How to come off Mirtazapine?

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Hi everyone,

I've been on mirtazapine for 8 weeks at 30 mg. It partially worked so my doc added Effexor and that has worked beautifully but now it's time to taper off the mirtazapine. From what I've read it's a horrible drug to come off of! Just interested in everyone's experience with this. Will it help that I'm on Effexor too? Is 8 weeks a long or short time to be on it as far as predicting how bad the withdrawals will be?thanks for any advice

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  • Posted

    Most people stay on mirt for at least 6 months and so 8 weeks is a shoort time to be in it. However, it is a very powerful drug and it may still be difficult for you to come off. In view of the short time you've been on it, I would probably try to reduce it more quickly than I would advise if you'd been on it longer because dragging it out obviously increases the time your body has had to adjust to it. I would reduce your dose to 15mg for a week then to 7.5mg for another week and then off it. If you start to suffer bad withdrawals (they usually hit at around day 4 after a cut) then you may need to reduce it more slowly. Good luck.

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    • Posted

      Evergreen-

      Thank you for your reply. It makes slot of sense. I see my doctor today so will talk about going off it.

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  • Posted

    8 weeks is enough for your brain to adapt. Is effexor added to do a crossover? Docs will usually cut dosage of first AD and balance it out with mgs of new AD until you are no longer on old AD and are at ideal dose of new AD. you may need to go through some transition symptoms during this time, getting used to new one while eliminating old one. Some people can breeze through it though and you might be lucky enough to not notice anything. I'm on both 3.75 mg mirtazapine (3 mo) and effexor (6 yr) and have been tapering mirtz slowly for the past 1.5 months (now down to 1.25 mg. My situation is different which is why the slow taper. So far so good

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    • Posted

      Thanks Cheryl,

      The Mirtazapine was not fully working so doc added the Effexor. Was feeling great besides the side effects from the Mirtazapine. For the past 5 days have tried to taper -went from 30 mg to 26.25mg and even that small reduction made me feel bad after a few day restless sleep, anxiety. I'm still early in my recovery from depression so don't want to push too hard by trying to come off Mirtazapine too quickly.

      How did you taper & from which dose if you don't mind my asking?

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    • Posted

      Hi Elisa,

      I started with 3.75 MG at the begrinning of September to aid in getting off of clonazepam quickly. 5 weeks after I started tapering and dId the following reductions and time span: 3.0 MG (2 weeks), 2.75 MG (1.5 weeks), 2.5 MG (2 weeks), 2.25 (1.5 weeks), 1.75 (3 weeks), 1.5 (2 weeks), 1.25 (current). I may be off give or take a few days but you get the general idea. I used a jewelry scale to weigh and did some math to figure out the weight of 0.25 mgs.

      The restless sleep and anxiety you may be feeling is having effexor added as a combination and not necessarily the reduction of the mirtz as you have only been on it short. It may be that one of the meds might be too high. What dose of effexor are you on?

      Figuring out the right dosage between the two is something only time will tell and everyone is different. Reduce/increase only one AD at a time otherwise it will be hard to tell which med is causing symptoms.

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  • Posted

    I should probably ask how long was it before effexor was added?
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    • Posted

      I was on 30 mg of Mirtazapine for two weeks before Effexor was added. Did one week at 75mg then up to 150mg of the Effexor. I'm going into my 6th week of 150 Effexor so am pretty much done with Effexor side effects. Maybe I just need to taper it slower. As far as I know 15 mg is the smallest dose Mirtazapine comes in. Is that what you able to break down into .25mg?

      Thanks for your help!

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    • Posted

      I see. Sometimes there are delayed reactions. As long as it doesn't persist just ride out the past few days and monitor.

      Yes I've been breaking it down from 15 MG.

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