Iv been on 30mg mirtazapine for 5 years

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Hi iv been on mirtazapine for 5+ years because a few years ago I was in a very dark place.

Now my mood seems a lot more stable then a few years ago, so I decided to cut down because I was getting anxious, the anxiety has subsided but it still comes back from time to time.

My head feels more clear but I get angry very easy I'm not sure if I should try to lower my dose any further because my mood is still a bit up and down a bit like before I was first put on mirtazapine.

To be honist I'm scared of coming off mirtazapine because I don't want to go back to that dark place and the terrible insomnia I had for years.

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  • Posted

    Hello daz94104, I am glad you found this place to ask these questions.  Calmer and I are in the process of tapering mirt and have lots to offer in support.

    It is ultimately not a good idea to continue on these meds indefinitely because they have a negative impact on the brain in the long term, so it is a good idea to get off eventually.  Do NOT cut again while you are having these effects; it means you are not stable, and further cuts will only disrupt things further and cause more suffering.  

    Some are able to come off without a problem, but many others are sensitive and simply can't do the big cuts that doctors tell you to do, 1/4 tablet at a time, for instance.  There are support communities for antidepressant and benzo withdrawal that advocate a 10% taper per month, only doing the next cut if you feel good/stable. One such forum is surviving antidepressants and if you do a web search for those words you will find the forum.  

    With mirt, a 10% taper necessitates getting a jeweler's scale which measures milligrams and weighing doses, but though a hassle, you can come off mirt with minimum withdrawal affects.  You can find such a scale on amazon for about $22.  Many are impatient and don't want to be bothered and think they can tough it out, but they end up suffering for doing so.  

    As for being afraid of being off the med and going to the dark place, a long slow taper would allow you to start doing some work to understand what the source of that depression is, via cognitive behavior therapy, meditation, mindfullness, and several other tools.  Because ultimately, there has to be a reason.  Very few people truly have an imbalance that the med is correcting; that is a hypothesis that has never born fruit in the scientific community, yet one that the mental health profession still pushes.

    You were on mirt for a long time, so coming off should be done slowly.  What dose were you on when you started cutting, and what size cut did you make?  Anger is a withdrawal symptom.

    We are here for you, and you are not alone!  Also recognize that the emotions you are feeling with the cut are not YOU but withdrawal, very common.  When you started taking the drug, an imbalance was created in the brain that caused your brain to adapt by up-regulating or down-regulating neuron receptors to restore "balance." Not that you are lowering the drug, another imbalance is created and until your neurons adjust again, you will have symptoms.  The bigger the cut, the bigger the adjustment that needs to be made and the stronger the symptoms.  So, slow and easy wins the race :-) Small cuts are easier for the brain to adjust to, fewer symptoms.

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  • Posted

    Hi Daz

    That anger could well be the Mirt' wether on it or withdrawing ... I get that sometimes too, I even wake up with it in the middle of the night sometimes ggrrr ... funnily enough, since cutting out a lot of the unhealthy carbs (chocolate/cale/bread) that Mirt' makes me crave I don't get the anger so much.

    Was insomnia your main problem for going on Mirt?  Me too ... a year I've been on Mirt' and tbh it's worked well for sleep, but it is time for me to try to wd so I'm doing a very slow taper.  

    You'll be perfectly fine if you do a slow taper, rule of thumb 10% every 3 or 4 weeks, do any faster and you'll get severe anxiety probably, it's not worth the risk.  It's not so easy to work out the drops but if you decide to I can help if youu like?

    Bear in mind that the lower doses are more sedating, i.e. 15mg is better for sleep - 30 & 45 mg doses being prescribed more for depression.

    I read an amazing book called "Say Goodnight To Depression" by Dr Greg Jacobs, it's well worth getting this under your belt if you have strong fears of insomnia, because fearing it can actually bring it on - crazy hey!

    Wishing you well Daz, keep posting, best wishes.

     

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    • Posted

      Hi thanx for replying to me. From reading your reply I think I might be cutting it down too big. I'm taking gr8 a tablet so I guess I'm now taking 15mg. The reason. I'm prescribed mirt is for depression due to a life changing accident then I lost a very close friend and became very depressed lost a lot of weight and wasn't sleeping well. After about a week the mirt started to work I was eating better and sleep wasn't an issue.

      I did try to just stop it all about a year ago but that was a bad idea my mood went crazy and I wasn't well mentally so I decided to take them again and I was fine. From doing the cutting down I can see that it's not going to be easy to come off this medication!

      Little cuts look like the best way because today I'm not feeling well and battling with your own mind is not easy. I'm glad if found this site for support.

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    • Posted

      Hi Daz

      Sorry to hear you have struggled so badly since losing your friend, I hope time has helped youu in some way.

      Let's see ... you are now taking 15 mg Mirt, is that right?  

      What dosage were you taking before you dropped down??  

      And when did you drop down??  

      It makes  a big difference, so lets work it out.

      I may take a while to get back to yo as I have to go out now, but I'll be happy to help, always happy to help.

      Wishing youu well

       

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    • Posted

      Hi 4 calmer, yes I struggled badly his death really knocked me for 6,.with time it has become easier.

      Yes that's correct I am now taking 15mg now, I am prescribed 30mg every night originally. 1 of the reasons why I decided I wanted to come off mirtazapine was because it was making me very groggy the next day and I do a physically demanding job and it wasn't doing me any favours.

      Now it's been about 1 week from when I started to cut down on my meds if got a more clear head and Had a productive week at work, but iv noticed that with the dark mornings I'm finding it harder to get out of bed in the morning.

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    • Posted

      Hi Daz

      You have dropped from 30mg to 15 mg which is a 50% drop, and so you may well get quite a lot of withdrawal, if not already then within 2 weeks - it tends to hit you between 7 - 14 days ... it's a shame you dropped so low, but I guess your doctor didn't advise.  How are you feeling now ????  

      Have a read of this 10% advice which is on this forum. Don't go any lower than the 15mg, stay right there, every night, as the full WD probably hasn't hit yet and if you go lower it will get worse?  The best thing is to wait for the WD to settle, the advice is 3 to 4 weeks between lowering the doses.  Let us know how youu are now.

      https://patient.info/forums/discuss/depression-resources-298570

      then scroll down to: " Reducing ADs using 10% withdrawal method"

      Wishing you well.

       

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    • Posted

      Hi calmer,

      I know it's a big drop and at first it wasn't easy my mood was a bit up and down, and anxiety was a bit of an issue. I tried drinking some valerian tea to help but it didn't help 1 bit like it usually calms me a little.

      In the past I tried to try just stop taking mirtazapine all together , and I was fine for like what you are describing around 2 weeks but then I guess I started to get withdrawal symptoms that I couldn't handle. So I started to take my meds again.

      At this 50% less dose I have noticed I'm not sleeping as well e.g. getting to sleep and staying asleep all night and I don't feel

      as well rested in the morning.

      Daz

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  • Posted

    My doctor tells me this, "if it aint broken do not fix it!" wink if the mitrazapine isnt causing you any issues,don't quit taking it. Its a safe drug and in your case it seems the good outweighs the bad by FAR! Keep doing what you're doing i would say!
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    • Posted

      Problem is the anxiety was coming back for daz. It is easier for doctors to tell you take these meds for life than deal with getting you off of them; doctors have very little understanding of how to get patients off and the drug manufactures offer little advice other than to say that coming off too fast can give you "discontinuation syndrome," but it is in their interest financially to keep you taking them.

      It is an individual choice and there's no right or wrong answer. 

      I made a cut of 10% last Sunday and yesterday I had a disaster occur that stressed me out, so for the first time since beginning my taper I had a bad night's sleep with lots of anxiety, and today I am feeling generally anxious.  I was never prone to generalized anxiety before medication, and though it was a long time ago I don't remember having insomnia issues before medication.

      When making these adjustments, our systems are more sensitive to stress and so we can have what's called "neuro-emotions."  That's what I am experiencing now.  The best we can do at these times is be kind to ourselves and know that this is not real, as I said before, but emotions caused by the small imbalance caused by the cut.  I probably would have made it through with little trouble if I hadn't had that disaster yesterday LOL!  So, I'm kicking back on the couch today :-)

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