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Altostrata

Tips for tapering off mirtazapine (Remeron)

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Hibari

I think tapering two drugs is a personal choice and one that I made with a very clear head.  I don't regret the choice at all.  I have years of body-mind training and felt very comfortable trusting what my body was telling me. 

 

Has it made it more difficult?   At times yes, but not overall.   I only know that once I had 6 months of Remeron tapering under my belt, I felt and knew on a body level that it was time to start tapering the Lamictal.  I have gotten some push back on this site about making that choice but I knew what I knew.  I was able to get support for my choice from some good friends that I made here on SA so that helped me during my journey.   I also still appreciate the amount of information that can be found here. 

 

So I did taper both drugs at the same time till starting in July of 2015 till May of 2016.   As I am now on a low dose of Remeron and feeling the cuts more intensely, I have decided to concentrate only on my Remeron taper and then maybe to another Lamictal cut in between.

 

In order to support myself tapering two drugs, I had weekly acupuncture combined with Reflexology.  

 

Wishing you well. 

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Pokey

Leah and Hibari: good luck to you both. Your body, your decision. My only word of advice to Leah is if and when you do come off xanax is to consider the Ashton method to taper by crossing over to valium. Xanax tablets cannot be cut in small enough portions to allow a tolerable taper, whereas the valium can and then can be finished off with a liquid version of the valium.

 

Wishing you the best

 

Pokey 

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leahy

Thank you, Pokey.

 

By the way, I have found melatonin to be helpful for sleep. I take a low dose (2.5 mg) when I need to. Insomnia was a huge problem for me in tapering Remeron even though low doses are supposed to make you more sleepy.

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Pokey

I have tapered down from 30mg Remeron to 22.5mg with no issues. I've been at that dose for almost 3 weeks now and finding that I am sleeping really well and waking up more rested than I have in a long time. People talk about finding a "sweet spot" for themselves with this med. I am wondering if I have stumbled upon mine? At 15mg I was not waking up very rested and at 30 it was to activating. 22.5 does not seem that different from either 15 or 30 but I can't argue with how I'm feeling these days. I've complained so long of unrefreshing sleep after coming off a benzo and doxepin. I think for now I'm willing to stay where I'm at as it is so nice to feel refreshed and alive again

Pokey

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leahy

Around 20 mg was a great spot for me, too. Some days I think I should go back there and stay there so I can have a life (albeit a fat, overweight) one.

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Pokey

My waistline seems to be staying the same. I try to be cognizant of my food intake and back off when I'm feeling hungry at non-meal times. Remeron can stimulate appetite but does not mess with your metabolism. So I try to stay aware of that. I see my doc in a couple weeks and I'm going to ask him to stay at 22.5mg and see how it goes.

Pokey

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leahy

I diet all the time. But I am as fat as a horse. I have gained 50 pounds over 17 years. I don't believe Remeron does not mess with metabolism. It sure as hell increases appetite.

 

I went to my Weight Watcher leader's doctor years back because I was so upset about not losing nothing on weight watchers. (I am close friends with the WW leader's daughter. The referral was a personal one, not one made by WW.) I counted every point. The Dr. examined me thoroughly. In reviewing my meds she pointed out that Remeron causes weight gain. Big time.

 

"We use it for anorexics and little old ladies whose husbands died and they sit in a chair all day and do not eat. Put them on Remeron and they gain much needed weight."

 

You are one of the lucky ones, my friend, if weight gain is not an issue. It is a problem for many of us.

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Altostrata

Remeron is very well-known for causing weight gain.

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Hibari

My waistline seems to be staying the same. I try to be cognizant of my food intake and back off when I'm feeling hungry at non-meal times. Remeron can stimulate appetite but does not mess with your metabolism. So I try to stay aware of that. I see my doc in a couple weeks and I'm going to ask him to stay at 22.5mg and see how it goes.

Pokey

Pokey  Your statement that Remeron can "stimulate appetite but does not mess with your metabolism"  is not true. 

 

Many people who work out faithfully and eat normally gain lots of weight on Remeron.

The reason I am stating this is because I am one of those people.  I had no weight issues before Remeron and in fact was a little underweight.  I did not change my eating at all when I first when on it and in about 5 months I gained close to 21Lbs and since then probably 5 more.  I have tried many health and weight loss programs to get the weigh off and nothing  has  budged it.  

 

There are stories all over the internet about people rapidly gaining weight Remeron while working out and eating well.  You will also read stories of people coming off of Remeron and without dieting or working out, the weight just starts to fall off.  You can even find stories of that here.   I am one of the people who is praying that will happen. 

 

As Leahy mentioned, there are many doctors out there who confirm the weight gain associated with Remeron.  I had a psychiatrist and gynecologist both confirm that.

 

I'm glad you have not gained weight on it. 

 

It's also important that other people know that the weight gain on Remeron has a lot to do with it's effect on metabolism and not a weakness around food. 

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Pokey

I'm tapering off Mirtazapine still. I'm at 11.25mg. I was at 30mg. I feel weak and tired a lot. Low energy. Makes me think I must have something seriously wrong, thinking surely it can't be the Mirt I ask, but no other cause for the fatigue and malaise is presenting itself. Above I said I was not gaining any weight, well that has certainly changed.  I have gained weight. I'm 15 lbs heavier than usual. Got to get off this stuff. The fatigue & malaise sucks the marrow out of my bones. Can anyone else relate to these symptoms? I figure I should be off towards the end of summer. 

 

Pokey

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leahy

I'm tapering off Mirtazapine still. I'm at 10.25mg. I was at 90mg. I feel weak and tired a lot. Low energy. Makes me think I must have something seriously wrong, thinking surely it can't be the Mirt I ask, but no other cause for the fatigue and malaise is presenting itself. I have gained weight. I'm 60 lbs heavier than usual. Got to get off this stuff. Yes, I can relate to these symptoms? I would like to be off towards the end of summer. 

 

But I have a feeling I won't be off until next winter.

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Pokey

Leahy- is your fatigue and weakness more in the morning like mine is or is it different? My GP said he thought the fatigue, etc. was more likely in the morning because it was close to when I take my dose at bed time. Kind of a morning hangover. But I don't buy that. Mirtazapine has a 1/2 life of about 30 hours, so there should be a steady state of the drug in my system (except when I cut) at all times, so taking a dose at bedtime should not be affecting the level of the drug in my system in the morning. I have no idea, and I dont think he does either,  why I feel worse in the mornings when I wake up. But it sucks, I know that.

 

Pokey

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leahy

I agree with you, Pokey. I honestly do not think my every day hangovers has anything to do with the half life since my symptoms are worsened when I decrease but take 4 days to truly torture me. That leads me to believe the half life is not the immediate issue. My symptoms have more to do with the overall 20 year change in the architecture of my brain caused by taking the medication and my struggles to rebuild my brain as I decrease dosages. And any time I decrease the hangovers are WICKED and get worse as the days and weeks go by. So the immediate effect is not the problem. It's the days and weeks and months after tapering that have been a serious problem.

 

So now I take it very slow and grow fatter but I am terrified of feeling sick. I hate being fat but being sick is unbearable. 

 

Leahy

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Pokey

Yeh, I think I have may a similar thing going on with the architecture of my brain. I was one xanax and doxepin for 25 years. Doctors kept saying I needed it which was all BS as it turns out. Was a long taper to get off them both. I had a weak moment with my GP and let him put me on mirtazapine to help with sleep. His claim was that he prescribed it to little old ladies and had no problem with it, was very safe, etc., etc. I have a new doc now and he's all for me getting off and I will never go another psychotropic ever again. NEVER!!!  

 

Yes, I often feel sick too. Like I got the flu all the time. Weak, tired, stiff, achey. Really puts a damper on life doesn't it. There are things I want to do, like travel, but I just don't feel like it. I try to keep up my exercise, which helps. I really want off badly, but know if I try to push it, it will backfire. 

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leahy

Same story. Exactly. It definitely puts a damper on life. I want off badly but I know what happens when I try to push it.

 

My GP told me also that they put little old ladies and anorexics on mirt to make them gain much needed weight.

 

I might qualify for the "old lady" at this point - just not so little. Thanks to mirt.

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chicken

Same story. Exactly. It definitely puts a damper on life. I want off badly but I know what happens when I try to push it.

 

My GP told me also that they put little old ladies and anorexics on mirt to make them gain much needed weight.

 

I might qualify for the "old lady" at this point - just not so little. Thanks to mirt.

Dr. trying doing that to my grandmother in the nursing home and I found out....We stopped it immediately!

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leahy

Chicken is no chicken anymore!  Great job.

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JamesMoore

Hi all, my apologies if this has been asked or answered elsewhere. Although I have posted before, this is my first tapering question.

 

I wondered if anyone had experience of changing from Mirtazapine tablets to Mirtazapine liquid. Was it rough, if so how long did it take to stabilise. What were the effects of changeover?

 

I'm just transitioning on to liquid myself and I'm starting to find it very rough, I guess I'm looking for reassurance that probably doesn't exist given that we are all different. I'd be grateful for any advice, thanks for reading this.

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Hibari

Hi James.

 

Yes, I experienced what's called an "unexpected cut" when I switched my Mirtazapine from tablets to liquid.  The exchange is not equal and I read on this site that switching to liquid even if you are not lowering your dose causes this cut.  It appears that the liquid suspension is not equal in potency to the tablet form.  It's not a huge difference but a difference.  

 

You have the option of going up slightly on the liquid or holding till you stabilize.

 

A moderator from the site may have more specific advice.

 

Hang in there, I found that it does pass. 

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JamesMoore

Hi Hibari, thanks so much for taking the time to reply. That definitely feels like what's happening, thank you, I normally suffer a bit of dizziness and anxiety when I change boxes of tablets but this is more substantial. Fingers crossed it doesn't last too long, thanks for your advice. By the way, congrats on getting past the Remeron, that's brilliant. Best wishes. James

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nz11

Hi James

Hey i was just looking and i couldnt see your intro thread maybe i have missed it.

What do you think about the idea of doing a drug sig?

Are you making the liquid yourself or getting it made up for you?

Did you do a drop at the same time? If you are making it yourself how are you doing it?

 

I never took liquid myself but from what i read some are making the switch to liquid easier by taking part liquid and part tablet dose.

 

Unfortunately we are all guinea pigs in a massive chemical experiment.

Sorry it is rough at the moment hoping it settles soon.

Wishing you stability.

nz11

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Altostrata

We suggest taking part of the dose in tablet form and part in liquid to make a gradual switch.

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JamesMoore

@nz11 - Thank you, I will update my profile with my drug info, thanks for the tip. The liquid is pharmaceutical preparation (i.e. not made myself) and I didn't drop at the same time, just transferred on (what I thought) was the same dosage. A little easier today, we'll see.

 

@Altostrata - thats a great tip, thank you so much I will look to that if things get worse or don't settle. Very grateful for your advice.

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Pokey

, I'm sorry, but I dont understand what the issue is going from a tablet to a liquid form of Remeron. When I tapered off xanax using valium, when I got to a low dose range I switched to liquid valium and I dont recall any issues. My lab experience tells me if you have a concentration of say 10 mg/ml then if you take 0.5ml you get 5 mg. But that does not seem to coincide with the trend of the discussion here. Is it a case that mirtazapine does not stay in a homogeneous solution? If thats the case shaking it should help I would think. I'd appreciate knowing what the issue is as I am getting near 7.5 mg and was thinking going down from there should be done by using a liquid form of the medication. thanks

 

Pokey

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Pokey

I am now at 9.375mg of Remeron. Question: Does a Remeron taper get more difficult the lower you get? By that I mean are the withdrawal sxs worse the lower you go in dose. I'm going nice and slow. Only cutting once every 4 weeks. But man I feel like crap, all the time. I felt pretty good when I was at 15 and then cut to 13.125 and had more good days than bad when at 11.25. I am cutting by 1.875mg per cut. Actually when I made this last cut from 11.25 to 9.375 I took 7.5 + 1.875 and cut a 1.875 piece in 1/2 for a week and now have been on 9.375 for 3 weeks. But am feeling crummy much of the time.  My plan is to get to 7.5 and stay there for a while and then go on a liquid and cut from there using that. It still amazes me how such a small dab of a drug can have such an impact on how one feels.

 

Pokey

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Pokey

I looked at the article. Pretty technical but got the jist. Seems like I'd be correct in saying it takes longer then to stabilize after a cut when you get to the lower dose range? I made my last cut May 6. Waiting for relief.  The fatigue is exhausting. I sleep but wake up feeling like I never slept. I have to fly a couple times this weekend. Going to be a long 4 days.

 

Pokey

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Aelius

I`d like to ask for an advice. Has anyone experience with changing a manufacturer of Mirtazapine? I`ll probably reach 15mg in July. I wanted to use 15mg tablets but found out 15mg tablets are not available from the same manufacturer (Mylan, generics). I would have to either swap for another manufacturer or keep cutting 30mg soltab tablets. What do you think?

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mammaP

some people are sensitive to a change in manufacturer. I have some symptoms with different brands. If you have any of the old ones left you could break them and make up the dose with some from each, gradually reducing the old one while increasing the new one. I had to do this when I moved to a new area and the pharmacy uses a different brand. 

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Aelius
On 28. 5. 2017 at 11:22 PM, mammaP said:

some people are sensitive to a change in manufacturer. I have some symptoms with different brands. If you have any of the old ones left you could break them and make up the dose with some from each, gradually reducing the old one while increasing the new one. I had to do this when I moved to a new area and the pharmacy uses a different brand. 

That`s a good idea, I`ll do it. Thanks.

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Pokey

I am down to 7.5mg now. Have been for a awhile now and am holding here through the summer while I'm traveling etc. and will restart my taper this fall. But in the mean time I wake up every morning feeling like HELL!! Tired all the damn time. Feel ill alot. Stiff, achey. Upset stomach alot. Is this still possibly the mirtazapine??

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