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Clarity regarding medicine
Hello
I have been prescribed currently desvenlafaxine 50mg
mirtaz 7.5 mg
clonotril 0.25
It's making me severe drowsy whole day so I am loosing interest in life always sleepy.
Previously I was prescribed fluoxamine 100mg which was better for mind and drowsyness was less compared to desvenlafaxine.
Can I take now fluoxamine and mirtaz together ?.. because my doctor is out of town and not reachable for few weeks.. I am not happy with the results of desvenlafaxine and not interested to increase the dosage & can I take clonotril daily atleast for next 2-3 months ? I am also doing yoga, and giving importance to diet..please guide..
Answers (6)
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This all need a detailed history and assessment
Mirtazipine and clonotril both are sedative at a specific dose
Please consult online for further information and treatment plan
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Hi.. you need a change of medicines. Consult online for a second opinion
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Your drowsiness is because of Mirtazapine and not because of Desvenlafaxine..Desvenla is activating agent,it removes drowsiness but mirtazapine causes increase in sleep,appetite,makes person drowsy…above this two you are also taking clonitril which increases day time drowsiness..
Very fresh opinion of mine..reassess yourself,your symptoms are that severe right now to continue with 2 antidepressant?!..because in case of depression,there are other ways of dealing with symptoms than just increasing dose or changing medicines.
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Take second opinion from other psychiatrist,it will help you out with fresh perspective
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Hey, the side effects of these medications are usually drowsiness. We will need further history, so that we can plan medications accordingly.
Please consult online or offline.
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Dr. Indraja Sharma
Psychiatrist
7 yrs exp
Kota
• Excessive daytime drowsiness is most likely due to mirtazapine (7.5 mg) and clonazepam, both are sedating.
• Do not switch or combine fluvoxamine with desvenlafaxine on your own—overlap increases risk of side effects (including serotonin toxicity).
• Fluvoxamine + mirtazapine can be used together, but only under medical supervision with proper dose planning.
• Daily clonazepam for 2–3 months is not advised due to dependence and worsening daytime sedation; it should be short-term or PRN.
• Yoga and diet are helpful but won’t counter medication-induced sedation.
Best next step: seek an online psychiatric consult for safe medication adjustment rather than self-changes.
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Dr. Seujee Goswami
Psychiatrist
13 yrs exp
Bangalore
Excessive daytime drowsiness and reduced motivation can occur with certain antidepressant combinations, particularly when sedating medications are taken together. Mirtazapine and clonazepam are both known to cause sleepiness, and their combined effect may explain your current symptoms. Medication responses vary between individuals, and a drug that suited you earlier may not always remain the best option later. However, switching or combining antidepressants without supervision can carry risks.
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Do not restart fluvoxamine or change your current medications without consulting a psychiatrist. Combining or switching antidepressants requires careful planning to avoid side effects and interactions. Since your treating doctor is unavailable, seek a second opinion from another psychiatrist, preferably through an online consultation, for medication adjustment and guidance on managing drowsiness.
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Daily use of clonazepam for several months is generally not recommended without close medical supervision due to the risk of dependence and worsening daytime sedation. Continue supportive measures such as yoga, sleep hygiene, and diet, but medication changes should only be made after professional review.
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