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EveWill: Tapering Mirtazapine, have excessive daytime drowsiness daily


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Hi Everyone I’ve been tapering Mirtazapine for 2 years, currently on 3.3mg. I have a continued issue with excessive daytime drowsiness, just feel like I’m on a sleeping pill all the time. This is the biggest and worst side effect, others include concentration issues and periods of excessive fatigue. My questions is there any hope the drowsiness will improve at some point, it makes me feel quite desperate at times as I can only taper slowly otherwise I encounter even more suffering.

 

Medication history

Aug 2019 20mg Citalopram for 5 weeks, came off CT experienced WD

had no idea what was happening to me.

Oct 2019 prescribed 15mg of Mirtazapine after 2 weeks upped to 30mg. Began tapering in March 2020

30-22.5 April 2020

20mg May 2020

18.5 June 2020

Then did larger drops of 12-14% per month until October 2020.

Resumed 10% drops reaching 7.5mg in December 2020.

Throughout 2021 % drops from 10% down to 5% reaching 3.75mg Dec 2021. Drops now down to 3% and currently holding at 3.3mg after a cascade effect of WD. Gradually stabilising and planning now to do longer holds between drops.

Edited by EveWill
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  • ChessieCat changed the title to EveWill: Tapering Mirtazapine, have excessive daytime drowsiness daily
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Dear @EveWill

welcome to Surviving Antidepressants. 

Can you please help us advise you better by filling in your drug signature? Please add all drugs, supplements and psychoactive substances. 

How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

It is a good idea to stop tapering for a while, as you have mentioned to allow your body to catch up with all the changes. The lower doses get more and more difficult. A long hold might help you get back your footing. 

 

What time are you taking your mirtazapine? Will moving it to the evening help with the drowsiness and fatigue(is there fatigue as well or just drowsiness?). How is your sleep? Have you ruled out biological causes for the drowsiness - anemia, thyroid issues etc. It might be worth getting a check up. 

 

Let us know how you are feeling - what are your current symptoms? How are they distributed around during the day? 
OMW

 

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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Hello Evewill. I too am tapering Mirtazapine. My dose now is 3.6 mg and I have daytime drowsiness and excessive fatigue as I've lowered my dose. I  think it's pretty common but will subside at some point. It might be when we are off completely so my plan is to just keep going. I was just reading some posts from a lady tapering Mirt and she said the daytime drowsiness abated after she was off along with other stuff. I'm able to drink an extra cup of coffee in the afternoon and I try to nap when I get really tired. Sometimes I am able to nod off or at least I rest some. Marie.

10/13--10/14 Ambien. Started tapering 1/14  Jumped 10/14.  Done.                                                                              

3/14        7.5 Remeron  still taking this.                              

2/14         75 Trazodone   -    Tapered by dry cutting all the way down.

1/16        4 mg Trazodone  -  Jumped. Bad mistake. Got hit with late withdrawal 6 weeks later. Reinstated.

4/16        Reinstated 1 mg, updose to 2 mg Trazodone

2/19        .04 Trazodone. Walked off.  Done.

10/3/19  Started 7.5 Mirtazapine taper cut to .073 gram weight, pill weighs .076

4/5/20    New Mirtazapine Taper - Compound Liquid 7.35 mg April '20, 7.25 mg May, 7.05 mg June, 6.99 mg June, 6.78 mg July, 6.57 mg Aug, Sept 6.35 mg, Sept 6.24 mg, Sept 6.21 mg, Oct 5.99 mg, Oct 5.90 mg, Oct 5.70 mg.

1/11/21 6.05 mg Messed up taper due to syringe change. Must remember the 1 ml syringe contains 1.5mg! 1/16/21 5.99 mg

2/21 5.75 mg, 3/21 5.6 mg, 4/7 5.45, 4/14 5.30, 5/12 5.15, 5/25/21 4.99 mg, 6/29 4.87 mg, 7/14/21 4.74 mg, 8/5 4.62 mg 8/17 4.5 mg, 8/30 4.38 mg,9/16 4.26 mg,10/9 4.14 mg, 10/23 4.05 mg, 11/6 3.96 mg,11/17 3.87mg.***Jan 22 Liquid was changed/couldn't tolerate***Changed back to pills. Feb 22/3.9 mg, 2/17/22 3.8 mg, 3/23 3.7 mg, 4/7 3.6 mg, 5/10 3.5mg,6/10/22 3.4 mg

 

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Thanks for response I’m sorry you’re suffering this way too. Have you suffered like this all the way through too? I really can’t bear the thought of this lasting until I get off, my taper has become really slow and at 3.3mg now it could take me another 4 years from here to get off. The drowsiness has been so bad I can’t do more than a 15min trip in the car and wake up every morning feeling so drugged 😥. May I ask how long you’ve been tapering?

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Hey @EveWill, I'm also tapering mirtazapine after 18 years on it. I too know the drowsy/lethargic/fatigued daytime feeling, and I absolutely hate it. I also had it on the full dose. I only know one tricks to make it sort go away: Every evening I plan a kickstarter activity for next day. This morning I washed floors 0530 here in Denmark. For me it is important it is a sort of a braindead physical activity: Cleaning is perfect. On the plus side: After a week and for the entirety of your withdrawal period your home will be spotless. When it comes to withdrawing from mirtazapine my experience is that forced physical activity is a good thing. Btw: I am new here but I have written with several of SA mirtazapine folks and they are so nice helpful people. Check out @Gigi68, I found her introduction yesterday, and she is on a dose a little lower than you, write wonderful detailed posts about her fight, and generally doing better the lower she gets. 

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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6 hours ago, EveWill said:

Thanks for response I’m sorry you’re suffering this way too. Have you suffered like this all the way through too? I really can’t bear the thought of this lasting until I get off, my taper has become really slow and at 3.3mg now it could take me another 4 years from here to get off. The drowsiness has been so bad I can’t do more than a 15min trip in the car and wake up every morning feeling so drugged 😥. May I ask how long you’ve been tapering?

I have been tapering two years from 7.5 mg. I had to stall my taper a few times though. Once was when I made mistakes on a syringe, another when they pharmacy changed the formulation of my liquid med, and when I held a couple months due to a big vacation coming up. I am on 3.5 mg now (not 3.6).

Try not to think of how long but see yourself as getting healthier as you knock those dose numbers lower. I just think about getting to the 2's, after that I'll think about getting to the 1's, etc. These are my small goals and when I meet them I am happy.

 

I know the drugged feeling and I hate it. That's why I'm getting off!. I remember when I first started taking Mirt I felt so drowsy for the first two weeks. This reminds me of that. Makes sense so tired when starting, and so tired when going off. I have been tapering slow too. I'm knocking off .1 mg every 4 weeks or so. We're both getting fatigue at a similar dose so I guess this is what it takes to get off. We can do this. Marie.

10/13--10/14 Ambien. Started tapering 1/14  Jumped 10/14.  Done.                                                                              

3/14        7.5 Remeron  still taking this.                              

2/14         75 Trazodone   -    Tapered by dry cutting all the way down.

1/16        4 mg Trazodone  -  Jumped. Bad mistake. Got hit with late withdrawal 6 weeks later. Reinstated.

4/16        Reinstated 1 mg, updose to 2 mg Trazodone

2/19        .04 Trazodone. Walked off.  Done.

10/3/19  Started 7.5 Mirtazapine taper cut to .073 gram weight, pill weighs .076

4/5/20    New Mirtazapine Taper - Compound Liquid 7.35 mg April '20, 7.25 mg May, 7.05 mg June, 6.99 mg June, 6.78 mg July, 6.57 mg Aug, Sept 6.35 mg, Sept 6.24 mg, Sept 6.21 mg, Oct 5.99 mg, Oct 5.90 mg, Oct 5.70 mg.

1/11/21 6.05 mg Messed up taper due to syringe change. Must remember the 1 ml syringe contains 1.5mg! 1/16/21 5.99 mg

2/21 5.75 mg, 3/21 5.6 mg, 4/7 5.45, 4/14 5.30, 5/12 5.15, 5/25/21 4.99 mg, 6/29 4.87 mg, 7/14/21 4.74 mg, 8/5 4.62 mg 8/17 4.5 mg, 8/30 4.38 mg,9/16 4.26 mg,10/9 4.14 mg, 10/23 4.05 mg, 11/6 3.96 mg,11/17 3.87mg.***Jan 22 Liquid was changed/couldn't tolerate***Changed back to pills. Feb 22/3.9 mg, 2/17/22 3.8 mg, 3/23 3.7 mg, 4/7 3.6 mg, 5/10 3.5mg,6/10/22 3.4 mg

 

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