Severe nausea on tapering - what do you recommend ?

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Have been following a very slow taper from 15mg as you good folk recommend (unlke my doc who thought I should  do it over a couple of weeks!). Now down to 5mg but nausea is awful. Can anyone recommend something to help please.  Have tried ginger, peppermint and calomile but has not helped.

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13 Replies

  • Posted

    Really sorry to hear you are suffering like this.  In my opinion, there is nothing worse than nausea. Ironically I was put on mertazapine because I was so nauseous.  It went on for 13 weeks day and night and I lost 1.5 stone, absolutely no help from GP practise, all the anti nausea pills made me feel worse.  It was then decided that it was anxiety in hospital so was put on the 7.5mg for a couple of weeks, then 15mg and then 30mg.  I personally feel the mertazapine is masking something as I have suspected mild primary hyperparathryoidism and the 30mg I felt was making me feel unwell, also put back the 1.5 stone I lost but just on the stomach and thighs.  I have recently cut back from the 30mg to 15mg and I too feel very slightly nauseous, nothing like before but it worries me as I could not go through that 13 weeks as I literally wanted to die.  Peppermint is not all its cracked up to be and if you overdo it, which I have done in the past, it can cause the sphincter muscle to become too relaxed which has happened in my case and so I suffer with gastric problems as well.  I don't really know what to suggest, I guess eventually all of us will have to come off this drug at some point.  If you cant stand the nausea then how about trying to up it to say 10mg and graduate it down.  Actually you are cutting down quite a bit from 15 to 5mg.  It is difficult cutting these tablets, I know from the 30mg and these pill cutters are not brilliant.  I havent even told my surgery I have reduced the amount, they wouldnt be bothered anyway, it's just pushing out repeats each montha and then a review in 12 months (if you are lucky).  My lovely cleaning girl who was taking codeine for a bad back has been on cocodomol for two years, 120mg of codeine per day and they havent even reviewed it and now they are concerned as she is addicted to it.

    Try little meals and dont go long lengths of time between meals.  I always carry a box of crackers, also drink plenty of water.  I eat very bland things like plain rice but I try to eat healthily as I have severe osteoporosis which does cause me anxiety and is always at the back of my mind when I am trying to do a few chores in the house.  My nausea started a few days after a racing heart right out of the blue so that is why I think in my case it is masking something but if it came back as bad as before I personally would increase the dose again and to hell with the fat stomach.

    Sorry I cannot be of help, but you are not alone with this nausea problem.  I hope you feel better soon.

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    • Posted

      Elaine - just your reply helps a great deal knowing I'm not alone fighting a problem. Many of the things you raise are pertinent - my doc doesn't know or appear to care about the problems with Mirt and withdrawal - happy to keep on with the repeats and yes the racing heart, anxiety, a feeling that something else is wrong etc.. I really appreciate your replying. Thank you 
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    • Posted

      You are most welcome, I hope you feel a bit better soon.   I noticed that someone on a different thread is saying that after six months on mirtazapine of 30mg dose, she feels its doing nothing now with dark days and is losing weight but with increased energy.  I have suggested she gets her thyroid checked as the latter two symptoms sound a bit like an overactive thryoid.  These GP's and psych teams always like to blame everything on stress, maybe it's the easy option rather than looking for a physical reason which is causing anxiety.

       Let us know how you go.

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  • Posted

    Hi - I'm sorry to hear you're struggling so much, I have taken different meds in the past that gave me feelings of nausea . . . I used 'seasick bands' or 'travel wrist bands' which you can buy from any chemist, or on Amazon, they've always helped me . . . might be worth a try for you?
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    • Posted

      Susan

      That's a good idea! - used to put them on the children for  car sickness when they were younger and they seemed to help.  Thanks so much for replying

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    • Posted

      Hi

      Sorry to read of your suffering, no one should have to endure this coming off AD's.

      Can you expand your Mirt history a little; how long were you on, what mg and how did you taper ~ knowing the answers may well pinpoint any issues with the taper plan.

      Wishing youu well.

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    • Posted

      Calmer

      Thanks for reply. Precribed 15mg for anxiety,depression,insomnia. Was on for 4 months and feeling better decided to taper. Having read so much on here about slow withdrawal I went to 12.5mg for March, 10 for April and then 7.5 for May. All was ok but when I dropped recently to 5 the 'wheels fell off !' Sleep like a baby - in fact too sedated all morning with zero energy. This nausea and upset stomach is the worst. I have read that mirt is more sedating at lower doses and considered just dropping all together but too scared to do that because really helps with sleep. Guess I should go back to 7.5 and try again. The problem is reducing at small doses -even with a pill cutter you can't be accurate. So will try this method of grinding and making a paste to control 10% reductions if I can get hold of equipment. No point discussing with doc. Appears to have no idea that coming off 15mg mirt would be a problem. Maybe ok for others but I'm a sensitive soul !!  Any comment welcomed as usual from you wonderful forum members !

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    • Posted

      Good idea to try the bands, I got some very quickly from Amazon.  They didnt really help me but as I said I think my underlying problem causing the nausea was something else.  I might give them a go again for this slight nausea.
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    • Posted

      OK My Cloud, you were all ok until the drop from 7.5 to 5 mg - this is actually a 33% cut, way too big for the sensitised nervous system to enable it to stabilise & restructure.  Mirt' is difficult to taper, 'seemed'  like you coped with the previous cuts but they got bigger right?  And the accumulation hit you hard.

      Yes you are right, I think you should go back to the 7.5mg asap, and just wait until you feel stable again, and you will.  And no, so right not to try just jumping off, you'll get even worse symptoms.

      Have a read here for an informed choice, take your time, make a plan for a 10% every 4 weeks or even a 5% taper (I do 5%) every 2 weeks.  Make the solution yes, I use the liquid Mirt' ~ available only in UK on precription, or you can get the Sol Tabs which are easier to dilute than the tablets.

      Shout out if I can help, I'll be here for a while yet, I'm stll tapering too.  

      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".

      And for the Sol tab info:

      https://patient.info/forums/discuss/mirtazapine-tapering-simplified-510495

      Wishing youu well MY CLOYD

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    • Posted

      Calmer - you are an angel !. In my simple mind I thought I would drop by 2.5mg each month  ie the same drop but as you point out the drop last friday from 7.5 to 5 was a huge % drop. Maths was never my strong point but no wonder my sensitive nervous system is complaining - and it waited 3 days to do so ! Thank goodness for this forum and wise people like yourself who share their knowledge and wisdom. God bless !
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    • Posted

      I have to agree with Calmer - excellent!  I am also tapering mirt, and I use the SolTabs to make my liquid to dose more accurate amounts.  I use a suspension vehicle called OraPlus which is thick.  I use about half water and half that, because even with the SolTabs the danged Mirt is not very soluble and tends to settle.  The OraPlus helps keep the particles suspended so that in the time it takes to draw up my dose, it is still even throughout.  

      You could do the same with regular mirt tabs, though the hard part is getting them powdered and into solution.  One tends to lose some of the tablet along the way.  Best solution for that is to get a milligram jeweler's scale, powder the tablet and then weigh out the amount you are going to mix with your liquid so that you get, say, a 1 mg to 1 ml solution.

      Anyway, kuddos to you, my cloud, for getting so far in your taper!  You can do this, but it is very important at this stage to go way slower.  It is really easy to kick off rebound insomnia as the histamine receptors get freed up at these low doses.

      Good luck!

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    • Posted

      Betsy

      You're another treasure with sound advice. I just had not realised the difficulties at low doses - I thought having cut down from 15 to  7.5mg the last steps would be easy ! How wrong i was - back up from 5 to 7.5 tonight, stabilise and then the slow taper recommended. Thank you so much for your reply. Best wishes.

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    • Posted

      Thank you and thank you Betsy, fantastic advice there also.  

      Yes it can take 4 days or even 2 weeks before any signs, symptoms or sensations kick in.  Some get them after a month.  It sounds like it has only been a few days since your drop to 5 mg?  Youu should be ok sooner rather than later.  

      Let us know how youu get on.  Happy to help.

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