When last I found time in the chaos to write in this space I had just been handed a prescription from Mirtazapine and was preparing to embark on yet another pharmacological experiment with this chemistry set I call my body. I was hopeful that it would be the last piece of the puzzle, but I am sorry to report that yet again the downside outweighed the benefit and that three weeks later I am no further ahead for having endured the mind numbing fog of these damn pills. I suppose to say I am not further ahead is not completely accurate, I have succeeded in eliminating one more drug from the list of viable options.
In terms of helping me sleep the Mirtazapine worked too well. My wife had had a brief encounter with the drug nearly ten years ago and she remembered fondly the ease with which she slept while on the medication. These warm memories made her optimistic that I would like the drug. The anxiety that comes with new pills was actually enough to counter the drug early the first night. I could feel it pulling me down, the lethargy invaded my body quickly, but it took a shockingly long time for my mind to submit to the process. When it finally did I was out. My wife got up with my son around 6:30 the next morning, I had taken the pill about 10:00 the night before, and I was still groggy so she let me stay in bed. Over the next 2 ½ hours she cleared our bedroom of a week’s worth of laundry and I didn’t awaken. At 9:00 when I came too was stunned to see the amount of work she had done in the room without be coming to. It made me a little uneasy to discover how soundly I had been sleeping so many hours after taking the pill. I was not happy to still feel like I could lie down and fall asleep for several more hours. We were expecting company so I did have to get up, but I didn’t really wake up the entire day. My focus was off and my brain was like molasses.
Experience has taught me that these types of side effects lessen over time so I did continue with the medication and slowly the fatigue side effect did let up. I was always a little groggy in the morning, but once I got moving things cleared up and I was ok. Focus did remain a challenge and it cropped up in a most uncomfortable arena. I had chosen the Mirtazapine in large part due to its lack of sexual side effects, but I discovered that my inability to focus created a problem in the bedroom worse than the SSRI drugs. In the middle of the day I did ok, but in the evening or after I took the pill I had some performance failures. This was disheartening, but I carried on with the experiment in the hopes that the focus would be the next area of improvement.
Three days into the medication the second side effect popped up. I got hungry. I got all day, still wanting food after large meals hungry. I would literally eat dinner and not feel a bit less hungry than when I sat down at the table. I was so hungry that one evening after I discovered that I had decimated the snack options a couple days prior to going grocery shopping I got in the car and drove to the store to get food. I gained six pounds in the first ten days, and eight total in the first two weeks. I was able to slow the rate of gain through will power alone. There was no letup in the hunger. This was going to be a losing battle.
I was told to give the drug two full weeks unless some truly intolerable side effects appeared. After fourteen days I was feeling less anxious, but I honestly wondered if it wasn’t just another consequence of my inability to focus. Not being able to pay attention to the anxiety is not the same as living without it. I was also tired, gaining weight, and experiencing some confidence issues in the bedroom. I failed to see the net gain in this equation and stopped taking the drug. My weight settled back a couple pounds but it is going to be a real bitch getting the rest off, and it probably won’t happen until spring. I am still tired, but I was tired before I took the drug too, my focus has returned and I think everything else is back to normal as well. I stopped the drug about 5 days ago and I have noticed and uptick in anxiety, but I still don’t see the drug as a net benefit.
The failure of this experiment brings me back to the question of what to do next. Zoloft is the conversation we have had, and I am fairly certain it will work, but will it work before the onset of the sexual side effects? I suppose there is only one way to find out, but these experiments take such energy I am not sure when or if I will feel compelled to try again. I have gone almost two full years without the SSRI type medications. That is more than twice as long as any other break since I began taking them in 2001. The side effect itself impacts my marriage in negative ways. I cringe to think of this impact if we are trying to have another child. My wife says it won’t be a big deal, but what is she supposed to say? There are never any easy choices.