Mirtazapine - Anabolic/Androgenic?

[ChrissyDee]

Hi all

I was reading a very old forum post on this (2013) and I wanted to rehash it because I am interested in knowing more about this drug and there seemed to be a few people with some good knowledge on here.

Without going into great detail what I am trying to work out is what role Mirtazapine plays in altering Testosterone and in turn causing hair loss. I am a female and every time I have been put on this drug I am one of the people who suffer the (very rare) hair loss as a side effect. The issue is I love this drug, it works miracles for my insomnia and depression but I cant deal with the hair loss, its quite severe. Its def not due to stress or anything else as we have experimented going on and off it. Its definately the Mirtazapine causing it.

I am trying to get to the bottom of this, chemically, why would this drug be causing hair loss? Anyone have any ideas?

I have posted the original quote from 2013 below. This is what got me thinking about the link between hair loss and this drug....

Hi guysNew to this forum but always pop in for a read. The Dr threads are great.i believe the trycyclic anti depressant Mirtazapine to be a growth agent. For the last year I suffered anxiety/mild depression and insomnia and gastro issues after a prolonged phase of working 14 hr days in construction. My docs refused to accept any other explanation other than depression, bar one who was a good listener and open to ideas. I agreed to try all the ssri's they prescribed and the sleeping pills too - none worked and most made me feel wired. My own research suggested adrenal issues and being much inclined to natural products, I put myself through a series of trials on various substances over 12 months - I had nothing to lose. It took that time to get a cortisol test from my local surgery (UK). The test is available ok, for free, but all but one of the docs I saw, claimed it was pointless - even one who specialises in cortisone injections! Sure enough, my cortisol was off the chart high.i had pre-empted this obvious revelation by hitting dhea at 100mg per breakfast and 50mg mid afternoon. My skin, energy, focus and physique all improved substantially as the dhea drove down my cortisol through an increase in sex hormone activity. Ironically, my high cortisol had not made me heavier but lighter and with much less fat - as it was always accompanied by adrenalin - symptom pounding heart day and night. Perhaps also, cortisol's suppression of T led to a dominance of E which in itself does not actually increase fat cell numbers but potentiates anxiety and insomnia. My testes were much larger and harder each morning and held their size over the day.i had been given MIRTAZAPINE by my doc at one point and used it on the odd day when sleep was vital - it is better than anything I have ever tried for that! I knew also, it was a sledgehammer for knocking down cortisol. Recently, I took it in conjunction with the DHEA. The effect was incredible. After 4 days use I went alpha male overnight. I have used plenty of aas cycles in the past, short and long, and I can tell you that the effect of dhea and 15mg Mirtazapine combined was psychologically far more powerful. Not just that, but my vascularity/pumped appearance was very notable. I felt stronger and über confident. I didn't walk faster, I walked slower...with real purpose. I noted that the rate of testicular shrinkage over the daily circadian rhythm was more pronounced (suggesting higher endogenous androgen levels), and I could control this by reducing the dose of dhea. It felt like a high dopamine mindset with the addition of strength and calm. The hangover associated with this drug disappeared after only two days and seemed to be caused by using dhea with it, for without - the day lag was heavy. Also, the dhea seemed to remove the excessive appetite associated with Mirtazapine and I wanted to eat meat constantly with the combo?!So... What is going on here? I actually want to do this again next week as it was such a good package - sleep, confidence, growth, mood, improvement in many functions. Is mirtazapine somehow potentiating the effects of dhea, or does it need dhea to maximise it's function? I would compare it, for me, to doing 40/50mg per day of dbol without the caffeine like symptoms, instead a calm and focused demeanour. My lifting felt really easy too. I appreciate everyone is different but I hope the merits of this personal experience are worth sharing.Nick[/QUOTE]

 

[Godstrength]

Hi all

I was reading a very old forum post on this (2013) and I wanted to rehash it because I am interested in knowing more about this drug and there seemed to be a few people with some good knowledge on here.

Without going into great detail what I am trying to work out is what role Mirtazapine plays in altering Testosterone and in turn causing hair loss. I am a female and every time I have been put on this drug I am one of the people who suffer the (very rare) hair loss as a side effect. The issue is I love this drug, it works miracles for my insomnia and depression but I cant deal with the hair loss, its quite severe. Its def not due to stress or anything else as we have experimented going on and off it. Its definately the Mirtazapine causing it.

I am trying to get to the bottom of this, chemically, why would this drug be causing hair loss? Anyone have any ideas?

I have posted the original quote from 2013 below. This is what got me thinking about the link between hair loss and this drug....

Hi guysNew to this forum but always pop in for a read. The Dr threads are great.i believe the trycyclic anti depressant Mirtazapine to be a growth agent. For the last year I suffered anxiety/mild depression and insomnia and gastro issues after a prolonged phase of working 14 hr days in construction. My docs refused to accept any other explanation other than depression, bar one who was a good listener and open to ideas. I agreed to try all the ssri's they prescribed and the sleeping pills too - none worked and most made me feel wired. My own research suggested adrenal issues and being much inclined to natural products, I put myself through a series of trials on various substances over 12 months - I had nothing to lose. It took that time to get a cortisol test from my local surgery (UK). The test is available ok, for free, but all but one of the docs I saw, claimed it was pointless - even one who specialises in cortisone injections! Sure enough, my cortisol was off the chart high.i had pre-empted this obvious revelation by hitting dhea at 100mg per breakfast and 50mg mid afternoon. My skin, energy, focus and physique all improved substantially as the dhea drove down my cortisol through an increase in sex hormone activity. Ironically, my high cortisol had not made me heavier but lighter and with much less fat - as it was always accompanied by adrenalin - symptom pounding heart day and night. Perhaps also, cortisol's suppression of T led to a dominance of E which in itself does not actually increase fat cell numbers but potentiates anxiety and insomnia. My testes were much larger and harder each morning and held their size over the day.i had been given MIRTAZAPINE by my doc at one point and used it on the odd day when sleep was vital - it is better than anything I have ever tried for that! I knew also, it was a sledgehammer for knocking down cortisol. Recently, I took it in conjunction with the DHEA. The effect was incredible. After 4 days use I went alpha male overnight. I have used plenty of aas cycles in the past, short and long, and I can tell you that the effect of dhea and 15mg Mirtazapine combined was psychologically far more powerful. Not just that, but my vascularity/pumped appearance was very notable. I felt stronger and über confident. I didn't walk faster, I walked slower...with real purpose. I noted that the rate of testicular shrinkage over the daily circadian rhythm was more pronounced (suggesting higher endogenous androgen levels), and I could control this by reducing the dose of dhea. It felt like a high dopamine mindset with the addition of strength and calm. The hangover associated with this drug disappeared after only two days and seemed to be caused by using dhea with it, for without - the day lag was heavy. Also, the dhea seemed to remove the excessive appetite associated with Mirtazapine and I wanted to eat meat constantly with the combo?!So... What is going on here? I actually want to do this again next week as it was such a good package - sleep, confidence, growth, mood, improvement in many functions. Is mirtazapine somehow potentiating the effects of dhea, or does it need dhea to maximise it's function? I would compare it, for me, to doing 40/50mg per day of dbol without the caffeine like symptoms, instead a calm and focused demeanour. My lifting felt really easy too. I appreciate everyone is different but I hope the merits of this personal experience are worth sharing.Nick[/QUOTE]

I used to take this back in the day.... Remeron is the brand name I believe. As I suspected it affects dht which in males leads to hair loss... A quick search and I found this post with an article attached but could not bring up the article. It is possible this is somehow affecting your hair loss although I know very little about how dht would act in females or what you could possibly do about it. But I think at the very least you may want to Google mirtazipine and 5 alpha reductase and/or dht and go from there... I hope this helps some.


Remeron can increase 5-alpha reductase. 5-alpha reductase is inversely related to cortisol and mirtazapine reduces cortisol. Five-alpha reductase converts testosterone to DHT. Testosterone and DHT are the two primary androgens in your body. Testosterone develops muscle and testicular tissue. DHT develops prostate, penis, body hair, balding, voice pitch, and nervous system strength. The odd thing about DHT is that it can improve weight lifting performance more than testosterone, but it does not affect muscles. This is because part of your strength comes from the nervous system itself. Think of your nervous system as the electricity in your body. DHT can make that electricity stronger. DHT is able to cross the blood-brain-barrier where as testosterone does not. Because of this, DHT can affect mood and behavior where testosterone cannot. DHT is thought to responsible for aggression and confidence. DHT seems to affect verbal aggression, but can actually be calming and can actually curb extremely violent behavior. Basically it contributes to a certain kind of moderately aggressive behavior.*

 

[ChrissyDee]

Its so interesting !! I may be female but its definitely having an impact on my hormones, another thing Mirtazapine (Remeron) does is make me slightly aggressive. I wish I could work it out, I love the drug so am trying to find another drug with a similar profile but without whatever is causing the hair loss, or even an explanation of what may be going on so that I can take to my doctor would be great (GP's these days have NO idea about this stuff !)

 

[ChrissyDee]

.*[/QUOTE] Remeron can increase 5-alpha reductase. 5-alpha reductase is inversely related to cortisol and mirtazapine reduces cortisol. Five-alpha reductase converts testosterone to DHT. Testosterone and DHT are the two primary androgens in your body. Testosterone develops muscle and testicular tissue. DHT develops prostate, penis, body hair, balding, voice pitch, and nervous system strength. The odd thing about DHT is that it can improve weight lifting performance more than testosterone, but it does not affect muscles. This is because part of your strength comes from the nervous system itself. Think of your nervous system as the electricity in your body. DHT can make that electricity stronger. DHT is able to cross the blood-brain-barrier where as testosterone does not. Because of this, DHT can affect mood and behavior where testosterone cannot. DHT is thought to responsible for aggression and confidence. DHT seems to affect verbal aggression, but can actually be calming and can actually curb extremely violent behavior. Basically it contributes to a certain kind of moderately aggressive behavior.*[/QUOTE]

Interesting you should say that Mirtazapine (Remeron) can increase 5-alpha reductase !! A Dermatologist gave me Finasteride for my hair loss which is a 5α-Reductase inhibitor. Does that mean its the same thing ???

I was diagnosed with pattern hair loss before I put 2 and 2 together and realised it was the Mirtazapine causing it. I never took them at the same time. I wonder if I took the Mirtazapine and the Finesteride together if they would help alleviate the hair loss issue, or could that cause extra issues.

 

[Godstrength]

.*

Remeron can increase 5-alpha reductase. 5-alpha reductase is inversely related to cortisol and mirtazapine reduces cortisol. Five-alpha reductase converts testosterone to DHT. Testosterone and DHT are the two primary androgens in your body. Testosterone develops muscle and testicular tissue. DHT develops prostate, penis, body hair, balding, voice pitch, and nervous system strength. The odd thing about DHT is that it can improve weight lifting performance more than testosterone, but it does not affect muscles. This is because part of your strength comes from the nervous system itself. Think of your nervous system as the electricity in your body. DHT can make that electricity stronger. DHT is able to cross the blood-brain-barrier where as testosterone does not. Because of this, DHT can affect mood and behavior where testosterone cannot. DHT is thought to responsible for aggression and confidence. DHT seems to affect verbal aggression, but can actually be calming and can actually curb extremely violent behavior. Basically it contributes to a certain kind of moderately aggressive behavior.*[/QUOTE]

Interesting you should say that Mirtazapine (Remeron) can increase 5-alpha reductase !! A Dermatologist gave me Finasteride for my hair loss which is a 5α-Reductase inhibitor. Does that mean its the same thing ???

I was diagnosed with pattern hair loss before I put 2 and 2 together and realised it was the Mirtazapine causing it. I never took them at the same time. I wonder if I took the Mirtazapine and the Finesteride together if they would help alleviate the hair loss issue, or could that cause extra issues.[/QUOTE]No theoretically it will inhibit the 5a reductase which increases from use w remeron. So my understanding is this....

Either they will cancel each other out- or it will solve your problem imo. I'm no doctor so I'm just making suggestions based upon what I see.
Remeron increases 5a reductase
Finistride inhibits it (renders it inactive).

I would definitely give it a shot and see how you respond to both. It may be the thing to stop your hair loss.


I do believe the 2 are directly correlated and thats why 1 (remeron) increases 5a red. And causes hairloss and the other 2 (finastride) inhibits 5a red. And stops or reduces the shedding.

The only thing I can see may be a problem is this. It is possible that it is the dht that is making you feel good. It gives a sense of alpha amd confidence. I know remeron had other benefits such as great sleep. But basically if the 5a red is converting testosterone in your body (yes women have test too just at a different test/estrogen ratio than males) to dht and that is part of what makes you feel so good on it then inhibiting the 5a red could also in turn inhibit the conversion from test to dht.

At the end of the day theres only one way to know and thats to try the finastride and see if it helps while at the same time being able to retain the good that you are getting from the Remeron. I dont think the finastride would make the hairloss worse as it directly combats the the very thing (imcrease in 5a red.) that I believe is responsible for your hair loss.....


Good luck w everything let us know how it goes.

Oh and also I agree w you, that doctors actually know very little about this kind of stuff. It took me all of 5 min to fimd the info I did and I wish our healthcare took time to be more case sensitive to patients and what specifically is involved w them. I know there are some really good Drs out there but I'm speaking in general.

 

[ChrissyDee]

Remeron can increase 5-alpha reductase. 5-alpha reductase is inversely related to cortisol and mirtazapine reduces cortisol. Five-alpha reductase converts testosterone to DHT. Testosterone and DHT are the two primary androgens in your body. Testosterone develops muscle and testicular tissue. DHT develops prostate, penis, body hair, balding, voice pitch, and nervous system strength. The odd thing about DHT is that it can improve weight lifting performance more than testosterone, but it does not affect muscles. This is because part of your strength comes from the nervous system itself. Think of your nervous system as the electricity in your body. DHT can make that electricity stronger. DHT is able to cross the blood-brain-barrier where as testosterone does not. Because of this, DHT can affect mood and behavior where testosterone cannot. DHT is thought to responsible for aggression and confidence. DHT seems to affect verbal aggression, but can actually be calming and can actually curb extremely violent behavior. Basically it contributes to a certain kind of moderately aggressive behavior.*

Interesting you should say that Mirtazapine (Remeron) can increase 5-alpha reductase !! A Dermatologist gave me Finasteride for my hair loss which is a 5α-Reductase inhibitor. Does that mean its the same thing ???

I was diagnosed with pattern hair loss before I put 2 and 2 together and realised it was the Mirtazapine causing it. I never took them at the same time. I wonder if I took the Mirtazapine and the Finesteride together if they would help alleviate the hair loss issue, or could that cause extra issues.[/QUOTE]No theoretically it will inhibit the 5a reductase which increases from use w remeron. So my understanding is this....

Either they will cancel each other out- or it will solve your problem imo. I'm no doctor so I'm just making suggestions based upon what I see.
Remeron increases 5a reductase
Finistride inhibits it (renders it inactive).

I would definitely give it a shot and see how you respond to both. It may be the thing to stop your hair loss.


I do believe the 2 are directly correlated and thats why 1 (remeron) increases 5a red. And causes hairloss and the other 2 (finastride) inhibits 5a red. And stops or reduces the shedding.

The only thing I can see may be a problem is this. It is possible that it is the dht that is making you feel good. It gives a sense of alpha amd confidence. I know remeron had other benefits such as great sleep. But basically if the 5a red is converting testosterone in your body (yes women have test too just at a different test/estrogen ratio than males) to dht and that is part of what makes you feel so good on it then inhibiting the 5a red could also in turn inhibit the conversion from test to dht.

At the end of the day theres only one way to know and thats to try the finastride and see if it helps while at the same time being able to retain the good that you are getting from the Remeron. I dont think the finastride would make the hairloss worse as it directly combats the the very thing (imcrease in 5a red.) that I believe is responsible for your hair loss.....


Good luck w everything let us know how it goes.

Oh and also I agree w you, that doctors actually know very little about this kind of stuff. It took me all of 5 min to fimd the info I did and I wish our healthcare took time to be more case sensitive to patients and what specifically is involved w them. I know there are some really good Drs out there but I'm speaking in general.[/QUOTE]


Makes sense !! I wonder what sort of doctor could confirm this for me, a pharmacologist maybe? I guess I could just give it a try, as a woman I just don't like messing around with hormones haha

 

[B4Hand]

I prescribe Remeron all the time and have never had a pt mention this side effect. According to UpToDate alopecia only occurs in about 1% of users, but I'll definitely be more observant of this in the future!

 

[B4Hand]

Also, another antidepressant that's great for sleep is trazodone.

 

[bigdavid]

Been on 45 mirtazapine for years never had any issue with hair loss personally. And this is an issue I am susceptible to so I would deff notice it. Be careful not to blame all issues on one cause. How old are you? That is likely the driving factor to your hair loss, though of course almost all medications have alopecia as a rare side effect

 

[ChrissyDee]

I prescribe Remeron all the time and have never had a pt mention this side effect. According to UpToDate alopecia only occurs in about 1% of users, but I'll definitely be more observant of this in the future!

It kind of makes sense. Remeron increases 5a reductase, which is responsible for hair loss. I have tried going and off it over the course of 10yrs and everytime my hair falls out, it starts within 2 weeks.

Any suggestions of another drug that works like Remeron but doesn't interfere with 5a Reductase?

 

[ChrissyDee]

Been on 45 mirtazapine for years never had any issue with hair loss personally. And this is an issue I am susceptible to so I would deff notice it. Be careful not to blame all issues on one cause. How old are you? That is likely the driving factor to your hair loss, though of course almost all medications have alopecia as a rare side effect

I am 49 but its been going on for 10yrs, Ive been able to go without an anti depressant for a few years, but I need one quite desperately now, just don't want to go down the hair loss road again would try other drugs but SSRI drugs make me too edgy

 

[bigdavid]

I am 49 but its been going on for 10yrs, Ive been able to go without an anti depressant for a few years, but I need one quite desperately now, just don't want to go down the hair loss road again would try other drugs but SSRI drugs make me too edgy

Typically agitation from ssris goes away after a month or two. Which ones have you tried? There are newer antidepressants out there like viibryd and trintellix you could try

 

[ChrissyDee]

Typically agitation from ssris goes away after a month or two. Which ones have you tried? There are newer antidepressants out there like viibryd and trintellix you could try

Im not sure what Country you are in, but Im in Australia? Ive found a few of the SSRI are not available here for some reason. Ive tried Zoloft and Duloxotine and Lexapro. I get nausea, insomnia, loss of appetite and a bit of mania. I also have issues with ectopic beats, so don't like to mess with any drugs that can possibly affect the heart, I would like to try Seroquel, its been suggested to me, but I've read bad things about that drug, so it makes me nervous.

 

[B4Hand]

I would try trazodone. It's an antidepressant that helps with sleep. Seroquel is an antipsychotic that causes brain fog for a lot of people I've worked with. I'm always told how much clearer their minds are after tapering off it. I'd definitely let that be a last resort.

As far as the ssris, all of them come with the GI side effects. If you're real sensitive to them, I'd start Lexapro at 5 mg or Zoloft 25 mg and slowly titrate up. Like bigdavid said, if you can make it past the first couple weeks you've got it whipped and the side effects aren't noticeable.

 

[ChrissyDee]

I would try trazodone. It's an antidepressant that helps with sleep. Seroquel is an antipsychotic that causes brain fog for a lot of people I've worked with. I'm always told how much clearer their minds are after tapering off it. I'd definitely let that be a last resort.

As far as the ssris, all of them come with the GI side effects. If you're real sensitive to them, I'd start Lexapro at 5 mg or Zoloft 25 mg and slowly titrate up. Like bigdavid said, if you can make it past the first couple weeks you've got it whipped and the side effects aren't noticeable.

I I really struggled with 5mg Lexapro and I'm not sure I could have slept on it, I'll ask my GP about Trazodone. Thanks for advice it's been very helpful