Mirtazapine Withdrawal- the key to success

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In a month I will have come off mirtazapine completely and for some of that time I have been able to work and do my job pretty darn well.

I went on mirtazipine for anxiety and it did not work and I put on 1 stone in weight was drowsy all the time and generally doped out. In some ways it was actually causing more anxiety and depression as well. Withdrawing from mirtazapine is different for every person and everyone has to go at their own pace. For me, it was extremely slowly when I got down to 7.5mg and lower. The tablets don't allow you to do this so request the mirtazapine solution that you dispense with a 1ml syringe into a little bit of water every night. Going cold turkey is a terrifying experience, the one most awful experience of my life and its also dangerous. I do not agree with people advocating taking valium during the withdrawal process because for anxious or depressed people a drug that powerful leaves you vulnerable to addiction because speaking from personal experience that is exactly what happened to me. Valium in my experience is nowhere near as hard to withdraw from than mirtazipine because it is so short term whereas the mirtazipine is a long drawn out business making it hard to lose perspective on what is a withdrawal symptom and what is your underlying problem. I kept a diary of my symptoms so I could look objectively at what I was experiencing and sort it out, but I still forget sometimes. As I said earlier about some of the time I have been able to work Im talking about the past 6 months where I have been following a plan devised by myself that works if you find the quicker withdrawals like \"half a table for a week then nothing\" or cold turkey dont work. There is a website by the organisation called CITA (google it) and they have a Back To Life handbook that you pay £13 for and it gives you a specific plan for mirtazipine withdrawal, tells you supplements to take such as the powerful detox drink Noni Juice, how to alter your diet to help decrease withdrawal symptoms. I had my vitamins tested and whereas before the process I was fine, afterwards I had a chromium deficiency making me very sensitive to sugar. If you can hack it I have found that a low carb, low sweetner, low sugar diet like the Atkins or the Dukan diet work very well as the mirtazipine plays around with your blood sugar levels and therefore makes you even more unstable. My basic way of withdrawing was this:

Ill use the drop from 0.1ml to 0ml (of syringe solution which with the 7.5mg solution equates to about 0.75mg very very tiny!!) as an example because that is what I am doing right now:

Week 1, take 0.1ml apart from wednesday when you take nothing

Week 2, take 0.1ml apart from monday and wednesday \"\"\"

Week 3, take 0.1ml apart from monday, wednesday and friday \"\"\"

Week 4, take 0.1ml apart from monday, wednesday, friday and sunday

Week 5, take 0.1ml apart from monday, tuesday, wednesday, friday and saturday (only take 1ml on thursday and sunday)

Week 6, take 0.1ml only on thursday.

week 7 , take nothing!

So each week you are cutting out one day of the week's dose which I have found really suits mirtazapine because if you just drop down a dose the withdrawal hits you really hard 2 weeks after and by 3 weeks on the dose I was horrifically depressed. If its too fast you can do the week 1 pattern for 2 weeks etc which I did for a while. I do see what they mean about mirtazapine having a short half life because it does hit you in the face at the 3 weeks marker, it is as if it just leaves the body very quickly between 2 and 3 weeks of dropping a dose. The gradual withdrawal that I ended up doing I think really suits mirtazipine because of this aspect.

The drop downs I did was, 30mg, 15mg, 7.5mg (half a tablet) (with the tablets I simply dropped the dose again when the withdrawal symptoms subsided) this bit was debilitating and I do not advocate it. Use the plan set out in the Back To Life booklet instead. When I tried to go to nothing from 7.5 then I experienced absolute horribleness. So I switched to solution and did 1ml (7.5mg), 0.9ml, 0.8ml, 0.7ml, 0.6ml etc etc down to 0.1ml which Im doing now. I got the solution from my GP so it is not hard to obtain it in the UK, it costs the same as a regular prescription, i think it is available in America aswell but im not too sure.

Finally i will just outline my withdrawal symptoms: vivid dreams, disrupted sleep/over-sleeping (I did a test using SleepCycle, an app for the iPhone to test whether a small dose of mirtazipine could affect my sleeping and I found with the analysis tool that I had much less deep sleep and was much more easily disturbed to being fully awake during the night than when I didnt take any mirtazipine. I think this is why you oversleep on mirtazipine.) Paranoia, itching skin, body shocks (like tingles that run from the top of your head to your toes), headaches, fatigue, bruxism or teeth grinding (can make my jaw ache), depression, anxiety, nausea, burning mouth syndrome (like a numb tingling in your tongue), floating sensations when going to sleep, cravings for sugar and carbs, confusion, forgetfulness, angry outbursts, irritability, hot/cold flashes, insomnia (the most disturbing for me but on my really slow plan I dont get this problem at all), social withdrawal (probably because my emotions were so erratic i was embarassed for anyone to see me), body aching especially in my back where I hold most of my tension, sensitivity to noise and light, blurred vision.

Some more tips: People often fear it is their illness coming back when they are experiencing withdrawal symptoms, this was not true for me because as I am nearly off mirtazipine now it is the best I have felt since I started taking antidepressants. They are only supposed to be used short term but I ended up on them for 6 years. If you felt no effect with the antidepressants after a few months it is best to come off them. Dont even risk it with drinking alcohol, it makes the withdrawal even worse, your body is going through a lot and it needs as little rubbish to deal with as possible. If you feel a burst of energy as I have done during this process even if it is 9pm go for a jog. Dont just sit around waiting for it to turn into a panic attack. And finally go with the flow and remember its not real and only temporary. \"This too shall pass.\" So just do your best at real life and hibernate through it all. This drug is not easy to come off just as all antidepressants are hard to come off, it has been compared to heroin withdrawal and having researched heroin withdrawal I agree with the comparison. If you drop too suddenly and end up seeing the doctor because you are suicidal and at your wits end you must slow down and dont let them just pump you back up to 30mg, just go back up to the last dose you took before you went crazy and go slower next time. A word of warning: the majority of GPs and doctors do not understand antidepressant withdrawal and from my experience neither do psychiatrists fully, they just prescribe. However you must not blame them for their ignorance even though it is hard not to when you are in hell, you put the drugs in your mouth so YOU have to get yourself rid of them at YOUR pace. It is sadly the ways things are in the UK at the moment.

The best of luck to anyone who is on this road.

I hope something I said in there helped you.

If it didn't nothing lost!

Kathryn.

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  • Posted

    I believe that CITA are now CITAp, they come up when I google them, full name is Council for Information on Tranquillisers, Antidepressants, and Painkillers, they still seem to offer the Back to Life booklet
    • Posted

      Thank you Tina , I have replied but it had not shown up ? Anyway yes I have ordered the book :-)

      Jane

  • Posted

    Guys, I have a vital question to ask as the shrinks don't seem to be able to give me a straight answer: if you take Mirtazapine to a compound chemist and have him make smaller denomination capsules (eg. 4mg, 3mg, 1mg, etc), does the process of crushing change the pharmakodynamics of the drug? In other words, does the process make the drug lose effectiveness? Thank you.
    • Posted

      Hi Bret

      from what I understand if your tablet is not the orally disintegrating tablet then you should have no problem breaking the MIrt into smaller pieces and making a solution.

      the problem is when people try and take an extended release and cut that. It's called dumping. The process of doing this can make you sick. So no cutting or doing a partial,on the extended release

      ive read a few people that compound MIrt either through the pharm or by themselves with water. Like a thing lower than 3.75. I hope this helps. So no compounding does not change the effectiveness...

      😃

  • Posted

    Hi, I am trying to come off this drug also after previously using it for a year and half, then switching to Trazadone for a year and half, then in February this year switching back to Mitazapine again.

    I feel it is making my anxiety worse and affecting my memory and cognition in strange and unusual ways that I don't like. I tried discussing this with my GP but he was dismissive. Also I said last week I am coming off it and he said I should be ok going from 15mg daily to nothing. Ha, how wrong he is!

    I am currently using just 7.5mg now, I tried going cold turkey one day and felt so suicidal it was unreal, it was horrendous. Also mitazapine helps me go to sleep and I feel I have become chemically dependent upon it as a,sleep aid. I got my doctor to prescribe me melatonin tablets as a sleep aid.

    I so want to get off this drug for good, any anti depressants, I am sensitive to them all and none of them really aid me that well. I want to be medication free.

    Currently feeling more anxious coming off them but realise this is the withdrawal effects. Also not sleeping well and waking early with anxiety and racing heart, like I have a,hangover. Cant wait to be free of this horrid drug for good. Been on medication too long now

  • Posted

    I'm trying again to get off these once and for all. The docs agree they are clearly not helping and should not have me feeling so awful .. less then a week in reducing 1/4 off my 15mg and I'm feeling awful ..I have zero energy ,never felt so wiped out. .Legs and arms feel achy and heavey, emotions up and down and lngt I woke up with random weird dreams .anxitey little up, but taking propamomol to help .I just feel awful and I'm Tring to not cave and give in and keep thinkng I will feel half human once am off qnd hopefully in time have my old energy back. Trying to ride thjngs out. I'm taking vit b and omega and on a healthy diet but I really hope I can get off these once and for all.

    Any tips or advice would be great

    Shez

  • Posted

    Hi shez

    Sounds like you are coming off the Mert too fast, I would suggest drop 10% a week, then see how you feel. I used a pill cutter to get down from 15mg to 2.5mg then asked doctor for liquid mert.

    Good luck

    Pat50

    • Posted

      Thanks pat yeah I went at 10per last time over 3 months then got half way and couldnt hack the adrenaline rushes etc. So docs upped me back to get settled to try again. I took 10per off for 4 days then I've docs said take half a tabelt but I was like blimey I can't reduce that much. I know my body well so I said I will take 1/4 off I have been doing this 4-5 days and feel awful :-( I've been on propanonol 1.5 weeks and this also seems to make me feel weak and fatigue. I feel like my body going through the mill. It's also pmt time so this on top of all this seems draining me. I hate taking pain killers never mind these meds .I have zero energy or motivation . I'm taking it easy and eating and drinking often trying to ride things out .I've got a cutter I use and I'm taking close to a 1/4 off but blimey I feel extra sensitive to these thjngs again . It's hard to see my self getting off them .I don't know what else to do. I've got sertraline to taper over as last resort but after my journey with mirt I never want another med like this near me . I felt strong and ready to get off but blimey it's draining :-/ thanks for reply
  • Posted

    I had been on antidepressants for about 20 years, the last 13 of which were on Effexor.  Last fall, I decided I wanted to be free of ADs so did a fairly fast taper off of 37.5 mg, on my own.  I didn't realize what ensued was due to withdrawal, thought I had adult ADD due to all the mental symptoms.  Things got so bad this spring with the depression and anxiety that I begged a new psych for help and he put me on Mirt, starting at 7.5 mg.  He said it was a gentle AD and that I could play with it, add as needed, up to 45 mg.  Well, initially it really helped, especially with sleep, which I had been having such a hard time with.  But very quickly, the Mirt wasn't holding me and I began upping the dose.  At 37.5 mg, I was totally apathetic and had no energy, unable to get off the couch, didn't care about anything including feeding myself or any of the things I used to enjoy.

    I went back to my p-doc in desperation, and he reinstated the Effexor since that was something I had previously "done well" on.  When I took that first dose of 37.5 mg, my mood liften WITHIN THE HOUR!  I was so happy to feel better!

    Then I came across information about AD withdrawal, and it all fell into place for me.  I realized that the horrors of the last 6 months were due to Effexor withdrawal, and that that first dose back on was like a junkie getting a hit of the drug when in withdrawal - instant relief!  No way should the Effexor have worked that fast otherwise, since as they say about most ADs, it can take a month for them to start working.

    What I'm not sure about is why the Mirt initially worked but then kept failing me.  Was it the Effexor W/D or the fact that Mirt pooped out very quickly?  The fact that the Effexor instantly pulled me back up leads me to believe that it was W/D.

    So, there I am, realizing that I was now on TWO ADs that I need/want to get off of!

    When my doc reinstated the Effexor, he dropped my Mirt to 30 mg, a 7.5mg drop over what I was taking.  I thought I was having a drug interaction, because when starting the two drugs together, I was having burning/numbness of the lips, tongue and tops of my hands.  My doc didn't know what to make of that.

    I did a lot of research about AD W/D and tapering, and am following the 10% per month tapering plan, because I clearly had such a rough time of it going off the Effexor too quickly, before, that I ended up back on and some!

    When I did my first 10% taper of Mirt, I again had the burning/tingling sensations.  I now realize that it was W/D from the MIrt.  When my p-doc cut the dose the first time, that was a 20% cut!  Too much!  

    I intially started tapering both drugs by 10% but now realize I must be patient and focus on one.  I'm choosing the Mirt because it has caused me to gain weight, and as a recovering bulimic (haven't puked in over six years), gaining weight is a stressor.  Mirt has been great for sleep, but my research tells me that the sleep benefit is true at low doses and that was true when I first started it.

    Even at smaller than 10% cuts, I have noticed the burning sensation side effect and moodiness.

    I bought a pill crusher to break the tablets down into powder, and a small milligram scale (around $25 from Amazon) to weigh out the powder, which I mix in milk or juice at night.  Seems to work well.  The recommendation is 10% PER MONTH.  Patience is the problem.  I want to be done with these drugs ASAP, but the suffering I went through isn't worth going off too fast. I'm just sick that I didn't realize about W/D before ending up on TWO drugs, not one!

    I hope my tale will help save someone out there some suffering!

    • Posted

      Sorry to hear you're having such a rough time getting off the ADs but I agree slowly does it. Keep strong

      Pat

  • Posted

    Thank you so very much for sharing this wonderfully useful information.  It will undoubtedly help lots!
  • Posted

    Hi Guest! I'm trying to come off mirtizaphen and having a very hard time. I'm on it only for 3 months mostly 7.5 mg. I tried a month ago come of but I tapered to fast and I had to go back on. Right now I'm at 3 mg. Well I'm not sure bc.idont have a scale to measure it. Tomorrow I will get it, than I can measure it. My biggest problem is brain zap. It's wakes me up during night and I have it all the time. Sleep is the other big problem. I sleep if I Locky 4-5 hrs only. Did you get brain zap too? I'm so afraid is never will go away or I won't able to stop this medication. I never had anxiety or depression I got this med for nausea and for appetite. 
    • Posted

      Yup, you are another example of how withdrawal does in fact cause depression and anxiety in those who never had it before the drugs!  I am sorry you are having trouble coming off, but mirt is known as one of the worst for these problems.  You are not alone.  Evergreen, Calmer and I are a few here tapering off.  Goof for you, Eva, that you ordered a scale.  Just gotta take control fo the taper.  You have gotten down pretty far, but these low dosages are the most difficult to get through.  How long ago was your last cut and from what dosage?  I'm sure it was too big of a cut.  The brain zaps and lost sleep are a sure sign of that, and you do NOT want to cut further while having such symptoms.  You may even need to updose 1 mg or so if the symptoms have been going on too long or are too bothersome.  What was the last dose you were on where you still had good sleep?

      From here on out do not cut more than 10% of the previous dose if you can stand it.  I know it will seem like forever to get off, but slow and steady wins the race.

       

    • Posted

      Hi Betsy. Thank you to getting back to me. After 2 months off using remeron mostly for 7.5 mg I stoped it in Dec. 1st. After 1 week I could not take the imsomnia and brain zap went back on it for 2 day I took 7.5 mg than done to 3.75 mg and done to 3.00. I'm on 3 mg for 3 weeks now. It's to fast. I was sleeping good on 3.75 mg but I have brain zap since I'm on it. Is just getting worst. What do you think is it remeron or sit still a clonosapin what I was taking befor remeron for 3-4 monts?
    • Posted

      Ok, so you came off clonasapin how long ago, and how quickly did you come off?  Do you mean clonazapam?  
    • Posted

      While we wait to tease apart what is what, what was the timing between clonazapam and mirt?  How did you feel going on the mirt?  Did it ever work for you?  

      So, you had lost your apetite and had nausea?  How long were you having troubles with those and was it after stopping the clonazapam?  Those could have been withdrawal effects of clon.

      I would say go back to the last dosage of mirt that you felt decent at and hold there for a solid month.  Your nervous system has become very destabilized and the cuts likely caught up with you.  If that is 3.75 then give that a go; it should help within four days.

      I'm also sending you a PM

    • Posted

      Hi Betsy. I started to have nausea last year December do to stress in my life, or menopause. Could not sleep, ask for a sleeping pills, GP give me a clonozapan. That time I had no idea anything about anxiety pills or dep. pills.  I was taking it for 3-4 months and was getting bad anxiety on it told my GP I want to stop it. He said just stop. I did it cold turkey. Big mistake I know now. Was very sick for 3 weeks and I started to get thingiling feeling in my brain. I thaught it will go away. Never did, after doctor put me on remeron and I never felt good on that only sleeping was good and get back my appetite, but felling very depressed, and brain zap was getting worst. That's why I want to come off from remeron. I went up 3.7 mg. Hope is going to help. Thank you for a good advise and you carring. Betsy what is PM means?
    • Posted

      PM: Private message.  So for more clarification, you went on clonazipam a year ago December, were on it for 3-4 months, did a cold turkey on your doc's recommendation, had withdrawal for 3 weeks, and then went on Remeron about 6 months later, around October and November, and then started coming off the Remeron in December.  Is that right?  And you had the brain zaps and lost your appetite, since after the clonazipam CT? Would you say the depression was there before Remeron or only after starting it?

      I think you were still having protracted withdrawal from clonazipam the symptoms of which your doctor was trying to treat with Remeron.  I hope that the 3.7 mg makes you feel better; give it four days at least to see if it helps.

      I do hope that you'll join the surviving antidepressant forum as the very experienced folks might have something to add given your CT from clonazapam.  It is probably too long out to reinstate any of it, but the withdrawal from benzos can be far reaching and I think it was bleeding through the Remeron, which is why it wasn't helping.  Danged doctors!!

    • Posted

      Hi Betsy, i lost my appetite do to stress in my life in December and lost 25 lbs. had all kind off test,  all came back good. Than in Jun doctors told me is stress related so they put me in Jun on clonosaphen. So everything is happening since than. In 6 months went on clonosophin and stoped after 3-4 months using. Than after 3 weeks  the same doctor put me on remeron in October. I'm feeling ok less brain zap, but sleeping was not great. I will stay on 3.7 mg for a months than slowly tapper off. Thank you again. God bless and help everybody for this long and hard journey. I will keep in touch how I doing.
    • Posted

      Hi Eva, when I do a search for clonosophin, I get nothing but your thread here, so I think you mean clonazapam?  It would help if you could get the name because if it was clonazapam, that is a benzodiazapene and very addictive, and a cold turkey stop is definitely going to mess you up.  What dosage were you on, do you remember?

      Normally, mirt would knock you out - it is notorious for sedation and causing people to sleep longer than they even want to.  The fact that you still weren't able to sleep is likely due to the clonazapam withdrawal.

      Coming off benzos quickly will definitely cause rebound insomnia.

      I would recommend your joining a support forum called surviving antidepressants where you can post your situation and drug history, and very experienced people can guide you.   Do a web search for those terms and you will come up with it, or follow the link for "10% taper" in this thread and it will take you there:

      https://patient.info/forums/discuss/depression-resources-298570

    • Posted

      Hi Betsy. Yes it was not correct spelling. Is clonazepam. I was on 0.5 mg half pills for 3-4 months. And stop cold turkey ( my doctor told me). Yes I think you right 100%. And I will try to take it very slowly this time. Thank you so much. It's been a terrible ride but I will, we will make it.  Today I'm much more positive!

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