ME/CFS
Outcome unclear
ME/CFS brain fog, low energy; mirtazapine for hypervigilance, antipsychotic worsened fog
- Condition
- ME/CFS
- At worst
- Moderate (mostly housebound)
- Ill for
- Not stated
- Last post
- Oct 2026
In their words
- Condition: ME/CFS
when I'm in a flare, I have low metacognition ... but also low energy
In context ↗ - At worst: Moderate
I try to do focused activities in short bursts, until my attention starts to wander
In context ↗
Summary
Someone with ME/CFS described flares of low energy and poor metacognition, when thinking felt concrete, easily overwhelmed and poorly self-regulated. SSRI trials failed, but mirtazapine gave great results for hypervigilance. An antipsychotic later badly worsened their brain fog, and they moved on to a Parkinson's dopamine drug.
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What they tried
Also tried
mirtazapine· Helped a lotfocused activities in short bursts with focus breaks· HelpedSSRIs· No changeAbilify· Worsesynthetic dopamine substitute primarily used for Parkinson's· Not said
Their words about each treatment
- SSRIs · No change
I failed all my SSRI trials, a class of meds I previously found extraordinarily helpful
In context ↗ - mirtazapine · Helped a lot
found great results with mirtazapine which treats hypervigilance, but my what a struggle to get there
In context ↗ - Abilify · Worse
it fucked up my brain fog something fierce
In context ↗ - synthetic dopamine substitute primarily used for Parkinson's · Not said
I ended up going on a synthetic dopamine substitute that's primarily used for Parkinson's
In context ↗ - focused activities in short bursts with focus breaks · Helped
I try to gradually build up the amount of time I can stay on task. it helps me regulate/reconnects me with my ability to hold consistent states of mind
In context ↗
Their path
They say too little about how ill they were at each step to draw it on the severity scale, so the steps are listed as they describe them. Dates are when they posted.
| When | What happened |
|---|---|
| 2026-10-06 | flares with low energy and low metacognition, easily overwhelmedwhen I'm in a flare, I have low metacognition ... but also low energyIn context ↗ |
| — | mirtazapine gave great results for hypervigilancefound great results with mirtazapine which treats hypervigilanceIn context ↗ |
| 2026-10-06 | some energy back but metacognition not fully onlinewhen I'm well enough to have some energy but not well enough to put my whole functioning metacognition back onlineIn context ↗ |
| 2026-10-12 | Abilify badly worsened brain fogit fucked up my brain fog something fierceIn context ↗ |
| 2026-10-12 | switched to a Parkinson's dopamine drug after AbilifyI ended up going on a synthetic dopamine substitute that's primarily used for Parkinson'sIn context ↗ |
Adverse events
- Low-dose Abilify / aripiprazole“it fucked up my brain fog something fierce.” In context ↗ Made symptoms worse
Symptoms mentioned
Their words about their symptoms
- Brain fog
it fucked up my brain fog something fierce
In context ↗ - Anxiety & low mood
found great results with mirtazapine which treats hypervigilance
In context ↗ - Headaches & migraine
or just got past a migraine
In context ↗