Mirtazapine (Remeron)?

[Autumn]

Hi Eddie,

Thanks for asking. I'm not too well. 10 months of sick leave and little improvement. My last 2 appointments with gp happened over the phone. He seems very absent minded or stopped caring? I don't know. He didn't ask any questions at all about how my days are, my sleep, or the rash/allergic symptoms I've been having and told him about on the phone. Just asked 'how are you mentally?'. To which I replied I was having a hard time and felt frustrated and somewhat worried. So my sick leave note now says 'cfs with mood disorder'. Yeah well, whatever... I'm done. It's weird when you speak honestly about how you feel your emotions are somehow pathological. But yeah, it's the same stuff all over again: doc doesn't know what to do so the fact that you're not getting better is your fault and it's just all in your head. Also, if we wait long enough and ignore the problem altogether the utter exhaustion and pain and whatnot eventually turns into depression. See, you were just depressed all along!
Besides 5+ years of physical therapy, osteopathy, psychotherapy, supplements,... and I'm worse off.
So I guess I'll be going back to work at the end of July as sick leave doesn't get me anywhere and there's no help at all.
Sorry for ranting

How are things for you? Did you manage to get off the mirtazapine?

 

[EddieB]

Sorry that you’re not feeling well. I’m right there with you.

I’m down to a crumb, about 1.5mg of the Mirtazapine. I have no idea what it could be doing, but I can’t seem to do without it. So for now, taking it daily before bed.

I finally got the test results back from the entero/echo virus, negative. So other than the high EBV antibodies, really nothing to go on. So it was decided to forget about treating viruses and try to work on the nervous system.

My gastrologist sent me to a physiatrist, who ironically turns out is his wife. Small world. I’m not concerned, both are highly rated doctors and there aren’t many in the semi rural area I live. Anyhow, she admitted that this was a bit out of her scope, would involve some trial and error, and that she would help however she could. Fair enough.

After a lengthy discussion, she asked that I stop the mirt for three days, the start 100 mg of gabapenten. This something I was considering, my wife takes it nightly for her neurological problems. She also prescribed setraline, which I wasn’t too keen on. She also had me do a GeneSight test. It’s a DNA test that supposedly shows which drugs are more compatible. Waiting for results.

So two days off the mirt, I get a horrible relapse, one of the worse ever. Tried the gabapentin, nothing. It happened that I had a phone appointment with my pc doctor the next day, she said to stop the gabapenten and go back on the mirt. Took about a week, slowly got back to where I was, not great but not in agony.

Then, Monday of this week, I wake up with a huge canker sore under my tongue, and a golf ball size lymph node. So much for not having a virus. I called the immunologist, she said that because there is both the sore and the swollen lymph, they’re connected and it’s viral. She had given me a script for Valacyclovir, and thinks it may be time to give it a try.

I’ve read where others have gotten some good results from antivirals. I don’t know what to do. Right now, this lymph/canker sore thing is raging, pretty sure I’d need to wait till it calms down before trying anything else.

I don’t remember, did you have high EBV antibodies?

 

[Jean Gould]

Anyone on this antidepressant for sleep?

I took it in the past, combining it with Efexor at the time. It did help me sleep then. But apart from that I have horrible experience with antidepressants. As in no effect on mood or being completely emotionally numb, side effects, and horrible withdrawals.

I'm worried about taking it again (seriously, I'm crying about it - and not because I'm depressed).
I've been on sick leave for the past 4 months after a crash. Worst one so far, after 10+ years of this illness.

Gp suggested either this or Trazodone. But I've had a bad reaction to the latter after taking it once in the past. Combining it with Bupropion at the time, which was the possible culprit.

Anyway, I definitely need (deep) sleep and to be able to eat as I have some bad GI issues.
Any thoughts on whether this is a good idea or not?

Thanks

▲



After New eve I was very depressed. The winter blue, may be linkedto a low level of D3, which I was tested for one year before. So I had Efexor and Trazodone. Efexor for the mood and Trazadone for sleep.The first one worked in few days. Trazodone was presented to me as a sleeping pile. It seems to be a certain rat-catcher type, old molecule, without the same structure that Prozac, Efexor and family.Efexor that I used in the past with my specialist doctor play on my sleep clock, putting my sleep time to midnight. I keep it, but it's not the best. Trazodone seems to be magic, I take 1/4 of 50mg, I wake up relax and refresh but I can't use my brain before noon. Also I have more pain to the right side, it is a little be hepatotoxic.

''anti-depressor'' is a catch all category. Don't be ashame to take it. Just imagine that your body need insulin. If you body need a molecule you have to take it.

 

[EddieB]

▲



After New eve I was very depressed. The winter blue, may be linkedto a low level of D3, which I was tested for one year before. So I had Efexor and Trazodone. Efexor for the mood and Trazadone for sleep.The first one worked in few days. Trazodone was presented to me as a sleeping pile. It seems to be a certain rat-catcher type, old molecule, without the same structure that Prozac, Efexor and family.Efexor that I used in the past with my specialist doctor play on my sleep clock, putting my sleep time to midnight. I keep it, but it's not the best. Trazodone seems to be magic, I take 1/4 of 50mg, I wake up relax and refresh but I can't use my brain before noon. Also I have more pain to the right side, it is a little be hepatotoxic.

''anti-depressor'' is a catch all category. Don't be ashame to take it. Just imagine that your body need insulin. If you body need a molecule you have to take it.

I’m down to a crumb (1/4 of a 7.5) of Mirtazapine at night, can’t sleep without it.

 

[Ughhh]

My new psychiatrist prescribed this. She didn't mention it's an antidepressant. I'm taking it at 1/4 of a 7.5mgs and it knocks me out like I have to get ready before and make sure I'm in bed, when I wake up I feel like I don't know who I am or where I am like a massive blackout. I'm finding it has lingering effects of sedation for hours after waking up. Psychiatrist says I'm super sensitive, well no sh*t I told you that! I don't know if I'm going to last much longer trying this I am finding myself not wanting to take it and I'm already fighting off wanting to eat everything since starting Lyrica. sigh.

 

[EddieB]

My new psychiatrist prescribed this. She didn't mention it's an antidepressant. I'm taking it at 1/4 of a 7.5mgs and it knocks me out like I have to get ready before and make sure I'm in bed, when I wake up I feel like I don't know who I am or where I am like a massive blackout. I'm finding it has lingering effects of sedation for hours after waking up. Psychiatrist says I'm super sensitive, well no sh*t I told you that! I don't know if I'm going to last much longer trying this I am finding myself not wanting to take it and I'm already fighting off wanting to eat everything since starting Lyrica. sigh.

Hello,
Mirtazapine is a strange medication, it has different effects at different doses. Like you, I started with a crumb that knocked me down bad. I knew at that point it wasn’t going to end well, but the doctor insisted and I went along. It wasn’t the right medication for me, but I do know it has helped some people, and we’re all different. If you’re using it as an antidepressant, doses below 15mg won’t do much.
From my experience, make very gradual changes in doses up/down to minimize the bad effects.

 

[Ughhh]

Are you still taking the crumb or did you wean off of it?

My Dr. prescribed the Remeron for sleep. I'm already on a tricyclic antidepressant called protriptyline that does nothing for my mood, but I can tolerate it so I keep taking it bc I cant tolerate most antidepressants.

 

[EddieB]

Are you still taking the crumb or did you wean off of it?

My Dr. prescribed the Remeron for sleep. I'm already on a tricyclic antidepressant called protriptyline that does nothing for my mood, but I can tolerate it so I keep taking it bc I cant tolerate most antidepressants.

I was on it for digestive issues, it seemed to help for while, but quit working and left me dependent on it to sleep. My highest dose was 22.5mg.
I weened down but still took a crumb for sleep for like 6-8 months, finally got off it completely about 6 months ago, just now starting to sleep somewhat normal. If you need something for sleep, it’s probably no worse than anything else. I would take as little as possible, just enough to get the job done.

 

[Not dead yet!]

I just wanted to add my voice to the "I react horribly to antidepressants" chorus. The last time I tried anything in that class, I had panic attacks for months. I took a deep dive into the side effects. People who get bad effects can end up with "new" bipolar. That made me scratch them permanently off my list. I don't need that on top of everything else.

The carnivore diet didn't work out (ref to previous post in this thread). Some other single-food diets did help a lot, on a temporary basis, like the "spud diet" and the "rice only" elimination diet. One thing I learned is, if you have "air hunger" it might go away with a 5%-10%max fat eating plan. Single food diets can do that no problem. Just can't do it forever. It really helped my kidneys and my coughing though. Some people say spud diet is also an antidepressant but without the side effects. Not sure as I don't need antidepressants for depression, I was hoping for pain relief and better sleep.

 

[EddieB]

I just wanted to add my voice to the "I react horribly to antidepressants" chorus. The last time I tried anything in that class, I had panic attacks for months. I took a deep dive into the side effects. People who get bad effects can end up with "new" bipolar. That made me scratch them permanently off my list. I don't need that on top of everything else.

The carnivore diet didn't work out (ref to previous post in this thread). Some other single-food diets did help a lot, on a temporary basis, like the "spud diet" and the "rice only" elimination diet. One thing I learned is, if you have "air hunger" it might go away with a 5%-10%max fat eating plan. Single food diets can do that no problem. Just can't do it forever. It really helped my kidneys and my coughing though. Some people say spud diet is also an antidepressant but without the side effects. Not sure as I don't need antidepressants for depression, I was hoping for pain relief and better sleep.

I firmly believe that antidepressants have a big effect on the gut and it’s microbes. I also think that doctors are clueing into this, in particular gastrologists, as they are prescribing them more and more. Trouble is, no two cases are exactly alike, everyone’s different, what can help one person can hurt the next. Very hard to know who/what to trust. For myself, they may have created a short term, false sense of well-being that crashed me into a worse state. I’m in no hurry to take any more.

 

[Not dead yet!]

I firmly believe that antidepressants have a big effect on the gut and it’s microbes. I also think that doctors are clueing into this, in particular gastrologists, as they are prescribing them more and more. Trouble is, no two cases are exactly alike, everyone’s different, what can help one person can hurt the next. Very hard to know who/what to trust. For myself, they may have created a short term, false sense of well-being that crashed me into a worse state. I’m in no hurry to take any more.

The gut flora might be the answer for why I react badly. I have Celiac. So my T cells, according to the research I've done, are occasionally wiping out some of my flora, depending on how much gluten they're reacting to. It's impossible to have zero gluten.

After a food poisoning event around year 2000 or so, I became unable to drink alcohol, became progressively more tired, had a progressive increase in migraines, and Celiac was probably triggered. But I wouldn't figure it out for nearly 15 years. I thought I was doing vegetarian badly. I kept trying to fix my diet, but I never suspected that the healthy whole wheat could be the cause.

For many gut illnesses, stool transplant can be a cure. But for Celiac, it's a change in the way the T cells behave, it's a different reading of the genetic code of a person (behavior of HLA). So once triggered, the flora will always suffer the assault. Even new flora.

So if antidepressants are therapeutic because they rearrange the flora to be healthier, that would explain why I have bad reactions (my autoimmune illness messes that up), and why the drugs take weeks to have "full effect."

But why the panic attacks and bipolar if you suddenly stop? That has to be a brain effect, not flora. I'm speculating that it happens because the brain is trying to keep neurotransmitters as high as before but is struggling to do it on its own.

I had to suddenly stop after a few weeks. I was dehydrated from the constant diarrhea. The dose was already low since I was only just starting the meds. The panic attacks have stopped now, but it was terrifying. I was afraid it may be permanent.

 

[EddieB]

The gut flora might be the answer for why I react badly. I have Celiac. So my T cells, according to the research I've done, are occasionally wiping out some of my flora, depending on how much gluten they're reacting to. It's impossible to have zero gluten.

After a food poisoning event around year 2000 or so, I became unable to drink alcohol, became progressively more tired, had a progressive increase in migraines, and Celiac was probably triggered. But I wouldn't figure it out for nearly 15 years. I thought I was doing vegetarian badly. I kept trying to fix my diet, but I never suspected that the healthy whole wheat could be the cause.

For many gut illnesses, stool transplant can be a cure. But for Celiac, it's a change in the way the T cells behave, it's a different reading of the genetic code of a person (behavior of HLA). So once triggered, the flora will always suffer the assault. Even new flora.

So if antidepressants are therapeutic because they rearrange the flora to be healthier, that would explain why I have bad reactions (my autoimmune illness messes that up), and why the drugs take weeks to have "full effect."

But why the panic attacks and bipolar if you suddenly stop? That has to be a brain effect, not flora. I'm speculating that it happens because the brain is trying to keep neurotransmitters as high as before but is struggling to do it on its own.

I had to suddenly stop after a few weeks. I was dehydrated from the constant diarrhea. The dose was already low since I was only just starting the meds. The panic attacks have stopped now, but it was terrifying. I was afraid it may be permanent.

There are so many variables it’s hard to know. Some people get good outcome from antidepressants, others don’t. Doctors and researchers know how antidepressants work, but have no idea why they work.

I use the analogy of a empty jar of peanut butter. If you keep scraping with a spoon, you will get a tiny bit of peanut butter each time. But if you took a towel and wiped the inside of the jar, you’d get a bunch more, one time. But, now, there’s nothing left.

I think antidepressants can work the same way. They are agonists and antagonists, they block or push chemicals. If something is already low, say serotonin, and the drug sucks it up, you may feel better for a short period of time. But unless the gut can replace, it’s gonna run out, just a question of when. Then comes the crash.

Again, this is just speculation, it’s way more complex than that. But based on my own experiences, that’s my take at this time. I’m not currently taking any antidepressants, this has been the longest period in years. Like you, I was afraid some of the effects were permanent. My ability to sleep has restored somewhat, anxiety can be a problem, but I now recognize it and don’t freak out as much when it hits. I continue to have severe digestive issues, that may require that I try another medication at some point.

 

[TJ_Fitz]

I used Remeron maybe 20+ years ago. It did help with sleep, for maybe a year, then it seemed to stop working for me.

My sleep isn't great now, but it's better than years ago. I have a couple of things to thank for that. Maybe they will help you, maybe not.

First, I have chronic sinusitis. If I can't breathe through my nose, then I can't sleep without heavy drugs or serious sleep deprivation. At times, I've had to use Afrin to sleep. I dilute Afrin to 1/8th strength and put it in a metered, refillable nasal spray bottle, and it's still effective without all the side effects, and the rebound congestion isn't as bad. But rebound congestion is still better than sleep deprivation!

Second, I've worked through a lot of previously pent-up, unacknowledged, unexpressed feelings (trauma) that were causing a lot of anxiety/fear. I've used hypnotherapy, self-hypnosis, and the "write and burn" exercise to drag unconscious things into conscious awareness where I can face them and deal with them. Over the years, this has eliminated most of my chronic anxiety. Mostly now I'm dealing with sadness/mourning (over how thing should have or could have been).

I hope you can find some answers for your particular situation. These problems can be incredibly complex and layered!