Mirtazapine Tapering Simplified

Treatment and medication
1

A number of people have asked for withdrawal advice thinking it is a mine field, it isn't, if followed slowly and carefully it is pretty straight forward.

Mirtazapine is available in 3 different forms, tablets of 15, 30, & 45mg,  Sol Tabs which can be dissolved and liquid.   The liquid is very expensive, only available in the UK, and doctors are reluctant to prescribe it because it costs approx £66.  Maybe you could get the latter on a private prescription - beware that the liquid, once opened only lasts for 6 weeks, which may be an issue once at the lower end of the doses.

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 agin.  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.

If you are tapering from 30 mg less 10% = 27 mg = 27 ml

Liquid Mirt' is ready to use, but the ml to mg is different and needs working out, for instance 12.75 mg Tablet = 0.85 ml liquid Mirt, 7.5 mg tablet = 0.5 ml liquid Mirt.  If anyone wants the breakdown I'm happy to share/send my copy.

People who have been on Mirt' for a considerable time, especially if over a year, would benefit from doing a slower taper of 5% every 2-3 weeks (me also), or maybe those of us who are sensitive to the drops.

Happy to help if anyone needs more info' ~ wishing you well, as always.

Calmer  

 

2

Thank you so much, this really simplifies things and I know I can go to my doctor with a plan . . . thanks again for the time you have taken, that's so much appreciated!

3

Hi. Thanks for your post. I've been crushing 4 x 15mg pills and then adding to a mixture of 30ml water, 30ml maple syrup. Give it a good mix before taking dose - I assume that's ok?

4

Hi Orangedog

Yes thats great, just have to be careful as it's not so stable because the tablet doesn't dissolve so well, and the lining of the tablet is a nuisance maybe?  How is it going for you now, are you doing a slow wd?

These Pharma' companys have a lot to answer for, turning their backs instead of manufacturing lower doses to enable people to get off the AD's.  Where there's a will there is a way !!  

 

5

Pleasure's all mine Susan, just happy to help.  Hope it goes well for you, keep in touch x

6

Yes the tablet linings are like little flakey bits but not too annoying. Currently at 12.75, been dropping 5% every two weeks. Have tummy troubles now and then but not sure if that's linked or not!

7

Yes those tummy troubles are quite common, maybe if they get bad you could push the 2 weeks out a little, just a thought?  I know it seems to take for ever to taper, but in the long run I think it wins over all the protracted suffering others speak of.  

I know I've had to watch my diet carefully, sugar hits me hard, I think it causes RLS which is pretty annoying when it keeps me awake, so I'm on limited treats now !  

Sounds like you're doing great apart from that, good for you, long may it last.  

C 

8

That's good to know its a common side effect and not something else! I guess I just need to watch my diet too. I really don't want to do reduction every 3 weeks because it'll take so long to get off them!! I suppose I need to weigh up the pros and cons.

9

Hi Calmer

Its trouble again can you send how to work the measurements please,

Thank you

Px

10

HI, i have been reading your thread with interest. I hope you are rid of this horrible medication. i am still in early stages felt so awful on the 45 mg and am apering very slowley myself with the aid of a pill cuuter. Just hate the nauseous feeling and losing weight. My appetite has just gone. !!

11

Hi, thanks a lot for this information. I have a couple of questions?

  1. Do you have any experience with having the solution made by a compounding pharmacy and what the main differences would be? e.g. would it last longer, etc
  2. Do you need to grind the Sol Tab?

Thanks again.