Mirtazapine Tapering - Advice please

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Hi Everyone,

I would appreciate any advice on the following please... I have been on Mirtazapine since Oct 18, started on 15mg & gradually increased to 45mg, presecibed for Depression and OCD (I'm also on Fluoxetine 30mg which I plan to stay to keep the OCD at bay). Over the past 8 weeks I have gradually tapered from 45mg to 15mg with no problems,the next step was to go 15mg to 7.5mg, I managed only 2 days on the 7.5mg and have had to go back to 15mg. I've had the most awful anxiety since saturday, I feel so defeated especially as in recent weeks I have felt my best since my breakdown last October. Has anyone had a similar experience or have any advice? Will the anxiety lesson as I continue on the 15mg? I see my psychiatrist next week so hopefully he can shed some light on why tapering at the low dose has been so difficult.

Many thanks

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  • Posted

    you have reduced very fast.

    i was on 45 and have tapered over 19 months to 3 mg. will take a few more months to get off

    this can be a hard med to get off. the doctors are unaware of this

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    • Posted

      Hi Sarah,

      In total I have been on the medication for just 12 months and Ive tapered from 45mg to 15mg in 2 months, I most will most definitely be taking my time tapering off the 15mg and won't make any changes to the process until ive seen my psychiatrist next week. I really had no idea it would be this hard 😦 Thank you so much for your reply xx

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  • Posted

    You seem to be in a similar situation to me - I found going from 45-30 no problem and went on the medicine around the same time as you. When I went down to 15 I really struggled for a week with swinging bouts of extreme anxiety, low mood and paranoia. That only lasted a few days though. I stuck it out though, it's been about 2 weeks and I feel stable again. I'd say if you are feeling ok take your time on the higher dose when coming off them. I'm not an expert but I've heard some people alternate between doses so take a higher dose then a lower dose every other day (so take 30 one day, 15 the other).

    I am nervous about when I go onto a lower dose of 15mg though as that seems to be that last hurdle is when people get really bad side effects. But I am tired of feeling apathetic and groggy all the time, so really want to get off them. But I think patience is needed.

    Good luck, hope that you can get off them sooner or later without it causing too much stress

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    • Posted

      Hi there - its such a relief knowing i'm not the only one going through this so thank you so much for your reply. I did 45mg one day 30mg the next for 2 weeks, then 30mg for 2 weeks then 30mg one day 15mg the next for 2 weeks then on advice from GP 15mg for 1 week, she actually suggested 15mg every other day for a week then drop again to one 15mg twice a week then stop. I stupidly thought i was doing the right thing by dropping to 7.5mg daily & only managed 2 days before i was hit with this ferocious wave of anxiety, its not even OCD related, its just there with no reason or thought behind it. I'm back on 15mg and staying on this dose until i feel stable again. Thank you so much for taking the time to reply! Wishing you all the very best also xx

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  • Posted

    Been on 15mg about 18 months then started to taper about six weeks ago I was doing great got down to 1.875mg without to much problem then reduced again by half that's when my insomnia kicked in followed by anxiety big time gone back to 3.75 mg to stabilise ready to resume my taper yet again asked my doc if I could have liquid mirt not much joy there but did get a repeat prescription to help me go slower really is a hard drug to get off at the lower end good luck with your tapering stay positive the road to getting off this med is a hard long one we will all succeed I'm sure

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  • Posted

    hi , i split my 15 mg tablet into roughly 4 quarters ( used pill cutter) . so dropped down from 3/4 of tablet , that's 11.25 mg for a month. then 1/2 , that's 7.5 mg tablet for a month. Then 1/4 , that's 3.75 mg for a month. Then took 3.75 mg every 2 nd day for a week, then every 3 rd day for a week. Until i got down to taking it once a week, then stopped. All ok except for little morning anxiety which soon wears off when u don't dwell on it and panic. Still can't sleep well but managing.

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    • Posted

      Ahh that is excellent advice! Thank you so so much - thats exactly what i'll do!! Thank you so much again. A huge well done to you - you really should be very proud of yourself. Lots of best wishes xx

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    • Posted

      Just to add my doctor advised this way and it worked out well for me. Everyone reacts differently to various ways to withdrawal. Just keep busy and don't focus on that anxiety that can creep back in. Your body is just adjusting to each dose drop , so be patient. Stay on the lower dose for longer if needed. A friend of mine takes 3.75 mg a night as can't come off and enjoys life. Thats the thing, qualify if life. If you feel good on lower dose just continue with it.

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    • Posted

      Interesting that you say morning anxiety - I have definitely noticed this. I wake up and feel like there's no way I can face the day. But generally by the time I am at work it's calmed down. And I agree, as much as it's tempting to sit in and wallow, keeping yourself busy is key. The worst moments I’ve had is where I’ve given into my own anxiety and low mood and bailed on something.

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    • Posted

      that was me to a tee! it doess ease as the day goes on. it takes time. just take each day. you will get good and and bad days. don't dwell and keep focused.

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