Morning anxiety during withdrawal

Edited , 4 users are following.

I have stopped mirtazapine 10 weeks ago at the beginning of April after tapering off from 15 mg since December 2019. I went faster than recommended because I had no major issues in lowering the doses first to 7.5 then to 3.75 and 1.875. After 1.875 I dropped 0.1 mg every 3-4 days till reaching 0.1 then jumped off. Normally I expected the rebound insomnia to appear and it did at 0.4 mg. After stopping completely the first 3 weeks and a half I slept around 3-4 hours per night in one block being unable to fall asleep again once waking up (usually around 3 am). After that period I started to have random nights with longer sleep (5, 6 even 7 hours) but in the last two weeks things went wrong again coming under 5 hours and constantly waking up around 4.30 - 5.00 with a very strange feeling that I am not able to describe in words. It's like I am shaken by an electrical burning without being able to determine where it starts and where it ends and once awake I feel weak, trembling and somehow anxious. I have to get out of the bed and start moving around waiting 1-2 hours till I get better. I checked on the forums about this feeling and I may think about a spike in cortisol that is waking me up. I did a blood check at 08.00 in the morning and the level of cortisol was in range but very close to the upper limit.

During withdrawal I am already using a variety of supplements to help like magnesium glicinate, holy basil extract, l-theanine, lemon balm, ashwagandha, b and d vitamins and for the nights when I cannot fall asleep naturally I took valerian but it is effective for me only in dose larger than 600 mg which is affecting the stomach and gallbladder. I also do a lot of breathing and mindfulness meditation.

Any ideas about this strange morning feeling or similar experience during withdrawal ?

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7 Replies

  • Posted

    look at surviving anti depressants. lots there about cortisol spikes including shutting out the early morning light.

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  • Posted

    @sept76 thank you for the info. I checked and found useful information describing exactly my situation.

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  • Posted

    hello I wonder if there is anyone that can offer some sort of advice, I was taking mirtazapine for just under 8weeks and decided I wanted to come off them as I was only taking them due anxiety and panic over the virus but I felt I was in a much better head space about it and choose to come off, I was taking 15mg for the most part of the 8 weeks and then tapered to to 7.5mg, I did that for a week and half until my doctor advised me to just stop altogether, first few days I felt great but after about 4 days I started getting very anxious and panicky for no reason, im worried as I'm not sure if this is withdrawal or just me being anxious as my doctor has said but this is normal for me to feel anxious for no reason at all, its effecting my sleep alot and the in my opinion is useless, suggesting im just an anxious person and that maybe i should try going back on the meds, i really dont want to be on them as I didnt ever feel like i needed them before the pandemic and dont feel the need to take them just for the sake of it, please can someone give me some insight im desperate, I feel like im going mad , this anxiety is crippling


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  • Posted

    I just decided to use this thread to make updates to my withdrawal journey as I keep going.

    Now I am in the week 14 since stopping and things look like this:

    1. generally feeling better than the weeks before but still stressing looking for a new job
    2. constantly falling asleep around 10:30 pm much easier than last weeks
    3. no more adrenaline rush at falling asleep
    4. sleeping mainly 4:30 hours but also twice I slept 6 hours. Interesting that I sleep always complete cycles of 1:30 hours.
    5. still having problems waking up at 3:00 or 4:30 due to cortisol raising without being able to sleep again
    6. still cannot nap at all during day (it happened to drift for 1 or 2 minutes but I wake up immediately with kind of panic).
    7. lower anxiety during morning but random episodes of deep fatigue during afternoon
    8. decided for a while to replace the morning and afternoon sessions of running with fast walking in order not to add more cortisol
    9. increased sessions of mindfulness, binaural beats, breathing exercises and cold showers with good results in BP (115/65 and under 60 heart rate).
    10. this week no digestive issues as I also reduced supplements only to morning (Mg, Fish Oil reach in DHA, NAC and randomly B vitamin complex).

      I will update next weeks looking forward for improvement in insomnia and morning difficulties.

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  • Posted

    After a pretty bad week 15 with a zero hours sleep night and difficult mornings things went very well during week 16 as I finally managed to have at least 6 hours sleep each night. Looks like that as I am able to sleep more the body is recovering and both adrenaline rush and morning dreadful waking up are less present. I even had a nine hours sleep night (the first in 2 years) so looks like I needed 3 months and a half to see the signs of getting over the rebound insomnia generated by mirtazapine withdrawal.

    Really happy to see that I can feel normal again after the weird and strange feelings I have experienced being on mirt. Also it is good that now I managed to fall asleep again after waking up around 3 am or 4:30 am which was impossible in the first three months. Still very interesting that I have only complete cycles of 1:30 hours sleep.

    And one combination that works now to help me fall asleep in the evening if my first natural try fails : 1 mg natural source melatonin + 200 mg L-Theanine + 30 drops Lemon Balm tincture.

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  • Posted

    what can cause cortisol raising? and how did you managed to solve that problem so what you describe hre doesn't happen to you anymore, i think i have this, the only difference is that i'm still tapering, i'm at 1.6 mg and i really want to know what you have done to make all that hell go away! 😃

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  • Posted

    Actually it did not go away completely but it is less severe than it was during first weeks of withdrawal. I think that I had it also during tapering but probably it was hidden by the sedation given in the morning by mirtazapine.

    You may look on surviving antidepressants forum where there is an extended topic on the cortisol morning reaction. Seems like our receptors being deregulated by mirtazapine have a overreaction to the morning cortisol curve. Cortisol spikes and generally any increase of cortisol is generated by stress both mental and physical.

    Overall my sensation is that with time passing as the brain is healing and getting to work again without mirt things settle and the more we sleep the less cortisol we have as good and enough sleep is listed as a major cortisol reduction factor. Once rebound insomnia is going away probably also the mornings will be better.

    Holy basil extract and phosphatidylserine are the supplements that are mentioned to reduce cortisol and I am taking them in the morning.

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