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MikeL: mirtazapine


MikeL

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How I taper Mirtzapine:

I put my Mirtzapine pill in 300mL's of water. After it dissolves, I shake it up and use an oral syringe to pull some water out and discard it.

Pulling out 1mL more each night means the taper will take 300 days. 

December 2017 Cold turkey-ed Xanax.

May 2017 Mirtazapine (1mg) at bedtime.

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  • Moderator Emeritus

Hi MikeL and welcome to SA,

 

SA's recommended tapering protocol is to reduce by no more than 10% of the previous dose followed by a hold of about 4 weeks.  Many members find that as their dose gets lower they need to go slower by making smaller reductions and/or holding for longer.  Your method of tapering means that each time you make a reduction the % of the previous dose is getting greater.

 

The reason for tapering slowly is that the drug changes the brain.  We become physiologically dependent on the drug.  It isn't a physical dependency like nicotine or caffeine.  Reducing the drug slowly means that generally withdrawal symptoms are kept to a minimum and we can live our lives as normally as possible.  Reducing too quickly, getting bad withdrawal symptoms and updosing can destabilise the nervous system.  Some members have found that they have been unable to stablilise after this has happened.

 

If you are reducing from 300mg, which may be the case given the information you have provided, a taper from 300mg to 1mg would take about 4 years.  If you are reducing daily by 1mg that totals about 30mg over a month.  You can see by the follow figures how soon your reductions will be over the 10% of the previous dose.

 

The first 10% reduction would be to 270mg (30mg reduction), the next to 243mg (27mg), the next 218.7mg (24.3mg), the next 196.83 (21.87mg).  

 

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

  • Please leave out symptoms and diagnoses.
  • A list is easier to understand than one or multiple paragraphs. 
  • Any drugs prior to 24 months ago can just be listed with start and stop years.
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
  • Link to Account Settings – Create or Edit a signature.

 

I suggest you read the information below so you can understand why the 10% taper is recommended:

 

Why taper by 10% of my dosage?

 

Why taper paper: dose-occupancy curves

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

Tips for tapering off Remeron (mirtazapine)

 

This is your own Intro topic where you can ask questions and journal your progress.

 

 MISSION ACCOMPLISHED:    13 November 2021 -  0mg Pristiq      

Woohoo!!!  Finally off Pristiq   

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full tapering program     My Intro (goes to my tapering graph)    My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.  I do not provide tapering advice via PM.  Please post questions in your Introduction topic.  Please do not tag me for any reason.  I am an unpaid volunteer and assist members if I am able to and when I have the time.  Thank you for your understanding.

Mid Nov 2021 changed to low carb diet due to diabetes & cholesterol.  Lost 1/16 body weight, BP has reduced a lot. 

Links to my exercises and weights.  I also do 3 x 5.5 min with HIIT on exercise bike with 20 secs/min as fast as I can cycle.

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7.5mgs.....its 10% per month.....

300 days = 10 months.

300 mL's of water

December 2017 Cold turkey-ed Xanax.

May 2017 Mirtazapine (1mg) at bedtime.

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  • Moderator Emeritus

Thanks for clearing that up.  Sorry, you had me totally confused, but not having all the information made it difficult.

 

You still need to be careful that you don't inadvertently exceed the 10% of previous dose.

 

Please create your drug signature as requested above.  Thank you.

 MISSION ACCOMPLISHED:    13 November 2021 -  0mg Pristiq      

Woohoo!!!  Finally off Pristiq   

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full tapering program     My Intro (goes to my tapering graph)    My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.  I do not provide tapering advice via PM.  Please post questions in your Introduction topic.  Please do not tag me for any reason.  I am an unpaid volunteer and assist members if I am able to and when I have the time.  Thank you for your understanding.

Mid Nov 2021 changed to low carb diet due to diabetes & cholesterol.  Lost 1/16 body weight, BP has reduced a lot. 

Links to my exercises and weights.  I also do 3 x 5.5 min with HIIT on exercise bike with 20 secs/min as fast as I can cycle.

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  • 4 weeks later...

My mornings are toxic. Extreme cortisol/adrenaline/anxiety.

 

Cold turkeyed Xanax three months ago.

Currently on 7mgs of Mirtazapine at bedtime.

December 2017 Cold turkey-ed Xanax.

May 2017 Mirtazapine (1mg) at bedtime.

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  • Administrator

Welcome, Mike.

 

Please put your questions and symptom reports in this topic.

 

Those toxic mornings are because your nervous system is sensitized by withdrawal and over-reacting to the normal morning spike of cortisol, the daytime activity hormone.

 

You may be tapering too fast. You've been reducing every day? It might be a good idea to hold now for a bit, let that cortisol reaction settle down.

 

Tapering takes as long as it takes.

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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  • 1 month later...
On 3/4/2018 at 10:29 PM, MikeL said:

How I taper Mirtzapine:

I put my Mirtzapine pill in 300mL's of water. After it dissolves, I shake it up and use an oral syringe to pull some water out and discard it.

Pulling out 1mL more each night means the taper will take 300 days. 

1 mg of Mirtazapine

December 2017 Cold turkey-ed Xanax.

May 2017 Mirtazapine (1mg) at bedtime.

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Hi MikeL,

 

Sounds like you decided to go much faster than 300 days or were you already through most of your tapering when you first posted in early March? Have your mornings gotten any better? At what point (what mg) did you start to experience morning issues?

 

I’m now at 8.0mg and I have the same issue and continue to wake up at about 3am everyday, except for weekends, which is irritating since I know my body/mind can sleep. I’m still able to fall asleep just fine so I quit trying to use melatonin, unisom, L-Theonine, etc, cuz none of these things help me stay asleep and they just intensify the morning grogginess (except for L-theonine, which leaves no effect). I’m still hoping that eventually this will go away but for now I’m trying to just accept getting 4-5 hrs sleep/night (Mon-Fri) and keep a positive attitude, which is very hard since I used to complain about being able to sleep too much. Within 3 months it’s become the complete opposite. I just lay there for 2-3 hrs until my alarm goes off at 5:30a and try to stay relaxed so at least my mind doesn’t stress. I tell myself that lots of people live with only 4-5 hrs/night and they function just fine, so will I. I should just get up and do something else but I’m always hopeful that I’ll doze off because I feel tired. Sometimes I’m about to doze off and then my body jerks or a sudden snore wakes me up, and then I start all over ..so frustrating.

 

Take care.

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • Moderator Emeritus
On 3/4/2018 at 10:56 PM, MikeL said:

7.5mgs.....its 10% per month.....

300 days = 10 months.

300 mL's of water

 

Are you doing 10% of your original dose, or your current dose? This could be a big difference.

Current: 2019: 0.04 mg Paxil!! This is real. Soon, after taking Paxil my entire adult life, I will be free.

Long story short: After 18 years on Paxil, "tapered" almost completely off over a month, at doctor's advice in July 2015.

Self-care includes magnesium, reasonable exercise, mindfulness, this forum and nutrition/eating enough food.

Also on 100 mg Zoloft unfortunately!! (which I now will have the knowledge to taper properly)

-------------------------------------------------------------------------------------------

Longer version: On Paxil since 1996--anxiety & depression caused by (undiagnosed) under-eating / eating disorder.

Doctor kept increasing dose, up to 60 mg; it never really helped but said it really was the best "med" for me.

Rapid doctor-led "taper" July 2015, down to 5 mg, with Zoloft as a "cross-taper" = Essentially a cold turkey. 

Severe withdrawal but didn't know it; believed it was my "underlying condition," and kept tapering, 5mg to 4 to 3  to 2 to 1.  

Feb 2016: Found SA! As of June 2016, tapering from 1mg at rate of 5-10% per month, Brassmonkey Slide! 

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