Anything I should know about Mirtazapine? - Thyroid UK

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Anything I should know about Mirtazapine?

crabapple1 profile image
12 Replies

Evening everyone, happy new year to you all. I have been prescribed Mirtazapine but haven't started taking it yet. Does anyone else have any experience of taking it alongside Levothyroxine? If so, is there anything I should know about possible impacts on my Levo dose amount or anything like that? Should the two be taken far apart? (I am guessing they should.)I found one study online which found that Mirtazapine increases FT3 and decreases FT4, and another saying it increases the risk for hypothyroxinemia (as far as I can see this only relevant to pregnant people but again is to do with lowered FT4.)

Any advice or insights hugely appreciated, as always - thanks so much in advance.

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crabapple1
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Zmalp profile image
Zmalp

My husband had it for a while before he was on Levo. He was misdiagnosed. Had no positive effects, just made him very sleepy. He came off it relatively easily though by tapering it down over a couple of months so if it’s not for you, it’s not the worst to come out off.

crabapple1 profile image
crabapple1 in reply to Zmalp

Thanks for this, I hadn't considered what might happen coming off of it, so that's helpful to know.

Jaydee1507 profile image
Jaydee1507Administrator

Reading back on your previous post where you were undermedicated, did you ever get a dose increase? I'm sure if you got your thyroid treatment and any low vitamin levels optimised you might not even need an antidepressant.

Anyway, years ago, on Levo only which doesn't suit me I tried Mirtazapine (along with every other anti D that never worked) and had an unusual side effect of my feet and ankles swelling up. Never got far enough to know if it would have helped, but unlikely. Now wish I had got some T3 added to my Levo.

What were your latest thyroid results?

crabapple1 profile image
crabapple1 in reply to Jaydee1507

I did, I am now on 200mcg/day. Last blood test was in September, results are below with the prior test's results for comparison. I went up to 200mcg from 175mg sometime in early September.

July 13th - TSH 3.86 (0.3-5.0), FT3 3.2 (3.8-6.0), FT4 10.9 (7.9-16.0)

Sep 29th - TSH 0.45 (0.3-5.0), FT3 not done, FT4 14.5 (7.9-16.0)

My ferritin is still crap (it's 10 ng/ml with a ref range of 15.0-300.0).

I'm struggling with getting my vitamin levels up. It's a direct result of my depression, I go into a black hole for days or weeks, don't take my supplements, basically stop caring for myself or eating properly, etc. I go around in cycles like this and find it v hard to be consistent. I'm hoping the Mirtazapine will be a temporary fix that might settle me a bit to allow me to be more consistent in my mood which would mean I do actually take my meds and supplements consistently!

My anxiety has been debilitating lately and has been affecting my work and home life quite badly. It's really distressing.

I've taken a few different antidepressants over the last 20 years and like you I don't feel like any of them ever really worked, maybe I'm being overly optimistic here.

Jaydee1507 profile image
Jaydee1507Administrator in reply to crabapple1

I've been there and I'm sorry it's happening to you. Your FT3 on the lower dose does look very low, I suspect with the higher dose it isn't much higher either. Pleased to see you got the increase though! You're likely someone who would benefit from added T3 but hard to be 100% sure with no FT3 result though your symptoms are pointing that way. Have you ever considered that?

What helped me so much was to remove gluten, dairy and soy from my diet. I know it's really hard when you have negative 'go' in you but start by clearing the cupboards of anything containing those things, then buy fresh whole foods and shop from the 'Free From' aisle reading labels carefully. Doing that kept me off antidepressants for many years. I'm only now adding in T3 (long story) but tbh I was similar to you in that my brain wasn't capable of much and only barely functional on many levels. Dairy was a terrible culprit for fatigue and anxiety.

Back to antidepressants, the only ones that ever did anything at all for me were Prozac and Seroxat but even then there were almost intolerable side effects. I'd highly recommend trying to get some T3 added.

crabapple1 profile image
crabapple1 in reply to Jaydee1507

I've considered T3 but it's too hard to get. I'm not comfortable buying online from abroad or something (and can't really afford that option anyway) and my NHS trust point blank won't prescribe it. Getting my GP to test my FT3 is like pulling teeth and requires 5 or 6 visits and phone calls back and forth to wrangle. I'd love to try T3 but just don't see how I could make it work.

Removing gluten/dairy etc is one of the things I'm hoping I can be more consistent with if I can level myself out a bit. I did it successfully for a while back in September and did feel good. No chance of clearing the cupboards though, I've two kids under 10! I'm going to have to rely on self-compassion and willpower all the way :-)

Thanks for your advice and kind words. I'm sorry you've been through it all too. I'm 40 now, I look back over the last 20 years with sadness and wonder what my life could have been had I not had this condition. It's a slog isn't it.

Jaydee1507 profile image
Jaydee1507Administrator in reply to crabapple1

It's a huge slog. In many ways I was never so relieved when my boys went to Uni which is pretty tragic. Just all the running around after them and late night requests for specific things etc blah. Life shouldn't have to be that hard. I struggled on through my 40's until at 49 I got medically retired. Just couldn't carry on, been more or less housebound ever since. I get my T3 privately as locally the Endo's are anti T3. Paid for one consultation and now the tablets are only 60p each. Money well spent.

If you're not eating right then getting on track is going to be a challenge. Also be sure to eat the chicken livers/pate for ferritin. You're worth it.

humanbean profile image
humanbean

You might find this of interest :

drugs.com/tips/mirtazapine-...

There is no mention of thyroid on that link.

crabapple1 profile image
crabapple1 in reply to humanbean

Thanks for this. Am side-eying the "prominent sedative effects" line...not sure I need to be even more tired than I currently am!!

serenity70 profile image
serenity70 in reply to crabapple1

You will need to be aware, well aware, of the side effects, and coming off it can be a nightmare and very, very tricky. I dealt with the fall-out of my dear dad coming off it, he couldn't sleep trying to come off it, at all, had awful withdrawals, it was like watching someone come off heroin, seriously horrible, debilitating experience. The anxiety was worse trying to taper off it, and he was never the same. He got dementia, memory loss, almost overnight. I did some research and it can cause memory loss, but do your own research. There's a support group for Remeron/Mirt on fb. May be worth taking a look, experiences can differ.

in reply to serenity70

I've never had a decent night's sleep since coming off mirtazapine either, horrible stuff; memory's terrible, interesting to know I'm not the only one.

Eliotf profile image
Eliotf

reminder that all the SSRIs interfere with your thyroid system, so the mirtazapine might be a lot better than any SSRI

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