Could Mirtazapine/Remeron be causing these weird symptoms?

[Isaiah2017]

I'm having a hell of a hard time and experiencing rather weird symptoms. Whether they've anything to do with Mirtazapine (Remeron) is something that I strongly feel but can't quite convince any doctor of.

 

I was put on 15 mg of it in spring 2015 for depression and a severe insomnia - I hadn't slept an hour like since 25 nights back then! The benefits showed immediately within a day and surprised myself and my family. I would sleep well and be in a very happy and cheerful mood.

 

Then however, from summer 2016 I developed some strange food intolerances; caffeine, sugar, fruits containing high amounts of fructose, yoghurt, butter and so on. Eating anything of that would cause me jitteriness and insomnia. I steered clear of those foods.

 

From autumn last year though, a lot of those food intolerances have relented and it changed into intolerance towards medicines and supplements that I was on; the thyroid medicine for hypothyroidism, Vitamin D, Calcium, Vitamin E and could never again tolerate any new medicine or supplement. Symptoms resulting from these are, again, jitters, insomnia and a strange kind of feeling of being struck on the head, like I can't hear anything and the thinking becomes very unclear and blurred. Coupled with this is a weird sensation that if a medicine has any potential side-effect (even physical, such as urine retention), I get it at all costs. So I'm steering clear of the culprits here too.

 

However, avoiding the culprits doesn't end my misery, it just helps in avoiding a whole new set of symptoms, because since autumn 2016 I'm under constant brainfog anyway, have heart palpitations immediately after every meal (but worst after breakfast), have concentration and focus issues, lead a life without any hobbies, wishes or desires. Nothing excites me, nothing interests me and nothing catches my attention. Leave tasks pending for months (the most unlike me habbit), have badly lost my sense of humour. My sense of humour was something that I literally used to pride on, and friends from around the world would call me to fresh up if they were having a dull day. My mind feels numb, although it isn´t as if it´s the sedating effect of the Mirtazapine because 90% percent of the nights I don´t sleep well, and on a lot of nights I feel as if I´m asleep with an awake mind!

 

The GP who put me on it considered it to be just the effects of anxiety and depression and recommended the doubling of the dose to 30 mg. When I contested that, given that I´ve my doubts of a lot of these issues being brought upon by Mirtazapine itself, she referred me to a psychiatrist. He too strongly denies of Mirtazapine having any hand to play on it and instead thinks it´ll be best to combine it with another antidepressant for day-time.

 

He put me on Paroxetine, boom, a flood of side-effects! Then changed to Fluoxetine (Prozac) - third day on it and having weird feelings. The heart poundings are one and is in fact making me very depressed and hopeless!

Edited December 6, 2020 by Isaiah2017

[Isaiah2017]

It has been suggested by someone I know that the antihistamine effect of Mirtazapine might be related to some of these issues. Is it possible? 

Also, how many antidepressants are there with antihistamine effects? Are all sedating antidepressants antihistamine as well? 

[notloki]

1. Then we would see these symptoms in other antihistamines. 

2) A lot of sedating antihistamines are antidepressants or AP-AAP. The first antidepressants were modeled after antidepressants. 

[jt07]

First, I'd like to welcome you to CB! I'm glad you found us.

I have taken mirtazapine for six years and just recently went off to lose weight. Honestly, I agree with your doctors. It sounds to me like the mirtazapine is no longer working for you and that depression has returned. I never had any of those symptoms you describe except maybe a little brain fog because mirtazapine is so sedating.

I'm not sure that doubling the dose of mirtazapine is going to do much if indeed it stopped working. Maybe, but I have never found that meds that stopped working would suddenly start working again by raising the dose. I think it is good that your doctor added another antidepressant though. However, you should keep your doctor in the loop and tell him that the fluoxetine is making you more depressed. I don't know how old you are, but if you are under 25 (I believe) there is a risk of suicidal ideation with antidepressants. If you are experiencing suicidal feelings, call your doctor immediately. If you think you might hurt yourself, go to the ER.

So what I think is that it is good that you are trying a new antidepressant. I think a lot of the symptoms you describe are depressive symptoms and are likely to be the result of the mirtazapine stopping working and symptoms of your depression returning.

[Isaiah2017]

On 6/11/2017 at 9:39 PM, jt07 said:

First, I'd like to welcome you to CB! I'm glad you found us.

I have taken mirtazapine for six years and just recently went off to lose weight. Honestly, I agree with your doctors. It sounds to me like the mirtazapine is no longer working for you and that depression has returned. I never had any of those symptoms you describe except maybe a little brain fog because mirtazapine is so sedating.

I'm not sure that doubling the dose of mirtazapine is going to do much if indeed it stopped working. Maybe, but I have never found that meds that stopped working would suddenly start working again by raising the dose. I think it is good that your doctor added another antidepressant though. However, you should keep your doctor in the loop and tell him that the fluoxetine is making you more depressed. I don't know how old you are, but if you are under 25 (I believe) there is a risk of suicidal ideation with antidepressants. If you are experiencing suicidal feelings, call your doctor immediately. If you think you might hurt yourself, go to the ER.

So what I think is that it is good that you are trying a new antidepressant. I think a lot of the symptoms you describe are depressive symptoms and are likely to be the result of the mirtazapine stopping working and symptoms of your depression returning.

I´m open to such ideas and suggestions of ultimately depression and anxiety triggering off such symptoms, and I went to a psychiatrist only after being convinced of it. So I don´t contest that, but my psychiatrist himself was so confused at our first appointment that he too pointed towards these being result of a possible underlying liver or heart disease, or some hormonal issue - all of which I´ve got checked and all test results came back negative. So even he isn´t sure what to make of it.

 

When I´d depression which led to Mirtazapine, the symptoms were very classical, such as insomnia, spells of extreme sadness and constantly pondering the purpose of my life etc. Now however, it´s very rarely that, it´s just that I feel numb and disinterested in anything..

 

The food, medicine and supplements intolerance that I´m experiencing, is it really something that´s associated with depression, even if in rare cases? I´m confused.... I´m 27 by the way and have stopped Fluoxetine due to the worsening of symptoms by it - at the psychiatrist´s advice. He might ask me to see him soon though.

 

My gut feeling still is that combining anything with the Mirtazapine won´t work. Switching over to another one altogether might be a better option, but switching to an antidepressant like Paroxetine or Fluoxetine isn´t a good alternative since they´re not sedating like Mirtazapine.

 

Which one are you on right now, if I may know?

Edited December 6, 2020 by Isaiah2017

[mikl_pls]

I would try to get of mirtazapine if possible (unless you already have), and if you don't tolerate fluoxetine, perhaps try citalopram or escitalopram—they have a generally high tolerability profile.

[Isaiah2017]

17 hours ago, mikl_pls said:

I would try to get of mirtazapine if possible (unless you already have), and if you don't tolerate fluoxetine, perhaps try citalopram or escitalopram—they have a generally high tolerability profile.

I forgot to add here that before I was finally put on Mirtazapine, my GP tried Citalopram. It kept my wide awake the whole night and gave me inorgasmia. Was discontinued after five days.

[dtac]

If it was me, I would taper off Remeron and see if any of the symptoms subside. I was on 45mg for almost 2 years and stopped it cold turkey. Had insomnia for several days, brain zaps, dizziness, but it subsided after a week.

[Isaiah2017]

On 6/13/2017 at 5:57 PM, dtac said:

If it was me, I would taper off Remeron and see if any of the symptoms subside. I was on 45mg for almost 2 years and stopped it cold turkey. Had insomnia for several days, brain zaps, dizziness, but it subsided after a week.

I´ve an update, a rather confusing one or maybe.... I won´t know.

 

Regardless, My psychiatrist put me on Sertraline (Zoloft) and that that caused worsening symptoms of depression and insomnia. I called him and he said that unless the symptoms make me go wild, I should stick to it and see if things ease up and if the side-effects subside let´s see in 20 days. No way I can stay awake for 20 nights! I´ve tried six days and I felt like a zombie due to the lack of sleep. He is adamant on putting me on a combination of Mirtazapine and something else for daytime. Clearly not working in my experience.

 

Yesternight, at my own risk, I tapered the Mirtazapine to 7.5 mg and had an okayish sleep (could deteriorate with time with a 50% reduction in dose). An encouraging news,, the early morning heart palpitations were minimum, my thinking was clearer and sharp, the akathisia was almost non-existent).

 

Till, till however I´d my lunch. Immediately after my lunch, the akathisia is back in full force, my thinking is clouded! Where the hell lies the connection between my psychological symptoms, especially the akathisia, and my diet?!

 

 

Edited December 6, 2020 by Isaiah2017