mirtazipan withdrawal help needed

Hi Norma, thanks for your reply, do have any physical symptoms? For example heavy head, nausea trembling,generally feeling unwell, now and again a feeling of doom.how long have you been on your current dose? I'm afraid I can't get any help from my gp as all she wants to do is increase my dose, I have been taking it for 17 months. and it wasn't helping one bit, this is why I want off this awful drug.l wish you well in your journey.

Thank you Norma, please keep me posted on your progress, looking back on old posts it seems that a lot of people have a rough time withdrawing from this drug, why is it that GPS put you on a powerful drug that is difficult to come off of and then reluctant to take you off? Can I ask why you are taking it, I was put on it for anxiety, but have had so many problems since taking it. I have read a lot about it and it says that it causes problems, messes with your head etc.anyway nice talking with you.

Hi norma iv been on this drug now for ten years and my moods havd been up and down all time i was put on it for Anxitey and fibromyalgia and still feel that its not working im in constant fear ov life itself and every little thing that goes wrong im in the middle ov changing my g.p and  hope to get some help with my moods good luck liz 

Hi Elizabeth sorry I never replyed to you I thought I had but looking this morning I probley forgot to press the reply button.Anyway if I were you I would wait until you see your new GP and tell him how you feel,but if you've been on a tablet for 10 yrs and you don't think it's doing it's job let him know.He may be able to give you something else while you withdraw from Mirt.But please wait until you see your new GP good Luck let us know how you get on and keep in touch.

Sorry to hear of your problems Norma, the reason I have decided to come off this awful drug is because it just isn't working, why take a drug if it doesn't work, every time I tell my gp she just wants to increase the dose,useless,I do think this drug causes the symptoms, my daughter says that they mess with your head and I do believe she is right. Docs are all to eager to prescribe these drugs but are not ready to help when the going gets tough, hope you manage to sort yourself out and stay strong.

Hi norma thank you for your reply im at new docters on friday going to have a long chat about meds and the way i feel will keep intouch and let you know how i get on good luck everyone liz

Be strong and make sure they listen to you.I repeat it's your body.Good Luck

Whilst everyone is different and react differently to withdrawing from Mirtazapine I do not think the above advice is generally considered best practice.

The problem is Mirtazapine has a short half life 20-30 hours depending on the persons metabolism.  By alternating doses in this way you are causing quite big fluctuations in the level of the drug in your system from day to day.

If you look at the charity MIND's website you'll find they have some really useful web pages on advice for withdrawing from ADs.  They also don't recommend withdrawing by alternating doses by rather just by simple gradulal reductions.

As I say everyone is different and not trying to be little anyone's advise but, from personal experience, my partner was wrongly advised to withdraw from Citalopram (another drug with a short half life) by alternating 20mg doses rather than stepping down to 10mg and she still suffers effects several years laters.

My advice would be to just step down the daily dose as gradually as you feel the need.  Split pills if you have to, or there is a liquid form of Mirtazapine available if that proves too problematic.

Good luck and take care of yourself

Whilst I appreciate wat u r saying and u r absolutely rite that everyone is different I reduced gradually and this was the advice of my consultant psychiatrist...

I totally agree with you, i have quite a strong metabolism but as you say we are all different go by what your own body tells you.If my husband took some of my meds he would never wake up yet they have no effect on me .So listen to your own body and slowly does it .( what's the rush )

Thank you for your advice, I am on day 27 on my reduction from 30 to 15, I had no idea how awful I would feel by each passing day, nobody prepares you for this, please tell me it gets better I really don't know what to do with myself. Excuse my ignorance but what is meant by a short half life?would really appreciate some help.I think these forums are wonderful and a very big thank you to all for their valuable info.Take care to each and every one of you.

The half life of a drug refers to the amount of time it takes for the level of the drug to reach half what it was when you took it.  For if you took one pill of 30mg of Mirtazapine in 20-40 hours you would have 15mg left in your body.  After another 20-40 hours you would have 7.5mg left etc.

It's one of the reasons why when you start a drug it can be a while until you get any benefit as it takes a while for the accumulated level of the drug to build up.  Its also why when withdrawing if you are going to get any side effects when dropping the dose they often appear a little while after dropping the dose (as you still have the accumulated level of the higher dose still in your system gradually working down it's half lives).

However everyone is different and what works for one person for withdrawing may not work for another.  Sompe people tend to have withdrawak symtpoms more that others etc.

One of the problems with withdrawing is that it is sometimes difficult to tell what are withdrawal symptoms and what are whatever illness you were taking tyhe drug for re-surfacing.  Again I would recommend having a read of the MIND web pages on Anti Depressant withdrawal as they cover this.

On the plus side you've done really well to get down from 30mg to 15mg.  If you can bear it I would just stick at 15mg for a while longer and see if your symptoms get any better before attempting any more drops in dosage.  Trust your body and take it as slow as you need.

 

Good advise don't rush it untill you feel better.

Hi, sorry to be a pain but I wonder if you can help, your advice is most welcome, whilst I am feeling dreadful all day l forget to mention that by the evenings I feel lot better can't understand this as once I top up the meds overnight I am back to square one again feeling bad. I question myself as to whether I should be taking this at all, do you know if this is normal? I have looked on the Mind website but cannot find anything on withdrawal.

No Margret don't come straight off it you will just feel a lot worse.Ride with the storm untill you feel better then next time you come down make it even slower even if you break them in half.But please don't just stop it won't help.Take your time and be patient .

Well depression and anxiety can fluctuate with different time of the day.  Personally I know that when I'm suffering from anxiety it tends to dip a bit by the evening.  So it could be that.

Or it could be that Mirtazapine just makes your anxiety or depression worse.  That's what I felt and is why I'm currently tapering off (down from 45mg to 12.5mg at the moment).  However even if that is the case I would not just stop taking the mirtazapine.  It's tempting to rush it and some people are able to go cold turkey but it's not recommended advice.  Follow norma72045's advice below instead and take your time, frustraing as that can be.

I'll post the link to the MIND web pages in a seperate post but it probably won't appear for a little while as posts with external links need to be moderated to appear.

 

Link to MIND website pages on withdrawing from AD's below:

http://www.mind.org.uk/information-support/drugs-and-treatments/medication-stopping-or-coming-off

I have just managed to get onto the Mind website, thank you for putting the link up. Would you mind me asking what your physical withdrawal symptoms are, do you get any black thoughts and feelings of doom and gloom? Also are you reducing with the help of your gp? And are you on tablet form. Many thanks.

Hi I decided to cut down as my own decision.  Haven't seen my GP since he upped my dose to 45mg earlier this year.  Although a touch hpocritical I wouldn't recommend withdrawing without talking to your GP first, for me I felt the pills just weren't working and were making thigs worse so though I would cut down and see how it went.

In the event I hav found it remarkably trouble free and certainly feel better than when I was on the higher doses.  Have tapered down from 45mg to 7.5mg currently.  For me I cut down by 7.5mg every 7-9 days and have been going a bit slower dropping down from 15mg.  I have just usd 15 and 30mg tablets and cut in half etc. as needed.

As I say I haven't had any real troubles doing this, certainly none of the symptoms you list.  But everyone is different and reacts differently.  It may be that you cut down by a bit too much too quick and you may have to taperdown a bit slower than you would like.  I've been on the Mirt since January this year, whereas you said you've been on it for 17 months, so maybe not that much of a suprise that cutting your dosage by 50% has caused some problems.  Not trying to be-little your suffering in any way just that for most people we need to realistic about how quickly we can taper down off a drug our body has got used to over a long period of time.

Of you've not seen them it might be worth seeing your GP if nothing else they could maybe help manage some of the symptoms you're getting.

Apologies for all the typos in the above, hopefully you can understand it!

Hi, I did ask my gp about coming off but she said that I needed to increase the dose, that's all they ever want to do, i have been rendered to a doc for mental health upon seeing him he said that I didn't show signs of anxiety and put it down to depression which I am not, he told me to cut down from 30 to 15. Four weeks ago then prescribed adrenaline to take as well.Upon reading the side effects I decided not to take it as it said it has suicidal tendances, on reflection maybe I did take a big reduction, only on the advice of this new doc, surely he should have known better. I found taking the mirt was giving me symptoms that I never had before taking it. Originally I was put on it door poor sleep and lack of appetite. I just want to feel normal again, maybe try a herbal remedy.

Margret are you at the moment on 15mg? If you was originally put on it for sleep,and lack of appetite,my opinion would be to take your health into your own hands and come off it but very very slowly.I can't believe Gps give drugs like that for such mild symptoms .I don't normally tell anyone to ignore there GP advise but sometimes (as I've been told lately ) you have to take your own health in your own hands.Go by your gut instinct but do take it slowly and see how you feel.I wish you well.

Hmm not sure what to say, I've never heard of Adrenaline being prescribed to help withdrawal side effects.  Surely adrenaline would only make any anxiety worse?

I think sometimes GPs are a bit unwilling to recommend cutting pills in half which given Mirt only comes in 45, 30 and 15mg varieties might be why they suggested going from 30 to 15.

Regardless, rather than looking back and wishing thinsg were different the important thing is to focus on how you feel now and going forward.  I think I agree with norma above (and your MH doc) that getting off the Mirt would be best for you.  Once off you can always evaluate how you feel and what you wish to do next.

Do you think your withdrawal symptoms have waned at all since your original post?

No not really, still wake in the early hours feeling sick and upset stomach, today I feel really shaky with the most horrendous headache, I keep saying to myself maybe tomorrow will be better, my gp told me that it was all in my head, lost all faith in her hence making my decision to weane myself off, I have to say that I never had dark thoughts before taking this drug, not nice at all, I really do think it messes with your head. By the way this other doc that prescribed setraline doesn't know I'm not taking it,really don't want another drug to come off of.

Thank you Norma,how are you getting on? Thought I might try a herbal remedy once I finish with the drug, far less harmful.x

Ah ok it was Sertraline not adrenaline, that makes more sense.  Quite often I've read that they prescribe Sertraline (or other med) to take as you're making the final reduction in the Mirt.  I think the theory is that as one drug is leaving your system the other is starting to take effect.

However as you say yhou don't want to jump straight into taking another drug which I can understand.  You've been on the reduced dose for about a month now right?  I have read other posters saying it's taken them a while to ride out withdrawal side effcts so you might want to hang in there a bit longer and see if things get better.  If they are genuine withdrawal symptoms they should start to ease eventually.

The other option would be to slghtly increase the dosage of Mirtazapine (say to 22.5mg) and see if that eases your symptoms and if it does once stablised try cutting down again more gradually.  I can appreciate you may not want to try this though as you've spent a month grinning and bearing it so far.

Did you read the MIND pages?  When you get to the one listing withdrawal side effects Mirtazapine is a drug with strong anticholinergic effects so you could expect to be feeling some of the side effects listed under that section which include feeling sick, insomnia, flu-like symptoms etc.

Sometimes it helps to know why it is you're feeling the way you do even if there is still no easy answer.

 

Hi Margret and Clarkio I'm still on 22.5 mg but it's only been 2wks so I still have a few problems bad temper( poor Hubby ) I'm also loosing weight,and very tearful but my sleep is settling down so the rest I can cope with for a bit longer then I'll drop to 15 mg,as I say Margret just take it slowly untill it settles Down then drop a little more.Theres nothing to rush for.

Hi to everyone, well just a general update, reduced my dose down to 7.5 5 days ago, the feelings are awful, terribly jittery, waking in the early hours panicking, really don't know what to do, is there anything you can take to help get you through? Does anyone know if its ok to take 5htp child's reducing down? Also how are you all getting on, God I wish there was an insight to how long this will go on.

Hold on in there Margret I think you've come down to soon.either go back to your 15mg for a few weeks longer or ride the storm I've been told the worse time is when you get to 7.5 but were all different let me know how you get on. Wish you well 

Hi Margaret.  Sorry to hear you're not feeling so good again.  

Had you got to the point on the 15mg where you felt ok then?  If not then as norma says to drop again seems like rushing it a bit.  

Even if you did feel ok on the 15mg, given the problems you had going down to 15mg I think a drop down to 7.5 mg is maybe pushing it a bit in your case.  

It's just my opinion but I would probably say try taking 11.25 (i.e. 3/4 of a 15mg pill for a while and see how you are on that.  Either that or get a 15mg pill and just cut a bit of a corner off and see how you are.  If you feel ok after a week then cut a bit more off etc.

HTH

Hi Norma,

Hi Norma, just posted an update but it seems to have disappeared? Don't know what happened there, well it's been 4 weeks since I reduced to 7.5,still feel awful it doesn't seem to get any better, I feel a physical wreck,, after reading through various posts on here, some people don't seem to be getting these side effects, how I envy them, to me it just seems like a punishment, and a nightmare that never seems to end. I keep telling myself that there is a light at the end of the tunnel but it seems a mighty long way off, how are you coping? Are you feeling any better?I just wish there was an antidote.I can't speak to my gpas she doesn't know about my withdrawal, so no help there, all she wants to do is increase the dose, we sing from a different hymn sheet unfortunately, I would give anything to feel normal again instead of like a zombie.

Hi Margaret, sorry to hear you're still having a rough time.  As you allude to in your post do try and stay positive, feeling this way will not last forever even though it feels like an enternity when you're going through it.

You stated in an earlier post that your Mental Health Doctor (Psychiatrist?) advised reducing and stopping the Mirtazapine and starting Sertraline instead.  Given that I would go back to your GP or another GP at your practice, they cannot recommend you increase the Mirtazapine dose if the specialist doctor has said to reduce it with an aim to stopping it.

I would explain to them what a hard time you are having coming off the Mirtazapine and that you do not wish to rush into taking another AD until you can "baseline" how you feel without any drug in your system.  If nothing else they should be able to presribe you the liquid form of Mirtazapine which would allow youto reduce more gradually when you feel able.

Again my sympathies at not having an understanding GP, whilst not able to offer any magic cure my GP is very good about encouraging patients to decide theit own couse of action, so it may be you have to switch to another GP if necessary.

Sorry this is probably not much help.  The only other piece of advice I can give is try not to fight how you're feeling, just accept it for now, say to yourself "I'm not feeling great at the moment but it will not last forever so for now I am just going to live with it".  I know it sounds a bit like hokum but often acceptance is enough to lessen how we feel.

Hi clarkio, thank you for your words of encouragement, I do indeed have some very bad days, I fully appreciate what you are saying and I do believe that there is a light are the end of the tunnel, some days I ask myself why am I putting myself through this then I go on this site and it gives me hope,what would I do without the support that is given to me!! I have now reduced the tablet down to 3.75 or there about, it's difficult to get it exact, this is my .4th day on this dose and I do believe the withdrawal symptoms get worse,it doesn't help when I can't get any sleep, I wish there was an antidote for this awful drug, I just keep telling myself that it's only temporary and that it will get better, well so I'm told, I fully appreciate that I'm not alone and have a lot of fellow sufferers all in the same boat and we all need to give each other hope.