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I wanted to write my story for anyone out there trying to find encouragement during withdrawal process. When I started coming off Mirt I kept searching for success stories, but forums are usually filled with struggle stories instead. If you are in the weeds of withdrawal, may be this post will give you a little bit of hope.
I was put on 15mg of Mirtazapine in January of 2017. My main symptom at the time was severe insomnia: 0 sleep for days, may be 5-6 hours of sleep in a week. But I also experienced episodes of terrible anxiety, bordering panic and depression symptoms. Looking back, I'm convinced this was brought on by a few weeks of continuous Ambien and Xanax use for sleep. I was 36 at the time, never had any psychological issues before, never took any meds. I was suffering for about a month until I found a doctor who stabilized me with Mirt.
It worked almost immediately. Within one week I started sleeping for the first time in a month. Anxiety and depression faded as sleep returned. I was on 15 mg for 2 weeks, but I felt too sedated the next day. Went down to 7.5mg after 2 weeks. Then down to 5mg after another 2 weeks. And from there on did a 0.5 reduction every 2 weeks or so. Finally jumped off after being at 0.5mg for 5 days.
I had some rebound insomnia with earlier tapers, but once I got below 4 mg it was pretty smooth (because of the lower reduction, I guess?). When I jumped off back in June for the first 10 days I felt great. But slowly sleep started getting worse and worse: and at 2 week mark it hit me hard.
I went back to 1mg and stayed there for a coupe of months – sleep normalized immediately. I got 0.2 and 0.1 mg pills and decided to go as slow as I can. In the end I took way longer than I should have, but I was going through some life-changing transitions at the time and insomnia was not something I was prepared to deal with. It took me about 6 month to go from 1mg to 0.1mg, doing 0.1mg cuts every few weeks. Then I was taking 0.1mg every other day for a few weeks. Then every 2 days for 2 weeks and then I stopped. I had a few setbacks during this time, but not as troubling as the ones I had before: only 1-2 nights of bad sleep.
It's been 2 month since my last dose and I think I'm ready to say: I'm Mirt free and I sleep well!
So if you are taking this medication for SLEEP here's some advice I can offer:
1. In my experience, lower doses of the pill worked just as well – or better – than the original 15 or 7.5mg. From what I've read 3.5mg seems to be the perfect dose for sleep for most people. I did great on 1mg as well: asleep within 15 minutes, which is very fast for me even before insomnia problems. So if your doctor prescribes it for sleep, I suggest trying the lowest possible dose: it will be easier to withdraw from later.
?2. When stopping this medication go slow and and jump off from the lowest dose possible. In a lot of the stories I've read people have jumped off from 3.5, 5 or even 7.5 mg. This medication seems to have effect even at 1mg (at least for some people). I took too long, but I'm guessing you should be ok going from 1mg to 0.1mg in month or so. You can either make your own solution or find a compounding pharmacy that will prepare small dose pills for you.
3. Expect delayed withdrawal. I was usually hit with insomnia 10-14 days after lowering the dose and it seems to match other stories I've read.
4. If you are being prescribed Mirt for sleep, I suggest you only take it short term and try to fix the underlaying issues that are causing your insomnia and at least manage it better without medication. Taking Mirt long term can make you dependent on it and make your initial insomnia problem worse once you stop. Keep a good sleep hygiene. Have your hormone levels and thyroid functions tested. Make sure you get adequate levels of Magnesium, vitamins D and B-6 and Zinc (all these are crucial for melatonin production). Include exercise in the first half of the day, if possible. Get out into the sun light first thing in the morning. Wear blind fold and/or ear plugs to bed (this easy trick was surprisingly helpful for me). And this one is my favorite trick of all: listen to podcasts or audio books when you can't sleep (a monotone voice, no dialogue works best). I find this extremely efficient in turning my mind off. Best case scenario – it will make you fall asleep. Worst – you will learn something new
5. And lastly, try not to fight for sleep when insomnia does strike. It's easier said than done. But fighting make things much-much worse: it adds anxiety and sadness on top of exhaustion. And will most definitely not make you sleep. When it's 3 am and you just know sleep will not come tonight – just try to accept it. The truth is that we are built to handle some sleep deprivation. Yes, you will not feel great the next day. But usually it's not as bad as you think it will be when you are laying there awake in the middle of the night. And worrying about it will not make you fell better.
If you are fighting the insomnia fight right now – hang in there!
?Unfortunately, there's no short cut. But it will get better.
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