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suzyontour: Advice on tapering off mirtazapine


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I was on daily

20mg of diazepam 

40mg of propranolol 

50mg of quetiapine

nightly

40mg of propranolol 

50mg of quetiapine

30mg mirtazapine 

 

I have weened off all diazepam 

(I am now prescribed 10x 2mg a month for as and when needed. I take 1 or 2 a week maybe)

I have weened off all propranolol daily and nightly 

I have weened off the  50mg quetiapine I was taking in the morning 

and 25mg of the nightly quetiapine 

 

so now I’m just on nightly

25mg quetiapine and 30mg of mirtazapine 

 

 

I think I’ve done well to date but I am determined to be off all,  but how do I ween the mirtazapine? And do I continue on 25mg of quetiapine whilst I’m weening off the mirtazapine? I have not had any problems coming off 75mg of quetiapine so far?

what might a mirtazepine taper look like and what precautions can I take to make things any smoother?

thanks

suzy

 

 

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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  • Erimus changed the title to suzyontour: Advice on tapering off mirtazapine
  • Moderator

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

Your first task is to create a drug signature, with the following:

 

  • All current medication you take, the dose you take, when you started the drug, and when you made dose changes
  • All current supplements you take
  • An accurate history of recent drugs, taken in the last 12-24 months
  • Dates for recent should be written as 7 Oct 2023, or Oct 7 2023, or early Oct 2023, or mid Oct 2023
  • A history of drugs taken 24 months ago and beyond - if applicable
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  • Please leave out symptoms and diagnoses. See my signature for example of clear and concise information.

 

Active Monday-Friday UK time

 

Taper calculator spreadsheet

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021, 55mg - 23 Feb 2024, 60mg - 20 March 2024, Start tapering - 24 April 2024

Current dose: 55.09mg  (1 July 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

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  • 2 weeks later...
Posted (edited)

Hi 

I was on 100mg of quetiapine 50 am and 50pm. I jumped to 25mg at night. I experienced withdrawal intensely first week then it gradually got better. I have been on 25mg for 4 weeks and have now stabilised. I now understand hyperbolic tapering which I didn’t before I jumped.

I am also on 30mg of mirtazapine.

GP has prescribed Liquid for mirtazapine taper which I will commence after quetiapine taper.

GP has now prescribed me quetiapine liquid which I am waiting for chemist to get in.

my doctor told me they only have liquid in equivalent of 20mg. I know I need to transfer and stabilise on same liquid dose as my 25mg tablet equivalent before I start taper. Could someone please tell me what ml dose I’d start on if the liquid is only 20mg and I need to be on 25mg please?

thank you 

 

Edited by Emonda
Name to title

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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Posted (edited)

Hi there please could someone provide clarity.


I was on 100mg of quetiapine 50 in morning 50 at night for 8 months and dropped to 25mg at night. I experienced WD but was able to manage it. I am now stable and all symptoms have gone.
I managed to get my Dr to prescribe the liquid so I can taper slowly for the final 25mg as I’m a teacher I need to be alert and patient.
I know I need to start liquid at same dose and stabilise before I start dropping. However the only dose my dr can access here in uk in liquid is 20mg. What would I take in ML to equal my starting liquid dose of 25mg please?
 

Edited by Catwoman73
Added username to title

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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Posted same question twice but it’s not showing. Wondered why?

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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  • Moderator

Hi @suzyontour- apologies for the delay.  We are all volunteers here, and sometimes it's hard to keep up with the demands of our personal lives and this site, particularly when things are busy!  

 

So we need to know the exact concentration of the liquid- is it 20mg/mL?  It should say right on the bottle.  Let me know what the concentration is, and I'm happy to help with the math!

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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  • Emonda changed the title to suzyontour: Success in getting liquid for taper- But..
  • 2 weeks later...
Posted (edited)

Hi @Catwoman73

Hi all so I got the liquid (this is for quetiapine, I have mitrazapine liquid too but I’m doing quetiapine first)
It’s 20mg and front label says to take 1.25ml to be on equivalent of my 25mg tablet. I will stabilise on equivalent dose before attempting the taper
So I’m doing a 10% hyperbolic taper so when I do drop what will my first drop equal?
Will be minus 10% of 1.25ml?
So 1.12ml? Is that right?
Then next drop 1.01ml and so on?
Can someone clarify please?
Thanks

Edited by Erimus
Added @catwoman73

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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Hi

Hi all so I got the liquid (this is for quetiapine, I have mitrazapine liquid too but I’m doing quetiapine first)
It’s 20mg and front label says to take 1.25ml to be on equivalent of my 25mg tablet. I will stabilise on equivalent dose before attempting the taper
So I’m doing a 10% hyperbolic taper so when I do drop what will my first drop equal?
Will be minus 10% of 1.25ml?
So 1.12ml? Is that right?
Then next drop 1.01ml and so on?
Can someone clarify please?
Thanks

 
  •  

 

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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  • Moderator
5 hours ago, suzyontour said:

Hi @Catwoman73

Hi all so I got the liquid (this is for quetiapine, I have mitrazapine liquid too but I’m doing quetiapine first)
It’s 20mg and front label says to take 1.25ml to be on equivalent of my 25mg tablet. I will stabilise on equivalent dose before attempting the taper
So I’m doing a 10% hyperbolic taper so when I do drop what will my first drop equal?
Will be minus 10% of 1.25ml?
So 1.12ml? Is that right?
Then next drop 1.01ml and so on?
Can someone clarify please?
Thanks

Hi @suzyontour- so the concentration of your liquid is 20mg/mL.  You will be taking 1.25mL for now until you stabilize.  '

 

To calculate your next dosage, take your current dose, 1.25mL and multiple by 0.9.  So you will be decreasing to 1.125mL- or round up to 1.13mL.  

 

Hold there for however long you need to in order to stabilize, then multiply that dose (1.13mL) by 0.9 for your next dose.  That will be 1.02mL.  And so on.  Don't hesitate to come here to ask math questions- this is the type of math you definitely want to get right lol!  Incorrect dosing could be very bad!

 

That being said, if you find stabilizing after a 10% drop too difficult (like me!), you can drop by a smaller amount.  I'm currently dropping in 5% increments.  And even that might be too much, so I'm entertaining other options.  Just keep us posted, and we'll help you make decisions along the way.  Hopefully you will tolerate the 10% drops with little difficulty, but you do have options if that's still a struggle.  Just let us know- we're here to help!

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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@Catwoman73

 

thank you.

just out of curiosity, what dose would I jump off at, following this taper?
 

I’m going to transition from tablet to liquid on Friday as I’m home for the weekend. I will be back if I have any further questions 

thank you again 

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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@Catwoman73

Advice please
I am going abroad soon and need to take my liquid with me that states it needs to be refrigerated at all times. I need to keep it cold for at least 12 hours, from home to resort, during flight etc. 
what are my best options for doing this and is it ok at UK/ Europe airport security?

Mirtazapine 30mg from May 2023- Current- quetiapine-25mg at night from October 2023-then raised to 50mg at night from Jan 2024- raised to 50mg at night and 50mg in the morning from March 2024- jumped from 100mg-25 Mg on 17 May 2024- been stabilised for 4 weeks-just been prescribed 20mg liquid to hyperbolic taper the last 25mg of quetiapine before starting mirt taper

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  • Moderator

I am in the same boat- travelling on Wednesday!  Check with your airline for any specific instructions that they have, but this is what I'm doing.  I have a small gel-pack lunch bag that I am bringing mine in, and have ordered some other small ice packs as well.  Often, you can ask your flight attendants to keep your meds in the fridge during the flight (just write yourself a note to remember to get it back just before landing!).  And you can also request some ice on landing if your ice packs have warm up.

 

In terms of security, the last time I traveled I was on an injectable medication that I did not want going through the x-ray machine.  I just asked them to inspect manually.  They had no issue with this.  Make sure you travel with your medication in its original bottle, with your name on it, so they know it is legitimately yours.  

 

I'm not sure if the fridge in my resort room has a freezer to re-freeze my ice packs- my plan is to ask the kitchen at one of the restaurants to freeze them for me the night before I fly back.  Most resorts are pretty accommodating with this stuff. 

 

I somehow missed your last question about jumping off... sorry about that!  Lower is better in these cases.  The highest I would recommend is 1% of your original dose.   But I think many of us need to go much lower than that.  You can gauge that as you progress through your taper.  It does get tougher at lower doses, so wait to see how you go.  My personal plan to to jump off at 0.25% of my original dose, if all goes well.  If not, I'll continue to taper even lower.  Here's a thread on the endgame taper:

 

Managing the Endgame Taper

 

Hope that helps a bit!

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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