Mirtazapine withdrawal

If anyone could share some of their experiences and perhaps advise on when this nightmare is going to end I'd really appreciate it. 

I’m 34, otherwise healthy, started Mirtazapine (in some sense against my instincts) about two years ago due to severe anxiety (no depression at all) and panic attacks. My Doctor prescribed Mirtazapine 30mg, to be tapered upwards from 7.5mg. 

I remember the first few days I felt a weird sensation when swallowing (simply felt like uncoordinated swallowing, where the food/drink seemed to be going at the wrong velocity towards its target). However, after a while and increasing dosage this symptom vanished more or less. 

Fast forward about a year and a half forward, and (apart from helping my IBS by making me numb) - the drug was totally useless anxiety-wise. I was still feeling very bad. True, I had not gotten many panic attacks, but I found that they were just transposed with a very generalized anxiety which I believe (self-diagnosed) had almost become a phobia: I became afraid of trying new things altogether from fear of having e.g., an allergic reaction (never had any of those ever in my life and never feared them before either). I had quit sports because I could not stand the sensations involving an increase in heart rate or blood flow. Done all of the tests and all is fine with my heart and everything else for that matter. It’s all in the head but the head controls your body and your mind.

 

The Mirtazapine just made me numb; I could feel less love to my fiancée (now wife!) and cared less about the world in general. Realizing that I had just become more anxious (if less panicky) the Doc upped the dosage to 45mg. What a disaster. More than a month afterwards I was just getting more and more anxious on a daily basis.

 

Eventually, AMA, I decided that going on Mirtazapine was the biggest mistake of my life. I started tapering, very VERY slowly. I think I went from 45 to 15mg with relative ease, taking more than two weeks at a time to decrease the dosage by 3-4mg at a time. Each time, I would feel great for 2 days, then start developing quite severe cramps and feel lousy for another week or so, then I’d get slightly better. Knowing that I am really ultrasensitive to any change in physiological parameters I tapered from 15mg to 3.75mg in a turtle’s pace: 3.75mg at a time, with more than a month (and even two sometimes) between each taper. I have a PhD in Chemistry so I know what I’m doing. Again, every time, after 2-3 victorious days where I’d feel like I’ve conquered mount Everest, I’d then feel lousy for 4-8 days; but then things would seem to be a bit better. Weirdly, at the lower doses of 7.5mg and 3.75mg I started again experiencing swallowing difficulties; I started choking on water and became very mindful of my swallowing dyscoordination. Still I felt altogether quite alright – and I believed that the remainder would be similar.

 

How wrong was I. I have come off it completely exactly two weeks ago. Again 2-3 days where I felt fine, then a few more days with cramps. Then, good old panic hit, with terrible anxiety that just keeps getting worse and worse. I feel terrible weakness, zero energy, I have withered due to loss of appetite (since when I eat my stomach just cramps a few hours later; actually not so bad since I had put on some weight during my time on Mirtazapine). I feel completely overwhelmed by the symptoms: every time there is something new. I feel weird tingling sensations and I have strange feelings of pressure in my stomach. I get dizzy a lot and then just feel weak. My muscles are sore without any reason. I was certain that these issues would resolve in a few days; Mirtazapine’s half-life is quite long and I know that receptors can take 2-3 weeks to get re-modulated (actually that’s why they always say that the beneficial effects of Mirtazapine will take around 2-3 weeks to become effective when you go on it). But I did not expect this gradual and horrible worsening of symptoms over the last 14 days. I have had to start treatment with Benzo’s (as needed, I try to avoid them but sometimes there’s just no way around it) and they seem to help in some instances, whereas in others they only seem to do a moderate/poor job at managing the symptoms. For the first time in my life yesterday I suffered from ED. Never happened to me before and despite a very supporting and loving wife, I felt that was yet another crushing blow. The weird thing is that all these things are not getting me depressed – just really anxious.

 

I can only hope that things will start to get better. I have no idea when these things would begin to get back on track. Doctors seem to be quite oblivious to my suffering, not really believing that withdrawal could be so powerful yet not finding ANYTHING else wrong. The situation is really frustrating.

 

One thing is clear to me: I’m never, EVER going back on this horrendous drug. It was a huge mistake beginning with it, and for all of you who need these kind of drugs: ask your GP or Psychiatrist what are the withdrawal difficulties expected for the medication. I know I sure wish I had asked it.

 

If anyone could share whether they’d experienced similar withdrawal symptoms and how long they’d persisted, I’d really appreciate your comments. I hope that by posting this someone else will also benefit as the internet searches are really frustrating as well.

 

 

 

  

Same here. One of the biggest mistake of my life and now I have to taper off slowly to be able to go back to work. Can you please share how you exactly are taperig off? 

By the way, what was your last dose? Jumpimng from 3.5 mg to zero is not a good idea..

the reason your having withdrawal is you need to substitute something for this drug,  try celexa,  you eat less and it doesn't make you tired, the only drawback with celexa is sometimes i can't sleep but then i take a bayor pm. 

remeron or mirtazapine as its called im on a very low dose half of the 15mg or 7.5, and i won't go any higher, there should only be withdrawals for a few days beyond that if your feeling down you need to replace this with another antideppressant.

Deborah A.Davis, B.A.,M.A.

Thanks for your reply. I wish you all the best and an easy journey with your reply. 

Before I tell you what I did, let me just reiterate that I am not an MD and anything I write is from my personal experience and not based on medical training (although I am a researcher in the Neurosciences...). 

My slow slow tapering began after an increase in dosage from 30mg (which I had been on for around a year and half) to 45mg (which I had been on for less than two months). I started by testing the effects upon going down by 7.5mg at a time, but very, very slowly. I found that at the higher dosages, going down was not so terrible and after around two weeks I could taper another dosage. Going down like this from 45-->15 took around 3 months or so. The real problems started when I started tapering from 15mg to 0. Since I figured that what really matters is the precentage in which you decrease rather than only the actual dose, I started going from 15mg downwards by 3.75mg at a time. This already started to be much more difficult than going from the 45-->15... and the side effects were not good. I therefore took it very slowly, each time staying on the new dosage, sometimes for more than a month, until I felt that things were more or less OK, then I'd take another dose off. This lasted around 4-5 months until I reached 3.75mg. 

Now - 3.75mg is less than 12% of what you'd normally take (30-45mg) and I stayed on that for 2 months, and I felt rather OK for over 1 month before I dared to stop altogether. Could be that I should have made an effort to go downwards to 3.75/2 but I felt that given my 73kg, that would really amount to a tiny increment.... and I also take into consideration that the (idiot) psychiatrist I was seeing suggested the following taper plan: "take 30mg for two weeks then 15mg for another week, then stop completely."  It's quite unbelievable and it's hard for me to imagine how badly I'd feel had I done that. 

In any case, it's really tough, but now I feel I have to ride it out. To me it also appears that since I stopped any form of sports or exercise, all these issues are exacerbated... 

I was also thinking on an interesting fact: just as the "beneficial" effects take 2-3 weeks to appear when on Remeron, it could well be that the worse of the withdrawal effects would also appear around these times. I just hope they won't persist... 

All the Best

 

I've been on Mirtazapine for 4yrs quite a few times I've tried to come off it.I was put on it for chronic IBS which caused me anxiety.Over the last 3mths I've come down from 45mg to 15mg with great difficulty ,if I get anxious I take a 5mg Diazapam .At the moment I'm not doing to bad but one thing I've really noticed is my IBS pain is getting worse each time I come down a bit.But this time I'm determined to get off it .If my IBS gets to bad I'm just hopeing when I'm totally of it maybe it may get a little better.               (Like it's got to get worse before it gets better ) fingers crossed. The reason I wanted to come off it is I'm on quite a lot of meds for more serious problems.I think we should take our own health into our own hands instead of in my case being told (stay on these drugs longer and you'll feel better) in the future if a drug don't work after a month I won't take it. I totally agree with you one of the worse drugs I've ever tried to come off.My next hurdle is to come off Pregablin which I was given for the same reason,and that's another drug that's difficult to come off.Good Luck to you. Don't give up you'll get there.

Incredible. Yes, it's tricky. it gets difficutl from 7.5 downwards. I do not understand why. How did you technically taper? Just cutting the pill? How long did your withdrawal simptoms last?How are you feeling right now?

I was on doziapin for 20years and was told I had to come of them because they can cause heart attacks or overdoze affects it took about 10 weeks but had some realy bad days they give me 15 mg of miazapine whitch didnt do any good they made me feel worse than id felt in years so I went back to docs and she doubled the doze (I must admit I feel a bit better at the moment)she said to give them a month and to go back after that to let her no how I'm doing so my docs are not bad but I wont hesitate to try to come of them if they dont work but its never that easy I no the side affects can be terrible because ive suffered with depression most of my life and I'm 66 plus I get panic attacks so I hope you find what is good for you and helps you the most god bless 

Thank you Dave I'm 71 and had two near death experiences and I think that's one reason I get anxious but I'm definitely comeing off Mirtazapine I've had Diazapam for years and they do the job for anxiety for me,but they are trying to stop them after about 30yrs as they say it can be addictive it just makes me laugh as if it makes any difference at my age and all these years.Do take care and only give it a month

like you I was on Diazapam for years they took me of them whitch took a long time that was years ago I was put on them when I got high blood pressure at 25 they helped relax the musles (and everything else ) but them days were a bit different but I'll only give these a month so if I have to come of them the withdrawl symptoms mite? not be as bad but good luck in whatever you take (we are like walking chemists ) 

Chemists or Guinnea Pigs  

I was on Mirtazapine for two years and wish I had never heard of the evil drug. It did nothing for my anxiety and I gained about a stone in weight so decided nearly six months ago, against my doctors advice to very gradually wean myself off, taking the last tablet nine weeks ago. For the first two weeks I felt fine and then it hit me like a brick wall. Terrible anxiety, mainly at 4am, lasting two/three hours, nausea, itching, foggy brain. Whilst some of the feelings have decreased I still occasionally have nausea and still wake at 4am feeling very frightened. It seems that I just get over one symptom and another raises its head. At the moment my bladder seems to be ultra sensitive I feel the need to keep visting the loo.

Trouble is there are so may side effects when coming off this drug that you don't know if it is the drug or something else.

I found a group called CITA - Council for Information on Tranquillisers and Antidepressants. they have a helpline and they have been heaven sent for me as, at times I have felt so wretched that I have considered going back on the drug. They have a book called Back to Life which is so helpful. Although I know I have a long way to go I do have the odd few days when I feel that I am improving so my advice is to hang in there and take each day at a time.

Did you go cold turkey?

Hi Jean

well done for sticking it out. May I ask what was your final dose of Mirtazapine? It's helpful for others to know when withdrawing themselves.

I too contacted CITA, they are brilliant and a godsend, especially as GP's don't acknowledge WD's, so you can end up feeling alone! 

many rhanks

jo x

I found 30 mg made me sleep for up to 12 hours and reduced it myself to 15 mg. I stopped taking it 6 weeks ago because it was painful to urinate. The effect of going off it was miraculous - my backpains went away immediately.

Hi, I ve been off mirtizapine for two weeks, I ve noticed your last post was 20days ago,I. Was just wondering how you are getting on.i agree with you 100% about this tablet !!! I will never touch again I was on it for 3 months I was only taking a quarter of 15mg tablet,I went down even lower for a week and stopped taking them,first few days I felt fine,then it hit me,the cramps,the nausea the total feeling of sheer panick the whole of my shakes inside I just never feel like eating I am a total mess.before I took these tablets I had anxiety like you I could choke on a drink of water I was always feeling like I couldn't t swallow food,I have trouble with my inner ear which causes me to have anxiety hence why I was put on these vile tablets,I also wish my gp had warned me about the side effects.i hope you are feeling well now, I hoping you can tell me how long these withdrawl symptoms will last. Many thanks

I was on 45mg for about 10 months. Four weeks ago I dropped to 30mg for around a week, then down to 15mg every second day for a week.

Two weeks in I experienced a terrible rage. Once I recognised it was probably the withdrawal I spoke to my GP who wanted to increase the dose again. I told her I would think about it and then reduced the dose once more.

Emotionally I feel like a fog has been lifted. A coupe of times I have become tearful but not accompanied with the bleakness I felt before starting the meds. Knowing that these were probably withdrawel symptoms I looked at them as a good sign as it meant the medication was leaving my body.

i wasn't quite ready for the physiological symptoms. I had 3 nights of waking up after about an hour absolutely soaked to the skin and freezing cold. I would spend the rest of the night dozing in and out whilst trying to keep warm (duvet, electric blanket, onesy and dressing gown JUST kept me comfortable.

During the day I would swing between hot and cold.

My mood has remained positive but in the last week I had to go for an urgent chest X-ray to rule our lung cancer because I had developed a cough that just wouldn't go away or develop further. I was out of breath just going up the stairs and would have to sit to recuperate.

The X-Ray came back fine. I now believe the coughing is also linked to the withdrawel. I am feeling worse today than I have in the last week. The hot and cold sweats have gone but I am still changing temperature all the time ( jumper on, jumper off all the time).

I am begining to get weaker because even the thought of eating makes me nauseous knowing that if I eat even a small portion of anything I will feel sick for hours after. I am now forcing a slice of toast and egg a day to just get something into my body.

In all it's been about six weeks since I started the whole weaning but I did do it rapidly. I will be riding out the physical effects as I am finding life has colour once again and I can feel positive emotions (it's been a while since I felt much of anything except grey) I see this as a battle and one I am going to win, with each new symptom I see it as the death throws of the medication and a step closer to my victory. It works for me. 

Good luck to everyone and just remember none of us are alone and we genuinely know what it feels like. 

 

Hi Susan,it was very interesting reading your post, I m having hot and cold moments and I have mild asthma which has felt worse since coming off miritizapine, I take cyclizine for for sickness,as my inner ear problem causes severe sickness,they are marvellous I can take them up to 3 times a day if I want.i m struggling to eat at the moment but after taking cyclizine  half an hour later I m able to eat something light.please ask your doctor about them as I know how ill you can feel when you can t eat, I used to be sick up to 15 times a day when I was at my worst with my ears and these tablets saved me! Take care xx

Are your withdrawal s. completely over?

Hi, I m still not sleeping well and I ve had to take a low doze of diazapam to stop me shaking,my whole body shakes on the inside,my appetite is a little better but I m still feeling quite sick,it's 24 days since I stopped taking it and I just want it out of my system,or and the anxiety is through the roof without the diazapam,thank you for asking,I hope you are well