Problems to tapering mirtazapine. Help me please.

i am on mirtazaphine and it does make you put on weight. i am on a low carb diet. i started eating a banana for lunch as well. i lost 17 kilos without excercise. the more you eat bad the more weight you will put on.

Hi Ismo,

What dose are you at right now?  Have you gone back to 3.5mg and if so how long for?   Lets see if I can help with the tapering a little; whilst your method is alright, it seems a little haphazard.  It is best to taper slowly, making a drop of 10% every 4 weeks, or if you are most sensitive (like me) 5% every 2 weeks.

For advice on tapering Mirtazapine slowly at the recommended rate of no more than 10% every 3 or 4 weeks, please see the following which is within this forum,

https://patient.info/forums/discuss/depression-resources-298570

and then click on the link "REDUCING AD'S USING 10% WITHDRAWAL METHOD".

Here is the Mirtazapine pill to liquid instruction for anyone who might want to taper slowly.

You will need a 15 ml syringe and also a 1ml syringe with markings on at 0.1ml intervals

A pill crusher (available from Amazon)

A clean medicine bottle or small jar

A small accurate measuring jug or medicine cup with measure on. 

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• Crush up 2 x 15mg (or 1 x 30mg) Mirtazapine pills until they are a fine powder (although the outer coating does not grind up as fine as the white Mirt’ powder that is inside, but that's fine. So long as the white Mirt’ is a fine powder.

• Then measure 30ml of half water and half maple syrup (or something else to your taste) and pour into the medicine bottle.

• Then pour in the powder and shake it vigorously. So 1ml of the liquid equals 1mg of Mirtazapine. N.B. Mirtazapine is not soluble in water and so you must shake it vigorously every time you take out a dose to ensure you are getting an accurate measure of Mirtazapine.

• Also you should store it in the fridge. It is recommended to keep it no longer than four days, but a reliable source kept (her) each batch for two weeks without a problem.

So from the 30 mg / 30 ml draw up the syringe what you require. 

1 ml of the liquid = 1 mg.

This has been tried and tested and works very well. Just make sure you shake it very well before drawing up the syringe.

Credit to Evergreen.

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Using Mirtazapine SOL TABS:

Sol Tabs can be very useful if you are withdrawing, or maybe even if you are changing doses. Sol Tabs dissolve very readily in water but they settle due to the fact that Mirt' is not soluble. Ora-Plus suspension liquid, available from Amazon (around £19) will help with this, it does keep the Mirt suspended long enough to dose accurately. 

For every milligram of Mirt, add the same amount of liquid

I would suggest half water and half Ora-Plus

So if you want to taper from 15 mg less 10% = 13.5 mg 

Mix 3 x 15 mg (45 mg in total) Sol Tabs of Mirt with 45 ml of water

Each nightly dose is 13.5 ml - using a 20 ml syringe draw up the 13.5 ml

The method above is enough for 3 nights, throw away the remainder, and on day 4 start again. Of course you can adjust how many Sol Tabs you use as and when necessary.

*You will need a 20 ml syringe and also a 1ml syringe with markings on at 0.1ml intervals

So for 3.75mg of Mirt, less 10% = 3.38 (or round it up to 3.4 mg the best you can see on the syringe) or for 5% 3.75mg less 5% = 3.5 mg.  Yes it might be difficult to see on the syringe, do youur best.

However, before you start to do any more tapering, I wouuld wait at the dose you have gone back to until you feel you have stabilised.  Mirt' is difficult to taper from, you are right, but if you follow a slow plan you won't have the nightmare symptoms that you have already experienced.  

If you need help with the sums I'm happy to help, let me know.

Hang on in there, you will be ok, it might take longer than youu were planning but it is doable, with a little kindness to yourself.

Wishing you well.

Hello Ismo

Thanks for this advice is really much appreciated. I have been on mirt for six years and I want to start withdrawing....The procedures with liquids looks complicated. Does mirt exist in liquids at the pharmacy's?

I quit mirtazpine cold turkey after being on it for 12 years. Mitazapine is not addictive so there is no withdrawal, however, there is what's called a "discontinuation syndrome" that may occur, but in my experience it was nothing compared to getting of Paxil some years ago.

If you think it's going to be awful, it will be awful. But I would recommend quitting cold turkey and drawing it out over weeks and being miserable. Just take a benzo if the anxiety becomes unbearable.

Good luck!