mirtzipine withdrawal + anxiety return

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Hi,i have been tapering for 80 days approx.The last cut was to 0.77ml(7%cut to 11.55mg)  -I had a week of feeling good,2 weeks of feeling rotten ,a week of pretty good and another 5 days of feeling rotten with bad anxiety.I am puzzled as to why i am feeling rotten again.Anyone got any ideas?Do i ride it out again or do another cut?The next cut will be 5%.

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  • Posted

    It could be that you are getting anxiety coming back now the mirtazapine is below therapeutic levels. I've not got much experience of mirtazapine withdrawal , but I'm sure there are people on this forum who know more. The only time I tried reducing it, I didn't get anxiety , but just felt tingly and it was the brain zaps that defeated me.

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  • Posted

    I just went cold turkey on 45mg. I had tried tapering before but it just prolonged everything. This way, I felt weird for about a week and then it was over. I did have to taper off Paxil, years ago—that was a different beast. SSRIs are notoriously difficult to quit. Mirtazapine works differently and is much easier to stop. 

    However, now that it's been a month and a half, my anxiety is coming back. It comes and goes so I can't tell if it's truly returning or if it's just an anomolie. That could be happening to you too. It takes time, which is infuriating, because nobody wants to spend any time with anxiety—it's the worst.

    That's the complicated part when it comes to these meds: sometimes you can't tell if it's "withdrawal" or just your symptoms returning.

    But again, I have to mention, that mirtazpaine has no true "withdrawal" because it's not an addictive substance that you build a tolerance to, like a benzo or opioid or alcohol. But discontinuing mirtazapine can still be challenging, especially if you were taking it to treat anxiety or you're taking other meds with it.

    Hope that helps?

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  • Posted

    Hi Plainden

    I can't do 7% either ... just 5%.  

    In my H/O, its a bit of a gamble wether to do another taper right now, because you aren't stable/settled yet from the last drop, hmmmm I've heard about this happening with other folk.  

    Be reassured that the discontinuation syndrome of Mirt' can and nearly always does cause symptoms which come in windows and waves, just like you are describing ... a week good, a week bad, then good etc.  

    If its too much you could step up 2% so that the last drop would have been 5% and see if you settle; I know its difficult to know what to do.  Or just wait for another week or so and see if there is a change or iimprovement.  

    Its worth keeping a chart/journal when you taper, you might see the same daily/weekly pattern and I think this can be reassuring.  For instance, I have noticed I have4 or 5 days feeling ok, then I feel fatigued for about a week, then a little lower for 4-5 days, then I feel good again - then its time to start over and do another drop ... ugh!!

    Also, if there's a stressful time or added difficulty life can throw curved balls right?  Don't do a drop, wait for a better time maybe.

    Best wishes x

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    • Posted

      Hi + thanks for reply.I must admit I thought the taper wld follow pattern of feeling good,feeling awful (when reduction kicks in) and then feeling good again ready for it all to start again with next cut-I did not expect another period of feeling awful.So i suppose i'll just have to prepare myself for anything.

      I decided against another cut as i need to get stable again,however I did decrease reduction to 5%.I am much better today -either due to the lower cut OR simply due to my head sorting itself out after another week of being unwell.We'll never really know.I also slept much better last night-the past few nights i've been awake from 3am .

      I do keep a diary of how well/bad i feel and the cuts i make-so far there is no pattern whatseover ! (unfortunately).

      Before i make another cut i need to be stable for a couple of weeks so here's hoping.

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  • Posted

    When tapering (mine was from Effexor at a very high dose - damn, it was like being hit by electricity) I might add it is to be remembered that when you get down to low doses, those very seemingly small reductions each period make up a large % of previous dose (eg, reduction by 5mg from 15mg = 33% reduction). My doctor actually gave me diazepam and clonopine to reduce the dreads for the last 21 days. Yep, awful.  They can now do genetic tests to see which anti-depressants will have adverse effects on a person - I don't think this will be common for some time, but imagine the money, suffering and time that will save.

    Good luck

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