Mirtazapine -coming off?

[OneMoreStepAlongTheRoadIGo]

I've been on mirtazapine for nearly 2 years now. Before I went on it I was a complete wreck for at least 6 .oaths. hyper vigilant, anxious and really not sleeping.

It got tk the point where I wasn't sure if the sleeplessness was causing anxiety or vice versa.

I agreed to go on mirtazapine and its been a wonder drug for me. BUT I am so groggy in the mornings and lethargic half the day. I do have ME/cfs so it might not be the drug but I'm starting to wonder.

Also I'm morbidly Obese.... I know it's known to contribute to weight gain but I was huge already. I suspect I am heavier but no way of knowing.

I'm looking at zoe diet and gut biome and it looks like mirtazapine really doesnt help there either.

So I'm thinking of stopping (speaking to gp of course but they're variable about withdrawal advice I find and let you decide)

I am really worried about the insomnia retuning. I would love to sort it . I'm not super anxious right now and in a much better place. But it could be peri or I might get withdrawal jnsomnia . I'd have to see it through wouldn't I? I can't go back to not sleeping though.

I have been fairly balanced the last 2 years . Its worked. But I've also had therapy so maybe I'd manage better now?

My effexor withdrawal was awful many years ago. I'd.lvoe to withdraw safely.

Or maybe I need to be on it forever. I so need to lose weight though...

Hi , I’ve been on mirtzapine for 10 weeks and it hasn’t helped with anxiety . When did you notice any improvement? Thank you

I think by 10 weeks I'd had some improvement - mainly because I was sleeping. For the last 2 years it's been a wonder drug and kept me sane.

I dont think I felt happier/a different person but realised that certain situations weren't getting to me like they used to.

Sleep was almost instant and life changing as I was not sleeping. I'm worried about this coming off!

So spoke to Dr (5min phone call not even my dr) and just told to alternate doses then come off....

I thought wisdom was to halve rather than alternate!?

And no support. I wanted to ask about magnesium for sleep as I'd heard that might help... but no chance

Any thoughts?

So I'm thinking I'll just have it for a couple of weeks (it's a pill with a line so that means it can be done right?)

No idea if there's a way to Quarter it or to alternate doses or to go cold turkey after 7.5

Iv taken my first 7.5 dose and feeling anxious even though I know side effects/withdrawal won't be until later anyway! I'm worried the next few months are going to be awful!

I just stopped taking it altogether without any tapering, and didn’t have any side effects/withdrawal symptoms, so you might be surprised. I’m still falling asleep easily but have recently started waking at 4am again which is really annoying.

😮😮😮 oh wow. The Internet is full of all the difficulties coming off it.

I had a really bad withdrawal 20 years ago from effexor that its made me worried but great to hear its not always like that. Really is.

What dose were you on and why did you stop suddenly? Have you found you lost weight coming off it?! All the things...

But yes even 4am wouldn't be bad its the staying awake til 5am then sleeping I can't stand which i got to before I went on it.

You can buy pill cutters from the chemist that are really good

I've just ordered one from amazon!

I feel a bit "naughty" that I'm not doing g the GPs "every other day." But I think I'll do 7.5 for a couple of weeks and if I'm okay then do 3.75... and then hopefully stop!

Mirtazapine is awful for weight gain.

If you start struggling with mh symptoms again, speak to your gp about starting a low dose of something else- duloxetine might be a good one. They taper one up as they taper the Mirtazapine down which will balance things out.

Good to hear that you're feeling so much better now. 😊

I stopped taking Mirtazipine very quickly several years ago, when I switched to a different drug. I don’t remember any issues at all (but it was a few years ago, as I say).

You should be able to reduce the size of the dose first, and when you can’t chop it up any smaller, you can start spreading out the doses out as well. Every other dose, then every third dose, etc. It's up to you when you finally just stop.

It seems like there's no deadline for you, as such, so you can take your time. And if you start having trouble with side effects, it's fine to go back a stage until the trouble fades and then resume tapering.

Good luck. Keep us posted!

Thanks. I really appreciate your posts. I can't believe I got just a sentence from my GP and then left high and dry.

Didn't even get told to contact her if it was difficult or my mh symptoms came back. Just yes come off them /alternate every other day/ and that's it.

And day 1 of 7.5. I've worked up after sleeping 8.5 hours (9.5 after taking it) which is normal for me but feel a bit more alert (normally I'm very groggy in the morning like a hangover on this drug.)

I also feel a bit nauseous. I think that must be coincidence as I can't believe it would make a difference the first day I drop and I ate chip shop chips yesterday which I haven't eaten anything greasy for a good while.

Oh I then slept another 3 hours having dreams about oversleeping wrapped into one about my difficult family. Oops!

Day 2 of 7.5. Woke up wide awake in the night which never happened before. So my body is aware all is not the same. I've basically had a morning in bed and hoping that I'll be all right for work.

I did get back to sleep but aware I probably need to relearn "sleep hygeine" as I've completely relied on mirtazapine to knock me out each night so far and not and to worry!

Day 3 7.5 slept 11.30 - 4.30 ish. Then went back to sleep about 5.30 for an hour.

Grrr. Worried this is the sign of things to come again and if rep becomes 3.30 I just won't function

Had difficulty getting up today (used to 9 hours sleep on the drugs)

I have been taking Mirtazapine for several years for insomnia - 15mg.
It has worked great for me despite the odd bad night but the weight gain has made me want to come off it, if it wasn't for the weight gain I would happily stay on it !
Several months ago I decided to try and come off it, I bought a pill cutter and started taking 11.25mg for a month, then 7.5 mg for a month then down to 3.75 mg for a month - with no issues.
I then alternated 3.75 mg every other night for a week then stopped.
After a few days I felt like the insomnia was coming back so went back to taking 3.75 mg every night.

I went on holiday in August and about a week before I had a couple of bad nights, then started feeling anxious about not sleeping on holiday so ended up back on 15 mg a night.
I am now back down to 7.5 mg a night till the end of October, then I will reduce to 3.75 till the end of November, then I was thinking alternate one night on one night off for a month then hopefully stop.

Florida - yes if I wasnt worried about weight gain (and now gut health too) I'd stay on it forever. It was pretty much magic - take it and 30mins later sleep all night. Sleep had been an issue for 13 years on and off for various reasons so it really did do its job.

I've been on 7.5 for 4 nights now and I know I'm not sleeping as well (doing a bit after waking early) but its manageable.

I'm really impatient now I want off. One online group recommends 10% a go and do that for a month+ each time which would take years. If I can somehow get through withdrawal and keep my job I really would like to do that.

It sounds like 7.5 - 3.75 was okay for you but after that its tricky? Has the dr given you any advice? I've got a pill cutter but assume 3.75 is the smallest I can do with it. I'm also aware its not "reliable" as in the drug can be spread out in the pill differently.

I was wary of every other night as thought it might be like coming on/going off it but if it works I'll try it!

I haven't spoken to my doctor at all about coming off it.
I found I was fine on the 3.75 for weeks but maybe it was pre holiday anxiety that affected my sleep, hence me going back up.
This time, once I get down to 3.75 and I have been taking that for a month, I will then alternate one night 3.75, one night nothing for a month, then try two nights nothing etc and go a bit slower.
Last time I only managed five nights not taking anything before I went back onto 3.75
I don't think you would be able to cut smaller than 3.75 really with a cutter, 3.75 looks tiny

I find it easy to come off, OP.

Thanks Florida - the "half" tablets (7.5, half of my 15 tablets)) I'm doing at the moment feel tiny already. My GP was next to useless so can't see her prescribing 7.5 tablets for me to do this with.

@stargirl1701 wow really!? How did you do it? How long did it take? I keep seeing horror stories on line - but am also aware its probably those with difficulties posting. My main worry is about sleep.

Many moons ago I came off a drug (think it was effexor) and was so ill I ended up taking 2 weeks off work with it but that was over 20 years ago (eek)

I'm trying to take all sorts that are good for your "gut biome" and thinking I'm killing it all off with the tablets I'm on :(

I'm on mirtazapine 30mg and I'm going to titrate up to 60mg

I am so so so so grateful for this drug it has literally saved me I was fully suicidal and I have three young children 😥😥😥

I don't care if I get fat but the psychiatrist said to me I won't get fat because I barely eat anyway and what I am eating now with it yes I get the munchies and eat through the night but I weighed 40kg 6 weeks ago so I want to put on at least a stone

I forgot to take it one night at 15mg and had horrendous brain zaps I thought I was dying in my sleep.

It's helping with my anxiety, my drive and my utter despair

If you do come down on it based on my experience I would say you'll want to cut by less then 15mg per dose

How much are you on?

Ask for it in a liquid so you can reduce by 3.5 every 4 weeks

Take a pre biotic if you're worried about gut health

Wondering now if that's why I got my first ever bout of thrush when I started on it

I drink a prebiotic juice every morning and also have kefir anyway

Do you eat a wide range of food? Like different types? That's the best way to have a good biome, I say this as a clean eater and someone interested in food

I took it for about 6 months and just stopped. No issues.

I'm on it again since August this year for sleep alongside Paraoxitine for anxiety and depression.

Wow stargirl - proper cold turkey?! I have been on 15 for 2 years and if I miss I does I really know about it the net day - my brain is just a mix of hyper and cant focus. However 7.5 has been mostly okay.

Sillymd - Oh it absolutely brought me back from the brink. It was an amazing drug for me when I needed it and I dont doubt that. I just am morbidly obese and I'm stable so want to try life without it, and lose some of the weight. I can see it would really help to weight gain if you were under.

The kefir/kombucha/kimchi is new to me but I've been doing this a few weeks and am trying to start cutting out as much UPF as I can. I think my diet was the opposite of "clean" tbh....