Problems to tapering mirtazapine. Help me please.

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Hi, I start using mirtazapine 22.2.2016 to getting off opamox but now

i realize that first I just tried to get off too quickly. It took 2 months to get 

off opamox. It was bad mistake to take mirtazapine I think. First I used 7,5 mg dose maybe one month and then second  month I use 15 mg and then I start to stopping slowly. It took two and half month to go 15 mg to 3,75 mg but then it went much harder. I allways make a liquid. 15mg mirtazapine and 500 grams water. Last days I took that water 123 grams = 3,69 mg mirtazapine 12 days period and then I tried to taper 1 gram per day that liquid. When I take 122 grams it effect more than I think. Next day after that I took 121 grams and then I feel so bad that I can't taper anymore next day and maybe even back to 122. This seems allmost imbossible to get off. I know that I don't have any sickness on backround. These is just 100% withdrawing symptoms. I will start to school next month 10.8. Can you help me and give some tips what I should to do? During this four and half month mirtazapine period I have gain weight 10 kilograms. I also can't exercise when using this drug, just a little walking. When I started to use mirtazapine my doctor and two other persons say that it won't be problem to get off mirtazapine but now its much much bigger problem that it was to getting off opamox. Sorry my bad english.

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  • Posted

    hi

    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.

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  • Posted

    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,

    http://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. 

    --------------------------------------------------------------------------------------------

    • 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.

    + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + +

    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.

     

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  • Posted

    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?

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    • Posted

      It isn't really complicated once you get your thoughts around it.  

      The liquid Mirt is available only in the UK I believe, Sol Tabs are next best to make a liquid with.  However, if you are USA/Australia, I believe there are compounding companies, where do you live?  These are available to be delivered I understand.

      Best wishes smile

       

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    • Posted

      Hi Charles98819

      I don't know that is there mirtazapine liquids. I use normal 15 mg mirtazapine. I use a digital scale and put exatly 500 grams water to shaker and the mirtazapine pill there and wait about 15 minutes. Then I shake it hard about 20 seconds and then wait until the foam disappears. Then I put exactly right dose that liquid to other shaker. First I can go faster but then slower. You see what is suitable speed for you. Don't rush too fast. If symptoms goes too nasty then stop in that dose a while or even take back a little if you note that you are moved too fast and continue when you feel better. The last 3,75 mg is much harder and you can go much much slower. This my water method advantage is that you can go very stable. Tell me if you didn't understood something that I tried to explain. I have so bad english but I think you got it. I hope that this helps you smile 

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  • Posted

    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!

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    • Posted

      For some people there is no withdrawal from mirtazapine. For other there is severe wothdrawal 

      the drug companys can sugars coat it all they want with " discontinuation syndrome " call it what you want but insomnia severe corisol surges vomiting and diarrhea, muscle cramps , sweating,and brain shocks dont add  up to withdrawal then I wouldn't know what else to call it .

      simple test do the symtoms go away if the drug is reinstated?  If yes ...then it isn't mind over matter. 

      Be careful with any AD as they all have potential for physical addiction. 

      Wishing everyone the best 

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    • Posted

      But that's not withdrawal. To go through withdrawal the substance in question must be addictive. If you take benzos or vicodin or heroin or drink alcohol, your body builds a tolerance and you need to take more and more for the same effects. Quitting benzos or alcohol cold turkey can kill you. I've kicked both, and it's hell on earth.

      Mirtazpaine is not addictive. You don't need to up your dose because of tolerance. 

      I felt uncomfortable for about a week when I quit mirtazapine cold turkey. That's all. I just reminded myself that it was temporary and I would feel better soon. And I did. It will be 5 weeks since I took mirtazapine, on Tuesday.

      It's not as simple as "do the symptoms go away if the drug is reinstated." You're probably experiencing symptoms of depression or anxiety, which is what you were prescribed mirtazpaine for in the first place. ADs change your brain chemisty, some worse than others, and it takes time to get back to "normal." But mirtazapine is one of the more gentle drugs out there. I had to taper off Paxil and it took me months. It was awful. But SSRIs are different, and they're MUCH harder to stop than mirtazapine. That's not my optinion, that's a fact.

      I'm sorry but it is irrespsonsible to say "all ADs have potentional for physical addiction." That is just plain scientifically not true. 

       

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    • Posted

      Paxil and SSRI were MUCH harder for you to stop. 

      Mirtazapine was much harder for me to stop. 

      Thats the difference in individual chemisty. 

      Because a problem is not YOUR problem doesn't mean it's not a problem 

      that's just being self centered. 

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    • Posted

      I'm sorry, I wasn't being self-centered and I didn't mean for it to sound that way. I was just saying that, in general, SSRIs are much harder so discontinue, because that is the nature of SSRIs. Mirtazapine is praised by the medical community as being much, much easier to stop.

      Were you on another AD at the same time as mirtazapine? Every person I've ever talked to that had a hard time coming off mirtazapine was on another AD at the same time, or still had an underlying anxiety disorder that was no longer being treated, so of course they felt terrible when stopping mirtazapine. 

      Again, sorry if that all came out wrong. I want to help, not hinder.

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