Mirtazapine Withdrawal Lasting Fatigue/Exhaustion

I took 15mg Mirtazapine for 2 months with bad side effects. Unfortunately I was persuaded that upping to 30mg would be less sedative, so less likely to cause side effects, and also more effective for anxiety and depression.

This turned out not to be the case, although it was less sedative so the grogginess was better.

I took the 30mg for another 3 months before tapering off over the course of 5 weeks by shaving the pills down smaller and smaller.

I now realise that this was very fast but as we all know, healthcare providers usually know nothing about withdrawal. Unfortunately neither did I. I felt physically and mentally better and better the entire time I was tapering.

Around 9 days after my last dose I got very sick. At first I thought it was a virus as one had been going around.

I initially could barely eat and was severely fatigued and flu-like. Flu like symptoms went away after around two weeks but it has taken more like 6 weeks for me to able to eat okay.

I also then developed heart palpitations, often at night and severe morning anxiety and adrenaline rushes. Blood tests showed elevated cortisol. I had a range of other symptoms such as bruxism and hives on my face at one point.

Around 2.5 weeks ago my symptoms mostly resolved, but at the same time the fatigue became much worse.

Since then I have improved a bit in terms of the fatigue but there are okay days and awful days. If my sleep is poor I'm very ill the next day. I worked from home for the first 2.5 weeks of withdrawal, and since then I've been unable to work other than attempting to return for a few days and then having a major fatigue crash.

The fatigue improvements have come after I moved in with family so that I don't have to do much because I was too exhausted to get up to get food and eat and drink. That's how debilitating it has been.

The fatigue has now morphed into more of an intense sleep deprivation feeling when it is bad, rather than physical exhaustion which is an improvement but it is slow and as I said, I'm doing almost nothing. My sleep is sometimes okay and sometimes I wake up very early which means I feel horrible again.

Now that I can move more I will try to go for short walks each day in the hope that this will help the fatigue and sleep. I do currently sit outside when I can.

My question really is regarding the long lasting, debilitating fatigue. I do think my body is still finding homeostasis as I'm still having changeable sleep and my libido (which the drugs killed) is slowly improving but not linearly, so this could be a reason for the fatigue.

The improvements are very much non linear, I have a couple of days where I'm a bit better each day then a worse one after poor sleep.

Has anyone experienced a reduction in most of their symptoms but had long lasting, severe fatigue for weeks afterwards? It is currently 9.5 weeks since I became unwell and close to 11 since my last dose.

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