signs of serotonin syndrome.

  • Thoughts of harming or killing yourself – contact your doctor or go to a hospital straight away.

  • A skin reaction known as ‘erythema multiforme’(itchy reddish purple patches on the skin, especially on the palms of the hands or soles of the feet, ‘hive-like’ raised swollen areas on the skin, tender areas on the surfaces of the mouth, eyes and genitals, which may be accompanied by fever and tiredness).

  • Severe rash, blistering (bullous dermatitis), peeling or other effects on the skin, eyes, mouth or genitals, itching or high temperature (symptoms of severe skin reactions called Stevens-Johnson syndrome or toxic epidermal necrolysis).

  • Muscle pain or weakness, or swelling caused by abnormal muscle breakdown sometimes accompanied with dark coloured urine (rhabdomyolysis).

  • In rare cases mirtazapine can cause disturbances in the production of blood cells (bone marrow depression). Some people become less resistant to infection because mirtazapine can cause a temporary shortage of white blood cells (granulocytopenia). In rare cases mirtazapine can also cause a shortage of red and white blood cells, as well as blood platelets (aplastic anemia), a shortage of blood platelets (thrombocytopenia) or an increase in the number of white blood cells (eosinophilia).

  • Abnormal sensations in the mouth (oral paraesthesia).

  • Swelling in the mouth (mouth oedema).

  • Hyponatraemia.

  • Inappropriate anti-diuretic hormone secretion.

  • Increased salivation.

  • Slurred speech (dysarhtria).

  • Sleepwalking.

  • Difficulty passing urine.

  • Changes in blood enzymes (shown in blood tests).

In children under 18 years the following side effects have been commonly observed

  • Significant weight gain.

  • Hives.

  • Increased blood triglycerides.

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