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Dolemanana: Long-time listener, first time caller: My journey with Mirtazapine


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Posted (edited)

Hello, there! I've been using this site to inform my process for tapering off of Mirtazapine (Remeron) since 2020, when I had an extreme reaction to dropping from 3.75mg to 0mg. I stopped sleeping, had nausea, vomiting, diarrhea, dizziness...the works. I was fine until day 16 when I had a seizure at work. I immediately reinstated, and after a few months of stabilizing, continued weaning at the recommended 10% decrease.

 

But it's been rough. That was 4 years ago and I am still doing this. For the first 1.5 years, I was crushing pills and weighing powder, but had issues with scale calibration and getting a consistent enough dose. This stuff is also confusing, and I have messed up my math and decreased too much too fast and suffered the consequences. In 2022, I switched to liquid suspensions. After a lot of experimentation, here is my withdrawal symptom timeline that is always the same.

 

MY Withdrawal Symptom Timeline

 

3-5 days in (normal withdrawal with a 10% decrease, I usually stabilize by day 7)

Flu-like symptoms

Nausea
Fatigue
Headaches
Anxiety

 

9 days in (occur with a 15%+ decrease and are discontinuation symptoms, if these occur, I reinstate immediately )
+ Diarrhea
+ Severe Nausea
+ Severe Headaches

+ Insomnia 1-2 nights

 

11 days in (everything from previous list plus...)
+ Worse than usual nightmares

+ Insomnia

 

16 days in (I only let it get this bad once in 2020)
+ Severe anxiety/paranoia

+ Insomnia
+ Tingly sensations, nerve issues
+ Inertia/severe depression
+ Severe diarrhea
+ Slurred speech and reduced motor function

+ Seizure

+ Stroke-like symptoms

 

The only reason I haven't quit cold turkey is because these symptoms make it impossible to work, and working is obviously a necessity. I am now in a job that provides enough vacation and sick time that I am ready to make the drop, but have not identified a target exit dose.

 

I am currently looking for doctors or nurse practitioners licensed in CA who will be able to help me have a game plan. My current doctor is not familiar with discontinuation syndrome but has been supportive. They recommend going cold turkey at 1mg, which I am at now, and I am nervous that I will end up in the hospital again. I am also dealing with an autoimmune disease and fibromyalgia, but I am strong now and feel ready to take the next step.

Edited by Emonda
Name to title

2004 – 2016: Off and on, various (Zoloft, Prozac, Celexa, Ativan, Wellbutrin)

2017: Mirtazapine, Ativan

2020: Mirtazapine 30mg, tapered to 20mg, then 15mg

2021: Mirtazapine 7.5mg, tapered to 3.75mg, failed CT, reinstated and started slow taper + Wellbutrin SR 100mg

2022: Wellbutrin 150mg + Mirtazapine slow taper = March 3.375mg, April 3mg, May 2.625, Sept 2.03, October 1.9

2023: Wellbutrin 150mg + Mirtazapine slow taper every 4-8 weeks = got down to 1.29mg

2024: Wellbutrin 150mg + Mirtazapine slow taper every 4-8 weeks = currently at 1.05mg (May)

 

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  • Emonda changed the title to Dolemanana: Long-time listener, first time caller: My journey with Mirtazapine
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Welcome @Dolemanana,

 

2 hours ago, Dolemanana said:

it's been rough. That was 4 years ago and I am still doing this

 

It is a slow process, and it's also not a race. I try to focus on how far I've come rather than how far I have to go.

 

2 hours ago, Dolemanana said:

In 2022, I switched to liquid suspensions

 

Hopefully you are finding it easier now to be consistent and accurate. That is vital.

 

2 hours ago, Dolemanana said:

MY Withdrawal Symptom

 

They all look like typical WD symptoms to me: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

2 hours ago, Dolemanana said:

The only reason I haven't quit cold turkey

 

Yeah, that wouldn't be a good strategy, especially given the hard work you've put it to get to where you are.

 

Given what you describe, I wonder if you should slow down your taper, or consider The Brassmonkey Slide Method of Micro-tapering. I find this more manageable...but it can still be hard at times.

 

2 hours ago, Dolemanana said:

They recommend going cold turkey at 1mg, which I am at now, and I am nervous that I will end up in the hospital again.

 

Yikes! that's way too high a dose to jump off. You'd want to be down close to 0.1mg...but it varies by person and drug. 

 

2 hours ago, Dolemanana said:

I am currently looking for doctors or nurse practitioners licensed in CA who will be able to help me have a game plan

 

I'm not from your country, so I cannot comment on any of the people on this list.

 

Below are a few links I find helpful:

 

Windows and waves pattern of stabilization

 

Emotional Spirals

 

Non-drug coping strategies

 

Melatonin for sleep

 

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


Magnesium

 

Omega-3 fatty acids (fish oil)

 

Avoid alcohol. 

 

Don't change the manufacturer of your AD.

 

This is your own Introduction topic.  Each member has only ONE Introduction topic.  Your own Introduction topic is the best place to ask questions and the place to journal your progress.  This keeps your history in one place and means you do not have to repeat your story. 

 

Once again, welcome to S.A.

 

Emonda

 

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg,

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