Mirtazapine Withdrawal - Cold Turkey

I stopped Mirtazapine 2 weeks ago. I'm a 43 year old male and I've been on it for about 14 years, mainly at 30mg a night but sometimes at 45mg. My reason for stopping it is I put on a lot of weight and now have severe acid reflux. A taper would have been a more sensible option, but I thought a few weeks of discomfort is a small price to pay vs the discomfort I've been in for the last few years with reflux. I never knew what reflux was and how awful it is....i's always thought it was just being a bit sick in your mouth, not severe pain and life changing physical illness. I'm allergic to Omeprazole and all of it's derivatives so my options are limited with medication, hence coming off Mirtazapine and addressing my weight

Having seen many explanations of other peoples experiences I thought I'd add a basic timeline of my own and what you might experience.

First and foremost, coming off Mirtazapine is nothing like coming off hard drugs. I've come off hard drugs before, it's important not to make your experience worse by panicking about how terrible it might be.

Days 1 - 3 - Probably the worst days in terms of nausea and feeling generally unwell. Bit of jaw clenching as I moved through these days and some difficulty swallowing. I king of tackled it by doing a lot of cycling, but there is only so much cycling you can do. I work as a professional singing leader.....I worked these days with limited issues. I never slept well while taking Mirtazapine, I have a sleep disorder and sleeping tablets do nothing with me. Some people will find the lack of sleep problematic, I've rarely, regularly, slept more than a couple of hours a night since I was 11, but I will suddenly have a day I sleep for long period. I have a headache that never goes away

Days 4 - 11 - Not bad, had a bit of chest pain and nausea, but nothing horrific. I've not really noticed myself sleeping worse but I have noticed I think I've had my eyes closed for hours and it's actually been 5 mins. It can be a bit disconcerting. Headache is very much still there. I get these weird waves of warmth that pulse up and down my body like a rush....I quite like it in a weird sort of way. Is the peeing an abnormal amount to be expected? Dropped 1.5 kg in 5 days

Days 12 - 15 - Up until this point the reflux has been acceptable, but it was pretty bad over these days. I think it's a combination of withdrawal and 'normal' reflux. Breathing is a bit shallow, headaches are much more noticeable. Had a bit of diarrhoea, but nothing i wasn't expecting and it cleared up with OTC meds

I'm kind of thinking I'm through the worst of it, but I will update if it changes. I don't feel well, but I didn't feel well to start with. What I find tolerable is not going to be the same as someone else. From what I read, men are more likely to have longer, more unpleasant withdrawal. If you are fit and well when you start coming of Mirtazapine you will notice feeling bad to a greater intensity. Tapering is a much more sensible approach, don't suffer for the sake of it.....I don't have any sense, that's why I chose to do an abrupt stop. I want it done and dusted in a short period, I knew what to expect. My doctor will not be pleased I did it this way.

The reason I was prescribed Mirtazapine is that I have several diagnosed disorders. These include Bi-Polar disorder, OCD, GAD and, because my Dad was at that appointment (and thought it would be funny) a morbid fear of onions. I don't know how those conditions will be effected by stopping Mirtazapine.....I'm pretty confident it didn't have any effect on changing my strong dislike of onions (clearly the route of all my issues and now permanently on my medical record....thanks Dad!). What I can tell you is that for the 1st 11 years I was OK with Mirtazapine. It's not something they prescribe unless they think you really need it, you shouldn't stop taking it for the sake of it. None of these medications are an instant cure, it can take 12 months to notice any difference in how you feel, mentally, not 12 days. There are medications for instant relief, I cant take beta blockers and I'm allergic to most anti psychotics. I could take heroin, but slow my heart down and hand me an onion and it might be game over....apparently 😉

Anxiety wise, I haven't noticed anything particularly bad. I still had major panic attacks when I was on it, but I knew what they were so over the years I've mastered near continual breathing exercises and worked them into my daily life. I know that withdrawal can be scary, I wrote this because that fear can amplify itself when stropping medications. You have likely been reducing that anxiety by taking the tablets and maybe it's back. Perhaps you google it and read a horror story about someone that chewed off their own leg and hopped to the centre of the town wearing a high heeled shoe? What I hope is that you didn't have a terrible time and made it worse by reading how bad it could be, thus condemning yourself to have a worse experience

Be well

M

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