Mirtazapine withdrawing nightmare

Treatment and medication
1

Hello All,

               I have been taking antidepresants for 15 years, first 11 years on citalopram which worked great and kept me well for 11 years. Then 4 years ago i fell over and they stopped working. After trying many others i ended up on Mirtazapine. Initially they lifted my depression and i went up to 30mg. For a long time i kept getting stomach problems and a burning tongue. It was decided between myself and my gp that the mirt was probaly causing this as i had all the tests going to rule out anything else. I decided it was time to come off. I was told to drop the dose to 15 for 2 weeks and then stop. Gees that didnt work, and i was so ill i went back on them. At first i thought it was my illness returning and carried on with the medication. Then 6 months later i had another go and the same thing happened.It has took me the last 2 years to work out whats going on. My depression has long passed an what i expereince is horrendous withdrawal symptoms. I can now literally create symptoms by myself. If i drop the dose to 22.5 then i feel good for a few days then withdrawal hits, up the dose back to 30 and they dissappear. However on 30 i feel heavy headed and increased boughts of anxiety. Drop the dose and these symptoms go, ok for a few days and then withdrawal symptoms appear. Doctor has told me i need to come off them and totally agrees with what ive told im. However i am still unable to get off them and feel trapped. I was given propranolol 10mg 3 times a day to see if that would help with withdrawal but they dont. To give you an example i can be going through my day, anxiety levels start to rise, take the propranolol and nothing changes, take 7.5 mirt and the anxiety dissappears, although my head becomes heavy. Being a professional person and pretty level headed, i am now trying to plan my escape from this nightmare. It would appear that i need to drop the dose at such small increments that my body can get used to it. Cutting my pills to do this will be a challenge and a half.I am sort of relieved that i finally realise what the hells going on. This has taken me over a year to work out with a diary entry every day. The doctor stills tells me they are not addictive, but i have to disagree. Everyone around me who love me have always said don't play with the dose, as they think its all to do with my thought pattern, but as with anyone with depression you have to rely on your own thought pattern. 3 weeks ago i saw a different doctor and he said stay on the 30mg and ride it out. I took his advise and had 3 weeks of waking with a hangover, and heightened anxiety through the day. At the end  of the 3 weeks i thought stuff it i'm not going to take a tablet tonight and see how i feel tomorrow, that day was the best i'd had in months, no anxiety, clear head, feelings of happiness, and appetite, if the tablets were doing what they are supposed to then a single missed dose in months would not have made any different? Anyone who thinks withdrawing from an antidepressant is straight forward,you might want to think again, and of course if anyone has a solution to help me i would be extremely grateful.

2

I've been on Mirt 30 on two occasions and successfully came off them both times wen I recovered. No withdrawal symptoms. My tip was reduce to 15 every alt nite for a month, then 15 every third nite for a month , 15 every 4 th nite for a month and so on so ur body adjusts and does not notice. Took me about 5-6 months and no probs x

3

Sorry I've not got the answer for you. After getting withdrawal effects from dropping to 22.5mg twice a week (agitation and brain zaps) I'm now chipping a small bit off the end of one of my two 15mg tablets, every 3 days and I've been relatively OK so far. Time will tell. So I do identify with your problem. However, I do have the advantage that mirtazapine has been very successful for me, with few side effects. I just want to get off it now I'm better. You might remember that a few weeks ago I seemed sceptical about the withdrawal symptoms - well I admit I was wrong to doubt them! We can only keep on plugging away.

4

The most successful way seems to be dropping one dose per week. Do this for as many weeks as you feel comfortable. Then drop 2 doeses a week for however long. Continue til you are off of them. Some people take 8 or nine months and do it very slowly to minimize WD. This program is the CITA protocol. Used to have a web site, but they lost their funding.

Hope this helps.

5

Thankyou all for your kind replies, I definitely like the sound of dropping one dose a week, then 2 etc. I have been on 15 for 3 days now and don't feel too bad, but am now wondering whether the drop might be a bit quick and I'll get hit with withdrawal shortly, maybe I should go up to 22.5 and go from there? I definitely don't want to go upto 30 as that seems to hit me too hard

6

Well, it can't hurt to go up to 22.5 and start there. You might be more stable. Please keep us posted.

7

I read what was said twice so I could fully absorb what was said ..and I must say firstly I feel for you (Craig); although no one can truly empathise as we can't walk in each others shoes. It strikes me that you seem to have a good educated grasp on your predicament and have utilised even a diary and made good use of a close GP:Patient relationship.

It's difficult for someone to advise or suggest as like I said you seem to be doing all the right things; youve taken a systematic and common sense approach and monitored yourself very well. This makes your plight particularly sad to hear about as to date and after so much effort you've not YET got the result/outcome you are looking for ..'freedom from mirtazapine'

If its of ANY small consolation (and I mean small), I have experienced some of the experiences you've spoke about (e.g. ..."waking with a hangover, and heightened anxiety through the day"...)

I've struggled to comment further but empahising with you and after thinking and thinking the following (which might be worthy of instant dismissal) comes to mind - and forgive, there is an element of clutching at straws (sorry):

Firstly, considering and combining the two old adages - first coined by the great Albert Einstein: ..."Insanity is doing the same thing over and over again and expecting different results"... AND the second by Sir Conan Doyle's characer Sherlock Holmes: ..."Once you eliminate the impossible, whatever remains, no matter how improbable, must be the truth (solution)"...

Taking the focus of Mirtazapine - Have you considered bolstering up your body's (and minds) defences prior to and coinciding with when you are attempting to 'ween' yourself off Mirtazapine. Meaning to say take a holistic approach ...eat wholesome energy releasing foods, take some gentle exercise, drink plenty of water (to help cleanse/detox your system), distract yourself with as many positve tasks as you can (e.g. meditate, massage, talking therapies etc). I know there's a chance some of these have already been tried or are currently being done, BUT thinking outside of the box and trying another approach while taking the focus off the actual Mirtazapine MAY pay dividends. 

The issue seems to be one of withdrawal, and I remember once seeing a TV show some years ago charting the experiences of a group of celebrities struggling to come off both illicit and prescribed drugs by going to a resort come therapeutic getaway. There they each followed a body and mind strenthening regime which included some of the suggestions above (inc. detox).

Other slight thing to mention is (and this is extremely true of myself). The mind (or rather subconscious) can and often sabotages any positive life changes or efforts we wish to make. I guess it's like the placebo effect as it's sometimes a case of an outcome/resut being the result of a 'self fulfilling prophesy' aka if I think it'll happen, then it will! (please apply this concept to your particular context/situation).

As said previously, just a thought and very much clutching at straws.

Final thought, or rather question. If money was no object -how do you then see yourself being able to finally rid yourself of Mirtazapine? (or do you see even all the money in the world not making a difference to any solution?) - There is a rationale for my asking the question.

Hope you can have a peaceful sleep and equally peaceful start to the day in the morning.  

Best wishes to all ... zzzZZZzzz 

8

Sounds a good approach and surely worthy of a try!

Good luck and much peace

9

Another good suggestion ...it seems there're are others rooting for Craig...

Hope things pay off for him soon!

10

Love the quote about insanity Karl, so so true. I am on my third day of 15mg and have to say its pretty hard going. I am making it through the day but still feel rubbish. After taking 30 for 3 weeks and missing a single dose and feeling good I think the drop to 15 maybe a little fast. It a battle in my mind as i want off but my instinct is to do it quickly. I think I am going to up my dose to 22.5 and see if i can get a little stable on that. Its that dilema now ive come down dont go up, but know through experience that withdrawal will come soon if I stay on 15. I will keep posting as I go in the hope others may find the info useful.

11

Karl, in answer to your question about money, i don't think any amount of money would cure me of my illness. I will admit that money can take the pressures away from everyday life, and maybe would provide me with more relaxation time to help relieve my symptoms

12

I too was taking Mirtazapine at the 15mg dose nightly. My GP suggested I up the dose to 30mg after approx 4-6weeks, which I did for a few days before getting what I associated as being 'worsening' side effects. So, I reverted back to the 15mg. After a week or two or three (can't recollect exactly) of being on the 15mg (and with the heavy morning groggy effect along with an intense depressed mood) I became convinced it was THE MIRTAZAPINE at fault, so began the quest to come off it.

Now this is where my experiences are very similar to your own in so far as the when I halved the dose to 7.5mg the next day I felt a real respite from my normal negative mood as and symptom; I would go as far as to say I was even pleasantly surprised (allbeit) tentatively such was the surprise of having a mild feeling of happiness/peace). This NEW feeling might even last 2 or 3 days BUT THEN ...my feeling that my 'weening' off was going to plan SUDDENLY was met with my having a lousy day. What the hell? I thought as it seemed I had taken a few positive steps forward but then slipped back.

Simply put, my attempt to 'ween' off went along these lines:

15mg >>> Reduced to 7.5mg on night #1(fairly positive following day) >>> Another 7.5mg night on #2 (fairly positive following day) >>> Another 7.5mg on night #3 (lousy day and left thinking what the hell).

It seems any respite/positive days following a reduction in the drug are followed by a return of some/all/more lousy side effects!

Clearly there is similarity with Craig's (and many? other peoples experiences.

Conclusion: Mirtazapine for some/many is a difficult drug to come off due to what are proving to be lousy withdrawal effects...

I have just took my 7.5mg and now can only hope n pray that tomorrow (Wednesday) I feel better. Wish same for you Craig too!

Peace

[My humble personal experiences only].

13

Karl, Have you tried the CITA method, whereby you drop 1 dose a week for however many weeks you can stabalize, then drop 2 doses a week, etc. You can go as slow as you need to. Some people take 8-12 months to come off of it. By dropping only 1 dose per week at a time, your body adjusts better to the change.

Just a suggestion. Wishing you all well!!

14

Hi Kathy (thanks for your kind input) ..No I haven't tried the method you've described. It is nodoubt a valid and proven (dare I say it) better approach but I think I'd lack the patience to see it through (as its a long term approach to 'weening off'wink. For my sins I am currently of the mind that (for me atleast) I'd sooner come off as quickly as I can (or attempt to do so). That's not to say I'm brave or 'fool-hardy' enough to just abruptly stop and thereby go 'cold turkey' but rather just reduce my usual 15mg dose to 7.5mg for a few days followed my miss a day, take a day (still with the 7.5mg) for another few days before EITHER coming off totally OR halving the dose further to 3.75mg and following the same routine as previously mentioned before coming off. Needless to say this will expose me to some degree of 'cold turkeyness' as withdrawal shows itself (which has already been in evidence and with similar predictability to what was reported by Craig). Today as I write I feel a little lousy but not as lousy as yesterday. By lousy I mean 'racing negative 'gloomy' anxiety filled uncontrollable lifes not worth living thoughts.

Background factors: Pressure from a forced house sale, difficulty getting support/understanding from my young adult sons, long term unemployment and chronic back pain and thyroid condition ALL weigh heavy on my mind/psyche and lead to the following cycle of worry>>>stress >>>anxiety >>>continued agitated depression!!! (note. depression has never been far from me since around 1993 and takes hold easily depending upon what life event I'm facing). I guess that's why I had desperately invested so much hope that Mirtazapine would help me where other meds had not. Sadly any slight benefits (attributable to the drug or placebo effect) SEEM to have been outweighed by the negative side effects esp. immediately upon waking up and continuing throughout the day; with only the occasional more settled feeling (slight) coming evening time as the dark cloud lifts and I am able to focus a little on a 'distraction' activity like watching a documentary or movie.  

Sorry for going on ..I hope I haven't confused.

Best wishes and much peace!

Karl

15

When reading through the various posts on mirtazapine withdrawal, it strikes me that the reason for wanting to reduce/get off it is highly relevant. There is a huge difference between those who are coming off it because isn't working and/or it has unacceptable side effects, and the group for whom the mirtazapine has done it's job and they are now recovered. In the first case, the patient is feeling lousy and the withdrawal effects can add to that, and it seems that you, Karl and Craig, are in that category, you are not in the best condition to deal with the withdrawal effects but you are anxious to get off it as soon as possible. I am in the second category, I'm reducing the mirtazapine because I don't need it any more. I can take the reduction process as slowly as necessary, my main concern is to stay well. It does help to think about these things, I find, and everyone has to make their own choices about how quickly to reduce. So you do what feels best for you, listen to your body, and see each of your decisions as a positive step towards a (hopefully) better future.

16

Hello Pixie, thanks for the reply, and I find what you have said very interesting. Once upon a time when i was on citalopram and it kept my depression away i decided to come off. I realise now that when i first tried i was probaly experiencing withdrawal and that kept making me think that my depression was returning so i just stayed on them. When i became ill the second time whilst on citalopram I tried upping the dose but it didnt helped and the dr made me switch to mirtazapine. I did slowly start to feel a bit better but even as i climbed the doses I never reached total relief. I believe that more knowledge at this stage was actually hindering me. The first time when i made a recovering i never questioned the tablets as i was too poorly to care.

     Since the start of mirtazapine i kept experiencing tummy problems and a sore mouth which i blamed solely on the mirt. This has caused me to constantly play with the dose to se if i could alleviate the symptoms. This has gone on for the last 2 years and i am probaly in a situation now where i don't really know the way forward.All i have managed to work out is if i increase my dose to 30 after a few days i get to a point where i can barely function. However if i lower the dose to 15 and ride it I end up starting to feel rough and uneasy. My dr suggested that i come off mirt and go back to citalopram, as he believes a drug that made me well before should definately help me a second time, and my body has been without it now for 4 years. I have no problem accepting that I may need to take something for the rest of my life as my depression seems heriditory, as my gran and father had it. The biggest problem for me is on the 2 occasions i have tried to get down on the mirt i become too ill or week minded to take the plunge and jump to the citalopram....Sorry to go on, but thats where i'm at ...

17

You raise a good/valid point Pixie (in my humble opinion) ...I guess regardless of what ones personal experiences are of Mirtazapine (or ANY drug) one should be aware that there are/may be two camps ..two opposing schools of thought ..two views, groups and based on differening experiences (for want of a better description).

I may not have explained myself very well in previous posts (my mind is foggy sometimes, sorry) but for me (personally) I'm not 'anxious' about the drug so much, but rather about ACTUAL and REAL things/circumstances etc that i face I call 'my life issues' (e.g. chronic back pain, thyroid condition, forced house sale, single parent etc etc which collectively weigh very heavy on me).

Sadly I am someone who is never far from depression (first bout around 1993) ..So even when I'm experiencing a settled period (chapter) in my life it lurks in the shadows not far away - (typical cycle is I guess: negative life issue(s) [stressor] leading to worry [incessant rumination/thinking] leading to anxiety leading to re-emergence of depression [can't function or struggling to do so] ...and then this too then feeds into the cycle as a issue and so around and around the go - like a 'Merry Go Around' that I can't get off or stop!!!

NOW, if Mirtazapine or any other 'suck n see' drug/intervention/activity doesn't atleast alleviate any aspect of that cycle or the depression itself ...then its not worth (me) continuing with it; which I've decided to do re. Mirtazapine.

That said, I'm not 'anxious' about the drug itself, but only about the negative life issues (which remain and are legitimate (I do recognise though that I may uncontrollably be making a 'mountain out of a mole hill' over but like I said its hard to stop or get off as a drepressive). So its my life's issues that I'm anxious about and which sets the wrecking ball in motion which inturn causes dibilitating full blown anxiety and agitated depression to rear its ugly head AGAIN. I hasten to reiterate, Mirtazapine doesn't make me anxious, I just simply see it as just one drug that hasn't worked for me. For those that it has worked for ..thats truly nice to hear. Regardless what people's individual experiences are, I wish ALL peace and a measure of happiness!

Best wishes Pixie (and I do hope I haven't bored you with the long comment - just speaking out aloud and trying to give myself a activity to focus upon for a little while. Hope you understand)

Regards

p.s. Day #4 'weening off' Mirtazapine  ..feeling better than yesterday and fairly steady, but still experiencing some panic/anxiety/negative mood) ..I may attempt a further reduction to 3.75mg tonight (fingers crossed withdrawl does cruch me tomorrow)

18

Karl, I just want to wish you well in your reduction going forward, knowing the problems I have experienced, I hope the decisions you make with the dose are the right ones and you have good days to come..

19

Truth is Craig ..it's things you and others that are sharing on here that's helping me. Strange as I know of any SSRI called CRAIG or PIXIE or KARIN! (excuse my attempt at humour).

Many thanks for your sharing and support!

Sincerely wishing you a peacecul evening, good nights sleep and settled day tomorrow (same to everyone else too).

20

I agree with what others are sharing, its almost like therapy. I am on my third day of 15 and although the days are wearing i keep comparing them to last weeks when i was on 30 and have to sat these are easier. Each night before i go bed i'm managing to convince myself another 15, and my safety shield is "whats the worst that can happen?" I can always take more