Tips for tapering off mirtazapine (Remeron)

[ChessieCat]

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.

 

[Nomansland]

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...).

[kate1385]

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! 

[bubbles]

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.

 

[Dhenchey]

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

 

[ChessieCat]

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:

 

 

[Altostrata]

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.

[PortugueseSea]

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!

[Altostrata]

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

 

[Docc]

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 June 18, 2022 by ChessieCat
added topic title before merging with existing topic

[Mirtazapine20mg]

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. 

[Altostrata]

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. 

[pinkfairy]

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.

[Altostrata]

@brassmonkey can you assist?

[brassmonkey]

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?

[Jools44]

Hi all,

 

I am needing to move from using a liquid prep of mirtazepine to the tablet form.

 

I am looking at making my own liquid at home. Initially I am happy to make up the dose every day as I find the liquid prep I’ve been supplied isn’t that stable.

 

I will be starting at 15 mgs.

 

My question is can I just use water to make a liquid from the tablet if I’m making it every day (so not requiring storage) or is it necessary to use a suspension? The brand I will be using is Remeron.

 

TIA

[pinkfairy]

On 6/29/2022 at 7:56 PM, Altostrata said:

@brassmonkey can you assist?

Thank you Altostrata.

[pinkfairy]

On 6/30/2022 at 8:52 PM, brassmonkey said:

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?

Hi Brass Monkey, thank you for your reply. I am going to go sort my signature now if i can fathom how to do it.

 

I will go do all that with the tablets now as well and i will get back to you when they are weighed out. Appreciated. 

 

Pink.

[pinkfairy]

On 6/30/2022 at 8:52 PM, brassmonkey said:

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?

I have no idea what is happening i have just updated my signature and it said saved but its not showing that it as saved.

My tablets are 15mg pills.

How do i get the average it has been that long i have actually forgot would i  weigh 10 pills separate add the overall weight then divide by 10?i had a friend skype me to help with the mirt,i cannot remember what the weight was oh man i didn't even write the answer down but i did write the answer down for what 7.5mg would weigh and that is 0.075g..

My previous dose is 6mg i crush that and re-capsulate all my tablets.

Yes that is correct the weight of the powder is 0.060g on the read out of the scales when the powder is weighed out.

I hope this helps.

 

Pink. 

[brassmonkey]

You can either weigh ten tablets individually, add them up and divide by 10, or weight ten tablets all at the same time and divide by ten. That will give the average pill weight.

 

So what is it we are trying to calculate?

[pinkfairy]

16 hours ago, brassmonkey said:

You can either weigh ten tablets individually, add them up and divide by 10, or weight ten tablets all at the same time and divide by ten. That will give the average pill weight.

 

So what is it we are trying to calculate?

To be honest i think i am replying from an old post of mine what i did. So i think i will start again and what i would like some help with if at all possible please.

I have tried to fill out my signature but for some reason it isn't allowing me to write every-thing.I am talking to Shep ,on my thread about it.

What it is i am at 0.052 of the diazepam now and all going fairly smooth, but for such along time i have had a "feeling" to stop tapering the Diazepam and switch to the Mirtazapine, so that the rest of the benzo can cushion some of the Mirt, i understand none of these drugs are easy at all.

I have read around here about tapering the Mirt,i asked Altro ages ago and she did say the Mirtazapine to taper.

I got down from 7.5mg to 6mg in 2019 by using the scale crushing and re-capsuling them.I just can't do cut and hold any more.I have tapered the benzo by micro tapering its taken me 3 years to come down from 4 mg with some really long holds in between its worked. I am literally doing 3% a month with the benzo. I would like to switch drugs.

.What are other peoples input on this when i am so low now on the benzo?

Could i taper the Mirtazapine by using part liquid for the Mirtazapine say 5 mgpw powder and 1ml liquid, so i aren't doing a full switch just a gradual one over time and then do your slide but i would only do 1% a week.None of this is set in stone for me i am just looking at the safest ways possible to slowly start reducing the Mirt.I hope this makes sense and i will look forward to peoples in-put.Thank you.

[pinkfairy]

I weighed 10 pills altogether and it came to 1.466 then i divided by 10 and it came 0.1486

 

[brassmonkey]

I see no problem with tapering using both liquid and powder. It will just be a bit more complicated. Would you be reducing the powder portion until you are just on the liquid?

 

Doing a 1% a week Brassmonkey Slide would be a very mild way to taper. A number of other members are doing 1% and it seems to be working well.

[pinkfairy]

20 hours ago, brassmonkey said:

I see no problem with tapering using both liquid and powder. It will just be a bit more complicated. Would you be reducing the powder portion until you are just on the liquid?

 

Doing a 1% a week Brassmonkey Slide would be a very mild way to taper. A number of other members are doing 1% and it seems to be working well.

Sorry for the late reply for some reason these comments keeps going into junk on my emails.

Thank you for getting back to me.

Yes i thought about doing a gradual crossover from powder to pills and yes using the powder to reduce.

Or shall i stay on the powder and do the brass monkey slide and when i hit a real low dose say maybe 2/3mg then switch over gradually with liquid.

 

I would def do 1% a week for me its listening to my body and not going past my threshold of pain, the calendar in this house went out the door in 2020 i have done a symptom based taper.

Just just trying to work out which method would suit me.If the maths is going to be easier with powder i could be swayed for that one as i wouldn't have a clue about liquids but i am always willing to learn.

[brassmonkey]

All told it will be easier to stick with just the powder and do a Brassmonkey Slide until you get to the lower doses, then change over to using liquid. The math is pretty much the same for both liquid and powder, but it gets tricky when you combine the two.

[pinkfairy]

41 minutes ago, brassmonkey said:

All told it will be easier to stick with just the powder and do a Brassmonkey Slide until you get to the lower doses, then change over to using liquid. The math is pretty much the same for both liquid and powder, but it gets tricky when you combine the two.

Thanks for being upfront and saying it gets tricky when combing the two.I will go with the Brassmonkey slide and when i get low switch to the liquid.Awesome stuff.

 

So the tablets i already crush and weigh on a scale and the weight is 0.060g but my dose is 6mg.I know you use the mgpw, mgai so to use this so as not to get confused is it 6mgai and 0.060 mgpw  have i got that correct? then to get the percent do i  put this in the calculator would it be week 1) 6 - 1%=5.94.

week 2)5.94-1%=5.88.

Week 3)5.88 -1%=5.82

week 4)5.82-1%=5.76

2 week hold.

 

Thank you.

 

[brassmonkey]

" is it 6mgai and 0.060 mgpw"   should be is it 6mgai and 60mgpw.

 

This is close, but you have the units of measurement wrong.  The 0.060 would refer to grams (0.060g) and is what you will see on the readout of the scales.  For mgpw it would be 60mgpw. Other than that, everything else is correct.

[pinkfairy]

11 hours ago, brassmonkey said:

" is it 6mgai and 0.060 mgpw"   should be is it 6mgai and 60mgpw.

 

This is close, but you have the units of measurement wrong.  The 0.060 would refer to grams (0.060g) and is what you will see on the readout of the scales.  For mgpw it would be 60mgpw. Other than that, everything else is correct.

Total progress because YESSS at getting the maths correct that is a huge win for me, for about 6 years i couldn't even comprehend any maths.None., 

I know i got it the wrong way around but oh my goodness it really goes to show how much healing as occurred and actually the extent of the injury before.It is another mile stone in the bag.

I am holding on both drugs, having a well deserved rest and starting the Mirtazapine taper in Sep, with the brassmonkey Slide.

 

Thank you very much for all your help.

[pinkfairy]

I thought i had this figured out but i am sat weighing the mirtazapine out for the nightly batch for the next 2 weeks and some-thing as just dawned on me that i would like you to clarify if you could please.

I really hope i can articulate this to get what i mean across...

Here goes...

On the scale it weighs 0.060g which would be mgpw if i am wanting 1% off 6 that would be 5.94 mgai ?but the weight of the drug can only go down on the scale say 0.059g,0.058g,0.057g and so on yes you could jump 0.059g-0.050g (don't ever do that anyone).

So when the scale is weighing 0.060g that is mgpw but my actual dose where i am at is 6mgai.?

So in September, when i weigh the dose out do i take it to 0.059g mgpw and the actual dose i take now would take would be 5.94 mgai then stay at that for a week.

 

SO the 2 week would be- 0.058g mgpw and the dose would be 5.88 mgai.

 

3 week on the scale would be -0.057g mgpw and the dose would be 5.82 mgai.

 

Week 4 the scale would be 0.056g mgpw and the dose now would be at 5.76 mgai.

 

Hold that for 2 weeks.

 

Then do the same again for the second week. 

 

Thank you.

 

 

[brassmonkey]

When the readout on the scale says 0.060g then your dose would be 6mgai.

 

When a person is working with a very small reduction, such as 1%, there is going to be "rounding error" because the scales just can't measure that small. Standard rounding procedures say to round up at 6 and down at 4. For tapering many people prefer to round up each time. This can give a slightly smaller dose sometimes, but it is the more cautious approach.

 

The numbers you posted should work fine. Just try to be as consistent as possible.

[BigCat]

@pinkfairyI dread the last few titrations and I have only just started on my journey @brassmonkey on that slider... so far, so good. 

I suspect that there is nothing that will totally remove my anxieties when the time comes.  They will pass, they will pass.  How far have you come?  I read your signature!!!  

We underestimate what we can tolerate and fear the worst!

 

[pinkfairy]

22 hours ago, brassmonkey said:

When the readout on the scale says 0.060g then your dose would be 6mgai.

 

When a person is working with a very small reduction, such as 1%, there is going to be "rounding error" because the scales just can't measure that small. Standard rounding procedures say to round up at 6 and down at 4. For tapering many people prefer to round up each time. This can give a slightly smaller dose sometimes, but it is the more cautious approach.

 

The numbers you posted should work fine. Just try to be as consistent as possible.

Just when i thought i had it sussed (puts head in hands)

 

right, that makes total sense thank you for helping and i will do for sure. I think come September i will maybe post a month of figures just so i know 100% i am getting it correct.

Thanks again.

[pinkfairy]

1 hour ago, BigCat said:

@pinkfairyI dread the last few titrations and I have only just started on my journey @brassmonkey on that slider... so far, so good. 

I suspect that there is nothing that will totally remove my anxieties when the time comes.  They will pass, they will pass.  How far have you come?  I read your signature!!!  

We underestimate what we can tolerate and fear the worst!

 

Mines more apprehension of that cage door been fully left open knowing that we are going to be leaving and exiting this coal mine after all these years of being chemically straight jacketed.

I can't wait for freedom but there is apart of me that when i get close to the end i will be like "i can't do it" but actually yes we can. Its that leap and we have to feel it in our bones that will be caught and if we aren't....we will fly.

 

You will do real good, just stay the course and keep your eyes forwards the only time i look back is to see how far i have travelled.

 

I will look forward to your success story. 

[brassmonkey]

@pinkfairy you've got it down, it's just that things can't be as exact as we want them to be. Keep things consistent in the way you do them and the little fluctuations won't cause any problems. It's not about the exactness of the dose, but rather keeping the blood serum levels in a consistent range while reducing the peak amount gradually so the body doesn't notice.

 

@BigCat if the taper is done slowly and smoothly, then the last few reductions should be a nonevent. You shouldn't even notice them.

[pinkfairy]

3 minutes ago, brassmonkey said:

@pinkfairy you've got it down, it's just that things can't be as exact as we want them to be. Keep things consistent in the way you do them and the little fluctuations won't cause any problems. It's not about the exactness of the dose, but rather keeping the blood serum levels in a consistent range while reducing the peak amount gradually so the body doesn't notice.

 

@BigCat if the taper is done slowly and smoothly, then the last few reductions should be a nonevent. You shouldn't even notice them.

Thank you, yea i get that as i have used the scale right down to 0.052mgpw and those doses are spread out 3 times so one weight is at 0.010g the other the same and the night 0.015g i will switch to liquid at some point to taper off the rest of the way but that is for a rainy day.

That is what i have done with the benzo taper and its been mostly smooth seas all the way with keeping it consistent holding as soon any symptoms appeared. I hope that this one is the same.

 

I will pick it up once i get into the swing of it i think there is apprehension there with switching from one taper to another and wondering what the pattern will be like for this drug. I wont know until i set sail.

 

I do have one lingering fear its when i was pulled of paxil those WD didn't hit till nearly 4 month out and then all hell broke loose. So this is where the lingering fear comes in ,i think because t AD have a time lag wont it accumulate and all the little cuts will hit me that is my only concern.It didn't hit me with the benzo though, but for some reason there is more concern with the AD for me.

I have seen your success with it and plenty of others so my rational mind knows it works.

 

 

[Boges11]

Quick question….. who has tapered off Mirtazapine or knows of stories of those who have severe akathisia and tapered with it?
thank you 🙏