Stopping mirtazapine

[Benjammin69]

So 8 days ago I reduced my mirtazapine to 15mg and added Wellbutrin ... today I stop mirtazapine altogether... other than anxiety and a bit of a low mood it’s been ok. Anyone quit or cross tapered like this before? Any advice let me know

Cheers guys

[Hry]

Hi there, I have been taking 30mg mirtazapine for 7 weeks now. It has helped me a lot with my sleeping issues but I would like to come off the medication or at least reduce it to 7.5-15mg as I feel extremely tired and drowsy during the day. Are you having any sleeping issues after tapering to 15mg? I read in another thread you were also taking quetiapine. Are you on this medication while tapering mirtazapine? Thanks

[Benjammin69]

Like the topic says.... if I was to stop taking it would I have any withdrawals? I want to simplify my med regime and this isn’t doing anything for me anymore

[Benjammin69]

So.... I have tapered off of 30mg mirtazapine over a period of 8 days.... And wow! The adrenaline surges I can feel in my body, the panic, the trembles and shakes. I obviously have reduced to quick! Anyonelese got experience with this?? I’m going to reinstate at 15mg... for a week or so.

Peoples experiences and views are welcome

[MyNameIsTerry]

How long were you on it? That's a very fast taper. You've dropped a couple of therapeutic dose levels there.

I would look at a much slower taper and be mindful of the half life in ensuring you at least stabilise your blood plasma levels before moving down further (although I would take longer than that to see how I adjust).

[MyNameIsTerry]

It's not supposed to as far as I know. But I would be wary of withdrawing multiple drugs at the same time just so I knew which was doing what.

[Benjammin69]

How long were you on it? That's a very fast taper. You've dropped a couple of therapeutic dose levels there.

I would look at a much slower taper and be mindful of the half life in ensuring you at least stabilise your blood plasma levels before moving down further (although I would take longer than that to see how I adjust).

I have been on it since August 2016, I was on 30mg and reduced to 15mg for a week then 0mg and I have only got in to trouble yesterday really and today’s been a rough ride with pure adrenaline and anxiety. I’m going back up to 15mg and still going to cross taper with bupropion.

Do you know how quick withdrawal symptoms go away? I need this adrenaline gone as it’s impacting my driving and everything

[Maca44]

I would be looking at months not days to come off 8 days is way to quick.

[Benjammin69]

I would be looking at months not days to come off 8 days is way to quick.

It was My psychs suggested taper unfortunately so I just went with it and bang! Hit me like a bitch

[Benjammin69]

Hi so.... as you may have read I have been having some trouble reducing mirtazapine and my depression and anxiety are going crazy. I have spoke to my psych and he has said about going back up to stabilise. I will re start the dose I was stable at which is 30mg. Million dollar question how quick will I stabilise ?? I am feeling very panicky and low right now...

[Benjammin69]

I need your help so I stoped my meds over 8 days and started a new med
. Anyway my mood has crashed I am in dark deep depression, I can’t drive, I’m dizzy, I’m sick, I got no energy. What the hell is going on ? Last week I was absolutely fine how quick has this escalated


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[nomorepanic]

side-effects from the medication - they are nasty things to be honest

[Benjammin69]

So I’m finding myself back in that dark place with ruminating thoughts and my mind going at 200mph! I reduced my meds too quickly so I have reinstated but please someone tell me this goes away soon! I can’t bare the mind whirling around so fast and not letting me focus!


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[Benjammin69]

So after a too fast taper and a crash in my mental health I find myself back in that deep dark depression which I managed to beat last year! I have reinstated my medication and I am 25 days on Wellbutrin and I am waiting to ‘stabilise’ but at the moment my head is going at 200mph and fixing on to things which I never normally would ... I see bleach my brain says drink it.... I see scissors ... my mind said cut it... it’s just awful - I do not want to hurt myself or commit suicide at all but these thoughts I can’t stop and I’m trying to remember how I stopped them last time but it’s all a blur.... I’m in therapy for the last year, I have made myself leave the house when I don’t have the energy to , I am spending time with family and trying not to stay alone but please if anyone knows how to get out my head please let me know! I can’t have any more meds than I am on already (quetiapine, buspar, mirtazapine and Wellbutrin)... my psych has suggested using benzos to calm my mind when it’s too fast...

[nadosa]

You can get out of your head if you are present. Be. Focus on your breath. Your senses. Focus on the now. Dont think about what if or what will be or what was.

[MyNameIsTerry]

I have been on it since August 2016, I was on 30mg and reduced to 15mg for a week then 0mg and I have only got in to trouble yesterday really and today’s been a rough ride with pure adrenaline and anxiety. I’m going back up to 15mg and still going to cross taper with bupropion.

Do you know how quick withdrawal symptoms go away? I need this adrenaline gone as it’s impacting my driving and everything

Sorry I didn't get back to you, I don't pop on the Meds board as much these days.

This med has a half life of 20-40 hours so it's harder to determine how long it is going to take to be eliminated (as a guide) as this is across gender groups. But men do eliminate it quicker than women, average 26 hours for men vs 37 for women. With that in mind it may come out completely around a week and less for clinically insignificant.

The trouble is not only what the drug does on a consistent basis but any changes they make e.g. down regulation in SSRI's prevents reuptake by plugin holes where it would be absorbed through. Mirt works by blockers binding to nerve cells therefore as you remove the Mirt more of that blocking is no longer happening and the body may need some time to adjust to that as it does with the down regulation of SSRI/SNRI's.

I'm not sure how long that will take, it's one Ian would know I bet. There may be some studies out there but I've never been on Mirt so I've not looked at it as much.

Perhaps something else to consider is how Mirt works in a different way dependant on dose? Low doses up to 15mg tend to give the antihistamine effect so make you tired but these are said to alter to it's Serotogenic activity once you move up a dose. So, I wonder whether reinstating to 15mg is doing little in that respect and it's still a form of withdrawal? A question for the psychiatrist but why is there a need to withdraw so quickly in the first place?

[Benjammin69]

Alot had happened since then I have reinstated at 30mg approx 10 days ago and I’m still waiting for my mood to stabilise - I am finding myself back in the grips of depression which is awful seeing as I have been in remission since April! The withdrawal symptoms have all but stopped except low mood and energy, depressive rumination and a bit of anxiety. I had 3 weeks off reducing mirt so I’m not sure how long it will take to re stabilise I was hoping by now I would be much further forward. I can’t work with my thoughts and mood the way it currently is :-(


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[MyNameIsTerry]

Sorry to hear this, it must feel like a soul crusher right now. The med itself will have stabilised by now at that dose but I think something major like this is just a big shock and it takes a bit of time to subside. Take it day by day and see what happens, hopefully any day now you might get some relief from it.

[MyNameIsTerry]

It sounds to me like your anxiety has ramped up and your mind is overstimulated. Are you finding it really hard to concentrate? Are your thoughts racing? This can be very tiring if so.

You are getting intrusive thoughts and these are always more intense and more frequent when overall anxiety levels go up. I've spoken to many OCDers who say this and also say the opposite is true in that as those levels subside the thoughts decrease.

Whilst these thoughts can be very scary, they are literally just the subconscious blurting stuff out that normally would be catered for by some other process or ignored because they are meaningless. So, try not to panic as they come and don't analyse them negatively i.e. obsess over what they mean, because they mean nothing, its just a hyperactive self protection system. Try to acknowledge them as simply thoughts, no more important than a thought popping in to buy some milk when walking around the supermarket.

With this being a drug withdrawal issue, I don't know if that will be possible and it may mean riding this out first but if so, it's something to try.

Try to calm your nervous system with anything relaxing, an exercise or activity, breathing work, etc. Again, this may not work for you right now but it may help with adrenaline levels. Too much adrenaline ramps up these thoughts too so a bit of gentle exercise or breathing work can help with this.

If you can, resist any urges to protect yourself from these scenarios in the thoughts e.g. don't hide knives or lock the bleach away, because as you already know this is not something you would do and reacting this way can keep them going.

It's good to know you have your family to support you. When things are really bad, feeling some safety from their presence can be very important.

[Elen]

Hi

This is just a courtesy reply to let you know that your thread was merged with another of your threads.

Please when posting on similar topics add it onto your previous post rather than starting a new one.

It is nothing personal it is just to make it easier for people to follow your story and to give you advice as a whole.

Elen

[Benjammin69]

It sounds to me like your anxiety has ramped up and your mind is overstimulated. Are you finding it really hard to concentrate? Are your thoughts racing? This can be very tiring if so.

You are getting intrusive thoughts and these are always more intense and more frequent when overall anxiety levels go up. I've spoken to many OCDers who say this and also say the opposite is true in that as those levels subside the thoughts decrease.

Whilst these thoughts can be very scary, they are literally just the subconscious blurting stuff out that normally would be catered for by some other process or ignored because they are meaningless. So, try not to panic as they come and don't analyse them negatively i.e. obsess over what they mean, because they mean nothing, its just a hyperactive self protection system. Try to acknowledge them as simply thoughts, no more important than a thought popping in to buy some milk when walking around the supermarket.

With this being a drug withdrawal issue, I don't know if that will be possible and it may mean riding this out first but if so, it's something to try.

Try to calm your nervous system with anything relaxing, an exercise or activity, breathing work, etc. Again, this may not work for you right now but it may help with adrenaline levels. Too much adrenaline ramps up these thoughts too so a bit of gentle exercise or breathing work can help with this.

If you can, resist any urges to protect yourself from these scenarios in the thoughts e.g. don't hide knives or lock the bleach away, because as you already know this is not something you would do and reacting this way can keep them going.

It's good to know you have your family to support you. When things are really bad, feeling some safety from their presence can be very important.



Hi Mate, thanks for your reply it is really appreciated!

I am finding it hard to concentrate and just live life at the moment, my mind is racing and locks on to any thought which is distressing. At the moment my mind won’t let me continue to progress as it cannot function fully it is literally just scanning and locking in to one thing. I had this before when I had MDD mixed with anxiety.

My psych has said I can use benzos when it gets to bad but I am avoiding those as don’t want to rely on them to have a peaceful mind also I don’t find they work with anxiety caused by depression.

I was absolutely fine and fully functional 3 weeks ago before my psych pulled me off the mirtazapine so re-instating I thought would work quicker than it has done.

It’s really hard not to focus on these thoughts, I have been in therapy for the last 12 months and last week I couldn’t attend face to face as I felt that awful.

I’m hoping this will calm down soon mate I really do! I literally am living day by day at the moment

As always thanks for your views and response

[MyNameIsTerry]

No worries, just wish something helped because when it's this bad each day is a massive uphill climb and then you wake up and do it all over again. I hated it.

When I went on Duloxetine it reduced me a wreck. Those first 10 or so days were the worst and all I told myself was that tomorrow it will break and I just held on teeth gritted. Nothing was going to help me then, I was so agitated the first few hours of the day I would stand in the kitchen as I just couldn't sit down.

The last two mornings I gave in on the Diazepam I had resisted and it did help. Those couple of hours where it calmed the symptoms of adrenaline down a bit helped with not only the symptoms of my chest feeling the pressure and me wanting to run a 30 second mile screaming (think the lift scene in the film Crank :winks:) but also the thoughts of despair that I was going through yet again today.

If they can help, you know tons about managing them so you won't get tolerant. But sometimes you just need a few hours or that one less awful day and you get a little boost from that respite. If you can find that somehow, any how, it will do you good.

I hope something helps. Hang in there. You went through it before and kicked it's backside so you will again. Mirt is supposed to kick in quicker for those it works for so fingers crossed and I agree with you that your body has been used to it before so it should get into it sooner this time, it's perhaps the major imbalance of the shock of the withdrawal that needs to abate a bit first and then things will seem a bit easier to cope with.

Given the thoughts have come from the withdrawal, once you get stable again I would expect they will either go or greatly reduce. Some people have intrusive thoughts starting antidepressants and they often seem to go once they get through the side effects window.

[Benjammin69]

No worries, just wish something helped because when it's this bad each day is a massive uphill climb and then you wake up and do it all over again. I hated it.

When I went on Duloxetine it reduced me a wreck. Those first 10 or so days were the worst and all I told myself was that tomorrow it will break and I just held on teeth gritted. Nothing was going to help me then, I was so agitated the first few hours of the day I would stand in the kitchen as I just couldn't sit down.

The last two mornings I gave in on the Diazepam I had resisted and it did help. Those couple of hours where it calmed the symptoms of adrenaline down a bit helped with not only the symptoms of my chest feeling the pressure and me wanting to run a 30 second mile screaming (think the lift scene in the film Crank :winks:) but also the thoughts of despair that I was going through yet again today.

If they can help, you know tons about managing them so you won't get tolerant. But sometimes you just need a few hours or that one less awful day and you get a little boost from that respite. If you can find that somehow, any how, it will do you good.

I hope something helps. Hang in there. You went through it before and kicked it's backside so you will again. Mirt is supposed to kick in quicker for those it works for so fingers crossed and I agree with you that your body has been used to it before so it should get into it sooner this time, it's perhaps the major imbalance of the shock of the withdrawal that needs to abate a bit first and then things will seem a bit easier to cope with.

Given the thoughts have come from the withdrawal, once you get stable again I would expect they will either go or greatly reduce. Some people have intrusive thoughts starting antidepressants and they often seem to go once they get through the side effects window.



Cheers mate -thank you. You know what it’s like when you feel like you can’t escape your own mind and the thoughts go round like a hamster wheel! It’s awful and because I’ve reduced mirt, added Wellbutrin then re added mirtazapine I think my CNS is just over stimulated. I hate that everything takes 4-6 weeks to kick in as someone who is anxious and depressed count them days down like chalk on the wall in the film castaway!

Yeah I’m so stupid as I save benzo’s for a bad day... then I have a bad day and don’t take one lol.. it’s not funny really but what is a bad day?!?

Once these thoughts and rumination calms down I can move on with life and focus on wellbeing... just a matter of time I think


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[MyNameIsTerry]

Yeah I often do that with things I save up. I try to push through without. Especially with benzos and z meds worrying about running out later when I may need them. It's part of my anxiety I think, trying to be more of a boy scout for later. I've done it with money ever since getting into debt early on in my working life with credit cards.

That 4-6 week thing is something I think we all say on here but whether it's true is debatable. I think its a worst case for starting meds thing. When I started Cit in week 4 it started getting easier and by the end of week 5 the side effects had cleared. Then starting Duloxetine it hit me like a train for about 10 days when I went up to the standard therapeutic dosage and after that it did decrease (just carried on at a lower level for ages but I think my GP should have switched me and I knew nothing about this stuff back then so trusted him).

So, whilst it possibly could be x weeks that doesn't have to mean at the same intensity. And you started back up fairly soon so if any changes were still happening to cause the withdrawal you would have started reducing or eliminating that effect by reintroducing the drug I would have thought.

In a switch between same class meds there is a dip as we changeover and I doubt that causes a complete backing out of the down regulation effect, it wouldn't make sense. So, it seems plausible the Mirt binding effect could have been in the process of unpicking itself to return to the pre Mirt state and reinstating the dose has interrupted that. I don't know much about the binding though but it's not like these meds work fast like benzos.

How long have you been on the Wellbutrin? I wonder if part of this is start up side effects too?

Yeah, mental agitation is horrible. A few of us on here have mentioned it being one we've found hard to deal with. It makes you feel like you're going mad...but no drawing a face on a football and talking to it like in Castaway :winks:

[Benjammin69]

Yeah I often do that with things I save up. I try to push through without. Especially with benzos and z meds worrying about running out later when I may need them. It's part of my anxiety I think, trying to be more of a boy scout for later. I've done it with money ever since getting into debt early on in my working life with credit cards.

That 4-6 week thing is something I think we all say on here but whether it's true is debatable. I think its a worst case for starting meds thing. When I started Cit in week 4 it started getting easier and by the end of week 5 the side effects had cleared. Then starting Duloxetine it hit me like a train for about 10 days when I went up to the standard therapeutic dosage and after that it did decrease (just carried on at a lower level for ages but I think my GP should have switched me and I knew nothing about this stuff back then so trusted him).

So, whilst it possibly could be x weeks that doesn't have to mean at the same intensity. And you started back up fairly soon so if any changes were still happening to cause the withdrawal you would have started reducing or eliminating that effect by reintroducing the drug I would have thought.

In a switch between same class meds there is a dip as we changeover and I doubt that causes a complete backing out of the down regulation effect, it wouldn't make sense. So, it seems plausible the Mirt binding effect could have been in the process of unpicking itself to return to the pre Mirt state and reinstating the dose has interrupted that. I don't know much about the binding though but it's not like these meds work fast like benzos.

How long have you been on the Wellbutrin? I wonder if part of this is start up side effects too?

Yeah, mental agitation is horrible. A few of us on here have mentioned it being one we've found hard to deal with. It makes you feel like you're going mad...but no drawing a face on a football and talking to it like in Castaway :winks:


Hi Mate,

Started on the Wellbutrin 27 days ago lol so on 28 days that’s 4 weeks so I should be fixed tomorrow ..:roflmao:

My mind does seem quieter today but it is still early doors. I think it has got to be a combination of both which is makes things even harder as I was managing situational anxiety before where now I am managing the symptoms of depression - re the energy, not wanting to do anything etc

The meds are meant to give you some respite to work on the things that will truly help re: exercise. Therapy and staying active... so I am waiting for that to start to take hold.

I find that my brain can only really focus on one of the beasts at anyone time so I’m either not depressed but extremely anxious or not anxious and severely depressed....

I am holding on to the fact that I messed with my meds rather than thinking it is a relapse of depression. I am still thinking I will get better within a few days...

I’m the same as you. I have loads of benzos in my bathroom cabinet which I end up just storing and fighting through this mess with sheer willpower. My therapist suggested against that and to use the meds to reduce my symptoms etc - I even had expired diazepam and had to swap them at the doctors

[MyNameIsTerry]

Noticed you saying you are getting one or two normal days on James thread. Glad to hear it mate, perhaps the med is kicking back in to stabilise the mess the sharp withdrawal caused?

I bet it's quite a relief?!!! :yesyes::yahoo:

[Benjammin69]

Noticed you saying you are getting one or two normal days on James thread. Glad to hear it mate, perhaps the med is kicking back in to stabilise the mess the sharp withdrawal caused?

I bet it's quite a relief?!!! :yesyes::yahoo:


Yeah had a good window on Monday and Tuesday, yesterday was a car crash but it’s obvious the recovery is going to come in windows and waves. It’s been an awful journey! Pretty intense.

Thanks for your help mate much appreciated

[Benjammin69]

I’ve had my consultation with my psych and instead of introducing a new drug we are going to increase the mirtazapine to 45mg augment that with my usual quetiapine. He also wrote me a script for cl9nazepam PRN....

How quick will 45mg increase take to work for anxiety and depression...

I’ve stopped the Wellbutrin now as it was too activating!

[Mindprison]

Hi Benjammin

I'm only on 30mg but was on 45 briefly before I went on Pregabalin. I take both now but I dropped the mirt to 30 because I liked the minor sedation it gave me at night for sleeping.

When I put the dosage up to 45mg it took a few days for my body to adjust and I started seeing some benefit after a week or two. I would say that if it's going to make a marked improvement, it will do so within 3 weeks.

Sometimes it can take a while for it to build up in your body to that theraputic level.

[Benjammin69]

Hi Benjammin

I'm only on 30mg but was on 45 briefly before I went on Pregabalin. I take both now but I dropped the mirt to 30 because I liked the minor sedation it gave me at night for sleeping.

When I put the dosage up to 45mg it took a few days for my body to adjust and I started seeing some benefit after a week or two. I would say that if it's going to make a marked improvement, it will do so within 3 weeks.

Sometimes it can take a while for it to build up in your body to that theraputic level.



Hi mate

Thanks. I tried pregabalin and it didn’t work for me . I went all the way up to 450mg and it just didn’t work. At the moment Ive been through most SSRI, most SNRI and most anti anxiety meds too... so at the moment just trying to stabilise on mirtazapine as it has worked before.

I have benzo to help but don’t want to rely on those.

Cheers


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[Barney b]

Hi All
This is my first post on the forum and have been reading about Mirtazapine as I have been on 30mg for the last 2 years. Started to have bad anxiety issues so doc put this up to 45mg, then two weeks later my psychiatrist suggested going back down to 30mg as he wanted to put me onto pregabalin.

I have reduced the Mirtazapine back down to 30mg and am having awful nausea and extreme fatigue a week on. I was just wondering if this could be a withdrawal problem but am not sure as I was only on the increased dose for just over two weeks.

Have not started the pregabalin because of all the bade side affects I have read (diagnosed with possible fibromyalgia)

Any advice or help would be greatly appreciated - thank you!

[hanshan]

Hi BarneyB,

The nausea and fatigue could be due to the change in dosage, or it could just be anxiety about changing doses and starting a new medication. Many people with anxiety suffer a spike in anxiety just before or after they start a new medication, particularly if they read through the list of potential side effects - every new medication these days has a list a mile long, though the vast majority of people will only experience one or two of the most common, if at all.

My advice is to start the pregabalin, even if you feel heightened anxiety at first. Most people on NMP have found it easy to start, with slight dizziness or clumsiness being two common and temporary side effects that pass after a week or two for most people. If pregabalin works it can be a real godsend, though it doesn't work for everyone. Good luck.

[Benjammin69]

Hi Barneyb ,

It is probably not withdrawals but it is hard to say, it usually takes 4-6 weeks for a drug to produce some results and that is the same with decreases and increases. I would probably say that the nausea and fatigue are linked to the reason why you increased in the first place and as such the introduction of pregablin should take that away unless it is a product of depression as such the mirtazapine increases would work better for that than the pregablin.

I have been up and down, off and on mirtazapine and only when I reduced and came off completely was I mega unwell on dosage reduction it seems to be ok


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[Zoe01708]

Hi Benjamin

I came off Mirtazapine, reduced from 30mg to 15mg within a week I had awful panic, but this goes in a couple of days it happened again when I reduced from 15mg to 7mg. Not everyone will have withdrawal, this is just my experience of it and it was not pleasant but it did pass quick. Hope I have helped somewhat.