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Tips for tapering off mirtazapine (Remeron)

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Altostrata
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

All postings © copyrighted.

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Jakebob

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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Altostrata

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

All postings © copyrighted.

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Pens
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. 


2009 Paxil 2015 sertraline 50 mg 2016 Pristiq 50mg 2017 - 2018 Pristiq 50 mg 

2019  mirtazapine 7.5 mg January to March,  Ciprolex 10 mg April to May 

XL Bupropion June to August pristiq  50 mg September to November 10 then stopped

2019 November 1,  lorazapam  1 mg for 14 days, Mirtazapine 7.5 mg. 

2019 November 10, mirtazapine 1:8 mg. too quickly ( didn’t know about SA.

2020 Jan 1, updosing to 1.9 mg. getting a rashJan 11 tapered to 1.8 ml. mirtazapine. January 25, 2020, mirtazapine 1.6 ml., 14/03/2020 mirtazapine 1.5 ml. 27/03/20, 1.44 mg. 28/03/20, 1.43 mg, 29/3/20 1.5 ml.,
OTC eye Gel, ginger pill if needed 

Nasonex if needed 50 mcg.,
 

 

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manymoretodays

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

Started with psycho meds circa 1988 I think 27 or 28 total.

AD's, antpsychotics, antiseizure mood stabilizers. Lithium, lamictal ,benzos, and stimulants. Some med. for narcolepsy once(Provigil,) Gabapentin........probably more.  Ask me?......I probably was on it.  Haphazard W/D's by Dr. recommend or uneducated self.

10/2014- off Lexapro--had been on highest dose 10 mg. then 5 mg. for a couple of years, went from 5 mg. to 3 mg. liquid and then CT in hospital(voluntary).  I got out of the hospital on a combination of low dose adderal salts x1/day and trileptal 150mg. x2/day.

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!

 

3/21/2016---I did some unwise updosing of trileptal/oxcarbazepine with some stressful stuff......doubled the above dose x2 during this last wave but began liquifying again and on approximately 68mg. starting today.  11/12//2016 24 mg. oxcarbazepine  12/9/2016 off oxcarbazepine/trileptal!!!! :) optimistic  2016 December 9- completely off all medications!!!!!

Omega3's,EPA +DHA= 1800 mg/day. Magnesium complex, orally, diluted in a liter of H2O(that I can shake up.....it usually dissolves more completely as the water gets down to room temperature) and/or Epsom salt baths prn.   Vit. C, D3, and E.  B12, melatonin tapered to 1mg., and bioidentical hormones sublingually.  Trace mineral drops.  L-lysine.  L-methylfolate=400 mcg plus daily spinach. Totally ready for a good long window to hit soon and getting better strings of full days and partial days along the way.  Definite improvement overall since I first arrived on the SA survivor ship.  Herb and alcohol free since 5/15/2016.  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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cathnz

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.

 

Untitled document.docx

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ChessieCat
Posted (edited)

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

 

Q:  What dose are they?

 

Edited by ChessieCat

Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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ChessieCat

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


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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cathnz
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.

 

Untitled document.docx

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ChessieCat
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


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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ChessieCat

@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.


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

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Laurenjade08
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.

 


Citalopram 2014 - came off after 1 week

sertraline 2015 - came off 4 days

Fluoxetine November-dec 2018 - came off after 24 days due to severe side effects

started mirt 20th December 18 (15mg)

30mg for ONLY 3 days Jan 17-20th 

15mg again 20th jan - 7th feb

22.5mg 7th Feb- 21st feb

15mg 21st Feb - 4th March

4th March reinstated to 22.5mg.

drops from 22.5mg - 

20.3mg(2%), 19.9mg(2%), 19.5mg(2%), 19.1mg(2%), 18.8mg(2%), 18.5mg(2%), 17.9mg(3%), 17.4mg (09.08.2019 - 3%), 16.9mg (16.08.2018 - 3%), 16.4 (30.08.2019 - 3%), 15mg (06.09.2019 - 9%) holding steady until start Nov. Got down to 10mg 25th July, since then updosed to 12mg, been suffering. 

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greyed

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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DataGuy
Posted (edited)

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)

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

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

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greyed

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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