Titration off Mirtazapine

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I'm titrating off Mirtazapine after 15 years at 30 mg. I have been taking it slowly, just minor discomfort, a quarter of a tablet (15mg) for 2.5 to 3 weeks. I'm just about to make the next cut and am a bit worried about that. I have been on 15 mg for 15 years, the higher dose of 30 mg on and off during the last 5 years. I'm able to cut the 15 mg tab into 4 pcs. Any suggestions are welcome.  My husband is just about to undergo radiation for the next two months (cancer & we need to stay out of town)  I'm hesitant to continue the taper. Should I just stay where I am in the titration and continue when we're

back home and in familiar  surrounding?  INPUT APPRECIATED

 

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13 Replies

  • Posted

    Hello,

    If I were you I would stay where you are in terms of dosage until perhaps your husbands treatments is underway.

    It depends on your disposition to anxiety. If you are under strain/stress then any withdrawal symptoms could be more intense. There is no harm on staying in 15mg for a while longer as you have been on mirtazapine for a number of years.

    A slow taper is advised. I wish you and your husband all the best.

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    • Posted

      Thank you Paul,

      I have had a few replies simular to yours and now feel confident to stay on the latest dose and not worry about tapering down at this time. Again many thanks.

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    • Posted

      I've been on 15mg for 12 months then went to 7.5mg for 3 weeks then 3.75mg but after that drop I suffered really bad abdominal cramps, insomnia and anxiety. Feeling fine back on 7.5mg so will go with that for a few months my doc said then reduce again. She reiterated to me there's no rush to come off and take it slow. I was under stress at the time of reducing which meant it really wasn't the best time to reduce. Take care and all the best 

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  • Posted

    Hi Karen,

    I have also been on Mirtazapine for 15 years. For several years I have been on 45mg. I am also trying to come off this drug. I was going to reduce monthly but I felt well with little in the way of withdrawal symptoms so I have so far reduced the dose by 7.5mg every 3 weeks. I drew up a calendar so that I stuck to the same day every 3 weeks and I had a goal to work towards. I'm now down to 22.5mg, I am due to reduce on Friday 7th Oct, however I have an exam coming up and my husband is due to have coronary artery bypass surgery very soon, so I am considering staying on 22.5mg until things calm down.

    So far 7.5mg reduction has been fine but I may find I need to reduce by smaller amounts as the dose gets smaller. There are some that say a 10% reduction is advisable, but I found that too complicated to estimate in terms of cutting tablets.

    If your husband is receiving treatment, and you are away from your home environment, you may be adding extra stress by further reducing the dose whilst you are away. So my advice is to stay as you are so you feel well and can support him, whilst you both deal with the inevitable challenges of radiotherapy and being away from home.

    I hope this helps.

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    • Posted

      Thank you for your email, Catherine. It sounds like you are doing well with your titration too. Thanks for letting me bounce an idea off of you - I think that staying at my last dose makes the most sense. It will take a little longer but could reduce stress a lot, since one never knows the result of the next cut.

      It sounds like you have a simular situation with your exams and your husband's surgery. Surely it isn't harmful to hold at the dose you're on.  I wish you both well. Again thank you for taking the time to answer my questions.

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    • Posted

      That's what I thought. There's no rush and I'd rather take it slowly and get off them for good rather than rush it and feel ill. Glad I cold help you too. Take care x

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  • Posted

    Hi Karin

    Sorry to read of your situation.  Doesn't the mind work in mysterious ways ... there's you about to enter a difficult and stressful time in yours and your husbands life and you go wondering about wether to adjust your meds', pretty scarey time to do it.

    But there is nothing wrong with a plan, and I think after so many years it would really help you to pace yourself, be kind to yourself physically and mentally/spiritually.  I would think the best thing is to do your reading and planning over those 2 months, and see if you feel up to it once you have returned home again.

    Lots of details for an informed choice, click on my name and read those under my status.

    I wish you and your husband well, am here for quite a while yet, happy to chat anytime.  I'm still tapering myself, slowy ... ugh

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    • Posted

      Thank you Calmer. I  was wondering about the 10% taper, but with travel etc. it seems more complicated. I asked my doc for a RX for Remeron which is much easier to work with. Also purchased a liquid suspension for this purpose, which I haven't used before but appears to give me 4 days of a measured dose. 

      Six weeks ago I had to reduce my Cipralex (anti-depressant) from 20 mg to 10 mg (someone made a error in dose some time ago and I caught it recently)  So far tapering down on the Cipralex and Mirtazapine have been okey.

      Thank you for your input and charts - I will see if I can use the 10% taper or if that is too difficult to do while travelling and Paul's treatment. It probably cannot hurt to stop at  any point and hold that dose steady, taking it up again when it will work best.

       

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    • Posted

      Not sure what a "RX for Remeron" is ??  Could it be the one that melts under your tongue?

      Yes, always good to hold well inbetween doses anyway, good idea.

      Does that liquid dose come in a 66 ml bottle?  The dosage isn't the same, its not 1 ml for 1 mg, so its not 4 doses.  Be careful.   15 mg is equivalent to 1 ml.  According to the leaflet, the bottle lasts for 6 weeks; I've pushed it to 8 but wouldn't fo beyond that, might start slipping as it loses its potency once opened (after 6 weeks that is).  

      Sounds like the tapering has gone well so far.  Great job !

      Best wishes Karin.

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    • Posted

       The liquid suspension comes in a pint bottle and gets mixed with the appropriate amount of crushed Remeron (a larger, soft tablet that the Mirtazapine).  I'm thinking that I will divide and or crush the Remeron with the mortar and pestle, divide the powder and mix the suspension with the remaining about to be injested. If I can't do the math for the mg to ml. I will follow the 10% decrease. Actually II'm not too concerned as my doctor wrote instructions for tapering 25% over two weeks.  My taper will be slower. Thank you so much for you assistance.

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  • Posted

    Y are u doing that was it what your pshic or gp suggested? If not and doing it on your own. That can be very dangerous. Personally i refuse to take that medication, had a very bad reaction on my first dose. Almost died. I see you have been on it many yrs so im assuming you never had that happen. I normally dont condone this med to new users or others that have symtoms like i did...good luck, but please do that with your pshics or gp decisions...
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  • Posted

    Thank you for your kind warning. Yes, I am under the care of a shrink for the titration. I have changed the amount and time, he recommended 15 mg, 7 mg, 3.75, mg every two weeks. I told him I needed to titrate at least every three weeks. Also discovered that the taper was too large, so I halved it. I'm being consistant and keeping a good record.  I ran the change by my GP  and he felt it was fine. I may have to hold the dose when my husband goes for radiation treatment, however I was told it's no problem to hold at that titration and start tapering again when there's less stress.  Thank you for your concern - Mirtazapine is a very powerful drug.

     

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    • Posted

      Thats good to hear. If you need any help or reminders actually anything with meds and stuff, thiers a great app i use. I started it to remind me on times n the new meds to take & to show my doctors wat was going on so i didnt have to carry a bag of meds. Its called carezone. Easy to use. Also u can do stuff like keep track of things like ur moods, pain, weight, head aches stuff like that. I found it to b very helpful plus i got it on a notification that will wake the dead up...lol

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