I'm slowwwllyyyy coming off of Mirtazapine but am scared to death!

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My doctor originally put me on 15 mgs Mirtazapine to help with my sleep and anxiety. But now I'm sleeping too much and upon awakening in the AM (even after 8-10 hours of sleep), I am still so majorly fatigued and feel like a zombie. Plus, I've gained a lot of weight and want to eat all the time. So now I'm weaning off of Mirt and went down to about 7.5mgs a night. Even at that dosage, I am still having these side effects. Now, I'm literally shaving a tiny tiny piece of the tablet a week at a time until I'm completely off. This is my 2nd time trying to go lower than 3.75mgs. The 1st time I tried to go lower than that, my anxiety increased and I also was not sleeping very well.

Now there are other possible contributors to my anxiety and insomnia increase. I suffer from chronic pain which tenses my muscles up constantly. I feel like my body is in constant "fight or flight" response and just cant relax, no matter what I do. I also have mild sleep apnea, which may be a contributor, so between the chronic pain and sleep apnea, my sleep gets interrupted.

I am also on Fluoxetine, Buspirone, Lamotrigine, and Clonazepam, along with the Mirtazapine..

I would appreciate any feedback on my post and wonder if anyone has any safe and good tips on how to get off of Mirt without dealing with so many withdrawal effects.

Thanks!

Rachel

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  • Posted

    Hi Rachel - well done for getting down to 7.5mg! You've probably heard/read that at lower doses Mirt is more sedating, so not surprising you are still suffering from the tiredness. How long have you been on it in total? I also suffered with extreme tiredness that lasted for about 2-3 months but it has now thankfully totally disappeared. (I was also put on it for severe insomnia and related anxiety.). I've managed to slowly taper down to 8mg at the moment. Not sure where you're based, but have you considered buying the liquid form? It's expensive (about £60 a bottle) as you can't usually get it on the NHS, but it lasts a really long time and in my opinion it is sooooo worth the money because you can really accurately measure your doses for the purpose of tapering. I tried cutting pills and it gets impossible after a while. At some point it is going to get difficult to measure even with the syringe and liquid, but you can get right down to about 0.3mg with it. This way you can do a slower, more accurate taper and this will definitely help lessen the WD. One tip - if you do buy the liquid you'll need to buy a different syringe to the one included in the bottle which is a fat syringe provided for people taking a 15mg dose. Take the bottle to your local chemist and tell them you're slowly tapering and ask to buy a 1ml syringe that fits it. which will give you the ability to measure much more smaller, accurate doses. Remember also that you need to convert your dose: 15mg of pill = 1ml of liquid. Final tip - when switching to the liquid form, don't do a drop at the same time. Give it a week or 2 after switching to the liquid, as the switch can sometimes cause mild WD itself (the doctor will tell you it doesn't, but just my experience and better to be safe than sorry!). Good luck, let me know how you get on x

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    • Posted

      Thanks Gillian.

      I've been able to now get down to about 1.87 mg. I've introduced Amytriptaline which is an anti-depressant but is supposed to help with chronic pain/Fibromyalgia, which I may have. My psych Dr said I can continue to wean off Mirt and I shouldn't have w/d effects b/c I'm now taking the Amytriptaline.

      I'm thinking of stopping Mirt in a few days but also am thinking to cut it just one more time, which would be .0937 mgs. I don't think I can get the liquid here through my insurance here in the states.

      I'm not feeling as sedated and fatigued in the mornings now but when I do, it's usually if I pushed myself too hard the day before and my body gets a flare up.

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  • Posted

    I'm 2 weeks off the drug completely now as I was having the same problem - sleeping TOO much! I went from 45 to 30, then 30 to 15 (this was the hardest jump for me), then 15 to 7.5. Then like you just breaking off a tiny bit. Then I just stopped.

    My main issue was anxiety and low mood which caused insomnia. It worked wonders for that but feeling groggy all the time as well as just generally apathetic made me decide to come off it. Plus the fact that I barely recognised myself in pictures from a year ago from looking so bloated was another factor.

    For me, the bad news is that yes after a week or so off them I could already feel myself not sleeping as much. However, the good news is that even though I might not get as many hours, the quality of sleep is better (so far). On Mirt I could sleep a good solid 8-9 hours, but would wake up feeling like I had barely slept. I might only get half that, sometimes less, but I've learned not to stress about that as that contributes to me not sleeping.

    For me I think the fear of having to get up having barely slept and "how will I function" adds to my anxiety and it's a vicious cycle. So far the general anxiety hasn't come back, maybe I've just been lucky or maybe I've not been off it long enough, but the ups of feeling like myself again and already seeing a difference is my weight outweighs the insomnia.

    Best of luck with it, everyone's experience is different. But I can say being off it where I'm generally feeling the ups as well as the downs is something I focus on when I am getting the anxiety and insomnia.

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    • Posted

      Hi kh. Mirt made me feel the exact same way as you and I put on about 20 - 25 pounds.

      I'm hoping by weaning down very VERY slowly, I won't get withdrawal effects.

      I'm at 1.87 mgs soon to attempt to cut it again down to .937 mg. We'll see.

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  • Posted

    Hi Rachel

    before you do anything i strongly encourage you to join or just browse and take as much information as possible on survivingantidepressants.org

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  • Posted

    Hi Rachel. You are on a lot of meds that effect your brain which could be conflicting with each other causing you to feel unwell - so it's no surprise you don't feel good. Also taking Mirtazapine combined with a Benzo like Clonazepam would cause a lot of sedation.

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