Investartist: Tapering off Remeron

[Investartist]

After 15 years on 7.5mgs of Remeron I decided to taper off on April 1, 2019.  I cut in half to 3.75 mgs for 25 days. Then I stopped taking it since April 25th.  About a week later I started itching and having all kinds of skin burning symptoms.  After 5 days of this I realized that I might be having withdrawal symptoms.  I just reinstated at 7.5mgs two days ago but am having all kinds of spaciness and discomfort.  I know it will take about a week for my blood levels of Remeron to stabilize and hope this stops the withdrawal.  I now realize that I should have tapered very slowly and just did not realize how strong even my low dose of 7.5mgs could be.  I was totally stable until a week ago so I hope that I caught this quickly enough.  

 

So my history is:

7.5mgs Remeron for 15 years....very stable and no issues.

Cut to 3.75mgs Remeron for 25 days.

Stopped completely for 7 days before any withdrawal symptoms started on May 2nd, 2019

Reinstated 7.5 mgs on day 12 of cold turkey on  May 7th, 2019

Itching symptoms have stopped almost completely after 2 days  of reinstating but having spaciness and general body discomfort and edginess.  

 

 

My thought is to stabilize and wait a few months before tapering again at no more than 10% per month as recommended.  Any advise would be much appreciated.  I hope I am doing this right to stabilize?

 

Thanks!

[Gridley]

Hello, Investartist, and welcome to SA.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  All you have to do is copy the history you gave in your post using the following link.  That way, your drug history will appear below each of your posts, which is helpful to the moderators.

 

Account Settings – Create or Edit a signature.

 

How severe are your symptoms?  Generally, we advise members to reinstate at a considerably lower dose than the previous dose, because the brain will have adapted somewhat to the lower dose and can be overwhelmed by a too-high reinstatement.  However, if you're doing pretty well, the 7.5mg reinstatement may be fine. The fact that the itching went away immediately is encouraging.   Another factor is that it takes about 4 days about four days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.  If 7.5mg is a good reinstatement dose for you, the beneficial effects should increase over the next several days.

 

Please monitor your symptoms over the next few days and make notes on paper.  If your symptoms worsen, it is a sign that the reinstatement was too high, and you might want to consider lowering the reinstatement.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

This link is specifically about tapering Remeron, including how to obtain the small doses you will need for a taper, or, should it be necessary, a lower reinstatement.

 

Tips for tapering off Remeron (mirtazapine)

 

You are right when you write that you want to stabilize before beginning a taper.  It still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows (ups and downs), but symptoms won't be as intense. Then when you're stable you can begin a 10% taper.

 

Why taper by 10% of my dosage?

 

Please let us know how you're doing.

 

 

 

[Investartist]

Gridley,

 

Thank you so much for your response!  My symptoms are pretty strong today with a strange spaciness and edginess  and today is the hardest day I have had.  They seem to get worse as the day progresses... I know this is withdrawal.  As of today it has only been one week since my first symptoms appeared and it has only been 2 days since I reinstated at my old dose of 7.5mgs Remeron.  I know I have to wait for at lease 4-5 days for the blood level to be stable.  I am hoping I may soon feel some improvement. 

 

I appreciate the references you gave me!

[Altostrata]

Hello, Invest. Gridley did a good job of laying it out -- give the 7.5mg mirtazapine a chance for a few days more. It may be fine, but it's also "normal" to have ups and downs while stabilizing.

 

If you get steadily worse as the 7.5mg ramps up, it may be too strong. Please let us know how you're doing.

[Maca44]

I jumped from 30mg of Mirt which I was on for over 3yrs so dropped to 15mg a week later I crashed so panicked and went back to 30mg but my body didnt like it. Got very bad anxiety dry heaving first thing and headaches. Dropped back to 15mg and now after a week im feeling better but headaches come and go. Feeling fairly stable now but for some reason trying to go back to 30mg got rejected so I can not go back to that dose. Now giving it another week then I will start 7.5mg and see how that goes,no turning back now methinks.

[Investartist]

I am happy and very relieved to report that I am feeling much better today after reinstating just 4 days at 7.5mgs Mirtazepine.  I would say I am feeling 90% months normal.  I plan to just stabilize for quite a while before I consider tapering again and in the future I will follow the 10% a month reduction philosophy.

 

Thank you so much for each of your ideas!  You are all providing such a needed public service!!!

[Maca44]

Good to hear but don't panic if you get the odd off day its to be expected. Like you I'm staying at 15mg for sometime after stupidly dropping from 30mg. Won't be doing that again in a hurry.

[Investartist]

That is really good advise Maca44...I remember that healing is not always linear and that there can be windows and waves!  I know that it is important for me to just give the brain stability with no dose fluctuations and I plan on trying to keep my stress level as stable as best as I can too.

[Maca44]

59 minutes ago, Investartist said:

That is really good advise Maca44...I remember that healing is not always linear and that there can be windows and waves!  I know that it is important for me to just give the brain stability with no dose fluctuations and I plan on trying to keep my stress level as stable as best as I can too.

Yes I have been really trying to get any stress under control and its helping. I drive for a living so I've been forcing myself not to get all upset if someone cuts in front of me or does something daft where, normally, i would get all tense hooting my horn and carry that stress with me for the rest of the day. Its a real effort to stay calm but its working and I just don't engage, life is so much easier without the stupid stuff making me upset. I guess its just re learning how you deal with stuff. Feeling stable is the time to stay where I am regards to dose so I'm in no rush to cut to 7.5mg of Mirt thanks to the info here but I will drop again in good time.

[Investartist]

Okay I spoke too soon about my recovery.  I am now on day #10 of reinstating my original 7.5mgs of Remeron.  I seem to be getting worse the last 3-4 days during waves of symptoms.  They get worse as the day progresses.  Sometimes they ease some in the evening. My worst symptom is a skin burning symptom where I feel like I have a sunburn all over my body.  I think they flair with increased stress.  This is very discouraging. I’m trying to hike and exercise more when I am feeling bad as it distracts fro the discomfort.  

 

Im guessing since I went off the Remeron quickly over 37 days it will take a while to stabilize.  

 

I would really appreciate any suggestions or ideas to cope.

 

🙋🏼‍♂️

[Maca44]

You have got to be patient, I'm in the same boat and each time i have a wave its the worst wave ever but in fact its not its just another wave. The cruel part of all this is that you get days/hours/weeks of feeling ok then out of the blue its all back to hell. I have stopped looking for answers of how to get well again as I find the less time I give this the better I feel, the answer is, there is no answer you will feel better when your ready to. 

[Maca44]

How are you doing ?.

Have things settled down or are you still struggling.   

[Investartist]

Hi Maca44,

 

I’m having good periods and then rough patches still.  I just try to be as kind to myself as I can and be patient.  Stress of any type will cause an increase in symptoms.  I think that this withdrawal syndrome causes our threshold for anxiety or stress to be lower and the body must have time to heal this.  It’s been about 12 days since I reinstated at 7.5mgs Remeron.

 

I hope you are having a good day!🌈

[Maca44]

Yes funny how stupid things can set us off isn't it. All I had to do yesterday was reset my phone and that ruined my whole day and sleep last night, what I had to do was a simple thing, but O no I had to get all wound up and stressed which set the anxiety off. Today is good so looking back it all looks very silly to get so upset about such a thing but at the time I was so uptight. Good days bad days all part of recovery. Today is good and that's all that matters 😀