coming off mirtazipine

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Experinces of anyone coming off/stopping  mirt having had NO problems taking it in the first place would be interesting.I have had no problems at all but i think i'm pooping out after 5 months being on 30mg.Having felt crap for about 10 days the doc put me up to 45 on fri to see if any change.Been on 45 for 3 days with no improvement.When i first took mirt it was instant -it was amazing.I suppose i am hoping that any improvement i get with 45 will be more gradual ......and long lasting.If after 4 wks on 45 I think i might come off but can i stop relatively quickly seeing as i had to problems when i first took it? (some folk seem to have had real probs.)

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  • Posted

    Hi, I will be interested in any replies you receive. I too, have recently gone up to 45mgs. I'm really confused about some of the things on here e.g I can't understand why 15mgs is more effective for sleep than 30 or 45. Can someone please clarify? Many thanks all.
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    • Posted

      Hi i asked a similar question and got two excellent replies, have cut and pasted them as i dont know how to direct you to them:

      Post 1

      Hi Philip, put ximply the theory is that the more sedative effects of Mirtazapine are counteracted by the more activating effects you get on doses of 30mg or above.

      The sedative effects are caused by Mirtazapines anti-histaminics effects, whereas the actual anti-depressive effects of the drug are caused by it's ability to stop reabsorption of Serotonin into nerve endings in the brain.  More accurately it inhibits the sensors which monitor how much Serotonin is in synapse gaps which causes the seperate nerve endings to not re-absorb so much Serotonin.  SSRIs which Mirtazapine is not work by inhibiting the nerve endings ability to reabsorp Serotonin directly.

      Mirtazapine is also thought to have an effect on Noroadrenaline which is where my laymans knowledge ends I'm afraid.

      But essentially at 30mg and above you get more of the anti-depressive qualities of the drug which is meant to counteract the sedative effects.

      In practice I didn't find much difference between 15mg and 30mg or 45mg but then again Mirtazapine just didn't seem to work for me for whatever reason.

      Ultimately if you think the drug might be helping you and you might benefit from upping the dose try it and see how it goes.  With ADs it's often a case of balancing the benefits against the side effects.

       Post 2

      The sedation on Mirtazipine is caused by it blocking the histamine H1 receptor.

      At 15mg the H1 is pretty much fully blocked so any higher dose will not make you more tired. However doses higher than 15mg do continue to increase the seretonin and (most importantly to this discussion) the Nor-epinephrine (nor-adrenaline to you and me). So with the extra adrenaline comes more alertness.

      So in a nut shell, tiredness maxes out at approx 15mg but the stimulating side continues to increase with higher doses. Thats the therory but individual variation occurs.

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  • Posted

    Well I can only relate my experience. I had no problems with mirtazapine, I was on 30mg for 6years and it was very effective. However I am getting considerable problems with withdrawal symptoms now I'm VERY gradually reducing it. Of course I have been on it for a lot longer than you.
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  • Posted

    Hello, too have been taking mirt for 3 years and it finally stopped working, I increased the dose but it didn't help, when I started reducing I felt unwell and thought it was my illness returning, I persevered an soon realised it was withdrawal, I kept going and the Dr gave me propranolol to ease the symptoms and they have help a lot.i am now down to 15 and feel so much better, the grogginess has subsided and I feel more like myself.
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