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Tips for tapering off mirtazapine (Remeron)


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On 1/19/2018 at 3:01 PM, Abilifyneedhelp88 said:

Hi Samantha,

 

I successfully tapered off Remeron 15mg three years ago. What i did was an olive oil base with pulverized remeron tablets.  The person I got info on for the recipe was Roy Katz who is a compound pharmacist.  I could not get a dr to agree with me to write the prescription for liquid so I made the liquid myself and decreased 1mg at  a time over several weeks. I think it took me a good 6 months to get off totally. But you should contact Roy and get the recipe for the liquid titration method. He is more than willing to talk with you about concocting your own. Google Roy Katz and give him a call to get the right amount of Remeron per mg of Olive oil. it is a liquid suspension and you can get an even amount of Remeron using a syringe. Hope this helps and Good luck with your taper. I do not suggest cutting them in half  or even cutting them at all. I got a pestle and bowl and pulverized them and then put them in the olive oil , then measured out the right mg with a syringe and took it that way. Do not try to get off this fast. Its a slow drawn out taper designed to give you as little side effects as possible..

 

On 1/19/2018 at 3:09 PM, samanthaelizabeth said:

How much Olive Oil?

 

 

On 1/19/2018 at 6:27 PM, Terry said:

 

People do just fine making a suspension with Remeron and water -- see the first post in this topic.

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

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  • 5 months later...

Hello Everyone! I'm preparing myself for tapering off mirtazapine very soon. I have GEMINI-20 scale to weight my tablets, but I would rather prefer to use liquid mirtazapine and measure my doses with a syringe. I probably won't be able to get liquid mirtazapine from a pharmacy, so I have to make my own suspension. However, I'm little confused about that process. I have only orally disintegrating tablets. I want to make 15 ml suspension so that 1ml = 1mg. From what I understand I cannot dissolve the tablet only in water. Or can I? I need some suspending vehicle like Ora Plus https://www.amazon.com/PADDOCK-LABORATORIES-Ora-Plus-Suspending-Vehicle/dp/B000GGHSQM/ref=sr_1_1_a_it?ie=UTF8&qid=1545007008&sr=8-1&keywords=oraplus&fbclid=IwAR12cH9g3DPzRxU3iH3A5jPDsBQPmezkOt3tnG6sGUEosNJT4IID6uPGSFI.
So the process would look like this:
- I drop my tablet in the mixing tube then add 7.5 ml of water and shake it vigorously
- Then I add 7.5 ml. Ora Plus and shake it again
- I now have a 15 ml. solution. 1ml = 1mg of mirtazapine
- My first dose would be 13.5mg so I remove 1.5ml. of the solution with syringe 
- Drink the rest (13.5 ml. of the solution)

Do I have to crush the tablet into powder before dissolving them in water?
Has anyone used this method?
I'm still trying to figure out how to do it properly. Any advice would be greatly appreciated? Thank you.

December 2009 - February 2012:  Paroxetine (Seroxat), occasionally Clorazepate || February 2012 - November 2012: Escitalopram || November 2012 - May 2013: Venlafaxine, also benzodiazepines, mostly Xanax || June 2013 - December 2013: only benzodiazepines Xanax, I'm starting to become addicted to it. || December 2013 - March 2014: again Paroxetine, very often Xanax || March 2014 - June 2014Fluoxetine. Changed Paroxetine to Fluoxetine. I was practically addicted to Xanax at this point. || I had an unpleasant accident in June 2014. Abruptly Stopped taking SSRIs but was still addicted to benzos. || August 2014 I started taking Clomipramine and in September 2014 Mirtazapine 10 mg. This was the time I stopped taking benzos for good. The withdrawal was pretty hard for more than half a year.  || October 2014: Stopped Clomipramine and for month tried Sertraline

September 2014 to Present DayMirtazapine 15mg 
December 2014 to August 2018 I was on 30 mg Paroxetine.  Started tapering in January 2018
. Going twice from 30mg to 20mg in a matter of 2-3 days. Didn't work. Started again in February 2018.

Generally every 2 months I was making a big drop by 10mg in a matter of two weeks. I stopped taking it completely in August 11th, 2018.  My Symptoms include depression, anxiety, sleeping problems, apathy, anhedonia, photophobia, afterimages, other vision problems (hard to vocus my eyes), tinnitus, brain fog. The problems with my eyesight are especially annoying and scary.  After four months they have become more severe.

 

Currently: 15mg mirtazapine, 0 paroxetine

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Please always read these topics from the beginning. Likelihood is high your questions have been answered. See

 

 

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

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  • 9 months later...
On 4/10/2012 at 8:07 PM, Altostrata said:

Shelf-life after being opened is 6 weeks.

Hi Altostrata , does that mean when you open the pill container that mirtazapine caps should be discarded in 6 weeks? I have some from October. I have been discarding the liquid in 5 days. 

2017–20 18 sertraline 50 mg
2018 Pristiq 50 mg
2018 Ciprolex 10 mg
2019 bupropion 150 mg
2019 to 2020 Mirtazapine 7.5 mg
2019 clonazepam 0.5 mg
2020 escitolopram 10 mg
2020 May Pre-Gabalin 150 mg, June  sertraline 100 mg to 50 mg, December pre Gabalin 110 mg
2021, December  pre-Gabalin 53.5 mg to 48 mg, December sertraline 38.8 mg to 38 mg
2022, January sertraline 38 mg to 36 mg, February sertraline 36 mg to 34 mg, March pre-Gabalin 48 mg to 46.2 mg, April 5 sertraline 34 mg to 33.6 mg., April 24, Sertraline 33.6 mg to 32.9 mg, April 24, stopped Calcium citrate 150 mg, May 4 melatonin 1.25, May 13, melatonin 1.5 mg,May 2, Brand change on sertraline and pregabalin May 13 Sertraline 31.2 mg May 21 Sertraline 30.8 mg, May 28, Sertraline 30 mg, June 6 29.2 mg, June 16, 29.2 mg to 28 mg.

 

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Pens,

You could check the prescription label to see if there is an expiration date. 

I might check with the pharmacy/dispensary as well.  Ask them how long the capsules/tablets retain their potency.

Usually it's awhile......but Idk for sure.

 

I used oxcarbazepine caplets for quite some time, and they did not have an expiration date on the bottle.

 

Good question though.

I expect each medication and form, may have it's own expirary date.  Pharmacists are good resources for this type of information, or at least that's what I found.

Edited by manymoretodays

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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  • 1 month later...

Hi everyone... can anyone help please. I need to start tapering my Mirtazapine, but the tablet is coated with a pink film. Has anybody made a liquid from Mirtazapine in this form (i. e coated in pink film). On the packet it says do not crush or chew. I'm praying someone has successfully made a liquid out of a similar tablet, as its my only option. 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Q:  What type/brand of mirtazapine are you using?

 

Q:  What dose are they?

 

Edited by ChessieCat

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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There are 7 pages of images here:  https://www.drugs.com/mirtazapine-images.html

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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On 7/23/2020 at 6:31 PM, ChessieCat said:

Q:  What type/brand of mirtazapine are you using?

 

Q:  What dose are they?

 

Hi @ChessieCat,

 

The box says APO-Mirtazapine (Apotex). 

 

They are 30mg

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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1 hour ago, cathnz said:

The box says APO-Mirtazapine (Apotex). 

 

They are 30mg

 

https://www.drugs.com/imprints/apo-mi-30-11632.html

 

I suggest that you do a search for other members tapering mirtazapine and check out how they are getting their doses.

 

Use this as your search term in a search engine:  site:survivingantidepressants.org mirtazapine remeron mirt mirtazipine

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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@cathnz

 

If the tablet is scored then the tablet can be broken in half and then the coating isn't going to be "sealing" the tablet which means that the coating isn't actually there for any reason to do with absorption of the drug.

 

You will need to find out if the tablets are immediate release.  You can find this out by asking the pharmacist.  I've done a search online and I haven't been able to find out this information.

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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  • 2 weeks later...
On 7/24/2020 at 10:15 PM, cathnz said:

Hi @ChessieCat,

 

The box says APO-Mirtazapine (Apotex). 

 

They are 30mg

Hi,

are you unable to get the orodispersible form of tablet? They are available in most countries as far as I am aware. There was a national shortage of them but this should have been resolved by now.

 

Amitriptyline 2010 (1 month), Sertraline (4 days), Fluoxetine Nov 18 (24 days).

Mirtazapine Dec 18 (15mg)

Mirtazapine Jan 19 (30mg x3 days)

Mirtazapine January-March 2019 (22.5mg)

Mirtazapine April 2019 tapered SLOW until July 2020 - Hit withdrawal wall at 10mg

Up dosed slowly up to 30mg (14 weeks)

December 2020 37.5mg (SEVERE symptoms)

January 2021 decreased to 30mg

July 2021 decreased to 22.5mg

Severe anxiety, bed bound, weight loss, SI

April 22 - introduced Venlafaxine 37.5mg.
Reduced Mirtazapine 22.5mg to 15mg - no withdrawal so far (fingers crossed).

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I've been on them for less than 2 weeks, 15 mg. Insomnia is my primary issue. Can I make the drop to 7.5 mg without the 10% tapering, with how short I've been on them? Thanks.

2020 July 28 - August 9: 15 mg Mirtazapine

Quit cold turkey. Experienced tiny brain zaps, dulled emotions, insomnia.

2020 September 2 - 4: reinstated with 7.5 mg Mirtazapine

2020 September 4 - 12: went back to 15 mg Mirtazapine

2020 September 13 - present: reduced to 7.5 mg Mirtazapine

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Hi @greyed,

 

You should first try a smaller drop, say 10-20%. Plasma levels will take around 5 days to stabilize, so I would avoid dropping again until you are sure symptoms are not too bad. Coming off these drugs needs to be done cautiously. People can have problems with very short term usage that lasts much longer than the time they were taking the meds.

 

Another thing is that you need to be especially careful with the last few milligrams. Often the biggest receptor occupancy drop occurs there. In fact, in many drugs the first 80% of the taper results in only a 10-20% drop in receptor occupancy, and then receptor occupancy falls off a cliff during the last few mg

 

Here is the full article by Horowitz and Taylor if you are interested: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30032-X/fulltext

 

Edit: here is a link to the topic on dose dependency curves.

 

 

Edited by DataGuy

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

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I read that those at risk of withdrawal syndrome are people who had been on the medication for at least a month, so if true, isn't applicable to me. I'm very uncomfortable with exposing myself to the drug for any longer and cannot trust myself with the tapering. If that means some withdrawal symptoms temporarily, I think I will be okay.

2020 July 28 - August 9: 15 mg Mirtazapine

Quit cold turkey. Experienced tiny brain zaps, dulled emotions, insomnia.

2020 September 2 - 4: reinstated with 7.5 mg Mirtazapine

2020 September 4 - 12: went back to 15 mg Mirtazapine

2020 September 13 - present: reduced to 7.5 mg Mirtazapine

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  • 5 months later...

Hello everyone,

 

i was asked by the mods to share some informations about making liquid out of the NORMAL mirtazapine/remeron tablet (NOT the SolTabs).

First, mirtazapine is only slighty solutable in water and always immediate release, which means you have to make a suspension out of it (via suspension addon "Ora-Plus" OR stirring it well enough before drawing up your dose, a magnetic stirrer on low speed may make it easier). Like Brassmonkey said its "powder hanging in water like a cloud".

 

I found some german documents that state that the normal mirtazapine/remeron tablets can be made into a suspension ("normally" for patients who are not able to swallow and need a stomach probe). So i will just share these documents with you.

 

NOTE: These documents are in german, if you want to translate them, use this easy google translator for pdfs: https://translate.google.com/?hl=de&sl=auto&tl=de&op=docs

 

 

1: Document from german pharma manufacturer "1 A Pharma" http://www.1a-files.de/pdf/sondenboegen/mirtazapin_122009.pdf

 

-> "The tablet disintegrates in 15 ml of water within 7 minutes. A finely divided suspension forms. Alternatively, grind the tablet in a mortar and disperse in 15 ml of water. The suspension with a syringe pick up and apply. Rinse the probe with 10 ml of water before and after application."

 

 

2: Document from hospital pharmacy of the university of basel: https://www.crit.cloud/uploads/2/7/6/1/27612891/zermoerserbarkeit_tabletten.pdf

 

-> search for "Remeron" and you will find the 30/45 mg normal tablets. There is a sign "Z / S", which means it can be crushed and suspended.

It will say the alternative to this would be to use "SolTabs", so we can be sure the normal tablets are meant in the table.

 

 

3: Document from the central pharmacy of St.-Johannes-Hospital Dortmund http://qz-chemnitz.de/Teilbarkeit/arzneimittelliste_sonde.pdf

 

-> search for "mirtazapin" (without "e" at the end) and you will find the normal, coated mirtazapine tablets. In the table you see a Z which means it can be crushed and an A which means it can be suspended. The X indicates its possible, while the o would mean its not.

 

In the end i want to say that in the german taper forum, nearly everyone uses normal tablets to make a suspension for tapering, not the SolTabs (they dont seem quite common here, but they are available). So i just wanted to share you these informations and say its very possible to make a suspension out of the normal mirtazapine tablets.

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg (dose feels much more consistent now)

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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  • 1 month later...

Looking at the binding profile of mirtazapine, would it be reasonable to say that once you get to the lower doses it largely becomes a (very) strong antihistamine? Or is my understanding way off? Just wondered what some more knowledgable minds think?

25/8/2020 - 15/9/2020 - 15mg mirtazapine

16/9/2020 - 30mg mirtazapine

17/9/2020 - 22/9/2020 - 7.5 mg mirtazapine

23/9/2020 - 6/10/2020 - 3.75mg mirtazapine

7/10/2020 - 15/10/2020 - 7.5 mg mirtazapine

16/10/2020 - 20/10/2020 - 15 mg mirtazapine

21/10/2020 - 22/10/2020 - 7.5 mg mirtazapine

23/10/202 - 26/11/2020 - 15 mg mirtazapine

27/11/2020 - 10/12/2020 -13.5 mg mirtazapine

11/12/2020 - 17/12/2020 - 12 mg mirtazapine

18/12/2020 - 26/12/2020 - 11.75 mg mirtazapine

 

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@AdviceNeeded

 

JanCarol is a moderator and has been a member since 2013.

  

On 9/17/2016 at 6:25 PM, JanCarol said:

 

Also, I wanted to let you know that mirtazapine was one of the drugs I have experience with - I was only on low dose amounts for sleep (at below 15-30 mg, mirtazapine acts more as an antihistamine, makes you sleepy.  Weirdly, the less you take, the sleepier you get!).  

 

 

On 3/7/2016 at 2:22 AM, JanCarol said:

 

Mirtazapine is a unique drug, in that the less of it you take, the more sedating it is.

 

7.5 mg is more sedating than 15, and 15 is more sedating than 30.  Also, it can be sedating at higher doses until you get used to it.  Then, as you acclimate, as Fresh said, it becomes more activating.  I think it is a receptor thing - at low doses 7.5-30 it hits this antihistamine channels, but 30 and higher it hits the neurotransmitters.  You are right on the line.  It could be sedating, it could be activating, it could be both.

 

 

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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@ChessieCatthanks. That was pretty much my understanding.

 

So, as you taper down you’d effectively be going from withdrawing from an antidepressant (acting on serotonin and norepinephrine) to eventually withdrawing from something which is largely an antihistamine? I’m just speculating and very probably oversimplyfying.

25/8/2020 - 15/9/2020 - 15mg mirtazapine

16/9/2020 - 30mg mirtazapine

17/9/2020 - 22/9/2020 - 7.5 mg mirtazapine

23/9/2020 - 6/10/2020 - 3.75mg mirtazapine

7/10/2020 - 15/10/2020 - 7.5 mg mirtazapine

16/10/2020 - 20/10/2020 - 15 mg mirtazapine

21/10/2020 - 22/10/2020 - 7.5 mg mirtazapine

23/10/202 - 26/11/2020 - 15 mg mirtazapine

27/11/2020 - 10/12/2020 -13.5 mg mirtazapine

11/12/2020 - 17/12/2020 - 12 mg mirtazapine

18/12/2020 - 26/12/2020 - 11.75 mg mirtazapine

 

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  • Moderator Emeritus

I do not think it is worth wasting the mental energy trying to figure out how something "works" when it comes to psychiatric drugs but about what is happening to us by noticing the symptom pattern.  You are now aware that another member has experienced the drug causing sleepiness at lower doses so if a similar thing happens to you then you can assume that it is probably the drug causing it and not something else.

 

When we know about something then we are less likely to get stressed because of not knowing/understanding and we can often find ways to work around it and/or cope with it.

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

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@AdviceNeeded

 

See Post #1 of this topic.  There is a quote from a research paper regarding the drug being more sedating at lower doses.

 

Also note that mirtazapine has a long half life (also mentioned in Post #1) which means that it might take longer (7-10 days) for withdrawal symptoms to appear after making a reduction.

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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@ChessieCat thanks again.

 
I’m definitely finding the lower the dose, the quicker it seems to induce sleep. Sleep is still fitful and I wake early feeling less than refreshed, but it does seem to have improved slightly as the dose has reduced.

25/8/2020 - 15/9/2020 - 15mg mirtazapine

16/9/2020 - 30mg mirtazapine

17/9/2020 - 22/9/2020 - 7.5 mg mirtazapine

23/9/2020 - 6/10/2020 - 3.75mg mirtazapine

7/10/2020 - 15/10/2020 - 7.5 mg mirtazapine

16/10/2020 - 20/10/2020 - 15 mg mirtazapine

21/10/2020 - 22/10/2020 - 7.5 mg mirtazapine

23/10/202 - 26/11/2020 - 15 mg mirtazapine

27/11/2020 - 10/12/2020 -13.5 mg mirtazapine

11/12/2020 - 17/12/2020 - 12 mg mirtazapine

18/12/2020 - 26/12/2020 - 11.75 mg mirtazapine

 

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  • 3 months later...
On 8/6/2014 at 8:39 PM, wulfgar said:

Thanks mlrp! There is a lot that the md:s of today lack in understanding of these drugs. Mirtazapine is metabolized by the liver enzyme CYP3A4. There are several drugs, herbs and foods that up or down regulate this enzyme. There is an incomplete list at wikipedia. 

http://en.m.wikipedia.org/wiki/CYP3A4#CYP3A4_ligands

- Substrates is drugs that is dependent on functional CYP3A4 enzyme for its breakdown (like mirtazapine).

- Inhibitors reduces the enzyme and causes serum concentration of a CYP3A4 drug to increase.

- Inducers does the opposite and causes the CYP3A4 enzyme pathway to function better and causes blood serum to decrease.

 

Some/few doctors warns for grapefruit to patients who are taking statins and mirtazapine. Star fruit, pomegranate, papaya are also strong inhibitors. (http://www.ganfyd.org/index.php?title=Inhibitors_of_CYP3A4) Valarian root, as many of us insomniacs have tried is also an inhibitor.

 

A tip to all of you. Google your drugs with a search string like : mirtazapine cyp*

to find out what enzyme is responsible for the breakdown of your drug.

Then search like CYP3A4 inhibitors and CYP3A4 inducers to find stuff you should not eat.

Some drugs are also inhibitors or inducers so look up the drugs you are taking!

Many benzodiazepines and the Z-drugs is also substrates that uses CYP3A4!!!

Hi Wolfgar, 

Thank you for this very important information

What happens if I take a few drugs that use the same enzyme ? 

Is there any consideration I need to make as to how to taper them down ?

regrettably, I somehow got to the terrible situation where I am taking Mirt, Ambien, Benzo and escitalopram 
I'm in the process of tapering down escitalopram 

May 2020 - 30mg Mirtrazapine
May 2020 - 2mg Ativan (for anxiety)
Sept 2020 - 20mg Escitalopram
Jan 2021 - started suffering from right side scalp+face pressure pains, relieved by Ativan
Jan 2021 - increased to 3mg Ativan (not suffering from anxiety. for right head pains)
June 2021 - started tapering Escitalopram (hoping it's the source of the head pains)
Jan 2022 - 10mg Escitalopram (head pains stay the same)

 

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On 5/2/2017 at 1:23 PM, leahy said:

I'm

On 5/2/2017 at 2:37 AM, Pokey said:

I'm tapering off Mirtazapine still. I'm at 11.25mg. I was at 30mg. I feel weak and tired a lot.

 

On 5/2/2017 at 2:37 AM, Pokey said:

The fatigue & malaise sucks the marrow out of my bones. Can anyone else relate to these symptoms?

. I'm at 10.25mg. I was at 90mg. I feel weak and tired a lot. Low energy.

Hi Friends

 

I have also found that when I reached 15mg tapering, and even more when going down,

I have very heavy fatigue and tiredness, that gradually passes (not completely) as the day progresses.

 

I'm sure it's because of the mirt, because when I didn't take it for 2 days, the fatigue was much much lower. 

It must become more sedating at lower doses.

 

So there is a BIG catch 22 tapering this awful drug.

If I taper slowly, I will suffer fatigue for a long long time, which causes depression.

If I taper quickly, I risk serious WD

I think that I will try to taper quickly, since it's not logical to suffer this malaise and suffer from depression just becuase of this sedating affect at lower doses.

Any suggestions ?

 

 

May 2020 - 30mg Mirtrazapine
May 2020 - 2mg Ativan (for anxiety)
Sept 2020 - 20mg Escitalopram
Jan 2021 - started suffering from right side scalp+face pressure pains, relieved by Ativan
Jan 2021 - increased to 3mg Ativan (not suffering from anxiety. for right head pains)
June 2021 - started tapering Escitalopram (hoping it's the source of the head pains)
Jan 2022 - 10mg Escitalopram (head pains stay the same)

 

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  • 1 month later...

 

Hello! I would like to ask for some advice. I have been taking cipralex SSRI for 9 years.but due to my sleep problems and stomach problems my doctor changed it.Currently I am taking Mirtazapine 30 mg and 3 * 0.25 alprazolam. Mirtazapine 30 mg Soltab. Do you think that dissolving this alone in water and withdrawing it with a syringe would work for the taper? What monthly percentage reduction rate do you recommend? Which would be better to reduce first alprazolam or Mirtazapine? Thanks for any tips.

 

 

2012-2021 cipralex 10 mg all right

2021.03. dulsevia 30 mg is the same as cymbalta 10 days scared memory problem as if my brain is spinning. Start sanax 3* 0.25 benzodiapem.

2021.03-04 Scippa 15 mg SSRI is similar to cipralex for 3 weeks Scippa 15 mg Scippa 10 mg alternately for 2 weeks restlessness nervousness concentration is poor scippa 10 mg weakness weakness for 2 weeks Cipralex 10 mg nervousness weight loss 2 weeks concentration okay.

Stop escitalopram.

06/05/2021 mirtazapine 30 mg only. Morning sedation.

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7 hours ago, Krisz1977 said:

 

Hello! I would like to ask for some advice. I have been taking cipralex SSRI for 9 years.but due to my sleep problems and stomach problems my doctor changed it.Currently I am taking Mirtazapine 30 mg and 3 * 0.25 alprazolam. Mirtazapine 30 mg Soltab. Do you think that dissolving this alone in water and withdrawing it with a syringe would work for the taper? What monthly percentage reduction rate do you recommend? Which would be better to reduce first alprazolam or Mirtazapine? Thanks for any tips.

The moderators can give you guidance on which medication to taper first.  I tapered off off Mirtazapine and at first I was cutting the pills (Not Soltab). Towards the end, I switched to liquid tapering and did that through a compounding pharmacy.  When I made the switch to liquid, I held for two weeks and then started the taper again.  I found there was no problem for me switching to liquid but it was a compounded formula. 

7 hours ago, Krisz1977 said:

 

 

 Sept 2013-Apr 2014:  After death of my mom put on as series of meds. Zoloft 6 days, Lexapro1 day, Nortriptyline 10 days, Liquid Prozac 1 week, Cymbalta 1 week.

Got off Clonzapam: 1/2014-9/2014. After given Lamictal, stopped Clonzapam at .125mgs

Completed Remeron taper: 41.25 -0.025mgs  1/2015-4 2017. 

Completed Lamictal Taper: 200mgs-0.05 mgs 7/ 2015-11/2018. 

Clonazapam  December 2018. 0.625 Had paradoxical reaction to Lamictal wd, broke my heart to take a benzo but wasn't sleeping and not thinking straight. 28 March, 2019  4% taper Total: .625mgai   26 May, 2019  4% taper Total: .575 mgai,   24 June, 2019 2.5 % taper  10 Clonzapam tablets weigh1.999 mgpw  Average  200 mgpw.  0.0073mgai 9AM, 0.0073mgai 3PM, .415mgai, Total: 561mgai,  10 July, 2019 (Compounded pills) .0073mgai 9AM,.0073mgai 3PM, .415mgai,

Total .561mgai   26 August, 2019 (Back to regular pills due to bad reaction) .0078mgai 9AM, .01075mgai 3PM, .360mgai PM, Total: .545mgai   26 Sept. 2019 .0775mgai 9AM, .1mgai 3PM, 0.350mgai PM: Total: .5275mgai   31 Oct, 2019 .0750mgai 9AM, .0925mgai 3PM, 0.340mgai 930PM, Total: .5075mgai,   30 Nov. 2019 .0775mgai 9AM, .0825mgai 3PM, .3325mgai 9:30PM, Total:.490mgai   31 Dec. 2019 .0775mgai 9AM,  .080mgai 3PM, .3225mgai 9:30PM,  Total: .4775mgai   31 Jan. 2020 .0725mgai 9AM, .0750mgai 3pm, .315mgai 9:30PM, Total: .4625mgai    29 Feb. 2020  .0675mgai 9AM, .0675 3PM, .305 mgai 9PM Total: .440mgai 31 March 2020 .065mgai 9AM,  .065mgai 3PM, .2925mgai 10PM, Total: 4225mgai  30 April 2020 .0625mgai 9AM, .0625mgai 3PM, .2775mgai 10PM  Total: .4025mgai 31 May 2020 .0625mgai 9AM, .0625 mgai 3PM, .2526 mgai 10PM, Total: .3775mgai  30 June 2020 .0625mgai 9AM, .0625mgai 3PM  .2175 mgai 10PM Total .3425mgai.   31 July 2020 .0575 mgai 9AM .0550 mgai 3PM .180mgai 10PM Total .2925mgai  31 August 2020 .0475mgai 9AM, 0.045mgai 3PM, .01475mgai 10PM Total: .2375mgai  30 September 2020 0.0375mgai 9AM 0.035mgai 3PM 0.110mgai 10PM  Total: .1825mgai 31 October 2020 .0325mgai 9AM .0350mgai 3PM  .0725mgai 9PM

Total: .14mgai  30 Nov. 2020 .03mgai 9AM  .0276mgai 3PM 0.450mgai 9PM Total: .1025mgai 31 Dec. 2020 .02mgai 9AM .02mgai 3PM .02mgai 9PM Total: .06mgai  5 February, 2021 .0150mgai Stepped off of Clonzapam, Benzo Free

 

Additional Support:  Armour Thyroid 75mgs,  Vitamin D, Vitamin C, Magnesium Glycinate

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28 minutes ago, Hibari said:

The moderators can give you guidance on which medication to taper first.  I tapered off off Mirtazapine and at first I was cutting the pills (Not Soltab). Towards the end, I switched to liquid tapering and did that through a compounding pharmacy.  When I made the switch to liquid, I held for two weeks and then started the taper again.  I found there was no problem for me switching to liquid but it was a compounded formula. 

 

Thank you for your reply Hibari. I will ask the moderators as well

2012-2021 cipralex 10 mg all right

2021.03. dulsevia 30 mg is the same as cymbalta 10 days scared memory problem as if my brain is spinning. Start sanax 3* 0.25 benzodiapem.

2021.03-04 Scippa 15 mg SSRI is similar to cipralex for 3 weeks Scippa 15 mg Scippa 10 mg alternately for 2 weeks restlessness nervousness concentration is poor scippa 10 mg weakness weakness for 2 weeks Cipralex 10 mg nervousness weight loss 2 weeks concentration okay.

Stop escitalopram.

06/05/2021 mirtazapine 30 mg only. Morning sedation.

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  • 4 months later...

Micro tapering Mirtazapine by Liquid Prep

 

what is better for weaning Mirtaz  ? MICROTAPERING mirtaz  0.1 mg every day  or cut and hold (10% of last dose every 4 weeks)?

 

Edited by ChessieCat
added topic title before merging with existing topic
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Among other adverse effects, mirtazapine is known to cause increased sweating

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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  • 3 weeks later...
  • Moderator

Information on Soltabs:

 

All the reference information I read, Member's say you can crush it and weigh it. Then dissolve it in your mouth or water and you can also dissolve it in water and use a syringe to dispense the correct dosage. You just don't want to use any other liquid other than water.

 

Edited by Frogie

PREVIOUS medications and discontinuations: Have been on medications since 1996. 

 Valium, Gabapentin, Lamictal, Prilosec and Zantac from 2000 to 2015 with a fast taper by a psychiatrist.

 Liquid Lexapro Nov, 2016 to 31-March, 2019 Lexapro free!!! (total Lexapro taper was 4 years-started with pill form)

---CURRENT MEDICATIONS:Supplements:Milk Thistle, Metamucil, Magnesium Citrate, Vitamin D3, Levothyroxine 25mcg, Vitamin C, Krill oil.

Xanax 1mg 3x day June, 2000 to 19-September, 2020 Went from .150 grams (average weight of 1 Xanax) 3x day to .003 grams 3x day.

19-September, 2020 Xanax free!!! (total Xanax taper was 15-1/2 months-1-June, 2019-19-September, 2020)

I am not a medical professional.

The suggestions I make are based on personal experience.

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  • 4 weeks later...

Hi all, 

 

I am preparing to start a mirtazapine taper this spring/summer and am debating how to approach it, i.e. whether to crush and weigh the tablets, lobby my GP to prescribe me liquid or make my own liquid...

 

If I go down the DIY route which is most likely, I'm concerned about the particular brand of mirtazapine that I take because it says not to crush it. I wonder if anyone else is familiar with the exact brand I have because when I've looked up the different tablets I have not seen one that looks to be the same as mine. The brand is Genesis Pharmaceuticals, MA Holder is Activase Pharmaceuticals and manufacturer is DDSA Pharmaceuticals. The 15mg tablet I currently take is a yellow, biconvex, capsule shaped film-coated tablet with a score line on one side and 15 embossed on the other side. 

I will attach a photo to this post. 


Does anyone recognise this particular tablet and has had success at making their own liquid or crushing/weighing? I'm wondering whether or not to ignore the advice about 'do not crush'.

 

I tried an unsuccessful taper last year by cutting up the pills but that was before I knew about the 10% rule of thumb. My reductions were way too steep and I had to reinstate. I want to do it properly this time round so am doing lots of research..any advice would be massively appreciated!

 

Thanks in advance..

 

Kate 

 

 

IMG_7003.jpeg

IMG_7004.jpeg

Sep 2011 - March 2012 citalopram 50mg

March 2012 - Apr 2012 tapered 50mg citalopram down too fast 

Sep 2013 - Oct 2016 citalopram 30mg 
Oct 2016 - Jan 2017 tapered citalopram 30mg down too fast

Reinstated citalopram 30mg in April 2017

Added mirtazapine 15mg in June 2017  

Jan 2021 - July 2021 tapered citalopram 30mg down too fast

July 2021 - Nov 2021 tapered mirtazapine 15mg down too fast 

Reinstated mirtazapine 15mg in Dec 2021 + Reinstated citalopram 10mg in Feb 2022

FOUND SURVIVING ANTIDEPRESSANTS 

Waiting to stabilise and will then attempt tapering with 2.5% reductions

 

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If it's scored, you can cut it or crush it. The instructions tell you not to crush it because they want you to take a full dose rather than improvise. But you need to improvise to taper mirtazapine, unless you get the prescription liquid.

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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Thank you @Altostratafor your response, that’s reassuring to know.

 

I may start with crushing and weighing and then use a liquid when I get down to a lower dose. 
The tablets have a yellow coating however and I read on a thread here that tablets with a protective coating cannot be made into a liquid. Did I read that correctly?

 

Thanks,

Kate 

Sep 2011 - March 2012 citalopram 50mg

March 2012 - Apr 2012 tapered 50mg citalopram down too fast 

Sep 2013 - Oct 2016 citalopram 30mg 
Oct 2016 - Jan 2017 tapered citalopram 30mg down too fast

Reinstated citalopram 30mg in April 2017

Added mirtazapine 15mg in June 2017  

Jan 2021 - July 2021 tapered citalopram 30mg down too fast

July 2021 - Nov 2021 tapered mirtazapine 15mg down too fast 

Reinstated mirtazapine 15mg in Dec 2021 + Reinstated citalopram 10mg in Feb 2022

FOUND SURVIVING ANTIDEPRESSANTS 

Waiting to stabilise and will then attempt tapering with 2.5% reductions

 

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1 hour ago, Altostrata said:

If it's scored, you can cut it or crush it.

 

18 hours ago, kate1385 said:

 

IMG_7003.jpeg

 

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

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. 

Please DO NOT TAG me - thank you.

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Hello @kate1385,

 

my tablets look almost the same (lot of mirtazapine tablets from different manufacturers look like that here in europe).

I crush several tablets, mix the powder VERY well and weigh it, like a lot of people here.

 

Mirtazapine always comes in immediate release form, as oral disintegration tablet (which should "not be crushed and used immediatly after removing from the packet", but i know people who cut them to taper or store liquid made out of them for a short time) or as normal film coated tablets. The film coated tablets can be crushed, cut or suspended and the film has nothing to do with the absorption, its immediate release. Ive read that the coating should "prevent an aneasthetic effect on the tounge" or "avoid bitter taste", which ive never felt or heard from anybody, wether with DIY liquid nor cut tablets/powder.

 

In the leaflet of my manufacturer (again, they look almost the same) is statet "can be halved/can be divided into two equal doses". Also please look at this post where you will find german pharmacy/hospital documents that state that the tablets can be crushed (and made into a suspension for patients with a feeding tube). Here are other english documents that state it can be crushed:

 

https://cdn.mdedge.com/files/s3fs-public/CP01602046.PDF

 

https://www.saferx.co.nz/assets/Documents/c35d9e078f/RAC_crushing_guide.pdf

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg (dose feels much more consistent now)

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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2 professional pharmacy formulas for mirtazapine suspension

 

(For people who have problems making their own liquid with water only. Nothing we did not already know, but want to share these official recipes.)

 

 

#1 Mirtazapine Compounded Oral Suspension, Veterinary -> https://file.wuxuwang.com/yaopinbz/USP42-NF37/USP42-NF37_1533.pdf

 

Note:

 

- Says veterinary, but should be no problem to recreate and use for us to taper (like always you can create any concentration you want,

   you may not need the Ora-Sweet Syrup for taste, only Ora-Plus or any other suspension agent. Refrigeration preferred (Ignore the 'Assay' part in the pdf,

   thats just for analysis).

 

- Because the suspension agent Ora-Plus can to be diluted up to 50 % with water, you may disperse the tablets in water (directly in the bottle) instead of using mortar and pestle before adding the amount of suspension agent you need for your preferred concentration.

 

- If you want to use mortar and pestle, see this example video for how to prepare it. I would be little more cautious and grind the tablets as fine as possible and transfer all into the bottle/container by washing the mortar multiple times with the suspension agent though (like the formulas suggest). Just take your time and do it accuratly. Usually a glass/porcelain mortar with a smooth surface and a spout makes it quite easy. The finer the powder the better the suspension.

 

- Stability/Beyond-use-date is stated at 90 days, but would suggest to be a lot more cautious, especially if the suspension agent is mixed with water (if you plan to dilute it, would recommend distilled or boiled water when you want to use it for more than a few days). Also some members reported issues with a new/old bottle made by their pharmacy after 30 days, so maybe try 7 days or 14 days maximum and adjust when problems occur. If you use water only (without a suspension agent), SA suggest a maximum of 7 days refrigerated). I could not find a stability study for mirtazapine suspensions, so better be safe than sorry.

 

 

#2 Mirtazapine 7mg/mL Oral Suspension -> https://cdn2.hubspot.net/hubfs/471158/LAB_DOCS/Mirtazapine_Suspension_Oil.pdf

 

Note:

 

- Essentially the same as formula #1, just with a different suspension agent (shouldnt matter which one you use if you choose to go that route) and ratio.

   You may not need to add a flavor.

 

- Unit 'gm' means gram 'g', but again you can create any concentration you want.

 

As with all suspension, wether made with water only or with a suspension agent, dont forget to shake well everytime before dosing!

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg (dose feels much more consistent now)

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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