Mirtazapine as a replacement for HRT- any alternatives to this

[BG2015]

I was previously taking HRT from 2017 to June this year when I was diagnosed with hormone sensitive breast cancer.

I cannot take HRT anymore but am suffering with horrendous night sweats which is affecting my sleep, I'm probably getting 5 hours of very broken sleep with insomnia mixed in.

My GP has prescribed me mirtazapine but having read the side effects I just don't want to gain weight. It seems the majority of people do. I'm in the middle of chemo and losing my hair - I don't want to be bald AND fat.

I'm not vain but just an average 52 yr old size 14 that tries to eat well exercise and keep my weight stable. It's just going to affect my mental health so much if I put weight on. I've already gained 8lb since starting chemo with steroids and only tolerating certain foods during chemo week.

Can anyone suggest an alternative as I'm not going to take this medication.
Thanks

I've been on Mirtazapine for 3 years, the highest dose, for depression. Initially, I craved carbohydrates, was mad for bread especially. I gained about 5lb, then went on a diet.

Sorry to read you are having a tough time at the moment

I came off mirtazapine and went on to take sertraline which I found had much fewer side effects and I was able to maintain my normal weight.

Not sure how sertraline works in regards to hormones but it may be worth researching?

The Menopause board on Mumsnet is really helpful for further advice too!

I take mirtazapine and have lost 21 lb since June.

@SnowyMouse
Did you put that weight on because of the medication?

I take clozapine as well, so it's hard to know which caused the weight gain.

Following this thread as I'm taking my first Mirtazapine tonight and quite nervous of the side effects

Hi, I've been taking Mirtazapine for nearly 12 months and prob need to start tapering it soon. I found I gained weight initially as it did give me an appetite in the evenings but I've since lost the weight that I gained and more.

Is it mainly to help with sleep as there may be more natural alternatives?

It's the night sweats that wake me this resulting in imsomnia.

I'm not going to take them, I just feel like I need something else, acupuncture or something

@BG2015 I can understand your hesitancy. I'm assuming you are under a consultant for the chemo, what is their view on the night sweats and insomnia?

I took it before the GP would give me HRT.

Good news, I’ve never slept so well. Hot flushes and sweats all stopped.

Bad news, I gained half a stone. I stopped after about 6 months as I felt that Although they helped they weren’t addressing the real issue.

I had some success with Menopace and other supplements. I tried magnesium spray for sleep which was ok, but better when I had an Epsom salt bath.
Ive no idea if it’s safe during chemo though.

@rainbowninja

My surgeon and chemo specialist have both recommended I speak to my GP about the sweats and the insomnia in particular, hence why I spoke to him last week. I do wonder though whether the chemo is making them worse, my temperature fluctuates so much throughout the day. I can go to huddling under a blanket to literally stripping off the next. A lot of people I've spoken to say chemo affects their temperature and hot flushes/sweats.

I'm considering just riding the chemo out (last one should be 1st Feb) and see whether the sweats settle.

@BG2015 ahh I see and yes that was my thinking - that it would either be a side effect of the chemo or an indicator of what's going on with your hormone system which sounds relevant to your treatment.

@rainbowninja
I was having night sweats in 2017 after my hysterectomy- the HRT was just amazing. Felt so good on it. So I do think I'm menopausal with chemo certainly adding to the mix!

I've been taking Mitrazapine for about 9 weeks. I haven't put weight on and I put weight on easily. The sleep is wonderful. I hope you get better soon BG2015.

I'm sorry, it sounds like you've been going through the mill.

I've been on mirtazapine a few weeks now - prescribed becuase I was really struggling to sleep much.

I was really, really against taking antidepressants, but my GP was really reassuring. She said you need to give it a year, and just look at it as a way to reset your sleep patterns.

I have had so long of not being able to sleep (menopause/stress) I think my body had just forgotten how to get a full night. I'm a few weeks in and my golly the difference. I am now very rarely waking up in the night, whereas for months if not years, I've been awake on and off all night, every night. It's bloody miraculous stuff.

I am finding my appetite has increased (and I was overweight before), I'm just not feeling full at all. So I think I will have to make a very conscious decision to cut down on food and ignore my stomach telling me I'm hungry.

I got offered it for Menopause insomnia and I wouldn't touch it with a barge pole.

I*veleft40
*
How are you finding the mirtazapine? Has it helped? Any side effects?

I've still not taken mine.

@BG2015

I*veleft40 * How are you finding the mirtazapine? Has it helped? Any side effects?

I've still not taken mine.

I have name changed since I wrote my post but it's still me.

I'm on day 6 now.

No huge side effects. Very happy with dcs for first couple of days but has since calmed down. Sleep has defo improved. Falling asleep faster and in a much deeper sleep. Was worried about youngest DS has he wakes me up every night - I still wake up for him but fall asleep again no problem where as before, I used to be awake a couple of hours before falling back to sleep.

The only real side effect is I'm much more jumpy. Things are making me jump much more than usual and I really feel it through my body when I'm startled by something. I can only describe it to that feeling you get when you feel like you're falling when you're asleep.
It's quite intense and takes my breath away but it's slowly fading as the days go by.

Slightly more hungry but it's nothing too major.

I've taken mirtazapine (not HRT related though) for 18 months and I haven't gained weight at all ..in fact I've lost 12kg since this time last year.
In my eyes it can be a brilliant medication. I sleep well and feel much less anxious.
I think it's worth a try.

I decided to give them a go. I've broken them in half so am only taking 7.5mg.

I was on them for a week and the night sweats and insomnia were better. Then I had chemo on Tuesday so can't tell if they're working as I have hunger and insomnia from the steroids.

By next week things should settle down.