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Tips for tapering off mirtazapine (Remeron)


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3 hours ago, Nomansland said:

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

 

I think I have seen a post where a member put parchment paper in the bottom of the mortar/bowl.

 

Found it:

 

On 9/27/2021 at 12:08 AM, bubbles said:

I crush the tablets first and add them in powdered form. I bought a mortar and pestle especially for this purpose and I line it with baking paper (I think Americans call it parchment paper). The paper helps me to make sure get all of the powdered tablet when I transfer to the suspension bottle.

 

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Antidepressant Withdrawal Syndrome and its Management

 

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

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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

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Thank you very much for your search @ChessieCat!

 

I would like to add some more notes/experiences.

 

I did prepare two samples, one by mortar and pestle according to the formula/video (with making that slurry/paste in the mortar after grinding , grinding again and gradually adding more liquid) and one by dispersing the tablets in water first and add the suspension agent afterwards. The one prepared by grinding in the mortar was a lot finer and more homogenous. 

 

When i tried to make my own liquid with water only or with water + maple syrup mix in the past, it didn't suit me.

 

I don't know why. In the past i dispersed it in water without a mortar, for the reason of possible loss of medication. But i also tried to grind it first in the mortar and put the dry powder in the container and then tried to mix it with water or water + maple syrup. Even with a lot of shaking, some parts always seem to floated on top of the liquid and stuck together a bit. Maybe my tablets aren't suited for that.

 

So I didn't make that paste/slurry first with a tiny bit of liquid, like it is stated in the formulas/video and then add more and more liquid at the time. 

 

What i want to say is:

 

To me the step to make a paste/slurry first seems quite crucial. I think there a good reason why you find it in every suspension formula, regardless of the type of medication. From the look of it now, it doesn't seem to float on top and is even finer/more homogenous. Additionally, when you have that slurry/paste, it also helps to grind it even more (wet milling/grinding is often preferred and more efficient to dry grinding).

 

I used a glass mortar with a spout this time to clearly see if there would be a significant loss of medication by transferring the suspension over to the bottle (by washing it a few times with more suspension agent). To me it looks like almost nothing is left in the mortar when washed carefully

(also, when preparing multiple tablets the possible loss would of course get proportionally less and less).

 

I know quite some people who taper with water only or water + maple syrup (thats from the facebook group), with and without grinding in a mortar first, so i don't say it doesn't work. Maybe it was just my tablets or something else. But for me it didn't work the way i prepared the liquid in the past.

 

But now, i really think about trying to switch to liquid again in the future, these professional formulas give me more confidence (right now i always take my weighted powder in a container with water anyway, so it wouldn't be a 'real' change from dry to liquid like when you use capsules). Don't know when yet...

 

Sorry for the long text! Just want to share my thoughts and maybe it will be helpful for someone.

 

To be honest i cant imagine a pharmacist will prepare a professional suspension more carefully like we could at home with some more time (and knowing what all could get wrong if we would be careless and not consistent...).

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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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Thank you @ChessieCatand @Nomanslandfor all your helpful advice.

 

I have just had to step away from it for now though because sifting through all the info on this site and making notes on how to approach the mammoth task of tapering actually triggered a wave! A clear sign from my body that I’m not yet ready to even consider tapering just yet. 
When the time comes I will revisit your invaluable comments and no doubt have another question.
Thanks again both! 

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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On 2/25/2022 at 4:56 AM, ChessieCat said:

 

I think I have seen a post where a member put parchment paper in the bottom of the mortar/bowl.

 

Found it:

 

I will say that while I get most of the powder in this way, obviously it's not 100%. That said, I think it would be fairly consistent from batch to batch, so I'm not overly concerned. At least, I have had no issues with it. :)

 

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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  • 3 weeks later...

Can you just use water when liquid titrating remeron when it has a coating?  I tested it and it looked like it dissolved. It took extra few minutes

 

2017  started elavil 25 mg for sleep

2021.  Stopped taking snd realized I was in withdrawal

2021. Pharmacy switched generic. 
25 mg wasn’t helping for sleep

had to go up to 40 mg to stabilize for withdrawal ,  not working May 2121 rehab put me on klonipin equal to 30 mg of valium

switched to 30 mg of Valium

presently on 81/2 mg Valium and 15 mg of remeron for sleep. I’ve only been on remeron fir 4 months. I’m scared to be on it and I want to know if I can withdraw from it at same time as Valium. I’m not that stable on my dose and having bad withdrawals

May 27 2022 went up to 9 mg Valium to try to stabilize. At first It was t working. I feel a little better but still have high anxiety. Remeron not working as well ever since I went up on my dose of valium. Not sleeping well but my anxiety keeps me from feeling exhausted u til later. Then I burn out. 

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  • Moderator Emeritus
42 minutes ago, Dhenchey said:

Can you just use water when liquid titrating remeron when it has a coating?  I tested it and it looked like it dissolved. It took extra few minutes

 

 

Please carefully read ALL of Post # of this topic:

 

 

 * * * * * *   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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  • 4 weeks later...
  • Administrator
On 1/8/2022 at 11:40 AM, amjad said:

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)?

 

 

Please read the first post in this topic and Micro-taper instead of 10% or 5% decreases
 

You can taper by 10% or micro-taper, according to your preference. Usually, people micro-taper when they find tapering by 10% or 5% per month doesn't work for them because they get withdrawal symptoms from those reductions.

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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  • 1 month later...

Hello guys!

 

I really can't do the liquid as I don't trust myself to be consistent enough, plus my family would have qualms about that, don't ask. Would it be okay to use ground Mirtazapine and fill gelatin capsules with it by using a scale?

Any resources for that, I think I have read the thread well enough but still feel at a loss.

 

Thanks!

Early December 2021 - Started Metroclopramide (Anti-Emetic) nausea 30mg (10mg 3x day).

Mid December 2021 - Akathisia symptoms start; Metroclopramide gets changed to PRN, taken 5mg, first every other day, then once every 3 days.

Early March 2022 - Akathisia diagnosed; Metroclopramide stopped; started Propranolol 10mg x twice a day to no effect, Biperiden PRN (0.5mg to 1mg).

Early April 2022 - Started Tandospirone 30mg (10mg 3x day), Quetiapine 25mg (only taken once, it skyrocketed symptoms).

Mid April 2022 - Mirtazapine 7.5mg, 10 day window followed. Discontinued Propranolol.

1st of May 2022 - Akathisia symptoms continue, Mirtazapine upped to 15mg. 7 day window followed. Tandospirone cut to 2x 10mg.

20th of May 2022 - Mirtazapine cut back to 11.75mg (1/4 of a 15mg pill).

Current regimen: Mirtazapine at bedtime for akathisia/sleep/anxiety/depression, 11,75mg; Tandospirone after breakfast and lunch for anxiety, 10mg BID; Biperiden PRN 0.5mg to 1mg.

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Just added:

On 4/11/2012 at 1:07 AM, Altostrata said:

Cut up or crush tablets, weigh fragments or powder with a digital scale
In principle, this would be a more precise way of tapering than cutting up tablets:

  • Cut up or crush the tablet
  • If crushed, make sure the shell fragments are evenly distributed in the powder
  • Weigh the tablet fragments or powder for a dose with a digital scale
  • If powder, put the powder into an empty gelatin capsule to make it easier to ingest

 

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...

Mirtazapine liquid loses potency fast

 

Hello all, I’m using a pharmacy made mirtazapine liquid that can be used for a month after opening. Now I’m currently in a burnout and super sensitive to meds etc.

 

so when I open a new bottle I get energized and my head feels like I’m updosing. During the month this slowly fades and I get really tired at the end. Like withdrawal tired.  Then I open a new bottle and the Mary go around starts again.

 

anyone has similar experiences?
 

I used the liquid a while when i was healthy and noticed the tired symptom once when it was like 1 day after expiry. (Never let it expire) but now i feel the whole degrading process during the month of use.

 

thinking of going to tablets to prevent this  

 

Edited by ChessieCat
added topic title before merging with existing topic

Mirtazapine 7.5mg feb, 2013 - 12 may 2013 - cold turkey

Temazepam 20mg daily feb, 2013 - dec 2014- succes full taper

temazepam 10 mg aug - okt 2017 kindled unkowningly, poly drugged with diazepam 5mg and 7.5mg mirtazapine

diazepam 5mg 2017 - 2018 successful taper

mirtazapine 7.5 mg 2017 - 2018 successful taper, no noticeable WD symptoms during and after taper

taper regime:

7.5 - 2 mg: 0.1 mg dry cut daily

2 - 0 mg: 0.1 mg liquid cut weekly

mirtazapine 7.5mg 2020 - current. Unknowingly where kindling with a liquid solution that was expiring before it shell life (pharmacy grade)

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Hi Docc

14 minutes ago, Docc said:

so when I open a new bottle I get energized and my head feels like I’m updosing. During the month this slowly fades and I get really tired at the end. Like withdrawal tired.  Then I open a new bottle and the Mary go around starts again.

I make my own liquid from tablets and I have some observations regarding this. I have found that if I don't keep it in the fridge my reaction to it is more stable. But I am not sure if it is my imagination or not. 

2004: (apr): Citalopram 20 mg, June 60 mg., dec 20 mg

2004 (dec): Mirtazapine 15 mg.

2014 (Jun): Citalopram stop cold turkey. Began 10 mg Vortioxetine

2017: (dec): Mirtazapine 15 mg ->30 mg (after three day stint on psych ward)

2020: (aug): Vortioxetine 10 mg stopped cold turkey. 

2020 (dec): Mirtazapine 30 mg -> 15 mg (GPs instructions)

2021 (feb): Mirtazapine reinstatement 26,25 mg

2022 (Jan): Mirtazapine (5% taper): 14. Jan 24,9 mg, 6. feb 23,7 mg, 1. marts 22,5 mg, 15. marts 21,3 mg, 2. april 20 mg, 26. april 19. mg, 25. may 18.1 mg, 26 jun 17 mg

 

Have always taken fish oil capsules. Do not drink alcohol when tapering. 1 multivitamin pill a day. Try to eat healthy, but impossible on mirtazapine. Use sleep mask, helps a lot on morning dread. 

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  • Administrator
On 6/18/2022 at 7:24 AM, Docc said:

so when I open a new bottle I get energized and my head feels like I’m updosing. During the month this slowly fades and I get really tired at the end. Like withdrawal tired.  Then I open a new bottle and the Mary go around starts again.

 

As you've said in your Introductions topic that you feel better towards the end of a bottle, your body may be saying that it would prefer 7.0mg rather than the 7.5mg you've been taking.

 

Over time, our bodies change in the ways they metabolize the drug.

 

If you notice withdrawal symptoms when the bottle is 90% empty, it doesn't make any sense to continue taking doses from the bottle until your withdrawal symptoms get worse, then endure potential kindling from the stronger doses from a new bottle.

 

If I were you, I would have 1) reduced my daily dose to 7.0mg -- why take more than is necessary? 2) replaced the bottle of liquid when it was 85% empty, rather than evoke withdrawal symptoms by using the old liquid; 3) if you continue to feel better on a weaker dose towards the end of the bottle, consider tapering it. 

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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I have just read through this thread and it's highly fascinating to say the least.

 

I have held my Valium taper while I am researching and looking into the mirt taper.

 

This information is over whelming I won't lie, but I am really wanting to learn how to do this and get it absolutely correct. Then I can have the confindence and ability to move forwards in control of the taper in the future.

 

My starting dose was 7.5mg 

now I am at 6mg when the mirt is crushed it weighs 0.060grams=6mgs.

 

So how would I know the volume of water to use and how would I know what to take out etc.

 

Thanks in advance pink.

Binge drinker thru out my life 17/37,recreational use of street drugs 17-30. Numerous AD from age 23 upwards

Matazpine 30mg 2007-2012

Paxil an zopiclone 2012-2016

Taken off Paxil in four weeks in janurary 2016

Given diazepam 2-4 feb to June 2016

C/t diazepam June (had no idea not too)

Reinstated 8mg of diazepam in July,crossed over to 8mg of diazepam! given 7.5 matazpine.

Nov 2016 at 5 mg of diazepam

Given Olanzpine 2.5 November 28th-stopped

paxil 1mg 3rd of dec -stopped

Started liquid diazpam 10th of jan.alchol free 13month

February 2018 - reduced to 4 mg diazepam and 7.5 mg mirtazapine

November 2018 - tried 2% diazepam reduction - updosed back to 4 mg after one week

 

 

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@brassmonkey can you assist?

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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  • Moderator

First off, your signature is four years out of date, would you please bring it up to your current status.

 

I'm going to need some more information so we can figure out where you are and how to get where you want to go.

 

What is the strength of your tablets as listed on the bottle?

What is the average weight of 10 whole tablets?

Is your previous dose of 7.5mg a whole tablet or crushed powder that you weighed out?

The 6mg you are currently taking, is that 0.060 on the readout of the scales when you weigh the powder?

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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