Tapered down....

Hi,

over the the last 7-6 weeks I have been tapering my mirtazapine dosage from 45mg to 7.5mg. The taper plan was :
45mg 2 weeks
30mg 2 weeks
15mg 2 weeks
7.5mg 1 week and current dosage....

reason for thread read is when and what dosage is right to jump off. I feel I could jump off now but don’t want body freaking and to have to updose as this will defeat all the hard work I have put in.

currently my side effects from tapering are sedation during the day due to the 7.5 lower dosage and that’s it.

just to also say I have other meds that I take which are helping the withdrawal so propranolol, seroquel and hydroxyzine,

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Originally Posted by Benjammin69

currently my side effects from tapering are sedation during the day due to the 7.5 lower dosage and that’s it.

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Which is probably a good indicator that you could stop from 7.5mg without major issues. You can always reintroduce it at 3.75mg if it triggers significant withdrawal

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just to also say I have other meds that I take which are helping the withdrawal so propranolol, seroquel and hydroxyzine,

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Both quetiapine (Seroquel) and hydroxyzine target the *same receptors at similar potencies as mirtazapine which may account for the lack of significant withdrawal symptoms. While it is not an uncommon combination, I don't really understand why doctors keep prescribing them together.

* Receptor binding potency (Ki) is measured by the amount of drug needed to saturate receptors, the lower the Ki the greater the potency.

Mirtazapine: H1: 1.6 Ki, 5-HT2a: 69.0 Ki, D2: 1000 Ki
Hydroxyzine:H1: 2.0 Ki, 5-HT2a: 50.0 Ki, D2: 378.0 Ki
Quetiapine : H1: 6.9 Ki, 5-HT2a: 118. Ki, D2: 500.0 Ki

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Originally Posted by panic_down_under

Which is probably a good indicator that you could stop from 7.5mg without major issues. You can always reintroduce it at 3.75mg if it triggers significant withdrawal



Both quetiapine (Seroquel) and hydroxyzine target the *same receptors at similar potencies as mirtazapine which may account for the lack of significant withdrawal symptoms. While it is not an uncommon combination, I don't really understand why doctors keep prescribing them together.

* Receptor binding potency (Ki) is measured by the amount of drug needed to saturate receptors, the lower the Ki the greater the potency.

Mirtazapine: H1: 1.6 Ki, 5-HT2a: 69.0 Ki, D2: 1000 Ki
Hydroxyzine:H1: 2.0 Ki, 5-HT2a: 50.0 Ki, D2: 378.0 Ki
Quetiapine : H1: 6.9 Ki, 5-HT2a: 118. Ki, D2: 500.0 Ki

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Right that is me 5 days off mirtazapine - I jumped off at 7.5mg. So far I am really sweaty, have no appetite and diarhoea. Mild anxiety but no depression. Previously when I have reduced I have slipped in to that suicidal depressive stage but I seem to have avoided that. I will hold on and ride these withdrawal symptoms out. Any advice Ian? Or is this normal withdrawal signs?

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Originally Posted by Benjammin69

Right that is me 5 days off mirtazapine - I jumped off at 7.5mg. So far I am really sweaty, have no appetite and diarhoea. Mild anxiety but no depression.

...I will hold on and ride these withdrawal symptoms out. Any advice Ian? Or is this normal withdrawal signs?

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The side-effects are relatively common. They tend to begin easing once the drug is out of the system which for mirtazapine is at around 4-8 days depending on how quickly you metabolise it, but in your case this is complicated by being on two other meds with similar modes of action. But even so the worse should soon be behind you. Loperamide (Imodium), available from pharmacies and all good supermarkets, should fix with the diarrhoea, however, it can be mildly sedating which may add to sedation from the hydroxyzine and quetiapine, so be extra cautious if doing anything potentially hazardous, although mirtazapine would have been much worse in that regard. Still, right now is probably not a good time to take up skydiving! :shades:

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Originally Posted by panic_down_under

The side-effects are relatively common. They tend to begin easing once the drug is out of the system which for mirtazapine is at around 4-8 days depending on how quickly you metabolise it, but in your case this is complicated by being on two other meds with similar modes of action. But even so the worse should soon be behind you. Loperamide (Imodium), available from pharmacies and all good supermarkets, should fix with the diarrhoea, however, it can be mildly sedating which may add to sedation from the hydroxyzine and quetiapine, so be extra cautious if doing anything potentially hazardous, although mirtazapine would have been much worse in that regard. Still, right now is probably not a good time to take up skydiving! :shades:

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Thanks Ian! Your a gem! I’m gonna let the side effects calm down over Xmas period and then start with reducing the quetiapine from start of January. That’ll be a toughie. I’ve been quiet lucky as today is the only day I feel withdrawal, I’ve taken a lorazepam but it’s not really done much which normally links to either being ill or drug related I’ll was which. I find if you’re body if battling a virus or withdrawal it tends to increase tolerance to benzo effects. So needing more but I tend to never up dose and just ride them out

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Originally Posted by Benjammin69

start with reducing the quetiapine from start of January. That’ll be a toughie.

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It should be much the same as with mirtazapine with the last couple of dose drops often triggering more severe reactions. Just do it by small reductions at a time at 10-14 day intervals, or even longer if needed. There are no gold stars awarded for weaning off quickly.

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Originally Posted by panic_down_under

It should be much the same as with mirtazapine with the last couple of dose drops often triggering more severe reactions. Just do it by small reductions at a time at 10-14 day intervals, or even longer if needed. There are no gold stars awarded for weaning off quickly.

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Ah man it’s been 7 days since I jumped and I’m cold sweaty, chills and flat mood. I’m gonna hold out for another 2-3 weeks before I try 3.75mg. There is a possibility it is a virus as both my young boys have norovirus so it could be that with me as the hydroxyzine and quetiapine act as an antiemetic so I just feel like shit

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Originally Posted by Benjammin69

There is a possibility it is a virus as both my young boys have norovirus so it could be that with me

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It could be as all the symptoms you're experiencing are consistent with both viral infection and mirtazapine withdrawal.

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Originally Posted by panic_down_under

It could be as all the symptoms you're experiencing are consistent with both viral infection and mirtazapine withdrawal.

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Turns out family all had norovirus and the sweats and symptoms was to do with that. I am now 2 and 1/2 weeks off and I’m in the clear. Thanks for your help Ian.

Ill prob reach out when I’mComing off 200XR quetiapine. In a few weeks time :-)

Hope you had a great Christmas and have a great new year

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Originally Posted by Benjammin69

Ill prob reach out when I’mComing off 200XR quetiapine. In a few weeks time :-)

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Oh, more work. :ohmy: I'll have to put in for a pay rise! :winks:

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Hope you had a great Christmas and have a great new year

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And to you, mate.

Very quiet Christmas this year. My landlord and family decided to vacation on the mainland - he should have booked 2 weeks in hell instead, it would have been cooler - leaving me to look after the farm so it was just me, the 4 sheep that mow my 'lawn' and keep me awake at night with their snoring and occasional headbutting of the cabin walls and a handful of other animals.