Tapering off Mirtazapine

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I'm coming off Mirt because of the weight gain.  I spoke to my GP and she said "don't bother tapering,  just come off them,  because it's a low dose". Which I know isn't wise to do.  I've been on 7.5mg since September last year.  Before that I was on them from February to August.  Going from 7.5mg up to 45mg,  and then back down, Finishing off at 7.5mg without any side effects at all.  Last night I cut the 7.5mg in half and woke up with nausea and a headache.  It was worse than being on a high dose of 45mg.  Should I just stick to the 7.5mg and take it on alternative nights,  every two,  then every three and so on.  Has anyone tapered off in this way?  Thanks you.

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  • Posted

    Hi hun

    I did a week of alternative nights then decided to come off cold turkey as unfortunatly the side effects outweighed the benefits. Im not going to say its easy as its not some people have no side effects and other's have loads. I would say i was fine first few days then the anxiety and insomnia plus headaches nausea. I have chronic abdominal nerve pain thats debilitating so now i have been on a trycilc for a week today so im not sure if its side effects of that or still withdrawl from mirt. Ive been off now 5 weeks. Can i ask why you were put on them and if you are being put on something else. I had severe depression and wasnt eating but long term they i believe have caused my stomach problems. X

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    • Posted


      I was put on them as I wasn't sleeping. Came off them no problem,  but made a mistake of going back on them as I wasn't sleeping again.  I did alternative nights with the 7.5mg,  came off with success apart from insomnia. My GP wasn't very helpful.  She asked me twice,  what is the purpose for the phone call.  I was told that you had to let them know when you withdraw from meds.  When I went down in doses, I never had any side effects.   I thougt with a small drop in dosage wouldn't affect me.  I just want to be med free as the Mirt has made me put on a lot of weight.  I also take Pregabalin for my anxiety.  Which I will carry on with for the time being. x

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  • Posted

    Funny how you sailed through declining doses last year, but after one night you were suffering ... at least you now know youur system in more sensitive.  I wouldn't do alternative nights if I were you, if you get unstuck with anxiety etc it might be hard to stabilise again, so I just wonder if its worth the risk?  We're all different, its up to you but I would try a 10% drop firstly and see how that goes for you.  So yes go back to 7.5 and wait to feel stable again and then start the taper using a liquid.

    Making a liquid from Mirt Sol Tablets (available on prescription) is easier than making a liquid from the tablets.  Instructions included - click on my name and follow the link under my status.

    Hope this helps you and that you feel better soon x

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    • Posted

      Thank you. I did mention Sol tablets to my GP ,  but he said it wasn't available on prescription. Whether it has something to do with  here in Wales,  where prescriptions are free.  But doctors will just fob you off with anything.  I will look at your link.

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    • Posted

      Could maybe double check with the local Pharmacy?  I did 5% drops every 2 weeks rather than 10% every 4, just a little kinder on the CNS. 

      Yes Doctors .... mine told me it would be "out of my system" within 3 weeks!!

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    • Posted

      Hi Swanscity, one thing I didn't ask you ... how long have you been back on Mirt this time??  Youu can also use this method for Pregabalin if ever you need to - the 10% taper also applies xx  

      Here is the pill to liquid instruction:  

      I wouldn't recommend dropping any more than 10% every 3-4 weeks, or if struggling with that 5% every 2 weeks.  

      You will need a 15 ml syringe and also a 1ml syringe with markings on at 0.1ml intervals

      A pill crusher (available from Amazon)

      A clean medicine bottle or small jar

      A small accurate measuring jug or medicine cup with measure on. 


      • Crush up 2 x 15mg (or 1 x 30mg) Mirtazapine pills until they are a fine powder (although the outer coating does not grind up as fine as the white Mirt’ powder that is inside, but that's fine. So long as the white Mirt’ is a fine powder.

      • Then measure 30ml of half water and half maple syrup (or something else to your taste) and pour into the medicine bottle.

      • Then pour in the powder and shake it vigorously. So 1ml of the liquid equals 1mg of Mirtazapine. N.B. Mirtazapine is not soluble in water and so you must shake it vigorously every time you take out a dose to ensure you are getting an accurate measure of Mirtazapine.

      • Also you should store it in the fridge. It is recommended to keep it no longer than four days as it may lose its' potency.

      So from the 30 mg / 30 ml draw up the syringe what you require. 

       1 ml of the liquid = 1 mg.

      This has been tried and tested and works very well. Just make sure you shake it very well before drawing up the syringe.

      Credit to Evergreen

      + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + 

      Using SOL TABS, similar to the above:

      Sol Tabs can be very useful if you are withdrawing, or maybe even if you are changing doses. SolTabs dissolve very readily in water but they settle due to the fact that Mirt' is not soluble. Ora-Plus suspension liquid, available from Amazon (around £19) will help with this, it does keep the Mirt suspended long enough to dose accurately. 

       For every milligram of Mirt, add the same amount of liquid

      I would suggest half water and half Ora-Plus

      So if you want to taper from 15 mg less 10% = 13.5 mg 

      Mix 3 x 15 mg (45 mg in total) Sol Tabs of Mirt with 45 ml of water

      Each nightly dose is 13.5 ml - using a 20 ml syringe draw up the 13.5 ml

      The method above is enough for 3 nights, throw away the remainder, and on day 4 start again. Of course you can adjust how many Sol Tabs you use as and when necessary.

      *You will need a 20 ml syringe and also a 1ml syringe with markings on at 0.1ml intervals

      *A small accurate measuring jug or medicine cup with measure on.

      Good luck.

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    • Posted

      Hi Calmer

      Sorry for the late reply. I will try this method.  I spoke to my GP and she suggested just coming off the 7.5mg. Which I didn't. I was cutting the 7.5mg in half (it probably wasn't accurate).  I took them every other night then every two and so on until I finished.  Two days after,  the withdrawals started.  The nausea and headache

      Would this mean I am just taking 1mg a night?

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    • Posted

      Hi Calmer

      Excuse me for being a bit dim.  I am going to drop 10% from 7.5mg.  How many tabs would I need to crush to make the liquid method.  And how much water do I mix with it.  Thank you.

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    • Posted

      I would make enough for 4 days, so crush 4 tablets of 7.5 mg.  Are you adding Maple Syrup - there is something called Karo Syrup that might be better than Maple Syrup as it is thicker I'm told, available from Waitrose or Amazon or search maybe?  

      So add the crushed tablets to 15 ml of water and stir vigorously then add the 15 ml of syrup.  You will now have 30 ml (give or take) or liquid.  Shake vigorously each night before drawing up 6.75 ml ... this will be a bit of a guess - I would round it up not down.  After 4 nights discard any left over and repeat the following night.

      Good luck.  Let us know how it goes.  If you get too many symptoms youu could try 5% next time.  

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    • Posted

      Thank you.  What about the 2% drop.  Would it be the same amount of tablets and whatever solution to add.  But obviously not drawing out same amount of liquid for 10% from syringe.  I'm thinking now that 10 maybe too much at first. I was going to do it with the syrup.  I've heard about Ora Plus Oral,  but it seems quite expensive.

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    • Posted

      Itds good to go with Ora Plus because not only does it help to suspend the medicine, it also helps to preserve it, but yes, others have just used Maple Syrup.

      Yes the same amount of tablets and just draw out what you need.  5% could be a good place to start smile


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