Unwanted Mirtazapine Hallucinations Options
#1 Posted : 4/13/2019 2:10:48 AM

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I wanted to share a weird experience I had under the influence of the antidepressant Mirtazapine which occurred about two months ago. Back in January, I went to see a doctor. My appetite had been slowly decreasing over the last 6 months and had eventually become nonexistent. I was also having general stomach discomfort. The doctor ended up prescribing Omeprazole to attempt to fix the problem, along with Mirtazapine to try and bring back my appetite while the Omeprazole worked. I took them daily. During this time, everything seemed very normal, but looking back, everything was very weird. The Mirtazapine did make me hungry, but it felt like a fake hunger.

I was still in between jobs back then, and wasn't doing anything at all besides sitting on the couch, getting interviews, and going out for interviews once or twice a week. I didn't have any obligations or anything that I had to keep track of except for the occasional appointment. The Mirtazapine made me feel like everything was going to be okay no matter what for the first two weeks. Then it got weird. Usually the drug was very sedating and I would fall asleep peacefully soon after ingestion. This night I had drank a few beers, took it, and laid down to rest. I ended up having horrible dreams that seemed to last for eons. Then I would wake up in a haze, look around, and fall back down and have more bad dreams. For example, one dream consisted of hanging out with a few people at a house. After what had felt like two hours in the dream someone revealed to me I hadn't even been invited, and I would realize that was correct. Then about two hours later they would say something like "You know we don't even like you or know you, right? We're not even sure why you're here." I then realized this was also correct. A few hours later someone said "We know you've been stealing from us." I realized this was correct. At one point I woke up from one of these dreams, and looked around my bedroom. The walls seemed cracked in a lot of places. I remember thinking "I never realized how cracked my walls were." Then, the character Squidward from the Spongebob Squarepants show materialzed in flashes of blue, pixelating light on or inside of my bedroom wall. He opened his mouth and started yelling at me incoherently. Not two seconds later, Spongebob himself arrived the same way - materializing in flashes of blue, pixelating light. He also started screaming things at me that I couldn't understand. Then they disappeared. I think the whole scenario probably lasted about 8 seconds. I went back to sleep.

The next day I woke up and decided I was going to flush it all down the toilet. I took the Mirtazapine bottle and looked inside of it. Although I had been using the 30 pill prescription of 15 mg tablets for two weeks, taking one a day, I had a lower amount left in the bottle than I should have. This led me to believe I had been taking it more than once a night on at least a few occasions without realizing I had done so.

One of the reasons I wanted to share this is because I think the current stigmas associated to when you should or shouldn't take drugs is very strange. Growing up, I was told not to do drugs and as a result I would go through life without drug related problems. Honestly, I don't think this is bad advice for the average person who is happy and just wants to live their life without added complications. But I think the inverse of this dynamic should also be considered - just because a doctor gives you a drug doesn't mean it's universally, unquestioningly, going to be okay for you. I understand the general audience in this forum isn't people who are untraveled in determining whether a drug is or is not good for them, but I felt like bringing it up anyways.
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#2 Posted : 4/13/2019 12:13:44 PM

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Mirtazapine is known to cause hallucinations when larger amounts are taken. I believe that pharmacologically, it has some simmilarities with MDMA.
#3 Posted : 4/13/2019 8:34:14 PM

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Mirtazapine particularly has "strong antihistamine effects" which could also be related to the episode with the hallucinations.

Also: "Although not clinically relevant, mirtazapine has been found to act as a partial agonist of the κ-opioid receptor at high concentrations (EC50 = 7.2 μM)"

Pharmacology seems to be quite substantially different from that of MDMA, from what I read.
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