How to come off mirtazapine safely

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Been on Mirtazapine for approx 4 months, currently 22.5mg. Also taking 40mg Seroxat. What's the best way to come off Mirtazapine? The side effects outweigh the benefits. The medical profession have just left me in limbo. They were quick to put me on to the Mirtazapine but have offered no help in coming off. The waiting list to see a physchiatrist is months. The duty doctor just told me to go from 30mg to 15mg & then come straight off them. My own doctor said that there's not much she can do other than help me with the insomnia by prescribing me a week's supply of 7.5mg Zopiclone but no more after because they're addictive. So i feel that i am well & truly in complete limbo at the moment. Due to the insomnia, they advised me to go back on 30mg but the side effects were too harsh. They then advised me to drop to 22.5mg but still the insomnia continues & side effects are harsh. I've been sleeping 4 hours per night roughly for the last 2 weeks, which is having a detrimental impact on my mental & physical health. I feel the sooner i can safely get off the awful drug the better. The longer i take it the worse the withdrawals will be. I do realise that some withdrawals are inevitable but i obviously would like to limit the severity & duration. Any help would be appreciated.

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  • Edited

    Mirtazapine is a horrible drug to get off. I have been on a year but only 7.5mg and the past couple of weeks mirtazapine has given me hell I think it has stopped working! Some I'm going cold turkey starting from today, I've had enough off this horrible drug! If I was on 22 mg like you I would wean off it 1st to a lower dose for 2 weeks then another lower dose after that....good luck 😊

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    • Posted

      I've only been on approx 4 months now. Started on 15mg then 30mg. I was told drop it to 15mg but after a week i wasn't coping to well with the withdrawals, insomnia being the worst of these. Put back on 30mg but couldn't stand it so went down to 22.5mg for the last few days & not tolerating this much either. Tempted to drop down to 15mg but not sure that's a good idea. But really don't want to prolong this suffering any longer. Haven't got any 15mg tablets, i split a 30mg in half so not sure how i'll drop it to 7.5mg other than using a tablet cutter. The doctor doesn't want to know, the local mental health team having basically washed there hands. So i am currently under the crisis team short term, who occasionally contact there consultant for advice. I have no clear plan or direction on where to go from here. Completely frustrated & confused on what to do for the best.

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    • Edited

      hi there,

      i realise this is quite an old post.

      im reading reviews and your post is pretty much how my situation has been woth this horrible drug.

      i would love to hear from you and how or if you did came off them.

      im getting pretty desperate and any comments from you would be much appreciated

      many thanks in advance and hope you doing well.

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    • Edited

      HI THERE,

      i am on a different dosage of the MITRAZAPINE 45 going to 30 mg as I am finding 45 too strong. i am in the u.k and find very little help from the doctors all i would say is just reduce the dose as slowly as you can with a pill cutter. i have got 30 mg tablets and 15mg so cut the 15 mg in half and half again. you have to be kind to yourself and minimise the side effects as much as possible and drink lots of water. Take it easy.

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    • Edited

      I totally agree....the gps etc have not got any idea what to advise which is right. yes I'm on 15mg a year. put on too much weight and constant hunger. Dont touch Zopiclone etc. been on them 2 yes and GPs just kept prescribing. I'm also stuck as bern on benzo 3yrs. now trying to reduce. no sleep now despite combo. my friend took 3 to 4 months coming off mirtaz every other day a week or so then every 2nd then 3rd then stopped. but she is on Trazadone so sleeps still but now ifvwakes takes 10mg melatonin.

      I have a psych and she has cut me too quick on benzos. told me not to go on forums but sod that...more help and info from others same boat and issues than shes ever given me. they put you on but no idea how to help us off

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  • Edited

    Hi Tim

    It is advisable to taper no more than 10% per month, or 5% every 2 weeks. Or listen to your body - if WD symptoms are present wait a little longer before you reduce your dosage.  Under no circumstances just stop taking them.  The doctors suggestion of just stopping on 15mg is ill informed.  I know because like you I had no help from the medical profession.  They have no idea or refuse to admit that mirtazapine presents with serious withdrawal if tapered too quickly or just stopped cold turkey.  In fact they don't like to use the word withdrawal for antidepressants, preferring the word discontinuation syndrome!!!!!!!

    I was on mirtazapine for less than 6 months.  I was taking 15mg.  I just stopped cold turkey on 31 May this year.  They did not work for me.  I went to weeks my gp for help with withdrawal, mainly horrific and crippling insomnia and was was basically just left to get on with it.  I went many  weeks with either 2-3 hours sleep a night or in several instances no sleep at all for the entire night.  Whilst the medical profession are not eager to provide a patient with sleeping tablets to address the crippling insomnia,they will readily supply other equally horrendous antidepressants to ease insomnia.  Their argument is sleeping tablets are addictive.  So are antidepressants like mirtazapine if you need a stronger dose to cope, or can't come off them for fear of severe and protracted withdrawal.

    So now that I've had my mini rant I wanted to let you know that if you are prepared to conduct a very slow taper as suggested above you can reduce your withdrawals and successfully be free from mirtazapine but it is long process.  It has taken me 4 months.  I take magnesium supplements at night and probiotics.  I try to take a walk every day and as a back up (my security blanket) I have a supply of sleeping tablets which btw I have not taken now for over two weeks.  Buy a good quality pill cutter.  This will help with the tapering.  I believe you can also get mirtazapine in liquid form which would improve the accuracy of tapering but I don't know whether that option is available easily on NHS.  I also saw a counsellor and I have had a little advice from (of all places) a decent vitamins and health food shop.

    Anyway to summarise, I am now medication free, no mirtazapine and finally no Zopiclone.  I know we are all different and these drugs affect us all differently but I just wanted you to know that it can be done.  I was abandoned by the doctors so I completely understand where you are coming from and I want you to know that you are not alone.

     

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    • Posted

      Hi Christine,

      Thank you for the information. I dropped from 30mg to 15mg the main problem i really had was insomnia. There solution was to increase the dose back to 30mg. After 2 days i decided it wasn't a good idea. Then i suggested 22.5mg, been on this for 3 days. The insomnia is not improved whatsoever. So i thinking of dropping back down to 15mg & staying there for a couple of weeks & then drop down to 7.5mg for a couple more weeks & then stop because i'm not sure i could go lower with a pill cutter. I don't think they will agree on liquid because of ignorance they don't see withdrawal from mirtazapine as an issue, believing it to be one of the easier ones to come off.

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    • Edited

      Hi have been on mirtazapine 30 mgs for over 10yrs and zoplicone 7 i requested a drop in zoplicone to 3.75mgs as i was taking morphine for a fractured arm and i couldn't function thought i was doing well so reduced my mirtazapine myself to 15mgs

      I now have most horrible dizziness and light head and severe nightmares am tempted to go back to to 30mgs can't function with this!

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    • Edited

      Hi Julie i was on 15mg of mirtazapine for about 6 months i was in a daze all day. so i cut down to half a tablet a night every other day, then to half a tablet a night, but had to take diazapram as i was shaking all day and so anxious , i am now back to half a tablet as i refuse to take the full one, i am still not clear headed and very nervous all day. i detest taking them but i cant function without them YET . i hope you find a way of cutting down. good luck.

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    • Edited

      i had to go back to 30mg as my symtoms were dreadful! i am still not well have had vertigo this 2 wks as well as all the other withdrawal effects dreadful drug this is my 2nd attempt tried last year am going to leave it to new year and the taper by slivers of it every month thank you and good luck to you👍👍

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    • Posted

      Sheila I'm in the same situation how long did it take for each stage of your taper and how long total? I'm having horrendous and painful side effects have to taper myself before I can't function. It's for sleep so I know insomnia will be a significant issue but can't stay on this. Hope you're feeling better, thanks.

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    • Edited

      New to this forum can't figure out how to remove a comment I made or if I get notifications if there's a response. Any Admin sees this please email me if I don't respond to comment or your response on here, thanks.

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  • Edited

    Hi again Tim

    If insomnia is your main issue (and I completely get it) you could try a little experiment.  I have read that the 15mg dose of mirt is the best for dealing with insomnia and not at the higher doses.  If you have a 30mg tablet try cutting that in half and taking that about half an hour before you go to bed.  

     

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    • Edited

      Hi Christine,

      Yes, when i was taking 15mg i had no problems falling asleep but woke up in the middle of the night & couldn't get back to sleep. Now on 22.5mg it takes me longer to fall asleep but still waking up in the middle of the night

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    • Posted

      This is currently happening to me. It's pretty horrendous. Take anything you can for sleep like magnesium tablets. Calcium tablets too. Valerian and tulsi are meant to help. Unfortunately there's nothing much else you can. There are BZs like valium but that's even more addictive and you'd struggle to get doctor to prescribe it! I'd mention it though.

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    • Edited

      Hi Christine,

      I was told the same by an Insomniac consultant in the only insomniac nhs hospital in the uk in London. That Mirtrazapine is at its most affective dose for insomnia (Not as an anti-depressant) at its lowest dose 15mg even half that at 7.5mg . I was told the same from my Neuropsychioyrist. I was on the highest dose of 45mg for over 8 years . split dose of 15mg in the morning and 30mg at night. I was put on this dose by a Psychiotrist who obviously knew no better.

      So ive managed to go from 45mg to 30mg at night, I did it over 1 day without much side effects and have stayed at that dose for several months. last night after weeks of awful sleep , I decided to lower to 15mg , its only been the 1 night so far but i slept a bit better. I have a fuzzy head headache & have physical anxiety, so im thinking to help reduce any aide effects , I should probally reduce them slowly. so tonight , I might try 15mg plus half of a 15mg so 22.5 mg

      and do that for a few weeks then reduce to 15mg. This is something anyone who takes Mirtrazapine for insomnia is worth considering. google it to research about this. I will try to update you all (anyone that are interested) to see how I get on!

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