Hi folks I'm new here but have been lurking for a while. I have been reading the Mirtazapine withdrawal threads. I am taking Mirt 7.5 mg and want to taper. Has anyone here tapered successfully and now fine without W/D symptoms? What was your tapering like and how difficult was it?
I tapered Ambien and trazadone previously and want to taper Mirt and be drug free.
Hi Annie,
I'd been taking 15mg of Mirtazapine daily for six months and decided I wanted rid of it. I found it too sedating and nearly ten hours of sleep each night, beset with spectacularly strange dreams, struck me as counterproductive.
I too have done withdrawals so I knew some of the factors that need consideration.
First, Mirtazapine has a comparatively short half - life (20 to 40 hours), so each drop in dosage is going to be followed by results fairly quickly. By comparison, Valium (diazepam) has a half - life of 20 to 200 hours.
Second, without access to the liquid form of the drug, reducing the dose by tiny amounts is difficult. Reducing my dosage to 7.5mg was possible in a practical, by simply halving the tablets. This meant I wasn't having to mess with crushing tablets.
The aim in a taper is to reduce the serum level of the drug in the body. In this case, I reasoned that what couldn't be achieved fully with dosage could be furnished in another way. So, having dropped my dosage to 7.5mg daily, I went on to taking Mirtazapine every second day, then every third day and so on.
I carried out my taper over three months or so. During it, I followed these simple guidelines...
* Set a timescale for each cut in dosage.
* Make each cut when you feel comfortable doing so.
* If you feel you're struggling, remember you can also return to the pre-cut dosage for a while.
* Tapering is not a race...your body will tell you if you're using the right timescale.
* Beware of unfounded expectations. If you're expecting a withdrawal effect to start, it will start. Psychoactive drugs are powerful...so is your brain.
I've found that stopping Mirtazapine hasn't given my a particularly challenging time.
Above all, remember that any taper can and probably will vary. Only the person engaged in it can tailor it effectively.
Hi Annie 57955. I'm new to this forum to but what I can recommend to you do it wery slow. I tyres to come off it a month ago and almost endup in hospital. New I do it very slow and is still very hard. Lots of brain zap and insomnia is the worst. I'm now at 4 mg. Try to start with 10% off for about 3-4 weeks and try to drop it other 10%. If is to hard, try 5%. Good luck to you
Thanks for your response. It's good to hear that one can taper this med without too much trouble. If you did one pill on, one pill off the first week, I figured it would be 30 mg total for the week.
Now if I tapered with 10% cuts my weekly amount that would total 47.25 mg. It looks like (if my math is right) that the way you tapered had bigger drops.
It's interesting that you did not get slammed with withdrawal. It's so hard to know which way to taper. I could crush the pills and weigh the dose to go the 10% way.
Hi eva.
Yes go slow if that works for you. Try taking fish oil supplement for brain zaps. Magnesium citrate in the evening to help with sleep or an occasional half a Unisom. Good luck with your taper.
Hi again,
I agree with what Eva says in that you can take a step back if a 10 percent cut is too much for you.
I wasn't affected by 'brain zap' or insomnia. However, for the latter, I had another plan in mind. Ideally, I'd have exercised but being disabled (irreparable slipped disc) it wasn't an option. Instead, I kept myself busy, with a variety of hobbies and work projects. I was therefore ready to sleep. I also used this technique as necessary...
If you can't sleep, have a serious talk with yourself. Convince yourself that you must not, on any account, go to sleep. Tell yourself that you must stay awake. Nine times out of ten, this paradoxical intent would see me waking to the alarm as usual.
My experience suggests that your attitude can make withdrawal much easier. It is your choice, to act in a way that suits you, in your own time. This way, any pressure comes only from you...ultimately, congratulation can come from the same source.
I agree having a more positive attitude can greatly help with tapering. I used to have sleep anxiety and I don't have that anymore. I keep myself busy with things too. I like what you said about telling yourself not to sleep, and how it works to get you to sleep. I guess we must trick that brain lol.
I got some time to think about your way of tapering versus the 10% way. I just finished up with the Trazadone taper and want to give myself a few weeks before I start a new taper. I'll be back to post more once I start. Again, thank you for your helpful advice. annie
Anyone else have a successful taper from Mirt?
Annie, I would advise the 10% method crushing and weighing, at least until you get down to such small doses that the scale won't be accurate enough. How long were you on mirt? What dose are you coming off of? Davhill was lucky to have gotten off without much trouble with his method, but I have seen people at the other end of the spectrum with severe withdrawal issues that weren't resolved by reintating prior doses, and you won't know which type of person you will be until it is maybe too late. The 10% method is very conservative but also very safe.
For additional support, I recommend creating an account at Surviving Antidepressants, a forum where you will receive experienced guidance and support. It sounds like you are already familiar with the 10% method, so perhaps you have visited SA already.
My pleasure! Make sure to only start the taper when you're ready. And all the best with it.
David
Hi betsy. I've been on 7.5 mg for a year and 9 months, and finished with Ambien and Trazadone tapers. This mirt drug sounds a bit tricky to come off of and I want off badly. I believe it's contributing to shoulder tendonitis that I have now for over six months. Gee wiz I hope I will be one of the lucky ones. I'm leaning towards a conservative 10% taper. Tell me betsy about your tapering experience. Has it been difficult or not so much? Are you still taking it?
I was only on Mirt for 5 weeks after trying all sorts of other drugs that didn't help me in anyway other than making me have panic attacks. I was put on Mirt for stress. Iwas only on 15mg and this was making me anxious all day so the doctor said to double the dose and this made it worse. So I halved the dose and felt great for about 4 days. So i decided to drop the drug all together and have Diazepam as a back up if I couldn't cope. Again I was fine for a few days and I mean really fine, back to my old self. Had one bad nights sleep but I have always been a bad sleeper. Then the anxiaty creeped back in. Its been exactly a week today since my last Mirt tablet and I've only had 3 Diazepams in the last week. If I think about it I get anxious but if I keep working I'm fine. Just typing this is making me feel hot and bothered but I'm determind to kick it cold turkey style.
Hi Annie,
You won't go wrong if you follow Betsy below Betsy & I have been tapering for some time using the 10% method, although the 10% method says to stick to each taper for 3 to 4 weeks, I go one step further and do a 5% every 2 weeks, kinder to the system, All good, no complaints.
Annie are you in the UK? Liquid Mirt' is available here although you may have to beg for it from your doc' ~ but seeming as you have already done 2 or more tapers and now at the last hurdle, I would use this as a strategy to coax your doctor. I take the liquid so it's been simple to do the drops. I am at 7.5mg from 15mg.
Wishing you well Annie, keep up the good work, great to see you doing the research before jumping off Mirt. You'll be fine, just go extra slow.
About me
For advice on tapering Mirtazapine slowly at the recommended rate of no more than 10% every 3 or 4 weeks, please see the following which is within this forum,
https://patient.info/forums/discuss/depression-resources-298570
and then click on the link "REDUCING AD'S USING 10% WITHDRAWAL METHOD".
Hi si675,
You have been very lucky to get off with some anxiety if you have tried so many different meds that didn't work for you. Trying and changing these drugs is Russian Roullette, sensitizing the nervous system and causing a lot of imbalance. You may just be lucky enough to have the genetics to metabolize these drugs really quickly, which is why they didn't work for you. There's an actual genetic test called the cytochrome p450 that can help doctors make better decisions about which drugs to put people on.
Many less fortunate folks end up really messed up by all the trying and changing. Cold turkey is generally NOT recommended with psych meds.
I think your best bet is to investigate non-drug methods for controlling anxiety, such as cognitive behavior therapy, meditation, and the like. It really is about our thoughts; our thoughts perpetuate suffering, but once we recognize that we are generating our anxiety with the thoughts we have, that awareness is the beginning of change. Look up self help CBT on the web as a starting place. This is adviseable for anyone suffering from anxiety and depression, because the drugs are ultmately just a band-aid, and very risky on top of it given the side effects and withdrawal that most people experience with them.
Hi Calmer. I don't have access to the liquid, I am in the US. I like the idea of going 5% every 2 weeks. Is that possible with crushing and weighing the doses? I wonder how accurate a scale is and if my doses will be all over the place.
Hi Annie,
I am in the US so am doing the weighing. I can teach you much LOL! So, most people get the Gemini 20 jeweler's milligram scale on Amazon. It can be a finicky littel bugger, so I have learned by trial and error and what I have come up with is the following:
1) Weigh two weeks of dosages at a time and put them in empty gel caps from Amazon
2) Calibrate the scale at the beginning of the weigh session. Then, in between dosage weights, weigh one of the 10 g calibration weights to make sure the calibration is holding. It maybe necessary to recalibrate during a weigh session.
3) I weigh chunks of pill and use powder to get the final amount I am aiming for. My Teva mirt weighs 10 x the dosage weight, so if I am going for 17 mg, I will weigh half a 30 mg tablet, which is approximately 150 mg, and then add 20 mg powder to get 170.
4) Since some powder sticks to the pan, you will want to shake powder around in the pan, then tap it back into your container, tare the scale, and then go from there. That way, the residual that sticks is zero'd out.
I also do 5% cuts every two weeks. I have found that crushing the pills and weighing the powder problematic for getting the powder into the capsules since it tends to stick in the pan and not flow easily into the capsule, losing powder. That is why I weigh pill chunks as best I can and add tiny amounts of powder to get the final amount. I feel like a drug addict with my scale LOL! But these are the lengths we must go to to safely come off these drugs!
Oh boy betsy, it sounds like I'll be asking lots of questions once I get my scale. Is that okay? I just finished my last taper and want to give myself some time before I start though. Thank you.
annie
Very wise to be prepared and ready. And yes, you can ask away!
Betsy
Anyone else finished their mirtazapine taper, finished their withdrawal, and feel fine now. I would love to hear about your experience? How long did it last and what was it like. Thanks everyone.
Yikes. The more I read about mirt's withdrawal the more anxious I feel about starting my taper. I'm on 7.5 mgs. I want to get off because I think it's giving me shoulder muscle pain. Has anyone here finally finished and feel good?
I know several of us are tapering but I don't know anyone who is off and feeling fine on this forum. Those people tend to disappear!
You've got your scale now? I think you will find that reducing by 5% two to three weeks will be a piece of cake, giving your system plenty of time to adjust. When down to the last couple of mgs, it gets tougher, so there is no rush, and even a reduced dosage can bring relief for side effects. Be open and flexible. When down at that level, it is probably wise to even crawl at a reduction rate of 2.5%.
The alternative is to stay where you are at, right? So taking an ultra conservative approach to reducing is working in the direction you want to go. You can always updose to the previous dose if you feel uncomfortable symptoms.
When you do get down to the smallest doses, you can make your own liquid using something thick to suspend the powdered tablet in and an oral syringe for dosing. There is a suspension liquid product called Ora-Plus, and I am going to try that.