Long COVID with agonizing insomnia and panic, now partly better after mirtazapine and diet
- Condition
- Long COVID
- At worst
- Moderate (mostly housebound)
- Ill before improving or writing
- 3 years
- Last post
- Mar 2025
In their words
- Condition: Long COVID
after getting long Covid
In context ↗ - At worst: Moderate
I couldn’t sleep at night, I barely ate anything ... Life was really, absolutely agonizing for a few months.
In context ↗ - Now: Somewhat better
But eventually I managed to stabilize and slowly but surely, get back to a place where life is bearable again.
In context ↗ - Began after: COVID
avoided it for several years after getting long Covid
Read from 20 of their posts and comments; links to the 14 this page draws on
Summary
A Reddit user with long COVID of several years had months of agonizing insomnia, panic, lost appetite, gut pain and brain fog. Low-dose mirtazapine (7.5 mg) greatly helped sleep, anxiety, appetite and mood, though its benefit faded after about a year. A restrictive diet eased stomach and gut problems; antihistamines, aspirin and sunlight helped. They recovered only partly and were still sensitive to foods; dental work was costly but worthwhile.
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What they tried
What they credit
Also tried
Their words about each treatment
- Amitriptyline · Worse
I also tried Amitriptyline and also had a terrible reaction to it.
In context ↗ - mirtazapine · Helped a lot
It was a real game changer for me helping tremendously with all of those things.
In context ↗ - antihistamines (including Benadryl) · Helped
when I started taking an antihistamine before bed it helped a lot
In context ↗ - spending time in the sun · Helped
Spending time in the sun has been helpful, not too much though cause I burn pretty easily
In context ↗ - extremely restrictive diet · Helped
Eventually, both the stomach pain and the gi problems went away, possibly because I started eating a much more restrictive diet.
In context ↗ - aspirin · Helped
Benadryl and aspirin both helped a lot when I got sick a few months ago
In context ↗ - SSRIs · Worse
They caused some issues for me, made my insomnia and fatigue worse and made me very irritable.
In context ↗ - hot shower or bath · Helped
The only thing that gives some temporary relief is taking a hot shower or bath.
In context ↗
Approaches: Other antidepressants
Their path
How ill they were on the ME/CFS severity scale, estimated from what they describe at each point, in the order they describe; they don’t give enough times to place each step. Hover or tap a point. Dates are when they posted. What the levels mean.
Show as a table
| When | What happened | Where they were | After |
|---|---|---|---|
| onset | long COVID; months of agonizing insomnia, panic, lost appetite, gut pain and brain fogLife was really, absolutely agonizing for a few months.In context ↗ | Moderate | |
| 2023 | mirtazapine eased sleep, anxiety and appetiteit has a pretty strong anxiolytic effect and has helped with falling asleep at night and maintaining my appetiteIn context ↗ | Mild | |
| 2024 | restrictive diet eased stomach pain and GI problemsboth the stomach pain and the gi problems went away, possibly because I started eating a much more restrictive diet.In context ↗ | Mild | Elimination diets (other) |
| July 2024 | mirtazapine benefit faded after about a yearit's not nearly as helpful as it was at the beginning.In context ↗ | Mild | |
| March 2025 | feels cold; hot showers give only temporary reliefThe only thing that gives some temporary relief is taking a hot shower or bath.In context ↗ | Mild |
Adverse events
- Mirtazapine (Remeron)“I was knocked out cold for the night I slept for over 10 hours and could barely get out of bed in the morning. It made me feel pretty drowsy 24/7 for about a week” In context ↗ Side effects
- Mirtazapine (Remeron)“it made me insatiably hungry all the time ... I did gain significant weight after starting.” In context ↗ Side effects
- Mirtazapine (Remeron)“The only other symptoms I have noticed are dry mouth and mild irritability.” In context ↗ Side effects
- Amitriptyline (Elavil)“I also tried Amitriptyline and also had a terrible reaction to it.” In context ↗ Side effects
- Amitriptyline (Elavil), Mirtazapine (Remeron), Antidepressants (unspecified)“They caused some issues for me, made my insomnia and fatigue worse and made me very irritable.” In context ↗ Made symptoms worse
Symptoms mentioned
Their words about their symptoms
- Sleep problems
made my insomnia and fatigue worse
In context ↗ - Anxiety & low mood
crippling depression and anhedonia
In context ↗ - Brain fog
my brain felt like it had been cracked open and fried like an egg
In context ↗ - Gut problems
my stomach is still pretty sensitive
In context ↗ - Breathlessness
I used to wake up feeling short of breath with a flush face
In context ↗ - Temperature regulation
Yeah same problem. The only thing that gives some temporary relief is taking a hot shower or bath.
In context ↗
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