Mirtazapine withdrawal - tips and experiences thread

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This is a follow up thread to 'Coming off mirtazapine', for people to share their experiences and tips, and give support to one another.

Mirtazapine is a very powerful drug and an exceptional antidepressant which works much more quickly than others, sometimes within days. It has many very good attributes, but also has some bad side effects such as weight gain for some, which means there are many people trying to withdraw from it.

What most doctors don't tell you, is that it is not an easy drug to come off. You will usually be advised to halve your dose for two weeks and then come off it. Sometimes, people are told to just stop it and start another AD with disasterous results. This thread is for those people who have successfully withdrawn from mirtazapine to tell others how they did it, or for those currently part way through the journey, or for those who are facing the withdrawal process and are daunted by the thought of it.

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  • Posted

    I have just come off mirtazapine and these are my tips:

    Are you sensitive to drug fluctuations? If 'yes' or you don't know, start by cutting by the smallest amount possible. For me, coming of 30mg, that was done by obtaining 15mg pils and using a pill cutter to cut just one quarter of one tablet (so a drop to 26.25mg). I did this for two weeks, but some recommend 4 weeks, just to make it easier for your body to adjust. You may also wish to ask your doctor for the liquid form of mirtazapine so you can withdraw by the 10% method, where you drop 10% of your last dose every four weeks.

    When you make this first small drop, you will get an idea of how sensitive you are. I didn't feel it too much; maybe just a bit of nausea around four days after the drop. But I figured I could more than cope with that and so I did another cut of 3.75mg for two weeks. Again, this was fairly smooth sailing. I continued in this way dropping 3.75mg at a time for two weeks which I shortened to ten days and then finally to one week. I did this because I was coping well and was withdrawal free before the time came for my next drop. Do not speed up like this if you are not finding it relatively easy. Some people need more time.

    When I got to 7.5mg I started to slow down and managed to break my pills into smaller pieces meaning I was cutting by an eighth of a pill at a time. But this is not accurate and so I recommend making a liquid at this point. I will detail the method of this in a separate thread.

    After 1.8 mg I cut by 0.1mg a day until I reached 1mg then cut by 0.1mg every two days until I was off.

    My withdrawal was relatively painless. My worst days were 4 - 5 days after each drop and these days I was very nauseous. I had already lost my ability to sleep whilst still on mirt so cannot comment much on that part of it. I have to take a small amount of temazepam for sleep and intend to taper from that too in a few months.

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  • Posted

    Brilliant evergreen

    I will cerrtainly be following this thread.

    Thank you for all your help to date.

     am now stable on 7.5 Mirt and so very grateful i took your advice to reinstate... life seems on the up

    How are you doing now?

    God bless xx

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    • Posted

      Hi Lorraine why did u reinstate? Was it insomnia or your mood? Has it increased your appetite? I want to reinstate and taper off but worried about my appetite increasing again but can't cope with the struggling to sleep all night every night
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    • Posted

      Hi Lorraine. so pleased to hear you are feeling much better. Hopefully, 7.5mg will suit you and you might be able to stay on it (if you want to).

      I am feeling absolutely brilliant today. I have had a rough couple of days with nausea and lack of sleep, not all caused by withdrawal though as was up all night checking on a horse with colic on Thursday night, and only got 4 hours sleep the night before, so felt dreadful yesterday. But I managed to get 7 hours sleep last night. Not caught up by any means but feel fantastic today, considering.

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    • Posted

      Hi Sarah

      Sorry for the delay in responding. I went back on mirt due to protracted withdrawal symptoms. I was so ill and would never consider a quick or abrupt stop again. Going to follow evergreens advice and stabilise and then taper excruciatingly slowly! How are you doing?

      God bless ♥

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    • Posted

      Hi Lorraine, doing ok. Insomnia seems to have gotten worse last couple of months. I was on metarzapine 6 years and came off completely within 4 weeks. Temazepam and zopiclone got me through but I was sleeping unaided some nights, now I need something every night. It's been 4 months; my doctor thinks it's nothing to do with withdrawal as its been so long. How long has it been since you initially came off them? Your new plan of action sounds positive, I'm thinking to try the same?
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    • Posted

      Hi Sarah

      I was on mirt for six weeks only and was on citalopram for six months prior to that. I came off mirt cold turkey on doctors orders. My body seemed to go into shock and I slumped back into depression. You have done amazingly well coming off them. I must say I wouldn't be at all surprised if your sleeping issues are down to mirt withdrawal. Have you been ok other than sleep problems?

      Hope so, and hope your sleep issues resolve quickly.

      God bless x

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    • Posted

      Hey Lorraine, thanku! yes been fine apart from sleep problems. In fact happier and feel more in touch with my emotions. Iv had my down days but it's January blues and my brothers anniversary in Feb, (the reason I went on metarzapine in the first place.) so if only I could sleep ..it's frustrating.

      If you were only on tablets for short period it shouldn't take long to taper off. I think you just have to make sure you are ready and the reason you went on them is resolved? The worst part besides sleep issues for me was the anxiety and teeth clenching etc when it was coming out my nervous system. But I did it all too quick.. I hope it goes well for you too smile

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    • Posted

      Hi Lorraine, my new psych doc has given me Mirtazapine because my Paxil has quit working. I've seen all the bad withdrawal effects and not sure if I want to try it. I have got to do something. My anxiety is so bad. My heart races and I feel like I'm going to come out of my skin. Nausea is unbearable at times and I have developed gastritis from the anxiety. How did you do with Evergreen's taper schedule? Do you normally have the withdrawal type symptoms when tapering off a psych med or is it usually easy for you? I have been on Paxil for 15 years and there's no way I can taper right now without bad withdrawal. I've lost about 24 pounds since this has been going on. They want to put me on a low dose of an antipsychotic medication, but I don't like those drugs. Wish I could just go back on another antidepressant.
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    • Posted

      Hi tonia

      I have reinstated on mirt as I didn't taper properly. I really like this med as it stopped my depression and anxiety in its tracks. If tapering is done properly like evergreen has done you will be fine when it's time to come off. It may be worth having a look through evergreens threads. Lots of great tips to successfully withdraw. I would definitely recommend mirtazipine, no yukky side effects and works quickly. Please let us know how you get on.

      god bless♥♥

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    • Posted

      Hi tonia

      this is my forth week now on 15mg. Started to work immediately. Managed to look after my granddaughter all day today. Mood lifted immediately and now the energy returning.

      are you going to start today?

      xx

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    • Posted

      Tonia hi, so sorry to read of your suffering.  I have read of AD's "pooping out", sometimes because of conflicting medication, more stress or alcohol, sometimes the doctors just don't know what causes it.

      Also I have read that when this happens you go through a withdrawal process which fits with the symptoms you speak of.  I wonder, are you still taking Paxil?  I ask because you may need to do a mediocre taper for relief from the symptoms.  I'm not sure Mirt' is going to lessen the symptoms of wd from Paxil.  I would be asking the doc for a Benzo though.

      I am wd from Mirt, slowly and so far its gone ok, from 15 to 5 now, if you go slowly off it, no more than 10% (or 5% in my case) every 2 to 3 weeks the journey might be slow but free from suffering.

      Wishing you well x

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    • Posted

      How long have you been on Remeron? Were you taking it for anxiety or depression or both? I have OCD, anxiety and depression.
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    • Posted

      Hi tonia

      I had both anxiety and dreadful depression. I spent six months on citalopram and didn't get better. Switched to mertazipine. ..wham life returned! I wouldn't fear it, I would welcome it ♥♥

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