StillChill: Olanzapine 2.5mg and Mirtazapine 22.5mg

[StillChill]

After three years of sobriety from alcohol, I had a two day relapse of moderate/minimal drinking. This may have started my minor “kindled” withdrawal, that slowly deteriorated my sleep. A month later I was at the hospital because I hadn’t slept in days, was extremely anxious, and had a tremor that I wanted to check out. 
 

I ended up being given Zyprexa/Olanzapine 5mg and sent home to eventually see my psychiatrist. Days later my psychiatrist saw me and I went down to 2.5mg after being on 5 for 3 days. Took 2.5mg for 2 weeks, 1.75 for one, then stopped. Two weeks later took 2.5mg again after insomnia for 1.5 weeks slowly dosing down again to 1.75, then stopped. At the same time I started taking Mirtazapine, which helped for sleep and got me “off” olanzapine. 
 

A month later I’m struggling with sleep still, 4-5 hours a night, extremely fragmented. Not sure if this is the Zyprexa/Olanzapine WD, or Mirtazapine causing this. I DO NOT want to take Olanzapine again, really no matter what, wondering how I should go about my Mirtazapine treatment? I’m still relatively new to these drugs, been on Mirtazapine for 7 weeks, however I know if I come off this drug I won’t be able to sleep, and risk having an episode that leads me to ER and back on Olanzapine. Not sure what to do…

 

Olanzapine: 5mg 3 days

2.5mg 2 weeks, two week break, 1 weeks 2.5, 1 week 1.75mg. 
 

mirtazapine: 22.5 mg current.
started m: 7.5mg for 2 weeks, 15mg 2 weeks, 22.5mg 3 weeks. 

Edited March 15, 2023 by Gridley

[Gridley]

Welcome to SA, StillChill.  Thanks for completing your signature.  It's very good you came to us before starting your taper.

 

We're a site for tapering off psychiatric drugs and can help you get off the Mirtazapine.  The issue of an episode caused by lack of sleep is beyond our scope, though we can make non-drug suggestions to help with sleep.

 

Are you have other symptoms other than sleep problems following the discontinuation of Olanzapine?

 

As with other psychiatric drugs, we recommend tapering Mirtazapine by no more than 10% of your current dose every four weeks.  I want to prepare you for the fact that this safe taper will take a while, longer than you've been on the drug.  This is a common occurrence.  

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Mirtazapine, including how to get the nonstandard doses needed for a 10% taper.

 

 

Tips for tapering off mirtazapine (Remeron)

 

Here are some sleep tips.

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Tricks and tips to fall asleep faster

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.

 

 Melatonin for sleep   

 

It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

[StillChill]

Thank you @Gridley, I recent read a post from @Mcat and their story is very similar to mine, minus the benzos but I have a history of alcohol withdrawal and likely kindled my nervous system into a imbalance/sensitivity. 
 

I’m currently wondering if I should stay at 22.5 for a while and stabilize at this proper dosage, before going down? I’m only 3 weeks into this dosage. I also have been hand splitting the pills, and am going to get a scale to do so more accurately, and stabilize? 
 

I’m unsure if the olanzapine is causing WD symptoms, or if it’s just the Mirt mixed with lack of sleep. While I was on the Olanzapine I was completely incapable of coping, extreme anxiety all day, and couldn’t think straight at all. 
 

My PDoc precise the Olanzapine after the ER, and she says I can take it “as needed for insomnia.” Which I feel like it’s wrong to do that, so when I was taking it off and on for the short time, it was wreaking havoc. It’s been over a month since I’ve taken any, and I have been off and on as far as symptoms. 

[Gridley]

52 minutes ago, StillChill said:

’m currently wondering if I should stay at 22.5 for a while and stabilize at this proper dosage, before going down? I’m only 3 weeks into this dosage.

The would be a good idea, especially since you can't tell the source of your WD symptoms.  It's a big help to start a taper from a stable state.

 

52 minutes ago, StillChill said:

I also have been hand splitting the pills, and am going to get a scale to do so more accurately, and stabilize? 

That also would be excellent.  There really is no way you can get an accurate and consistent dose splitting pills going all the way down from 22.5.  Many members use the Smart Weigh Gem20 scale, available on Amazon. 

 

 

 

[StillChill]

Thank you @Gridley I ordered the scale to get started on that. 
 

Would it be at all wise to start my dose with the scale with a direct 10% cut when it arrives, since my dose hasn’t been super accurate since I have been at 22.5? Maybe make the 10% cut to 20mg right away, and stabilize there? 

[Mcat]

Hey, me again, this is something important that few medical professionals seem to understand about Mirt: up to 15mg is sedating and helps sleep - beyond that, it can have the opposite effect. So, whoever advised you to go beyond 15 if sleep was/is your primary issue did you a great disservice. I know that doesn't help solve the dilemma of where you are currently, but it's important info. 

[Gridley]

15 minutes ago, StillChill said:

Would it be at all wise to start my dose with the scale with a direct 10% cut when it arrives, since my dose hasn’t been super accurate since I have been at 22.5? Maybe make the 10% cut to 20mg right away, and stabilize there? 

I'd stay with the 22.5mg.  I'd use the scale to get an accurate 22.5 and hold there to stabilize. 

[StillChill]

11 minutes ago, Mcat said:

Hey, me again, this is something important that few medical professionals seem to understand about Mirt: up to 15mg is sedating and helps sleep - beyond that, it can have the opposite effect. So, whoever advised you to go beyond 15 if sleep was/is your primary issue did you a great disservice. I know that doesn't help solve the dilemma of where you are currently, but it's important info. 

@Mcat

I was aware of that, said that to my psychiatrist and she said that it will still be sedating still up to 30mg, but lower than 30mg it isn’t therapeutic for depression. 
 

My sleep hasn’t changed much from the transition from 15-22.5, I still fall asleep okay at around 11-12 but wake up at 4-5 every morning. This is why I feel like I can drop down to 15mg okay, still slowly, but won’t experience much in between. 

[StillChill]

@Gridley

1 hour ago, Gridley said:

I'd stay with the 22.5mg.  I'd use the scale to get an accurate 22.5 and hold there to stabilize. 

I also should add, I have a prescription for Hydroxyzine. I’ve only used it 3-4 times. Was givin it at the beginning of my insomnia phase. 
 

would it be I’ll advised to take that ever? Like if it was between that and reinstating Olanzapine, should I try the Hydroxyzine first? 

[Gridley]

5 hours ago, StillChill said:

 

would it be I’ll advised to take that ever? Like if it was between that and reinstating Olanzapine, should I try the Hydroxyzine first? 

Definitely the hydroxyzine instead of the Olanzapine.  I'd advise you use the hydroxyzine as little as possible.  I know from my own experience that it's a slippery slope with sleep aids, so great is the desire for sleep.  The problem with antihistamines for sleep is that if you use them too much, they can turn paradoxical (cause you to stay awake).

[StillChill]

6 hours ago, Gridley said:

The problem with antihistamines for sleep is that if you use them too much, they can turn paradoxical (cause you to stay awake).

@Gridley
Isn’t Mirtazapine in low dose just acting as an antihistamine? Won’t long tapering through low dose assure that will happen? 

[Gridley]

 

@StillChill

 

I'm not an expert on Mirtazapine.  According to this source, Mirtazapine at low doses has more of an effect on histamine receptors--but that doesn't mean it still doesn't have an effect on the other two receptors. How much?  Unknown, as are so many things about these powerful drugs.  This means a slow taper is still necessary.  

Why Do Lower Doses of Mirtazapine Cause More Sedation?

Mirtazapine acts mainly on 3 receptors: histaminergic, noradrenergic, and serotonergic receptors. However, at low doses (e.g. - 7.5 mg), mirtazapine has a higher affinity to (and thus preferentially blocks) the histamine-1 receptor, compared to the other 2 receptors.^[

 

 

 

 

 

 

 

 

 

 

 

 

4 minutes ago, StillChill said:

 

 

[StillChill]

@Gridley

 

Im haven’t really ever “stabilized” on any of these meds. Still experiencing insomnia, like the drug is the only thing controlling sleep at all. Wide awake at 4:30 every morning, 4-5 hours of sleep. Experiencing the common jolts and twitches in the morning and severe depression upon waking. So I’m not sure what to look for as far as “stabilizing” not sure if this is from the Mirt I’m in that relatively new, or from the Olanzapine WD that I was on for a few weeks. The Olanzapine was absolute misery though, and there really is no way I can reinstate that as a good idea, only minimal and shortly helped with sleep. 
 

Q: What should I look for to begin my Mirt tapper, and if the side effects are from the Mirt, a rapid Tapper would still be ill advised? 

[StillChill]

@Gridley

 

Im haven’t really ever “stabilized” on any of these meds. Still experiencing insomnia, like the drug is the only thing controlling sleep at all. Wide awake at 4:30 every morning, 4-5 hours of sleep. Experiencing the common jolts and twitches in the morning and severe depression upon waking. So I’m not sure what to look for as far as “stabilizing” not sure if this is from the Mirt I’m in that relatively new, or from the Olanzapine WD that I was on for a few weeks. The Olanzapine was absolute misery though, and there really is no way I can reinstate that as a good idea, only minimal and shortly helped with sleep. 
 

Q: What should I look for to begin my Mirt tapper, and if the side effects are from the Mirt, a rapid Tapper would still be ill advised?

 

Q: I’m also now concerned snider if that I may have a paradoxical affect from the antihistamine properties of the drug. It could have led to my initial bout of insomnia, because before everything I was prescribed Hydroxyzine, before that I was occasionally trying benedryl, I may have been harming my sleep without knowing… 

[Gridley]

52 minutes ago, StillChill said:

What should I look for to begin my Mirt tapper

The usual definition we use for "stability" is that your symptoms are more or less the same each day without wild swings.  As you said, because of the Olanzapine it's going to be impossible to tell what's causing what in your symptoms.  In terms of start date for your taper, it's going to be a matter of informed guesswork.  I suggested waiting a couple of weeks after you start using the scale so you'd at least be starting with a base of a consistent dose.   

 

1 hour ago, StillChill said:

if the side effects are from the Mirt, a rapid Tapper would still be ill advised?

It's going to be a question of balance.  The following quote from Why taper by 10% of my dosage? is about this question.

 

2) If you are suffering adverse drug effects, you may wish to taper faster, such as 10% every 3 or 2 weeks, but you need to balance the adverse drug effects vs risk of withdrawal if you taper too fast. You can have both adverse drug effects AND withdrawal symptoms, which you will not like.

 

The thing is, you don't know if you're experiencing side effects from the Mirt or not, just like you don't know if you're experiencing a paradoxical reaction.  We are in the realm of total guesswork and have to make the best guess possible, staying calm, not rushing into anything and weighing the balances. Which is going to be worse, side effects or withdrawal?  With withdrawal, if you go too fast you destabilize and it takes a good bit of time to get back on track.  So you want to avoid that.  Side effects lessen with lower doses.  So you want to achieve that.  The two are in conflict.  Then there's the possible paradoxical effect situation that I known you're concerned about.  Are you having a paradoxical effect?  Unknown.

 

At this point, since everything is unknown, you need to establish a baseline.  My suggestion would be to wait 2 weeks to get a consistent dose.  Then start a 10% every four week taper and see how that goes.  It's going to be step-by-step, feeling-your-way journey off the Mirt.

[StillChill]

@Gridley thank you! I appreciate the thought out response and work behind this. 
 

I really am trying my best. Exercising daily, getting out of bed even if I don’t sleep at all, staying busy, but it’s all falling down around me. I’m trying not to catastrophise, really I am. I just am pretty certain I’m kindled at this point and damned if I do damned if I don’t.

 

I made a few big mistakes in the last months trying to ease stress and sleep, being convinced I was suffering Major Depression and possibly even bipolar, but I’m neither now, and I unleashed potent drugs on my CNS that I already compromised years ago with heavy drinking, and then CT WD from alcohol, and after 3 years of sobriety I went and undid all that work.   

[StillChill]

I also need to add supplement to my signature but don’t know how. 
 

magnesium threonate: 432mg 

melotinin: 2mg 

l-theanine: 200mg 

valerian root: 400mg off and on but stopped taking to try and stabilize. 

[Faure]

49 minutes ago, StillChill said:

Exercising daily, getting out of bed even if I don’t sleep at all, staying busy, but it’s all falling down around me.

Hi, sorry to see you are not doing well. Be very careful of exercise. It can cause you to feel worse, especially vigorous exercise. It is best to do gentle walking. Your body is going through a lot, it is stressed and tired and you need to give it rest. 
 

The best things to do are to take it as easy as you can and keep your drug regime consistent and stable.  This gives you the best chance of stabilising. 
 

SA does not recommend many supplements as they can also upset you. The only two are fish oil and the other is magnesium.  It’s a good idea to to start one at a time and at a low dose to check you will be ok with them. 
 

You can update your signature here. 

[StillChill]

@Faure

 

i know supplement are not recommended, but if I’m already taking them, I should maintain, right? To not disturb anything? 
 

I’ve been taking the mag and theanine for years. Melatonin and Valerian root has been off and on for only the last few weeks. I understand that is not ideal, but what’s done is done and I was trying to use anything that was not Olanzapine. 

[Gridley]

52 minutes ago, StillChill said:

I also need to add supplement to my signature but don’t know how. 

Use this link and press "save."

 

Account Settings – Create or Edit a signature.

 

1 hour ago, StillChill said:

 

I made a few big mistakes in the last months

All of here have.  I know I have, big time.  I hope you won't kick yourself.  You didn't undo all the work--you're off the alcohol and you've been sober for 3 years.  That's a reality that shouldn't be forgotten or discounted; it's a massive achievement.  Two steps forward, one step back may be a cliche but it's true.  So now you begin to step forward again to get off the Mirtazapine.

[StillChill]

1 hour ago, Faure said:

The best things to do are to take it as easy as you can and keep your drug regime consistent and stable. This gives you the best chance of stabilising. 
 

The trouble here is stabilizing, I haven’t been stable on these drugs at all, was told to wait out the side effects, and they have only mutated into worse side effects. So I’m trying to look for what that stability would be, and from reading through the threads, that’s what a lot of us struggle with. I want to keep it consistent, but I already haven’t done that, so I’m just having a hard time making decisions about what is best to do… do I implement all the supplements I was using and stay with that rn, or remove what is not recommended?  
 

There are so many variable, I wish I never took any pills at all, none, but I have. So now I just have to guess at what’s right, and so far that hasn’t benefited me too much. 
 

 

[Mcat]

@StillChill if I were you, I'd be cutting that l-theanine out. I tried a 200mg dose a couple of weeks ago when I was on struggle street with sleep and anxiety, hoping it would help, and I'm pretty sure it had a paradoxical effect (and also gave me a headache and the runs) - I think because this is a pretty high dose to start off on and I'm kindled. I'll come back to down the track at some point, but much more carefully (way lower dose). The magnesium and melatonin sound pretty safe, but I'd probably lose the Valerian in your shoes as well; that's another I tried a while back when in WD insomnia, and I'm not sure how much it helped and might have just complicated things (it, too, can have a paradoxical effect). I ended up coming to the conclusion that simplifying is the best strategy, and only using supplements I feel sure are safe and helping, and I feel better for it. I also became aware that the constant scrambling to add more things in the mix and try this and that was both born of and feeding into sleep anxiety, which is also part of the picture for those of us who suffer bad insomnia or very patchy/unreliable sleep. It's soooo hard not to flip into that, and I still have some, but I'm trying not to feed it and let it get the upper hand. 

[StillChill]

@Gridley@Altostrata

 

I’m struggling with being so new to AD, while also withdrawing from Olanzapine. I’m having difficulty discerning if I’m developing dyskinesia, pretty sure I am, and if it’s from the Mirtazapine or withdraw from Olanz. I know there is no way of knowing, and I can just try to make the best guest, but I feel like it’s the Mirtazapine at this point, or both, but not just the Olanz. I’m concerned I may be a rapid metabolizer, and these drugs have extra problems with me. 
 

this is how my typical day works out now:

 

Morning: wake up between 4-5:30 in the morning with horrible depression, severely awful thoughts that are obsessive and tormenting. Physical anxiety sets in by 6:30, usually able to calm down between 7-8:00, almost fall back asleep but experience jerks and jolts that wake me and release surges of cortisol. 8-9 I reluctantly get out of bed…

 

Noon-afternoon: force myself to be active, so work, exercise, walk, call friends, drive around. I’m extremely exhausted during this time. Worst part is I start to have tics and twitches. My eyes will dart, fingers have pulses or charges that cause movement, teeth and jaw feels tight and “electric,” I’m super sensitive to motion and movement. This scars the s*** out of me multiple times but I calm myself down. 
 

evening: I start to feel somewhat myself again, the tics and jumps come and go, but my mood is getting better, I get a new revived sense of hope. I eat dinner 7:00-8:00. Take supplements(Mag, L-Theanine, melatonin. 8:45) Go for a walk, talk on the phone. 

 

Night: 9:15 take 22.5 mg Mirt before bed that I weigh on the scale, I’ve also noticed not all pills weigh the EXACT same, or my scale is broken although it’s brand new. After I take my meds I brush teeth and do other nightly chores. Meditate outside for 15 minutes. In bed by 10:00. Usually fall asleep between 11-12:00. 4-6 hours of sleep. 
 

wake up feeling horrible all over again. 

I get so scared because this has always been a big fear of mine, and it’s happening to me. I see homeless people on the streets, and I’ve always empathized with them. No I see them and they often exhibit signs of medication side effects. The same jolts I have. The same tics and twitches. Why did I ever take these drugs, or any substances. Why couldn’t I just live life the way it was intended. I gave into fear and stress, leading me straight down the path that I feared most. 

 

[Mcat]

I relate to all those regrets and all the jerks/twitches/sensitivities, and I'm only on low-dose Mirt. I know for sure it's the drug (made worse by stress/anxiety). I expect you'll see a reduction in all that as you bring the Mirt dose down - but that doesn't help you cope with how it is now. Hang in there.

[StillChill]

I’ve found myself into another pickle, constant decisions to be made that have life-long implications…

 

I had a visit with my psyche, told her that I’m still only sleeping 4-5 hours at best, last night I think I only got 3 hours. She added gabapentin to my prescription to try to combat the jolts/jerks, and told me to continue on Mirtazapine 22.5 for another 2 weeks and see if anything subsides, if not she will recommend tapering and discontinue Mirt, but at a much quicker rate than recommended here…

 

I need to still be able to get the meds from her, so I need to either try to say I want to go super slow, lie and say it’s going good to get the same dose, or go along with the fast tapper because I’m getting side effects like TD, anhedonia, DDR, jolts, Akathisia, and more. 
 

I can’t deny the side effects, they aren’t getting better and I’m not stabilizing. My only option may be to quickly tapper, and then take the gabapentin on the way down so that I can sleep avoid SOME symptoms.
 

My CNS has to be super sensitized rn, but it won’t stabilize with drugs in me it seems like. I feel obsessive and almost crazy. I wake up so filled with anxiety I think I’m going to go crazy. I’m at a loss of what to do and could use any guidance at all. 

[StillChill]

I’m also very concerned that if I keep sleeping this little, I am going to go truly psychotic and end up in the hospital on more/worse meds… does anyone have experience here in the sleep department, and what point I should consider the Gaba for sleep to avoid going back on AP’s? 

[Faure]

Quote

do I implement all the supplements I was using and stay with that rn, or remove what is not recommended?  

I’m afraid I’ll have to leave it to mods to advise you about supplements. They may say to reduce them slowly….I think I may have seen 25% reductions suggested but I don’t know for sure. @Gridley?

[Altostrata]

Hello, @StillChill

 

Your history indicates it's unlikely you have withdrawal from going off Zyprexa, you were taking it for less than 2 weeks.

 

It seems to me that you upset your nervous system with re-introduction of alcohol and maybe experiments with Zyprexa and trazodone, etc.

 

On 3/15/2023 at 12:16 PM, StillChill said:

A month later I’m struggling with sleep still, 4-5 hours a night, extremely fragmented.

 

In terms of what we deal with here, which is withdrawal syndromes, 4-5 hours a night is not bad.

 

As I understand it, you are under the active care of a psychiatrist who is attempting to fine-tune your mirtazapine dosing for sleep or whatever. We do not offer peer support for treating insomnia or psychiatric drug maintenance, that is what you pay your doctor for.

 

A word to the wise: Sometimes you should quit when you're ahead. If a very little bit of a drug gives you a little bit of sleep, more is not necessarily better. You need to give your nervous system time to settle down, not pound it with drug changes. Most likely, you had success with 7.5mg mirtazapine but the higher dosing is too much and you're having a paradoxical reaction.

 

Please let us know if you want to taper off a psychiatric drug.

[Mcat]

I really feel for you in this dilemma, and I've also tossed up whether it's best in my case to come down faster using other meds (because of the jerks and the way Mirt seems to affect my already kindled CNS), but my dose and sufferings are less so I'm hanging in there hoping to stabilise and reduce slowly when the time is right. The 10% or less taper is the way to go, but for those getting intolerable side effects, it might not always be possible. I've hung in because I'm scared of the unknowables, e.g., will I sleep at all if I come off the Mirt fast? Will other drugs do anything to help or just create a bigger mess? As others have said, it's a matter of looking at the balance and going for the lesser of evils - except the problem is you can't know what happens if you come off fast. I think if I were in your shoes I'd probably reduce faster to a certain point, e.g., go down 15mg, using another med for sleep/jerks, and then try to stabilise on the Mirt on that dose for a slower taper. For me, 15mg still gives me notable jerks, 7.5 less so (as long as I don't stress too much; anxiety ramps them up) - it does seem to be dose dependent to a degree. But don't do that just because I say I would (I can't know for sure what I'd do and we each have to make our own lonely decisions in the end and live with the consequences). I so hope the right way forward reveals itself to you.

[Mcat]

PS: I agree with Alto that you are likely suffering (like me) because of bad advice to increase Mirt dose above 7.5. I get the feeling we have similar nervous systems - I simply cannot handle anything about 7.5. The noradrenaline stimulation messes me right up. 

[StillChill]

17 minutes ago, Altostrata said:

 

A word to the wise: Sometimes you should quit when you're ahead. If a very little bit of a drug gives you a little bit of sleep, more is not necessarily better. You need to give your nervous system time to settle down, not pound it with drug changes. Most likely, you had success with 7.5mg mirtazapine but the higher dosing is too much and you're having a paradoxical reaction.

 

Please let us know if you want to taper off a psychiatric drug.

@Altostrata

yes I would like to tapper, and also thank you for your help and creating this community. 
 

I think everything you said is correct, and it puts me in a very uncomfortable dilemma…maybe even unfixable. 
 

anyway, I wonder if I should tapper down quickly, 20mg>17.5>15mg and put myself in the more sedating dosage? 10% per week instead of 3-4 weeks.
 

rn I’m not sleeping well, I feel dreadful in the morning, have brief windows, and felt better(not good) at the lower dosage. 

 

thanks again for your help! 

[StillChill]

25 minutes ago, Mcat said:

I so hope the right way forward reveals itself to you.

Thanks for this part! It’s weirdly encouraging! 
 

They are for sure lonely decisions, and I’ve been making them since the start of this, and they all seem wrong in hindsight, but there is no way to know really. I was suppose to go up to 30mg, but I can’t imagine being any higher than this. 
 

I’m afraid the jerks/jolts are going to become worse as I taper down though. I do think it’s a symptom of kindled WD more than anything. You and I both get em probably because of a history of WD, and also our dosing is slightly inconsistent. If I drop my dose, they may come back, in which case I might be forced to try a Gabapentenoid and see if they reduce the jolts, which might lead to more symptoms I’m chasing away, but I dunno what other options I have… 

[Altostrata]

How long have you been taking 22.5mg mirtazapine?

[StillChill]

3 minutes ago, Altostrata said:

How long have you been taking 22.5mg mirtazapine?

Started 22.5mg on February 17th. 

[Mcat]

Nope, the jerks are not just a symptom of WD/kindling for me because they started last year when I had been on this drug and was stable for months before I ever went off it. The bad thing is that they are both side effect and WD symptom for some of us, but if I was getting them bad and I was on a high dose, I'd want to reduce because at least then there's hope they would reduce at a lower dose. I know this because they stopped 6 weeks after I came off too fast a couple of months back.

[StillChill]

5 hours ago, Altostrata said:

How long have you been taking 22.5mg mirtazapine?

@Altostrata
Started 22.5mg of February 17th. 
 

**sorry, forgot to tag** 

I’m sure you’re busy with helping others and also living your own life, I mean not to be impatient or rude. So excuse me if this comes off that way.