Mirt Withdrawal Insomnia - Ideas?

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I've been on mirtazapine (remeron) for 3 weeks. I was prescribed it after an intense reaction to a couple SSRIs that left my not sleeping and with frayed nerves. I started the Mirt at 15 mg, but as it was way too sedating, I cut down to 7.5 after the first week. I've decided to come off it as it doesn't seem to be doing much, and I don't like the side effects:

-daytime sedation

-dry eyes

-constant thirst

-GI upset

-headaches

The last two days, I've taken only crumbs of the pill - maybe 4 mg, and my sleep has been rough.

Last night I tried melatonin as well, and was able to fall asleep, but still woke in the middle of the night unable to fall back asleep (without the help of .75 mg of lorazepam).

Any tips for surviving the insomnia? I was a GREAT sleeper before i tried any psych meds, and i'm leary of relying on lorazepam as a bridge to sleep.

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6 Replies

  • Posted

    Hello,

    Sorry to hear your having a rough time.  Just a suggestion, don't take the Lorazepam and have an alcoholic drink instead?, lie in bed sipping it.

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  • Posted

    You do not say why you took the SSRIs.  I will assume anxiety.

    So you were on 15mg for for 1 week, then 7.5mg for about about 12 days, then 4mg for 2 days.    

    How did you sleep on the 7.5mg?   If it was okay you could go back on that. 

    It depends on your priorities.  12 days was not long to try that dose.  The side effects might have reduced.  

    I have been on various doses of mirt and did not get most of the problems you have had.    I put up with some side effects because the alternatives are probably worse or my GP would not prescribe them.  Also I take an SSRI with the mirt.   That may counter the daytime sedation.   

        

         

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    • Posted

      Yes, you're correct, i took it for anxiety. A few life stressors converged and made me especially anxious. The life events are over, and i've had a rough time with the side-effects that seem to be causing me more anxiety then anything.

      I really want to be off all medication. An SSRI isn't an option to combat the sedation as they gave me extreme akathisia.

      I slept ok on 7.5, some days better than others, but I'd rather come off now while i haven't been on it that long, then try and come off it later. I just don't know how to get over the insomnia hump.

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    • Posted

      I hope you are right in assuming it is a hump.  Assuming it is, what is wrong with taking a sleeping tablet temporarily?   I took zopiclone until I started the mirt.   
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    • Posted

      I'm hoping it's a hump since I'd never had any sleep issues before starting the SSRIs and subsequently using Mirt.

      I guess I'm wary of replacing one habit forming drug for another. I also don't think i'd be able ot get a script for the zopiclone.

      I take it you're still on the mirt and haven't tried coming off it?

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    • Posted

      Presumably you were not ill before taking SSRIs.  For it to be a hump you are assuming you are now "cured".   I hope that is true.

      I dont think zopiclone is habit forming - I think it loses its effect after a while.  I still do not see why you are wary - as you would only be taking it for a short time.

      I contracted generalised anxiety overnight in March 2015.   

      The first GP I saw put me on citalopram and did not care that I could not sleep so I changed GP (at the same surgery).  The new GP is far better.   She gave me zopiclone for sleep and diazepam for anxiety attacks (which I hardly needed).  However I was really depressed every morning.   The GP suggested mirtazapine which I initally rejected because of the side effects I had read about, however I later researched these drugs more and came across "rocket fuel" which is an SSRI or SSNRI plus mirt.  I mentioned it to the GP and to my surprise she said okay. (I was surprised because GP guidlines preclude augmentation until several  monotherapies have been tried).   So I changed SSRI to Sertraline and started on the mirt.   I only take the mirt to counter the insomnia probably caused by the SSRI.    The mirt was miraculous.  I think I had built up a huge sleep debt, and mirt got rid of that immediately.  I am 90% well on the combination, and I suppose I would be much worse off if I came off it, so have no intention of doing that. 

      The main difficulty with the mirt is that it wants me to sleep for about 12 hours so I take it at 9pm so that I can get up at 8:30am.  (I am retired). 

      I am gradually reducing the dose (down from 15mg) to see if I can improve on that.  

           

                

                    

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