Tapering below 1mg – please HELP! Insomnia is bad.

Posted , 5 users are following.

Hi guys, 

I'm new here and was really hoping to get some answers: I keep searching on forums for situation similar to mine, but can't find anything.

I started on Mit at 15mg for acute insomnia at the end of Jan 2017.

That dose was too strong, so went down to 7.5mg in 2 weeks.

Then March 1 down to 5mg.

Each time I would go down on a dose some sleep regression followed, but would usually resolve in 1-2 days and sleep would even imrpove some.

Going from 5 to 3.75 was more difficult: some anxiety, sleep got pretty bad. I decided to slow down and got 1mg and 0.5mg pill from a compounding pharmacy. So from 5mg I went down to 4, 3.5, 3, 2,5, 2, 1.5, 1 – all in 2 week intervals. Some minore bumps with sleep here and there, nothing of exraordinary. I thought I'm DONE. I took 0.5mg for 5 days and stopped. I didn't even think about it anymore, slept great.

Then 1 week out had a first night with 0 sleep. I thought this was just one last bump on the way out. Slept better the following week. Then at 2 weeks off it hit me again, progressivly harder: 5 hours a night, then 3 hours, then again 0. 

I panicked and went back to 1mg, thinking may be I jumped off too quickly  from that last dose. I honestly didn't think it was doing anything anymore!

This time I got 0.2mg pills and decided to go a bit slower. 

I stayed on 1mg for 3 days – imediate improvement.

Went down to 0.7mg for 1 week – still feeling good.

Went down to 0.5mg – same night couldn't sleep.

Went up to 0.6mg for a week – slept well.

But tonight again – 0 sleep. 2 weeks to a day since I went down from 7mg to 0.7mg. Plus some anxiety (but I think it's just about sleep). 

So my QUESTIONS: should I wait at 0.6mg and see? Should I go back up? If yes, than to what dose? 0.7? 1? And then going down even slower? Does the 10% rule apply to below 1mg? We are talking 0.00 then, it gets ridicolous. Would going from 0.7 down in 0.1 increments be better? Or should I just stop all together and ride this rebound insomnia out?

I'm doing all the "right" things for insomnia otherwise: esxersize, eat healthy, go to/get out of bed at same time, starting accupuncture, taking natural supplements etc. 

Any advice or success stroies on this last leg of taper is very much appreciated!

0 likes, 12 replies

12 Replies

  • Posted

    Hi Maria,

    I've read your story with interest, you know you're doing really well to get down to the noughts, I think it's just an accumulation when you get the "blips" of previous drops in dose.  Yes you're right, you have a choice of staying at 0.6 mg or sliding down slowly to the last tiny drop of Mirt.  Most of the people I speak to have had some rebound insomnia once off Mirt' ~ AD's alter the brains chemistry and when we stop them it is trying to find its way back to homeostatis.

    Personally I went further than you have so far, I went 0.6, 0.5, 0.4, 0.3, 0.2, 0.1 mg, dropping every 7 days ... so yes, quite a bit slower than you.  

    Then to trick my brain, as it were (!) I alternated, taking 0.1 every other day for about a week, then skipped 2 doses the following week (I skipped say Tuesday & Saturday), then I skipped 3 days a week, then 4, then 5, then for 3 weeks I just took it on a Friday ... that's just me !  

    I think after stopping Mirt we can lose confidence as to wether we will be able to sleep without it, and that is where the Mindfulness/meditation/even hypnotherapy might help.  

    Hope some of this helps smile  

    • Posted

      Thank you so much for reading and taking time to reply. 

      Last night I couldn't sleep again at all on 0.6mg – second night in a row. So at around 2 am I decided to take a little extra, and went up to 1.5mg. I'm not sure if it did the tirck, but I fell asllep around 4am, I think. What freacked me out last night was that I'm getting these waves that keep me awake: poindig heart and hot flashes. Some chest burning. I'm not anxious per se, but my body seems "freaked out". I think I want to stay on this higher dose now for a few week to stabilize. And do a slower taper from there. 

      Did you have any rebound insomnia when you did you 0.1 drops?

      What about when skipping a day/2 days etc? A couple success stories I've read were actually done by skipping a dose, even from as high as 7.5 mg. Other people say it's not good. 

      Were you taking any other medications during this taper? 

      Are you off now? How has the sleep been since you stopped alltogether?

      Sorry, a lot of questions! 

      It's very hard to stay positive and think I can ever sleep on my own again indeed sad 


    • Posted


      Yes it's easy to get upset in the middle of the night when insomnia strikes. I think you're right to stabilise & try to slow it down again, I'll bet you will settle with a few days.

      I got the odd night when sleep was poor whilst tapering when in the noughts.

      I got the hot flashes occasionally, and I did get some rebound insomnia about 3 months out !! but was fine until then - ok now. I stopped in January. I think 1 mg served my insomnia (reason I took Mirt in the first place) well, just as well as 15 mg !

      I wouldn't recommend the alternating doses in the higher doses, only at the very end.

      No I didn't take any other meds, occasionally Phenergen as sleep aid? or Benalyn / but the body gets used to them so best to use just occasionally.

      Yes I'm sleeping great now (touch wood). You'll get there, sometimes it takes awhile to stabilise at the end, but have faith, Rudd the waves x

    • Posted

      Thanks again for replying. This is the most helpful info I've found so far!

      I agree about lower doses working well: I slept great on 1 mg. I guess I thought it wasn't doing anything at such a low dose and I was just sleeping great on my own, ha.

      When your rebound insomnia hit you at 3 month out, how long did it last? Days, weeks? How bad was it (how many hours would you get on average)?

      I'm tryinng to get an idea of what I'm in for, cause then it's easier to cope. I know everyone is different, but just to have a general sense.

      Have you tried any natural supplements with success for your insomnia?

      Thank you for your support!

    • Posted

      Start again ...

      you sound like me Maria, trying to prepare and look at it from every angel.

      I guess the sleep problems lasted 2-3 weeks (on 2 occasions).  Its easy to get spooked in the middle of the night when unwanted thoughts come rushing in whilst tossing and turning.  I tried so hard to remain positive (!!)  I took the advice of the sleep program the NHS use for insomnia, to get up and distract yourself with some quiet occupation, like reading, knitting, drawing, colouring ... its a hard thing to do but it helped in the long run ~ now I remind myself if doubts about sleep creep in that I got through it, it didn't harm me at all ~ OK it was difficult and my eyes were sore, but I managed on 4 hours broken sleep.  No I didn't really take supplements, they can't cover Mirt' discontinuation in my humble opinion.

      Also worth a mention, what helped me was cutting out all stimulants, including chilli, sugar, chocolate of course, coffee and any caffeine.  I felt better mentally with this and still do.  I practice and read around yoga and they call stiumulating foods "Rajasic" - also included in this are onions, garlic, white flour including pasta & pastry, so refined foods - they are said to bring a restless state of mind and make the person over-active.

      Hope they allow this post this time smile  

    • Posted

      Yeah, I'm trying to gather as much information about this as possible, since my doctor – even though good an knowledgable – is of no help when it came down to withdrawal symptoms. He said most people don't have those symptoms, and if they do, those are ususally mild and go away quickly. 

      Last night I got about 3-4h again and I'm on 1.5mg now. Starting to get a bit worried that the Mirt doesn't work as well anymore after all the dose jumping,

      I do try to stay calm and positive. I manage on 3-4 hours of sleep quite ok, even though I'm exhausted. It's the 0 hours nights that I can't handle. I'm actually ok during the night, telling myself I will just  "rest" and if I don't sleep tonight I will sleep better tomorrow. But come morning and my calm is out the window cause now I have to function (I have a small child to take care of and I also work part-time). I also wonder if some of the next day aniety is a WD sympton. 

      Regarding supplements: 

      I did find L-theanine helpful for night awakening. Even when I was still on higher Mirt doses I would fall asleep ok, but wake up 2-4 times during the night (would fall asleep rather fast usually). After I added 200mg L-theanine before bed I sleep through the night (if I manage to fall asleep that is smile.

      I also take Magnesium, fish oil and vit D. I also heard great things about accupuncture and will give it a try. 

      Probably a good idea to try and cut down sugar and carbs (I don't eat too much, but I do have cravings sometimes for both). 

      Thanks again!

  • Posted

    Hi Maria

    If it's any consolation you are not alone.  The insomnia you describe could be mine.  In a week I might get a couple of nights of 3-4 hours.  Then a couple of nights of 5-6 hours (not very often) and then the 0 hours you describe (awake all night). It's very depressing but from what I have learnt from reading other users posts, is that it will eventually work it's way out.  Medical advice about withdrawal from ADs is to give it approximately 3 months.  That sounds far too long when you are going through this every night but keep telling yourself it will pass.  

      I very stupidly went cold turkey on the 31 May this year after taking a dose of 15 mg for 5 months.  I haven't taken it now for 7 weeks but had I known about how insidious this drug is, I would have tapered like you are doing.  

    Best wishes

    • Posted

      Hi Christine,

      Yes, it's a little bit calming to know this is "normal". 3 month does sound like a very long time indeed. At least you are almost half ways there! I think it also depends on how long your were on the drug. 5 months is not a long time, you should some improvement sooner. 

      What I don't undesrtand is why I got hit with insomnia even though I tapered, and quite slow from what I gatherd. You quit CD, I tapered, yet we are in the same boat right now. May be I would have been hit even harder if I didn't, who knows. I've never taken any "mind" meds before, may be I'm too sensitive to them. 

      Are you taking anything else for sleep at the moment?

      Or found something that helps a little?

      Last night I downloaded MySleepButton app and tried it for the first time: I think it is a very good concept and would definenetly help if you not in WD. But it helped a lot to take the mind off now sleeping and zone out even though I didn't fall asleep for at least another hour while listening to it. Give it a try! Good luck.


    • Posted

      And one more thing: 5-6 hours in WD is considred GOOD. So celebrate those nights for now. 
  • Posted

    I can't share with any success story as I am not that far yet (styll on 15mg of myrt), but I would not like you port unanswered as your situation is pretty similar to mine. Now I am on 15mg for the 2nd month, before that I was 1month on 7.5mg, amd before that have similar troubles with insomnia as you desribed. 

    To overcome that before putting myself to myrt, I used the following plan:

    1. Sunday: sleep-aid (e.g. diphenhydramine HCI) or ambien 5mg,

    2. Monday: klonopin,

    4. Tuesday: gapamentin (300mg).

    The rest of the week: none of those as I do not want to be addicted to any of them.

    Probably, I did not tell anything new for you, but unfortunately I do not see any other options. Eventuallt, I'll be tapering off fomr myrt, and the same plan would be essential for me too.

    The 1st and the most thing you need now is a peace of mind before going to bed. Having a safe peel as one of the ways to get that, although it is far from ideal.

    • Posted

      Hi henrich,

      thank you for sharing! 

      I really don't want to take any other meds right now, especially benzos: I believe they've contribudet greatly to my terrible insmnia back in January. I was taking Ambien for about 2 weeks, and couldn't sleep after stopping it. I tried alternating similar to what you are doing, and then take breaks and take nothing – this only made things worst. Long story short after about 3 weeks I started getting terrible anxiety and some depressive symptoms, I think due to interdose withdrawals from benzos. I never had such problems in my life, was never on any meds, so I totally freaked out. Luckly I found a good doctor quickly, who carefully took me off all the other meds and stabilized me with Mirt. I am not touching benzos or Ambien ever again. I think once I'll taper down Mirt one more time now, I'll be taking some OTC antihistamines to help on occasion (since Mirt work for sleep in a similar way). 

      I really hope tapering slowly + taking supplements + alternative treatments like accupuncture + LOTS of patience will get me through.

      Good luck to you!

  • Posted

    Hi Maria.Just wanted to give you some support.I'm on Mirt now for 7 months at 15mg am going up to 30mg(15mg am,15pm) for IBS/anxiety/depression and associated pain along with being put on Gabapetin and Tramadol.At the same time i was weaned off of Paxil (20mg twice a day) and Ibprofin.I'm still trying to adjust so i can here what your saying.Two things to consider that I do;Find a good counselor.Not a psychatrist or psycologist but a counselor.Someone that has a degree,listens and gives you suggestions.Also I get a theraputic massage every other week.It helps and it's something to look forward to,to help with the anxiety and pain.I also am strongly trusting and connecting to God to get me thru this valley in my life.I feel that Jesus's sacrifice is healing me and has cleansed me.I will pray for your healing and know that although it will take time you WILL heal.God WILL Bless You,Bob

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