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Drezden Mirtazapine Taper Troubles


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I am a 25 year old male and I've been on mirtazapine for about 7 or 8 years, I don't remember exactly when I started taking it. I've been at a 30mg daily dose for the entire time. I was prescribed the medication when I was around 18 when I was in a residential treatment center for drug addiction. I became addicted to heroin when I was 15 and I was in active addiction for 9 years. I've been clean and sober for over a year now, and now that I don't have any drugs or alcohol in my body I notice how mirtazapine effects me in a bad way. I feel flat mentally and physically I feel not great. 


My doctor is supportive of me tapering off mirtazapine and has setup a plan where I decrease the dose gradually by taking a 25% lower dose one day a week, then the next week for 2 of those days, and the next week 3 of those days..etc.. until every day I'm taking the lower dose at 22.5 mg, and once stabilized at that do the same thing until I'm at 15 mg every day. I'm on the 5th week and I took a lower 22.5 mg for 5 days in a row and today and tonight I feel terrible. 


I'm emotional, I feel anxious, hard to catch my breath, a little shaky and weak, dizzy and a little nauseous, vivid dreams, and really horrible teeth grinding all day. Mostly I am afraid and lonely. 


I have gone through heroin cold turkey withdrawal many times, and that is extremely painful mentally and physically but it's a quick thing, the worst is done after 5 days. I could handle it because I knew were the light at the end of the tunnel was. This mirtazapine is different, the half life is so long and I'm so afraid that I'll be tapering for a year and in pain the whole time.


I've turned my life around so much, I just got accepted to a university program starting this fall, and will finally have a college degree, I have an internship and job. I'm so afraid I'm going to ruin everything by having a break down during this tapering process and I'm scared that I could even possibly relapse into my addiction as a result. 


I go to AA meetings and get a lot of support there, but tapering off this medication isn't something I can talk about there because it's considered an outside issuer, so I found this form for help. My doctor seems to think it should be an easy painless thing to taper off slowly like this, but that is not the experience I'm having, even only 5 weeks into it. I'm sorry this post is so long, I didn't mean to type this much, but I haven't been able to talk about this honestly with anyone, or seek advice from people with experience. 

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What a journey you've been on..I've read on here many people doing slow tapers with next to no problems..so you will more than likely be just fine.


Good luck

2000 - sertraline for job anxiety low confidence (17 years old) ..which turned the next 16 years into nightmare!


On/off sertraline severe withdrawals every time. 2014 - felt better as reduced dose of sertraline no more inner restlessness. Doctor rushed off again. Hit severe withdrawal. Lost the little I had in life. Couldn't get stable again on 12.5mg. Was switched to prozac. Had severe reaction to prozac..came off in November 2015 at 6mg as felt more confused and damaged on it..Even more withdrawal ..rage, depression, dyphoria, near constant suicidal ideation, self harm impulses, doom, concrete block in head, unable to do much of anything with this feeling in head..went back on 6mg of sertraline to see if would alleviate anything. It didn't..reduced from December to June 2016 came off at 2.5mg sertraline as was hospitalised for the severe rage, suicidal impulses, and put on 50mg lofepramine which in 2nd week reduced all symptoms but gave insomnia which still have..psych stopped lofepramine cold turkey..no increased withdrawal symptoms new symptoms from lofepramine except persistant insomnia which has as side effect.


Taking Ativan for 8 months for the severe rage self harm impulses 1-3 times a week (mostly 2 times a week) at .5mg. Two months (I'm unsure exactly when the interdose started to happen) ago interdose withdrawal seemed to happen..2 days I think after the Ativan.



Nightmare that could have been avoided!

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  • Administrator

Welcome, Drezden.


Many people have found these taper schedules of irregular dosing trigger withdrawal symptoms. Their nervous systems need more stability.


We recommend a steady 10% taper, based on the last dosage -- the amount of the decreases gets smaller. See Why taper by 10% of my dosage? and Tips for tapering off Remeron (mirtazapine)


As you've dropped to 22.5mg, you might find updosing slightly to 25mg reduces the withdrawal symptoms.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus

Welcome Drezden,

Thank you for sharing your story, you have been through a lot already and have turned your life around. I can understand your concern, now that you have the opportunity for a happy and productive future. You will find a lot of support and help here and will be able to taper off mirtazapine without it disrupting your life if you take it slow enough.


My doctor seems to think it should be an easy painless thing to taper off slowly like this, but that is not the experience I'm having, even only 5 weeks into it. I'm sorry this post is so long, I didn't mean to type this much, but I haven't been able to talk about this honestly with anyone, or seek advice from people with experience. 


Most doctors don't have a clue about withdrawal and usually recommend tapers which are too fast, see:


What to expect from my doctor


What did you think about Alto's suggestion to updose slightly, she has a lot of experience with helping people to safely get off these kinds of medications, if you try an updose, please let us know how it goes.



I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?

VIDEO: How are psychiatric diagnoses made?

VIDEO: Why do psychiatric drugs have withdrawal syndromes?

VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes




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