Offshore: low dose of Remeron / mirtazapine for a long time

[Offshore]

Hi all,

 

First off--I am sooooo grateful for this website and forum.  Thank you to whoever thought of creating this site and brought it into reality however many years ago!  

 

I've been on a very low does of Mirtazapine/Remeron--I take an 1/8th of a 7.5mg pill (so about 0.9mg)--for over a year. Prior to that, I was on anywhere from 1.87mg  (quarter tablet) to 3.5mg (half a tablet) for about 4 years. I started taking it when I was going to school and working full-time and I was getting approximately 4 hours a sleep a night.  I am very grateful that it cured my insomnia 5 years ago, but now I'm sleeping fine and life is good and I think that it's time to get off of it.

 

When I tried stopping two weeks ago, I thought that I would be alright--I've read a lot of people's experiences through this site, and I realize that I'm taking an extremely small dose compared to others.  The trouble--I'm assuming--is that I've been taking it for so long that my brain has adjusted and become dependent on this small amount.  Currently, I have no trouble falling asleep and I've been exercising a lot to try and make sure that i'm tired, at the end of the day but I just can't for the life of me stay asleep for longer than 4 hours!  It's been about two weeks of receiving very little sleep and I'm wondering what else I can do to ween myself further off this drug. For my sanity, I think that I'll go back on my little dose for now. 

 

What do you think my next step should be? I'm already using a razor blade and cutting the pill into pretty much as small of a bit as I can. I've looked at getting a scale, but would a .001 g scale show amounts that are less than 1mg? At this point, I would need something that allows me to go from 0.9 mg to 0.7mg. Thank you in advance for any help or advice that you can offer!  

[Gridley]

Welcome to SA, Offshore.

 

The AWS Gemini 20 scale is accurate up to around 4mg pill weight.  Since much of the pill is filler, that would mean the scale would be accurate at much lower doses than 4mg active ingredient.  Go to Brassmonkey's (one of our moderators) thread and take a look at his signature in which he details how low he could go using the scale.  He got down to very tiny doses using the scale before it became inaccurate and he had to "eyeball" the powder.  Very likely you'd be fine with the Gemini scale.

 

Tips for tapering off Remeron 

 

I'm using the Gemini scale but haven't gotten quite down to the doses you're talking about, but it's doing fine at my current 1.9mgai (active ingredient) which for my brand of Lexapro is 19mgpw (pill weight).  Every drug and brand is different and you'd have to weigh your own pills to see what the ratio of active ingredient is to pill weight.  

 

This is your Introduction topic, where you can ask questions, post updates and connect with other members.

[Offshore]

Hello everyone,

 

I'm wondering if anyone has any experience with getting to what seems like a micro-dose and STILL not be able to come off of their medication without withdrawal?  I can't tell sometimes if this is all in my head or if am genuinely experiencing withdrawal...

 

Here's the backstory:

I've taken Mirtazapine/Remeron consistently for about ten years, but never in any doses larger that 7.5mg.  Starting about two years ago (and with the help of this site!), I started my taper by using a compounding pharmacy and went all the way down to 0.25mg.  I've been on this dose for approximately the last 4 months and I assumed (and hoped) that I would be able to stop from this dose.  Today (I'm writing this at 3:35am) is my tenth night completely off Remeron and while I can fall asleep, I can't usually stay asleep and I've been getting anywhere from 2.5 -4 hours of sleep per night.  It FEELS like my nervous system is just "off," but how can that be possible, given the small dose I've been taking?  

 

I will admit--I'm pretty demoralized right now and I'm not sure what my next steps should be. From what I've read, it seems like I'm on a much lower dose than other people who have quit, and yet it is STILL so difficult!   Should I go back on Mirtazapine?  Taper to 0.20mg? Maybe try magnesium and fish oil to calm my nervous system? Does anyone else have experience with tapering to what seems to be a micro-dose and not being able to quit?     

 

   

[DataGuy]

Hi @Offshore,

 

Sorry this happened to you. It's actually common to get much lower than 0.25mg of Mirtazapine before jumping. If you look in the Success Stories section, you'll see that some people actually got as low as 0.025mg, or 1/10th of your last dose. Even with low dosages like 0.25mg, the drug still has some significant activity at the receptors. I think if you are sleeping 2-4 hours a night, that is a sign that you should probably try to reinstate. Let me know if you need help with that, but if you are doing it yourself you should probably start with a lower dose than your last dose (maybe start with 25% or so). Sometimes acute withdrawal can sensitize the nervous system and make an adverse reaction more likely at higher doses. 

 

If you'd like some personalized help, please summarize your drug history as instructed here.

 

You seem like you're already familiar with the site, but here is a list of coping techniques if you need them.

 

Hope we are able to turn things around for you!

Edited December 27, 2020 by DataGuy

[Offshore]

Thank you Dataguy!  This is very helpful.  I appreciate all of the links that you put there--I love this site and the way that it's designed but it's also nice to have these helpful links here that are immediately applicable to my situation.  I was looking primarily through the general  and tapering topics on Mirtazapine, but I will go and check out some of the success stories now.  Thank you for taking the time to respond; I appreciate it!  Happy Holidays!

[DataGuy]

Happy holidays, @Offshore. Let us know if you have any more questions or run into any problems. Mirtazapine is a bit of a doozy and tapering is a surprisingly involved and complicated process. Just when we think we know enough, we realize there are very basic practical questions that we don't know the answers to. I'm glad you are close to getting off.

 

You might find this thread on tips for sleep problems useful, as well. 

 

Good luck : )

[Shep]

@OffshorePlease note I merged your two introduction threads together. This keeps all of your information in one place. Please continue to use this thread to document your taper and to ask questions. 

[Offshore]

Thank you @Shep and @DataGuy!  I greatly appreciate your work.