Remeron (Mirtazapine) Withdrawal Support Group

[[dr...]]

I'll testify that I jumped Jan 23 so it's been 4 1/2 months and I feel like I just got hit with the paws in the last month. At this point I can't tell between the mirt, the pandemic, and politics! I love the idea that it is a 6 month thing. Any port in a storm. I'll hope for the best.

[[Po...]]

Guys. Thanks for sharing. I went and did something stupid. 10 days after my final mirt dose I started a taper off the beta blocker I’ve been on for 10 years. Bad idea. When you withdraw from a beta blocker even as slow as I was trying to go one gets some adrenaline rebound. After so many days of my first BB cut my body started “buzzing” is the best way I can describe it. Being able to sleep pretty well while tapering the mirt went away. I became AWAKE and had pangs of anxiety and physical anxiousness. A miserable feeling. My chronic back pain ( for which I’m doing PT) at night got worse for which I take the occasional tramadol, but even that doesn’t  relive it. So I reinstated my usual BB dose and will wait on that at least until I see my cardiologist in 6 weeks since he said I could reinstate if I wanted to. I guess I naively thought all this crap was behind me 

[[Po...]]

Hi Guys. It’s another. I awoke last night and this morning feeling sick, miserable and in pain. Worse sxs than at any time during my taper. It’s like I didn’t spend the last 18 months slowly tapering off mirtazapine at all. My sxs would make you think I quit C/T.  I tapered slow and methodically and I’m waking up sick. Things improve some after I get up but not much.  I feel like I’d just as soon die as put up with misery. I don’t understand why this is happening. I’m so done.

[Guest [be...]]

Pokey, what kind of symptoms are you having ?

[[Po...]]

Fatigue, malaise, anxiousness, nausea, jittery, restless legs, fractured sleep and either air starvation or uncomfortable to take a deep breath and accentuated back pain which I realize is primarily caused by degenerate arthritis. But Overall I’m feeling ill.

[Guest [be...]]

So sorry to hear that Pokey, would you get those same symptoms when you would cut the remeron during your taper ?

[[Po...]]

I’d get some, not all at the Sxs the same time and not as strong as they seem to be now. It may have to do with the fact I was hospitalized early March for atrial flutter where they introduced a couple new drugs, then removed one then I had an atrial ablation, then they added another heart drug, then we stopped it , then they asked me to try stopping my beta blocker and I couldn’t and had to go back on it. My poor system has been pulled and pushed in several different pharmaceutical directions the last couple months  perhaps that has something to do with all this. It’s caused a wave from all on and off of different medications, some of them potent heart meds. Thankfully it turns out my heart is doing fine.

 

 

[[Ja...]]

I’d get some, not all at the Sxs the same time and not as strong as they seem to be now. It may have to do with the fact I was hospitalized early March for atrial flutter where they introduced a couple new drugs, then removed one then I had an atrial ablation, then they added another heart drug, then we stopped it , then they asked me to try stopping my beta blocker and I couldn’t and had to go back on it. My poor system has been pulled and pushed in several different pharmaceutical directions the last couple months  perhaps that has something to do with all this. It’s caused a wave from all on and off of different medications, some of them potent heart meds. Thankfully it turns out my heart is doing fine.

 

Pokey, I have been hit hard like this a couple of times during my taper. This most recent time it was severe and lasted 2 months but I am feeling pretty good now. I am crossing my fingers that this starts to go away in a month or so and by 6-8 weeks you will feel some real relief. You put in the work, now you are suffering but I am sure this will go away.

[[Po...]]

I hope you are right Jack. What I don’t get is why we do well for a while, then bad, then well again??

[[Ja...]]

I hope you are right Jack. What I don’t get is why we do well for a while, then bad, then well again??

 

Not sure, I went back to tapering at the same exact speed as before and am practically asymptomatic again. I don’t get it. I am mentally preparing myself to be slammed again out of nowhere.

[[Po...]]

I’ve been totally off mirtazapine 15 days now. I’m in a wave, I feel I’m crashing. Each new day getting more difficult. Last night got to sleep about 1am. Woke up about 3am in misery and pain. Really bizarre pain. I analyzed it and discovered I had focal points of pain in my shoulders, low back, hips but a weird diffuse pain/ discomfort in other parts of my body that came and went in waves. I could literally feel it start in my back and then wash down through my butt into my thighs and knees. I had discomfort under my xiphoid and nausea. I couldnt stay in bed with all this, the discomfort was to much to just lay there. I have to get up, stretch, self massage, walk to shake it off before I can go back to bed and try to sleep again. Which I did but then woke up an hour + later with the same symptoms. Something is going on in my sleep that makes me feel worse when I awaken. And all this seems to be getting worse each passing day/night. I keep thinking there must be something organic causing all this but then I think is this what the final stages of mirtazapine withdrawal feels like?? If so I don’t know how long I can hold up. It’s been a progressive worsening for a while now that I thought would improve once I was completely off but that has not been the case. I’ve had some scary thoughts in the dark of night. Please share any advice you might have. Many thanks Buddies

[[no...]]

I’ve been totally off mirtazapine 15 days now. I’m in a wave, I feel I’m crashing. Each new day getting more difficult. Last night got to sleep about 1am. Woke up about 3am in misery and pain. Really bizarre pain. I analyzed it and discovered I had focal points of pain in my shoulders, low back, hips but a weird diffuse pain/ discomfort in other parts of my body that came and went in waves. I could literally feel it start in my back and then wash down through my butt into my thighs and knees. I had discomfort under my xiphoid and nausea. I couldnt stay in bed with all this, the discomfort was to much to just lay there. I have to get up, stretch, self massage, walk to shake it off before I can go back to bed and try to sleep again. Which I did but then woke up an hour + later with the same symptoms. Something is going on in my sleep that makes me feel worse when I awaken. And all this seems to be getting worse each passing day/night. I keep thinking there must be something organic causing all this but then I think is this what the final stages of mirtazapine withdrawal feels like?? If so I don’t know how long I can hold up. It’s been a progressive worsening for a while now that I thought would improve once I was completely off but that has not been the case. I’ve had some scary thoughts in the dark of night. Please share any advice you might have. Many thanks Buddies

 

I'll throw my two cents in, Pokey - And I am sorry you are suffering. This has all the hallmarks of discontinuation syndrome. Every time I tried to cut to fast, or discontinue too fast, I'd face the same symptoms. Choppy sleep, nausea, frequent urination at night, etc etc etc. A way you could test this would be to reinstate your dose for one night. Since Mirtazapine does not need to build up in the body for it to take hold, you'd know pretty quickly. If it brought relief, then you may have discontinuation syndrome.

 

Personally, the other thing that helped me tremendously when the symptoms you described took hold was to cut virtually all histamine out of my diet. This list is the best reference I have found for histamine in food:

 

https://www.mastzellaktivierung.info/downloads/foodlist/21_FoodList_EN_alphabetic_withCateg.pdf

 

This time of year is hard for histamine intolerance anyway because of the seasonal allergies adding to the load.  And Mirtazapine beats the histamine receptors like nobody's business.

 

Anyway, that's the best I've got. I just wish you well and hope your suffering will dissipate no matter what you do.

 

Hang in there,

 

Dave

[[Po...]]

Thing is Dave I did a very slow taper from 7.5mg down to .1mg over 18 months. I was doing reasonably ok when I was still at .1 but then I jumped after 14 days at .1mg and BAM!!! Can this really all be discontinuation syndrome sxs with such a modest taper as that??

 

[[no...]]

Thing is Dave I did a very slow taper from 7.5mg down to .1mg over 18 months. I was doing reasonably ok when I was still at .1 but then I jumped after 14 days at .1mg and BAM!!! Can this really all be discontinuation syndrome sxs with such a modest taper as that??

 

Absolutely, Pokey. We are all different, but I personally tapered for 6 years to get off of 7.5mg. Too cautious? Maybe. But the best authority I have seen on antidepressant tapering is the Surviving Antidepressants website. They recommend no more than a 10% cut every 30 days - and holding in between if symptoms are present. People get mad at me when I advocate the super slow. And I get it. We all want to be off the stuff. But at what cost? My rush off Benzos almost killed me. That's why when it came to the Mirt, I just took it so slow.

 

I can't say for sure that this is what you are going through - but you were not feeling this way when you jumped. You were feeling confident about your decision, happy, and your symptoms were at bay. Even in my typical cuts, I wouldn't feel bad until a week or two after. So you are at day 15 after jumping and feel bad. It's not surprising, even if you just looked at this as another cut.

 

You did do a modest taper compared to some, but were quick compared to others like myself. There were others in between you and I. That's why we are all different. I may have gone too slow, but I had little trouble getting off. I just took my time.

 

I think your two options are to give it a bit more time, or, and personally this is what I would do. Take .1mg if you have it. If the symptoms clear, that's your tell.

 

I'm sad to hear you are feeling poorly. But this stuff is tricky. I know you have other meds at play for your BP, etc. But I just look at the coincidence of you feeling poorly and your discontinuation.

 

Dave

 

 

[[Po...]]

I followed the 10% guideline every 3-4 weeks until I got down to .3mg. I’ll think about the “ test” you suggest though I’ll need to get a Rx refill. I threw out all the mirtazapine I had left after stopping. But even if I do that one test won’t fix the misery. I’ve been having the thoughts maybe I should have just said to hell with it and stayed on a low dose the rest of my life. After a long benzo taper a few years back and then getting off another AD I’m worn out with this crap. Sick and tired of being sick n tired.

[[Po...]]

Ps. I was not feeling all good and happy before I jumped as you suggest. It’s all been a long slog for some time but it was better than I’m feeling now.

[Guest [be...]]

I might just stay on a low dose forever also once I get to that point, I haven't read anywhere that we could go into tolerance like we did with benzos ? I agree after my benzo nightmare this really sucks having to taper again.

[Guest [be...]]

I wish I never got on the Remeron but I reaaly think it did help me at the time.

[[no...]]

I followed the 10% guideline every 3-4 weeks until I got down to .3mg. I’ll think about the “ test” you suggest though I’ll need to get a Rx refill. I threw out all the mirtazapine I had left after stopping. But even if I do that one test won’t fix the misery. I’ve been having the thoughts maybe I should have just said to hell with it and stayed on a low dose the rest of my life. After a long benzo taper a few years back and then getting off another AD I’m worn out with this crap. Sick and tired of being sick n tired.

 

Understood, Pokey. Whatever decision you make, I hope it brings you some relief. I don't think anyone needs to be stuck on this stuff forever. But it does warrant careful tapering. And I know you were quite careful with yours. I suck at math, but used a percent calculator and rounded. 19 cuts at 10% would bring someone to approx 1.1mg. I know you were not waiting the full month as you said, 3-4 weeks in between. Some people don't have to, some people do - or have to wait even longer.

 

7.5mg

6.75mg

6.1mg

5.55mg

4.9mg

4.5mg

4mg

3.6mg

3.2mg

2.9mg

2.6mg

2.3mg

2.1mg

1.9mg

1.7mg

1.5mg

1.3mg

1.25

1.1mg

etc...

 

And just for general information for anyone, it took me 6 years because I took some mighty long breaks in my cutting. Like I would go 5 or 6 months sometimes. If I hit a level in my taper where symptoms presented with ferocity or intensity, I'd just stop cutting and hold until I felt on firm footing. Mirt withdrawal symptoms can take time to present.

 

I you do try to reinstate the .1mg, would like to know how that goes.

 

Feel better.

 

Dave

 

[[ju...]]

Pokey, i am sorry to hear that you suffer, i hope and wish you a peaceful aftertaper term.

 

Dave, as far as i understand you are saying that one should must go slow eventhough he/she feels well. It is very interesting that i am planning to go faster in good days, then i get slammed in bad days and i am saying that f..k it, no matter how long it lasts. Have you lived such things. "Impossible is nothing" for good days, "Hold until forever" for bad days. Lol.

 

Eventhough i am living crazy anxiety for some days, i get solace from the days when i take away my family to sightsee.

 

I am now planning to cut 0.15/2 weeks until i hit 3 mg, then 0.15/3 or 4 weeks. This scenario is equal to 3 years from 9 to 0 with no hold.  Is this still slow to you? Going slow is better than to be medicated new stuff. I have just read a FB group, where a member complains sxs after getting his taper from 30 to 0.15 in 2.5 years. Note that he hasnt run fast the last lap. He has gone from 1.1 to 0.15 in 1 year and he still complains about sxs. He ask for the help that he could stop or he should go into tiny doses like 0.075 and 0.025. According to the things you said he run the first lap(from 30 to 1) very fast and he gets accumulative effect i think.

 

Ben, are you on the side of me who thinks to go slow?

[Guest [be...]]

June, I dont know what to think, but I am like you when I feel good . I made a huge cut from 30mg to 22.5 mg that wasn't really that bad, I have been going slow since. This shit is crazy because when I feel good I forget how bad it is to feel bad and when I feel bad it just warps your mind so bad .

[[no...]]

Dave, as far as i understand you are saying that one should must go slow eventhough he/she feels well. It is very interesting that i am planning to go faster in good days, then o get slammed in bad days and i am saying that f..k it, no matter how long it lasts. Have you lived such things. "Impossible is nothing" for good days, "Hold until forever" for bad days. Lol.

 

Hey June!

 

That is exactly what I mean. I tapered for long enough that I realized that Remeron cut symptoms happen on very much a sliding scale. Sometimes people feel the cut immediately, sometimes the 2 week mark (or later) is when the nervous system recognizes there has been a change. In my case, it was both of those things. I'd make a cut and the next day I'd feel not so good. Then things would improve and around week 2, I'd get a huge wave of symptoms.

 

Whenever I'd push too hard, the restless legs, nausea, dizziness, anxiety, insomnia, all of that would come right back. Then I'd reinstate, stabilize, and things would be ok again.

 

I really think the 10% every 30 days is a good model. Because after 30 full days, your nervous system has had a chance to accept the change and go up and down and up and down and if you are still feeling symptoms at 30 days, then hold longer. If not, cut away.

 

You made me laugh with "Impossible is nothing" for good days, "Hold until forever" for bad days. That is the truth! Ha ha ha ha. It really does make us feel these ways.

 

Again, I really went slower than most anybody I know. So I am an extreme case in going slow. I was in touch with Erin Greene when she was tapering. We were messaging during that time. I thought she was going too fast, but going fast worked for her. It wasn't working for me. The symptoms were my guide. As I told Pokey, I would sometimes take many months off from cutting to let my nervous system truly catch up to the changes.

 

My only reason for being here and relaying any of this is so that you all end up where I am which is off the Remeron and feeling all right and living your lives. But I absolutely know that my way isn't the best way for everyone. But maybe some of what I went through can be applicable to others' journey's through this craziness.

 

Dave

[[Po...]]

Hi Dave, June et al. Well I reinstated last night with a loading dose of 1.7mg. I slept and feel better today. Will drop to 1mg tonight then .5mg and hold there hoping that will be an efficient dose to restabilize at. If so hold for a good amount of time and start going down slowly. I think what happened with me is I got to anxious towards the end of my taper, seemed like I had been tapering forever, and I rushed it towards the end. I believe I was thinking “ I’m at such a small dose now it won’t matter if I speed up a bit”. Well I guess I proved that as erroneous thinking Its amazing that such a small amount of a drug can have such a HUGE affect on a person. A fact that most docs don’t get at all. Luckily I have a doc willing to work with me. I have to kibosh my intrusive thoughts that I failed and reframe this as a minor setback, many of which occurs in life, and that it could be worse. Beats having cancer and At least I’m not starting again at 7.5mg.

Pokey

 

[[no...]]

Hi Dave, June et al. Well I reinstated last night with a loading dose of 1.7mg. I slept and feel better today. Will drop to 1mg tonight then .5mg and hold there hoping that will be an efficient dose to restabilize at. If so hold for a good amount of time and start going down slowly. I think what happened with me is I got to anxious towards the end of my taper, seemed like I had been tapering forever, and I rushed it towards the end. I believe I was thinking “ I’m at such a small dose now it won’t matter if I speed up a bit”. Well I guess I proved that as erroneous thinking Its amazing that such a small amount of a drug can have such a HUGE affect on a person. A fact that most docs don’t get at all. Luckily I have a doc willing to work with me. I have to kibosh my intrusive thoughts that I failed and reframe this as a minor setback, many of which occurs in life, and that it could be worse. Beats having cancer and At least I’m not starting again at 7.5mg.

Pokey

 

Pokey, great news sir, and sounds like a perfect plan. I am really, really glad to hear the reinstatement brought you some relief.

 

Yes, no failure. We all have to find the sweet-spot with this. And it is unique to all of us.

 

Hang in there and let us know how it goes as you stabilize and no rush this time!

 

This endeavor requires the marathon mind vs. the sprint mind.

 

Thanks so much for reporting back on this!

 

Dave

[[Po...]]

Coming up with a loading dose is a little tricky. Mirtazapine has a average 1/2 life of 30 hours which would mean it would take about 5 days to reach steady state if I had started with my target reinstatement dose of 0.5mg. The formula for calculating a loading dose for a drug is a bit on the complicated side so I did some back door approximation looking at different doses and the 1/2 life of mirtazapine. It’s alchemy somewhat and will require monitoring sxs, possibly adjusting a dose or two,  but hopefully will be close enough to get me where I want to be in 3-4 days which is .5mg. Hoping of course I stabilize ok at that dose.