JojoMirt: low dose mirtazapine / Remeron struggles

[JojoMirt]

Hello all,

I’m Jo from London.

Back in May I was prescribed Mirtazapine after struggling from chronic insomnia brought on by a covid infection back in March. I’d been struggling to get even 3 hours of sleep a night for weeks.

Not a stranger to insomnia (I went through a really bad patch of it 4 years ago, during which I went through a Valium CT/amitriptyline taper) I should’ve known better than to accept another psychotropic drug from a doctor. 
Initially the mirt helped immensely with sleeping and the dreams were incredible! But it didn’t last long and what also followed was horrible depression and the onset of suicidal ideation, neither of which I’d experienced outside of my previous experience whilst on psychotropics.

I clearly do not do well on these medications and am very sensitive to dose changes. I tried to half my 3.75mg dose to 1.875mg but all hell broke loose with withdrawals. So I went back up to 3.75mg and stabilised after a week.

I’m now possibly looking at a micro taper by water titration down to as low a dose as possible - could take 6 months. Though there is a side of me that’s tempted to CT off 3.75mg and try and suck up withdrawal hell for however long that takes rather than prolong my taking of this poison any longer. Any advice/experience would be greatly appreciated 🙏🏼
Big love to fellow survivors ❤️

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  It sounds to me as if your nervous system possibly has become sensitized from your previous drug history with the Valium CT, and the amitriptyline, and therefore you developed an adverse reaction to mirtazapine.  However, after being on this for several months, your brain has also become dependent upon it, so when you tried to cut the dose in half, you went into withdrawal.  I strongly suggest you do not cold turkey this.  People can take literally years to recover from a cold turkey, and become very sick for a very long time.  

Please read: 

 

Cold Turkey and Fast Tapers

 

I like your idea of a liquid micro taper.  We suggest a very gentle and slow taper, only reducing the drug by 10%. You made a 50% reduction, which was too big of a cut for your system to handle.  Even more gentle is the micro taper method.  I'll explain later. 

 

Can you please add the dates of (month, day, and year) your recent reduction and updose of the mirtazapine to your drug signature?  Thank you. 

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  The brass monkey micro taper is even gentler, reducing by 2.5% per week for 4 weeks, then a 2 week hold period.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Mirtazapine

 

Brassmonkey Micro Taper

 

Hopefully, when you do you taper, you will have minimal to no withdrawal symptoms.  Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Just in case, here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

I've given you quite a bit of information here.  Please read through it, and mull it over.  I suggest that you wait a few months before beginning you taper, to give your nervous system a chance to fully recover from the recent 50% reduction.  Good luck, and let us know how it goes!  

Edited August 9, 2022 by getofflex