Terrible reaction to Mirtazapine after one dose.

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Hi everyone

My name is Tom, I'm a 27 year old male, HIV positive (on treatment), and with a long history of on-going health problems dating back several years, including anxiety and depression / mood disturbances.

I was recently prescribed 15mg of Mirtazapine and took my first dose on Friday night just before bed. Within 20 minutes I felt a serious drug affect - extremely tired and out of it. Just before falling asleep I started experiencing really bad restless leg and arm on my right side - a sore squeezing pain / discomfort, which compels you to stretch your muscles in order to relieve it. I have had this before, but never quite this bad. I eventually fell asleep as the sedative affect was so strong.

Upon waking I still felt completely knocked out and could barely move. It took me ages to finally pull myself out of bed. I felt like I was in a thick fog the whole morning, and my muscles felt extremely weak. I was clumsy, off-balance, and slow in my body and mind. My mood did feel slightly improved already, however this was short lived.

I attempted to cook breakfast but felt so tired and weak I just could not do it. I started feeling extremely frustrated and angry at the slightest thing. After finally eating something I felt even worst, and slipped further and further into what I can only describe as a foggy dissociative psychosis. Every single sound felt turned up by a hundred, my parents voices felt extremely irritating, and I felt extremely anxious. Everything seemed strange and odd. Nothing felt real,and I was just overwhelmed by a sense of impending doom and darkness. My thoughts were muddled and I couldn't think straight at all. In addition, the aches and pains got worse and it felt like I had a really bad flu. I spent most of the day drifting in and out of sleep and my dreams were lucid and surreal. At one stage I was struggling to distinguish between dream and reality. By evening things had slightly improved but I still felt like I had been hit by a bus. My mood was terrible and I just felt rage and anger all the time. I refused to take a second dose last night and I'm so glad I didn't, because this morning I woke up feeling almost as bad.

Has anyone else had or heard of a severe reaction like this before? It felt like I was being poisoned, although I didn't have the classic symptoms of an allergic reaction.

My doctors assured me that although interactions with my HIV meds hadn't been studied, it was safe to take. Although there was a risk that one of my HIV drugs could increase the affect of Mirtazapine, because it is a booster. Perhaps this contributed to how I felt?

Just to say, most of these symptoms I had felt before, to varying degrees. For years I have experienced muscle weakness and pain, difficulties walking and using my hands, clumsiness and balance problems, vision and hearing difficulties, problems with cognition and memory, severe brain fog, heart palpitations, breathing difficulties, sinus problems, exercise intolerance etc.

But there was a clear exasperation of some of these symptoms since taking the Mirtazapine. I experienced the same thing upon starting my HIV medication. Despite this, I have been told by countless GPs, and 3 neurologists that what I am experiencing is psychosomatic / anxiety related. The last neurologist I saw ruled out any HIV-associated neurological complications. Hence why I have been prescribed Mirtazapine.

I have been seeing a naturopathic doctor for several years now and she believes I have damaged my body - predominantly my brain and nervous system, through using recreational drugs, and therefore maintains that there is physiological basis to my symptoms. Could it also be that I have a severe sensitivity to pharmaceutical medications? She strongly advised me against taking any antidepressants, but because I was so desperate I ended up going against her advice.

If anyone has experienced anything similar or has any thoughts it would be really great to hear from you.

Many thanks

Tom

1 like, 9 replies

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9 Replies

  • Posted

    Hi...I haven't taken Mirtz...however your reaction seems like it was directly related to your dose....and therefore I would have done the same thing and STOPPED it.

    Why did your Dr. discourage you from antidepressents?  Sounds like a good Dr....and if you are suffering severe depression etc...there is a drug called Wellbutrin known for very little side effects which I just started taking for major depression and severe anxiety and it is working for me.

    Also if you are not supposed to take antidepressents...did they say anything about not taking anti-psychoitics?  They may help you as well.

    The HIV thing brings much curiousity to me....this is a terrifying condition (in my eyes) and you seem to talk about it so openly and calmly.  God bless you...I hope the HIV medication keeps THAT condition in check.

     

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  • Posted

    Hi Tom my word your experience of side effects are very extreme. I hate this drug iv never known anything like it & things don't seem to get better on it. I was ok on 15mg I needed a good sleep so badly so it gave me a lift once the fog ect lifted. But once on 30mg my god I really wanted to end it so many times the pain I was going through in my hips & calf muscles, the constant battling in my head with the suger cravings.. the depression went unbelievable worse which I never thought possible. My eye sight has also go terrible. I was on it for 4months because I was desperate for it to work but couldn't go on any longer. You have to taper off this too so the longer your on it the harder it is. I don't think you should put yourself through this tbh. I had flu every 2weeks to ..I believe it's a hestimine blocker so causes low immune system. The doctors dnt seem to have much clue about the side effects of this drug or chose not to .. I felt like it was poisoning me..

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  • Posted

    Hi Misssy and Sharon.

    Thanks for your thoughts.

    My naturopathic doctor is against most pharma drugs for depression / anxiety as she thinks they often do more harm than good. Including the anti-psychotic ones I think. I might look into this Wellbutrin if it has few side affects though, thanks for the recommendation. Glad to hear it's working for you, I hope you have found some relief smile

    Sharon, I'm sorry to hear about your negative experience too. Sounds like you've been through a tough time on it. Yes, doctors often look bewildered when I mention certain symptoms / side affects. They have limited knowledge, and in reality are only trained to diagnose / rule out certain conditions, and treat the symptoms of disease with drugs. Also, it's terrible that with most mental health problems you are cared for by your GP, rather than being referred to a secondary care team like with any other condition, depending on the mental health service provision in your area.

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    • Posted

      I wish Tom it's the phyciatrist who is prescribing me this poison.I do research on this forum put it to her ..I'm also bipolar ..she just dimisses everything I say. I prefer my doctor he listens & has been with me with this depression for 20yrs.. my doctor will agree with me but can't do anything without her say so. I was so ill on mirt she told me to just come off it. No tapering. .I thought how strange with reading on here ..went through 2weeks WD for my gp to say you should of tapered but youv probably got through the worst so then I suggest citrolpram, pdr says no use for it here & puts me on venlafaxine which is the same as mirt I find out 4months down the line so ill again so tapering off that now. I hate the system & nhs there's no money for mental health ..I mentioned welbutrin but it's not legal in UK .. we have a very small choice I'm told. I think you are right these types of meds do more damage than good.. I'd luv to find a way out.. I really hope you find something that suits u x

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  • Posted

    Hi Tom

    Sorry to read of your suffering; I ought to say that I don't really feel qualified to advise you.  However, may I add that Mirt' is severly sedating on update, maybe for the first 5+ days.  I think it worrying when you said "My doctors assured me that although interactions with my HIV meds hadn't been studied, it was safe to take. Although there was a risk that one of my HIV drugs could increase the affect of Mirtazapine, because it is a booster. Perhaps this contributed to how I felt?" Yes, definately ... your symtpoms are extreme and I think you have made the right choice not to take Mirt.

    Weird (sometimes wonderful) dreams are a side effect, worth a mention.  They are 58 listed side effects to Mirt' and then some more ... ugh !  

    I hope you find the right path, AD's only mask depression they don't cure.  Great if you cannot manage life in general,  but in the end we have to live without them, so I applaude you seeing a Naturapath.

    Best wishes to you.

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  • Posted

    Hi Tom,

    Sorry to hear about your reaction to Mirtazapine. Is it possible that you were started on too high a dose, you might try half a tablet (7.5mg), actually my PDr. claims that 7.5 is the optimal dose for sleep. All the sedative related side effects are familiar to me however, they eventually subsided for me.  I'm not a medical professional, but yes, it does sound like you might be very sensitive to this drug.

    One cautionary note, I have just begun a downward titration from 30 mg. Mirtazapine so I have been on this site more than usual. You may want to Google or check this site for side effects AND length of time taking the drug before withdrawal effects - it seems to be a very short window of time. (I've been on Mirtazapine for 15 years so my experiences are probably clouded by times)

    I wish you well, you are the only one living in your body so be cautious about what anyone tells you, including medical professional. You know what you are experiencing and deserve support for it - I would try to ignor the psychosomatic labels. A friend who is a nurse once told me that some people are more sensitive to their bodies, medications etc. she didn't pathologise it. Well wishes to you.

    The

    I can relate to the

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  • Posted

    Hi Tom,

    Sorry to hear about your reaction to Mirtazapine. Is it possible that you were started on too high a dose, you might try half a tablet (7.5mg), actually my PDr. claims that 7.5 is the optimal dose for sleep. All the sedative related side effects are familiar to me however, they eventually subsided for me.  I'm not a medical professional, but yes, it does sound like you might be very sensitive to this drug.

    One cautionary note, I have just begun a downward titration from 30 mg. Mirtazapine so I have been on this site more than usual. You may want to Google or check this site for side effects AND length of time taking the drug before withdrawal effects - it seems to be a very short window of time. (I've been on Mirtazapine for 15 years so my experiences are probably clouded by times)

    I wish you well, you are the only one living in your body so be cautious about what anyone tells you, including medical professional. You know what you are experiencing and deserve support for it - I would try to ignor the psychosomatic labels. A friend who is a nurse once told me that some people are more sensitive to their bodies, medications etc. she didn't pathologise it. Well wishes to you.

    The

    I can relate to the

    Report
  • Posted

    Perhapts your HIV drug potentiated the mirtazapine, causing your first dose to be much stronger than you thought. Grapefruit juice does that with many drugs, including mirttazpaine. So, for sure, avoid grapefruit juice. i've experienced that first hand.

    And yes, just about all those symtoms can be caused by your underlying anxiety/depression issues. True drug withdrawal can as well. I don't mean mirtazapine withdrawal, which isn't really withdrawal, I mean if you stopped taking benzos or cocaine or opioids—that can cause those symptoms for months. I went through that myself and thought I was dying or brain-damaged for life. It gets better, but it takes a long time. Your brain is resilient but it doesn't bounce back overnight. Which is infuriating.

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  • Posted

    Hey Tom1988

    It sounds like you are either very sensitive and non-doseage related adverse to mirt - I really really think you should not continue, or indeed one of your HIV drugs has potentiated mirt, in which case it would be reckless of a doctor to continue prescribing it. Mirt has been very good for me, I didn't go through hell when starting it. However, over a ten day period a few months ago I inadvertantly took mirt both in the morning and in the evening b/c of a mix up with my webster pack. I went through something not unlike what you described - extreme fatigue, anxiety that was disabling, dissociative states with fugue characteristics, auditory hallucinations - it was f*&^%ked up Tom. It reminded me of when I was in a psychotic state when my depression wasn't diagnosed / untreated for three years, and somehow kept a lid on it until I noticed I would be watching TV and I was completely wet - I used to black out, having gone for walks in the rain, (I was studying in London at the time, so, yeah, it was raining a lot), found shopping in the kitchen, and then would find all this evidence I had been out for sometimes 16 hours according to the receipts in the bags, and "woke" in my loungeroom, TV on, like I had been sleep walking, but doing other stuff as well. I was diagnosed as schizophrenic at first - that was fun, this was back in the pre-Atypical Antipschotic days, where the drugs were sometimes worse than the disorder. Know I am on 150mg of Effexor a.m and 45mg mirt nocte. Best I have felt in long time, save for the cluster migraines and episodic acute bone pain. I hope you can find another A.D. - BTW, neurologists, God love them, can be more wrong than other doctors, b/c of the conviction of their views - as another poster wrote - it's your body, and we respond differently to treatment as an individual. Took me four neuro's before my migraine type was diagnosed, and that was a G.P who had dealt with clusters before - they are a rare type of migraine. My knowledge of HIV drugs is fairly rudimentry, but considering the number of types, the matrix modelling must be enormous, and I can't see any neuro saying for sure about any effect a new drug being introduced - I might have to call a neuro-immunologist I went to school with and ask her about this. I don't know which drugs you are on, the AZT regime? Would be interesting to hear what she says - good luck to you, and my respect for being able to be so coherent in your letter considering your challenges - I don't think I would be able to remember the words to Bah Bah Black sheep if I dealt with your pathologies. Look forward to hearing from you again if possible.

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