Why is mirtazapine giving me seratonin syndrome now?

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 I have been tappering off of 7.5 mg of mirt. for a month now. Been on it for years. I started cutting the dose to 3.75 for a couple of weeks then went down to 2 mg for the last week. I am having terrible withdrawals but when I take 3.75 mg now I am having blurred vision, heart racing, agitation, restlessness and just feel weird when i take that much now, seratonin syndrome symtoms? Why would i feel like this? I never got this effect when taking it. Been on it since 2008. I actually feel more myself when i dont take it but having bad withdrawals too. It doesn't make sense to me. I feel very restless when taking 3.75 mg but feel ok taking 2 mg. So confused. Any info woud help! Thanks so much everyone. God Bless you on this journey

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  • Posted

    Richie, are you taking any other supplements?  I got mild SS when I had been off SSRI/SNRIs and took serotonergic supplements like 5-htp and Sam-E, then started Effexor again.  I stopped the supplements the day I took Effexor, but still had mild SS, perhaps because I had a pretty high level of serotonin in my system when I took the Effexor.  So, just wondering.

     

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    • Posted

      Hi Betsy. Thanks for the reply. I'm not taking any other supplements at the time. Do you think I'm having this feeling because I cut back on the remeron? I went from 7.5mg down to 1.8 a night. I dont feel well at all. When I take the 3.75 I get restless and have anxiety with a stimulating feeling. Maybe I'm on the wrong medicine? Hope your doing well. How do you feel on the Effexor? Is that a SNRI? I feel like I need to go to the Hospital. Something is just not right... maybe i'm experiencing my anxiety and depression I had before going on meds. Thanks again
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    • Posted

      Oh my, you are definitely suffering from withdrawal!  People have the hardest time getting off the smallest amounts of mirt!  I think you have become sensitized by the up and down.  If you are feeling that ill and that you need the hospital then you should probably go, just in case.  Your cuts were too fast and you never got stabilized, and then going up again has further caused repercussions.  I like to think of the effects of med changes as Newton balls bouncing off of each other; the ones in the middle don't move at all but the ones on the ends swing wildly.

      The 7.5 down to 1.8 was a 75% cut over the course of a month, way too much!  And going back up part way, you got way destabilized, still at 50%.  I don't think it is SS, but I'm no expert.

      Let us know if you went to the hospital and what came of it.  Get some magnesium glycinate, which can help with anxiety and insomnia.  

      I'm not sure why you would feel ok at 2 mg, but how long were you at that dose?  You were symptom-free at that dose?

       

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    • Posted

      Hi Richie,

      Sorry to hear that you are having such a tough time.

      As we know this is indeed a very difficult drug to WD.

      It seems to make a big difference in our experience of WD the longer we are on mirtazapine and you have been on for a long time.

      I began mirtazapine in January but I feel I have now got past the worst of WD.

      I went from 30mg to 15mg where I remained for 6 weeks.

      It was very tough and I had rapid heart rate, insomnia, nausea, pain every where and dreadful anxiety.

      Many times I was temped to go back to original dose but knowing I would have to WD some time I stuck with it.

      Then I dropped to 7.5mg and all these horrible conditions returned!

      I kept on reminding my self that 'All things pass and this will too' and I did some meditation and began reading about mindfulness.

      I tried to be kinder to myself which meant I should have patience and go slowly.

      Any way to cut a long story I feel that at last I am recovering.

      It is interesting that about 3 weeks ago I had a lot of stress to deal with and against my better judgement I thought if I nibbled a tiny bit of mirt befor bed time I might have a better quality of sleep!

      Well I did sleep but I felt dreadful for about 3 days!

      I was like a zombie and could not think,remember or work things out.

      I could not understand how such a very tiny amount could have any effect at all but it really struck me down!

      Glad to say I am ok again and I'm helping my husband to WD as he has been on mirt for a couple of years.

      He is now on 7.5mg from 45mg.

      He has not had any problems at all and next week it is he intends to stop mirt completely.

      I know this is not the reccommended way to do it but as we know every one has a different experience.

      He was on mirt a few years ago and he had no problems when he stopped the drug.

      As you feel so poorly Richie I think it would be good if you went to hospital to get checked out.

      I hope you soon feel better and my thoughts are with you and all others who are suffering so much.

      May you have better times ahead.

      Sunbird x

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