Mirtazapine (Remeron) Withdrawal - Mega Insomnia! My journey so far...

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Hi everyone,

There are already so many discussions on Patient.info about Mirtazapine withdrawal and a lot of good information but I felt like I needed to get my own discussion going to help myself on the journey and help others.

I've been on Mirtazapine for just over two years but I am wanting to get off it due to not wanting to be on any psychiatric drug at all. I know they help some people and a lot of people stay on them longer but I feel that the longer you are on them, the harder the withdrawal journey can be if you are susceptible to it.

I've tried three times to withdraw from Mirtazapine:

1. Summer 2017 - I went from 30mg to 15mg but within a week I just didn't feel right and people would mention it in work, "are you ok, you look pale". I just felt like the flu was coming, a heaviness was gaining ground. So I went back up to 30mg and the next day all them symptoms were gone.

2. Winter 2017 - probably not best time of year to withdraw, the dark evenings sure at to any negative feelings. I went from 30mg to 22.5mg (held for two weeks) and then dropped down to 15mg during a week off work. About 4-5 days later I began to feel a heaviness in my chest, the next day the feeling was more pronounced. I said to myself, "i'm going to go back up to 30mg tonight and see what happenes". 

The next day, the heaviness was GONE completely BUT something happened to me that had never happened to me before, I woke up before my alarm. I remember looking at the time and thinking 'that is odd, I always sleep right through to my alarm'. The following night is when it all kicked off. I went to bed around 10:30pm, taking 15mg, adamant to continue with my taper. Two hours went by and I was not sleeping. So I caved in and took the other 15mg, but....three hours went by and I was still wide awake. I started to panic and get heart palpitations, which become more and more pronounced until I was up and pacing the house. The following week became the toughest week of my life, going three days without sleep at one point, despite being given various sleeping tablets.

January 2018  - looking back, I probably should have gone back on 30mg and stayed on that dose until this day. That would have been 6-8 weeks ago but when you have insomnia, you first begin by trying to figure out 'why' and then 'how'. During the toughest times, you make the rashes decisions (big dose reductions).

So I had planned to go much slower, I went from 30mg to 26.25mg for a week and then down to 22.5mg, which went OK until about 4-5 days later again, Insomnia was back. 

I guess one way of looking at it is, I went from 30mg to 22.5mg within three weeks, which is a 25% drop, which is actually a big drop when it comes to the brain and body having to re-adjust without the chemical it has been fed for so long! I do ask myself though, how the hell did I even manage to get all the way down to 15mg before getting symptoms but in reality, that was over about 3-4 weeks, it was just a 50% reduction, hence a bigger reaction!

I look back at my use of Mirtazapine and I had been on 45mg at one point, not long though and I was on 15mg for a fair few months but spent 80% of my treatment time (2 years) on 30mg.

It's crazy how much you doubt yourself at first though, my GP's first response was to immediately up the dose to 45mg. Which I stuck to, for about 2 days, before panic and a failure to improve my symptoms lead me to asking myself whether the medication had 'pooped out' - I will be honest with you, I still regularly ask myself that but have to remined myself. 30mg worked well until I tried to get of it, by that though I mean I was sleeping fine (no insomnia) but felt well enough mentally to want to come off the meds. The sleep benefits in reality was the only reason I stayed on for so long.

So here I am, currently suffering with an inability to get to sleep and maintain sleep. The getting to sleep is driven by some bizarre adrenaline surges that start as soon as a sleep start begins (as I drift off), it feels as if I stop breathing momentarily (completely natural) but my body reacts in fear (adrenaline) and my heart begins to race. But this is NON-STOP, literally every time I try go to sleep and apparently this is exacerbated by sleep deprivation, so one big vicious cycle that takes some fixing - I've done it once, I WILL DO IT AGAIN!

I've upped my dose again and my plan is to go MUCH MUCH SLOWER and take it MONTH BY MONTH. I think that Mirtazapine is clearly having a massive impact on the receptors responsible for sleep, as well possibly impacting adrenaline/cortisol. So when removed, the body cannot cope by itself (at least not yet).

I haven't experienced any other symptoms at the moment, which is not like the first times, right now it's just insomnia. Hence why I often doubt myself.

So I plan to first, hold on a regular dose (30mg) and see if my sleep improves over the next month. Is anyone else going through Mirtazapine withdrawal now? Or have you been there and conquered it? Let me know, more people to chime in the better.

Wish you all the best of luck! And thanks for any help smile 

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12 Replies

  • Posted

    I stopped mirtazapine 10 days ago. I was on 30mg for a year and was told to reduce to 15mg for 7 days then STOP! I then started Fluoxetine.

    Well I’m having an absolute nightmare. I take Zopiclone 7.5mg which gets me to sleep but then I wake at 3am and can’t get back to sleep. It has made my anxiety worse to the extent I’m not functioning anymore and am very needy and cry all the time.

    I also have bad nausea as well, not sure if it’s Fluoxetine or Mirtazipine!

    I want to know WHO HAS stopped taking this and has got through it???????

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    • Posted

      The nausea sounds like Mirtazapine withdrawal to me, from what I've read about it. Seems that insomnia, nausea, itching, increased anxiety and other flu-like symptoms are most common reported.

      I've seen that some people use antiemetics to keep the nausea at bay, and some people have found low dose of antihistamines like Promethazine.

      I see so many people withdraw as quick as you and suddenly get symptoms you describe. I was told by the doctor 'we can get you of this in four weeks' 30mg>15mg>stop....I find it amazing that this is the advice we are given. It certainly never worked for me and I went slower.

      I would think you either brave it out, or take a small dose like 7.5mg and see if that removes your symptoms. If it does, you need to reduce from 7.5mg (or whatever dose i.e. 15mg) much slower.

      I would like to see what others have to say on our plight.

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    • Posted

      I know, people have just said I reduced too quick. I only did what the psychiatrist told me to do. It’s ruining my life! I’m not exaggerating.

      I have Bipolar 2 and also take lithium x

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    • Posted

      I am exactly the same, it is ruining my life too. I'm going back onto 30mg a night to see if things stable over the next week or so. I am then planning on getting of it really really slow.

      With your sleep, do you think you could manage without the zopiclone? I had to rely on that when I first attempted to get off it. I've realised I need to take it slow but you have been changed meds, so it's a tough one.

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  • Posted

    Hey Johnnyboy,

    I was on 15 mg of Mirtazapine for a year. I tried twice to get off with no success.  3 weeks ago I did a fast taper. 2 days at 7.5 then 2 days of 3.2 then stopped completely. It’s not as bad as I thought. The sleep isn’t as good but I get 6 hours. Have to try and keep busy and get physical some how. You can do it. 

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    • Posted

      Well done! 3 weeks ago is a good sign for you, most people seem to show extremely bad signs between 1-3 weeks. Keeping busy is definitely a good thing, time is the only healer and we can's stop time smile

      Keep us updated on how you get on, give us the thumbs up if you are all good after the 4 week mark. If all goes well for you, it will give a lot of people hope.

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  • Posted

    You were withdrawing way to fast Johnny. No wander you were going through all that. 2-5% reduction every 2-4 weeks. That is what the tapering recommendation is.
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    • Posted

      Perfect. It's good to be able to link the two finally. It's crazy but there is always a time for most of us where we just didn't know what we do now. I am very sensitive to reductions on Mirt, so my reductions are going to be exactly like you recommend.

      Are you going through an AD withdrawal at the minute Neil?

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    • Posted

      I was took off something overnight I'd taken for 20 years johnny swapped to mirtazapine. The last 6 months have been hell to say the least. There's a Facebook group I'm in if you're interested. Good group with good people. Let me know and I'll give you the admin name so you can join.

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  • Posted

    Hi I’m finding the withdrawals from this awful drug so hard I feel so unwell but have tried to come off it so many times 

    I started reducing from 30mg on 20th December, I’m now on 7.5mg and just feel like I want to stop taking it all together so I can get over the side effects as they seem to be going on forever when will this nightmare end

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    • Posted

      Hi Caroline,

      I think most people would agree that you are getting withdrawals because you are going down so fast. I've decided once I have stabalized on 30mg, I am going to cut at about 5% every 4-6 weeks and get on with my life. I think that if you are not currently having any side effects whilst taking Mirtazapine, then their doesn't have to be a hurry to get off. I barely thought twice when I took it for two years but then suddenly I wanted off it as quick as I could, which resulted in withdrawal symptoms everytime. Even though I went slower each time, in reality I was still doing like 25% every 4 weeks, it all catches up.

      I'm coming around to the idea that instead of doing as many reductions as I can, doing fewer and less often will result in the easiest ride down. 

      Hang in there, you've got so far but you have got to the point where you think it's the medication making you ill but it's not. You would probably be better off in four weeks time if you didn't do any further reductions than if you dropped any further. That is what I've come to terms with.

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  • Posted

    I don't know if you are still following this discussion but the key with mirtazapine withdrawal is taking it VERY SLOWLY.    I have been tapering mirtazapine (15mg) since January 1, 2018 and have been going at a rate of about 10% every month of the current dose.   After 9 months I am at 3.5 mg.   I have still experienced some moderate withdrawal on occasion at this slow rate but it is manageable.    I have gotten a lot of insight from survivingantidepressants org.     The goal is to get off the medication and the temptation is to reduce to quickly.  By going slowly, and listening to your body, you can get off of this eventually.  

    Yes, keeping busy and active is so important.   So is regular exercise, especially in the mornings.  For some people, including myself, tapering off mirtazapine is difficult, but possible.  Just go slow (no more than 10% a month) and go even slower if need be.  

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