Help getting off Mirtazapine

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Hi all, Im trying to withdraw from Mirtazapine and eventually go onto a tricyclic antidepressant (probably anafranil). Have managed to get down from 45 to 30 in 2 months, the weird thing is that even though i stay on the same amount i get sicker and sicker, i think it has to do with the fact that i have upped and downed it a few times as it has a very strong reaction when the dose changes... so am waiting another 10 days to see a psychiatrist through skype and hopefully she can point me in the right directions...i suffer mainly from anxiety, also OCD and depression and take a few other medications for it, plus i have had serotonin syndrome so need to be careful and have been mucked around by doctors and psychiatrists who dont know what they are doing... any advice welcome, main symptoms are migraines that last for hours, constant shivering, vertigo, dizziness etc.. guess i will be okay once i stabalize on a new anti depressant, didnt want to write too much...anyway, if you have come off or are coming off mirtazapine then anything you can share with me would be invaluable... thanks for reading

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  • Posted

    Hi, is there any reason you are more particular to a TCA? People respond very differently to antidepressants so you do need to find the right one for you, however TCA's are associated with more interactions and side effects and the risk of toxicity in overdose is higher. All antidepressants can cause serotonin syndrome too

    You should definately have a proper consultation with your psyhiatrist. The symptoms you are experiencing - headaches, dizziness, vertigo are known withdrawal effects of the mirtazapine. Sometimes your doctor can prescribe you medicines to help you with your withdrawal symptoms. Counselling and therapy are very effective when used with antidepressants even in major depression so I would try to go to some counselling sessions if possible.

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  • Posted

    Hi,rochan, I've been coming off 45mg aswell. Right now I'm down to 12.5 it's been a very slow journey .But you do have to take it slow.  The best advise I can give you is Google the CITA PROTACOL,they deal with withdrawal of lots of drugs,you can also email or phone them if your suffering any problems and they give you a quick response.  Just remember all our bodies are different and we all react differently.              But they are the best.  Take care 
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  • Posted

    Hi, I haven't tapered off Mirtazapine but I have discontinued use of a benzodyazapine last year. I found that Benzo Buddies (UK) was extremely helpful in helping me titrate off the medication. If you are interested just enter those keywords. Although most people are trying to come off a benzodyazapine there was information on antidepressants as well.

    I think that Norma is correct in saying  that you have to take it slow and each of us is different. It took me a year to titrate off Clonzapam at the right rate for me. Charts are helpful but as Norma said everyone is different and what works for one of us might not work for another. The best of luck to you.

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  • Posted

    Thanks for the advice guys, yeah i want to try a tri cyclic AD because SSRI and SNRI have failed me. Im prepared to put up with the side effects if it helps. Hopefully next week i will see a psychiatrist and get some good advice. Will check out CITA as i see it is mentioned numerous times here.
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  • Posted

    I was on this for a year heres how i did it.

    3 weeks 1½ per day - 22.5 mg

    4 weeks 1 per day

    3 weeks ½ per day

    first 3 weeks       2 1½ 2 1½ 2 1½ 2,  1½ 2 1½ 2 1½ 2 1½,  2 1½ 1½ 2 1½ 1½ 1½

    next four weeks  1½ 1 1½ 1 1½ 1 1½,  1 1½ 1 1½ 1 1½ 1,  1 1½ 1 1½ 1 1½ 1,  1½ 1 1 1½ 1 1 1

    next 3 weeks  1 ½ 1 ½ 1 ½ 1,  ½ 1 ½ 1 ½ 1 ½,  1 ½ ½ 1 ½ ½ ½

     last 2 weeks  ½ 0 ½ 0 ½ 0 ½,  0 ½ 0 ½ 0 ½ 0

    you say your on other medications, i hope its not any benzodiazapenes, these make anxiety worse. i had an awful time coming off lorazepam for two weeks and was only on 1 mg a day.

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    • Posted

      Yeah unfortunately i'm on valium among other things. your plan looks well structured. what kind of withdrawals (if any) did you experience when coming of mirtazapine?
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  • Posted

    hi rochan, no i didnt really have any side effects coming off so slowly, mirtazapine has about a 30 hour half life so 4-5 weeks per 15 mg should be time for it to get out of your system and your brain chemistry adjust. i wasnt sleeping well and have actually found that sleep better now im off it, i think it becomes ineffective and you just get used to it.

    was it the 45 mg of mirtazapine that caused the serotonin syndrome, or ssri.

    coming off valium (diazepam) is not too bad if done over a similar period., depending on the dose your on as it has a very long half life so you dont get the rebound as with shorter acting benzos like lorazepam or temazepam. valium is actually used sometimes to get people off other benzos for this reason, as one of the other commentors above about benzbuddies,  just g**gle benzodiazapine withdrawel and youll get lots of advice. aim to get yourself to where your only taking a small dose occasionally on a bad day, its much easier like that

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  • Posted

    i would add that it all depends on how long youve been taking benzos as to the effect they have, but i would bet thats what making you feel ill. also if you do want to cut down the valium i would suggest 2-6 weeks per 10 mg depending on how you feel, you have to find a pace that is comfortable. i was able to come off 1- 1½ mg lorapam in two weeks but was only only on it on and off for about 4 month, allthough with loraz being a stronger benzo it wasnt pleasant with all the usual symptoms.
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    • Posted

      la12, thanks again for your advice and comments, it was a combination of being in mirtazapine and prozac that gave me the serotonin syndrome, so one of them had to go, unfortunately i should have stayed on the prozac as i have to get off the mirtazapine... i was offered lorazepam by one doctor as it is stronger but resisted the temptation to take it, ive proven in the right circumstances in can slowly reduce my valium, the isue is getting off the mirtazapine an d starting a NEW AD, i took aropax successfully for 13 years so might ask to go back on that
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