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Lilac2018: Tapering Mirtazapine 7.5


Lilac2018

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Hello,

 

I recently attempted tapering Mirtazapine 7.5 using the tapering strips from the Netherlands and unfortunately I experienced  severe withdrawal symptoms. I want to reorder a slower plan but I wanted to ask the community some advice first. 
 

Some background on me, I was diagnosed in 2019 with postpartum depression. The depressive episode was kicked off by abruptly stopping Labetalol ( a beta blocker) 100 mg. I was told to stop cold turkey and I was suddenly awake for two days straight with tachycardia.  After reinstating the Labetalol 100 mg I slept normally for a couple days and then a 10 day episode of insomnia followed. Sleeping 1 hour or less a night. I thought I had been doing fine prior to that but looking back I realize I wasn’t quite myself and was feeling a bit low and disconnected. Hard to decipher when you’re a first time mom! I became very depressed, terrified and disinterested. It was awful. I had no history of insomnia or depression.
 

I was given Zoloft 25mg to start but experienced horrible nausea, dizziness, anhedonia and what I think was derealization. I only lasted 5 days. I was then given Xanax 50 mg and it made me sleep for a few hours but the rebound insomnia was horrible and I experienced intrusive thoughts for the first time in my life. I took three doses of Xanax and swore I would never take it again! Next was Trazodone 50mg. It did not help and made me feel even worse, especially in regards to the intrusive thoughts. It was pushed up to 100 mg. After a full night of not sleeping, something like akathesia and  some passive suicidal ideation I knew something was very wrong. I was given Mirtazapine 7.5 and was instructed to taper off Trazodone. The addition of Mirtazapine enabled me to sleep. I cut the Trazodone back to 50mg but was too scared to taper off.
 

So I stayed on both until beginning a taper of Trazodone 50mg in 6/2020. I came off completely in January 2021 without any real noticeable withdrawal symptoms. During that time I was taking both I still had intermittent intrusive thoughts and mild depressive episodes. After going off the Trazodone the intrusive thoughts are nearly gone and depressive symptoms are few and far between aside from intermittent anhedonia.  Now I’m dealing with hair loss, a thirty pound weight gain and daytime sedation. I’m ready to put this all behind me.

 

I ordered the tapering strips from the Netherlands. I selected the 56 day taper without any stabilization strips. Within 3 days of taking one 7.5, one 7.2 and one 7.0 I was sleepless, disoriented and extremely nauseous. My mood was fine. I believe that I need to stabilize on the new generic before reducing. I’m just not sure what a great plan would be to reorder. My instinct is to order one 28 day strip of 7.5, another at 7.2 and lastly one at 7.0. I feel like these small reductions will guide me on what to order next. Like I said I’m thinking the change of generic was the culprit rather than the reduction to 7.0 but it’s hard to know. 
 

I wanted to ask the moderators if they think I should move ahead with the taper strips or if liquid is advised. 
 

Thanks so much! 

 

 

 

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep.

 

 

Edited by Karma
Updated name

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep

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  • Moderator Emeritus

Welcome to SA, Lilac2018.

 

Your 56-day taper was much faster than we recommend, which is to taper by no more than 10% of your current dose every 4 weeks.  That means to taper by 10% (or less) and then hold at that dose for four weeks before the next reduction.  Was the 56-day taper recommended by your psychiatrist?  

 

Why taper by 10% of my dosage?

 

The following link is specifically about tapering Mirtazapine.

 

Tips for tapering off mirtazapine (Remeron)

 

On 6/5/2021 at 9:06 PM, Lilac2018 said:

I believe that I need to stabilize on the new generic before reducing.

That's a good idea.  Switching from one generic to another can be destabilizing.

 

On 6/5/2021 at 9:06 PM, Lilac2018 said:

My instinct is to order one 28 day strip of 7.5, another at 7.2 and lastly one at 7.0.

 

Dropping from 7.5mg to 7.2 for 28 days would be a 4% reduction from current dose, and from 7.2 to 7.0 would be a 2.7% reduction, so this taper would be well within our recommended guidelines.  As to whether the strips are better than the liquid, it's your choice.  The liquid is a convenient and accurate method of tapering.  The strips require a prescription, but that doesn't appear to be a difficulty in your case.  If you switch to a liquid, we recommend a crossover to the new form, which we can help you with if you switch.  The fact that you switched from generic to generic without a crossover period may have a been a factor in your destabilization.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (which you're already taking and may want to take daily) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, ask questions and connect with other members.  We're glad you found your way here.

 

Edited by Karma
Update name

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of May 2: 6.1mg

Taper is 92% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

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  • Karma changed the title to Lilac2018: Tapering Mirtazapine 7.5
  • 3 weeks later...

Thank you Gridley.

 

We ordered the 56 day plan because it was listed as the most common plan on the Mirtazapine order form. 

 

In regards to the supplements I take, they are due to deficiencies discovered by my dermatologist. I visited the dermatologist regarding my hair loss and I was deficient in Vitamin D and very deficient in Ferritin. Adding these supplements helped the strength of my hair ( in addition to Biotin and Biosil) but did not stop the shedding. I know the shedding is from Mirtazapine and my dermatologist agrees. I’ve stopped the iron and vitamin D for the time being while I’ve waited to stabilize from the failed reduction.

 

I’m a bit worried regarding my extreme reaction to the strips. It was such a small reduction( over 3 days) and my body revolted in a way that’s just not manageable. I’m trying to figure out how to discern if my reaction to the strips was an allergy to one of the binders or actual withdrawal. It doesn’t seem to totally line up with Mirtazapine’s half life. 
 

I’ve actually just started feeling normal. About a week after my attempt and taking my normal generic dose I experienced strange things happening with my vision. It felt like my left eye was moving and jerking away from looking forward(my husband said it wasn’t). It made my eye muscle feel very sore. I also had extreme fatigue. Is the perceived eye movement a common withdrawal symptom?

 

I would like the opportunity to have another child and I believe a slow taper off of 7.5 at 10% would take two years? Is that correct? The weight gain concerns me. Starting off heavier with a second pregnancy would probably cause the postpartum hypertension to come back. I know this isn’t a question that can be answered here. Just putting it out there in case other moms have followed a similar postpartum journey. 
 

I am so beyond grateful for this site. Thank you for all that you do. 

 

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep.

 

 

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep

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  • Moderator Emeritus
2 hours ago, Lilac2018 said:

I believe a slow taper off of 7.5 at 10% would take two years? Is that correct?

Mathematically, the way you can figure how long a 10% taper (that is reducing by 10% of your current dose every 4 weeks) will take is as follows:  you will reduce by one-half your current dosage every 6 months.  So, in 6 months, you'll be down to 1/2 of 7.5mg = 3.75mg.  In another 6 months (at the one year point) you'll be down to 1/2 of 3.75 = 1.875mg, which I'm going to round up to 2mg just for convenience in description.  In another 6 months (at the 1.5 year point) you'll be at 1mg.  In another 6 months (at the 2 year point) you'll be at 0.5mg.

 

According to our general recommendations, we advise going down to the low .00's before jumping to zero.  For example, I tapered down to 0.025 Lexapro before jumping.

 

I know this seems like a long time.  But we have found that getting down very low is the safest method.

 

I see from your signature that you updosed to 7.5mg about a month ago.  How are you doing?  After an updose we recommend that you stabilize before continuing to taper.  "Stabilize" doesn't mean absence of symptoms but rather that the symptoms are tolerable and there are no big swings in symptoms from day to day.  You wrote that you just started feeling normal.  If that continues, you could give it 2 more weeks to make sure you're stable, then begin tapering again.

 

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of May 2: 6.1mg

Taper is 92% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

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Thank you Gridley. That’s very helpful. Two years is a long time but I feel like I’m at an advantage by starting off the right way( aside from the earlier attempt). 
 

I’m doing ok. Sleep is fine, some fatigue but nothing like it was the two weeks after I tried to taper. My mood is a bit low at times( sort of apathetic). I’ve been considering adding in Wellbutrin for some of the apathy/anhedonia and low energy. I know this would prolong starting my taper as I would need to adjust to it. Is this a bad idea when it comes to reducing Mirtazapine? Would it possibly make the Mirt withdrawal worse? I have days where I feel connected and more like myself and other days where I feel disconnected. 
 

It seems like most women that have PPD respond well to an antidepressant. I never really had that experience. Then again the Mirtazapine could be my problem! I’m functioning well, I just feel I could be more present and engaged. 
 

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep

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  • Moderator Emeritus

Hello @Lilac2018

 

Could you please create your signature  ? It will help us to understand your situation and see all your history at a glance.

 

Here is a direct link to your signature:

Create Your Signature in "Account Settings"

 

On 7/1/2021 at 7:23 PM, Lilac2018 said:

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep

You can copy and paste this in your signature.

 

Take care ☀️

2006 : 20mg Paxil+Bromazepam. 2008 : cold turkey of both. 2010 : Reinstatement 20mg Paxil + Bromazepam.

2014-June2017 : Switch from Bromazepam to Prazepam, slow taper to 0mg.

2018 to August 2019 : Paxil 20mg taper (3% every 15 days). 22 Aug 2019 updose to 10mg (was at 8.4mg).

25th Sept 2019 To April 2020 : found SA, holding at 10mg Paxil. 

April 2020 : Paxil 10mg to Prozac 7mg bridge. Details topic/21457

 

Current Supplements : magnesium citrate + fish oil

Current medication :

* 7pm Diazepam  : 0.85mg (15 Aug 2022) / 0.95 mg (24 April 2022) / 1mg Diazepam (since 29 Aug 2020)

* 8am Prozac : 6.16mg (25 oct 2022, feel awful, slight updose) / 6.08 mg (9 oct 2022) / 6.24mg (11 July 22) / 6.44mg (22 May 22) / 6.64mg (4 Nov 21) / 6.72mg (8 oct 21) / 6.8 mg (15 Sept 21)6.88mg (14 Aug 21)/ 6.92mg (23 Jun 21)

 

I am not a professional, I don't give medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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Hi Erell,

 

Okay, I believe it should be there now. 

Labetalol 100mg 12/2018-11/2019

Zoloft 25mg 3/2019 for 5 days

Xanax .5 3/2019 for 3 days

Trazodone 50-100mg for six weeks from 3/2019-5/2019. Then 50mg from 5/2019-1/2021.

Mirtazapine 7.5mg from 5/2019 until 5/31/2021. Tapering strips 7.5, 7.2 and 7.0 5/31/2021 until 6/2/2021. Back on 7.5 6/3/2021 until present day. 


I take vitamin D 2,000 IU, Biotin and Biosil and 10ml of liquid iron. I take Magnesium Glycinate 400mg on occasion when I have trouble falling asleep

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