Req90: mirtazapine withdrawal

[Req90]

Hello, I am 32-year old man currently suffering from withdrawal effects of mirtazapin. I was referred to this site by my psycologist at a local tapering-clinic to get some support and insight into my situation, so here it goes. I started Mirta in  7/2021 as a medication for my insomnia which started shortly after being tested positive for corona, i took 3,75mg until 2/2022 when Mirta kinda stopped working, i had to switch to to Ketipinor for two weeks and this switch caused me horrible side-effects(brainzaps, anxiety, panic attacks).

 

After two weeks me and my doctor decided to try Mirta again with 5mg dose, and it worked, i gained back my sleep. In 3/2022 after talking with my psycologist we decided to drop Mirta again, since everybody told me that such low doses don't cause WD effects, and those brainzaps etc. were caused by Ketipinor. So i quitted Mirta again, and again i had these same side effects,  my psychiatrist told me that we should up the dosage since these werent side-effects, but anxiety that i had before starting the meds, allthough i knew that i didn't have any anxiety when i started Mirta, i was in such a bad place that i went along with his opinion, but i didn't up the dosage up to 15mg as he ruled, but i up'd it to 7,5mg. After 4 days i got my worst episode yet when on Mirta, when i got some kind of panic attack which lasted for 2-3 days, i immediately lowered the dosage back to 5mg and during next two months i gradually got better.

 

In around 6/2022 i decided to start taper more slowly, my new psychiatrist, told me to try lowering the dosage 1mg every two weeks. 

Everything went pretty smoothly until i was in 1mg, for first two weeks all was good, then i started to feel those same WD effects that i felt when i quit cold turkey, except this time they were bit more mild, and i was able to participate in school even while under those effects. But on the third week while on 1mg i started to gradually loose my sleep, and currently i haven't had almost any sleep at all on these last 5 nights, on last two of these nights i was forced to take Imovane to get 3 hours on both nights. 

 

Im wondering about my options, could i reinstate some kind of dosage to see if it helps with my sleep. Today i visited a sleepclinic and they had two choices for me, either start taking ketipinor, or reinstate mirtazapin. I feel like i have to get sleep somehow and all my options are bad as others. 

 

I hope there is some reason in these ramblings, cause im not currently in a best form to write something like this. 

 

Drug/dose timeline:

 

Mirta 3,75mg 7/2021 - 2/2022

Ketipinor 2/2022 for two weeks

Mirta 5mg 2/2022 - 3/2022

MIrta 7,5mg 3/2022 for 4 days

Mirta 5mg 3/2022 - 6/2022

In here i started tapering

Mirta 4mg for 2-3 weeks

Mirta 3mg for 2-3 weeks

Mirta 2mg for 2-3 weeks

Mirta 1,75mg for 2-3 weeks

Mirta 1,50mg for 2-3 weeks

Mirta 1,25mg for 2-3 weeks

currently here Mirta 1mg 4 weeks

 

 

 

Edited November 2, 2022 by ChessieCat
removed excess white space/added heading to drug

[Altostrata]

Welcome, @Req90

 

How do you feel on 1mg mirtazapine?

[Req90]

I was afraid what the insomnia would cause, other than that i was actually pretty fine even though i wasnt sleeping. I did reinstate 1.5mg for two nights which was clearly too much, on second night i was able to sleep, and in the morning felt really good, but during the day i started to feel that i was on the edge of a huge panicattack, last night i took 1.125mg and again didnt sleep at all. And now i feel crippling anxiety, probably due to thoughts about the reinstatement dose being to high

[Req90]

So yeah, im beating myself about reinstating. Last night i got some kind of night terrors, everytime i was closing to a relaxation. Im thinking about going back to original dose. 

 

For possible future readers, try to sit on your hands when you feel an urge to reinstate, and think it for a day or two more

[Altostrata]

Suggest you take 1mg at the same time each day for a few days. There is a reason we recommend trying a very little bit.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Req90]

It's been a while since last time ive been here. After last post it took about 5 months for my condition to stabilize, but after it did i had a great summer, and was able to lower my dosage again. I went from 1 mg to 0.9mg, and things seemed to work well and i felt good, but after 3 months from reduction i started to feel mild withdraw effects, now its been about a month from start of those wd effects, and they are slowly getting worse, theres anxiety, dizzines, "humming" in head. 

 

Month before start of these wd effects there was one night when i forgot to take my dose, could it be possible that these effects im experiencing are because of that, or should i just treat these are delayed onset of wd, i know that theres probably no one with a right answer, but im just afraid about the situation, and felt like i needed to share this.

[Altostrata]

Sorry to hear you have these symptoms.

 

Before further discussion, Please put your drug and withdrawal history in your signature 

[Req90]

sure thing, updated it now

[Altostrata]

On 9/29/2023 at 5:27 AM, Req90 said:

Month before start of these wd effects there was one night when i forgot to take my dose, could it be possible that these effects im experiencing are because of that

 

Yes.

 

Especially with a small dose, you need to take your dose at the same time each day. Have you often forgotten to take your dose? Do you sometimes take it off schedule? This can cause odd symptoms and make withdrawal symptoms worse.

 

Other factors that can set back going off drugs: Drinking alcohol, taking antibiotics or others drugs, overexertion.

[Req90]

2 hours ago, Altostrata said:

 

Yes.

 

Especially with a small dose, you need to take your dose at the same time each day. Have you often forgotten to take your dose? Do you sometimes take it off schedule? This can cause odd symptoms and make withdrawal symptoms worse.

 

Other factors that can set back going off drugs: Drinking alcohol, taking antibiotics or others drugs, overexertion.

This was first time when i forgot to take it, i have never taken it off schedule and also never drink alcohol. I ran a marathon couple of weeks before start of these symptoms, didnt think that it could possibly have a negative effect.

 

Should i still stay at this current dosage?

[Altostrata]

11 hours ago, Req90 said:

Should i still stay at this current dosage?

 

That's what I would do.

[Req90]

Thanks for the advice. If this is some sort of kindling, is there a chance it will go away by holding the dosage? There are no wawes and windows, everyday is the same and there are no changes in my condition. But atleast its not getting worse.

[Altostrata]

It's not kindling, when you skipped a dose, that caused withdrawal and instability. If you don't make any more drug changes, you should slowly go back to your baseline prior to the missed dose.

[Req90]

Okay, good to hear that. Im going to try to keep a positive attitude and wait for these to pass.

[Req90]

I had an accident last weekend, and drank a sip of grapefruit soda. Through the week i had weird feelings and today i started to experience effects similar to kindling. I tried to read about the subject, but im not sure if i understood correctly. Grapefruit blocks absorbtion of mirtazapine, leading to higher amounts in blood, does this mean that the effect of mirtazapine is higher OR does it mean that the effective amount is actually lower because its not able to be absorbed?

[Altostrata]

I doubt that grapefruit soda did anything serious. By coincidence, you might have had a wave. Are you taking your dose at a consistent time?

[Req90]

12 hours ago, Altostrata said:

I doubt that grapefruit soda did anything serious. By coincidence, you might have had a wave. Are you taking your dose at a consistent time?

Based on what i have read, it seems that even small amounts can lead to difficulties. I have experienced kindling twice before and this is similar to those times. There might be some inconsistensies with the time i take my dose, but its always between 21.00 and 22.00.

[Prozack]

@Req90 What about your muscle and GI tract? Are you experiencing muscle cramps, weakness? Are you constipated? Do you have any acid reflux or delayed stomach emptyng? How is your cognitive function?

[Req90]

1 hour ago, Prozack said:

@Req90 What about your muscle and GI tract? Are you experiencing muscle cramps, weakness? Are you constipated? Do you have any acid reflux or delayed stomach emptyng? How is your cognitive function?

Small shaking of hands, bowel works normally. Some acid reflux but thats something that occasionally happens. Congnitive function is normal