Mirtazapine Withdrawal- the key to success

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In a month I will have come off mirtazapine completely and for some of that time I have been able to work and do my job pretty darn well.

I went on mirtazipine for anxiety and it did not work and I put on 1 stone in weight was drowsy all the time and generally doped out. In some ways it was actually causing more anxiety and depression as well. Withdrawing from mirtazapine is different for every person and everyone has to go at their own pace. For me, it was extremely slowly when I got down to 7.5mg and lower. The tablets don't allow you to do this so request the mirtazapine solution that you dispense with a 1ml syringe into a little bit of water every night. Going cold turkey is a terrifying experience, the one most awful experience of my life and its also dangerous. I do not agree with people advocating taking valium during the withdrawal process because for anxious or depressed people a drug that powerful leaves you vulnerable to addiction because speaking from personal experience that is exactly what happened to me. Valium in my experience is nowhere near as hard to withdraw from than mirtazipine because it is so short term whereas the mirtazipine is a long drawn out business making it hard to lose perspective on what is a withdrawal symptom and what is your underlying problem. I kept a diary of my symptoms so I could look objectively at what I was experiencing and sort it out, but I still forget sometimes. As I said earlier about some of the time I have been able to work Im talking about the past 6 months where I have been following a plan devised by myself that works if you find the quicker withdrawals like \"half a table for a week then nothing\" or cold turkey dont work. There is a website by the organisation called CITA (google it) and they have a Back To Life handbook that you pay £13 for and it gives you a specific plan for mirtazipine withdrawal, tells you supplements to take such as the powerful detox drink Noni Juice, how to alter your diet to help decrease withdrawal symptoms. I had my vitamins tested and whereas before the process I was fine, afterwards I had a chromium deficiency making me very sensitive to sugar. If you can hack it I have found that a low carb, low sweetner, low sugar diet like the Atkins or the Dukan diet work very well as the mirtazipine plays around with your blood sugar levels and therefore makes you even more unstable. My basic way of withdrawing was this:

Ill use the drop from 0.1ml to 0ml (of syringe solution which with the 7.5mg solution equates to about 0.75mg very very tiny!!) as an example because that is what I am doing right now:

Week 1, take 0.1ml apart from wednesday when you take nothing

Week 2, take 0.1ml apart from monday and wednesday \"\"\"

Week 3, take 0.1ml apart from monday, wednesday and friday \"\"\"

Week 4, take 0.1ml apart from monday, wednesday, friday and sunday

Week 5, take 0.1ml apart from monday, tuesday, wednesday, friday and saturday (only take 1ml on thursday and sunday)

Week 6, take 0.1ml only on thursday.

week 7 , take nothing!

So each week you are cutting out one day of the week's dose which I have found really suits mirtazapine because if you just drop down a dose the withdrawal hits you really hard 2 weeks after and by 3 weeks on the dose I was horrifically depressed. If its too fast you can do the week 1 pattern for 2 weeks etc which I did for a while. I do see what they mean about mirtazapine having a short half life because it does hit you in the face at the 3 weeks marker, it is as if it just leaves the body very quickly between 2 and 3 weeks of dropping a dose. The gradual withdrawal that I ended up doing I think really suits mirtazipine because of this aspect.

The drop downs I did was, 30mg, 15mg, 7.5mg (half a tablet) (with the tablets I simply dropped the dose again when the withdrawal symptoms subsided) this bit was debilitating and I do not advocate it. Use the plan set out in the Back To Life booklet instead. When I tried to go to nothing from 7.5 then I experienced absolute horribleness. So I switched to solution and did 1ml (7.5mg), 0.9ml, 0.8ml, 0.7ml, 0.6ml etc etc down to 0.1ml which Im doing now. I got the solution from my GP so it is not hard to obtain it in the UK, it costs the same as a regular prescription, i think it is available in America aswell but im not too sure.

Finally i will just outline my withdrawal symptoms: vivid dreams, disrupted sleep/over-sleeping (I did a test using SleepCycle, an app for the iPhone to test whether a small dose of mirtazipine could affect my sleeping and I found with the analysis tool that I had much less deep sleep and was much more easily disturbed to being fully awake during the night than when I didnt take any mirtazipine. I think this is why you oversleep on mirtazipine.) Paranoia, itching skin, body shocks (like tingles that run from the top of your head to your toes), headaches, fatigue, bruxism or teeth grinding (can make my jaw ache), depression, anxiety, nausea, burning mouth syndrome (like a numb tingling in your tongue), floating sensations when going to sleep, cravings for sugar and carbs, confusion, forgetfulness, angry outbursts, irritability, hot/cold flashes, insomnia (the most disturbing for me but on my really slow plan I dont get this problem at all), social withdrawal (probably because my emotions were so erratic i was embarassed for anyone to see me), body aching especially in my back where I hold most of my tension, sensitivity to noise and light, blurred vision.

Some more tips: People often fear it is their illness coming back when they are experiencing withdrawal symptoms, this was not true for me because as I am nearly off mirtazipine now it is the best I have felt since I started taking antidepressants. They are only supposed to be used short term but I ended up on them for 6 years. If you felt no effect with the antidepressants after a few months it is best to come off them. Dont even risk it with drinking alcohol, it makes the withdrawal even worse, your body is going through a lot and it needs as little rubbish to deal with as possible. If you feel a burst of energy as I have done during this process even if it is 9pm go for a jog. Dont just sit around waiting for it to turn into a panic attack. And finally go with the flow and remember its not real and only temporary. \"This too shall pass.\" So just do your best at real life and hibernate through it all. This drug is not easy to come off just as all antidepressants are hard to come off, it has been compared to heroin withdrawal and having researched heroin withdrawal I agree with the comparison. If you drop too suddenly and end up seeing the doctor because you are suicidal and at your wits end you must slow down and dont let them just pump you back up to 30mg, just go back up to the last dose you took before you went crazy and go slower next time. A word of warning: the majority of GPs and doctors do not understand antidepressant withdrawal and from my experience neither do psychiatrists fully, they just prescribe. However you must not blame them for their ignorance even though it is hard not to when you are in hell, you put the drugs in your mouth so YOU have to get yourself rid of them at YOUR pace. It is sadly the ways things are in the UK at the moment.

The best of luck to anyone who is on this road.

I hope something I said in there helped you.

If it didn't nothing lost!

Kathryn.

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  • Posted

    Hi katherine,

    im new have been on the rollercoaster of mert for 14 months im from australia and cant get liquid form so ill try crussing in water as i cut bk yr report was just fasinatiting i tryed cold turkey but i neally killed my self reallly!!!!! Cant believe this drug im bk on 15mg and will stay for a couple of weeks and then do yr stratergy thanks a heap please keep in touch

    trace21

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  • Posted

    Kathryn, I don't know you but you are a legend to me. I have struggled for 4 year to get of mirtazapine and I think I will succeed this time. Your post sent me down the road of an extremely slow taper using liquid and a syringe. I cant thank you enough

    Trace21 - I live in Australian too. I have just started this strategy. Started on 15 ml, 5 weeks ago, now on 13 ml. This was after having tapered off much faster using the tablets (this is my fourth go at getting off them. First time was 3 years ago) I am going great.

    A compounding chemist can convert the tablets into a liquid. I went to my GP told him I wanted him to organise with a compounding chemist to make up the script in liquid form. He rang them, they confirmed they could do it. He wrote what he wanted on the script, I gave it to the chemist and picked it up a couple of days later.

    I still had an insomnia problem but have addressed that with acupuncture.

    happy to answer any questions if I can.

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    • Posted

      Dear Dalsaan, is it ok to have a compounding chemist crush the pills into smaller denominated capsules (eg. 4mg, 3mg, etc)? Does the process make the drug lose effect? One shrink told me it does but I'm not sure if I trust him because it sounded like he hadn't encountered this before. Thank you.
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    • Posted

      Hi Dalsaan! I know this was over a year ago but am in a similar boat. I am attempting to come off of Mirtazapine for the first time. I have been on it almost a year. You said accupunture helped you get back to sleep?
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    • Posted

      I stopped taking Mirtazapine on Monday and Tuesday morning I'm having severe anxiety and panic attacks so I started back on the Mirtazapine its Saturday and I'm still having anxiety how long does it take for the Mirtazapine to start back working please help. I'm scared 😳 

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  • Posted

    I would like to know if there is anyone out there who has successfully managed to come off Mirtazipine. My psychiatrist took me off 7.5mgs overnight and at the same time I came off Duloxetine 60 mgs over a one week period. I have been through hell for seven weeks now, suffering with so many of the withdrawal symptoms. My doctor says my physical symptoms are due to recurring depression. He doesn't really acknowledge that there can be Mirtazipine withdrawal symptoms. I have been improving slightly as I now have only the constant nausea, lack of appetite for food or drink, back and neck pain, constant exhausting fatigue and intermittent skin itchiness. I don't see an end in sight and all the doctor wants to do is put me on a MAOI anti-depressant which terrifies me. Is it so difficult to ascertain what are withdrawal symptoms and what are depression indicators?
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  • Posted

    HI Gppapilon,

    I'm not a doctor I can only go on my own personal experience. My psych also said there are no withdrawal symptoms for Mirtazapine and I think for the majority of people that might be right. I also think some of us are very sensitive to it and go into withdrawal.

    I went off it a number of times having tapered as per Drs orders. I then experience many of the things you talk about - nausea etc. These resolved within a day (at most 2) of me starting to take the tablets again. From my perspective nausea is not a feature of depression but it is a common effect of drug withdrawal and if it was all a recurrence of my depression (as was suggested to me as well) it would have taken weeks for the medication to kick in and address the depression not a day or two.

    I found going from 7.5 to 0 was too much and that's why I am tapering as per about. I am still going on 10ml a night and will take as long as I have to.

    I would avoid going onto another anti depressant if you can and see if you dr will try a gradual tapering regime from 7.5

    Dalsaan

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  • Posted

    Interesting discussion. I jumped off from 2.5 mg of MT last Friday after an eight month taper and am having a torrid time of it. I had two rough nights, followed by two great and then rough again. Last night was so bad that I caved in and took 7.5 mg. Plan is to see if things settle at that and then to start again tapering even more slowly (I did 2.5 mg at a time). I too felt that it was my original problem coming back, but maybe not. I want to stay away from Drs as all they do is give you more crap.
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  • Posted

    Hi Gussie. I read Kathryn's post from January which I suggest you read if you can. She lists how she finally came off Mirtazipine by reducing the liquid form of the drug - in her post she tells you how. I did as she suggested and contacted C.I.T.A. - Council for Information on Tranquillisers and Anti-Depressants. I bought the book that they suggested from them and in it are tables on how to reduce various drugs, one of them being Mirtazipine. I found the book really informative as were the people on the end of the phone. I can relate to your torrid times - I went through six weeks of sheer hell after coming of the drug (7.5 mgs), overnight. The specialists response after 3 weeks was to go on to other medication as he felt I was suffering from depression. I refused and I am now in my 9th week of being off all drugs. I still get the fatigue but no more nausea, vomiting, gastric irritation and bowel problems, itchy skin, painful muscles, headache, dizziness, sense of doom... I lost 7kgs but I have now stabilised, have my appetite back although there are some foods and drinks that I can not bear the thought of drinking - I have not had a coffee for 9 weeks which is not a bad thing. I am on good quality multivits and minerals, Omegas 3, 6, and 9, Milk Thistle for my liver and Tahitian Noni Juice ( powerful anti-oxidant) as recommended by C.I.T.A.'s book Back to Life.

    I came so close to going back on to 7.5mgs many times so I can understand why you have done. I can not believe I am out the other side although fatigue levels vary daily. I do feel a bit flat sometimes but keeping an eye on this. To have my emotions back after so many years is strange - I had forgotten how to really "feel" my feelings. If I start thinking my flatness is a worry then I am going to think about taking 5HTP, also suggested by C.I.T.A.'s book. I wish you sincerely a recovery soon. Keep reading up on everything you can, I found the more information I had, the better armed I felt.

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  • Posted

    Hello Gpapillon (sorry if I did not spell that right),

    Thanks for your message, which is both heartening and scary. I have bought the back to life book and note the tapering method as also set out by Kathryn. I feel that this is worth trying and both your recommendations support this. I have also joined the paxilprogress forum as when I was tapering the benzo, I found the support of the now defunct Benzo island to be invaluable.

    I have recently started a new and very responsible part-time job and have some significant family events coming up soon so I can't afford to be flaky for these. So I am going to wait until I have a clear window to make the complete withdrawal. However, I can begin tapering again as soon as I have my breath back. I am not so keen on using the liquid again as it only lasts for six weeks once opened, which is a pest. I'd like to do it by tablets if at all possible but it may be too hit and miss.

    The taper up to withdrawal had been easier than the benzo one but the final benzo withdrawal was simple in comparison! Then I had just two weeks of feeling a bit off (but not too bad) and then was pretty much OK.

    Thanks again

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  • Posted

    HI this is trace.thomo ive been on mirtazipine for 16months now and have tried to come off then by myself since i put on weight and felt more anxious on them than off having muscle pains and joint pains witch i never had before. So i tried to come off but crashed badly now reading everyones problems withdrawal im just so scared to come off them im currently tapering off benzos being on them for 12 years im down to 1.5 mgs.

    Does any one trying to come off benzos i just need to know weather to stay on mert until i come off benzos any help me as i get no support from sycs or gps as they say its easy comming off meds im just really frustrated and at a loss what to do as comming off both meds at the same time might be to much for me to handle thanks for reading hope some one can give me advise

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  • Posted

    Hi there Tracy Sorry for the delay in replying. I suggest you contact C.I.T.A. - The Council for Information on Tranquillisers and Anti-Depressant. They are in the U.K. and their telephone number is 0151 474 9626 or their helpline is 0151 932 0102 - ring from 10am. You can leave a message and they will get back to you. Alternatively email them on cita@citap.org.uk. You will get thier advice on how best to come off both lots of drugs, in what order and over what period of time. I do wish you well, GPpapillon
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  • Posted

    I just wanted to say thank you to Kathryn for her advice on withdrawing from Mirtazapine, it has helped me so much. With her advice I am managing to withdraw from the Mirt. I hope my story will help others in my position to know that they are not alone.

    I ended up on Mirt for my depression as SSRIs did not agree with me so my GP suggested Mirt as the next drug to try. I started on 15mg and increased my dose slowly as I was worried about side effects.

    Over the years I have discovered that I am super-sensitive to medication so my experience may not be representative of what others might find. I found that the side effects never went away completely despite what the patient info leaflet said, and unfortunately some got worse. Incredible tiredness that lasted all day, alternating constipation and diarrhoea and nausea (which progressively got worse), dry mouth and constant thirst, hunger and weight gain (I was so hungry that food was all I could think about and I put on an extra 1.5 stone which I didn't need as I was already a stone overweight!), headaches, foggy-headed, easily confused, loss of memory (not good as my job is demanding), aching muscles and sore joints in my legs and lower back (my weight gain made this worse), restless legs when trying to get to sleep at night (I never understood what people meant by this until I experienced it, it is just so frustrating constantly having to move your legs to try to get comfy), vivid nightmares, tightness in my chest and breathlessness (which also got worse as time passed).

    I stuck with the Mirt as I desperately wanted to find a drug to make me feel better and every week I told myself that it might start working soon. However, after 5 months I felt I had only had one week where I had felt "up" and that it had now stopped working. On top of that, with all the side effects I felt that I had lost all quality of life, I wasn't able to go out or to work and I was constantly in pain. So with the agreement of my GP I started to withdraw.

    If you are at this point, I would also recommend buying the CITA Back to Life book and following their advice. I initially went about it the wrong way and decreased my dose too quickly and felt like I was losing my mind. I cried all the time, I developed incredible anxiety and panic attacks, I was scared to go out, scared to walk down the street. My father had to move in with me and look after me and do my shopping etc. I couldn't believe how my life had gone downhill so quickly. Then I read Kathryn's post about CITA and liquid Mirt and it was a light at the end of the tunnel. I bought the book, followed CITA's plan and then at my next appointment asked my GP for the liquid.

    The liquid solution I got is 15mg of Mirt for each 1ml of solution. I have played around with various drops but the size of drop that works best for me is reducing by 0.1ml (which is equivalent to 1.5mg) each week or every second week

    Withdrawing from Mirt is the hardest thing I have ever had to do both mentally and physically and is far worse than my original depression. I have found my dose changing regularly exhausting and most of the time my body doesn't know what's going on. The tummy troubles are still an issue as is the anxiety and panic attacks, I tire easily and I catch every bug going. I just try to go with it and do what my body tells me, sleep when I need to, eat when I need to and not when society tells me I should. I should add that I have had to be signed off my work while doing this, which causes me a lot of worry in itself over what my colleagues think of me and whether I'll have a job to go back to but I couldn't cope otherwise. If you are withdrawing, try to be kind to yourself and try to focus on the day you will be off it, that's what I try to do in the hope that I will feel better once it is no longer in my system. I have taken up meditation as I have heard lots of positive things about it's effect on depression and have got myself a

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  • Posted

    I just wanted to say thank you to Kathryn for her advice on withdrawing from Mirtazapine, it has helped me so much. With her advice I am managing to withdraw from the Mirt. I hope my story will help others in my position to know that they are not alone.

    I ended up on Mirt for my depression as SSRIs did not agree with me so my GP suggested Mirt as the next drug to try. I started on 15mg and increased my dose slowly as I was worried about side effects.

    Over the years I have discovered that I am super-sensitive to medication so my experience may not be representative of what others might find. I found that the side effects never went away completely despite what the patient info leaflet said, and unfortunately some got worse. Incredible tiredness that lasted all day, alternating constipation and diarrhoea and nausea (which progressively got worse), dry mouth and constant thirst, hunger and weight gain (I was so hungry that food was all I could think about and I put on an extra 1.5 stone which I didn't need as I was already a stone overweight!), headaches, foggy-headed, easily confused, loss of memory (not good as my job is demanding), aching muscles and sore joints in my legs and lower back (my weight gain made this worse), restless legs when trying to get to sleep at night (I never understood what people meant by this until I experienced it, it is just so frustrating constantly having to move your legs to try to get comfy), vivid nightmares, tightness in my chest and breathlessness (which also got worse as time passed).

    I stuck with the Mirt as I desperately wanted to find a drug to make me feel better and every week I told myself that it might start working soon. However, after 5 months I felt I had only had one week where I had felt "up" and that it had now stopped working. On top of that, with all the side effects I felt that I had lost all quality of life, I wasn't able to go out or to work and I was constantly in pain. So with the agreement of my GP I started to withdraw.

    If you are at this point, I would also recommend buying the CITA Back to Life book and following their advice. I initially went about it the wrong way and decreased my dose too quickly and felt like I was losing my mind. I cried all the time, I developed incredible anxiety and panic attacks, I was scared to go out, scared to walk down the street. My father had to move in with me and look after me and do my shopping etc. I couldn't believe how my life had gone downhill so quickly. Then I read Kathryn's post about CITA and liquid Mirt and it was a light at the end of the tunnel. I bought the book, followed CITA's plan and then at my next appointment asked my GP for the liquid.

    The liquid solution I got is 15mg of Mirt for each 1ml of solution. I have played around with various drops but the size of drop that works best for me is reducing by 0.1ml (which is equivalent to 1.5mg) each week or every second week

    Withdrawing from Mirt is the hardest thing I have ever had to do both mentally and physically and is far worse than my original depression. I have found my dose changing regularly exhausting and most of the time my body doesn't know what's going on. The tummy troubles are still an issue as is the anxiety and panic attacks, I tire easily and I catch every bug going. I just try to go with it and do what my body tells me, sleep when I need to, eat when I need to and not when society tells me I should. I should add that I have had to be signed off my work while doing this, which causes me a lot of worry in itself over what my colleagues think of me and whether I'll have a job to go back to but I couldn't cope otherwise. If you are withdrawing, try to be kind to yourself and try to focus on the day you will be off it, that's what I try to do in the hope that I will feel better once it is no longer in my system. I have taken up meditation as I have heard lots of positive things about it's effect on depression and have got myself a

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  • Posted

    Sorry for some reason it posted twice and it cut off the end of my post, even computers are a struggle for me at the moment sad

    So to continue:

    ..........meditation book with an accompanying CD which has guided me through it step by step. I am still struggling with meditating but I occasionally find little periods of calm in all of the turbulence. I have also tried hypnotherapy, acupuncture, taking regular short walks, reducing sugar in my diet and taking vit D and omega 3,6 and 9 supplements.

    I hope someone finds this useful. Good luck to everyone that is withdrawing.

    XX

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