Remeron (Mirtazapine) Withdrawal Support Group

I was in the hospital in February 2021, afterwards could not sleep.  After one month of insomnia every night went o my pcp who prescribed 7.5mg mirtazapine, early March 2021.  When I saw pcp again in early June I told him while sleep was better I could not handle the heavy daytime fatigue and brain fog.  He said we could either increase the dose to 15 and it might be less fatiguing or come off and perhaps sleep had returned.  He told me it was a low dose for a short time, 3 months, so I could just stop it.  I asked to go slower getting off so we agreed that I would go to 3/4 pill for one week, then 1/2 pill for one week, then 1/4 pill for one week, then none.  Everything went smoothly during the tapering down and I took the last dose on June 29.  On the 4th day off I started with headache, tinnitus, nausea, sweats and broken sleep.  Now on the 10th day off the nausea is getting pretty unsettling and sleep has gone from broken to close to nonexistent, was getting 5 or 6 hours and the past few nights sleep has deteriorated to maybe 2 hours.  I would hate to reinstate at this point, was trying to wait at least another week or two for improvement, any thoughts or suggestions?

I was in the hospital in February 2021, afterwards could not sleep.  After one month of insomnia every night went o my pcp who prescribed 7.5mg mirtazapine, early March 2021.  When I saw pcp again in early June I told him while sleep was better I could not handle the heavy daytime fatigue and brain fog.  He said we could either increase the dose to 15 and it might be less fatiguing or come off and perhaps sleep had returned.  He told me it was a low dose for a short time, 3 months, so I could just stop it.  I asked to go slower getting off so we agreed that I would go to 3/4 pill for one week, then 1/2 pill for one week, then 1/4 pill for one week, then none.  Everything went smoothly during the tapering down and I took the last dose on June 29.  On the 4th day off I started with headache, tinnitus, nausea, sweats and broken sleep.  Now on the 10th day off the nausea is getting pretty unsettling and sleep has gone from broken to close to nonexistent, was getting 5 or 6 hours and the past few nights sleep has deteriorated to maybe 2 hours.  I would hate to reinstate at this point, was trying to wait at least another week or two for improvement, any thoughts or suggestions?

 

A lot of the issues this drug causes seem to be caused by intolerance to things that would not have bothered us before. Mainly it seems to make us overly sensitive to the amount of histamine in our systems. Low histamine levels are good for sleep which is why antihistamines make us drowsy. You may be able to suffer through this withdrawal without reinstatement. I would try an extreme low histamine diet for a week. I would also avoid stress as that can cause mast cells to release histamine. Exercise will also increase histamine levels so you may have to temporarily avoid that as well. For example if you eat steak you are almost definitely not going to sleep a minute that night. If you choose chicken and white rice you will likely feel a little better. Spinach will keep you up but broccoli should be fine. If you do this and get at least 4 hours sleep a night then you might make it through. If it makes no difference you may want to consider reinstating and doing a taper. Honestly a three week taper is no different than cold turkey on this drug. That is not a taper at all.

Are constant heart palpitations part of this?

 

I've changed from water to half water and half maple syrup in my taper about a week ago and have been eating quite a few high histamine foods lately. Coconut, tomatoes, spices etc.

 

I can't figure out what is the cause of this of it's just anxiety and my mind has latched onto it

 

I'm noticing a bit of chest tightness, extreme head pressure pain, and acid reflux and weakness.

 

Could possibly be covid or something.

Are constant heart palpitations part of this?

 

I've changed from water to half water and half maple syrup in my taper about a week ago and have been eating quite a few high histamine foods lately. Coconut, tomatoes, spices etc.

 

I can't figure out what is the cause of this of it's just anxiety and my mind has latched onto it

 

I'm noticing a bit of chest tightness, extreme head pressure pain, and acid reflux and weakness.

 

Could possibly be covid or something.

 

When I taper too fast I get palpitations. When I came off of benzos I got them really bad. Acid reflux can cause palpitations because it irritates your esophagus and can cause esophagitis. Inflammation of the esophagus can stimulate the vagus nerve due to the proximity and trigger palpitations. Acid reflux can also trigger esophageal spasms which can feel heart related even when they are not. If I were you I would get your heart checked if you have not already and at the same time get that reflux under control because it is very likely to be the source of your chest tightness and palpitations. I have had gerd for 20 years and have been given chest tightness and palps from it plenty of times when it is not under control.

Can you tolerate magnesium? If so, buy peppermint liquid gaviscon and take four teaspoons four times per day. Take it after waking, after breakfast, after lunch and right before bed. Always drink a full glass of water before and do not drink any water for a while after. It will coat your esophagus but if you drink water afterwards it will wash it all down. I do this when I have your symptoms and usually after a few days I am back to normal. Eating bread can absorb the acid but you should use sliced manufactured bread and avoid fresh bread like Italian bread or rolls as the active yeast will just make your reflux worse. Anyway, it sounds like you have esophagitis but always have your heart checked to be sure. Liquid carafate is a great product to get it under control but it is prescription only and very expensive and most doctors are not going to prescribe it without an endoscopy.

Hello new poster here for mirtazapine. Hope everyone is doing well.

 

I have been in the process of tapering generic klonopin since basically the beginning of the year.

 

When I got down to 0.28 mg of the generic klonopin, (currently at 0.191 mg doing a DMT) my sleep really started to degrade so my primary doctor prescribed for me mirtazapine on 5/8 to help with sleep. They are 15 mg pills but I never take more than 7.5 mg a night for sleep with the generic klonopin and I also take 20 mg fast dissolve and 20 mg slow acting melatonin.

 

Definitely helps with sleep. I was really reluctant to add another drug but like many really needed sleep. I do not want to be on the mirtazapine long term either and thought about doing a DMT of that at the same time with my klonopin.

 

My thinking is maybe if I basically DMT the mirtazapine as well very slowly say 10% every 2 weeks but not sure of w/d impact. Appreciate any feedback.

 

Thx

seekingtoheal

The dance between Oxazepam (benzo common in Europe) and Mirtazapine is why I quit only temporary with benzo's. It is such a vital part of my story that I have decided to include this in my profile. That's why I started with benzo's again. That, and the fact that I wasn't aware of the right pace to taper Mirtazapine. I've copied the taperschedule from Jack37 and will taper once I am ready to do so. First, I will have to stabilize.

 

What a ride.....

 

I wish everybody a lot of healing.

The dance between Oxazepam (benzo common in Europe) and Mirtazapine is why I quit only temporary with benzo's. It is such a vital part of my story that I have decided to include this in my profile. That's why I started with benzo's again. That, and the fact that I wasn't aware of the right pace to taper Mirtazapine. I've copied the taperschedule from Jack37 and will taper once I am ready to do so. First, I will have to stabilize.

 

What a ride.....

 

I wish everybody a lot of healing.

 

Just keep in mind the holds in my taper were due to fairly intense suffering. I would modify the taper if I could do it again. There are a lot less holds at the end of my taper because I learned valuable lessons along the way. My taper is about 2 years even. The first 3/4 were a lot of too fast and then 1 month-3 month holds. Those holds were not voluntary. They sucked. Lol. I would still do the big cuts at the beginning because I think it was important to get a feel for the whole thing. However, after that I think I could have gotten through it much smoother if I spread the frequent cuts through the holds evenly then maybe the holds would not have been necessary.

For example there were times where I cut 1 mg per month for 3 months and then had to hold for 3 months while suffering. In hindsight cutting .5 mg for 6 months would have been the same thing and I assume would have felt much better. That is how I approached the end of my taper. When I started to feel symptoms I would halve my speed and have not had any significant holds since figuring that out.

Yes, I noticed this. I also notice a cut every week. I am not sure when I will start my taper, but I would have to be a lot better then now, and I would want to start my taper after winter. Also, I might do a percentage taper. I also heard that a taperstrip is better then liquid when you go to smaller dosages. But anyway, I'll first let myself stabilize. I have a lot of questions, but I am going to read this whole thread first. (that will take me probably a few weeks ) Thanx for the advice! 

Yes, I noticed this. I also notice a cut every week. I am not sure when I will start my taper, but I would have to be a lot better then now, and I would want to start my taper after winter. Also, I might do a percentage taper. I also heard that a taperstrip is better then liquid when you go to smaller dosages. But anyway, I'll first let myself stabilize. I have a lot of questions, but I am going to read this whole thread first. (that will take me probably a few weeks ) Thanx for the advice! 

 

Mathematically a taper strip would most definitely be more accurate than liquid. I don’t even know how to get it as it was a hell of job just getting someone to write me a script for a liquid compound which is a relatively common thing. I sometimes cut even twice a week but I deleted most of those entries from my signature because of character count restrictions. At least half of my taper I cut twice a week. This year I have been doing once a week. Also when it comes to accuracy at low doses the compound ratio is extremely important. Someone doing a 1mg to 1ml is going to have a much easier time being accurate than someone doing 15mg to 1ml. I went with 15mg per 5ml which would be equivalent to 1mg per 3ml. I did so to balance accuracy against the fact that liquid compounds tend to irritate my stomach. OTC liquid meds like benadryl for example always gave me gastritis like symptoms. So I had to compromise between accuracy and the physical amount of compounding solution I would be ingesting on a daily basis for years. I am happy with the compounding ratio I went with.

Jack.

 

I tapered from 15mg to 7mg over about 6 months doing 1mg cuts (psych ward) and then roughly 10-20 percent cuts. I was/still in severe benzo withdrawal and decided to hold at 7mg for 1+ year now. I am going to start tapering again.

 

Obviously, everyone is different but if you could do it again how would you approach getting off 7mg?

Does anyone else in this group deal with nocturnal emissions? I've never had this in my life before

Does anyone else in this group deal with nocturnal emissions? I've never had this in my life before

 

It is a common Remeron side effect that no one talks about. I did not have this  but had other related issues. The answer is yes. Other members have mentioned this in PM. I have spoken to others privately about these types of topics. I just never wanted to make anyone uncomfortable. I guess I am a little old school and don’t want to offend the ladies. Lol.

Mathematically a taper strip would most definitely be more accurate than liquid. I don’t even know how to get it as it was a hell of job just getting someone to write me a script for a liquid compound which is a relatively common thing.

 

Thank you for your reply! I will consider this. I guess I will do a percentage-taperstep every two weeks, but like I said, I want to get stable first. I think my familydoc will help me if I want liquid Mirtazapine, but I will have to find out. And maybe in later steps I will consider a taperingstrip. Liquid gives you more freedom to determine your taper yourself.

 

For anyone considering taperingstrips, my country has taperingstrips and I think your doctor can order them from US as well. I think they are custommade. Just google 'Regenboogapotheek' and 'english' and you will reach their english website. Or google 'taperingstrip'.

After 3 weeks off most side effects were improving but sleep had gotten almost nonexistent.  Insomnia was the reason I went on this drug and sleep had gone back to premirtazapine days.  I was falling asleep about 10 and waking at 1130 and no more sleep.  I haven’t been able to nap during the day at all, no matter how tired, since chemo days.  Last night I went back to taking 7.5 mirtazapine and slept from 11 to 4, a very good night for me.  Today I’ve been feeling some anxiety rolling in and out, could this be because I have restarted the mirtazapine and when do you think it will settle.  At this point, my plan is on trying to get back on the mirtazapine and staying on it for a while.  Any ideas how long it will take to stabilize back on the mirtazapine.

After 3 weeks off most side effects were improving but sleep had gotten almost nonexistent.  Insomnia was the reason I went on this drug and sleep had gone back to premirtazapine days.  I was falling asleep about 10 and waking at 1130 and no more sleep.  I haven’t been able to nap during the day at all, no matter how tired, since chemo days.  Last night I went back to taking 7.5 mirtazapine and slept from 11 to 4, a very good night for me.  Today I’ve been feeling some anxiety rolling in and out, could this be because I have restarted the mirtazapine and when do you think it will settle.  At this point, my plan is on trying to get back on the mirtazapine and staying on it for a while.  Any ideas how long it will take to stabilize back on the mirtazapine.

 

When I first went on it it took 6 weeks for my body to adjust. The first 2 weeks were particularly rough though. I don’t know if you experienced a long adjustment period the first time you were on it or not. However, I think it is fairly normal not to feel great right away. That being said, being that the main driver of sleep in Remeron is it’s antihistaminic properties if I were in your shoes I would try benadryl or Vistaril/Atarax for sleep first. It seems less risky to me than reinstating Remeron. Sometimes I wish I would have done that and rode out the other symptoms.

First time I went on with no noticeable side effects and started working for sleep on day 1.  Benadryl always seems to hype me up and doc said vistaril was pretty much prescription Benadryl.  I was trying to get off mirtazapine because of the day after fatigue and brain fog.  Doc thought it would pass with time but was no better after 3 months so he suggested either upping the dose to 15 to see if it was less sedating or trying to get off.  He suggested maybe trying to get off first and see what happened with the insomnia.  Not much in the way of bothersome effects while tapering off or for the first couple days off.  On day 4 off, nausea, headache, anxiety, tinnitus all started as well as sleep was starting to decline, maybe 5 hours at first.  I wanted to try to ride it out and made it 3 weeks and most symptoms had greatly subsided, except for the insomnia which worsened day by day until the last week I was down to about 90 minutes sleep per night and simply could not go on like that.  I tried trazodone after waking up after 90 minutes of sleep and some nights it would allow m to go back to sleep but never more than 2 hours with carryover fatigue next day.  Any suggestions for combating the next day fatigue and brain fog would be appreciated.

Just posting what is left of my Remeron taper in my signature before I edit it. I ran out of characters to post the rest of it. It has happened before and I cut out some of it but this time I am going to remove a lot of my cuts and get my characters down significantly. At least it will be here if I need to reference it.

 

8/21/19 started mirt taper 13.5 9/4 13.2 9/11 12.6 9/18 12 9/26 11.4

10/13 11.1 10/20 10.8

11/10 10.5 11/17 10.2 11/24 9.9

12/1 9.6 12/9 9.3 12/16 9 12/23/19 8.7

1/5/20 8.55 1/9/20 8.4 1/16 8.1 1/23 7.8 1/30 7.5 2/6 7.2 2/13 6.9 2/20 6.6 2/27 6.3 3/5 6 3/12 5.7 3/19

5.4 3/26 5.1

6/1 4.95  6/4 4.8 6/8 4.65 6/11 4.5

6/15 4.35

6/18 4.2

7/6 4.05

8/11 3.15

9/19 3

10/1 2.64

11/1 2.04

12/1 1.68

1/1 1.38

3/1 1.08

4/5 .78

6/21 .3

6/27 .24

7/4 .18

7/11 .12

7/18 .06 mg

Congratulations Jack on being a few days from the end of the Mirt taper. It's quite a feat to taper Mirt. It's just such a nasty drug. I'm stuck in a wave right now from an antibiotic but will press on at some point. I'm going slow and down to 4.74 mg.

 

Good luck for the jump! Becky

Great work Jack and good luck with your jump. You should be fine!

Ive been reading here re mirtaz taper. Ive 15mg tabs. Ive  cutting a quarter off a week now.

I have the choice of liquid 15mg is 1ml...doc says reduce by 0.1ml every week. I started opened bottle but it seems to burn my oesoph so had to discard as cant keep sfter 6 weejs open.

I have yet still to start my 0.5 clon taper using liquid (im UK)

 

I wanted to get to 7.5 mirt as well. All my back oesoph guts burn eating. I have just 5bweeks ago tapered off zipiclone after 2 half years. Gut pain worse since then. I am already in such pain eating let alone the benzo taper which most say get pain.

Is cutting a quarter off my 15mg tab ok every month and hold at 7.5 or should i revert back to liquid and rduced by 0.1ml every week like gp has said. I am scared and had horrendous pain 7 years . Sleep gives me respite

 

JUMPED!

 

Tonight I finally took my last dose. I have a little bit of benzo flu like symptoms the last couple of days or I am actually fighting something off. Not sure but I think it is from the Remeron. I am jumping anyway because there is no way I will stabilize on this .03 mg dose. It is extremely inaccurate and barely comes out of the syringe. Still was able to ride my bicycle for hours today without feeling too bad. Most of this week I was feeling great. I hope the withdrawal symptoms are not too bad now that I officially jumped. Fingers crossed. I am definitely scared but very glad to be done tapering.

FINALLY! It’s been way too long. I’ll keep everyone posted on how I am doing.

 

Jack

Just posting what is left of my Remeron taper in my signature before I edit it. I ran out of characters to post the rest of it. It has happened before and I cut out some of it but this time I am going to remove a lot of my cuts and get my characters down significantly. At least it will be here if I need to reference it.

 

8/21/19 started mirt taper 13.5 9/4 13.2 9/11 12.6 9/18 12 9/26 11.4

10/13 11.1 10/20 10.8

11/10 10.5 11/17 10.2 11/24 9.9

12/1 9.6 12/9 9.3 12/16 9 12/23/19 8.7

1/5/20 8.55 1/9/20 8.4 1/16 8.1 1/23 7.8 1/30 7.5 2/6 7.2 2/13 6.9 2/20 6.6 2/27 6.3 3/5 6 3/12 5.7 3/19

5.4 3/26 5.1

6/1 4.95  6/4 4.8 6/8 4.65 6/11 4.5

6/15 4.35

6/18 4.2

7/6 4.05

8/11 3.15

9/19 3

10/1 2.64

11/1 2.04

12/1 1.68

1/1 1.38

3/1 1.08

4/5 .78

6/21 .3

6/27 .24

7/4 .18

7/11 .12

7/18 .06 mg

 

Jack you have done a great job, man. I am celebrating you.

Could i ask you what have you suffered most after 5-6 mg till zero. I cant understand how depression sucked me after 8mgs till 5mg(now). It is very hard to cope with. Have you suffered that either ?

Posted on here a few issues. Can anyone be kind enough to help ??.

 

Saw jacks post re coming off. Well done. Cant understand how long you took. Did you use liquid? What amounr were you on? How long to taper and how often

 

I hope aoneone can re read my last post abd get back to me

Posted on here a few issues. Can anyone be kind enough to help ??.

 

Saw jacks post re coming off. Well done. Cant understand how long you took. Did you use liquid? What amounr were you on? How long to taper and how often

 

I hope aoneone can re read my last post abd get back to me

 

It took me 2 years to taper off 15 mg. My signature shows most of my cuts and will give you an idea of the speed. I used liquid. I had it professionally compounded at 15 mg per 5 ml.

 

JUMPED!

...

Jack

 

Great job Jack. I think you will do great. I am curious about your updates after this!