My Mirtazapine Experiences - Usage to Cold turkey to Withdrawal Three times over

I thought I would share my experiences using, stopping and experiencing withdrawal on Mirtazapine at a dose of 15mg and 7.5mg.

I was put on 15mg beginning October 2022 for anxiety and sleep following a series of family emergencies that caused both issues to arise out of nowhere. I'd had no history of either throughout my life. Had I known how seriously mirtazapine would effect me eventually, I would have taken it but would have stopped for good the first time I didn't need it, which was mid-December 2022.

The immediate effect of mirtazapine was instant symptom relief for both my sleep and anxiety disorders and based on this experience I genuinely believe that if you need it ... well you really need it. The mistake I made was to not understand how difficult it would be to get off it. My psychiatrist was unable to convey this to me as in reality most people aren't suffering serious side effects from mirtazapine withdrawal or are just on it for the long term.

Initial Side Effects while using 15mg Mirtazapine in late 2022 were as follows.

1. Dramatically increased appetite and water retention - I am a long distance runner and also do some powerlifting but was unable, despite this, to keep my weight in check. My weight during this time, increased by between 4 and 7kg. Keep in mind that I was burning 1000-1500 calories per training session 5-6 days per week and you will get some indication of how potent this appetite increase can be.

2. If I took Mirtazapine after 10PM at night I would feel exhausted the next day. This is to be expected and it was recommended to take it prior to 7PM.

Side effects while stopping and then experiencing withdrawal from 15mg Mirtazapine in Mid-December

1. Extreme difficulty sleeping after 7 days of going cold turkey. This took three weeks to improve but never really got better.

2. Extreme heartburn after 10 days of going cold turkey. This heartburn required use of esomeprazole and h2 acid medication as well as antacid drinks. It was so powerful that I was unable to drink anything but milk and water and could only stomach chicken and salad for dinner. The heartburn lasted approximately two weeks and then vanished.

Beginning Again

Around February 2023, due to further family emergencies and a resurgence of anxiety and increased sleeplessness, I began taking 7.5mg of Mirtazapine. This dosage seemed to curtail some of the appetite increase and so I was able to maintain a modest weight increase of between 2 and 4kg which did not impact on my running in a substantial way unlike the previous 15mg. Once the situation that required me to take Mirtazapine was over, I went cold turkey for a second time.

Side effects while stopping 7.5mg Mirtazapine in April 2023

1. Extreme difficulty sleeping which did not resolve like it did during my first stoppage in 2023. I would sleep ok one night (6 hours) then sleep poorly the next (4-5 hours of broken sleep). Neither at the 7-8 hours that I require.

2. Extreme heartburn after 10 days. Which resolved in the same timeframe of 2-3 weeks as previously. This was treated again with esomeprazole and H2 acid inhibitors and with an antacid lozenge called quickeze.

Beginning Again the second time - 7.5mg

I began taking mirtazapine again in late May as my sleep had not resolved and all I really wanted was to be able to have some. Somehow my second time with Mirtazapine, I had been unable to resolve back to normal natural sleep.

The real problems began in July 2023. I began to notice an increasing amount of pain in my muscles and joints following exercise. And a very long story short I became unable to exercise in any way without extreme muscle fatigue for days to weeks on end. Following a number of tests no reason could be found. It was thought that potentially I had some form of overtraining syndrome so rest was recommended. At the same time I was waking up with increasing feelings of pure exhaustion that felt the exact same as those that I had experienced when taking mirtazapine late at night instead of earlier with dinner.

So, on a whim, I decided to stop mirtazapine for a week in September to see what would happen. By the end of the week I was no longer exhausted and my pains had partially receded so that I was able to train again. I thought, success, it was mirtazapine. It was but things were about to get much worse. I'll skip to my final explanation of side effects.

Side effects while stopping mirtazapine the third time in September 2023

1. Extreme difficulty sleeping which did not resolve until a month had passed and with all stimulants stopped (in my case this was caffeine of any kind). I still dont get 8 hours a night but I regularly get 6.5 hours non-stop after almost 12 weeks. It was the cessation of all stimulants that really helped. I had never had a problem like this with caffeine before and I assume this has been brought on by mirtazapine.

2. Extreme heartburn after 10 days. Which resolved in the same timeframe of 2-3 weeks as previously. This was treated again with esomeprazole and H2 acid inhibitors and with an antacid lozenge called quickeze.

3. Extreme full body withdrawal symptoms. These occasionally still happen but are not as bad.

   a. Sweats

   b. body pains

   c. nausea

   d. general feeling of intense unease

   e. feeling hot all the time but then freezing when i ran (in an Australian spring...)

4. Tinnitus in one ear that has not gone away but is much better after 12 weeks.

5. Terrible gastric problems. I experienced intense stomach gurgling and bloating for the first month. This then became pain and painful bloating along with gurgling in the second month. Until eventually my GP suggested that I should try cutting out different foods. To my surprise I discovered that cutting out gluten and lactose did wonders and my stomach problems vanished.

So. Where am I at now.

1. My sleep is not 100% still. I get 6-7 hours unbroken for 60% of the week. But many nights I still only get 4 hours of broken sleep.
2. I still feel off many days, and being my normal self is difficult. Its like a half minor out of body feeling, half pain and discomfort feeling.
3. I still have tinnitus
4. I cant have fizzy drinks or very spicy food. This causes a flare-up of my heartburn.
5. My gastric problems are mostly resolved. I can have lactose consistently now. If I have normal gluten-containing food at volume and for days in a row I will end up with bloating and stomach gurgling and food goes right through me.

So. I think if you need Mirtazapine for anxiety and sleep then take it. But get off it as soon as possible and do not go back on just to satisfy your craving for normal sleep. And if I could take away any of the symptoms I had but still deal with the rest, it would be the heartburn. It is by far the worst thing I have ever experienced. For me even being surprised would hurt from it.

Good luck and I hope this helps someone.

p.s. I am notoriously bad at remembering things like checking posts. So if I don't reply or never post here again its just because I totally forgot I ever did it.

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