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Lala04: Mirtazapine Withdrawal

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Hello everyone, 


Looking for some support and help in identifying if what I'm feeling is prolonged withdrawal. I've been on SSRIs since I was 14 years old (I'm now 27) as I was diagnosed with anxiety & depression. I was on a variety of different meds over the years (see signature) but I never felt happy or less anxious but doctors never gave me an option to go off the meds - only increase or change them.


In 2022, I went on Mirtazapine and my symptoms got worse. I felt absolutely dreadful. I saw a new therapist and through everything we realized I had probably been misdiagnosed and I have ASD. In January 2023, I chose to go off my 30mg of Mirtazapine. My neurologist told me to taper off by dropping to 15mg for a week then stopping. About 2 days after I stopped, I had a horrible incident where I was out at a restauarnt with my friend and about 40 min after my meal, I felt really, really off and like my heart was racing and my body was pulsating.


I asked my friend if we could leave and she drove me to Walgreens to get Benadryl in case it was an allergic reaction. I began to develop a rash up my chest, neck, and face rapidly & my throat felt tight. I felt incredible panic so we called 911. They told me I was getting air and was fine. My fiance drove me to hospital and they gaslit me all the way and told me it was nothing but gave me some steroids. I was fine (super anxious & crazed but otherwise fine) for 5 days when one night I could not sleep and I had horrible heart palpitations. Went to an ER and was told I was fine. Then, 3 days later, I broke out in the rash again with the throat sensations so went back to the ER. They advised me to get an Epipen and see an allergist. I did, and he put me on an insane restrictive diet for 6 weeks where I only ate beef, rice, sweet potato, olive oil, bacon, porkchops, gluten free noodles, decaf coffee, oat milk, and sugar. During this 6 weeks, I did not have any crazy rashes (would still get redness on my chest & face but not the same extremes) but I did feel INCREDIBLY panicked, had diarrhea, and felt lots of throat sensations (which I was told was anxiety but unlike any I'd ever felt).


In February, I met with a psychiatrist who told me the episodes were most likely withdrawal but that I should go on a new antidepressant (Zoloft) & Xanax to reduce the anxiety. I listened and was okay.


On March 9th I had my skin tests for food allergies (30+ tests) and all were negative so my allergist said it was probably withdrawal. One day afterwards, I forgot my antidepressant pill (3/16). On 3/17 I took my pill. That afternoon, I began to develop the same rash across my face with throat tightness, extreme tachycardia, and a purple/grey line across my lip. I gave myself my Epipen out of fear. After that, I began having similar reactions + worse symptoms with numbness in my throat/face; tingling across my body; weird sensations that cause me to feel like I'm wet when I'm not or static across my arm or pain from nothing; EXTREME dryness of my mouth; huge pangs of fatigue; more pronounced veins in my face & chest; acne & random dark spots across my skin; burning sensations; sore throat; and muscle/bone pain.


I went to the ER several times & was hospitalized on 3/31 since they gave me benadryl, ativan, and xanax in the ER and my heart rate wouldn't go under 150 and my rash would not subside. The hospitalization was pointless but I did stop eating at that point & went back to the super restrictive diet I was on for the 6 weeks with my allergist. While I am no longer having ER level reactions, my symptoms aren't completely gone.


My mood, though, has increased significantly since being off SSRIs for good though, so that is a positive. But I'm just really frustrated. I've had a billion tests done and all are negative. I'm on 40mg of Zyrtec a day, 40mg of Pepcid, 25 mg of Hyrdoxyzine, and 10ml 4Xa day of Cromolyn and nothing seems to help. Doctors are all completely stumped and keep asking me if I'm anxious.


I'm just wondering if these symptoms sound as though it could all be from the withdrawal? Or is it something else? And do I have to only eat rice & steak for the rest of my life ??? Are there treatment options for people with extended withdrawal and what doctor could actually help? I hope you can all provide any support or knowledge you might have. I appreciate it. 

Edited by manymoretodays
just spacing for readability

2010-2020 (I'm not sure of the amounts/when I transitioned between these meds, did not take all at once - was switched around a lot by doctors)

  • Citalopram, Escitalopram, Fluoxetine, Wellbutrin

November 2020-June 2022:


June 2022 - January 2023:

15mg Mirtazipine, then 30mg in October

January 2023:

"taper" off mirtazipine under neurologist: down to 15mg for a week then off

February 2023-March 2023:

50mg sertraline 


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  • manymoretodays changed the title to Lala04: Mirtazapine Withdrawal
  • Moderator Emeritus
Posted (edited)

Hi @Lala04 Welcome to SA. I’m sorry you’ve had such severe symptoms. You’ve certainly had some serious ones. Even if all the symptoms aren’t related to withdrawals doctors sometimes can’t figure out what’s wrong with us. Been there, done that. I’ve been gaslighted by doctors so much. You did taper extremely quickly though, we recommend tapering no more than 10% of the previous dose per month, so some of the symptoms you’ve experienced can be from withdrawals. You tapered the Mirtazapine from 30mg to 15mg and then to 0mg in a month or so? That can definitely cause a myriad of symptoms. 


Check out the Symptoms and Self Care section. There are threads there such as: “ Skin issues, hives, acne, dryness, itching,” and “Irregular heartbeat, palpitations, tachycardia, bradycardia.” Tingling, numbness, burning sensations, throat problems etc can be symptoms of withdrawals too. To find things quickly you’re best to go to your own search engine, like Google, and type in survivingantidepressants and whatever symptom you want to check. 


Thanks for doing your signature, but could you please put in the other medications you were on as well. You mentioned taking Xanax in February. Are you still on Xanax?  You also mentioned you’re off SSRI’s now, when did you stop the 50 mg of Zoloft? Did you cold turkey?

Have your symptoms continued to improve a bit more since you started your diet? What symptoms do you have now? Are they severe or have they subsided a bit?


Thanks for all this info, sending hugs🤗

Edited by Carmie

Been on APs, benzos, ADs and opiates, all for chronic pain. Had severe Akathisia in the past that made me suicidal. Still on Seroquel. 2019:➡️ March10=7.25mg ✔️April17=7.0✔️June5=6.75✔️ July14=6.50✔️Aug28=6.25✔️Oct10=6.20 ✔️ Oct21=6.0✔️Dec16=5.80 ✔️  2020➡️Jan 21=5.60✔️April2=5.40✔️May29=5.20✔️Aug14= 5.0 ✔️Sep29=4.80✔️2021➡️ Jan31=4.60 mg✔️April24=4.40mg✔️Jul17=4.30mg ✔️Aug 28=4.20✔️ Oct 11=4.15✔️Nov1=4.10✔️ Nov21= 4.05✔️ Dec13= 4mg✔️  2022➡️Jan8= 3.95 Jan 31=3.90✔️March2=3.85✔️ April4=3.80✔️June16=3.75✔️July26=3.70✔️Sep2=3.65✔️ Oct21=3.60✔️Dec8=3.55✔️ 2023➡️Jan 26=3.50✔️March 17=3.45✔️ THIS IS NOT MEDICAL ADVICE, consult a doctor.

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I am suffering from Mirtazapine withdrawal now. I took only ONE dose of 15mg before developing an immediate adverse reaction and withdrawal-like symptoms.

Your symptoms of rash, closed throat and diarrhoea etc are classic symptoms of histamine overload. Mirtazapine is a potent antihistamine and it messes up your histamine receptors once you are off. Your allergist was right to keep you on a diet that is very similar to a low histamine diet. Histamines are released in the body every day for many biological functions. When your body releases more histamines that it can deal with, you need to keep the amount of histamine you ingest via food on the low side. I'm on the same diet myself to manage my symptoms.

The diet is not forever. Once your receptors heal and can release a normal amount of histamines again, you can go off the diet. This will also be the point when most of your symptoms have gone away.

Jan 29, 2023 - Took my one and only dose of Mirtazapine (15 mg)


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By the way, please stop all antihistamine medications. Your body is relearning how to release the right amount of histamine again. Such medication block up the same histamine receptors as Mirtazapine, so your body will not learn to readjust. Natural antihistamines are recommended instead, like vitamin C, stinging nettle, quercetin, tumeric, ginger etc. I learnt this from a Mirtazapine Facebook Support Group I joined.

Jan 29, 2023 - Took my one and only dose of Mirtazapine (15 mg)


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