Long COVID with migraines, gastroparesis and brain fog; mirtazapine helped then relapse
- Condition
- Long COVID
- At worst
- Severe (mostly bedbound)
- Ill before improving or writing
- 3 years
- Last post
- Oct 2026
In their words
- Condition: Long COVID
I’ve been ill with LC for 3 years when I tried mirtazapine
In context ↗ - At worst: Severe
I had severed daily migraine, inability to eat more than small bits of food, which I forced myself to eat. Felt like I was dying of malnutrition at the end. Temperature instability, sweating and shivering, repeated uti’s which was strange, unable to go outside or drive due to severe light sensitivity and brain fog.
In context ↗ - Now: Relapsed
I felt great up until this past week. Symptoms are returning. I am starting to have agitation on top of physical symptoms like headaches, pains, brain fog. Insomnia.
In context ↗ - Began after: COVID
I had vaccines, still had long COVID
Read from 32 of their posts and comments; links to the 18 this page draws on
Summary
A psychiatric NP who had long COVID for three years, with constant migraines, gastroparesis, brain fog and light sensitivity so severe she could not go out or drive. Mirtazapine (Remeron) at 7.5–15 mg brought near-overnight relief and about six months of feeling well, then she became agitated, angry and suicidal and tapered off it. Her migraines did not return and she was relatively well on an antihistamine protocol with periactin.
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What they tried
What they credit
Also tried
Their words about each treatment
- Remeron (mirtazapine) · Helped a lot
I started to take Remeron prescribed by NP and it brought back my appetite which in turn helped me to improve.
In context ↗ - statin · Not said
I stoop my statin as my cholesterol was good
In context ↗ - magnesium theonate · Worse
I have had the experience of trying magnesium theonate and it triggered flushing, sweating and chills.
In context ↗ - amitryptiline · Helped
It did help pain right away for pain. God sleep. The constipation became dangerous.
In context ↗ - LDN · Helped
Ldn is helpful. I take it in the morning and my sleep is much better.
In context ↗ - patches · Helped
I did try the patches. I felt better energy but I believe on the 3 rd day I had a migraine and stopped the patches.
In context ↗ - walking · Helped
I started by walking around the block. I would do the same walk if I felt up to it.
In context ↗ - lithium · Not said
I ordered lithium at microdose level of 5 mg from Amazon. It stabilizes mood, especially the depression with si.
In context ↗ - tirzepatide · Worse
But even the microdose caused me to feel sick to my stomach.
In context ↗ - periactin / antihistamine protocol · Helped
Doctor replaced Remeron with periactin as it has strong antihistamine properties as Remeron did. I am feeling relatively well lately
In context ↗
Approaches: H1 antihistamines · Other antidepressants
Their path
How ill they were on the ME/CFS severity scale, estimated from what they describe at each point, with time counted from when the illness began. 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 |
|---|---|---|---|
| 2022 (about three years before late 2025) | long COVID beganLong Covid for 3 years.In context ↗ | Moderate | |
| before mirtazapine, 2025 | could barely eat, constant migraines, could not go out or driveFelt like I was dying of malnutrition at the end.In context ↗ | Severe | |
| August 2025 | almost 90% overnight improvementThe very next day, no migraine, eating was wonderful, slept great.In context ↗ | Near normal | |
| February 2026 | symptoms returned with agitation and depression on mirtazapineI felt great up until this past week. Symptoms are returning.In context ↗ | Mild | |
| October 2026 | tapered off mirtazapine, started antihistamine protocol and periactinI am feeling relatively well latelyIn context ↗ | Mild | Cyproheptadine (Periactin) |
Adverse events
- Mirtazapine (Remeron)“it triggered mania or it could have been each day of improvement came with more agitation which became anger and irritability ... I was angry and aggressive” In context ↗ Mood or psychiatric effects
- Mirtazapine (Remeron)“I had suicidal thoughts and anger” In context ↗ Suicidal thoughts or attempt
- Mirtazapine (Remeron)“I realized it was the mirtazapine and had to slowly taper off which was extremely hard ... I dropped by tiny crumbs and then crushed it to divide into 4 etc. very hard and slow” Withdrawal problems
- Mirtazapine (Remeron)“Remeron is now causing more weight gain than I wanted ... Only side effect is wt gain” Side effects
- Amitriptyline (Elavil)“The constipation became dangerous. That’s my weak point” In context ↗ Gut side effects
- Magnesium“it caused me to have temperature intolerance ... it triggered flushing, sweating and chills” Side effects
- Low-dose naltrexone“Ldn sounds so promos but I seem to feel more pain on it.” In context ↗ Made symptoms worse
- Low-dose naltrexone“I slept well when I took it at night but there was definitely bad nightmares” In context ↗ Mood or psychiatric effects
- Tirzepatide (Mounjaro, Zepbound)“even the microdose caused me to feel sick to my stomach. I couldn’t eat, even at this small dose. I had been having gastroparesis and this made it worse so I stopped after 2 injections” In context ↗ Gut side effects
- Nicotine patches“I felt better energy but I believe on the 3 rd day I had a migraine and stopped the patches” In context ↗ Made symptoms worse
Symptoms mentioned
Their words about their symptoms
- Headaches & migraine
after 3 years of constant migraines, dysfunction of nervous system and digestion
In context ↗ - Gut problems
inability to eat more than small bits of food, which I forced myself to eat
In context ↗ - Brain fog
unable to go outside or drive due to severe light sensitivity and brain fog
In context ↗ - Temperature regulation
Temperature instability, sweating and shivering
In context ↗ - Sleep problems
I could not eat or sleep
In context ↗ - Vision problems
My vision has been blurry and last year was diagnosed with double vision needing prisms to correct
In context ↗ - Anxiety & low mood
I had suicidal thoughts and anger
In context ↗
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