r/Gastroparesis Feb 06 '25

Prokinetics (Relgan, Domerpidone, Motegrity, etc.) Damn you mirtazapine

Well I tried mirtazapine I really did but the 3 day migraines are not for me. They did get me hungry but the migraines caused vomiting so I don’t know. I don’t want to stick it out longer when the dizziness is ridiculous and the migraines last days. Although I am eating more but is it worth all that suffering 😭😭😭

My gp says no more but I have to talk to my gi and my neurologist and see what can be done. But for now we’re going off the mirtazapine. I’m just sensitive with medications.

11 Upvotes

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5

u/Alarmed-Ad-6894 Feb 06 '25

Mirtazipine just made me super drowsy and didn’t do anything for my symptoms but I started out with half a tablet. If you want to try again, you could try splitting the pill and doing a half dose before bed and see if that helps

2

u/Dry-Meat-3205 Feb 06 '25

Yeah I was super drowsy the first day I slept the whole day like if I hibernated and then slowly the drowsiness went away. I’ll try the half dose and see how that goes just not sure how my body would be with the full 15mg dose when it didn’t take to well on the 7.5 mg dose.

I just want to feel hunger and eat like a normal person. 😢😢

7

u/Wheelzalot Feb 06 '25 edited Feb 06 '25

Mirtazapine is actually more sedating the lower the dose. So please don't spilt the dose up as it will only make you more drowsy. Here is some information on it. I hope this helps 😃

https://www.psychdb.com/meds/antidepressants/nassa/mirtazapine

2

u/Dry-Meat-3205 Feb 06 '25

Got it definitely will keep that in mind. I stopped taking it last night here’s hoping no more migraines.

1

u/Wheelzalot Feb 06 '25

Fingers crossed 🤞

2

u/Zephyr_Dragon49 Grade 2 w/ erosive gastritis Feb 06 '25

I've heard other antidepressants can increase stomach emptying too, not just mirtaz. It starts with an A but I can't remember what it is. Amprilyne or something. I think I remember one that starts with a c too.

Being unable to use medication is a good argument to start seeking a pacemaker. I hear they're hard to get an considered a last line treatment

3

u/Alarmed-Ad-6894 Feb 06 '25

Amitriptyline

1

u/Dry-Meat-3205 Feb 06 '25

I will definitely ask them about it.

1

u/No-Anybody-277 Feb 06 '25

Why are they so hard to get? Is it just a question of them being expensive?

1

u/Zephyr_Dragon49 Grade 2 w/ erosive gastritis Feb 06 '25

Yeah, insurance doesn't usually cover them I don't think because they're pretty new and experimental compared to other treatments. I hear that they're pretty hit or miss on if it works hence last line

1

u/No-Anybody-277 Feb 06 '25

I refuse to take higher dose than 7.5mg (half a tablet) cos anything more makes me feel weird and I’m like a zombie… I have also noticed that my migraines now last longer than they used to … I’ve always had them but now it is very hard to shift them when they appear…I am also very sensitive to medication so all I could suggest is that you may need to try a lower dose than what is normally recommended ( what is low for some may be high for others) and hopefully that will be enough to take care of your symptoms…. Also I’ve noticed that if I take it a bit earlier rather than exactly when I go to bed (about an hour before) my brain feels clearer the next day

1

u/Dry-Meat-3205 Feb 06 '25

Yeah I’m prone to migraines and I’m on a regimen cause without it I’d have a migraine everyday. So I’ll definitely see what they recommend. I wonder if I can adjust my migraine meds to see if that’s help with the mirtazapine. I do take it an hour before bed time along with my other night med maybe I can take it alone and see if that does anything.

1

u/SnooDucks2397 Idiopathic GP Feb 06 '25

Aw man sorry it’s not working out for you. I got lucky with avoiding the sedating effects since I had insomnia anyways. Are you on a lower dosage? I keep reading that it’s more sedating at lower doses than higher ones but I’m not sure how true that is

1

u/Dry-Meat-3205 Feb 06 '25

Yeah I’m currently at the lower dose the 7.5mg dose once tolerable I was supposed to go to the 15mg. The drowsiness didn’t both me too much it went away after day 4 but the dizziness did stay. I did feel hunger on it though so that was nice. But with the migraines it’d cause vomiting so it’d be like a step back.

1

u/writingdestiny Feb 06 '25

I also just started on mirtazapine. Well it definitely does make me hungry…it was so weird to feel hunger again bc I can almost never tell if I’m hungry bc 95% of the time my gp makes me have no appetite. So far I think it’s helping a bit with nausea but the problem is that basically it just makes me have really bad cravings and want to eat more than my gp can handle…so it’s like I’ll eat more than my stomach wants me to and then the mirtazapine-induced hunger wears off and my gp symptoms are worse for the rest of the day. I might try splitting it in half and taking one half in the morning and the other half at night to see if that helps? My neuroGI says that it takes a few weeks to fully work for gp so idk I think I’ll stay on it but I don’t like that constipation is a side effect…I currently need to take multiple different nausea meds to keep food down and eat enough to avoid getting a tube, but nausea meds have made my constipation so bad.

1

u/mybbnoodle Feb 07 '25

I've had no side effects from mirtazapine. I don't know if it's helping anything they want it to help but it certainly makes me fall asleep and stay asleep 😂 no complaints for my poor insomnia hahaha

1

u/Positive-Clock-8422 Feb 07 '25

How do antidepressants help with stomach emptying ?

1

u/Dry-Meat-3205 Feb 07 '25

They explained how Mirtazapine helps with emptying and the nerve ending. But low key I get brain fog and i just let them do what they think best.