Chronic fatigue on Mirtazapine anyone?

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I went on Mirtazapine 15mg in December 2013, prior to that I was on 7.5mg for 8 months. I took it for anxiety after I was attacked by my brother in 2012. It helped me eat and sleep again, and it did help me start getting back outside after a long time agoraphobic and anxious. 

I remember I always felt tired on it but I think I just got used to it but some days I felt hungover but managed to carry on with no great difficulty. Then in spring 2015 I started feeling tired all day to the point I just wanted to lie down all day and slowly my agoraphobia crept back in. 

In the winter of 2015 I had some kind of anxiety breakdown, my son was suicidal due to bullying, my daughter was unwell and in hospital and I was having to juggle it all myself. My husband works full time and his boss wouldn't allow him any time off. During this time my fatigue worsened and with it my anxiety too. 

All of last year I had crippling fatigue and spend most of the year lying on my bed feeling absolutely exhausted. I was diagnosed with an underactive thyroid and put on thyroxine. My levels are now normal. Yet my fatigue this year so far is worse than last year.

Mornings are hell. I cannot function I feel so bad, and with 3 childen to get to school that's difficult, I remember I'd have the odd hangover feel morning early on taking Mirtazapine but this seems to have just got worse over the last 2 years and now I feel worse than ever. 

I took 15mg late Saturday night, about midnight as I forgot to take it earlier. I usually take it about 10pm. On Sunday morning it was 9am and i still couldn't open my eyes, I had to force them open and force myself out of bed. I am usually up at 7am even when feeling tired.. I spent the whole day in a drugged up state, feeling foggy headed, woozy/dizzy headed, sickly feelings and just generally drained. This continued into Monday too. So Monday night I took just half a dose as I was desperate for some relief and yesterday although still chronically fatigued all day I didn't feel as bad. I called Sunday and Monday a crash, all of last year I had random crash days where I'd have to lie in bed as I felt the most crippling fatigue. 

Last night I went back up to the 15mg after just 1 night taking a half dose, and wham today I am back feeling the worst crippling fatigue. My head feels so heavy, woozy, dizzy and I can barely keep my damn eyes open. This triggers my anxiety. I am terriified there is something serious wrong with me. I have had so many tests and my GP can't find anything other than the thyroid but I am sure this isn't from that. I told him about the mirtazapine and how I felt better the night I took half a dose and he is now concerned mirtazapine suddenly after 2 years has caused chronic fatigue and he wants me to come down to half a dose for a while and see how I feel, then work towards weaning off it. I am happy to do that, but I am scared but he wants me to just take 7.5mg not wean slowly. I told him I am too scared to do that but he said 15 to half a dose shouldn't cause any issues, I told him I'd read it was a nasty drug to come off and he said he hasnt' had any patients complaining weaning off. 

He won't prescribe the liquid. I take Actavis 15mg hard tablets. 

Can anyone relate to this type of chronic fatigue?  i have had 2 years of hell feeling llike this, I have been a pin cushio having test after test for nothing to be found. Recently all he found were my neutrophils were a litlte low and lymphocytes high, I panicked I had cancer or something but he assured me it won't be why I feel so tired. I just can't carry on feeling this bad, I want my energy back, I want to enjoy the last few years of my children being children, I do not want to be this drugged up fatigued mess who some evenings even struggles to cook dinner and has to order a takeaway. It's turned me into a recluse this last year and I have missed out on so many things, my agoraphobia has returned worse than before and my GP has to come to my house but I even find that hard as I have now awful social anxiety. I feel a complete mess. This drug helped me early on after I was attacked but now I feel no benefit of taking it other than yes when I think how anxious I was before I took it I am now so calm but I am sure it's because I am too tired to think, let alone panic. It isn't helping this last year of anxiety about my health or the agoraphobia and it won't because I am crippled by fatigue.

I feel a drugged up mess today, my whole body feels heavy and my head is so fatigued. Is this something mirtazapine could cause? I want off this awful drug if it is :-( My friend says it can't suddenly after 18 months start causing chronic disabling fatigue. 

Sorry this got long.


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  • Posted

    I have been on this for two years, upped dose, felt worse, lowered dose felt bit less drugged up but the anxiety hasnt gone.  Isolating myself too much, cant even to hairdresser, fear of what?   Dr is ok with me on 7.5 but would like me to try it twice a day.  I am not sure about that. Im tired enough already.  I have suggested cfs gpsthinks silly woman with depression im sure.  Wish there was a test for all this.  Fed up losing the days of my life to this illness. Do you have bad anxiety alongside the fatigue.  What to try next is my dilemma
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    • Posted

      Hi Ann

      So sorry to hear of your struggles but I can relate. 

      I had anxiety badly after I was attacked and that's why I went on mirtazapine as I was struggling to go out and so anxious at home. Mirt helped and I was back at appointments, days out etc... but then when the fatigue hit, last year i became a recluse and I haven't been for a hair cut, the dentist, optician...... I worry every day what if I ended up needing the hospital how would I cope. What if I had toothache, etc... I also don't have visitors right now as my social anxiety is so severe. it's ridiclous and I swear this drug has made me phobic of so many things.

      Prior to mirt I did have anxiety but I still went to appointments despite the anxiety etc... but this fatigue has caused crippling anxiety and I just can't get out and live my life. I depend on my husband to take the kids out to their appointments, he takes them on days out etc.. I am just too exhsuated and drained. I have huge energy crashes too so i have to pace.

      I have had CFS suggested to me but I know it cannot be that, it has to be a combo of health, maybe my thyroid, depression from this last 18 months of fatigue and maybe this drug. I feel like a drugged up zombie all day and I just can't think straight, I want off now. I need to see if it helps, if i am wrong then I am wrong but I need to try something because life this fatigued and housebound is no fun. I want to enjoy my life like I used to.

      I really hope things get better for you. You can message me anytime if you need to talk, I know exactly how you're feeling. Fatigue causes more anxiety and it just robs you off life because you have no get up and go to do anything or even work on the anxiety itself.


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  • Posted

    Hi Julie,I've been on Mirt for only 7-8 weeks at 15 mg and 3 weeks at 30mg.It's hard to tell yet how well it's helping with me yet as I also have IBS issues along with anxiety/depress.It seems to be helping overall but to early to tell.I also am taking Gabapetin ,400mg,for the IBS pain and nerve blocking.Tramadol as well for pain.I'm hoping this will help in the long run.I pray it does.God Bless You,Bob,Ohio,USA

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  • Posted

    Rest assured, it isn't just you. I've been taking 15mg for over a year and a half now, and like you I have had awful fatigue. It began when I first started taking it, but since my anxiety was so intense at the time it was prescribed to me I always chalked the feeling up to that. Eventually I began to wonder if it wasn't the mirtazapine causing it but I never made that conclusion until just this past month. My doc tried to increase me to 30mg and WHAM! Hit me like a Mack truck. On the 15 I eventually adjusted, although my weakness never really dissipate totally. Like you I haven't felt like doing much aside from lying in bed for the past year. It's horrible. I came back down to 15 from 30 after a couple of weeks because between the fatigue and horrible back pain I couldn't take it anymore. Now my goal is to get off this stuff altogether. I think it's going to be difficult. I have had a few terrible nights just from dropping back to 15 from 30 after taking it only a couple of weeks. I've needed Ativan to sleep for the past 2 nights while my body re-adjusts and levels back out on the 15. The med helped with my anxiety in the beginning, but never helped with my sleep or appetite which are the reasons it was prescribed to begin with. Truth be told, knowing now that it's been the cause of so many physical side effects it really just made my health anxiety worse. 

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