Mirtazapine: Strange Back Pain

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Riccardo Says:

Hello, I am taking 30mg daily before going to bed (male, 43 yo). I have started with a very low dosage of 7.5mg and over the course of about 1.5 months I reached the current level. I experienced clear drowsiness (which is a good as I was having trouble sleeping) and dry mouth from the beginning. While the effect of drowsiness right after taking the pill persists, the dry mouth seems to be mostly reduced (80% from the top at the beginning).

The reason why I'm writing is a strange back pain that started about 6-7 weeks ago. Here is why I find it strange and why I would like to hear from others if they experienced it like this:

1. I wake up every morning with acute back pain over all my back (bottom to below the neck)
2. Due to the pain I can hardly move in bed when I wake up. Often it's painful to just breath and I can find no good position.
3. I noticed a recurrent more painful area along the spine, but, like I said, pain is really everywhere in the back.
4. After I manage to get up, pushing through the pain, the pain fades in a matter of a few minutes as I start moving.
5. I don't experience pain during the day.
6. I did not change my sleeping habits, my mattress, my pillows etc.

Only a few minutes of pain in the morning would seem acceptable, if it wasn't for the acuteness of it. My guess (and it's really only just that, a guess) is that for some reason Mirtazapine is making me contract the back muscles through the night and then I somehow struggle to take control of my back muscles.

Would anyone let me know if they experienced similar back problems? Thanks!

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Darasa30 Says:


I am a 56 yo female in fairly good physical condition.

Initially I was very hopeful about Mirtazapine for depression and insomia. After just two days on the medication, I could see improvements in sleep which may have helped overall. Unfortunately I also developed back pain in my mid-back and lower back. I too experienced difficulty and pain when breathing.

Back pain began on Night 3 on 15 mg of Mirtazapine. Resolution of the pain was initially similar to yours, resolving quickly after getting out of bed. After 3 more nights, I began waking up during the night with the back pain, and it would not resolve during the day. I became concerned that the pain was morphing into chronic pain, something I have dealt with during times of great activity. Because my activity level has not been changing and there weren't other changes that occurred, I wondered about the Mirtazapine. I chose to stop the medication; the daily pain and nighttime disruption in sleep due to pain is not worth it. Waking up during the night with pain for me replacing one type of insomnia with another. So, Mirtazapine is not the med for me.

It doesn't look like a large population is impacted by this, but it is listed as a side effect in a small population of people. I'm feeling confident that I am one of those individuals, and although the pain could subside with time, the back pain in the meantime doesn't make it worth it. I wish I knew the mechanism of this side effect. Just know it happens is not enough for me.

I'm interested to know if you stayed on the med and if your back pain subsided.

Hope to hear from you.

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Riccardo Says:

Hello Darasa30,

Thanks for sharing your experience. Indeed, back pain is mentioned among the side effects, but I didn't find anyone else describing what was happening to me. I would wake up almost unable to move or breath with back pain. Anyway, I stuck to mirtazapine for about 3 months, because it was the third attempt with this type of drugs and having given up already twice before on account of side effects, I was determined to make it work, somehow. The sleep was immediately very good and the back pain eventually (3-4 weeks) subsided and become manageable. Eventually I gave up Mirtazapine on account of rapid and serious weight gain. I took on some 20+ pounds in a matter of weeks (6-8). Never happened anything like that as I'm naturally on the slender side. I would eat uncontrollably. Quite scary really.

I hope these personal accounts help someone else feel less alone in this. It's really shameful that drugs that should help you, give you such bad side effects.

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cat Says:
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Back pain could be coming from the colon. marazipine relaxes as you also get movement from gravity when lying down. If you have any diverticulos in colon it may cause the pain as it shifts. The body works as a whole believe it or not. May be

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Lesley Doogan Says:

I am ( was ) also on this drug ( for about 4 months ) until a couple of days ago and I have had serious (lower ) back pain.and cannot physically move my body without using the covers to help me turn over. My ankles have also swollen and is painful to walk sometimes. I hate them. I didn't mind the weight gain as I needed it but I also felt swollen with it. Hope you find something that works for you.I am a 51 yr old female.

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David Says:

Although I do believe that these drugs tend to affect each individual differently based on a variety of factors, I can also verify that the symptoms reported here are confirmed side effects of Mirtazapine at the US National Library of Medicine:


Everything from dry mouth, chest tightness, trouble breathing, body aches, weight gain, muscle spasms & muscle twitching are all listed on the front page there and you can also scroll down and click the link on that page titled "More side effects of this drug" to find 'muscle pain' listed as well as several other adversities, including 'decreased movement'.

Re: (post #3) - Your logic makes good sense and I do think it's a good idea to take things like colon health into account when discussing back pain, but I have my doubts that every Mirtazapine patient here who's complained has a colon problem. Hopefully others will post back and give us an update as to how they feel after stopping treatment. I suppose that will speak for itself.

Thanks for sharing your experiences!

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Kristy Says:
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I started 15 mg for about 10 days. First I started having kind of weak spells in my legs and my feet and ankles hurt. Then, yesterday I started having back pain that actually hurt to touch. Today the back pain in really horrible. I called my doctor and he wants me to cut my dosage in half for give days but I'm also eating like crazy and having bad dreams. I'm not sure what I should do. This was really helping me but I can't cause more problems.

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Butkus Says:

Wow, never thought that remeron was the culprit I have been having lower back pain for years. Stiff neck and joints, tightness of muscles. Never had these issues before, low and behold I go on the web and bingo, this explains it. Thought I had disc problems, but MRI just says inflammation, arthritis, Remeron could be the cause. I will be going off Remeron to see if my back pain clears up. This is all making sense now. My back is worse in the evening when I take it around 8:00 at night and in the morning when I first wake up. Hope this is helpful, other post certainly have been thanks

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Butkus Says:

yes I have lower back pain and until today didn't realize mirazapene was the culprit, now I do having read many other posts on this issue!! Never had problems with my back until using this drug, MRI shows just arthritis/inflammation, no disc issues other than normal wear and tear, who knew! thanks for all these posts, now maybe I can continue to play ice hockey and golf! Damn side effects, and I read the fine print didn't say anything about back pain....drug companies!!

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Dottie Says:
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Started Mirtazapine 15mg. Monday night, have taken tabs 2 so far, today is Wednesday woke up with severe back pain @ about a level 10. Nothing has changed or been different. Really think it's related to the Mirtazapine.

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Survivor Says:
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I think my dr should have never prescribed this drug for my insomnia and anxiety, due to the fact that i am a 3 yr survivor of colon cancer. Have taken this pill for 3 days going to urinate every half hour all night long .awoke this morning with terrible lower back and hip pain. I think i will discontinue use of this drug

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Well I used to have a burning sensation at my lower back for about more than six months . I am diabetic so neurologists gave me medicines for diabetic neuropathy . Of late somebody suggested me to meet a psychiatrist. He prescribed Mirtazapine 15 for a month, increased by half tab next month and then jumped to a dose of 30 mg. The burning pain is reducing at least a relief .

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Michael Says:
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I've been on remron for two going on three months about three weeks in started having lower back pain. I have had back problems but was good till I started remron. I feel weak had flew like systems for about week now have back and hip pain. 30 mg.

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Venus Says:
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Re: cat (# 3)

This makes perfect sense in my case as I was recently hospitalized for an inflamed colon but have yet to have a colonoscopy to diagnose whether it’s diverticulitis, chrohns, or UC. However, I was also recently prescribed Mirtazapine to help with sleep and felt almost immediate right and left flank pain after taking a 15mg dissolvable pill.

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Noella Says:

Yes I do feel the back pain but doctors at the er told me that those pills can't cause back pain, that it is not a side effect from these pills....But I told him that I felt back pain 2 days after taking remuron, how a coincidence. So now I am taking robaxacet for back pain but seems to only mask the pain! I am sore all day long :( I am a 56 old woman having anxiety for almost 30 years. I've done it all but this pill for me was the worst.

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Bolt Says:
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Re: Riccardo (# 2)

I have been on this medication for nearly 3 weeks on 16mg nightly. I find it is helping with my depression at a rapid rate, something unheard of for me. I noticed my feet swelling last week, this week my legs started too. Raising them overnight in bed has little to no effect. My balance has become impaired and I regularly feel dizzy.
I have been having back problems for a while, but the pain that started a couple of days ago is excruciating. I fear I will have to come off these tablets due to severe side effects. It has had such a positive effect on my depression though and I have tried so many meds none of which were as good as these. I have an appointment with my doctor in 3 days and hope she can recommend something as good but without the severe side effects.

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Bolt Says:
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Re: Bolt (# 15)

I also forgot to mention (I am very forgetful too just recently) that in less than three weeks I have put on almost two stones and have a craving for sweet things like, cake, biscuits, chocolate and sweets.

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