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Thread: Tapered down....

  1. #1
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    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 donít 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 thatís it.

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

  2. #2
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    Re: Tapered down....

    Quote Originally Posted by Benjammin69 View Post
    currently my side effects from tapering are sedation during the day due to the 7.5 lower dosage and thatís it.
    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

    just to also say I have other meds that I take which are helping the withdrawal so propranolol, seroquel and hydroxyzine,
    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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  3. #3
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    Re: Tapered down....

    Quote Originally Posted by panic_down_under View Post
    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


    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?

  4. #4
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    Re: Tapered down....

    Quote Originally Posted by Benjammin69 View Post
    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?
    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!
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  5. #5
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    Re: Tapered down....

    Quote Originally Posted by panic_down_under View Post
    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!
    Thanks Ian! Your a gem! Iím gonna let the side effects calm down over Xmas period and then start with reducing the quetiapine from start of January. Thatíll be a toughie. Iíve been quiet lucky as today is the only day I feel withdrawal, Iíve taken a lorazepam but itís not really done much which normally links to either being ill or drug related Iíll was which. I find if youíre 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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    Re: Tapered down....

    Quote Originally Posted by Benjammin69 View Post
    start with reducing the quetiapine from start of January. Thatíll be a toughie.
    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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  7. #7
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    Re: Tapered down....

    Quote Originally Posted by panic_down_under View Post
    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.
    Ah man itís been 7 days since I jumped and Iím cold sweaty, chills and flat mood. Iím 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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    Re: Tapered down....

    Quote Originally Posted by Benjammin69 View Post
    There is a possibility it is a virus as both my young boys have norovirus so it could be that with me
    It could be as all the symptoms you're experiencing are consistent with both viral infection and mirtazapine withdrawal.
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  9. #9
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    Re: Tapered down....

    Quote Originally Posted by panic_down_under View Post
    It could be as all the symptoms you're experiencing are consistent with both viral infection and mirtazapine withdrawal.
    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 Iím in the clear. Thanks for your help Ian.

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

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

  10. #10
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    Re: Tapered down....

    Quote Originally Posted by Benjammin69 View Post
    Ill prob reach out when IímComing off 200XR quetiapine. In a few weeks time :-)
    Oh, more work. I'll have to put in for a pay rise!

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