Safe to reduce dose again?

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I have been on mirtazapine 30mg for four years now but it has stopped working for me and so I am coming off it. I cut my dose to 22.5mg ten days ago and feel fine. So am planning to reduce to 15mg in a couple of days time if I still feel fine. Has anyone come off mirt after being on it for a long time and not had any severe problems? Am I going too fast or should I be okay to reduce further if I'm feeling okay?

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  • Posted

    As long as you feel well on the reduced dosage, I think it is fine to reduce again.  Bear in mind, though, that it will take two or three weeks for the dosage reduction to catch up with you, so if you are concerned that you are reducing too quickly, maybe stay on each dosage for at least a a few weeks to make sure your mind and body really are confortable on that reduced dosage.

    I also think that you feel the biggest difference in when you stop taking altogether.  For me, reducing was fine; in fact, I actually felt better as I was reducing my dosage.  The withdrawal effects didn't start until I stopped completely.  By the way, I've been off completely for a week now and already feeling much better.  The first fews days were horrible, not sleeping and not eating anything, but now I feel I'm almost back to normal!  Whoop whoop!

    It's gets worse briefly before it gets better, but it's worth it!  :-)  X

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  • Posted

    Hi Evergreen

    Sounds like you're doing well so far  lol ~ don't jump the gun would be my advice, wait a full 2 - 3 weeks ... just to be sure.  From what I have read 2 weeks seems to be the hardest time.  

    I think the majority of users on the forum all have a bad time, so it's possible you may not hear from the one's who had little or no trouble with wd.

    Best wishes.

     

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    • Posted

      I had terrible withdrawal when I tried to come off the mirt and onto trazadone a couple of years ago. Doctor said just to stop taking the mirt! I tapered very quickly, thinking I was being ultra careful going slower than doc said but was a terrible mess within days and after 10 days I had to go back on the mirt. So I know I need to taper far more slowly. This is day ten so I think I will have another 4 days on this dose and then drop it again. Thanks so much for your continued support. How are things going for you?
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    • Posted

      I would agree with Calmer, to stay at a dosage for a few weeks.  You want to feel solidly stable before the next cut.  I seem to have mild WD symptoms from 5 to 10 days after a cut.  Beware that the WD can get much worse below 15 mg - the brain seems to really notice the cuts more so they should be smaller than halving your previous dose.  If you find that you are having really strong WD that is too hard to take, reinstate the previous dose, get stable again, and then do a much smaller cut.  In the UK people seem to be able to get liquid mirt, and dose it with a syringe, so you can take 90% of your previous dose and so on.
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    • Posted

      I am doing pretty good really, my slow wd is all I have the courage to do ... I have the liquid (forgive me if I'm repeating), I have been doing a 5% cut every 2 weeks (which equates to a 10% drop every 4 weeks of course).  My biggest worry is the insomnia returning, I've read around insomnia and done a lot of work on myself (!!) for months prior to wd, hence taking it so slow.  I too was in a very dark and terrifying place for several months with insomnia & anxiety before Mirt - and it is haunts me to think it could return of course.

      Simply put:  I am a strong believer that to let your neurons readjust to sleep without the drugs, it takes precious time; it would be easy to say to myself I can do this quicker, but I want to be very careful, give myself the best chance.  I havn't ruled out staying at 7.5 if need be.  

      Did you say you couldn't get the liquid Everygreen?  I have a reduction  conversion chart if you would like a copy, if you can get the liquid it is easier of course.  Hope the next few days continue to be good for you.

      x

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    • Posted

      Hi Calmer,  when you do the 5%/2 weeks, do you feel any WD symptoms?  I've been doing the 10% once a month and do have anxiety withdrawal, which isn't too bad but bad enough!  If I can avoid it by doing what you do, then I'm all for it!
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    • Posted

      Hi Betsy,

      No I don't ... Teresa & I (on the fb group) have been doing this for some time, and it's ok, in fact I'm planning to try 5% weekly now ... fingers crossed - as always, I can just stabilise and go back to first plan if it goes wrong.

      Best wishes.

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    • Posted

      Sounds like you are doing really well. I know what you mean about the fear of insomnia. But with me I have it in any case, even on the 30mg. This was the final straw for me. The main thing mirt gave me was to make me sleep like a normal person after years and years of insomnia stretching back to childhood. I could put up with the weight issues and the constant struggle/hard work to stay slim because I could sleep. But when it pooped out on me, that was it. I want off it. It gives me nothing now other than keeping my itching and migraines at bay. And these two things are not worth the weight issue. I'm tired of being on a constant diet and working out very hard every day. It is not sustainable.
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    • Posted

      evergreen, maybe as you taper down on mirt you will get the sleep back, because it is supposed to be more sedating at the lower end. I am at 17 mg down from 37.5 mg, and still gaining weight grrrr!  Sleep is still ok for the most part, though the last several days I've been popping awake at about 5:30, too early for me!

      Of course, I've heard that rebound insomnia can happen when people cut too much too quickly, so slow and steady wins the race :-)

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    • Posted

      Will do Betsy, absolutely, any signs or symptoms and i'll slow it down back to 5% every 2 weeks.  Like Evergreen, so fed up with the constant weight battle, feeling like I'm wearing a fat suit !  Not like me at all.

       

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    • Posted

      Me, too!  I hope it works out!  My weight is still creeping up even as the dosage goes down!  It's really hard to be patient and go slow given that!
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    • Posted

      That is so annoying! It seems that even the smallest amount of this drug has an effect on weight. It doesn't appear to be a linear relationship to the dosage.
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    • Posted

      I have never had any trouble with weight throughout my entire life, until I took mirtazapine. I have always been the same size ten dress size since a teen. Now I only have to look at food and I put on weight. I am working out on the cross trainer for half an hour every day, plus mucking out and handling three horses, and walking the dogs, and doing the housework. The cross trainer tells me I am burning off 500 calories a time, and I am sticking to 1800 calories a day. Any less and I wouldn't have the energy to do what I do. I am managing to stay the same weight doing this, but it just isn't sustainable.
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    • Posted

      Wow, for all you are doing at that intake, that is really unreasonable!  I do think the stuff messes with metabolism!  The doc who put me on this knew I was a recovered bulimic yet didn't mention that weight gain was a side effect.  When I researched it and told him my concerns, he said that people with eating disorders do okay because they have "control"  How stupid was I to accept that explanation!  Then I went to another p-doc who said I just had to exercise!  Ok, I could be more active but am pretty good with activities around the farm, and I was able to maintain before eathing the way I am now, but my weight keeps going up!  It is REALLY starting to both me with my body issues!
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    • Posted

      So we'll all be looking forward to returning to slim once off Mirt' -  yayyyyyyyyyyyyyyyy !  I think you do very well Evergreen to be able to stay slim on the Mirt' - you must have tremendous will power - I thought I had too ... once.  It's a doube wammy because Mirt' makes me feel like skipping the gym, I can do good all day, it's the evening, so hard to say no.

      What day of WD are you on now Evergreen & how are you feeling?

       

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    • Posted

      I think it's day 12. I feel fine. Just the insomnia that's spoiling things, but that was there before I started the taper. I did feel really dreadful on day 2-4 so if that happens again when I reduce the dose, then I'll know it was very quick withdrawal symptoms. I do have very good willpower... most of the time, but I have to really want to do something first. I haven't broken my regime in 11 months, but do feel very weary of it now!
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    • Posted

      Hope it continues to be ok for you, no rush.  I think if you're doing the cross trainer every day for 30 minutes you're boosting your serotonin levels good and proper with the constant CV exercise, I dog walk every day for an hour in the morning & most afternoons too, maybe I should do more CV though.

      When do you plan to do your next taper?

       

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    • Posted

      I cut down to 15mg last night. However, I am seeing the doctor today to ask for the 15mg pills and if I start to feel withdrawals will take the dosage back up a notch. I plan to taper by 3.35mg for the next two and then by half of that amount. If I can't get the liquid, I have a pill griner and will make my own suspension cut with the inositol powder and water. My insomnia is just dreadful though and I feel wretched. This is nothing to do with withdrawals though because it had already hit me when I was taking the full dose of mirt. sad
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    • Posted

      Regarding the CV workouts; sometimes it's really hard and I think I am far too tired, but feel so good afterwards, so yes, I recommend it for you.
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    • Posted

      Hope you get on ok with your doc' & he/she gives you what you need.  

      Your reduction is quite fast, I feel for you - so many people feel the need to get off it quickly though, I do too, so I have 2 trains of thought running around in my Mirt' aggled brain !

      I sometimes wonder about Mirt' when it starts to poop out ~ I guess chemically the wd begins then, hence your insomnia starting prior to the taper ... hope you get something sorted for the sleep.  My therapist was so understanding when I told her the more tired I become the less able I am to sleep ... something unclicks in the neuroplasticity ... heaven knows what.

      I will return to CV very soon, I have a musical score to learn and I find the cross trainer, ear plugs & score time flies by and its all win win.

      Wishing you well Evergreen

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    • Posted

      Thanks, Calmer. I know exactly what you mean about the more tired you get the less you are able to sleep. My husband annoys me sometimes because he always says 'when you are tired enough you will sleep!' Arghhh! No, it just gets worse and worse. People who have never suffered from true insomnia have no idea. I had wondered too, whether the fact that it has pooped out on me has actually meant I had already been suffering withdrawal in a sense. I remember the thing that forced me back onto it last time was the insomnia. Knowing that I don't have the option of restoring my sleep will make it easier for me to stay off it, I think. The other worst symptoms were terriblle nausea and fatigue. If I can get through that, then I will get rid of this drug. But it's a shame, because it really was a great drug for me and gave me three and a half years free of depression, insomnia and migraines, which I was more than happy to trade my skinniness for. So I would never say it was an 'evil' drug.
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