Switching from mirtazapine to amitriptyline

Very true about the taper Calmer, I came off ''too fast'' initially - I was only on 7.5 for 2 weeks then stopped.  The side effects were horrendous - I had to go back on, and I think it was about a month then, but my GP had put me on venlafaxine, which was useless and a month later was in a right mess, so I was put on Pregabalin as an ''emergency drug''.   But your post has me interested... was this ''right mess'' still side effects of coming off - obviously in your opinion - and maybe I should have e.g. been on 7.5 for 6 months??

 

Thank you for your reply was prescribed 30 mg mirt last june after a bad break up i was previously on citalopram and amitriptyline for 12 years i got it into my head they weren't working so thats why i went docs who changed me to mirt initially was ok vivid dreams etc but then got all sorts of side effects blocked nose ,swollen eyes,bit of weight gain so yold doctor i wanted back on cit and ami he did i lasted 4 days on these as i went cold turkey on mirt i felt awful so went back docs and he put me back on mirt 15mg (i feel ashamed writing this) i also bought zopiclone of internet and was taking 3.5 with the mirt was doing okish,id been of work in this time for a back operation now recovered went back to work 4 weeks ago couldn't sleep went 3 days without so upped my dose back to 30 on the mirt yhis made me worse cronic insomnia so went back to 15 on the mirt with a full dose of zopiclone 7.5 this worked ok for a week ,but then my anxiety went through the roof with work stress so i went docs he said try sertraline and amitriptyline so thought id taper of the mirt went down to 7.5 and 7.5 zop my method in my thinking is now cut down the zopi and up the amitriptyline to 50mg eventually and just be on the amitriptyline just dont want to be on the mirt but your right im getting bad withdrawal symtoms from the mirt im sorry this is long winded but im just being truthful and honest thanks justin

I haven't took the sertraline as yet he gave me 50mg i wanted to get the mirt out my system also quite afraid to take it as ive read horror stories i just want to be normal and have a life,all this started with isomnia 25 years ago its cost me relationships in the past and to lose friends ive never been as low in all my life im 47 btw thanks for your reply earlier ian

When did you drop from 30 mg of Mirt Justin?  Are you saying it was 4 weeks ago?  

Did you then drop to 7.5 mg of Mirt?  

Upping and downing Mirt' can confuse the Central Nervous System and I read of folk having a bad time like yourself.    And a high percentage get worse going from 15 mg to 30 mg, seems to make any anxiety worse.  

Lets not rule out that Zopiclone carries its own withdrawal after 10 days or so, so a tapering is required for that also - just stopping brings on anxiety ... it can get confusing when taking more than one drug.  

Well, I think your best option is to go back to Mirt, do you think you could do this?  Reinstate and WAIT for stabilisation.  It might take a while, but having cold turkeyed it may well take a lot longer to stabilise.  You could search this site for Cold Turkey's and see what is written.  Of even google Mirtazapine cold turkey and I think you will be lead back to this site.

Hope a little bit of this helps. 

 

Hurrendous symptoms after only 2 weeks ..... ugh, how awful  

Well its hard to say wether you would have been better to stay on Mirt' for 6 months, most doctors say this is the minimum time for prescribing AD's don't they - whilst you sort out what the underlying factor is that causes us/you to be anxious/depressed/insomnia whatever in the first place.  I would have thought reinstating back to 7.5mg of Mirt (before trying another AD) would have stabilised you - doctors don't go along with AD's causing withdrawal, its just sad that they can't specialise in everything.

So are you still on Mirt 7.5 & Ven & Preg?

Sorry Justin, I meant to say reinstate to 7,5 mg and WAIT, no other AD's.  

I stayed on the Mirt7.5 and Pregabalin 3 x 100, ven I threw out the window.   Then finally (after 20 years) managed to see a Psychiatrist (1.5 hours!), he put me on Trazadone, stop the mirt dead (I was fine) and slow (weekly) cut down on the Pregabalin.   That was hard, and just 2 weeks after stopping Preg was close to S.  Emergency app with GP and she put me back on the 3 x 100 Preg.   Now I'm ''fine''.   Want to get off everything but therapy unavailable .... NHS cuts, damn tories...

 

Yeah roughly 3-4 weeks ago then did a week of 15 then a week of 7.5 i really dont think i can go back to mirt ive been 1 day on amitriptyline and 3.5 zopicloe going to do same tonight i know i will have to tape of zopiclone also just want the mirt out my system i really just want to be on amitriptyline,but idealy nothing at all but have had terrible insomnia for years,just feel really sick at mo stomach cramps dizziness muscle ache like you said it will be wd from mirt i really appreciate you getting back to me

Hi Ian, I'm sorry you are going through such a rough patch.  These drugs initially seem like the way to go to deal with difficulties, insomnia, depression, anxiety, etc. but they don't give benefit for free - there's always a cost with drugs and eventually the costs outweigh the benefit.  Then, the docs start trying this and that, because honestly it is really a guessing game, see what sticks.

So, if you want to get off everything, the first thing to do is get stable for a good month after any changes of meds.  Need the nervous system to get as calmed down as possible.  Changes in drugs and dosages means manipulating neurotransmitter levels which causes big swings.  Everything needs to calm down, sort of like swinging a ball on a rope, waiting for it to stop moving.  Then you can very gradually taper.  When working with more than one drug, it is best to only begin tapering one at a time so that you know what withdrawal symptoms are caused by which drug.  If you drop them all at the same time, you won't know which one is causing the problems.  The recommended taper rate is 10% of the previous dose per month.  So, if I were taking 15 mg of mirtazapine, the next month would be 13.5, then the next month would be 10% off of 13.5 (remove 1.35 mg) etc.  You could toggle the drugs, reducing one this way for a few months, and then holding on that one and working on another one.

I'm reducing two meds, venlafaxine and mirtazapine.  Now that I have a feel for what wd feels like for each one, I have been co-tapering, but 5% of each one, or maybe 8% of one and 2% the other.  It's work. Having had a failed cessation of venlafaxine with protracted withdrawal and then reinstatement, my nervous system is pretty touchy, and I'd rather stay comfortable and functional as I come off.  Think turtle, not hare.

There's a link within this thread that discusses the 10% method:

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

Follow it and it will take you to a site that has information about HOW to measure these dosages.

Hi Calmer.  My doc wants me to start Cymbalta while I'm still taking 30 mgs. of Mirt.  He said to call him in a week and we will "take it from there."  I won't do it.  I've been on Mirt for at least 20 years.  I think it has stopped working but I can't be sure.  I'm calling him tomorrow to say that I want to wean off of the Mirt (at least get down to about 5 mgs) over maybe 3 months.  My doc is a psychiatrist and I've been seeing him for years.  I am surprised by his giving me an antidepressant on top of an antidepressant.  Maybe he has a good reason but he didn't take the time to tell me.  I did the research on Cymbalta over this weekend.  I know the advise given here to listen to your body is wise.  I'll be checking back to let you know how I'm progressing.  I wish you all well.  Thanx again.