Mirtazpine - Use Or Withdrawal Causing Painful Vibrations/Muscle Tremors?

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I had posted before that my Internal Medicine specialist had prescribed 60 mg's of Mirtazapine at bedtime primarily for sleep. He also prescribed 900 mg's of Gabapentin and 60 mg's of Baclofen daily for what he was calling "Fibromyalgia symptoms." I was experiencing pain in my sternum, back, arm and leg, mostly on the right side of my body. I since paid for an entire spine MRI and it showed spinal stenosis, disc bulging and bone spurring primarily on my cervical and lumbar spine. The Internal Medicine specialist basically said that the MRI results weren't that bad and was not causing any of my pain. If anything, he cited that the MRI showed that the pain should be on my left side but not severe enough to be a problem. Again, "you have Fibromyalgia." Anyways, long story short; he placed me on the above medications to help with the pain and sleep problems associated with said pain. Things were much worse on the medications. As a result, in the last six weeks or so I have cut the above medications down as follows: Mirtazapine - 60 mg's to 15 mg's at bedtime - Gabapentin - 900 mg's to 300 mg's per day - Baclofen - 60 mg's to 15 mg's per day. If it were possible, the pain, muscle spasms and have gotten even worse since tapering off of these medications. Not only pain but painful vibrations and muscle spasms and tremors that run up my spine into my cranium. Also, down my right shoulder into my chest, arm and leg. A lot of spinal rigidity starting about twelve hours after my last dose of Mirtazapine which was also occurring while on the 60 mg per day dosage. The muscle spasms also run across my chest and affect my voice. The Ear, Nose And Throat specialist said all looked normal and to see a Neurologist. I'm on the waiting list and it won't happen soon in our socialized medicine system. Could it be side effects from the Mirtazapine, Gabapentin or Baclofen that have caused some of these new symptoms? Or, is it possible withdrawal symptoms from any of the medications? A mixture of the drugs side effects and withdrawal? The three drugs prescribed as they were seems like overkill to me from what I've read since. My GP is of little help and I've dropped the Internal Medicine specialist. It's driving me over the edge...,  seriously! Thanks for any thoughts and advice. 

1 like, 4 replies

4 Replies

  • Posted

    I'm so sorry to know you have so much pain and frustration. What you are experiencing re: meds can unfortunately be side effects of withdrawal or effects of starting -- takes about 3-4 weeks for an antidepressant (Mirt) to work; however, you don't know which med (if any is causing you more pain).  Baclifen is a skeletal muscle relaxan (maybe you should experiment with that for the spasms), I've never heard of a script for Mirt at 60 mgs (45 mgs seems to be the top for effectivenes) but maybe he gave you 60 mgs to help with pain and you might have dropped that too quickly but who knows.  The Gab... is for pain and my friend who has back problems with herniated disks takes 900 mgs without feeling that much better sooooo you may have dropped that to low to quickly.  Who can say.  Experimentation (short of a physicians advise) is all I can suggest.  I'm going thru Mirt withdrawal as I type so I know a bit of what you may be experiencing.  I do not; however, have pain but a truck load of anxiety.  I hope you are able to see a neurologist in the near future.  

    • Posted

      Thanks frazzled;

      ?I get the feeling that the Mirtazapine wears off through the day. As it leaves my body, the muscular pain and spasms increase in severity. A lot of rigidity as the day progresses. Then, seven at night comes around for dosing and I'm asleep by ten. If I awake during the night, I don't have the severe pain and muscle problems. I was not even close to this bad before starting all three medications. It could be an advancing neurological disease. When I get to see a Neurologist I'm certain they will do the battery of tests. Hope you are able to get off of the Mirtazapine and your anxiety calms down.

  • Posted

    Hi Campaigner.I started Mirt 7 months ago at 15mg at night upping to 30mg 4 1/2 months ago (15 am, 15pm) along with Gabapetin starting at 200mg 4 1/2 months ago going up to 600mg( 200 am,200 afternoon,200 pm) 2 months ago in 200 mg increments for IBS/back pain and anxiety/depression.You are right about the Mirt wearing off half way through the day.Also I really don't know if the combination of meds(along with 50mg Tramadol twice a day for pain) is making things better or not.The back pain is down,but my anxiety/depression seem the same but in a different way,if that makes sense.I was also being weaned off of Paxil after about 20 years at 20mg twice a day.I also get Librax(20 years) and Bentyl(7 years) twice a day to relax the colon.I am going to be weaned off of Librax this month however.It truly is a guessing game with it's ups and downs.It could be withdrawal to an extent since you lowered them all together,but like me with all the combinations it's hard to discern.I would say it's a mixture and keep trying to find a combo that works,but it takes time for your body to adjust fully to whatever combo you use,usually at least weeks.Hop this helps.I'll be praying for you.Hang in there!! God Bless You,Bob

    • Posted

      Oh my Robert I kind of freaked when I saw the # and names of meds. you are on.  I think you should go to drugs . co m (see if the bot catches that) and look at the interactions.  Did the same physician give you scripts for these meds and tell you how they may interact?  Also, were you told how to wean off and start?  I'm concerned.


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