Remeron (Mirtazapine) Withdrawal Support Group

[[se...]]

Hey all update on me. I have struggled with this drug since around September. I slow tapered dry and should have just held for some time. I tried a slow switch to liquid and that failed. I then tried to stabilize and just could not stabilize so decided to jump in late December at the staggering amount of 5.5 mg because I was just worn down and tired of tapering after my klonopin taper. Very bad decision. It's been rough.

 

As noted this drug is no joke.

 

Since late December in early February I took one 5.5 mg tablet and then around the 20th of March I decided to reinstate at around 2 mg and felt terrible after a week so I decided to stop again.

 

Tomorrow marks my 40th day since stopping and man it is rough. My symptoms are burning over my body, tingling, rapid heartbeat, and ringing in my ears, head pressure. Appetite is no issue and sleep is ok. Not sure if it is reprising old klonopin symptoms or not.

 

I am really struggling about re-instating but have so much concern for the time I have been off. Then I have to try to stabilize, I hope, then start tapering again and then have to deal with w/d symptoms whenever i could taper down and then stop again.

 

Terrible between a rock and hard place.

 

Hope all are doing as best you can.

 

 

seeking

[[op...]]

seeking -

 

sorry to hear about all of this! I do think the mirtazapine covers up a lot of benzo w/d sxs, and if we go off it too fast, we experience those sxs. You were already having a REALLY hard time with w/d from benzos before you started tapering the mirtazapine, so it makes sense that those sxs seem to have gotten worse. I'm SO sorry .

 

Personally, I would re-instate b/c I felt that the mirtazapine helped with my benzo sxs. But since you say you tried to reinstate at 2mg and you felt worse, it's hard to know what to do.

 

Sending healing vibes to you (and everyone). Keep us posted.

 

openroad

[[Fi...]]

Hey all update on me. I have struggled with this drug since around September. I slow tapered dry and should have just held for some time. I tried a slow switch to liquid and that failed. I then tried to stabilize and just could not stabilize so decided to jump in late December at the staggering amount of 5.5 mg because I was just worn down and tired of tapering after my klonopin taper. Very bad decision. It's been rough.

 

As noted this drug is no joke.

 

Since late December in early February I took one 5.5 mg tablet and then around the 20th of March I decided to reinstate at around 2 mg and felt terrible after a week so I decided to stop again.

 

Tomorrow marks my 40th day since stopping and man it is rough. My symptoms are burning over my body, tingling, rapid heartbeat, and ringing in my ears, head pressure. Appetite is no issue and sleep is ok. Not sure if it is reprising old klonopin symptoms or not.

 

I am really struggling about re-instating but have so much concern for the time I have been off. Then I have to try to stabilize, I hope, then start tapering again and then have to deal with w/d symptoms whenever i could taper down and then stop again.

 

Terrible between a rock and hard place.

 

Hope all are doing as best you can.

 

 

seeking

 

Hi Seeking,

 

I know this time has been hard for you and I empathize.

 

The symptoms you describe sound very much like a sensitized nervous system. And a sensitized nervous system will react strongly to any substance.

 

I think figuring out why you want to reinstate would be good to know. If the burning skin, rapid heartbeat, and headpressure is keeping you incapacitated, then it might worth reinstating at a super low dose. Reinstating won't solve everything but it could help with those symptoms.

 

On the other hand, the fact that you can sleep ok and have an appetite is a good sign. If that is helping you make it through all this and, and you are able to function, you might consider staying off.

 

I think it all comes down to whether you can function and what your expectations are for reinstating. From my experience, reinstating is a way to reduce symptoms and help us become functional. It won't make us feel normal like we do when we are med free but it does help us be in less pain till we heal.

 

FH

 

[[Fi...]]

Hey guys,

 

Just wondering what you think. I believe I may be having my first taste of Mirt withdrawal. I forgot to take my dose (1.94mg atm) on Friday and on Saturday I felt a little light headed but otherwise ok. Took my regular dose again on Saturday night, but on Sunday I started having waves of nausea hit me and developed diarrhea. Monday was a bit better, but then yesterday was much like Sunday, along with post-covid POTS hitting me hard. I had waves of nausea come over me several times and I woke up 2 hours into sleep trembling. I was running to the toilet all night and threw up in the morning, I haven’t vomited since before I took Mirt. 😕

 

It’s so confusing because I can’t be sure if it’s a long covid flare up, but my other long covid “bad days” didn’t quite feel like this, and when I was throwing up, I remembered the Mirt dose I forgot to take on Friday, and wondered whether I could be having some withdrawal. Any thoughts? I feel pretty gross, uncomfortable & anxious rn. 😩

 

Hi Slowphie,

 

I think staying the course and taking your Mirt as usual is the best way to go. You probably did experience some heightened withdrawal but it should even out. I have forgotten doses in my other tapers and it did not keep me from moving forward.

 

I'm sorry you have struggled to much with long Covid. Not fair to have to go through along with a taper. 

 

FH

[[se...]]

seeking -

 

sorry to hear about all of this! I do think the mirtazapine covers up a lot of benzo w/d sxs, and if we go off it too fast, we experience those sxs. You were already having a REALLY hard time with w/d from benzos before you started tapering the mirtazapine, so it makes sense that those sxs seem to have gotten worse. I'm SO sorry .

 

Personally, I would re-instate b/c I felt that the mirtazapine helped with my benzo sxs. But since you say you tried to reinstate at 2mg and you felt worse, it's hard to know what to do.

 

Sending healing vibes to you (and everyone). Keep us posted.

 

openroad

 

Thanks Open. I think I found out how sensitive I am to these drugs. Taking it day by day.

[[se...]]

Hey all update on me. I have struggled with this drug since around September. I slow tapered dry and should have just held for some time. I tried a slow switch to liquid and that failed. I then tried to stabilize and just could not stabilize so decided to jump in late December at the staggering amount of 5.5 mg because I was just worn down and tired of tapering after my klonopin taper. Very bad decision. It's been rough.

 

As noted this drug is no joke.

 

Since late December in early February I took one 5.5 mg tablet and then around the 20th of March I decided to reinstate at around 2 mg and felt terrible after a week so I decided to stop again.

 

Tomorrow marks my 40th day since stopping and man it is rough. My symptoms are burning over my body, tingling, rapid heartbeat, and ringing in my ears, head pressure. Appetite is no issue and sleep is ok. Not sure if it is reprising old klonopin symptoms or not.

 

I am really struggling about re-instating but have so much concern for the time I have been off. Then I have to try to stabilize, I hope, then start tapering again and then have to deal with w/d symptoms whenever i could taper down and then stop again.

 

Terrible between a rock and hard place.

 

Hope all are doing as best you can.

 

 

seeking

 

Hi Seeking,

 

I know this time has been hard for you and I empathize.

 

The symptoms you describe sound very much like a sensitized nervous system. And a sensitized nervous system will react strongly to any substance.

 

I think figuring out why you want to reinstate would be good to know. If the burning skin, rapid heartbeat, and headpressure is keeping you incapacitated, then it might worth reinstating at a super low dose. Reinstating won't solve everything but it could help with those symptoms.

 

On the other hand, the fact that you can sleep ok and have an appetite is a good sign. If that is helping you make it through all this and, and you are able to function, you might consider staying off.

 

I think it all comes down to whether you can function and what your expectations are for reinstating. From my experience, reinstating is a way to reduce symptoms and help us become functional. It won't make us feel normal like we do when we are med free but it does help us be in less pain till we heal.

 

FH

 

Thanks for the detail FH. I am functional, work fine, run errands, take walks, etc. Just feel terrible most of the time. I am fighting not reinstating because I know the time passed puts me at greater risk of not having it help. Both you and Open make good points. Not even sure what normal is.

 

Hope you are doing well on your progress.

[[ro...]]

Hello everyone, is there anyone here who could help me how to continue procceeding with my Remeron taper as in the next reduction size? Im so clueless about it...been on this crap since December 2020 so around 2 year 5 months? Prescribed for chronic insomnia originally. Thanks in advance!

[[op...]]

Hi Rosemarie -

Can you share with us where you are at in your taper (how much you take), how you have been tapering (pills, liquid, how often, etc.), and if you’re still having benzo w/d sxs? It was hard to tell where you’re at now from your signature. I’m sorry you’re suffering and hope we can help out.

 

Openroad

[[ro...]]

Hi openroad! I will be honest and say i think part of my suffering is abusing high doses of Mirtazapine to help me sleep as the lower doses were not helping my chronic insomnia. Biggest mistake ever. I was taking up to 60 mg (2 full pills at the start) then i reduced to 1 3/4 of pills...would that be...what ...52.5 mg...i did wrong i know. But i was just desperate for some sleep at the time. I have stayed on that dose for a couple months now but my condition keeps worsening so i figured its time for a reduction again. I'm having a lot of more symptoms that i doubt are from the benzo as i last took it more than 2 years ago but rather the high dose of Remeron. Visual symptoms (my vision is very bad), anxiety, sleepiness, feeling like i was hit by a tranquilizer dart 24/7 and many others.

[[ro...]]

Sorry for asking once again but i'd appreciate if anyone could help me with the next taper! Even if its a high dose sorry for being a bit too honest!

[[Fi...]]

Sorry for asking once again but i'd appreciate if anyone could help me with the next taper! Even if its a high dose sorry for being a bit too honest!

 

Hi,

 

We all make mistakes when trying to get off these meds.

 

The recommended way of tapering is to reduce no more than 10% of your previous dose. Since you are struggling with symptoms, you might try a 5% cut and then hold for 2 weeks. If you felt okay enough, you could cut another 5% and hold another 2 weeks.

 

So 5% of 52.5mgs would be 49.8, which you could round up to 50mgs. Then after 2 weeks, you would cut 5% of 50mgs, which would bring you down to 47.5mgs and you could round that up to 48mgs ans hold for 2 weeks.

 

You don't have to cut 10% per month. You could cut 5% and then hold for a month. We all learn how much our bodies can tolerate through this process.

 

I'm not sure whether you are dry cutting using a scale or using liquid. Either method is fine and makes for more accurate cuts. It is not recommended to eye ball the pills or snap them in half without some way of knowing what they weigh or how much you want to make into a liquid.

 

I'm only making suggestions based on what I have leaned here and through my own experience tapering.

 

Final Healing

 

 

[[op...]]

I agree with everything FH said!

 

And agree with not eyeballing it. A scale and a sharp pill cutter can be very helpful for those tiny pills.

 

here are a couple of suggestions:

https://www.amazon.com/gp/product/B011J88S8M/

 

https://www.amazon.com/gp/product/B07MH6XTL7/

 

The website Surviving Antidepressants may offer some additional support.

 

https://www.survivingantidepressants.org/topic/23158-tips-for-tapering-off-mirtazapine-remeron/

 

I would receommend reading through this thread to find out about other things folks have found helpful along the way!

 

openroad

[[Fi...]]

How are you doing Openroad since the small reinstatement?

 

I'm doing all right these days. I am feeling better as I move lower. I still have lots of sedation in the morning but not the mental symptoms I had when I first started tapering. That is such a relief.

 

How is everyone else doing these days?

 

FH

[[op...]]

hi FH,

 

I'm doing ok! Back to baseline and now down to .5mg. Still sleeping, which I'm grateful for. Not in any rush to get off this last tiny bit so will take it super slow. Glad you're feeling better as you've gone down! I did, too, for the most part.

 

Hope everyone is doing ok -

 

openroad

[[as...]]

Hi All -

 

I hope everyone is doing ok.

 

I'm reporting back to let folks know I had to reinstate. I jumped off mirtazapine at appx .8mg. I wasn't having any withdrawal sxs, so I figured it was safe to do so. In the 4 weeks that followed, I got continuously sicker. Stress and taking a claritin for a few days may have contributed. It's unclear. But by week four, I was having severe adrenal rushes, heart palpitations, nausea, severe GI distress, and complete inability to sleep. I took a risk and reinstated at .6 mg and it seems to have done the trick. My sleep immediately came back and the other sxs lessened.

 

This drug is no joke that it holds this kind of power at half a miligram. I'm astounded.

 

I'm going to stabilize on .6 and then start to taper down again. I have been dry cutting, but if I need to go much lower, I will likely need to get a compounded liquid.

 

Just leaving this here in case this information is helpful to anyone else now or sometime in the future. I have benefitted so much from the stories left by those who tapered before us.

 

Stay strong y'all!

 

openroad

 

Seems like this would be a good time to post a reminder chart on how strongly mirtazapine still binds to histamine and serotonin receptors at extremely low doses:

 

Mirtazapine

KiM values at receptors  h1=0.14 (binding to receptors causes histamine reduction), 5HT2A=2.0 (binding to receptors causes serotonin increase)

    H1       5HT2A

3.0mg  94%       51.5%

2.5mg    92%          47.0%

2.0mg    91%          41.5%

1.5mg    88%          34.7%

1.0mg    83%          26.2%

0.5mg    71%          15.1%

0.25mg  55%            8.1%

0.10mg  33%            3.4%

0.05mg  20%            1.7%

0.025mg 11%            0.87%

0.010mg  5%            0.35%

 

As you can see, at 0.5mg of Mirtazapine, you are still blocking 71% of your histamine receptor, so jumping from there from there would be a HUGE JUMP. Also, at .05mg, you have lowered serotonin production on mirtazapine by 85%, but still have a 15.1% boost of serotonin left.

 

I think at a certain point compounded liquid becomes a necessity.

 

So glad you stabilized, open road!! I know that was probably scary.

 

Stay strong, and go slow, folks. --Quinn

 

[[se...]]

Hope all are doing well. I am still thinking about reinstating. Days are rough.

 

May 25th will be two months since I tried my last reinstatement. I was thinking that during that try that I did not try long enough. Basically, tried a 2 mg dose for 5 or 6 days and am thinking that was not long enough. Part of my thought was going any longer and I would be hooked again.

 

I know it is a crapshoot and it might not help and I would have to deal with tapering again but my head pressure is relentless. I sleep ok and my appetite is ok...it is just the head issues. If I can get stabilized, then I would be doing a super slow taper.

 

If I reinstate I would start at about 2.5 mg and give that a week/10 days and if no better then maybe increment up by 0.5 or 1 mg.

 

Glad you are doing better openroad, and FH glad you are doing better. Quinn hope you are doing well.

 

To me this drug is worse than the benzo.

 

Seeking

[[as...]]

Hope all are doing well. I am still thinking about reinstating. Days are rough.

 

May 25th will be two months since I tried my last reinstatement. I was thinking that during that try that I did not try long enough. Basically, tried a 2 mg dose for 5 or 6 days and am thinking that was not long enough. Part of my thought was going any longer and I would be hooked again.

 

I know it is a crapshoot and it might not help and I would have to deal with tapering again but my head pressure is relentless. I sleep ok and my appetite is ok...it is just the head issues. If I can get stabilized, then I would be doing a super slow taper.

 

If I reinstate I would start at about 2.5 mg and give that a week/10 days and if no better then maybe increment up by 0.5 or 1 mg.

 

Glad you are doing better openroad, and FH glad you are doing better. Quinn hope you are doing well.

 

To me this drug is worse than the benzo.

 

Seeking

 

Hey seeking:

 

I'm confused by your signature. Are you currently on nothing or are you taking 5.5mg?

 

I noticed that you started tapering Mirtazapine pretty soon after you finished your benzo. I tried that, and the benzo withdrawal was still there under the surface. My worst benzo withdrawal came back, and I had to up the Mirtazapine substantially to get relief, way above where I had intitally started tapering the Mirt from (see my signature). I had to wait about 18 months post-benzo before I could taper the Mirtazapine without having hellish symptoms. At about 2 years post-benzo, I cut the Mirt pretty easily whereas before I couldn't cut it even slightly.

 

Not saying that updosing is what you should do. Just saying that benzo withdrawal is likely still in play. I've had a much easier time cutting Mirt. Initially, I cut it from 60mg down to 15mg with almost no symptoms, once I was way clear of benzo withdrawal. Since being at 15mg, I have tapered fairly easily but only because I added DAO at 15mg and the DAO enzyme gave me so much relief. Without DAO, I fear my symptoms would be pretty bad on just the Mirt taper, since I am at so low of a dose now.

 

There are no easy answers with this stuff. I think the only wisdom we know is that the slower we go, the better.  Whatever you decide, I hope you find relief soon.

Quinn 

[[se...]]

Thank you Quinn. I need to update my signature. I am on nothing now. Almost 7 weeks off my last reinstatement in March from stopping in late December.

[[Ho...]]

Hi there,

I'm here because I'm struggling big time and not sure why. Maybe you can help! I've been off Clonazepam now for nine months. It's been a slow but sorta steady (yet difficult) journey. I started weaning my remeron quite some time ago. I'm really bad at isolating catalysts. I read some people know what has sent them into a wave, or they know when they'll usually start to feel better after a cut.

 

Not me 

 

So I went down to by weight .14 grams of remeron. I don't know if that's why, but my anxiety spiked through the roof as it never did in my life. I'm doing OCD things, again, that I never ever have before. My spirits are getting lower and lower (and they were just starting up!) and my skin is burning again. Sometimes I just have to move. My thinking has also gone downhill/negative.

 

Is this usual when you make a remeron cut? I only went from .18 (1.7mg) to .14 (1.3 mg). What's your experience?

 

[[no...]]

@[Ho...]

 

It is often recommended for a Mirtazapine cut (with a benzo-sensitized nervous system) that you cut no more than 10% every 30 days and only cut that 10% or less if you are feeling stable. 10% would have been a drop to 1.53% which may seem like small change in terms of mgs, but can be a big deal when it comes to the nervous system that is trying to stabilize. So that was a biggish cut and also, how often have you been making cuts? Your signature shows you've cut massively since August 2022.

 

If you've noted an uptick in symptoms with this cut in particular, I would consider reinstating your dose to around the 2mg dose and holding for awhile. Even though you have been off the Clonazepam for 9 months, your nervous system is still trying hard to re-regulate. It might be worthwhile to leave that low-dose of Mirt alone for a bit. This coming from a guy who took like 7 years to slower taper off of a high dose of Mirt after crazy Xanax and Ativan withdrawal.

 

Shout out to Chi-town and hang in there.

 

Dave

[[Ho...]]

@Hotcoldhotcold, hello.

 

It is often recommended for a Mirtazapine cut (with a benzo-sensitized nervous system) that you cut no more than 10% every 30 days and only cut that 10% or less if you are feeling stable. 10% would have been a drop to 1.53% which may seem like small change in terms of mgs, but can be a big deal when it comes to the nervous system that is trying to stabilize. So that was a biggish cut and also, how often have you been making cuts? Your signature shows you've cut massively since August 2022.

 

If you've noted an uptick in symptoms with this cut in particular, I would consider reinstating your dose to around the 2mg dose and holding for awhile. Even though you have been off the Clonazepam for 9 months, your nervous system is still trying hard to re-regulate. It might be worthwhile to leave that low-dose of Mirt alone for a bit. This coming from a guy who took like 7 years to slower taper off of a high dose of Mirt after crazy Xanax and Ativan withdrawal.

 

Shout out to Chi-town and hang in there.

 

Dave

 

Oh geez, that must be it! I was feeling pretty good; so good I wondered if I should just stop the mirtazepine completely. What a mess I am! I've been rocking all through dinner and lucky I can even eat. I think you're 100% right. I've gotta stay here and go slower. I honestly thought I could cut every week. Never thought of a month, but from now on that's what I'll do. Thanks for taking the time to read my signature and analyze it!! I'm so relieved, you have no idea!!

 

I have a jeweler's scale but it's frustratingly inaccurate when you get lower. Have to figure that one out next.

 

Thanks again! 

[[op...]]

@[ho...]

 

Just seconding what Dave said (he has helped me out a lot!). I finally caved and got my doctor to send in a prescription for a liquid compound of mirtazapine to get off this last .5 mg. The pill is not weighing properly anymore. I get the liquid later this week, and hope it'll be more accurate. It's surprisingly tricky at this last bit.

 

Thanks for saying hi to us, Dave, and I hope you're well!

 

openroad

[[Hu...]]

Hey guys. Having a weird time.

 

Had a lot of health related stuff-two root canals-  that have caused me a lot of anxiety. But sometimes the anxiety has felt primarily physical, there even when my brain isn't worried about things, or doesn't seem to be.

 

Very scared my mirt has stopped working. I'm hoping I can switch back to my old SSRI citalopram that worked for me for 5 years (and never stopped working, I just switched to mirt for sleep)

[[Ho...]]

@hotcoldhotcold -

 

Just seconding what Dave said (he has helped me out a lot!). I finally caved and got my doctor to send in a prescription for a liquid compound of mirtazapine to get off this last .5 mg. The pill is not weighing properly anymore. I get the liquid later this week, and hope it'll be more accurate. It's surprisingly tricky at this last bit.

 

Thanks for saying hi to us, Dave, and I hope you're well!

 

openroad

 

Hi Openroad, wow, down to .5! Are you going to try and keep your cuts at 10%, even when you're at, say, .2?? I suppose there are a lot of people here who have jumped and have some experience in this, which clearly I don't have. So wondering what your plan is moving forward?

 

Thanks for posting OR!

[[op...]]

@[ho...]

 

I have basically been tapering .1 increments at a time since I hit about 4mg. It’s just been easier for me that way. For a while, I was going down .1mg every 8 days or so, but now I’m doing it about every month b/c I had a bad temporary crash last month after trying to jump.

 

So my plans is .5 for a month, .4 for a month, etc. all the way down to .1 and then walk off.

 

Hope that makes sense! So silly to draw this out but we’re all so sensitized at this point!