mirtazapine withdrawal

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I've been on 15mg mirtazapine for about 6 months now - it was to help with my sleep problems.  It's helped but I feel the side effects outweigh the benefits.  If I want to come off this how should I go about doing it?

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  • Posted

    This can be a tough one to come off of, and you have been on it long enough that you should do a slow taper of 10% off the previous dosage per month. You could do that every few weeks, but the goal is to make the withdrawal process as comfortable as possible.  I have read many posts by people who went from 15 mg to 7.5 mg (50%) a and suffered so greatly that they reinstated.  I am also tapering mirt, am down to 19 mg, so my next cut would be 1.9 mg, 10% of the previous dosage.

    Two ways to do this.  One is to get your doc to prescribe a liquid version that can be dosed with a syringe to measure the smaller amounts.  The other is to get a cheap jeweler's scale that can weigh mgs. In the US we can get one through Amazon for about $24.  I break off bits of the tabletsto get the amount.  Keep in mind, the tablets weigh more than the actual drug due to binders, so you would weigh your initial tablet and then weigh the fraction that you need off of that.  I hope this helps.

    Even at 10% cuts, I experience WD symptoms, anxiety a few days after the cut, and on and off headaches, diarrhea and burning skin sensations.  I don't even want to know how bad it could be with bigger cuts!

    If the side effects of the drug are too much to bear to wait out doing a slow taper, then you could go faster, but know that you'll likely have WD that may make you reconsider.  At least with the above methods, you could reinstate to the previous amount rather than all the way back to the full or half tablet amount. 

    Some folks get away with not having trouble with WD, but we tend to not know about them since it's only the ones suffering from WD that we hear from!

    Also, be aware that you could have WD symptoms far enough out that doctors and patients alike think they are relapsing, but in reality it is still WD.  You can go through a windows/waves pattern of feeling good, feeling bad, feeling good again and then feeling bad, with each wave hopefully being less severe than the last one, and with windows lasting longer and longer.

    Good luck!

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    • Posted

      Very good advice from Betsy, just to add a little ... if at any time during your WD you feel any nasty wd symptoms - stay at the dose you are on rather than going any lower - just wait until any anx' has passed.  I too am withdrawing after a year.

      Also a good site for you which explains and affirms, don't think the moderator will remove this as it is so very helpful for anyone trying hard to wd:


      Hope the wd goes ok for you, slower the better it seems, can't rush off the Mirt (!)  

      Wishing you well x

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    • Posted


      Many thanks for your reply.  I actually took 7.5mg for about 4 nights last week so I guess that would explain why I've been feeling very low and anxious the last couple of days?  I've now reverted back to taking 15mg.  I think I'll try and arrange an appointment with my doctor and ask about the liquid version.

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    • Posted

      Thanks for your reply and the link.  As I said to betsy0603 I think I'm going to struggle with cutting down very quickly so will chat to my doctor about the liquid version.
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    • Posted

      Hi Orangedog

      Yes definately as its a 50% drop, some people say they struggle 'slightly' with the 10% so worth noting.  Also put on your list ... always wait 2 weeks between drops - it can take 2 weeks to feel some wd effects from lowering, so dropping doses too quickly would be a double wammy.

      It's the same story, people are really struggling coming off too quickly then going back up - if only the instructions came with a CLEAR WD plan it would save so many people from the angst !

      I'm taking the liquid, its so easy to work out, for 5% which I'm doing every 2 weeks - just drop 0.5 each time.  Hope youur doc' gives it to you, give me a shout if I can help with the plan.

      Wishing you well

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