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sunnygirl12: Failed withdrawal from Remeron... Insomnia bad after reinstating?

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My first post here... I have been taking Remeron (Mirtazapine) for 16 years. I tried to come off of it in October, but I weaned too fast and have had problems ever since. I tried to taper off of 15 mg. I ignored my doctor's fast tapering plan and tapered from 15 mg. to 10 mg. The first part of the month was fine, but then a delayed withdrawal hit with horrible symptoms including insomnia. At that point I was only sleeping about 4 hours a night.


I reinstated so that I could continue to work... back to 15 mg. In hindsight I realized now I shouldn't have been changing doses so fast.


After having reinstated now for about a month, I am still waking up every night in the middle of the night wired! Why??? Could I still be having withdrawal symptoms even after I've been back to my original dose that I was sleeping well on? I want to try to withdraw again, even slower but I don't know how I'll do this if my sleep is already so poor! Thank you!!!

Edited by scallywag

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sunnygirl -- Welcome to Surviving Antidepressants (SA)
It's unfortunate, but not surprising, that your doctor is uninformed about what ACTUALLY constitutes a safe taper from these medications. I'm sorry to read that that you are suffering the results of his/her ignorance.
A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, particularly for in the last 12-18 months

  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
  • Any drugs prior to 18 months ago can just be listed with start and stop years.
  • You don't need to include symptoms or diagnoses other than the initial condition that led to prescribing the first drug.
  • We ask for this information in your signature so that we can see it at a glance. A list is easier to understand than one or multiple paragraphs.
  • You can find instructions in this topic: Please put your withdrawal history in signature
  • If you are using a phone or mobile device, you need to switch to the "full" or desktop version of the site. Instructions are in Post 8 and Post 9

You would be wise to stay at your current dose to let your symptoms settle down, i.e. your sleep pattern to return to normal, before even *considering* a dose decrease. This may take many weeks; you will, however, almost certainly see an improvement.

Remeron and other neuro-active medications affect on your CNS (central nervous system). When the medication is introduced and continued, your CNS responds to the presence of the drug by making changes to maintain an equilibrium. A more science-y way of saying this is that your CNS downregulates or upregulates neurotransmitter cells & processes to maintain homeostasis.
These CNS changes do not occur quickly. When a drug is discontinued or the dose is reduced, the CNS un-changes itself, undoing some or all of the changes it has made since the drug was introduced. Again, these changes or "un-changes" do not occur overnight and may take many weeks or months for some people. This "un-changing" done by the CNS to restore itself to a drug-free state is almost certainly the cause of symptoms while tapering and/or after discontinuing a medication.  You can learn more about this at these links:

What is withdrawal syndrome
How your brain responds to psychiatric drugs - aka "Brain remodeling"
Youtube video, 4 minutes: Healing from antidepressants


Insomnia and are sleep problems are common after fast tapers or sudden discontinuations of neuroactive medications, a group which includes anti-depressants. You may find some helpful suggestions at this link:

Tips to help sleep
Melatonin for sleep depending on the type of insomnia you're dealing with


For when the time comes, here are links to important information about tapering:

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 am glad that you found us.

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I posted here in November of 2016.  I wanted to see if anyone could possibly offer any suggestions for my situation. 

I am hoping this post will be linked to my original post in Introductions. I'm not very familiar with this forum, so in case it doesn't link I'll describe my situation. 

From approximately Sept. 20 to Nov. 1 of 2016, I consulted with a doctor for a taper. He had me drop from 15 mg. to about. 10.75 mg. of Mirtazapine. I didn't have any withdrawal symptoms for about 3 weeks. Then came severe withdrawals. I reinstated back to the 15 mg. after approximately 5 weeks.  

All of my withdrawal symptoms eventually faded except for the severe insomnia. I can fall asleep fine, but I still wake up in the middle of the night, around 4:00 a.m., with what feels like an adrenaline jolt, and cannot fall back asleep. My sleep improved some in the beginning stages, but after 4.5 months it is still so poor that I don't know how I could handle a taper.

I'm also wondering if part of my problem could be due to switching forms of the medication. I had taken tablets from a pharmacy for years, then for a month swtiched to a different pharmacy, then for the last 3 1/2 months switched to the Sol Tabs in preparation to WD. Recently I started mixing Sol Tabs with water without reducing, in prepartion to WD.
Since I started the Sol Tab solution, my sleep has become even worse, less than 5 hours a night.

I'm wondering if part of the problem is the tablet change? I'm wondering if I should go back to the tablets I took for 13 years from the same pharmacy?

After 4 1/2 months, why am I having adrenaline jolts and sleeping horribly? I'm wondering if I could have damaged my CNS. Thank your for any advice.... desperate to sleep so I can try to get off of Mirtazapine.

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I was wondering if anyone has any experience with this? In October 2016 I saw a doctor that tapered me too fast from Mirtazapine. I dropped from 15 mg. to about 10.75 mg. (Thankfully I didn't drop to 7.5 mg. which he recommended.) After getting severe withdrawals at around 3-4 weeks I reinstated around the 5th week or a little after. Unfortunately I did not know that I wasn't supposed to reinstate all the way back to my 15 mg., which I did. I realize that this was all a big shock on my CNS. Since I realized this was drastic I have not tapered any more and have tried to stabilize for the last 5 months.


Thankfully, things are not as bad as they probably could have been, as I am not having any withdrawal symptoms at all except for one, which is the insomnia.  The problem is that I fall asleep fine, but I wake up every night between 3:00-4:30 with what feels like an adrenaline jolt. It literally feels like a freight train going through my bedroom and when it happens I feel so completely wired I cannot get back to sleep. Continuing to work has been extremely difficult. I feel like I cannot possibly taper until I can somehow fix this, as I can barely work on as little sleep as I get.

I'm just wondering if this is something I could possibly fix, so that I can have an opportunity to taper again. Before the fast taper I consulted with a holistic doctor that said that my blood sugar was high and my cortisol was low. I feel like what's going on is that it was such a shock to my body that it sent my blood sugar and cortisol issues out of control and with the lack of sleep it's like a vicious cycle. I just wonder if this is something aI can possibly fix, or is it truly a problem from the big drop and reinstatement? I am quitting caffeine and alcohol and trying to change my diet with more fat and protein. I don't eat many carbs at all. I have tried Phosphatidyl Serine and I still had these adrenaline jolts waking me up. I really hope I can fix this with diet/supplements. Thanks!


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I've moved your new post to your Intro topic because it is about your own situation and keeps your questions, responses and history in one place.


Here are links to some SA discussions:

Sleep problems - that awful withdrawal insomnia


Sleep Hypnosis, Guided Meditations, Calming Videos



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I've been tapering 15 mg. Mirtazapine for about 7 months now. I am now down to 8.5 mg. After having received bad advice from a doctor about this time last year, I struggled greatly after he did a huge decrease in my dose. I waited quite awhile before I tapered again. I started out doing very tiny decreases because I was so hesitant of trying again, as little as 2-3%. Obviously I didn't put much of a dent in the 15 mg., so the past few months I decided to taper quicker, the recommended 10%. Still, I estimate the total time to be around 2.2 years. This just sounds SO LONG! I haven't known many people who have tapered from Mirtazapine, but I'm wondering about how long it would take most people to taper off of 15 mg. Mirtazapine?  Or if anyone could give me an estimate on how long to taper from the second highest dose from ANY drug? I appreciate anyone's answers. Thanks!

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The 10% rate is a general recommendation.  Some people can go a bit faster, some much slower.  There really is no "most people" rate.  I was staggered when it was first put to me how long it was going to take me to get off my drugs (I have three).  I could not wrap my head around it.  I was wisely counseled to take one day at a time and the end would eventually come.  


I am one year into my taper from 20mg Lexapro and am just below 10mg now.  As I get to the lower doses, I will have to slow down.  Then I have two more drugs.  That just the way it is.  Acceptance is key.  If you get upset about how it's going to take, this can worsen your withdrawal.  I know it sounds long, but the time really does pass.  


Your body will dictate how long your taper lasts.  

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Thank you so much Gridley. You hit the nail on the head with your statement "I can't wrap my head around it." It almost seems too impossible to believe. Of course, it wouldn't be, if we were given informed consent to start with and knew it upfront. I highly doubt anyone rarely does have informed consent. 

I usually don't stress much, but I am having such a hard time coming to terms with it. Part of why the long taper time from Mirtazapine is so concerning is that this drug is known for causing large amounts of weight gain, so with a long taper of course it means even more weight. 

I'm having such a hard time coping with the time frame, and I don't know why it's so difficult to accept. I've even been thinking of seeing a counselor to find out how to cope with it. But, since most doctors, and probably counselors, have no idea about withdrawal, I'm not really sure how they could tell me how to cope better. 

I guess eventually I'll come to accept it but even after 7 months it still seems difficult. Thank you so much for your reply! 

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Hi Sunnygirl12,

I empathize with your hard time coping with the the length of time your tapering is taking.  I am stabilizing on fluoxetine 10mg. due to reckless withdrawal of a few different medications.  I suffered so much that I am much more willing to wait to withdraw as safely as possible.


As far as weight gain, it helps me to stay away from flour, sugar, and too much fat, protein, and fruit but especially staying away from grains and sugar.   Good luck to you.

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Hi Sunny, I have been tapering from 15mg Remeron for the last 11 months. I am down to 5.5mg and am also feeling really daunted by the idea of having to go even slower now that my dose is lower. I have been in general tapering by 2-3% each week. But, now that I'm down to 5.5mg, the tick marks on my syringe are each roughly 1.7%, so two ticks is too much. I especially cannot do a 3% dose decrease when I'm in PMS. I had a day where I was just a mess with weepiness and negativity. I've gained 45lbs on this awful drug (putting me at 165 which is more than I've ever weighed in my life, even at 9 months pregnant). 

I was recently plotting out the rest of my taper just to see what percentage of my dose was what mg. for the remainder and I just cannot fathom being at 1mg and doing 10% decreases for 10 more months. Part of me thinks that 1mg is so little, that I should be able to jump off at some point, but theres another part that reminds me how sensitive I am. One time when I was trying Lexapro, I had only been on it for three days and at HALF the lowest dose, so only 2.5mg) and it was one of the worst reactions I've ever had to a psych drug. I felt extremely depressed all day and discontinued it immediately.

So, for what it's worth, I'm right there with you tapering off the very same drug. I'm pleased to report that my withdrawal symptoms have been very minimal. An average week for me looks like : Monday, drop by 2%, Tuesday, Hot flashes, irritability, Wednesday, more hot flashes, Thursday, marked irritability, Friday, Saturday, Sunday not much to report. 

Good luck and feel free to reach out to me personally via email : erin.marie.green@gmail.com

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Thank you so much for your reply! It's now been 8 months since I've been tapering and I'm now down to 6.9 mg. (I need to change my signature!) I really appreciate you reaching out to me. Some people say that Remeron is a very difficult drug to get off of, but I really don't have anything to compare it to. The hardest thing to me about this taper, and I know that you can relate, is that with the long tapering time, that means even more weight gain. I have gained a lot too, over 30 lbs. I'm afraid to even look recently after the holidays. I regret practically every single day taking this drug for that exact reason. It seemed to slow my metabolism to a snail's pace, even though I eat very little. I'm really worried if I'll be able to lose it!!
Thankfully, I haven't had many withdrawal symptoms this time, unlike the other times I tried after consulting with doctors who, like most, dropped my dose way too fast. I do find that if I go too fast, I have nausea and irritability. But I realize that there is always going to be some type of discomfort. 
I've been making my own solution out of Sol Tabs, and it's working out really well...
I'd love to connect with you on Facebook or e-mail... I have learned a lot about tapering! I will try to e-mail you, and my e-mail is lgkahle@aol.com.
Best of luck to you!!

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