long term mirtazapine use - taper/withdrawal so far

Treatment and medication
1

Hello. This will probably be a long post. But i'd like to start by saying this forum has been a great help to me. Thank you for everyone that posts here. I've been on mirtazapine since i was 18. I'm 26 now. worked my way up to 45mg and stayed on that until 2 years ago when i went down to 30.  

I'm going to mention a few things about me that i think are relevant.

after being on amytryptaline i was put on mirtazapine for insomnia and depression when i was 18. In hindsight my insomnia was from the fact i regularly smoked weed and had become dependent on it for sleep and the depression i'd had for years stemmed from a difficult childhood. i don't believe anything was wrong with me in terms of chemical imbalance or an actual disorder that i couldn't  have resolved myself, had i been mentally capable or had someone to guide me.

 i was an alcoholic from 19 to 25 never daily drinking apart from a couple of month long episodes, but 3/4/5 nights a week to excess. I went through an unpleasent withdrawal off that although not at the delerium stage. had a few months where i've drank to much and had slight withdrawals since but for the last 6 months i've only drank a handfull of times, normally still to excess though. The last month i've had nothing and i'm done with that now.

About 2 years ago i had a hernia operation and struggled sleeping afterwards due to the pain. I upped my dose to 60 mg thinking it would help me sleep better. I was at 60mg for about 5 weeks. i didn't notice any side effects but i was on codeine and other painkillers throughout and felt pretty off it anyway.

 went straight back to 45mg and for the next few weeks i noticed i felt quite nauseated and also had something which i wouldn't have been able to describe if i hadnt seen it written on here as "brain zaps". These happened mostly when i was in bed. Having had an operation pushing my bowels around and having being on codeine for over a month i didn't pay any attention to these symptoms and they went within a month.

 I went to the doctor at the start of this January and told him i wanted to start tapering down as i didn't like the side effects it had given me, particularly affecting my social life. I think once i was on this drug i lost my spark and most of the charisma i had. the side effects took a while to kick in and i think because the process was gradual i was unaware anything had changed. People i'd not seen for years pointed it out to me though. My dreams were messed up and i would get dizzy occasionally. For a reason i couldn't work out the doctor didn't think that coming off it was a good idea but i told him i was going to do it anyway and i could do with his advice. He said to halve 30 mg for 2 weeks then stop. He also said there'd be no side effects.

 A few days went by and i started to itch on my back and the lower half of my legs. A woman at work had gone home because of itching the first day i noticed it, so again i thought nothing of it and thought there might be  chemicals around or dust or something like that. Itching got worse and went to my stomach as well even though i'd had a short break from work. Thought it may have been because id switched a brand of supplement i'd been taking or because i was using a different shower gel. I even brought shower stuff meant for babies incase it was that haha

 about 10 days on 15 mg i was starting to get less sleep as well and generally feeling ill so i went back to the doctor and asked his advice again. The only thing i'd noticed about mirtazapine was i slept better on high doses, although that goes against what i read on here. He said to try 22.5mg for a week but from his demeanour i could see he didn't really believe me. He also gave me a speech on how some people think doctors are in on a conspiracy to get us drugged up so they profit from it, and i shouldn't come on forums like this one because they fill your head with rubbish. At this point it wasn't in my mind that reducing mirtazapine was causing me any symptoms other than insomnia. He'd told me there would be no withdrawal, I believed him and id approached it with a positive mind. I'd not looked anything up to do with mirtazapine. That changed when i got home.

 i found this site and it's helped me a great deal in terms of knowing what to expect, to reassure me that i'm not losing my mind and has pointed me in the direction of sources to show that my doctor's recommendation for withdrawal was too fast.

 since January 24th i was on 15 mg and as of last night i had about 2mg. I dont have scales to weigh doses. i break ten days worth of pills into roughly the same size and take them biggest to smallest. the smallest pill is then used as the marker for the next lot that i break. I make them slightly but noticeably smaller than the last of the previous batch then repeat the process. 

 I'l try and keep this short, these are the symptoms i've noticed since january

Brain zaps - occasionally. between 15mg - 7.5mg. none since below 7.5mg

Anxiety - I get nervous in social situations, not overwhelmingly but i can feel myself blushing and i stutter a bit when i speak sometimes. Mainly just with people i'm not good friends with. This didn't happen when on 30mg, i just had no desire to talk to people haha

Sleep Disturbance - nowhere near as bad as i feared so far, waking up a few times a night but getting 5 hours or so. 

Confusion - cant explain it other than i feel like i've just appeared in a situation even though i was concious of entering it. My memory is bad, particularly short term. I can get half way through a sentence and i just lose track completely. This doesn't happen often though.

Jittery - my body feels shaky and i'm easily startled. People saying hello makes me jump or if theres a sudden loud noise that i'm not anticipating my hearts jumping around! Any sort of stress or conflict that i witness makes me feel like im vibrating and i feel sick.

Lethargic - I've felt really sedated the past 2 weeks, not much energy and constantly tired.

Itching - a tiny bit, not really a problem anymore.

Racing thoughts - i would have thought i'm losing my mind if it wernt for this site.

Manic - I have moments when i'm really hyper, mentally.

Nausea and lack of appetite - not too bad managing to eat 3 meals a day but i'm not really hungry for them. Feel a bit sick in the morning and after eating

Dreams - when i do sleep my dreams are very intense and sometimes extremely disturbing and graphic. 

Sweats - couple of night sweats, i have a clammy face in the day and look terrible.

Depersonalised - feel a seperation between my mind and body. Weird feeling but i'm ok with it.

 My withdrawal symptoms would be scaring me and i would have been off work a long time ago had i not been through similar before. When i came off alcohol i went to a n e thinking i was having a heart attack. 

Positives - despite being tired i mentally feel more awake. even though that contradicts itself. i do feel more social i just have a little melt down when i talk to most people haha i also have had no craving for junk food and have lost about half a stone.

I'm posting this now as of today i'm stopping taking it altogether. a situation with a colleague at work over the past week (which i've been cleared of any wrong doing by the way, and have been asked if i want to make an official grievance against him) has led to me being able to use my holiday in one go so i have to take advantage of that. Other people causing me stress isn't worth it, but up until now i've have held my job down despite how i feel. The symptoms of tapering so far have been unpleasant but nothing i've not been through before and are manageable. Its the duration of it thats getting me more than anything and obviously i've not stopped taking it altogether until tonight.  A little bit concerned if i'm a bigger mess than i am now when my holiday runs out, then my doctor might not sign me off because "there isn't withdrawal". But both managers i spoke to today were really nice to me after i explained my situation and have said they'll do anything they can to help me so i'm in a good mood. Got no other pressures to deal with so i'm looking forward to it in a twisted way. It will be nice to be able to post here when i'm through it all, so i'm sticking it out whatever happens/ however long it takes.

 If you want to take advice from me i'd say to sort your diet out. I.e no processed foods or ready meals, drink water or de caf tea, get your fruit and veg. Remove anyone that causes you grief from your life. Walk away from any situations with tension. If you are physically capable then be outside as much you can. Exercise as vigorously as you can. Listen to music with a positive message behind it. Don't watch the news or read the newspapers. I don't think it's healthy to be bombarded with stories of paedophiles, people getting blown up or murdered on a daily basis anyway. Let alone when you have this to deal with as well. Focus on the positive things in your life. Even if it's one good thing for every 100 bad, the bad are irrelevant when your mind is elsewhere. Think of what you take for granted at the moment and concentrate on appreciating it. 

 This drug worked initially but i was on it way to long. I also feel if i'd have taken a month off smoking weed and would have had someone in my life who could teach me how to think with a positive mind, then i wouldn't have needed any medication for depression or insomnia. I'm not saying that's true for everyone but i feel for the sake of a quick fix i've been in a fog for my best years and i can't get that time back.

 if you read all this then thankyou, and i assume you're going through the same so good luck to you. Be patient and stay positive.

2

Wow what a wonderful post ♥

I will be following with great interest. I came off mirt for 30 days and then went back on it as the WD's got the better of me. On reflection I wished I had tried going another two weeks before throwing in the towel.

Thanks for the great post, I identified readily and will be really interested in sharing your journey

god bless ♥

3

Thank you so much for detailing exactly how you feel when coming off Mirtz it really helps and like you said makes you realise you are not losing the plot its just the tablets.  You are nearly there cant wait to hear how you feel in a week or so.  And i loved your advice on how to stay positive, I will try very hard to remember that.  Good luck

4

You've come along a long difficult path and hopefully your journey now will be a positive one.  I'd like to say well done to you, you've known really hard times and self prescribed in all sorts of ways.  I wish you strength and hope for the future, and also as you sound so optimistic, that you can now realise your goal.

I will watch with interest over the next coming weeks and hope all is well for you.  I too am doing a slow taper (sincer October last) and so far all has been ok, the fatigue being the hard part.

Wishing you well Muleton 

5

I'm glad you enjoyed my post. I wrote it all out then somehow deleted it so had to do it all again. Took me 3 hours altogether! I was actually nervous to see if anyone had replied but your first line cheered me up smile

Did you taper down or did you just stop taking it abruptly? Anything that i've successfully quit has taken me many attempts. I felt like i had failed each time i relapsed but it always made me better prepared for the next time.

 What did you learn from the 30 days that you didn't know before? Even if its just the realisation of how hard its going to be then you've taken something from it.

 Iv got no relationship, no kids, a job that can be replaced if it has to come to it. I wouldn't have stuck it out this far if i had any proper responsibilites. In terms of building for my life in the future, i've done nothing up to now. If after a few weeks/months im going mad from insomnia, itching all over and haven't left my house (which i don't think will happen but who knows...) nothing apart from myself will be falling apart and even though it won't feel like it i know every day of suffering will be a day closer to this being over with.

 Im lucky i can just drop everything and dissapear (if i need to) for a few months with no consequences. People who have a life will have to pick the right moment to try this and i imagine that will add extra stress as well.     

 Thanks for replying 

 

 

6

I actually left quite a bit of detail out as i could see how long my post was getting. if there is anything i've put that you would like me to expand on i can put it on here or send you a pm.

 The posts i've read with more detail have helped me a lot so i wanted my post to be similar to that for anyone who reads it. It was also quite theraputic to write it out as i dont talk to anyone in real life about this.

 To be honest, although i've been cutting down since January and i've been feeling the effects, from what i've read, i think my withdrawal is going to start properly any time in the next few days. I think it's going to get a lot worse physically and mentally before it gets better. Also, if i'd followed my original tapering plan i would have still been taking it for another 2 months, but with my work situation it has to be now.

 The positive thinking is something i've been actively working on for a few years. Its not going to make withdrawal (or life in general lol) painless, but in the past i've let situations get the best of me and resigned myself to just being the way i am. You know, i've always been miserable theres nothing i can do about it etc. Only you can make yourself strong, or stronger, mentally. It's not in many other people's interest to do that for you.   

 Your brain is your best mate or it hates you. With work you can control it a lot more than a lot of people would think. There is always something you can do to improve your situation, even if it's just the smallest thing smile 

7

I know I can make the changes to my outlook on life but when that horrible black cloud comes over its really really hard to imagine there is blue sky underneath!  I attended a group on mindfullness last night and oh my god I had no idea what they were talking about it made absolutely no sense to me whatsoever, I dont think that will work for me but as long as I can come off these horrible tablets and lose all the weight I have gained whilst on Mirtz I think I will be a happier person altogether.   Please keep posting on here how you are feeling and I wish you loads of luck, take it easy and be very proud that you are just going for it x

8

Thank you for your kind words, they are very much appreciated and i wish you all the same as well.

 Good luck with your taper, ideally i'd liked to have done it a bit slower than i have done. Can i ask what amount you are taking now and what amount you started at? Do you have a planned time for coming off altogether?

 Fatigue is something that didn't bother me initially but after the first few weeks it is quite maddening. Time seems to move slower for me and it's very easy to get frustrated and agitated about things.

 i really like your username haha Calmness is a handy trait to have when your going through this. I'm reminding myself to be calm several times a day! 

 good luck to you

9

Slept about 4 hours last night. Was awake at 1am and woke up at half 5 by a motorbike outside.

 I was quite nervous going to bed as i was aware this is the first time in my adult life i'm not taking a medication i've come to believe that i need. My thoughts were racing quite a bit as well which made it quite hard to switch off. I don't feel any worse than i did yesterday but i'm not expecting to dramatically worsen for a few days yet (fingers crossed it doesn't happen at all).

 Felt a bit sick this morning so i forced myself to eat a curry for breakfast as i only had two meals yesterday. Still feel sick now but don't think i actually will be. Going to try and stick to eating at 9am 1.30pm and 5.30pm. If i don't eat il just be getting more lethargic so although i don't like eating at the minute it needs to be done to keep myself as health as possible.

  

10

I'd never heard of a mindfullness group until you mentioned it. I've just had a quick look now. I understand how that could seem quite daunting and completely changing your outlook may seem like an impossible task. 

The fact is though, you are looking for ways to help yourself and that's something you should be happy about, so dont be down that it didn't seem right for you. 

 I wish i could give you some good advice but this is about the best i can manage. If you struggle to just generally be happy then start by purposely not reacting badly to things that are really insignificant but normally stress you out. I don't know what winds you up but stuff like , getting cut up when driving, someone not saying thanks when you hold the door etc Anyway you can practice controlling your emotions, even on insignificant events is important. If you purposely avoid reacting (physically or mentally) to these things eventually it will be a habit and you'l do it naturally. Then just work on to slightly bigger things.

 I'm going to post here at least every week, probably every couple of days so i'l keep you informed of how it goes. Are you coming off it as well? or are you preparing or just curious?

 

11

Hi muleton

I really like your positively andd determination. The 30 days I stopped taking mirt, left me presenting as a weeping and angry mess! I did get the itching but that went after a couple of weeks.

I spent a lot of time reaching for diazepam and isolating in my room. Hunger turned to couldn't eat a thing. Kept going to the loo! Guess our bodies try to detox. I had an overwhelming sense of fatigue and depression. Insomnia and a few hand tremors. Reflecting on it after day 25 I was getting good days or good afternoons. What i have learnt is next attempt to hold out a little longer! Importantly to remember that WD is time limited. I am really interested to see how your wd journey goes and really hope it goes quickly and smoothly.

God bless ♥♥

12

One major positive that i've completely missed is a huge increase in creativity. If you play an instrument, write or draw or if you used to do anything like that but gave it up, id highly recommend taking it back up again!

13

Hi M

Yes I'm happy to share with you ~ I was on 15 mg for a year, my plan was always to be on it for a year then taper.  I had chronic insomnia which lead to anxiety and finally agitated depression.

So I dropped 5% every 2 - 3 weeks depending on how I felt, I think this is key to a successful taper, if after 2 weeks I still feel low (low kicks in for me around day 7 after a taper) I will go longer.  Sometimes I do 7 or 8% which goes against my own rules really, but if I have a hard time I do a realistic 5% next time.  No I don't have a date for the finish line, just praying I get there lol ... without insomnia !  

Thanks, my username is partly my name so I can remember it (!).  

How are you now after little sleep last night?  Are you UK?  I am, you might want to get some Phenergen in case you get insomnia, its available over the counter.  And if eating becomes a problem the protein shake (preferably the good one's withouut sugar) with a banana might be palatable if you still have any sickness.  

Wishing you well M  

14

I'm also tapering off mirtazapine in fact I took my last one last night and I'm also scared of the effect this will have on my sleep and mood. 

I loved mirtazapine and how it got me through a really difficult patch but the weight gain has proved too much for me. I'll be watching your post with interest so please let us know how you're getting on xx

15

Wasn't going to write anything today but thought i'd share what i went through from yesterday afternoon. 

 Despite having no energy or motivation for it, I forced myself to do some weight lifting, and performed better than i thought. I felt terrible for the first 5 minutes but after that my mind was racing much less and i completely forgot about nausea and any other bad feelings. I ate straight after (not something i would normally do id usually wait an hour) and felt sick again but this went after an hour and i felt great. I played some guitar later which improved my mood further. 

 I was actually really happy by night time and watched a bit of tele before bed. I could feel myself falling asleep and could hear the tele still on so opened my eyes. The character on the screen was talking but his face looked completely different to usual. It was only for a split second and i know i'd imagined it but i was instantly filled with dread. My heart started pounding i was sweating and shaking and feeling really agitated.

 This lasted a good 30 minutes in bed and i was having to remind myself every few seconds i wasn't going to die. Then the brain zaps started lol I can't really describe the sensation i've experienced before but these were much worse and affected the whole of my head rather than just a section of it. These zaps progressively got worse and i did actually think at one point that this might be too much for me to handle and i'd made a stupid decision to go through withdrawal. I went down stairs and was going to have half a tablet but I didn't though and after another 20 miuntes of my brain exploding i must have been asleep by 1am. Woke up at 7 so i got a good 6 hours and i feel good again this morning although very tired.

 I kept a calm head throughout and was constantly reminding myself it was withdrawal and il be ok. Think it just shows how delicate your mood can be when going through this and even things that you know are ridiculous can still set you off and affect you physically for quite a while after.

Not getting carried away because i know it takes about a week for the full effects of a reduction to hit me, but i'm still optimistic. Also, i have started itching today and that is usually the first sign that things are going down hill in the next few days. 

 I'l say it again though, if i hadn't been through similar stuff before and i'd trusted my doctor about no withdrawals then last night would have resulted in me being in a n e at some point. There's no way you could have them effects (without expecting them and knowing they are normal) and not freak out and make the situation worse than it is.

 I should point out as well that although i am very happy with my sleep for both nights so far (4/6 hours) im dropping off a few hours after i would do if i was working and also waking up a couple of hours after i would need to be up. If i was still at work then sleep would be a major issue for me. 1 Because i wouldn't be getting anywhere near enough to feel well and secondly i would be worrying a lot about the effect it's going to have on my job in general, which would effect my mood, which makes sleep worse etc.

I'm a very private person and i really didn't want anyone knowing my buisness but i'm so glad i opened up to my employers and we've been able to sort something out to make this easier for me. I'd recommend anyone else to do the same. It's worth the five minutes of awkwardness and blushing as you are explaining your situation haha

16

Hi muleton

you are doing wonderfully well for the early stages. I'm certain this is down to your positive approach and your mindset to stay calm. It sounds like you accomplished a lot yesterday, try and incorporate plenty of mini breaks from activities in these early days. Are you taking anything like diazepam to help you over this period? Look forward to your updates ♥♥

17

Hi M

You had quite a fright night; I picked up on the "sudden feeling of dread" that you spoke of ... you said: " i was instantly filled with dread. My heart started pounding i was sweating and shaking and feeling really agitated", this is such a nasty side to Mirt' - I sometimes get this when I'm just about to fall asleep ~ I've tried to deal with it by saying to myself "oh here we go again, but it won't stay long and then be gone" by riding WITH IT instead of FIGHTING IT.  This might sound a little crazy, it is a form of mindfulness, but if you tell yourself not to "fear it", recognise it, accept it, and then let it pass.  The same with any unwanted thoughts, if we suddenly panic it multiplies 10 fold, and I think we do have a choice when it happens.  Does this make sense?

Also worth a mention, eating sugar, chocolate, puddings, cakes can be a trigger so watch that one.  Sugar is my enemy during wd, makes me so restless, agitated, disturbs sleep and sometimes causes RLS,  ggrrr hate that restless leg syndrome!

The itching can be awful can't it, Mirt' carries a huge histamine block, and when this is suddenly taken away (a quick withdrawal) it can bring on the itching, when Mirt' is taken away histamine flood the body and brain, can cause an assault so an over the counter, Anti Histamine (non drowsy) during the day will help with that, maybe for several weeks or a month once totally off Mirt.  

And I hear your cry about going downstairs when you said you were going to take a pill; I would say to have plan B ready if you need to do a little back track, nothing wrong with that, so many do, decide to go back to the dose which was working well before you stopped, i.e. I see you stopped at 2 mg, that right?  If so, and if you were good on

2 mg for a week or two then that maybe the best dose, if you were only on 2 mg very briefly you might need a little more, see how you go, nothing is written in stone, the important thing is to keep you comfortable during the wd, no point in beating yourself up or toughing it out when there is a kinder way.  I have to say 2mg to zero is a tough call, so maybe a little rocky for some folk.

Hope you're not aching from those weights, well done with that, keep focused, see the sunshine, hear the birds, taking in the good, it all helps.  

Wishing you well  x

18

Thanks for your advice I will definintely give it a go.   I dont get annoyed at things, Im just really sad.  So many things happened to me at once, being made redundant and having to find a new job, my partner leaving me and being so cruel when he didnt need to be and my mum being diagnosed with Leukaemia all within a few months and I just dont think my brian could take it!!  Luckily I managed to get a new job straight away and really love it, it took me a very long time to get over my partner leaving, my confidence was completely crushed and still is.  Mum is still really poorly but I am managing to cope a lot better with that now.   I think sometimes your jar gets too full and you can fit anymore in!!  I am so much better and the only thing I need working on now is my confidence not sure how you ever get that back?!  I have cut down from 45mg to 18.75mg I have been changing every 3 weeks and have had really blurred vision, felt very emotional, complete exhaustion, crying and the dark clouds have come back.  However, thanks to this site I realise its just the tablets and not me so fingers crossed I can be off them very soon and lose all this extra weight which is really getting me down and knocking my confidence even more.   Thank you for writing keep yours coming I will love to see how you get on.

19

Surprisingly i actually feel quite a bit better than when i last posted. I had a really bad headache for a couple of days but that has gone now. Nausea is still a problem but mainly first thing in the morning and after i eat my first meal. My thoughts have gradually slowed down and i don't really feel 'crazy' at the moment, as i have done increasingly over the last few weeks.

 The effects on my sleep have been nowhere near as bad as i feared. It takes me an hour to drop off but i'm getting about 5/6 hours a night, which is good for me. Also i've had no nightmares at all which is usually one of my main problems with any withdrawal. I've not had the brain zaps the last 2 nights either.

 The itching is worse in terms of how much of my body is effected now, but it was more intense when i did bigger drops earlier on.

 I feel like i'm at a crossroads now. Either, for some reason, i'm not going to have that big a reaction to stopping completely. (I think this because things got worse initially rather than i just felt fine straight away). Or, the initial worsening was from me cutting down the week earlier and the effects from stopping altogether haven't started yet lol So i'm either on the mend or its the calm before the storm, how exciting!

 Would like to add that i still feel worse than normal. My 'normal' state at the moment involves feeling like i've just got over the flu or i went out drinking last night and only got a few hours sleep before work lol

 It's all been very manageable so far though smile and i've seen a couple of replies that i've not got back to i'l do tat this morning. Good luck to whoever's reading this smile

20

I was smiling and nodding my head at the first two paragraphs. The first paragraph is spot on, you can make everything, not just withdrawal, so much easier if you can work out the right mentality to approach things with. There have been a couple of times where i've felt panic, or a depressing thought pattern start but i've stopped it straight away. And when i was getting the brain zaps, it was really unpleasant. But realising it's normal and it's just a moment that will pass was enough for me to ride it out rather than freak myself out into getting a ride to hospital smile

 I've been cutting sugar and most processed food out my diet for a couple of months. It makes me too hyper and increases how much my thoughts race which creates a better environment for anxiety and panic to thrive in.

 I actually went from approx 6.5mg to 4mg for 3 days then stopped. Before then i had done it a lot slower, particularly from 12.5mg to 6.5mg. I have seen a couple of people (not many) who came off 7.5mg ok although i know this wouldn't be recommended by anyone other than a doctor haha i was going to do 4mg for 2 weeks, then 2mg for 2 weeks, then 1 for 2 weeks then nothing but situations changed that.

 And i've actually been sitting in my garden in the sun watching the birds come in and eat off the feeders. I'm getting closer to them each day, i want to get to the point where they land on my head!

 Thank you for your reply