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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
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