Coming off Mirtazapine - extremely tired

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Hi all,

For about 8 years I was on high doses of Anafranil (225mg) and 15mg of Mirtazapine. I've been slowly reducing the amounts for over a year (!). Now I'm down to only 7.5 mg Mirtazapine. I am feeling a bit better mentally (more color in my life :-)) but am generally feeling very tired. Working full time and being a father of two little children, I am able to get about 7.5 hours of sleep per night (average), but wake up extremely tired and feel that my body needs at least 10 hours... Unfortunately, I just don't have those 10 hours... I am quite the zombie during the day and wondering if anyone else has experienced this, if this is definitely a withdrawal symptome or not? I assume that if this is part of withdawal, I should push forward and get it over with but am a bit afraid to go ahead. I remember, many years back, when I was on Mirtazapine only, that it did make me very tired. Funny that with the two drugs together I was less tired than now...

Any advice would be extremely helpful. Thanks!!!

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  • Posted

    I don't think it's withdrawal, but rather the fact that mirt is more sedating at lower doses. I would press on. You may get more tired before you get better but should feel much more alert again once you are off mirtazapine. Good luck. You have done really well so far. I am now down to only 1 mg of mirtazapine (down from 30mg) and feel much more drowsy in the mornings now.
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    • Posted

      Hi Evergreen could i ask you how long it took you to come from 30 mg to 1 mg please ..only ive been on 30 mg for 15 years !! I always want to reduce but even notice a difference in initial drop to 22.5mg then end up deciding i cant do this and go back up ..the tablet is doin nothing for me after all this time but im terrified of the w/d ..cpuld i also ask if you feel better on the lower doses x
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    • Posted

      I too was terrified of coming off mirtazapine after all the horror stories I read about withdrawal. I was on 30mg for four years and thought I would be on it forever. But then it stopped working seemingly overnight and despite persevering for another six months (it briefly started working for me again halfway through that period - very odd, I know), I realised I wasn't getting anything out of it any more. My depression and axiety was back and worse than ever, so was my insomnia. In addition, I was getting frequent urination at night. So I bit the bullet and started to com off it around 12 weeks ago. I came down to 22.5mg and felt really nauseous and fed up. Then I started taking large quantites of inositol (vitamin 8) powder. By large amounts, I mean 12-18grams (one - two heaped teaspoons) in my morning tea and this immediately improved my mood. I stayed on 22.5mg for two weeks and then cut to 15mg for two weeks. Again I had a sticking point on day 4-5 but it passed. After that I got the 15mg pills and cut to 11.25mg for ten days and then 7.5mg for ten days. I got no withdrawal symptoms with those two drops and so reduced my taper period to 7 days. I dropped to 5.625mg still using a pill cutter, then to 3.75mg and then to 1.875mg with the pill cutter. All drops for a period of 7 days and didn't have withdrawal.

      So next step I planned was 1.875mg every other day for a week and then off. However, when I dropped my first dose I got terrible withdrawals; high anxiety, heart palpitations, heart pain, and restless les syndrome in every part of my body as well as crawling skin on my scalp, so I had a rethink. Some GPs will give you a liquid for tapering but I made my own and am now cutting by 0.1mg a day and I have had no WD symptoms apart from being slightly irritable.

      Good luck, and don't be scared. I have tapered quite fast compared to many and it has been relatively easy. You may have to go more slowly, and that's fine. You need to find the pace that is right for you.

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    • Posted

      Oh, and yes, I feel loads better. Depression gone, and so has frequent urination. The inositol powder is fab.
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    • Posted

      Sorry Evergreen, I think I may have asked you before, but where do you get the Inositol from?  
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    • Posted

      Dear Evergreen thankyou so much for your really informative response ..i feel lighter reading it ..infact im going on to a m a z o n to order the vit 8 powder immediately ...are you still taking it daily now and could i ask is your sleeping ok as thats my main anxiety that i wont get any sleep ..can i say that before reading your message i thought id be on this drug forever ..cannot wait ro show my long sufferin partner ..you have given me hope thanku so much xx
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    • Posted

      Meant to say ive read your response 5 times i am delighted for you you have done absolutely brilliant x
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    • Posted

      You're very welcome, Kal. Yes, I am still taking the inositol. So is ith work stress. When the mirtazapine stopped working I returned to terrible insomnia. However, I am actually sleeping better now that I am down to 1mg but still have to use herbal remedies and temazepam. However, I have been able to cut the temazepam right down over the last couple of weeks so I'm feeling optimistic that I can learn to sleep naturally once I am fully off the mirt. But one thing at a time! Good luck and keep us posted with your progress.
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    • Posted

      Sorry, a section of my post got deleted. Second sentence should read 'Yes, I am still taking the inositol, so is my husband as it really helps him with work related stress.'
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    • Posted

      Thankyou Evergreen for making me feel so positive ..ive never seen reducing mirtazapine as a possibility for me but feel so much more determined after reading your experience ..you are a angel x
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    • Posted

      Yes. You need a clean medicine bottle, an accurate measuring jug, a dosing syringe, and a pill crusher. I use half water and half maple syrup for the liquid. Measure 60 mls of this and pour into the bottle. Crush two 30 mg pills or 4 15mg pills into a powder and pour into the liquid. Shake vigorously before each dosing. 1 ml of the liquid equals 1mg of mirtazapine. Easy peasy. Good luck and keep it refrigerated.
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  • Posted

    Hi Violet I took my first tablet of mirtazapine last nite I woke up at 3 then just rolled round the bed this morning I feel so tierd and spaced out its untrue scared now to take anymore
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    • Posted

      That's normal for mirt for the first few days, but it gets better every day and soon you will get good sleep and feela alert in the mornings.
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    • Posted

      I dare not take it again was an horrible feeling I can't feel like that or I'm never going to get back to work
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    • Posted

      It does get better within a few days, youur body get used to it.  I remember the frist few (maybe 4 or 5) mornings being tough and not sure if I could drive, but I did.  If after one night you give up you will be ok, but don't suddenly "STOP" once you've been on it a week or so because you have to taper slowly.

      It is an incredibly strong psycotic AD though, I perservered and it was good for my insomnia which lead to anxiety.

      Wishing you well, stay with us, let us know how you go on.  x

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    • Posted

      Hi calmer I don't think I can risk taking it again it's proper scared me I go to work at 10 am on a morning and can't risk feeling like I do plus like you said getting off it is a battle and I'd feel like crap again and can't risk anymore time off work
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    • Posted

      I wish doctors prepared people for this. You really need a week off work whenever starting a new anti depressant. But honestly, if you take one tonight, you will not be as bad as you were today, and the next day even better. For me I was only really knocked out for three days with each day being better than the one before.
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