Mirtazapine/Remeron: HAPPY UPDATE!

[IfIOnly]

I saw a new doctor today who thinks this may be a good fit and am little hopeful for this new prescription antidepressant/anti-anxiety/sleep med. I'm reading reviews online and so far no one has said it gave then insomnia, which has been why I've had to stop taking several meds even though they helped wonderfully with my depression. I'm pretty consistently hearing that it causes weight gain, which is concerning. I'm already 35 pounds overweight, and I'm petite and not active, so that weight is really noticeable and just a lot for my frame. I *think* I'd rather gain more than be depressed. 

I'm not looking forward to the process of introducing another antidepressant. It's hard. Hopefully it works out this time though.

Any experiences with Mirtazapine? Thank you.

Edited January 13, 2021 by IfIOnly

[sweet2ndchance]

I don't have experience with Mirtazapine specifically but I do have a lot of experience with anti-depressants in general. I don't think I've seen an anti-depressant that doesn't mention weigh gain as a possible side effect sadly. But I've never had an antidepressant make me gain an unbelievable amount of weight. I am overweight but very little of it is due to anti-depressants. In my experience, anti-depressants just made the weight more stubborn to take off when I'm actually trying to lose weight rather than making me gain weight. FWIW, I think you are right though, a little weight gain is nothing in the grand scheme of things to being depressed. Hugs. I hope this need med helps you.

[IfIOnly]

6 hours ago, sweet2ndchance said:

I don't have experience with Mirtazapine specifically but I do have a lot of experience with anti-depressants in general. I don't think I've seen an anti-depressant that doesn't mention weigh gain as a possible side effect sadly. But I've never had an antidepressant make me gain an unbelievable amount of weight. I am overweight but very little of it is due to anti-depressants. In my experience, anti-depressants just made the weight more stubborn to take off when I'm actually trying to lose weight rather than making me gain weight. FWIW, I think you are right though, a little weight gain is nothing in the grand scheme of things to being depressed. Hugs. I hope this need med helps you.

Thank you! I appreciate the encouraging words. I totally get what you're saying about weight gain and antidepressants. This particular antidepressant though is prescribed to people needing to gain weight (depressed or not) and particularly people with EDs. It actually significantly increases appetite and slows metabolism. There are a lot of people saying they ballooned in a matter of weeks, but there are other more moderate reviews as well.

I'm a little scared but ultimately it's not fair that, for example, my DH is married to depression more than *me*. He says he's fine with the possible side effects, so that's comforting. Knowledge is power though. A lot of people say they didn't know about that side effect beforehand. In fact, I picked up my RX today and neither my doctor or the pharmacist mentioned the weight gain aspect of the drug. I'm hoping to ride out any cravings or make better, low cal choices if they hit.

[Spryte]

My mother takes that one, among others.  She’s been on it for two years.  Her weight never changed.  She was over weight when she began it, and has stayed steady.  She is 80, not active in the least.  No weight gain or loss.  

As for how well it helps... I have no idea how it well it works alone as it’s part of a larger cocktail for her.  I do recall it was added in when other anxiety and depression meds were not enough, and it does seem helpful in conjunction with her other meds.  It is also helpful with her sleep issues.

I hope it works for you!

If it’s helpful at all... my thoughts are that depression is debilitating, and weight gain and tolerable side effects are a small price for having that crushing weight lifted for you and your family. Maybe you can begin the med knowing that as the depression lifts you can make a plan to work out and eat healthy.  Those two things will be easier when you feel better, and bonus, they will also help you feel better, possibly.  

Good luck!

[IfIOnly]

Thank you for sharing. That is really comforting to hear about your mom's experience. You are so right about how debilating depression is, and it does really hinder my ability to care for my health properly. I'm cautiously hopeful this med could be a positive thing despite, like you said, tolerable side effects. Thank you for your understanding and encouraging words @Spryte

Edited December 29, 2020 by IfIOnly

[MercyA]

No experience, just wanted to say that I hope it works wonderfully for you! 

[IfIOnly]

24 minutes ago, MercyA said:

No experience, just wanted to say that I hope it works wonderfully for you! 

Thank you, @MercyA! My anxiety is telling me all kinds of things. I'm anxious about taking the generic vs. name brand. Some people started with name, then switched to generic and had subpar or worse results. That's just one example of many. I'm trying to tune it out and act logically, but it's still there just gnawing at me. I had the anxiety and depression fade away before with meds (natural-5htp- and RX), and it was wonderful. Hoping for the best too. 

[Sweets]

Hi, My sister has been on Remeron now for about five years. It has helped her a lot with her night terrors/dreams. The psychiatrist put her on Remeron to help her sleep and it has helped her a lot. Ambien gave her too many side effects. She did gain weight on it, but the nightmares have stopped. She does suffer from severe depression after PTSD, stroke, and psychotic break. So her problems are severe, but she is on a good regimen of Latuda, Klonopin as needed, and Remeron. Plus one more medicine that I can't remember. I would say give it a try since it did help my sister get to sleep without vivid nightmares that would have her wake screaming. Plus, I hope sincerely that you find the help you need. It's been a long road for me to help my sister, and I would not wish PTSD and depression on anyone. 

[MercyA]

1 hour ago, IfIOnly said:

Thank you, @MercyA! My anxiety is telling me all kinds of things. I'm anxious about taking the generic vs. name brand. Some people started with name, then switched to generic and had subpar or worse results. That's just one example of many. I'm trying to tune it out and act logically, but it's still there just gnawing at me. I had the anxiety and depression fade away before with meds (natural-5htp- and RX), and it was wonderful. Hoping for the best too. 

I understand! I've had good success using my generic SSRI and generic thyroid med. 

Re: the weight gain. Yes, I've gained the predicted 15-20 lbs. taking an antidepressant. My mom did, too. But we literally cannot function without them, her due to her anxiety and me due to my OCD. I wish I was thin again, but life is so much better for everyone now. And honestly I haven't worked hard at eating right and exercising this year. 😬

[lauraw4321]

I will say that my grandmother took this and then fell and broke her hip. Dizziness is a common side effect. They took her off of it because of that. She was in her late 80s so it was obviously a big concern. 

[IfIOnly]

52 minutes ago, kand said:

I wish we could go back and have her never have gone off the med. I’m becoming a big believer in Healthy at Any Size. Thin and miserable is for the birds. 

I'm sorry your loved one is struggling. I read a lot of reviews from people who were being helped but went off meds because of weight gain. It's a hard position to be in. I agree with you though now at this point in my life and think you nailed it. I'm going to write this out and tape it to my bathroom mirror. Thank you. 

[IfIOnly]

45 minutes ago, lauraw4321 said:

I will say that my grandmother took this and then fell and broke her hip. Dizziness is a common side effect. They took her off of it because of that. She was in her late 80s so it was obviously a big concern. 

Oh, no! Thank you for the heads up. I did see this in the paperwork the pharmacist gave. I does say that's a common initial side effect that should hopefully going away and to call my doctor if it doesn't. I don't have any health problems like osteoporosis that makes this especially concerning for me. 

[IfIOnly]

Update: So far, so good! A couple of things.

Sleep: this AD has been able to replace Benadryl as a sleep med, which is huge. I've been trying to find something to replace Benadryl and all it's scary side effects for some time. I've tried prescription meds as well. And I'm taking little else to sleep as well. I used to absolutely need 50 mg Ben, 10 mgs of melatonin, and almost 5 grams of valerian root. I tried to play with doses and cut down even just one pill. No go. Right now I'm just sometimes taking 5 mg of melatonin, which is 1 time release and 1 sublingual. I haven't been able to stick with any other AD because they give me intolerable insomnia, even Trazadone.

Depression: Sadness is lifting. Moods are stabilizing. This is an antidepressant that works much faster than most. But my doctor told me that I should feel it's full effects around the 4-6 weeks. Anxiety is better too. Every day gets a little better and brighter than the prior. 

Noticing more energy, which is awesome. I am feeling a bit angry though. I'm reading this is something that can appear in the beginning but get better. I'm def. going to give the med the full 2 month trial barring anything too whack happening! I found through reading reviews, that for many people, this AD was a last ditch effort. They've tried everything else, but this worked for them. It works quite differently than most because it doesn't raise serotonin levels and for a bunch of other reasons I read but don't pretend to understand or will try to explain. 

Yay! 

Edited January 2, 2021 by IfIOnly

[IfIOnly]

"In particular, all measures of efficacy displayed the maximum change within the first 2 weeks of treatment, with further improvement occurring at much slower rates. Significant improvement within the first 2 weeks of treatment was highly predictive of the final response, and can serve as a guideline for clinicians when deciding about increased dosage, augmentation, or change of medication in unresponsive patients."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426820/

[Spryte]

So glad it is working for you!  It really has been good for my mom, and I believe (though obviously I’m not in her body) that she saw results fairly quickly, too.  However, like I said, she has cocktail of other meds for anxiety, depression and mood stabilization.  But adding this one really did help her sleep, mood, and depression.  And anxiety.  It was like the final piece of the puzzle for her.  She’s turning 80, and wishes she’d had it 40 years ago.

I hope it continues to improve for you, and wish you many, many good days ahead.  So very happy to hear that it is working for you so far.

[IfIOnly]

53 minutes ago, Spryte said:

So glad it is working for you!  It really has been good for my mom, and I believe (though obviously I’m not in her body) that she saw results fairly quickly, too.  However, like I said, she has cocktail of other meds for anxiety, depression and mood stabilization.  But adding this one really did help her sleep, mood, and depression.  And anxiety.  It was like the final piece of the puzzle for her.  She’s turning 80, and wishes she’d had it 40 years ago.

I hope it continues to improve for you, and wish you many, many good days ahead.  So very happy to hear that it is working for you so far.

That's wonderful for your mom. Thank you! It's early days yet, but with the positive results so far, I am hopeful. 

[IfIOnly]

Before I forget.

The first day after taking them the evening prior, I couldn't get out of bed! It felt like heavy weights were on me, and I was soo groggy. I stayed in bed and tried not to sleep so as not to mess up my sleep schedule but did doze off a time or two. So that was weird. The next morning was remarkably better. Now I'm starting to feel like I have a bit of energy when I wake up and throughout the day. I'm used to feeling pretty groggy during the day though due to all the sleep aids I was taking, so that could also be from not taking so much stuff at night. 

I deal with suicidal thoughts often. In the study linked above, the mention that suicidal thoughts disappearing were one of the first depression symptoms to go and in the first week even. There was a weird day or two transition where the the thoughts were still there but the anxiety that helps curb the ideation wasn't, and it concerned me more than a bit. I haven't had a suicidal though in a day or two now though, which is huge for me. Just a heads up I guess. 

[IfIOnly]

5 minutes ago, kand said:

This is so good to hear! It’s awesome for there to be a med that shows effects that soon. It can be hard for people to stick it out the first month if they’re having some side effects and not seeing anything positive. My mom has been on a cocktail for decades that they’re constantly switching around and it never quite works for her. I wonder if she has tried this. Usually I hate to hear that they’re switching her yet again, or adding more, but this does sound interesting.

Thank you! If what's she's taking isn't quite working, it may be worth a try. It's still early days, but so far I wouldn't say that I'm happy or experiencing joy like I did with other ADs. I just feel even and not feeling all the negative things like I did. I do hope to feel joy and find myself smiling again (naturally not forced), but time will tell, and I'll take even. 

It's so good to hear on this thread that moms are willing to take meds. My mom is so depressed but is very against mood meds and even discourages me from trying them. I know meds don't work for everyone, but my mom's depression has shipwrecked her love live and family relationships, but, sadly, she just doesn't see clearly the major cause of all the damage around her. 

[Spryte]

Oh, I’m so sorry to hear about your mom.  It’s hard when it’s your mom.  There’s no question.  Sending hugs.
 

Mine didn’t take meds until she was almost 77.  So there’s time.  (I’m guessing my mom is likely older than yours, but I could be wrong.)  It’s nice to see her have some relief after a lifetime without.  

[LucyHoneychurch]

Definitely listen to your body and if it's working for you - that's great. My experience was possibly the most negative experience of my life though I'm aware it's an atypical one. I was prescribed it along with an SSRI (which I've never responded well to and is definitely a confounding variable) in Germany, which is relevant only insofar as they don't take the Hippocratic oath or engage in patient disclosure so I didn't really know what I was taking or potential side effects until much later. On the plus side I did sleep and I no longer woke up dozens of time hearing voices telling me to off myself. On the negative side - I slept 20+ hours, was not awake when I was technically awake, I have next to no memories of 2.5 years of my life because I was in a dissociative fog (again, prone to this but the meds exponentially exacerbated it). I woke up years later when I ran out of meds and was cognitively incapable of figuring out the train ride to go get them. I had been top of my MA class at one of the top universities of the world, within the average parameters for weight, and found myself unemployed, 80+ lbs overweight, and without having spoken to anyone in that time and in a world set on fire. I also no longer seem to have a personality or any of my interests that previously excited me, even consumed me.

Clearly, that's not the norm, but maybe it would be a good idea to track how you're feeling and thinking regularly? And make sure you have a dr who listens to you / treats you with respect? The main killer in my case was that a) when I told my doctor that I couldn't think, was sleeping 20+ hours, had difficulty remembering, couldn't walk without stumbling, gained x amount of weight - he told me I was a very pretty girl and not to be so negative. And b) the side effects developed gradually concurrent with the mental decline, so while I was originally able to advocate for myself when things weren't that bad and give it the benefit of the doubt, by the time things got worse and worse, I was no longer able to think or really realize at all, I was too far gone.

That being said, I have heard that it can be effective in cases of major depression / anxiety for cases in which other meds are ineffective, so if your side effects are minimal - that would be such a huge plus that it may not matter. I'd just be vigilant - even regarding how vigilant you're able to be.

[IfIOnly]

8 minutes ago, LucyHoneychurch said:

Definitely listen to your body and if it's working for you - that's great. My experience was possibly the most negative experience of my life though I'm aware it's an atypical one. I was prescribed it along with an SSRI (which I've never responded well to and is definitely a confounding variable) in Germany, which is relevant only insofar as they don't take the Hippocratic oath or engage in patient disclosure so I didn't really know what I was taking or potential side effects until much later. On the plus side I did sleep and I no longer woke up dozens of time hearing voices telling me to off myself. On the negative side - I slept 20+ hours, was not awake when I was technically awake, I have next to no memories of 2.5 years of my life because I was in a dissociative fog (again, prone to this but the meds exponentially exacerbated it). I woke up years later when I ran out of meds and was cognitively incapable of figuring out the train ride to go get them. I had been top of my MA class at one of the top universities of the world, within the average parameters for weight, and found myself unemployed, 80+ lbs overweight, and without having spoken to anyone in that time and in a world set on fire. I also no longer seem to have a personality or any of my interests that previously excited me, even consumed me.

Clearly, that's not the norm, but maybe it would be a good idea to track how you're feeling and thinking regularly? And make sure you have a dr who listens to you / treats you with respect? The main killer in my case was that a) when I told my doctor that I couldn't think, was sleeping 20+ hours, had difficulty remembering, couldn't walk without stumbling, gained x amount of weight - he told me I was a very pretty girl and not to be so negative. And b) the side effects developed gradually concurrent with the mental decline, so while I was originally able to advocate for myself when things weren't that bad and give it the benefit of the doubt, by the time things got worse and worse, I was no longer able to think or really realize at all, I was too far gone.

That being said, I have heard that it can be effective in cases of major depression / anxiety for cases in which other meds are ineffective, so if your side effects are minimal - that would be such a huge plus that it may not matter. I'd just be vigilant - even regarding how vigilant you're able to be.

Oh, wow, I'm so sorry that happened to you. That is awful. Thank you for sharing and giving me and all who read this a heads up.

Can I ask what dose you were on? We're you taking another med alongside the mirtazapine?

I have read a few reviews from others who felt their cognitive abilities decline with mirt. That is so very unfortunate. 

I'm only sleeping 8-9 hours a night and do have some grogginess when waking, but a shower and food gets me going and out of it, mostly. I'm actually feeling more energy than I have in a long time actually. Not a burst or anything, but sustained energy throughout the day. No more naps are needed. 

My mental abilities are increasing as of now. The depression and all the sleep meds I was on were a horrible double whammy. My thinking was so slowed and I had a lot of mental confusion.

I'm feeling my goofy side again come back. I was sooo serious and not really able to lighten up and just be silly now and again. The furthest from it, sadly.

So far nothing concerning, but thank you for the warning and really great advice to monitor and protect my cognitive abilities. 

 

[IfIOnly]

Is there a cognitive test one can take every now and then to monitor cognitive abilities when taking mental health meds? What about monitoring personality and feelings? Is this a thing? 

Edited January 5, 2021 by IfIOnly

[LucyHoneychurch]

9 minutes ago, IfIOnly said:

Can I ask what dose you were on? We're you taking another med alongside the mirtazapine?

 

I took 15 mg - oddly, I just recalled that one brand they gave me when they were out of the one I was taking was a quite different experience in terms of lingering fatigue even at the same dose. I was also taking escitalopram at 15 or 20 mgs. It was definitely part of the issue.

But it sounds like it's working for you and if so that's really all that matters. I'm also hopeful for you that if these issues didn't start manifesting from the beginning, they're probably less likely to pop up randomly later.

[IfIOnly]

3 minutes ago, LucyHoneychurch said:

I took 15 mg - oddly, I just recalled that one brand they gave me when they were out of the one I was taking was a quite different experience in terms of lingering fatigue even at the same dose. I was also taking escitalopram at 15 or 20 mgs. It was definitely part of the issue.

But it sounds like it's working for you and if so that's really all that matters. I'm also hopeful for you that if these issues didn't start manifesting from the beginning, they're probably less likely to pop up randomly later.

Okay, I think that can be Lexapro. I'm so sorry your doctor didn't listen to you and help you find a better solution and for all you have suffered. That is unacceptable. 

Do you mean that one brand of mirtazapine over another caused more fatigue? I have heard of different brands of the same active ingredient causing drastically different results sometimes.

[LucyHoneychurch]

1 hour ago, IfIOnly said:

Do you mean that one brand of mirtazapine over another caused more fatigue? I have heard of different brands of the same active ingredient causing drastically different results sometimes.

Yes it was a different brand of mirtazapine that caused more fatigue and appetite. I'm not sure how that's even possible but it was noticeable.

[IfIOnly]

Update: Today is 2 weeks that I've been on mirtazapine. This med has been a life saver and changer. Sooo thankful. I did need to add the melatonin and valerian back in for sleep, but trust when I say that I have horrible, not typical insomnia. As I started to notice energy increasing in the daytime as the days went on, my sleep was becoming too light. The three meds together are working great though. I am hoping that in a month or two the med will even out and I can get off or decrease the other sleep meds. Either way, I couldn't be more thrilled.

More energy during the day, wake easier and get out of the morning grog faster, no more confusion, sadness, suicidal thoughts. I'm feel a sense of peace and well-being. Able to care for myself and my family better. Way less conflict with my spouse and kids. My thinking all around about people and relationships is more positive. I'm happy! Not an over the top smiley thing, but life is good. SO, SO THANKFUL.

Edited January 13, 2021 by IfIOnly

[IfIOnly]

Oh, and the anger side effect did go away thankfully. I was feeling a bit POed about things here and there for awhile. A bit of road, not rage, but irritation or something too. Things are fine now. Phew.

Edited January 13, 2021 by IfIOnly

[PeterPan]

On 12/29/2020 at 6:13 PM, IfIOnly said:

natural-5htp

If you were on it before, maybe you'd like to be on it again? There's a gene you can look at, TPH2, which shows up in the cheapest 23andme testing. Signals whether you have a defect in the gene that makes your 5HTP. If so, it would be why multiple people in your family are benefiting from it and might be a reason to stay on it.

[PeterPan]

38 minutes ago, IfIOnly said:

add the melatonin and valerian back in for sleep,

5HTP is the precursor to serotonin and melatonin. 

[IfIOnly]

Just now, PeterPan said:

If you were on it before, maybe you'd like to be on it again? There's a gene you can look at, TPH2, which shows up in the cheapest 23andme testing. Signals whether you have a defect in the gene that makes your 5HTP. If so, it would be why multiple people in your family are benefiting from it and might be a reason to stay on it.

I would in a heartbeat, but the insomnia was so bad at such a low dose that not even heavy sleep meds could get me needed sleep. This has been true with everything I've tried that increases serotonin naturally or pharmaceutically. I have high cortisol issues and I think other antidepressants just exacerbate my adrenal issues. I've tried a ton of stuff to lower at night or balance cortisol levels with no luck as of yet.

Below is the probable medical reason this AD is working for me.

"Mirtazapine binds also with high antagonist affinity to the 5-HT2, 5-HT3, and H1 receptors. This prevents the overexcitation of serotonergic neurons and adds a sedative component to the spectrum of pharmacological actions of the drug. On the hormonal level, mirtazapine, unlike other antidepressants, decreases the release of corticotrophin (^{Schule et al 2002}) and cortisol (^{Laakmann et al 2000})."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426820/

[IfIOnly]

18 minutes ago, IfIOnly said:

I would in a heartbeat, but the insomnia was so bad at such a low dose that not even heavy sleep meds could get me needed sleep. This has been true with everything I've tried that increases serotonin naturally or pharmaceutically. I have high cortisol issues and I think other antidepressants just exacerbate my adrenal issues. I've tried a ton of stuff to lower at night or balance cortisol levels with no luck as of yet.

Below is the probable medical reason this AD is working for me.

"Mirtazapine binds also with high antagonist affinity to the 5-HT2, 5-HT3, and H1 receptors. This prevents the overexcitation of serotonergic neurons and adds a sedative component to the spectrum of pharmacological actions of the drug. On the hormonal level, mirtazapine, unlike other antidepressants, decreases the release of corticotrophin (^{Schule et al 2002}) and cortisol (^{Laakmann et al 2000})."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426820/

Well I guess I can say I found something that finally works to decrease my cortisol at night. That's what the mirtz is doing for me.

[IfIOnly]

11 hours ago, PeterPan said:

If you were on it before, maybe you'd like to be on it again? There's a gene you can look at, TPH2, which shows up in the cheapest 23andme testing. Signals whether you have a defect in the gene that makes your 5HTP. If so, it would be why multiple people in your family are benefiting from it and might be a reason to stay on it.

I've been looking into that genetic test since you mentioned it and plan to have one done in the near future. Thank you for putting it out there!

[freesia]

Such wonderful news.  I am so glad for you.

[PeterPan]

1 hour ago, IfIOnly said:

I've been looking into that genetic test since you mentioned it and plan to have one done in the near future. Thank you for putting it out there!

Yeah who knows what you'll find. You can actually put those genes and paths in (HT, etc.) and see what pops up. You run the raw data through an engine like promethease to make it searchable. Fwiw I found the snip you gave of the research interesting. We're probably going to be putting ds on something, not sure, have a pdoc appointment. He's maxed out what we can do with 5HTP and the anxiety med he's taking ups aggression. To get him leveled out we're going to need a med that acts on those pathways (HT whatever) but does things I can't do with a supplement. 

[Ottakee]

That is awesome that it is working so well for you.

[IfIOnly]

2 hours ago, PeterPan said:

Yeah who knows what you'll find. You can actually put those genes and paths in (HT, etc.) and see what pops up. You run the raw data through an engine like promethease to make it searchable. Fwiw I found the snip you gave of the research interesting. We're probably going to be putting ds on something, not sure, have a pdoc appointment. He's maxed out what we can do with 5HTP and the anxiety med he's taking ups aggression. To get him leveled out we're going to need a med that acts on those pathways (HT whatever) but does things I can't do with a supplement. 

I hope the doctor is able to figure out a med that works well for your DS. It can take some time trialing different meds. I've tried a handful before this one, but you have some additional info. that could hopefully make the process easier. 

Thanks for the additional testing info!

[Plateau Mama]

I took Remeron years ago (like 18 year ago).  I did not gain any weight, but I had the hardest time waking up every morning.  It knocked me out, I literally could not function until noon every day.  

[IfIOnly]

42 minutes ago, Plateau Mama said:

I took Remeron years ago (like 18 year ago).  I did not gain any weight, but I had the hardest time waking up every morning.  It knocked me out, I literally could not function until noon every day.  

Oh, wow. That's rough. I hope you were able to find something that works better for you.

I wonder what variables there are in our unique body chemistry that makes one person drowsy and another be able to function more normally again. 

Not taking Remeron, just a generic, but I do wonder how much difference one makes over the other for some. It's weird because one ibuprofen brand over another doesn't matter, but I've read several reviews stating one worked better for them. A poster up thread noticed a difference in grogginess when her prescription brand was changed. 

Edited January 14, 2021 by IfIOnly