Coming off mirtazapine

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I thought I would start a new thread to give people tips for coming off this drug. I have gained so much advice and support from people on here and I owe my (so far) painless withdrawal to them. People like Calmer and Betsy, and plenty others too. I have been on 30mg mirtazapine for four years. I tried to come off them a couple of years ago and failed miserably, returning to my full dose after 10 days of awful anxiety and insomnia, as well as migraines and nausea. I had cut my dose to 15mg for a week and then dropped to zero.

This time I read every thread on here about mirtazapine withdrawal and started off really slowly, cutting down by just 3.75mg for two weeks. Then by a further 3.75 mg. At the same time I started taking a lot of inositol. I take a huge heaped teaspoon in my tea every morning. I had only slight nausea when I first started dropping my dose but I think that was me getting used to the inositol. Once I was down to 22.5mg of mirt, with no withdrawal symptoms, I figured I could go a bit faster and dropped my dose down to 15mg. I had no withdrawal symptoms after ten days and so have now dropped my dose to 11.25mg. I use a simple pill cutter from ebay to cut my tablets. So I am now on three quarters of a 15mg tablet. Mirtazapine had pooped out on me and so I already have terrible insomnia. I take temazepam some nights and benadryl on others to help me with that.

I will post my progress here. Who knows, I may fail miserably, but whatever the outcome, I hope it will help others. I was terrified of coming off mirtazapine, but now I am excited by it. I think the key is to take it really slowly and work out the pace your body can cope with. The smaller your dose goes, thee smaller the decrease in your dose should be. Good luck everyone, and please post your own experiences here. I know some people have really suffered despite coming off mirt very slowly. Everyone is different and I think everyone's experience can be a real help to others.

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  • Posted

    Hi evergreen

    this is fantastic info. Although i am withdrawing from citalopram eg reducing from 40mg. to 20 your info really helps me. I am due to introduce mirt next week. I posted a question yesterday as i was feeling sick and dizzy, and was asking is this normal on day 7 of reducing by half dose. Got only one response saying 'I'm surprised you don't know this'!!! It made me feel a little despondent.

    The last six months of depression have been awful and to start from scratch on a new drug seems daunting.

    This is my first time withdrawing from any drug (day 8 today and feel tearful too) your post is really helpful.

    god bless

    Lorraine

    god bless and wish

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  • Posted

    Hi evergreen

    this is fantastic info. Although i am withdrawing from citalopram eg reducing from 40mg. to 20 your info really helps me. I am due to introduce mirt next week. I posted a question yesterday as i was feeling sick and dizzy, and was asking is this normal on day 7 of reducing by half dose. Got only one response saying 'I'm surprised you don't know this'!!! It made me feel a little despondent.

    The last six months of depression have been awful and to start from scratch on a new drug seems daunting.

    This is my first time withdrawing from any drug (day 8 today and feel tearful too) your post is really helpful.

    god bless

    Lorraine

    god bless and wish

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    • Posted

      Hi Lorraine. It does seem as though you may be coming off the citalopram a little too fast. I would have reduced by a quarter to start with and stayed on that for 10 - 14 days, then reduce by a small amount again. Ask your doctor what dosage of citalopram is safe to take with mirt. It may be that you can start the mirt before you are fully off the cit because this will undoubtably help you because mirtazapine works very quickly for most people. At the beginning it is extremely sedating, to the extent where you are barely functional the following day, but this effect wears off day by day, so stick with it. Good luck with the mirtazapine. It has been a fantastic drug for me.
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    • Posted

      Hi thank you so much for your response xx my doc told me to reduce from 40 to 20 over two weeks then introduce mirt 15mg next week and take 20 cit every other day. Then back to see her on 17 th. I'm so glad you sent your informative post today. Do you know how long the sickness and dizziness hangs around? Xx
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    • Posted

      If you have reduced too fast, then it may not clear any time soon. If you are really feeling rough, then I would increase the cit back up to 30mg until you feel better and then reduce again more gradually. I have found doctors usually suggest reductions which are much too fast for many people. You need to find the reduction which suits you because everyone is different. Some people are able to quit cold turkey and suffer very few withdrawal symptoms, others feel and suffer every tiny reduction. xx
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    • Posted

      Bless you X that's exactly what I will do. I think cutting by half is too extreme!! Thank you so much for your help today xxx
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    • Posted

      Yes, probably too fast.  It is important to take control of your taper and not rely on the doctor's plan because, as evergreen I think said, they usually go too fast!

      As for mirt plus Cit, it is common for docs to put mirt together with an SSRI.  I was put on mirt and then reinstated Effexor because I was in protracted wd and the mirt could't overcome that.  That combo is jokingly referred to California Rocket Fuel!  The belief is that the combo is more effective than each drug by itself.  Do beware of any potential symptoms of serotonin syndrome, however.  Do a web search on SS to familiarize yourself with the symptoms.

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  • Posted

    Evergreen, I am so excited for you!  Thank you for putting your experience out here for all to learn from.  

    I think it is empowering to take control of your taper, and it definitely helps to keep a journal of when cuts are made by how much, and when withdrawal symptoms appear.  If you know that WD symptoms occur, say, 5 days after a cut, then when it happens again you KNOW what is happening and have the choice to push through or updose.

    The last 3+ mg are the hardest to come off of, so if you have access to liquid mirt or the Soltab version, that is the next best step to take in terms of tapering.  The Soltabs can be disolved in water and then you can make your own liquid to make that last set of tapers more tolerable.

    And yes, it isn't just about mirt - anyone wishing to get off their psych med, what-ever it may be, should follow the same plan.

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    • Posted

      You are very right, Betsy. I am not going to underestimate how hard the last bit can be. Best to be prepared for the worst and then anything else is a bonus. I will be taking the last bit very slowly.

      I have felt brilliant today. Probably because I am getting plenty of sleep with the benadryl. I have also bought some phenergan to try. At least this means I don't have to take the temazepam more than once or twice a week. My plan is to rotate the three of them to avoid tolerance.

      I really do think the inositol is playing a major part in my uplifted mood.

       

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    • Posted

      That is great!  I have some inositol powder I forgot I had, so your mentioning it reminded me to use it.  We shall see.

      I hope it just gets better and better for you!  I wish I was as close as you; I'm at 16 mg mirt, now.

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    • Posted

      I spoke too soon about the sleep. I took the benadryl which had worked so well for me for 3 nights and was still awake at 3 am. I had to take half a temazepam in the end because I needed to be up early as usual as well as be alert enough to fetch my son from work after 11 pm. Maybe, even though the mirt was not helping me sleep, the lack of it is actively preventing other things from helping me. We shall see. I still feel absolutely fine in other ways.

      Another thing I have noticed since stepping down to 11.25mg is my appetite has fallen off a cliff. I have to actively tell myself it's time to eat. I don't feel nauseous, just not hungry. I think I am returning to my pre-mirt days when eating was a necessity rather than an obsession.

       

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    • Posted

      Betsy 16 mg

      Evergreen 11.25 mg

      Calmer 9 mg

      We're in it together folks !  

      I slept for 10 hours last night, can't quite believe it!  I have been extremely busy and was phsically nckr'd so maybe thats why.  They do say the lower dose of Mirt' is more sedating which I find really odd.

      Evergreen I think you're right about the appetite, mine is less now than on 15mg, still can't go hungry though.

      Having the odd night of bad sleep is normal though Evergreen, I bet you didn't unwind, or had more on your mind, the high winds, that knocking sound??!!, or more caffeine or more worries - its important not to let a bad night bother you as it just makes you more worried that you are not going to be able to sleep!  So, I'll bet you get a good night tonight.

      Have you noticed the advert on this page on the right hand side re Zispin Sol tab ... are you getting that too???  big brothers' watching us (!)

      Have a great evening x

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    • Posted

      Is Zispin mirt?  Yes, the danged browser sure takes in everything we write and puts up ads based on that!

      At 17 I am still obsessed with having some kind of sweet everyday.  I am now keeping tabs on my caloric intake just to see where I'm at.  So, looking forward to breaking that barrier appetite-wise!  

      The messed up sleep does cause me fear since I've read so many stories of people having horrid insomnia when tapering down to the lower doses of mirt.  I've had the odd few nights of wakefulness but generally am still sleeping well.  Only been on 16 mg for a few nights.

      Evergreen, I forget if I mentioned trying Emotion Freedom Techniques.  Do a search on that and you will find lots on what it is and how to do it.  It is otherwise known as "tapping."  Bascially, you announce an affirmation as you tap on an acupressure point.  When unable to sleep, for me it would be "Even though I can't sleep, I deeply and completely love and accept myself."  Then, you begin tapping on a series of acupressure points, repeating a reminder phrase such as "can't sleep."  Each time you finish a round of tapping, you reassess your symptoms.  Can't really do that for sleep, but if it were anxiety, you'd check yourself to see if you feel less anxious.  For me, it takes about three rounds of tapping before I drop off.  As I'm doing it, I'm usually thinking in the back of my mind "this isn't helping," but after round three, next thing I know I'm waking up from having fallen asleep!

      Worth a try!

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    • Posted

      Yes Mirtazapine, Remeron, Zispin - all the same thing.

      Keep deleting my Cookies but the darn adds, whatever I look at come and find me !

       

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    • Posted

      I haven't noticed any sedation as I have gone lower. I actually found the 30mg more sedating than the 15mg when it was working for me. I only managed to get off the temazepam once I was on 30mg. I think that people say it is more sedating because they usually start on 15 and it knocks you for six, then when they up the dose it doesn't have that huge effect that the first 15mg has. But for me, it had stopped working completely. My onlly worry is that coming off it may actively make my insomnia even worse so that nothing would help me sleep. I am expecting to return to my pre-mirt state once I come off it. And unfortunately that is an insomniac.

      Yesterday I was in extremely high spirits. Almost like euphoria. Today, I still feel very 'up' but very tired. I am having some wine tonight as my lovely dad is fetching my son from work, so I'm off the hook. I'll see if the alcohol helps me sleep or has the opposite effect!

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    • Posted

      I think you will be fine, sleepwise, Calmer, because you are withdrawing so slowly and giving your body time to relearn how to sleep on its own. And if not, there are other alternatives that can help you, I know the fear though, and now I am in it, it is not so bad as I had imagined.
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    • Posted

      Like Calmer, I think you are taking it slowly enough for your body to adapt, so fingers crossed you won't have to face the curse of insomnia. I would be taking it much more slowly too if I was still sleeping well on mirt. In fact, if I was still sleeping well on it, I wouldn't be coming off. The weight thing got me down but it was a good trade off for the lovely sleep, but once that went, I wanted off. I actually feel in higher spirits now than before I started to taper. The mirt had totally pooped on me and I was back to severe depression and anxiety. Whether it is the inositol or the reduced dose, I don't know, but I feel so much better emotionally now.
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