Was on 75mg mirtazapine for 5 or 6 months recently cut back down to 30 over the last month, been getting panic attacks again daily so i went up to 45mg. i feel nausea, anxiety, hot and cold, dizzy hlp?

Come off slowly: 75 mg is a very large dose of mirtazapine. The maximum recommended dose is 45mg for depression. Abruptly stopping or reducing the dose of these psychoactive meds can bring their own problems. I recommend you work with a physician to adjust the dose to a safe and therapeutic level. Alternatively, a pharmacist can advise you on these meds.

ON YOUR OWN?: Consider seeing the dr who prescribed the med. I've always thought of meds as helpful but not curative. Meds + psychotherapy might be a better combination.

Unusual: Mirtazapine(reneron) often protects from GI side effects and sexual se do to the unique mechanism of action as a presynaptic Alpha 2 inhibitor- as you increased the dose it kicks in an activating component -notepinephrine) i.e. The lower the dose it tends to be more sedating thus fewer panic/anxiety reactions- we never treat statistics though. It doesn't sound like the right med for you?