Mirtazapine

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If anyone can help me to taper, I would really appreciate it. I was put on 15 mg over two weeks ago , then on 30 mg  two weeks ago. I am 5ft weight 103 and 67 years. I really hate this med, I am happy it works for others though. It does not help me sleep, have to supplement it with temazepam, it's not helped my appetite which was supposed to do, gives me diarrhea, headache, night . sweats,then I am chilled to the bone from inside out during the day. I live in Florida, my husband has a/c on and I am wrapped in a blanket. He is a good soul even offers to turn down. A/C, but then he will be too hot. I had been on Effexor 37.5 for 18 years, no problem, also on Klonopin and Temazepam. I fell on bathroom floor, was given Percocet, that's when the problems began, weight loss due to not eating, so my doctor gave me Mirtazapine To kick start my appetite, now I want of this drug. Any info would be of great help. Thank you

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8 Replies

  • Posted

    Hi Jaybee

    Not sure what happened above - did you copy & paste stuff from a while ago?  Might be better to start again with a repost as it may confuse folk.  But here is my reply:

    If you have only been on Mirt for 2 weeks there shouldn't be much difficulty withdrawing - personally I would do this over several weeks tho' take 15 & 7.5 alternative nights for a week, then 7.5 for a week, then 7.5/3.75 for a week, then 3.75 for a week, then 3.75 every other night if you feel ok, 3.75 twice a week, then 3.75 once a week then stop ... I know its drawn out, but better to be safe than sorry.

    Hope this may help a little x

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    • Posted

      Hi Calmer

      No I did not copy and paste, I only joined yesterday. I have taken note of how to come off Mirtazapine, sounds like a good way for me, thak you so much for taking the time to do this.

      x

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  • Posted

    Hi Jaybee

    Calmer has covered most of the material the I would, it's good advice. First you have only be on Mirtazapine for a month, so it shouldn't be a tough go to tirate off the drug. I think Calmer's suggest for cuts is good, if you ne ed to go slower decrease by 10% every week or two. You are the one in your body so you will have to decide what is best. 

    A good pharmasist can make a titration better if you have further questions.

    Take care and the best of luck.

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  • Posted

    I would add to the excellent advice given that if at any point in your cuts you find yourself having extreme reactions, go back to the previous dose and stay there until you feel stable for a week or so.  

    If you are in the UK, I believe you are able to get a script for a liquid version of mirt that can be dosed smaller by syringe than breaking up pills.  Some people are just that sensitive that they need to do the 10% cuts less frequently, or even 5%. It's about what you are comfortable with.  One person can be cavallier about certain side effects while the same ones may be intolerable to another person!  Good luck!

    You are on a cocktail that complicates your side effect issues. It is not clear to me if you are still on Percoset.  Did the appetite dimminish when you started taking the Percoset, or did you go off and then the appetite went? It seems that your doctor may have been chasing side effects of one drug with another, when in reality perhaps going off of the offending drug might be prudent.  However, if you ever decide that it is time to go off any of these drugs, you MUST do a slow taper and only one at a time!

    Do you mind sharing your time line of when you went on each med?  I, too, have been on Effexor for many years, other ADs prior to that, and am in the process of tapering off Effexor and mirtazapine. 

     

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    • Posted

      I was on Effexor since 1998 only 37.5 I was okay on that, twice my doctor tried to up the dose to 75 mg which did not work for me. I had a fall in October 2015 and was given Percocet for pain, that was when I stopped eating, it was the Percocet. Stopped that and Dr gave me Mirtazapine to kick start my appetite. I was to stop Effexor, take one every alternate day for one week and then go on Mirtazapine, I was fine doing it that way. I must admit that the days I didnt have Effexxor when I moved my head it would take ages for eyes to catch up and felt dizzy, as though I had been spinning around really fast and then stopped. I have read that people take a few capsules each week out of the pill and have tapered off that way. 

      As for my other meds, Klonopin I have been on one year and take as needed, Temazepam 30 mg I have been on three years, I don't want to stop them, I need those. I don't need the AD, in fact I feel as if I should not have been given them, my brother died and I should have grieved normally, just my opinion.

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    • Posted

      I would agree with you, Jaybee.  You have been on Effexor a long time, even if the lower dose.  I read a study where at that dose your serotonin receptors are still at 80% occupancy (it blocks the receptors so there's more serotonin in the gap...), so dropping below that dose does cause withdrawal effects, and the dizziness etc. that you described would definitely be WD.  Also, Effexor has a short half life, something like 15 hours, so doing the every-other day taper method does NOT work!  The longer one is on an AD, the longer it takes to get off.  I've been on it for 12 years.

      I tried to go off too fast last year and ended up with protracted withdrawal for 10 months, didn't realize it was withdrawal because it came on slowly and built to a horrid level of anxiety, depression and insomnia.  

      It is also possible you were having tolerance withdrawal with Effexor, affecting your sleep.  I was having really restless nights prior to going off.

      So, the long and short of it is that you probably SHOULD come off of Effexor, but need to do so slowly and carefully.  The psych drug withdrawal authorities recommend a 10% cut of the previous dose per 3-4 weeks.  If yours is the type with the beads, count how many beads are in each of about four capsules, and take the average.  Then remove 10% of that number from the capsule, and do that for a few weeks. Keep a journal of how you are feeling.  At 10% you should have minimal withdrawal symptoms that are tolerable.  Do not cut while having symptoms!  You need to feel stable before making the next cut.  Each month, cut 10% from the previous month's dose.  

      I have written up a post for people wanting to go off their psych meds:  https://patient.info/forums/discuss/withdrawing-from-antidepressants-and-benzos-safely-485891?page=0#1809368

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