mpa2020: Mirtazapine 4 months use taper

[mpa2020]

Hi everyone. I've using mirtazapine for 4 months at a relatively low dose for insomnia.

 

I started at 7.5mg in early March and since the end of March I'm at 22.5mg daily.

 

I now want to discontinue mirtazapine due to weight gain. At some point hunger at nighttime became really disruptive.

 

I've been educating myself on how to taper off. I take note of the 10 percent each 4 weeks general rule. My concern is that following this rule the taper would take close to 12 months

 

I understand it could be feasible if I experience no significant withdrawal symptoms after the first two reductions to accelerate but at a minimum it seems 2 weeks per 10 percent reduction is recommended. This would take at least 6 months

 

My concern is that the longer I take this drug the more weight gain, and perhaps the more dependent I become on it.

 

Specifically, since I've been on this drug for only 4 months if I take 6 months to taper off I'm effectively doubling the time I'm on this drug. This is especially concerning in terms of weight gain

 

I wanted to check if people's general experience with tapering from relatively short periods on a drug is that this allows to taper much faster. For example, would tapering over 2 months for a 4 months use make sense?

Edited June 20, 2021 by Gridley

[Gridley]

Welcome to SA, mpa2020.

 

To start:

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly--basically the information in your post.  You'll need to use a computer rather than a phone.

 

Account Settings – Create or Edit a signature.

 

I can see you've read our link about tapering no faster than 10% every 4 weeks, including the possibility of accelerating slightly depending on how you feel.

 

Why taper by 10% of my dosage?

 

1 hour ago, mpa2020 said:

For example, would tapering over 2 months for a 4 months use make sense?

 

It's taking a very big chance of experiencing some very unpleasant and long-lasting withdrawal symptoms.   A person is at risk of withdrawal after one month on an antidepressant and you're at four months.  About half of the people who try to discontinue suffer WD and half of those suffer severe WD.  

 

https://www.sciencedirect.com/science/article/pii/S0306460318308347?via%3Dihub

 

I know you want to be off the drug, but--speaking from personal experience and that of thousands who have written here trying to get help after a too-fast taper--withdrawal is something you want to avoid.  

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Brain Remodelling 

 

1 hour ago, mpa2020 said:

 

I've been educating myself on how to taper off. I take note of the 10 percent each 4 weeks general rule. My concern is that following this rule the taper would take close to 12 months

 

So you're operating from correct information, tapering off 22.5mg would take much longer than 12 months using the 10%/4week taper.  With that taper you reduce by half your current dose every six months.  So at 6 months into your taper you'd be at around 11mg.  At 6 more months you'd be at 5.5mg--far too high for stopping the drug.  I know it's hard to wrap one's mind around how long it takes to taper safely, but that's the unfortunate reality.  Please read the following link:

 

Cold Turkey and Too-Fast Tapers

 

The decision on how fast to taper is, of course, yours.  I hope this information is helpful to you.

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Gigi68]

Hi MPA2020, I understand your thinking that you should be able to taper off of Mirtazapine quickly since you haven’t taken it for very long. I thought the same. I only took it for 5 weeks before deciding to quit because it was making me so ill. The only dose I took was 7.5mg but I had so many horrible side effects. When I started reading about tapering and realized that this was going to be a really long process, I was devastated. I have spent a lot of time learning to accept that idea and I am doing better with it. It’s just incredible that such a short time on it can have such consequences. You may be able to come off more quickly. Some people can.

 

I learned to make homemade liquid and have now reduced to 4.88 since mid-February. My first drop was 17% and it was horrible for two weeks, then I started to feel better. I knew from that experience that I was going to have to go slow. I have been doing much smaller drops since then and experienced WD with each one. It has been uncomfortable but manageable. There is a great educational Facebook group called Mirtazapine: Support, Withdrawal, Recovery with lots of resources specific to Mirtazapine. Admins are also great. I recommend you join that group. 
 

Best of luck on your journey.  

[Faure]

Hello, I know the tapering takes ages and you want to get off mirtazepine. I have been on 15mg 2.5 years and have tried 3x to get off it. The first 2 times I did what the psychiatrist said - half dose for a week then stop. This led to severe insomnia and I could see I was headed to a bad place so reinstated immediately and was ok. The third time I reduced over several months by skipping doses. I became more and more high and crashed. I had to stop work for 4 months and suffered extreme fatigue. I was able to return to work, the pandemic hit and I’ve only been able to work 15 hours a week since because I still get abnormally tired. It also took a year for my mood to stabilise.  After 18 months on 15mg I decided to try again on the 10% reduction every 4 weeks. Brass monkey suggested the brass monkey slide which is *even* slower! I didn’t want to. But I thought about my previous attempts, the stories I read on here of how people are suffering dreadfully and decided to take his advice because I don’t want to experience horrific withdrawal.

 

So, I think it’s well worth starting the 10% reduction to avoid WD effects. You may well find you don’t experience many and you may be able to speed up and not much will be lost. If you do experience WD I expect you’ll be so happy you didn’t try to go faster! I know mirtazepine makes you want to eat, I have been lucky and only gained a small amount of weight. I am expecting once the dose is lower it will be easier to shift.

 

Wishing you the best of luck with whatever you decide ☺️