Mirtazapine withdrawal dilemma - advice needed please?

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I started withdrawing from Mirtazapine back in Jan of this year, from 7.5mg. I got the liquid version and tapered down by 0.5ml (.75mg) initially every week, but had to stop that and start by dropping a day a week as I got withdrawals etc. I have been doing very well and was able to drop back to dropping it over 4-5 weeks. I got down to 0.1.5ml and the withdrawals kicked in, nausea, anxiety, sleep problems, cramps, etc etc. I stayed where I was for a few weeks but as things didn't really improve I continued to drop down to 0.1ml. During this time I have had some ok days and some awful days. Yesterday and today have been awful, dreadful low mood, very tired, anxiety and horrid nausea again.

My question is, initially I was going to go down to 0.5ml then taper off that to nothing, but the thought of another 3 months before being off it completely terrifies me. I am thinking about starting to taper off 1 night a week, over the next 7 weeks at the 0.1ml, but wonder if the withdrawals will be worse than ever!

id appreciate some advice. I have done the taper so ridiculously slowly, that I am now just fed up with the whole thing, and want to get back to normal again.

i was initially put on it as in Feb last year I had the flu, and was left with anxiety, my GP then prescribed Propranolol which gave me insomnia, and so it went on from there! The Mirt only made me sleep in the first week on being on it. I started it in June 2013, so been on it just over a year and have been withdrawing from it since Jan this year.

Any advice appreciated.


Jo x

1 like, 51 replies


51 Replies

  • Posted


    The first time I went off I was told by my doctor to just quit! I was at 15mg. I went a bit crazy for awhile I thought it was me because. Was going through a rough time my kids insisted to go back on that medicine.

    the second time I was down to 3.7 and my doctor ( different doctor) told me to stop and switch over to trazadone the following night. Trazadone is notorious for making people sleep, so I understood the thought process but it went horribly. I didn't get sick the first week, but I didn't sleep much either I think I was getting maybe 4 hours per night something like that. I was off the remeron for 3 weeks and because of all the nausea, vomiting and flu type symptoms not to mention I'd wake up in a complete panic attack over nothing, I went back on 15mg. I kinda wish I had gone back on but at 7.5. Anyhow....I'm on week two of every other night and I'm ok. I did notice yesterday( my day off) I felt a little bit like the flu was coming on but went home took my evil medicine and felt fine. I have two more weeks and I'm not sure I will even go down anymore...I might just start every third day and just see. I have two weeks off in mid October so I'm shooting for that as my completion date to be oct 1st, because it will most likely hit me the second week to ten days like last time. I'll let you know. I do think giving my brain a day off from this drug is a good thing it can somewhat acclimate to " normal" I hope and I pray. I went off paxil before and people said that was bad and it is....but this is pure evil compared.

    good luck I know we can do it!

  • Posted

    Hi I'm new to this forum, it looks pretty useful so I'll add my experiences and hope they help.  Also hoping to get some support myself.

    I've been on & off Mirtazapine 15mg. for some years since 2005, tried coming off them for most of 2006. Tried to do it too quickly at first & had rebound anxiety attacks so rang the mental health charity Mind.  Their advice was good: take it very slowly and when you get to the smallest doses (less than a quarter of a tab.)if using dissolveable tab's dissolve one in 100ml of water then suck up however much you need in a small syringe (minus needle!) & squirt into mouth. When I got down to a really tiny amount I took it every other day & then stopped. I was Mirtzapine free for almost three years.

    That's a potted history, as it was a long time ago I can't recall all the fine details. My GP was great he gave me a couple of syringes with different calibration.

    It took a while though but it made me feel that I was taking control.  I recommend Mind, either website or telephone.  They also have a table which gives the half-life of most of the known drugs prescribed, i.e. how long they take to get out of your system.

    Slowly does it!

    • Posted

      Hi Sal

      Thank you for your reply & info. It's really helpful to hear how you tapered off once down to a tiny bit. How long did you do every other night for please, & did you have any withdrawals during that time?

      Are you back on it again now? 

      Thanks & best wishes

      Jo x

    • Posted

      Hi,  it was in 2006 so can't recall exactly but I think I did 3 weeks at a time on the tiny (like 1.5mg) doses, longer on the larger doses and if there were no problems moved on to the next step.

      I really took it gently and didn't have any withdrawals worth noting.  Seem to remember that a couple of weeks on every other night at, say 1mg, was so easy that I thought I may as well stop.

      Everyone is different and you have to do what suits your body & mentality but I reckon as slowly as your patience will allow is a good bet. 

      Again I recommend looking at the table of half-life of these drugs will give an idea of how long it takes to decrease by half in your system.  

      I am now back on the things again because I have ME/Chronic Fatigue Syndrome (pick a title) and each time I have what I call a crash it's accompanied by anxiety attacks which can lead to depression.  So since 2010 I've been up & down, dosage wise, like a yo-yo. Spent all of 2012 on 7.5mg with no problems.  Last year was a bad one, a gall bladder removal in June followed by a Breast Cancer op in October. Hey ho back on 15mg for a while but now on 7.5 again and planning to reduce again.

      I have to learn a few coping strategies because life keeps chucking rubbish  stuff at me and my tolerance of stress is low.

      There you are sorry it's a big fat post but ther's always a bigger picture isn't there?

      Sal  x

    • Posted

      Hi Sal

      thank you for your reply. Oh gosh I'm so sorry to hear of your illnesses and operations, what a lot you've had to go through! 

      I am am currently coming off by dropping one day a week, as per CITA's guidance. I'm down to 0.1ml and so can't wait to be off it. A couple people I've spoken to have done every other night, or every couple of nights etc and done ok..........Mmmm tempting. It's the unknown isn't it, I wish we could know how it would affect us at the end, to help make our decision.

      so far I'm having a run of bad days, where I feel really rough, along with days where I feel not too bad. The lady at CITA said its normal as the brain adjusts, and the good days will get more and more. Here's hoping as the bad days are awful! 

      Good luck with your withdrawal.

      Thanks  again, and take care of yourself Hun.

      jo x

  • Posted

    Hi everyone,

    I'm about to go on three days a week, Monday wed Friday and possibly Sunday depending how I feel, so maybe four days, without reduction of 7.5. When I get down to once a week I figure when the withdrawals hit at a week to ten days, I'll be able to hit it with a dose. Who knows if this will work. I've tried others ways so I'm willing to try this way. I've read of so many people who have weaned down to crumbs and still had such a tough time with flu and anxiety insomnia and just feeling like crap.

    good luck everyone and good health

  • Posted

    Jo, I am in the middle of bad withdrawals from Mirtazapine. I only have one thing to stress. This stuff is pure hell to get off of. It is different for different people. You will see some say that it isn't bad, and others end up going back on it. It has had me sitting in the middle of my bed in the middle of the night crying. I am 4 weeks since going cold turkey off 7.5 mgs. I can tell that things seem to be easing up, but there is no formula for pain free withdrawal from this mess. I don't mean to scare you, or dishearten you, but that is just the way that it is, and if you prapre for the worse, then maybe it won't be unbearable. If you have a close friend who doesn't mind you calling when you need someone to talk to, or a family member, I feel it helps a lot. It has for me. Good luck. But more than any of this, if you are a Christian, prayer is a source of comfort.
    • Posted

      Hi David

      I'm sorry you're having a tough time, you're right though it is pure hell coming off it! I came off last October so am off completely. It takes months to readjust I'm sorry to say! It's one of the most difficult drugs to come off.

      Just take each day at a time. X


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