mirtazapine reducing while on mounjaro

[ForBrickSnake]

I've been reducing mirtazapine since Feb while on mounjaro to get weight off caused by it. I've started to feel low and absolutely exhausted and food makes me feel sick. I haven't been able to eat properly since the weekend and struggling as I have a physical job. I've just paid for 10mg due to start this weekend now I'm scared to use it.

I've been feeling low after reducing mirtazapine should I increase again.

I wouldn’t be without my mitrazepine, if it helps stay on it. I hope you feel better soon

You probably need a medication review with your prescribing doctor.
I don't know about mirtazapine but there have been issues with some of medications being less effective on these weight loss jabs as they change absorption of the drug - contraception is one example with there being an increase in the number of pregnancies whilst on oral contraception and weight loss jabs.

Drugs are commonly absorbed in the intestines, the doses and dosing frequency of medication is based on typical times for the drug to get from your stomach to your intestines to your blood stream. This can be influenced by a number of things including when you last ate. There are quite a few slow release medications that have to be taken on a completely empty stomach slowing down the time from taking the tablet to getting it to your intestines and into your blood. It's likely that the way these weight loss jabs work means that these timings are affected and can result in doses that were effective before not being effective now. If you are also simultaneously reducing the doses even to doses that were previously effective they won't be anymore.

I think messing around with the doses whilst also changing your metabolism with the weight loss drugs at the same time is potentially is recipe for disaster. It might be better to take a slower step wise approach. Go back on to a dose of mirtazapine that's effective. Get on to a stable dose of the weight loss jab and then try to reduce the mirtazapine dosage. I would really recommend that this is all done under medical supervision

I spoke to my doctor and she said exactly what you have. She told me to stop mounjaro and increase mirtazapine. Then in a months time start again on mounjaro staying at a lower dose.

I'm glad you have seen a Dr. It might mean slower progress but if you can find the right balance between mirtazapine and the mounjaro in the medium to long term you'll like have a better time in terms of managing your mood and weight. Best of luck!