Shabby: Advice for Mirtazapine reinstatement

[Shabby]

I started Mirtazapine 7.5 mg last year around February due to sleep issues. This dose didn't help me,  and after 2 weeks I increased to 15 mg and after a month to 30 mg. However, it didn't help.

 

So it was mid-September 2023 that I started to taper off from 30 mg to 15 mg, and was on 15 mg for 2 weeks. Being so naive about the consequences of Mirtazapine, I fast-tapered, and on the 10th of November 2023, I reduced my taper from 7.5 mg to 3.75 mg. Two days after that I lost my libido and sexual function.

 

From the 10th of November to 14 December 2023, I was on 3.75 mg.

 

1. It was the 14 of December, and based on someone's advice I up-dosed to 6 mg from 3.7,  for 5 days.

2. I tapered back to 4 mg till the 5th of January from 6 mg, as somebody else told me I would inflict more harm to my neurons. It means I was on varying doses from 6 to 4 for 20 days. 

3. it was 12th of January that I regained all my sexual activity and libido, it normal as before. 

4. By the 5th of February 2024, I tapered to 3.5 mg.

5. I again gradually lost all my libido and sexual function by Med February, and by now I have zero libido and erection. No morning, night or daily erection, my penis is shrunken and atrophied. 

 

Based on the above information, did an up-dose of 20 days help me regain my sexual function?

 

Or it was a window from withdrawals? 

 

 

1. Should I increase my dose back to 7.5 or 6 mg to regain my sexual life?

2. Should stay at the same dose of 3.5 mg and wait?

3. Should I stop altogether cold turkey

4. Or I should gradually increase the dose? 

 

 

 

PLEASE HELP me

 

Thanks 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  What is your ultimate goal?  Is it to get off drugs, or is it to restore your sexual functioning?  

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements you are on and have been on, especially for the past 18-24 months?  Please only give us drug names, dosages, and dates, as best you can remember, in a list format.  Please read the link below for instructions.  

 

How to List Your Drug History in Your Signature

 

Sexual dysfunction is a very common side effects both of the drugs, as well as a withdrawal symptom of coming off the drugs.  

 

Because you have made many dose changes to your mirtazapine in a short period of time, and done a fast taper, it is likely that you have destabilized your nervous system, and then this has affected your sexual ability.  I personally believe that restoring your sexual function isn't dependent on any particular dose of the drug, but is more a matter of allowing your nervous system to stabilize and reach homeostasis.  I suspect you regaining it temporarily was probably a window from withdrawals.  This link will explain why fast tapering and changing the dose of our drugs destabilizes us so much: 

 

How Psychiatric Drugs Remodel Your Brain

 

If you decide to stay on the drug, I would consider staying on the dose you are currently on for quite a while, and allow yourself to stabilize, and see if that helps.  Making further changes to your dose is likely to further destabilize you. 

 

If you do decide you want to get off the drug, I would also stay on the current dose for a long time, and then when I feel stable, I would start a very slow taper.  

 

Here are some links for further information.  

 

Post SSRI Sexual Dysfunction

 

SSRI Induced Sexual Dysfunction as an Adverse Effect

 

 

 

Edited March 10 by getofflex

[Shabby]

Thanks for replying to me. 

 

At first, my ultimate goal is to restore my sexual activity. If I regain it, it will affect my mood anxiety and sleep, positively. 

 

Up-dosing to 6 mg exactly matches the time that I regained my sexual activity, which means 3 weeks after up-dosing I gained it. However, loss of sexual activity happened exactly 3-4 weeks after reducing my dose from 6 mg to 4 mg.  

 

Now the question is,

 

1. Am I losing that window of opportunity of up-dosing and regaining my sexual life back?

2 Will I do more harm if I go back to 6 mg, after being on 3.5 mg for 5 weeks now?

3. Am I taking the right supplements?

 

Please point me in the right direction, neither I want to lose my sexual activity, nor do I want to stay on this mes till the end of my life.  

 

 

Thanks 

 

 

 

 

[getofflex]

Please bear in mind the scope of this forum is to help people get off psych meds.  

 

3 hours ago, Shabby said:

1. Am I losing that window of opportunity of up-dosing and regaining my sexual life back?

I don't know.  Personally, I would updose very gradually, about 1 mg at a time.  That would be easier on your system.  The sooner you do it the better. 

 

3 hours ago, Shabby said:

2 Will I do more harm if I go back to 6 mg, after being on 3.5 mg for 5 weeks now?

You could possibly kindle, and make your symptoms worse by jumping around on your drug dose.  We can't predict that.  

 

Post Withdrawal Nervous System Hypersensitivity - Kindling

 

3 hours ago, Shabby said:

3. Am I taking the right supplements?

I don't see where you list your supplements.  The only ones we suggest are magnesium and omega-3.  Any others tend to have unpredictable results on a destabilized nervous system. 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

 

 

Edited March 12 by getofflex

[Shabby]

Thanks for your quick reply. 
 

I have put all my supplants and the dosages into the signature panel of my account. 
 

 

1. If I up-dose to 4.5 mg, based on your recommendation the sooner the better, from 3.5 mg, how often I updose to reach 6 mg? 

[Nicjk]

On 3/13/2024 at 12:59 AM, Shabby said:

Thanks for your quick reply. 
 

I have put all my supplants and the dosages into the signature panel of my account. 
 

 

1. If I up-dose to 4.5 mg, based on your recommendation the sooner the better, from 3.5 mg, how often I updose to reach 6 mg? 

Hi @Shabby did you end up updosing? If so, did it help?

[Shabby]

Nope, I am still on 3.5, and I am really scared to go up.