Mirtazapine taper sedation

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Hello,

I hope someone can help me out. I am on mirtazapine for 4 months now. First i was on 7.5mg for a month, then 15mg. Soon i could not tolerate this dose, and reduced to 13mg. Was fine at this dose for a month. Then on Early september, i started to feel severe agitation on this dose and was force de to reduce. Reduced to 7.5mg, on the third day of this dose i was severly sedated, was Iike i wanted to be awake and my brain wanted to shut me off. I dont understand why this happened , because when i was at this dose the first time for one month, i didnt even felt near as sedated as i was. Now upon reducing, after being on 13mg for almost two months, how can this happen? So i reduced to 3.75, was on 7.5mg for 3 days only, because i was almost like fainting the entire day. On 3.75, after 3 days my sleep suffered for one night, but after 5 days, i felt much sedated, but not as much like on 7.5m, i persisted on 3.75mg, after 7 days and now it seems to be more stable. Never the less, i feel extremly tired during the day, hang over like a train as passed over me. I tried even to updose to 4mg, but felt too much agitation restless legs, returned to 3.7 and it called down. So it seems i am stock on this dose. Any body got this inverse reaction? Normally i heard it would be the opposite of sedation when reducing. If so, did you notice the same reaction after a drop in dosage again? Is like my brain is inverted.

Thank you.

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  • Posted

    I'm also trying to come off mirtazapine. I'm down to 3.75mg at mo and having all sorts of withdrawal issues. I'm going to carry on until I've done 3 weeks on this dose and then halve it again. I'm determined to get off all medication as I have had no benefit in over 2 years - in fact the opposite and I have lost faith in doctors. It helps to know other people feel the same and that others have managed to get through this.

     

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    • Posted

      I hope you can get trought it. My CNS has started to reject the drug and force me to reduce more. Last week was 3.3, yesterday the agitation started again, will now reduce to 2.7mg and see how it goes. I am still on Zoloft protracted withdrawal, that is why my body is too sensitive to drugs. How is your sleep? Are you having sedation when you drop?
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    • Posted

      I'm sleeping reasonably well luckily. Just chopping 15mg tablet into 4 at mo as it's not worth discussing alternatives with doc. My family are doing their best to help me through. I hope you have good support too.

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    • Posted

      I am following your thread. As i am at this stage.

      mirtazapine never really did much for me, i c ouldnt get the dose up above 22.5.  Have been hovering around 7.5 for ages whilst trying others with no luck.  Now down to 3.75 and i feel nauseous a lot, did also when higher dosage, and insomnia has kicked in.  I am just so low doing things is a trial.  I just want to know if this will start to feel better when i finish taking this med or am i going to have to take another anti dep instead.  I have tried many and my body doesnt like them. Do you think i am just suffering withdrawals and thats why depressed.  Are you on any other meds. I have diazepam, keeping it below 10mg so hope easier to get off.

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    • Posted

      I feel very much like you do but I am determined to get off all medication. I think we must hope that eventually these symptoms will ease. I think it helps to chat to people having similar issues. 
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    • Posted

      Hi, glad to see you are at same stage as me 3.75.  I have stuck here for five weeks as i do not think my CNS has yer stabilised.  I was on 7.5 for a long time.  This med didnt really work for me anyway.  I am still having days of anxiety and others of extreme nausea.  Are you suffering these?   I am scared to drop to 1.87 until i feel better.  Having said that, i had nausea at the start which was one reason doc thought it was anxiety related.  I would love to be off med but feel so ill some days.  Have you gone any further down?  Or have you any symptoms.  I wonder if you were on this med for long, they say the longer youre on it the worse the coming off is.
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  • Posted

    The lower doses of Mirt can be more sedating for sure.  If I were you I would slow the taper down now, stay at 3.75mg for at least 2 weeks, or to be sure as you have upped & downed the doses for 4 weeks, let your CNS settle for a while.  I think the sedation will be the same - don't expect that to improve really, not until below 1 mg.

    The way forward is to taper no more than 10% every 3-4 weeks to avoid all the WD symptoms.  It is possible to make a liquid from Mirt so that enables smaller doses.  

    If you can 

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    • Posted

      Thank you for your help Calmer. I have been reading many of your posts to support others in mirt widthdrawal and taper. It is very kind of you doing this and helping people. I appreciate your advice. So my problem now is not to let the CNS settle down. The problem is it doesnt want to settle and keeps rejecting the doses while im am trying to be linear. For example is was at 3.75mg a week ago, for 3 days. On the fourth i got extreme agitation. I lowered to 3.3mg and it settled down for 3 or 4 days also, then agitation again. Now i am at 3mg for 2 days now and i feel the CNS its on the verge of causing agitation again. But not yet. I hope i can settle between 2.5 and 3 i hope. I am afraid that by CNS is somehow trying to reject the drug or i am getting more sensitive to it each day. If it was not, it would not stop the agitation upon lowering, i believe. At least I cant find any other explanation .

      I now some people who had to do CT because of adverse reactions months after use of some med. I hope i am not one of those and that the CNS is only adapting to the amount of drug i need. I also found that mirt is still masking my zoloft protracted withdrawal. I notice that when the half life reaches at 19:00pm i notice some symptoms of zoloft more stronger, like the impending doom feeling and the sound sensitivity. What do you think about this?

      Caroline: Yes, my parents are one of my lines of help. I could not do it alone. But i also have a strong belief in God who is helping going trought this with my prayers. I am glad your sleeping. It removes lots of burdens.

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    • Posted

      I am also now suffering the symptom of needing more air, like air hunger. Is this normal? Seem like i am with loss of air. I remember i had this symptom when i begun mirtazapine. Anyone can relate?
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    • Posted

      Trouble is with Mirt tapering, symptoms can come & go, windows & waves, some days here next day gone to return again.  There is no way of knowing which symptoms are from which drug (Mirt/Zoloft) but I do know its best to use the same taper for Zoloft i.e. no more than 10% every 3-4 weeks/or 5% every 2 weeks for the sensitive (me too).  

      That "impending doom" feeling comes and goes quite quickly right?  Its not a "day dream" but a "nightmare dream" that passes quickly maybe ... ?  If you didn't taper the Zoloft slowly I can understand you might have symptoms ~ I haven't experienced that, but if its too hard you might want to take a small dose perhaps to ease up the symptoms.

      The agitation, yes, Mirt', best to hold each dose for 2 weeks, you're going way too fast, I would stay at your current dose for a minimum of 2 weeks.  You might find those symptoms ease up, just wait, until the symptoms subside maybe?

      Best wishes.

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    • Posted

      I'm glad you have plenty of support. I've just dropped to 1.8mg so let's see what happens next. Bring it on Mr Mirtazapine!

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    • Posted

      Hi, i see you are ahead of me and down to 1.8, i am still,battling with nausea at 3.75.  I am now not sure if the nausea is coming from something else as ive had it some of the time prior to dropping.  I am very cautious about next drop.  I would be grateful if you could let me know how you get on.  Do you find the lowering has affected your sleep a lot?
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    • Posted

      Hi. Sleep seems ok although I'm not sleeping as long as I used to. Headaches and anxiety symptoms are there but I'm coping so far. I'm hoping to stick with this dose for 3 weeks and then stop altogether. Hope it goes well for you.

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    • Posted

      Hi Calmer,

      Air hunger seems to be vanished. Still at 3mg.

      The impending doom feeling is there most of times. I already tried zoloft reinstatement and it made my insomnia much more worst, had to drop. Tried pregabalin wich helped to attenuate symptoms, but had a bad reaction to it and had to drop it. When you did your taper of mirt, didnt you had high pressure rebound for the strong blocking of alpha2 receptors? I already had low pressure when started mirt, and it lowered even more, but one month and my body adapted, só i guess if i taper, i will get a high pressure rebound.

      Other problem is that the pills produced here in my country have always 5% more or 5% less of error range, but i think its the same process in every country, i think? Did you knew that? When tapering or taking you are always in error. I could be taking 3.2 or 3 or 2.8 without knowing it.

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    • Posted

      Another importante thing. When i sleep on mirt, the sense of falling assleep doesnt exist anymore. I simply shut off without being aware of that usual feeling everyones have of falling asleep. And when i shut down i go directly to vivid dream filled sleep, only to be awake like 5 or 10 minutes later, and this cycle of going directly to vivid dreams continues with lots of waking up in between them. I think zoloft destroyed completly my hability to fall and stay asleep. No sleep stages, goes directly to dreaming. So i think, tapering mirt would make even things worst? If i dont sleep correctly even on mirt, i suspect that my dream filled sleep is a mirt medicated sleep that is masking the destroyed sleep from zoloft. Any one can relate?
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    • Posted

      Hi Caroline,

      Insnt the drop from 3.75 to 1.8 a too much BIG jump? Its 50% the dose. I am now battling at 2.8mg from 3mg, and i only made this drop because i was forced, started to feel agitation. Feeling also a pain on my lower left abdómen. My problem is mirt is masking my already severe insomnia from zoloft. I hope my brain doesnt reject 2.8mg

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    • Posted

      Did you notice you felt more depressed as you lowered? I am very low and am not sure if its just thee decreasing and will pass fiven time.  I never had much help from this med, nor others. Tere doesnt seem to be a med out there to suit me Nd psych says i have anxiety needs cbt vut a waiting list. What do i do now, put it back up fo 7.5 or wIt it out
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    • Posted

      I just want to get off this tablet. I have been on 1.8 for 2 weeks and have found that I feel very anxious and sad. I stayed with my family for most of that time but came home yesterday. Since returning I have cried so much and feel very anxious. Surely it will eventually pass. sorry I took so long to reply.
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    • Posted

      Hi Ann. I'm still on 1.8 and finding it tough. I have stayed with family to help me through but came home yesterday. It's difficult on my own because I just cry and become overwhelmed by anxiety and sadness. I am worried that this is in fact how I will feel even when I am off the tablets. How are you doing?

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    • Posted

      So grateful for your reply.  I am at same point of mirtaz and feeling same as you.  Do you wake with extreme anxiety and agitation? Then it morphs into depression but the anxiety never leaves and i end up having to take a diazepam.  Each day has been like this since lowering slowly but i dont know how much more of it i can take.

      i domt think raising it will help as it is sending all sorts of confusing messages to the nervous system.  Dropping it lower will cause worse problems just now too.

      i am scared to go back to dr as when i explain symptoms all they can do is either increase it, or give a new ome, neither of which has been helpful in the past.

      this is sheer hell and imhave read about it but just want to be free of this drug, like you.  Domyou find that even trying to do,the simplest of things like going for a walk or to a shop is hard,  i just cannot see friends as im in such a mess.

      anyone out there for help.

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    • Posted

      Yes I recognise everything you say. I'm not sure if the diazepam is good in the long term but you must decide on that. Don't try to give up both though. I was on lorazepam for a while and didn't realise how addictive it was. I'm off it now but it was very hard to get off it. You certainly have to taper those meds very slowly. Get more advice. I've got 5 more days on the mirtazapine and then I'm going to stop. It will probably hurt a lot but I am determined to do it. It's hard to keep positive. I will be thinking of you. We are travelling the road together.

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    • Posted

      I am very worried as the symptoms i am having are those which made me go to dr to see psychiatrist to stop the agitation and inner restlessness.   Tried several and mirt was only one which helped a bit but agitation was just lowered not gone.  What i dont know is whether now i am down to low level, is the original symptom getting worse again because of that.  If so do i need to put dose up or need a new med altogether to curb it.  Or should i just try tomstick it out by dosing higher on diazepam.  Trying to get to see anyone is very difficult.  Left to your own devices unless life in danger
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    • Posted

      I can't advise you on what you should do. I think you have to talk to someone you trust and decide on your plan and make sure you have people to lean on while you go through it. Read up about Diazapam and perhaps chat to unbiased people about that medication. Try natural things to help. Mindfulness, exercise, vitamins etc. Take care.

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