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...

I've been on it for 7 years, started on 15mg then went up to 30mg during the pandemic. I started trying to wean myself off it for the first time a fortnight ago and it's going well so far. I'm using a pill cutter and I've probably been cutting off just under a quarter of the tablet, I think I'm going to do another week before dropping it further just to make sure I'm doing ok.

I was pretty worried about struggling to sleep but I've been dropping off fine, I did start waking up from 5am ish but that seems to have settled down now. I'm much less groggy/grumpy in a morning.

I've had no appetite at all but I'm not sure if that is due to another stomach issue I've been having recently. I've still been eating because I'm greedy and food still tastes nice but I've honestly not been hungry once.

Hoping to be off it by Christmas but I'm not going to rush myself if things don't feel quite right.

That sounds great Beans. It seems there's a few of us hoping to be off by xmas so might be nice to keep his for moral support 😊.

I'm also changing my diet currently so hoping to be less hungry/feel full due to that too.

Hey there, it sounds like you're doing it just right. I was on 30 and went down to 22.5 then 15 then 7.5 then stopped, 2-4 weeks each time but I can't remember exactly. I don't think at 7.5 it does much so you shouldn't get withdrawals other than some rebound insomnia. If you are struggling with sleep (I did for a week or two) then get some Melatonin or nytol / OTC antihistamine. Better to have a sleep aid there to stop the anxiety around sleep.

Also Effexor is famed for its hellish withdrawal and Mirt has nothing like it!

Yes I ended up in A nE in my early 20s coming off effexor cold turkey... oops.
Hence my worry I guess.

Also the Internet has the scare stories so it seems lots do struggle withdrawing from mirtazapine. The online support group on Facebook recommend cutting down 10% each time and a long time over a year... which I can't face!

Really glad you managed and yes a bit of insomnia is okay if I know it won't last. It's too much too take "just" for sleep issues although I really don't want the bad insomnia to come back.

I'm on day 5 and last night was extremely sleepy by 7/8ish and had to go to bed. This afternoon I was a bit jittery. But so far okay. I dont know whether to try cut down a bit more in a week or whether withdrawal hits more 2 weeks in!

I think withdrawal would happen almost immediately as at 15mg it’s not really an antidepressant, it’s a sleep aid - so the withdrawal is less around mood and more around zzz. You’re doing so well! I’d wait 2 weeks between dose changes but tbh stopping after 2 weeks on 7.5 should be fine. I’m terrified of withdrawals and suffer badly but didn’t coming off Mirt like that. I did try unsuccessfully earlier that year and the GP told me to go from 30 to 15 for 2 weeks then stop. Going from 30 to nada in 15 days wasnt a good plan for me. Stick at 7.5 a bit longer if you like - I don’t think dropping to 3.75 worthwhile… there are horror stories on the web about every med & I read them all too but they aren’t reflective of the norm I promise x

Thanks its great to hear you did it!

I'm only 5 days in from 15 to 7.5 and on one hand inpatient and want to cut down more and on the other hand a bit anxious about withdrawal!

Feel so groggy this morning. Its hard to wake up and I need to be fully alert for work. And felt nauseous but hoping that will go with eating. Its a bit like when I went on the medication in the first place.

So that was day 6. I'm thinking maybe I will give 7.5 a bit longer before dropping. I so want to be someone who doesn't have withdrawal effects that mean I need to have time off work (oh for a wfh job!)

Def wait 2 weeks total love. I promise by 2 weeks you will feel fine. Never go down before withdrawal effects have gone away x

Thankyou. I'm so impatient! Rest of today has been good and even felt alert this afternoon so who knows what's going on!

Will be 7th one tonight!

So took a week of 7.5 and no serious withdrawals. Bit spacey/detached at times and odd morning nausea but that's manageable.

Last night I was out with friends very late so didn't take my tablet as didn't want to sleep today.

Im shattered (4 hours sleep but selfninflcited)and so tired I think I will sleep tonight!

I'm just wondering whether to give it a go with no tablet for a bit as I've done one day already.

When would I get withdrawal symptoms? I don't fully understand why its out yourseysyem/when your body stops compensating for it.

I would always give any change 2 weeks minimum. Wouldn't it be good to have a week of clear water between you and any withdrawal feelings - even potential ones - before going to 0, for peace of mind? There's no hurry - but going back up again because of a failed attempt is much worse.

I so want off!!!

I've got some I've cut into 3.75 so I could take that and start a week of 3.75.

I think not having one last night just made me wonder about stopping and seeing if I was lucky!

It sounds like you really want to, so who am I to stop you! It will probably be fine! I was on a higher dose than you which is probably why I'm being over-cautious. Set yourself free from the shackles!

Wait to be clear I'm not telling you to stop taking it immediately!!

Thanks. I appreciate being able to discuss it 😊. I so hope I will get there. 🤞

I don't know if an issue I'm having is due to lowering my dose of Mirt or a horrible coincidence but it's really starting to worry me.

About 5-6days after lowering my dose I got this awful pain in my stomach right near my belly button, whenever I stood (but worse when getting out of bed) it felt like I had a weight dragging my insides down. I totally lost my appetite and had waves of feeling sick but I've been eating because food still tastes nice,

A day after it started I went to the doctors and I never go to the doctors but the pain came on so suddenly and so bad that I thought there must be a problem. She felt my stomach and said I've probably pulled a muscle even though I haven't done anything to cause this and said if it's not gone in 2 weeks to go back. Well the 2 weeks is just about up and although the pain is nowhere near as bad when I first get out of bed it's still there, I thought it was improving but it's horrible today. I just feel bloated and like I've got a constant stitch like pain right next to my belly button. Paracetamol/ibuprofen do nothing for it.

When I went to the doctors I didn't mention I was trying to come off Mirt because I didn't think it was connected but I don't know now whether it is or isn't and I also don't know whether the loss of appetite is due to the stomach pain or coming off Mirt either.

I have been reading online and there are a lot of people mentioning they've had stomach pains and issues, loss of appetite and sickness but they don't explain what type of pain/issue it is. What I'm experiencing is a horrible pain/uncomfortable feeling and I keep thinking surely my tablet can't cause it but at the same time I've done nothing to hurt it. I have been on it since 2016 so no idea whether I'd get more bizarre symptoms than your average person that's been on it a few months/years.

Oh no that does sound like it could be linked? Definitely go back as its been 2 weeks and I'd mention it in case it is.

When I was reading what I'd be letting my self in for if I jump off at 7.5 it did say nausea/vomiting/ stomach ache but no idea obviously if its the same issue.

I'm nervous for sleep too as I have to function for work but have made it so the next 3 weeks I have very little else on.

Day 3 of no medication here. I'm waking after 6 hours but crucially I'm managing to go back to sleep for a bit.

Some funny moments in the day where I feel a bit not there but it's manageable.

I physically feel tired this morning but already my brain doesn't have that hangover grogginess it normally has in the morning.

I am very aware a lot of issues start a week or 2 off so keeping fingers and toes crossed.

Day 5... I felt SO sick this morning I did wonder how I would get through work - but I only had to work out of home for the morning and told myself I could come home and recover.

I want to sleep now.

Definite reduced appetite but could be because I feel sick. Gosh it makes you realise no wonder I'm so large if normal people don't feel all these cravings alm the time!

Sleep- woke last night but did manage to get back to sleep :)

Day 6.
No nausea am yay
Woke up early 🙄. If I didn't have to get up for school/work would really have liked to have slept! Hoping I'll be tired tonight for sleep.
Stomach fine today.

I know it can take 2 weeks before it's out your system/your body starts reacting so still keeping fingers crossed.

I'm eating mostly healthy food and have to be out in the morning so keeping to a routine. Tempted to nap now though!

Glad things aren't too bad @OneMoreStepAlongTheRoadIGo

I lowered my dose again 2 nights ago so went from 30mg to around 22.5mg for 3 weeks and now I'm at 15mg.

Stomach pain is much better but still there, I've still not really got much of an appetite. Sleep so far hasn't been an issue (touch wood) although the night I lowered my dose to15mg I'd been up since 5am that morning so that probably helped. I have very vivid dreams all night but that's normal for me, I don't seem to ever go a night without dreaming.

Oooh great to hear! And lovely to have each other on the thread for support.

My appetites reduced but as I'm morbidly Obese this is a good thing for me. I hope this bit lasts!
I'm hungry just before a meal and find myself wondering if this is what it's like for normal.people!

It's strange because I've been eating far less than usual but my weight keeps going up 🤷🏼‍♀️ can't work it out. I already had a bit to lose and thought it'd be easy to shift at the min considering I have no appetite but obviously not. I was feeling really bloated when I had the bad stomach pain but now I don't feel as bloated at all so presumed my weight would have gone down not up.

Taper taper taper, and don’t listen to GPs about coming off ADs!

I don’t get withdrawals from Mirt, so I can take it as and when - you may not have issues (haven’t read whole thread, sorry.

I take a quarter of a tablet (I just bite it off) and it’s miraculous for sleep - it actually works better for sleep on a low dose, and you don’t get too much of the appetite stimulation/weight gain. It keeps my jaw clenching from SNRI under control, and has solved my lifelong insomnia. Sometimes I take it every night for a while, sometimes I only take it if I have trouble sleeping or the clenching is bad.