Share your Mirtazapine rebound insomnia story

Edited , 7 users are following.

Hi everyone, 

I am currently at the end of my Mirt taper but have trouble coming off it completely due to rebound insomnia. In my search for advice I found some relevant stories, but still don't get the full picture: 

– how long does it last?

– if doing a taper prevents it from occurring, then what did I do wrong?

– what can I do to help speed up the recovery time?

It seems to be on the most common WD symptoms. I thought it would be helpful not only for me to have a thread about it. 


1. How long were you on Mirt? At what dose? Did you taper or CT? If taper – dose reduction or dose elimination? (a few success stories I found used elimination) At what dose did you stop?

2. Did you get rebound insomnia with dose reducion or only when stopping completely? How soon after did it hit you?

3. How bad was it? Most people just say "terrible". But is it "fell-asleep-after-3am" terrible or "didn't-sleep-for-3-nights-straight" terrible? How many hours did you get on average? What's the longest you went with no sleep? If you had insomnia before Mirt, how does it compare?

4. How soon did you notice improvement?

5. Did you find any alternative solutions that helped? (supplements, acupuncture etc)


Below is my story:


1. I was on Mirt for about 4 month total, including taper (Jan-May 2017). Started at 15mg (for severe acute insomnia + anxiety brought on by insomnia). That dose was too sedating on the next day. Went down to 7.5mg after 2 weeks. Then down to 5mg after another 2 weeks. And from there on did a 0.5 reduction every 2 weeks or so. Finally jumped off after being at 0.5mg for 5 days. 

2. I had some rebound insomnia with earlier tapers, but once I got below 4 mg it was pretty smooth (because of the lower reduction, I guess?). It would hit me sometimes at the night of the reduction, sometimes few days later, and once 2 weeks after the dose drop. When I jumped off back in June for the first 10 days I felt great. But slowly sleep started getting worse and worse: and at 2 week mark to the day it hit me hard.

3. After a dose drop I would get 1-2 rough nights (2-4h of sleep) then things would level and even improve. But after I jumped off, at 2 weeks off mark I got 0 hours a night. I panicked and reinstated at 1mg. I'm now trying a slower taper: over the last 2 weeks went 1 – 0.7 – 0.6 mg. Been having some massive ups and downs: from immediate relief at 1mg, followed by some good nights (7-8h), followed by "meh" nights (3-4h), followed by s****y nights (0h). Then some relief again. Etc. 

Before Mir I would often get a garden variety insomnia: I'm an owl and a "busy brain". This rebound insomnia is quite different as in it feels very chemical: something it my body prevents me from sleeping. On some nights I would be nicely tired and relax, but as I'm drifting off to sleep, I would be awakened by this "wave": pounding heart, sometimes with a hot flash (not a panick attack!) I would shake it off, settle down, but it would happen again and again until I either fall asleep at a crack of dawn or not at all. Some nights I just feel bright awake even though I'm exhausted. I also wake up more than once after I fall asleep (luckily, for brief moments most of the time).

There's also an emotional component that goes with it: I can manage on 2-3 hours of sleep. But 0 hours night send me on an anxiety rollercoaster the next day. I'm a working mom, my days are long and hard, and after a really bad night I just feel powerless, frustrated and emotionally exhausted. I'm teary and fearful. Could this also be part of WD, with some anxiety creeping in?

4. I'm still in the midst of it, trying to figure out my next steps. 

5. Here are a few alternative things I'm trying:

– 200-400mg L-THEANINE 1h before bed (seems calming before going to bed and I don't wake up as often during the night). 

– 400mg Magnesium (don't know if it's helping, but was told it's good)

– fish oil, vitamin D, B in the morning (same – can't take if they help, but good for overall support)

– starting acupuncture next week 

– starting HOLY BASEL to hopefully help with the cortisol spike awakenings

I really hope to read your stories to get some inspiration and power through this tough stretch!


1 like, 19 replies

Report / Delete

19 Replies

  • Posted

    Hey how are you making liquid solution?

    Talking about my taper I was on 7.5 mg for 2 years. Tapered to 3.7 mg and insomnia came. Increased to 11.25 mg but no help. Till then I have reduced from 11.25 to 0.5 mg( tiny piece from tablet) but I am experiencing insomnia. Sleeping for around 2-3 days in a week. Now I am thinking to increase my dose to 1.875 mg because I m moving to USA for my higher studies. I know it's not inspiring but my life has been hell for the past 6 months.

    Report / Delete Reply
    • Posted


      Thank you for sharing and sorry for your pain. I feel you. 

      I'm not making a solution: I bring 15mg pills to a compounding pharmacy and they make smaller dose pills. They told me the lowest they can go is 0.2mg becuase the lower you go the more room there is for dose error. But I want to ask for 0.1mg pills next time to give it a try. 

      Did you just jump from 7.5 to 3.7 or did you taper? How fast were you tapering from 11.25 to 0.5 (how long between each drop)? Did you have insomnia all this time while tapering or were there breaks? 

      You say you are sleeping 2-3 days in a week. So other nights you get 0 sleep? That's tough. Are you taking any other medication to help? 

      I hope you feel better soon!

      Report / Delete Reply
    • Posted

      Hi Maria

      Compound pharmacy looks interesting. Anyways here is my story in detail :

      I started off with escitalopram (10 mg), clonazepam (0.5 mg) and mirtazapine (7.5 mg) because I was suffering withdrawal effects from my previous antidepressants. Last year I tapered escitalopram and clonazepam. And this is my mirtazapine taper update.

      Till 17th Jan - 7.5 mg

      From 18 Jan - 3.75

      Insomnia from 26 Jan.

      Increased the dose to 11.25 on 27 jan

      I thought I would get stable first and will again start taper. 2 months gone but there were days when I was going to office with no sleep. From April I stated reducing dose by 1.875 mg every 2 weeks. When I reached at 1.875 mg I started taking tiny pieces from tablet.

      Yes I stated taking vitamin b12, vitamin d. Also I took Ashwagandha to reduce stress hormone which helps me to feel ok after 0 night sleep. I hope this helps.

      Report / Delete Reply
    • Posted

      At 7.5 and have been for two years.  Tried halving it. Asked gp for liquid and was told it was expensive.  The old CITA method of dropping down one dose per week, then two doses per week seems worth a thought.  It seems a dreadful drug to get off, yet i used it for a year in 1999 and came off it by just halving, quartering etc, with no withdrawals at all.   I think they have changed the components since patent ran out as this time i feel so much worse.  Anyone else been on it in the nineties?
      Report / Delete Reply
    • Posted

      Hi Ann, 

      Could it also be that your body is more sensitive to it now since you were on it before? Just speculating. 

      My doctor was telling exactly that: you just take it for a few month, than drop the dose in half, and after a short while you can stop. Nope. Not in my case. I got hit with insomnia even after a very careful taper.

      Report / Delete Reply
  • Posted

    Hi Maria,

    How you getting along? I am  80 days off cold turkey at 7.5, Was on it 1 ½ years worked up to 15mg, Have spent the last ½ year trying to get off the MIRT.  I can tell how I’m doing if you are still interested? and our story’s seem the same, but I really don’t like  to scare people about symptoms and what not, As I know everyone is different.

    Report / Delete Reply
    • Posted

      I am now down to 3.75 and not having a great time.  Insomnia is not bad, I take diazepam at night.  What is bad is the general,unwellness feeling, aches and pains in back and hips, nausea and diar, wanting to isolate as feel so unwell.  Its only been two weeks but i just wonder if i continue will these side effects go before next drop? 
      Report / Delete Reply
    • Posted

      Hi Ann,

      I know how you feel ,  You seem to be ok with tapering, it is hard to say,  you have to listen to your body and mind, and decide for yourself, as you cannot compare to what others have experienced,  as your gender, age how long and how high of dose, and what all other medications and supplements people are taking. Try not to take the diazepam every day,  only when you really need it,  as it can become very problematic.  If the side effects have not gotten better after two week reduction, If I  was able to handle reductions like you are doing and if it were me, I would wait to stabilize at the dose 3.75, then try another reduction. Again the two week rule for waiting to reduce is just a rule of thumb not everyone can stabilize in two weeks. You have to listen to your body and mind.

      Report / Delete Reply
    • Posted


      I did not but a lot of people on this site and others have complained of  "flu-like" symptoms that you are having. diarrhea fatigue aches and pains. are felt by many who WD from this drug. Keep a book on how you feel, body and mind, this will help you understand what is going on inside you body and mind and each time you reduce you will know what to expect. Good luck Ann

      Report / Delete Reply
    • Posted

      I have had a bad night. Awake four times with aching in lower tummy,took paracetamol. Then panic awakenings. Feel just awful.  Appetite gone.  Still intrmittent diarrheoa and general fatigue.  Is this all normal,do,you think
      Report / Delete Reply
  • Posted

    Hi Maria

    I am wondering how you are doing as your story resonates with where I am. I am an owl with a busy brain too!   I was given mirtazapine for 2 years for sleep problems linked to work stress but  in the last 18 months have just taken 7.5 mg every 3 days.  All ok and I came off completely 7 weeks ago.  For the first 5 weeks no problem, then sleep became a bit broken.  I fell asleep ok but was woken suddenly feeling very hot with a wave exactly like you describe, but quickly fell back to sleep.  Then in week 7 - bang - its been terrible.  I haven't been able to sleep properly for about a week and lack of sleep has brought on anxiety again.  Its exactly as you describe. You are a little bit ahead of me so I wanted to ask if things have improved for you?  Have you found any improvement in your sleeping and did anything help?  I have come this far that I don't want to give in but don't want to get myself in a state with lack of sleep.  I have a job that requires me to be on the ball.  Would be great to know if the symptoms pass.

    Report / Delete Reply
    • Posted

      Hey... i know its a long time ago but what did you do and how are things now? i am in the same boat, only 3 weeks off and its a living hell. no idea what to do


      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up