Started mirtazapine last night - issues falling asleep

SDianeL

UPDATE 9/30 - Good news!! The Geri Psychiatrist took him off the Mirtazapine after 2 bad nights. She said she will discuss it at his next visit 10/17. And more good news, he has had 3 good nights after he came off it. I added a CBD gummy at night and that seems to help. I added more light in the bathroom and left our bedroom door ajar with a light on in the hallway so he can navigate to the bathroom. I left the seat up on the toilet so he could have a better target. I added blue toilet bowl cleaner and that also seems to help. Go figure. He has been complaining and obsessing about the sheets and pillows on the bed so I took off the top sheet and left a light blanket and changed his pillow and he said it was much better. Fingers crossed we found the right combo for awhile. I did add the waterproof mattress cover to the bed and ordered some male pads in case. I have a monitor that will wake me when he gets up and a sign for the bathroom. I forgot to put in this post that he has ALZ-Posterior Cortical Atrophy which affects his vision. That explains why I made the changes I did in the bathroom. Thanks so much for everyone's input and concern. Don't know what I'd do without this group.

UPDATE: 9/27 - ANOTHER BAD NIGHT. Took 2.5 hours to fall asleep, woke up at 4am went to the sofa and wouldn't come back to bed. Finally got him back in bed at 4:30. He got up this morning, didn't make it to the bathroom. Got a clean pair of underwear and put them on over the wet ones and got back in bed. Won't let me help him and just screams at me to leave him alone. He's back in bed and won't get up to take his pills and eat breakfast. It's now 10:15am. The doctor messaged me that she will call me today. I'm exhausted. Don't even know who to call for help. Who can help??

My DH, 78, diagnosed 2 years ago, Stage 5 going into 6 has been really depressed lately & the Geri Psychiatrist added mirtazapine  7.5 mg before bed. He started it last night and went to bed right away but he couldn't go to sleep and tossed & turned for 2.5 hours before he finally did fall asleep. He said it messed him up and made him dizzy. He did sleep well afterward. Going to reach out to the Geri Psy. doc tomorrow. Does it take time to get used to it? Or should we change to something else?

Jeanne C.

Every time we've added or changed a med, the doc has advised that it will take time, sometimes weeks, to work through his system and start to have impact. Definitely touch base with his doc, but be prepared to give it time. You've got this.

Marta

FYI: mirtazapine recently has added a black box warning for use in the elderly with dementia, similar to Seroquel and Risperdal.

Trazodone does not have black box warning for elderly with dementia (but does for young people). It is not on the Beers list

if you’re going to use a med with a black box warning, Seroquel and Risperdal are generally more effective, more quickly.

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Anngalyon

I am so sorry you're going through this. It's tough isn't it? We had to switch from underwear to depends several months ago. I actually like the brand at Kroger (if you have that chain in your area). They're much cheaper than the Depend brand. Those have worked really well for us. His MD prescribes Seroquel and it has worked better than any other brand he's taken. There were a couple (can't remember the names), but they made behavior and sleep much worse. So far, Seroquel has worked great with sundowning. Now, we have a bad couple nights about every 2 months, rather than on the daily.