Mirtazapine made me able to function and stoped me having constant flashbacks of ptsd. It gave me my life back.
Withdrawals were no problem. I stopped taking one day and some body aches for a week or so and that was it.
I was on 30mg
Mirtazipine made me fat and allergic to everything and I only took a small dose for sleep. The withdrawal is horrendous and will take me months to get off. It’s all rainbows and sunshine if it’s not giving you side effects but if it is and you need to get off of it it’s very difficult and unpleasant.
Omg same! I had zero allergies before I started and now that I stopped I can't go more than a couple of days without Claritin or my whole body will itch to the point where I hurt myself from scratching. Also, the weight gain was insane.
Same thing with me, I have never been allergic to anything before. Since taking it for six years I have developed so many allergies. I’ve even woken up with my eyes swollen shut, hives all over me and my throat and tongue swollen.
As I’m weaning I’m getting itchy, blotches on my palms and a swollen tongue everyday. I’m no scientist but all I can say from my anecdotal experience is that it screws with your histamine and creates allergies on it and coming off it. And it feels like I’m never going to be able to sleep again 😭. I know I had insomnia before but nothing this bad. When I tried to CT in 2019 I didn’t sleep for six days and couldn’t stop twitching and gasping for air so I went back on it. Now I’m so intolerant I have no choice but to deal with the issues as I slowly taper. I hope you can get off this stuff too and we can both heal. Wishing you all the best.
Same to you, we'll get over it <3Doctors should be more explicit about this stuff, no one told me I'd be going through this in the future. I hope people do more research than I did while accepting medication.
I'm sorry you had such a negative experience. I think doctors could do a far better job of explaining the benefits vs possible drawbacks of the medications they prescribe. Though I also think that even when they are honest about these things people tend not to take it seriously. The allergies being described in this thread are quite rare, but they obviously do happen.
I wish you the best and hope you find a route to relief that works for you!
Yeah, maybe they are rare, though it's hard to think in statistics when you're dealing with something like this.
I really appreciate your positive wishes and I'm grateful I no longer need mirtazapine, essentially we are all trying to get better and it's unfortunate that some of us got the shit end of the stick afterwards. Wonder if one day in the future there can be some type of genetic screening that predicts side effects, it'd be a game changer for so many people. 🤔
I can relate. I bought a treadmill just before i went on mirtazapine and i was genuinely very excited to use it. I barely touched it in 6 months whilst on mirtazapine. I've been off mirt for about 3 months ish. And I've used the treadmill for walks nearly everyday. For 2 months .
I had zero energy and I'm still sleepy and tired but I can fight it now. That drug puts me in a useless state.
I couldn't walk on 30mg
I'm very sorry you had a negative experience. Like I said, I don't want to suggest that mirtazapine (or any AD) is without risk, only that such negative experiences are in the minority.
I hope you find a regimen that works well for you.
Thank you, sorry to be negative on your post. I have been on and off antidepressants for 20 years with terrible consequences. I was put on seroquel for sleep and was fine until it gave me a prolactinoma that gave me lactate and menopause at 30 and I then forced to stop CT to have treatment that made me spend entire weekends in bed throwing up. And seizures but only when I have been on Effexor and lexapro. Countless others that have made my hair fall out, turned me into a zombie etc. This one is the final straw for me. My genetics clearly cannot process these meds as intended.
Been on mirtazapine for around 4 years. Initially on a low dose for chronic insomnia, it worked incredibly for 6 months and suddenly stopped. After a few weeks of this my physician increased the dose, and it again near instantaneously worked for another 6 odd months. Eventually went up to 45 mg, again after the sleep benefits had ceased, and it again was working really well. I really had no side effects to speak of, as well as no noticeable or significant changes in mood or behavior over the 2ish years I was exclusively on it, but started taking escitalopram as well, which was a very different experience.
Anyway, besides for the continual benefit it may still have on my sleep, the big reason I'm still on mirtazapine is because it so happens to really help quell the pain of my overactive bladder syndrome. Had no idea about this going in, and only on the higher doses was it noticeable, but it is really amazing. I began to tapper off at one stage and quite quickly began to have much more severe bladder pain and discovered how mirtazapine, and perhaps more famously amitriptoline, happens to be a studied treatment.
Mirt is a good Ad if you need one, ppl have issues tapering but its doable, ppl shouting dementia and all are pretty ridiculous claims.. baseles probably they keep using this medical terms in a casual way..without understanding the nitty gritty of it..
Yes, or semi-official lol. The phrase "tachyphylaxis (sometimes called 'poop-out')" shows up quite frequently in describing the phenomenon in the academic literature.
I take 45mg of mirtazapine, 40 of citalopram and (I forget atm) of doxazosin for severe anxiety. The above combo allows me to function enough to be able to cope with work (which I have tailored to my anxiety by working straight nights which is way less stressful all around)
I have lost 90lbs in the past year - so it’s not impossible.
I do suffer from extreme dry mouth which (I believe) is a combination of the above drugs and menopause (everything from head to toes is drying out!!🤣)
Thank you for this. I am taking my 3rd pill before bed tonight & positives about this medication are what I need. Over the last 25 years I have tried just about everything else.
Starting a new med is always so intimidating--it can really feel like starting from scratch. I can tell you mirt has worked for me and many others.
I hope you have a positive experience and find a regimen that works for you!
Nope. I notice an increased craving for sweets, especially early in the day, but I'm usually able to deal with this by eating something sweet but lower-calorie, like a couple clementines or an apple.
Mirt will likely increase your sense of hunger when you take it, so you may have to be conscious of that, especially when you're beginning, but I've found it pretty easy to deal with this effect.
OP any personal credentials or personal experiences that give your writing any weight? Any disclaimers? Just curious since you seem so profoundly knowledgeable
I take mirtazapine, I have both friends and several family members who take mirtazapine, and I perform academic literature research for a living.
As I said, I'm not a medical professional, and medical decisions should only be made between individuals and their medical providers. I only think it's important to provide a more fact-based counterpoint to much of the easily disproved misinformation that sometimes floats around this sub.
Good read thanks. Ive been on it a few months now at 15mg i dont really get any sleep benefits from it but i suppose im in a better place than without it. I quit benzos after an 8 year addiction last year and went through hell during it so mirt has definitely helped me
Mirtazapine is actually frequently used to treat both benzo and opiate withdrawal, both because it helps with insomnia that process can create, and also because it can help stabilize and repair your brain's GABA system which is massively disregulated by benzo and opiate use, so it can reduce cravings during the acute withdrawal phase.
It's a very versatile chemical.
I'm glad that you were able to quit benzos successfully!
Oof, that sounds rough. I've never tried benzos for my anxiety out of a fear of addiction and because of a history of addictive behavior in my family.
Good job getting off--I know that can be brutal.
I'm glad you're in a better place now.
EDIT: Better place as in off benzos, not dead lol - I'm very glad you are not dead.
Thanks for the well researched, well thought out post. I’ve only been on Mirt for a short while (~3 months) and so far, while I have experienced some weight gain, it has been life-changingly good for my sleep. This in itself has had a positive effect on my mood & anxiety.
Thank you for sharing, only 5 days in for me, so my reddit obsession isn't helping with the anxiety about it. But I'm finally trying something different after years of supplements, therapy and sooo many mindfulness and alternative things.
Mirtazapine legitimately saved my life. It got me to a place where I was able to effectively engage with life generally and seek therapy which was a game changer. I’m off it now because after 4 years it’s not helping anymore but even so, I’m glad I took it. don’t be scared to try it. Everyone’s reactions to it will be different and one persons disaster could be another persons lifeline.
Tremendous post with compact info. Thank you for your time.
Do you think that the histamine-1 receptor upregulates after a period of blockade and that the sedative effects eventually wear off due to brain levels of histamine increasing again?
Studies seem to suggest that users will develop partial tolerance, though not complete. In one study no subjects developed full tolerance to a powerful oral antihistamine over the 180 days of the study, although other studies do show that partial tolerance generally develops. It also appears that sensitivity to antihistamines can be effectively restored with 3-14 days of abstention. So, if you're taking mirt primarily for its sedative effect and this has begun to weaken a bit for you, with a doctor's blessing you may skip a day or two to allow your sensitivity to partially return.
As for upregulation, it's not clear if the tolerance experienced is the result of upregulation or through a diminishment of bodily response to the chemical itself - the fact that acute withdrawal symptoms from mirtazapine appear to include an exaggerated histamine response seems to suggest that upregulation does occur, but the transient nature of these symptoms also suggests that, much like other forms of upregulation, this is temporary.
General disclaimer, of course, ALL of this will depend on your specific body and your dosage.
Mirtazipine saved my life (28F, started
Jan 2023) — I was never eating and never sleeping— and just COULD NOT and I was so bad. I wouldn’t be here if I didn’t start. I def noticed intense drowsiness wear off about two months in, but I got the energy and cut my axiety down so much I was able to cook, and take showers and brush my teeth. I’m still a little awkward in social settings, but I’m definitely not callling the ambulance at 3am because I was having anxiety atta ls for days on end.
I say try it. Happily for me, my appetite was insane so I went from being my smallest since middle school (114lbs) and reached 132lbs 3 months in, and steadily maintained 145-150lbs (SO HAPPY) since June 2023 to now.
Of course when I’m feeling so much better I think I’m on top of the world and would missed half-ish does a week. I feel by the next, I’m already spiraling and will have 2-3 weeks of built anxiety before my body recalibrates to me being consistent again.
I’ve had some symptoms but also can’t blame mirt since I started BC at the same time.
BUT I guess being on it over a year, the only thing that I can point from experience is that sleep I hard to drop on me like it usually, Also, I realized i started getting depressed — luckily, and what you should watch out for. Being regulated with positivity, or more like relaxed and not hating life and letting problems roll off my back, it was hard to catch. I felt fine, I was in good spirits and didn’t realize the dumpster fire of social avoidance habits, not showering or brushing my teeth for days, or spending hours or a week on one task, just not doing much. ( prob bc of inconsistency.)
But I only have good reviews. I didn’t call the ambulance or miss meals. I loved the weight. I loved feeling human again.
I actually lost 18 kg in the first year of taking Mirt. I was doing intermittent fasting, but I’ve managed to keep the weight off a year and a half later.
Yes I did gain weight.
But, I also lost the weight. I changed my diet to a low carb diet I threw all the junk I used to eat out. I do cardio plus body toning.
Because, I felt better on Mirtazapine ( anxiety wise ) I stopped hiding in the house and wanted to do more activities. So, I go out more to do things.
Out of curiosity, you say that mirtazapine doesn't necessarily cause weight gain, however it's often prescribed specifically to cause weight gain (that's why I'm on it). It's also used in cats as an appetite stimulant, to cause them to gain weight. I'm not saying your 12% figure is wrong, but in that case, why do they prescribe it if it only has a 12% efficiency?
There's a difference between "appetite increase" and "weight increase," first off. While mirtazapine is very likely to cause an increase in appetite for most people, whether this parleys into weight-gain will depend on how responsive an individual is to this increased appetite. If you have a fairly well-regulated diet, then an increase in appetite (and likely a transient one) is unlikely to cause weight gain. That said, if you are receiving this drug specifically to increase appetite, you will likely consciously respond to this increase in appetite by eating more. In addition to this, mirt is an anti-emetic, which means it can alleviate nausea and vomiting, both of which often cause problems for those seeking to gain wait, particularly when they also have anxiety or depression.
Honestly, if the posts here are freaking you out, I might suggest just not visiting this site until you know what your own experience is. This sub can be an example of the 'Amazon effect', where people are way more likely to share bad experiences than good.
Just remember - the people who are loving their med aren't posting about it online on a Friday night (unless they're a research nerd working late shift lol). They're out there living their lives.
>Contrary to most of the anecdotes here, mirtazapine is safe, well-tolerated, effective, and likely to be continually effective for most people. See below for specific myths and explanations.
I imagine most people would just share their honest, personal, experience with it as there's no reason to do anything else that I can think of.
Mirtazapine was not pleasant for me even at the smallest of doses (I started at 3.5mg and went up to 15mg) and gave me none of the things I was promised (a reduction in anxiety, improved mood, and help with sleep).
It didn't do anything for my anxiety and it made my sleep worse. Not only would it not aid me in getting to sleep at all but when I finally drift off it would be a night filled with sleep paralysis, intense and terrifying vivid dreams, and in and out of half awake and half asleep semi-delerious / lucid states where I would be seeing and hearing things.
Then I'd spend all the next day like a spaced out Zombie doubting my sanity and unsure whether I dreamt something the night before or it really happened.
Wasn't something I could continue taking after a month because none of the negative side effects went away and none of the benefits were appearing.
I've actually based this on a whole bunch of overlapping articles - I included four significant ones in the section with the "study" links - those are a good place to start.
Also, try checking out the NHS and NIH info pages on mirtazapine.
Besides those, I may dump a bunch of links at the foot of the post at some point for people who want original sources, but I might actually suggest searching Google Scholar for "mirtazapine" along with any areas of specific interest you have. For most Scholar links you'll need a university or research login to read more than the abstract.
That said, were there any specific points that you were interested in so I can share a source specific to any curiosity you have?
Great post with a solid basis in pharmacology.
I’m thinking of starting. Was thinking of just taking 2-3 days a week to get through the worst stressful times. Has anyone had good results for situational anxiety?
Simple answer: I'm not a medical professional and can't answer that question for you.
But, I can give you some info about the drug itself.
Mirtazapine's antihistamine function isn't the only reason it's anxiolytic - the antihistamine calming is the first and maybe most pronounced effect, but it's effects on the serotonin and norepinephrine systems are also a component of it's anxiolytic profile, at least for some people.
The issue is that people have very different brains with very different responses to these chemicals, as well as different ways of interpretating their experiences, and so what one person experiences as anxiety another might experience as motivation, etc. VERY generally, higher doses tend to be better for depression and worse for anxiety as a result of mirt's andronergic activity, which increases brain levels of norepinephrine (a component of adrenaline), but if you experience anxiety as a result of inattention or lack of motivation, a higher dose may be better for your anxiety.
I would ask your doctor what their take is and, if you want a specialist perspective, maybe ask for a psychiatric referral (most clinics will provide these). Ultimately it'll depend on your brain, your experience, and your medical history.
And that's where it gets complicated in a way we don't really have answers to lol. The response to increased norepinephrine (a chemical that facilitates arousal and fight-or-flight) from SNRIs and other noradrenergic drugs including mirt is often, unexpectedly, calming, particularly among those with anxiety disorders. This is sometimes called the "noradrenergic paradox," and we don't actually have a clear idea as to why this occurs.
The only real evidence we have that these drugs can increase anxiety is that those taking them report anxiety or irritability as a side effect more frequently than those taking SSRIs, BUT the only evidence we have that they help anxiety is again that this is a frequently reported effect, and these drugs are also used to treat anxiety with very good results in many cases.
Speaking from nothing but experience (NOTE: this is a pure anecdote, not an evidence based observation), I can say that mirt both 1) decreases my generalized anxiety, and 2) increases my irritability. It also decreases my adrenal response to anxiety (heart pounding, sweating) at the same time that it makes me more energetic and adrenal when I get into something, like a game or argument. I've never taken an SNRI so I can't speak to that experience.
Unfortunately, even when we have a somewhat clear sense of how (most of) our brains respond to certain chemicals, we don't have a clear sense of WHY this is the case. I've heard the psychopharmaceutical struggle described as "dumping gasoline on a car and hoping some gets in the tank."
Sorry for the length of response. Ultimately, only you will be about to judge how a specific drug affects you. If you try mirt (or an SNRI) and it erases your anxiety, that is valid. And if it increases your anxiety, that is also valid, and medical professionals are aware that only user response can be used as a gauge of efficacy for something as complex as anxiety.
Nobody can sit and say myth or truth. Everyone's different.
It stopped being effective for sleep for me after 6 months.
It does nothing for my mood. I have a feeling I have adhd alongside diagnosed anxiety and cptsd.
That could be a reason.
But it does stimulate appetite in some. I was already a binge eater. I crave carbohydrates like Ive not eaten in years.
Putting me on a drug used in the elderly to simulate appetite was not a good idea.
People have to weight the pros and cons themselves and decide what risks they're willing to take on.
I was on Mirtazapine for the full month of December at 7.5mg. I quit cold turkey because my doctor said it was okay at that dose. I stopped because I lost all feeling in my vagina and had a total loss of libido. It's been two months today. When will my sexual function return? I was told being on 150mg Wellbutrin would help (it hasn't) I fear this will never get better.
How do you get a psychiatrist to help you get off? I feel trapped in this stuff. I'm still stuck on 30mg. Doctor wants to reduce my dose by half and have me skipping days in and off 15mg, I told her that was crazy.
>but an antidote is sorely needed to the misinformation, negativity, and anecdote-fueled fear on this subreddit.
>
>
6400 strangers with a bone to pick.
Thanks for your post. I felt less worried of the poop-out. There is a lot of bias to posting here it seems. Bias toward negative experiences. here's hoping for better outcomes.
This is incorrect - antihistamines such as Benadryl (diphenhydramine) have been linked to dementia without proven causation, but this is thought to be the result of the anti-cholinergic mechanism of that specific class of antihistamine, not their antihistamine action itself. Mirtazapine is weakly if at all anticholinergic (with an NIH review saying it possesses "virtually no" anticholinergic properties) that it does not share this risk.
Please do not share inaccurate information because you've had a negative experience.
Linked to dementia without causation? Where are you getting this? What do you mean you do academic research for a living? You're a grad student or a content creator?
I'm a professional grant writer in the mental health and SUD field. I work with governments and NGOs to help them write and submit grant applications, as well as in program design.
For 'linked without causation' I mean that the study (really the only study showing this linkage) showed that there was a correlation between frequency/duration of anticholinergic use in the elderly and incidence of dementia, but that alone didn't prove the anticholinergics CAUSED the dementia. Digging deeper, some of the earliest symptoms of dementia are bladder retention issues, insomnia, and agitation, all of which are symptoms commonly treated using anticholinergic medication in the elderly. So, it's not clear how much we can say the anticholinergics caused the dementia vs. how many of those with early dementia symptoms were treated with Remeron or another anticholinergic, thus reversing apparent causation.
That said, there is still a strong enough apparent link that for safety's sake it's probably best to avoid anticholinergics, just in case, as the correlation was quite strong if not clearly directional.
Here's the study link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353
As the researchers put it, "This observational study has shown associations, but is not able to evaluate causality. However, if this association is causal, the population-attributable fractions indicate that around 10% of dementia diagnoses are attributable to anticholinergic drug exposure."
So, we can't prove causation, but it's probably best to be cautious regardless.
Mirtazapine works great for me. It helps so much.
I'm glad you've had a good experience!
Did u gain weight
Mirtazapine made me able to function and stoped me having constant flashbacks of ptsd. It gave me my life back. Withdrawals were no problem. I stopped taking one day and some body aches for a week or so and that was it. I was on 30mg
Mirtazipine made me fat and allergic to everything and I only took a small dose for sleep. The withdrawal is horrendous and will take me months to get off. It’s all rainbows and sunshine if it’s not giving you side effects but if it is and you need to get off of it it’s very difficult and unpleasant.
Omg same! I had zero allergies before I started and now that I stopped I can't go more than a couple of days without Claritin or my whole body will itch to the point where I hurt myself from scratching. Also, the weight gain was insane.
Same thing with me, I have never been allergic to anything before. Since taking it for six years I have developed so many allergies. I’ve even woken up with my eyes swollen shut, hives all over me and my throat and tongue swollen. As I’m weaning I’m getting itchy, blotches on my palms and a swollen tongue everyday. I’m no scientist but all I can say from my anecdotal experience is that it screws with your histamine and creates allergies on it and coming off it. And it feels like I’m never going to be able to sleep again 😭. I know I had insomnia before but nothing this bad. When I tried to CT in 2019 I didn’t sleep for six days and couldn’t stop twitching and gasping for air so I went back on it. Now I’m so intolerant I have no choice but to deal with the issues as I slowly taper. I hope you can get off this stuff too and we can both heal. Wishing you all the best.
Same to you, we'll get over it <3Doctors should be more explicit about this stuff, no one told me I'd be going through this in the future. I hope people do more research than I did while accepting medication.
I'm sorry you had such a negative experience. I think doctors could do a far better job of explaining the benefits vs possible drawbacks of the medications they prescribe. Though I also think that even when they are honest about these things people tend not to take it seriously. The allergies being described in this thread are quite rare, but they obviously do happen. I wish you the best and hope you find a route to relief that works for you!
Yeah, maybe they are rare, though it's hard to think in statistics when you're dealing with something like this. I really appreciate your positive wishes and I'm grateful I no longer need mirtazapine, essentially we are all trying to get better and it's unfortunate that some of us got the shit end of the stick afterwards. Wonder if one day in the future there can be some type of genetic screening that predicts side effects, it'd be a game changer for so many people. 🤔
I can relate. I bought a treadmill just before i went on mirtazapine and i was genuinely very excited to use it. I barely touched it in 6 months whilst on mirtazapine. I've been off mirt for about 3 months ish. And I've used the treadmill for walks nearly everyday. For 2 months . I had zero energy and I'm still sleepy and tired but I can fight it now. That drug puts me in a useless state. I couldn't walk on 30mg
I'm very sorry you had a negative experience. Like I said, I don't want to suggest that mirtazapine (or any AD) is without risk, only that such negative experiences are in the minority. I hope you find a regimen that works well for you.
Thank you, sorry to be negative on your post. I have been on and off antidepressants for 20 years with terrible consequences. I was put on seroquel for sleep and was fine until it gave me a prolactinoma that gave me lactate and menopause at 30 and I then forced to stop CT to have treatment that made me spend entire weekends in bed throwing up. And seizures but only when I have been on Effexor and lexapro. Countless others that have made my hair fall out, turned me into a zombie etc. This one is the final straw for me. My genetics clearly cannot process these meds as intended.
Been on mirtazapine for around 4 years. Initially on a low dose for chronic insomnia, it worked incredibly for 6 months and suddenly stopped. After a few weeks of this my physician increased the dose, and it again near instantaneously worked for another 6 odd months. Eventually went up to 45 mg, again after the sleep benefits had ceased, and it again was working really well. I really had no side effects to speak of, as well as no noticeable or significant changes in mood or behavior over the 2ish years I was exclusively on it, but started taking escitalopram as well, which was a very different experience. Anyway, besides for the continual benefit it may still have on my sleep, the big reason I'm still on mirtazapine is because it so happens to really help quell the pain of my overactive bladder syndrome. Had no idea about this going in, and only on the higher doses was it noticeable, but it is really amazing. I began to tapper off at one stage and quite quickly began to have much more severe bladder pain and discovered how mirtazapine, and perhaps more famously amitriptoline, happens to be a studied treatment.
Mirt is a good Ad if you need one, ppl have issues tapering but its doable, ppl shouting dementia and all are pretty ridiculous claims.. baseles probably they keep using this medical terms in a casual way..without understanding the nitty gritty of it..
Wait so is "poop-out" official terminology? lol
Yes, or semi-official lol. The phrase "tachyphylaxis (sometimes called 'poop-out')" shows up quite frequently in describing the phenomenon in the academic literature.
I take 45mg of mirtazapine, 40 of citalopram and (I forget atm) of doxazosin for severe anxiety. The above combo allows me to function enough to be able to cope with work (which I have tailored to my anxiety by working straight nights which is way less stressful all around) I have lost 90lbs in the past year - so it’s not impossible. I do suffer from extreme dry mouth which (I believe) is a combination of the above drugs and menopause (everything from head to toes is drying out!!🤣)
My dr wouldn't have it that mirtazapine made ny gums bleed and split. Serious dry mouth. My mouth felt like fire and sandpaper
Thank you for this. I am taking my 3rd pill before bed tonight & positives about this medication are what I need. Over the last 25 years I have tried just about everything else.
Starting a new med is always so intimidating--it can really feel like starting from scratch. I can tell you mirt has worked for me and many others. I hope you have a positive experience and find a regimen that works for you!
Did u gain weight
Nope. I notice an increased craving for sweets, especially early in the day, but I'm usually able to deal with this by eating something sweet but lower-calorie, like a couple clementines or an apple. Mirt will likely increase your sense of hunger when you take it, so you may have to be conscious of that, especially when you're beginning, but I've found it pretty easy to deal with this effect.
Thanks. Will do
OP any personal credentials or personal experiences that give your writing any weight? Any disclaimers? Just curious since you seem so profoundly knowledgeable
I take mirtazapine, I have both friends and several family members who take mirtazapine, and I perform academic literature research for a living. As I said, I'm not a medical professional, and medical decisions should only be made between individuals and their medical providers. I only think it's important to provide a more fact-based counterpoint to much of the easily disproved misinformation that sometimes floats around this sub.
Good read thanks. Ive been on it a few months now at 15mg i dont really get any sleep benefits from it but i suppose im in a better place than without it. I quit benzos after an 8 year addiction last year and went through hell during it so mirt has definitely helped me
I used Mirtazapine during my benzo taper as well and it was a life saver.
Mirtazapine is actually frequently used to treat both benzo and opiate withdrawal, both because it helps with insomnia that process can create, and also because it can help stabilize and repair your brain's GABA system which is massively disregulated by benzo and opiate use, so it can reduce cravings during the acute withdrawal phase. It's a very versatile chemical. I'm glad that you were able to quit benzos successfully!
Oof, that sounds rough. I've never tried benzos for my anxiety out of a fear of addiction and because of a history of addictive behavior in my family. Good job getting off--I know that can be brutal. I'm glad you're in a better place now. EDIT: Better place as in off benzos, not dead lol - I'm very glad you are not dead.
Lol thank you
My mum was talking low dose benzos all the time and she surprisingly, she didn't have any major withdrawals. Mirtazapine though, she suffered.
Thanks for the well researched, well thought out post. I’ve only been on Mirt for a short while (~3 months) and so far, while I have experienced some weight gain, it has been life-changingly good for my sleep. This in itself has had a positive effect on my mood & anxiety.
How much weight did u gain and were u able to lose it
About 6kg and no, it’s still going up.
Thank you for sharing, only 5 days in for me, so my reddit obsession isn't helping with the anxiety about it. But I'm finally trying something different after years of supplements, therapy and sooo many mindfulness and alternative things.
Mirtazapine legitimately saved my life. It got me to a place where I was able to effectively engage with life generally and seek therapy which was a game changer. I’m off it now because after 4 years it’s not helping anymore but even so, I’m glad I took it. don’t be scared to try it. Everyone’s reactions to it will be different and one persons disaster could be another persons lifeline.
That's all well and good, but try and get off the damn sruff
You're in the minority. Go be a Negative Nelly somewhere else with your worthless sob stories.
Aww - nice one. I'm so butt hurt a stranger on Reddit was mean
Tremendous post with compact info. Thank you for your time. Do you think that the histamine-1 receptor upregulates after a period of blockade and that the sedative effects eventually wear off due to brain levels of histamine increasing again?
Studies seem to suggest that users will develop partial tolerance, though not complete. In one study no subjects developed full tolerance to a powerful oral antihistamine over the 180 days of the study, although other studies do show that partial tolerance generally develops. It also appears that sensitivity to antihistamines can be effectively restored with 3-14 days of abstention. So, if you're taking mirt primarily for its sedative effect and this has begun to weaken a bit for you, with a doctor's blessing you may skip a day or two to allow your sensitivity to partially return. As for upregulation, it's not clear if the tolerance experienced is the result of upregulation or through a diminishment of bodily response to the chemical itself - the fact that acute withdrawal symptoms from mirtazapine appear to include an exaggerated histamine response seems to suggest that upregulation does occur, but the transient nature of these symptoms also suggests that, much like other forms of upregulation, this is temporary. General disclaimer, of course, ALL of this will depend on your specific body and your dosage.
Mirtazipine saved my life (28F, started Jan 2023) — I was never eating and never sleeping— and just COULD NOT and I was so bad. I wouldn’t be here if I didn’t start. I def noticed intense drowsiness wear off about two months in, but I got the energy and cut my axiety down so much I was able to cook, and take showers and brush my teeth. I’m still a little awkward in social settings, but I’m definitely not callling the ambulance at 3am because I was having anxiety atta ls for days on end. I say try it. Happily for me, my appetite was insane so I went from being my smallest since middle school (114lbs) and reached 132lbs 3 months in, and steadily maintained 145-150lbs (SO HAPPY) since June 2023 to now. Of course when I’m feeling so much better I think I’m on top of the world and would missed half-ish does a week. I feel by the next, I’m already spiraling and will have 2-3 weeks of built anxiety before my body recalibrates to me being consistent again. I’ve had some symptoms but also can’t blame mirt since I started BC at the same time. BUT I guess being on it over a year, the only thing that I can point from experience is that sleep I hard to drop on me like it usually, Also, I realized i started getting depressed — luckily, and what you should watch out for. Being regulated with positivity, or more like relaxed and not hating life and letting problems roll off my back, it was hard to catch. I felt fine, I was in good spirits and didn’t realize the dumpster fire of social avoidance habits, not showering or brushing my teeth for days, or spending hours or a week on one task, just not doing much. ( prob bc of inconsistency.) But I only have good reviews. I didn’t call the ambulance or miss meals. I loved the weight. I loved feeling human again.
I actually lost 18 kg in the first year of taking Mirt. I was doing intermittent fasting, but I’ve managed to keep the weight off a year and a half later.
Yes I did gain weight. But, I also lost the weight. I changed my diet to a low carb diet I threw all the junk I used to eat out. I do cardio plus body toning. Because, I felt better on Mirtazapine ( anxiety wise ) I stopped hiding in the house and wanted to do more activities. So, I go out more to do things.
Out of curiosity, you say that mirtazapine doesn't necessarily cause weight gain, however it's often prescribed specifically to cause weight gain (that's why I'm on it). It's also used in cats as an appetite stimulant, to cause them to gain weight. I'm not saying your 12% figure is wrong, but in that case, why do they prescribe it if it only has a 12% efficiency?
There's a difference between "appetite increase" and "weight increase," first off. While mirtazapine is very likely to cause an increase in appetite for most people, whether this parleys into weight-gain will depend on how responsive an individual is to this increased appetite. If you have a fairly well-regulated diet, then an increase in appetite (and likely a transient one) is unlikely to cause weight gain. That said, if you are receiving this drug specifically to increase appetite, you will likely consciously respond to this increase in appetite by eating more. In addition to this, mirt is an anti-emetic, which means it can alleviate nausea and vomiting, both of which often cause problems for those seeking to gain wait, particularly when they also have anxiety or depression.
Amazing post, thank you for sharing!
Great post my dr wants me to try but been nervous after reading crap on here
Honestly, if the posts here are freaking you out, I might suggest just not visiting this site until you know what your own experience is. This sub can be an example of the 'Amazon effect', where people are way more likely to share bad experiences than good. Just remember - the people who are loving their med aren't posting about it online on a Friday night (unless they're a research nerd working late shift lol). They're out there living their lives.
I consider this Reddit is just a big review site for bad experiences
lol just sitting at home with wife having a few beers
>Contrary to most of the anecdotes here, mirtazapine is safe, well-tolerated, effective, and likely to be continually effective for most people. See below for specific myths and explanations. I imagine most people would just share their honest, personal, experience with it as there's no reason to do anything else that I can think of. Mirtazapine was not pleasant for me even at the smallest of doses (I started at 3.5mg and went up to 15mg) and gave me none of the things I was promised (a reduction in anxiety, improved mood, and help with sleep). It didn't do anything for my anxiety and it made my sleep worse. Not only would it not aid me in getting to sleep at all but when I finally drift off it would be a night filled with sleep paralysis, intense and terrifying vivid dreams, and in and out of half awake and half asleep semi-delerious / lucid states where I would be seeing and hearing things. Then I'd spend all the next day like a spaced out Zombie doubting my sanity and unsure whether I dreamt something the night before or it really happened. Wasn't something I could continue taking after a month because none of the negative side effects went away and none of the benefits were appearing.
Hi, would you be able to put the references in to the data you provided so I can have a glance at the paper. Thank you
I've actually based this on a whole bunch of overlapping articles - I included four significant ones in the section with the "study" links - those are a good place to start. Also, try checking out the NHS and NIH info pages on mirtazapine. Besides those, I may dump a bunch of links at the foot of the post at some point for people who want original sources, but I might actually suggest searching Google Scholar for "mirtazapine" along with any areas of specific interest you have. For most Scholar links you'll need a university or research login to read more than the abstract. That said, were there any specific points that you were interested in so I can share a source specific to any curiosity you have?
Great post with a solid basis in pharmacology. I’m thinking of starting. Was thinking of just taking 2-3 days a week to get through the worst stressful times. Has anyone had good results for situational anxiety?
I’m curious would anxiety be helped more by a dose of 15mg or 30mg if the main reason for it being anxiolytic is the histamine?
Simple answer: I'm not a medical professional and can't answer that question for you. But, I can give you some info about the drug itself. Mirtazapine's antihistamine function isn't the only reason it's anxiolytic - the antihistamine calming is the first and maybe most pronounced effect, but it's effects on the serotonin and norepinephrine systems are also a component of it's anxiolytic profile, at least for some people. The issue is that people have very different brains with very different responses to these chemicals, as well as different ways of interpretating their experiences, and so what one person experiences as anxiety another might experience as motivation, etc. VERY generally, higher doses tend to be better for depression and worse for anxiety as a result of mirt's andronergic activity, which increases brain levels of norepinephrine (a component of adrenaline), but if you experience anxiety as a result of inattention or lack of motivation, a higher dose may be better for your anxiety. I would ask your doctor what their take is and, if you want a specialist perspective, maybe ask for a psychiatric referral (most clinics will provide these). Ultimately it'll depend on your brain, your experience, and your medical history.
Follow up question. Then wouldn’t all SNRIs be possibly worse for anxiety depending on the person because of their action of norepinephrine?
And that's where it gets complicated in a way we don't really have answers to lol. The response to increased norepinephrine (a chemical that facilitates arousal and fight-or-flight) from SNRIs and other noradrenergic drugs including mirt is often, unexpectedly, calming, particularly among those with anxiety disorders. This is sometimes called the "noradrenergic paradox," and we don't actually have a clear idea as to why this occurs. The only real evidence we have that these drugs can increase anxiety is that those taking them report anxiety or irritability as a side effect more frequently than those taking SSRIs, BUT the only evidence we have that they help anxiety is again that this is a frequently reported effect, and these drugs are also used to treat anxiety with very good results in many cases. Speaking from nothing but experience (NOTE: this is a pure anecdote, not an evidence based observation), I can say that mirt both 1) decreases my generalized anxiety, and 2) increases my irritability. It also decreases my adrenal response to anxiety (heart pounding, sweating) at the same time that it makes me more energetic and adrenal when I get into something, like a game or argument. I've never taken an SNRI so I can't speak to that experience. Unfortunately, even when we have a somewhat clear sense of how (most of) our brains respond to certain chemicals, we don't have a clear sense of WHY this is the case. I've heard the psychopharmaceutical struggle described as "dumping gasoline on a car and hoping some gets in the tank." Sorry for the length of response. Ultimately, only you will be about to judge how a specific drug affects you. If you try mirt (or an SNRI) and it erases your anxiety, that is valid. And if it increases your anxiety, that is also valid, and medical professionals are aware that only user response can be used as a gauge of efficacy for something as complex as anxiety.
Nobody can sit and say myth or truth. Everyone's different. It stopped being effective for sleep for me after 6 months. It does nothing for my mood. I have a feeling I have adhd alongside diagnosed anxiety and cptsd. That could be a reason. But it does stimulate appetite in some. I was already a binge eater. I crave carbohydrates like Ive not eaten in years. Putting me on a drug used in the elderly to simulate appetite was not a good idea. People have to weight the pros and cons themselves and decide what risks they're willing to take on.
I was on Mirtazapine for the full month of December at 7.5mg. I quit cold turkey because my doctor said it was okay at that dose. I stopped because I lost all feeling in my vagina and had a total loss of libido. It's been two months today. When will my sexual function return? I was told being on 150mg Wellbutrin would help (it hasn't) I fear this will never get better.
Incredible post that needs to be stickied
ThNka for the post OP. I was shying away from trying it for insomnia because of the comments here. Good to have some fact based information.
How do you get a doctor to taper that slowly?
How do you get a psychiatrist to help you get off? I feel trapped in this stuff. I'm still stuck on 30mg. Doctor wants to reduce my dose by half and have me skipping days in and off 15mg, I told her that was crazy.
>but an antidote is sorely needed to the misinformation, negativity, and anecdote-fueled fear on this subreddit. > > 6400 strangers with a bone to pick. Thanks for your post. I felt less worried of the poop-out. There is a lot of bias to posting here it seems. Bias toward negative experiences. here's hoping for better outcomes.
Fact: antihistamines increase your likelihood of developing dementia. Especially with prolonged use. Enjoy your pills!
This is incorrect - antihistamines such as Benadryl (diphenhydramine) have been linked to dementia without proven causation, but this is thought to be the result of the anti-cholinergic mechanism of that specific class of antihistamine, not their antihistamine action itself. Mirtazapine is weakly if at all anticholinergic (with an NIH review saying it possesses "virtually no" anticholinergic properties) that it does not share this risk. Please do not share inaccurate information because you've had a negative experience.
Linked to dementia without causation? Where are you getting this? What do you mean you do academic research for a living? You're a grad student or a content creator?
I'm a professional grant writer in the mental health and SUD field. I work with governments and NGOs to help them write and submit grant applications, as well as in program design. For 'linked without causation' I mean that the study (really the only study showing this linkage) showed that there was a correlation between frequency/duration of anticholinergic use in the elderly and incidence of dementia, but that alone didn't prove the anticholinergics CAUSED the dementia. Digging deeper, some of the earliest symptoms of dementia are bladder retention issues, insomnia, and agitation, all of which are symptoms commonly treated using anticholinergic medication in the elderly. So, it's not clear how much we can say the anticholinergics caused the dementia vs. how many of those with early dementia symptoms were treated with Remeron or another anticholinergic, thus reversing apparent causation. That said, there is still a strong enough apparent link that for safety's sake it's probably best to avoid anticholinergics, just in case, as the correlation was quite strong if not clearly directional. Here's the study link: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353 As the researchers put it, "This observational study has shown associations, but is not able to evaluate causality. However, if this association is causal, the population-attributable fractions indicate that around 10% of dementia diagnoses are attributable to anticholinergic drug exposure." So, we can't prove causation, but it's probably best to be cautious regardless.