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Having trouble tapering. Can't get lower than 7.5mg. Can anyone help?

Posted , 8 users are following.

andy46832
andy46832

Hi,

Can anyone help. Have had some real difficulty tapering to come off mirtazapine.

Just a brief history:

Originally tapered too quick from 30-22.5-15-7.5-3.75 and then off over about 3 weeks. After 4 months on. So then went back on at 2mg but felt awful again. So then went back to 7.5 again. Felt alright and did this for 7 days and then tried to go down to 5.75 but am now feeling awful again. I really want to come off this stuff but just don't know how. Can anyone please help. I feel like I'm going crazy.

Should I just stick it out a bit longer on 5.75 or go back to 7.5. If I go back how long would someone suggest I stay on this level and what dose should I follow next.

I just don't know what to do...,

1 like, 44 replies

44 Replies

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  • lorraine24104
    lorraine24104 andy46832

    Posted

    I had the same problem dropping below 7.5. I should have settled for that because I left it too long and ended up having to reinstate 30mg. Started slow taper again and any signs of a problem below 7.5 and I'm going to stop there. 

    Perhaps the answer is to stay on 7.5 for a decent length of time, maybe 6 months and then do the last minuscule taper. That's what I may aim for.

    I hope it helps to know that what you are experiencing is quite common.

     

    • andy46832
      andy46832 betsy0603

      Posted

      Have gone back on to 7.5 where I felt stable before but this time definitely do not feel stable. What would you suggest? I don't want to go too high as then that means taking longer to come off. However I also don't want to keep messing about with different dose levels. Any suggestions?
  • Guest
    Guest andy46832

    Posted

    I can relate to this.  I've reduced by 10% every 2 weeks from 15mg and have been feeling very low, anxious, upset tummy and extremely tired all the time, despite sleeping 8 or 9 hours a night.  I've now been on 11mg for 3 weeks and think I will continue on 11mg for a couple more weeks to see if things improve.  So frustrating, just want to come off mirt but it's going to be a looong process.
    • betsy0603
      betsy0603 Guest

      Posted

      I'm at about the same dose, orangedog, and I am having the same problem with feeling extremely sedated, low motivation and energy.  I don't feel anxious, but I think that is because I have done the 10% PER MONTH taper.  You have been doing 20% per month, which is a bit too much for your nervous system to keep up with.

      Going too fast is like breaking a bone and expecting to keep using it before it is healed.

      Mirt has a very strong histamine block which leads to sedation.  At higher doses, the serotonin gets blocked (it blocks up histamine receptors well before serotonin receptors begin to block).  Serotonin is activating while histamine is sedating.  As you drop to a point where serotonin activation is no longer opposing the histamine sedation, sedation takes over!

      Dropping too fast at this point can cause the additional problem of rebound insomnia.  The nervous system tries to adapt to counter the sedation, but when you remove the brake that Mirt provides, you are left with the accelerator (the oppositional modifications the nervous system has made) STUCK - Insomnia!!!!

      So tread carefully, folks - slow and steady wins the race!

    • Guest
      Guest betsy0603

      Posted

      Thanks for your reply.  Maybe I'll stick at 11mg for a few more weeks and see how that goes?
    • betsy0603
      betsy0603 Guest

      Posted

      Wise, just to get as stable as you can before proceeding.  I think with the tiredness, if everything else is ok (no anxiety or other physical upset) then we continue tapering through the tiredness.  Still important to let the system digest each cut for 3 to 4 weeks before the next one.
  • andy46832
    andy46832

    Posted

    Thanks guys for your comments. I think the hard thing for me is that I have never felt too good on it. Always spaced out. So don't know really what a stable state is. I probably should have never kept on it in the first place.
    • karin03989
      karin03989 andy46832

      Posted

      So am i. Maybe i can not tolerate any antidepressant, have tried many also ssri´s, they where the worsed of all.

      I don´t like messing with my head, it feels not good.

      I wish i had never taken them and was keeping it by benzo´s, they helped me more than this crap. I know benzo´s are also not good but better for me than this!!

  • karin03989
    karin03989 andy46832

    Posted

    I relate to this too. I have bin on 11.25 mg and this was so sedating, totally feeling drugged en very tired and weak muscles, i could only sit. I am not a person who is sitting the hole day, i was a very activ person.

    Now all that is gone.

    It´s trough, how lower you get how more tired you are and depressen maybe because of the tiredness.

    I have reinstated 15 mg of Mirt and will go on with that for a long time, then to 7.5 mg for a long time and then off.

    I can not bare the enormous tiredness between 15 and 7,50 mg.

    But that can i do next year, it´s now to soon.

    • Guest
      Guest karin03989

      Posted

      I'm thinking of going back to 15mg too but I really don't want too - would like to persevere with the reduction but the tiredness is really doing my head in!  Is it common that tiredness is greater on the smaller doses?
    • karin03989
      karin03989 Guest

      Posted

      I had the same as you, the tiredness did not wore off. The tiredness was greater at 11.25 then 7.5 mg but that is for everyone different.

      I also did not want to go back to 15 mg but is was unbeareble.

      Yes it´s common that the lower the dose the more tired or sedating it is for the most.

      That´s why i will try next year what i have written above.

      It is for many people a struggle come off Mirt.

    • karin03989
      karin03989

      Posted

      I also did not want to go back to 15 mg but is was unbeareble.

      Mistake: but most be because.

      Sorry i am from Holland and my English is not very wellsmile

    • betsy0603
      betsy0603 Guest

      Posted

      Yes, it is true.  I am feeling much more sedated at 11.8 mg than at higher doses.  Mirt is a funny drug in that it blocks a bunch of receptors, and it is dose dependent.  It likes histamine receptors the best and that leads to sedation, a "brake."  At higher doses it then blocks serotonin receptors, the "accelorator."  So, coming down, serotonin is freeing up so the brake is starting to outweigh the accelerator.

      The longer you are on this drug (and all ADs), the more the body pushes back against it's affects with oppositional compensation.  A drug that applies the brake causes oppositional compensations that amount to an accelerator.  So, remove too much brake and you are left with too much accelerator, which means anxiety and insomnia!  This is why we must side-step slowly down the mountain, taper slowly.  Go too fasts with mirt and you run into bad insomnia.  People can have horrible insomnia but feel sedated all day long.  Ugh.

      It is definitely worth doing the 10% taper at these low levels, guys, to try to keep all of this craziness under control.  Hopefully, understanding what is happening will help it all be more acceptable, because it won't be forever.

    • karin03989
      karin03989 betsy0603

      Posted

      Thanks Betsy for your explenation. You know more of it then me. It is trough what you are saying, hopes that Orangedog it will understand because i can hardly find the words in English from what i have to saysmile

      Mirt is an unique kind of an ad, it can have multiple functions to work very different from a ssri and more difficult to get off, i think.

      Betsy, thanks for your effort to explain.

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