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Mirtazapine worked so well for me,but liver issues

Posted by TriedEveryMedication on July 2, 2021, at 10:01:49

appeared. Also possibly stevens/johnson.

45mg was great. Slept well, anxiety in check anhedonia was fading and I was started to enjoy life. Plus a little adderall XR (10mg) - had motivation.

Except liver enzymes got very out of whack, plus some other issues that went away when I DXed mirtazapine.

So now I'm on liver-friendly lexapro, except it doesn't do sh*t.

My pdoc thinks it was maybe the 5-HT2C action what was helpful. I looked for other drugs that are antagonists for this and couldn't find much. Mianserin is very similar to mirtazapine and probably has the same liver issues.

The theory on the liver issues is that CYP1A2 or CYP3A4 creates some toxic metabolite.

So anyway, my questions:

Do you think my psych is right that the 5-HT2C action in MIRT is what is helpful?

And if so, are there any alternatives that might be more liver friendly?

Thank you. I hope everyone is holding up in these interesting times.




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