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Tapering: Mirtazapine

active

5 posts

España

Hi, I'm Nieves

July 8, 2026··
I reintroduced mirtazapine after two and a half years due to a reaction to tropicamide, and it caused akathisia. I didn't know what it was, and the doctor told me I needed to go back on medication. This second time around, I’ve experienced a huge number of side effects, and by the fifth day, I was unable to stop taking it. I’ve been on it for two and a half months; I started at 7.5 mg and am currently at 5.4 mg, experiencing horrible physical, cognitive, and emotional symptoms. For me, the worst ones are total anhedonia—a complete lack of emotion—and the disruption of natural sleep.

Mirtazapine — 5,4 — actively tapering | without clinician

7 Replies

Based
BasedStaff2mo ago
Community AnchorEffexor
Hi @Nieves ! Thanks for joining us. If you’ve tapered recently and are feeling poorly, take some time between your next cut. The anhedonia will start to wear off when youre on lower doses or off. All the best! Keep us updated on how youre doing and please dont hesitate to share your knowledge with others and welcome them to the community!

Creator of Taper Community, here to help you.

N
Nieves2mo ago
WelcomerMirtazapine · active
"anhedonia" — @Based Psychiatrist
The anhedonia and total lack of emotion started right on the third day of taking it, along with a host of physical symptoms. Looking at the PSSD community, I don't know if there's any chance of improvement. It’s been two and a half months—one month spent tapering the dose—and I haven't improved, though I haven't gotten worse either. Do you really think this can get better? I hardly know of any cases where people improve after reintroducing the antidepressant that triggered a multisystemic reaction in them. Thanks.

Mirtazapine — 5,4 — actively tapering | without clinician

Catina
Catina2mo ago
Community AnchorEffexor
Hi @Nieves, and welcome! I'm really sorry about what happened to you with the Tropicamide causing akathisia.
"I didn't know what it was, and the doctor told me I needed to go back on medication." — @Nieves
Unfortunately, many doctors are not trained to recognize drug harm, so they add another drug thinking that will solve the problem. However, many times it can create new ones. Here is some info from Google AI about how the eye drops can cause akathisia: While tropicamide is used as an eye drop, it can occasionally absorb into the bloodstream and cause central nervous system disturbances. Restlessness and hyperactivity are recognized side effects, but specific, severe akathisia (a strong, painful inner compulsion to move) is a rare and unexpected reaction that should be evaluated immediately. Why Tropicamide Affects the Brain Tropicamide belongs to a class of drugs called anticholinergics. When the drug is absorbed through the eye into the bloodstream, it can pass the blood-brain barrier. It disrupts the delicate balance of chemicals in your brain that control movement and emotions. This is similar to how certain antipsychotics or anti-nausea drugs can trigger movement disorders like akathisia. Warning Signs of Tropicamide Toxicity If a significant amount of the drug absorbs into your system, you may notice these severe, systemic effects: Motor Restlessness: Constant pacing, shifting of legs, or an inability to sit or stand still. Mental Changes: Confusion, agitation, or seeing/hearing things that are not there. Physical Symptoms: A racing heart, dry mouth, and muscle rigidity. Because tropicamide has a relatively short window of action, the side effects usually fade as the drug leaves your system, which typically takes anywhere from 6 to 24 hours. However, severe reactions require medical attention.If you or someone else is experiencing severe adverse reactions, please tell me: What specific symptoms are occurring (e.g., severe pacing, confusion, or a racing heart)? Was this from a recent eye exam or other medical use? Is the person experiencing other side effects, like extreme dry mouth or blurry vision? ____________________________________ If I were you I would report my adverse reaction to the proper authorities so an official record can be made. To report an adverse reaction to a medication in Spain, use the Spanish Pharmacovigilance System online portal. Regarding the Mirtzapine....do your symptoms get worse after a cut or do they pretty much stay the same all the time? Do you think you have PSSD? Are your genitals numb? I'm really sorry you're going through all of this. As Based Psychiatrist said, you may need to hold for awhile before you try and make another reduction. Your poor nervous system is dealing with a lot right now and needs time.

Venlafaxine (tapering) - Current dose 17.92 mg
Trazodone - 50 mg
Levothyroxine - 25 mcg

“Your brain and body know how to heal. Trust the process and keep going.”

Please Note: I am not a healthcare professional. Any advice given is based on personal experience and that of others in the lay withdrawal community.

Based
BasedStaff2mo ago
Community AnchorEffexor
"Do you really think this can get better?" — @Nieves
Ive seen it get better, but its a case by case basis.

Creator of Taper Community, here to help you.

N
Nieves2mo ago
WelcomerMirtazapine · active
@Catina ...report it, but it was already too late; the reaction got worse by the day. By the sixth day, the akathisia was so unbearable... I started having urges to harm myself; I didn't know what was happening to me... Now, because I took more medication, I am even more damaged. I have no emotions—for me, that is the worst part of all, and it is the only thing I want to get back. If only I had known that what was happening to me was caused by the medication and not anxiety; then I would be fighting a different battle. @Based Psychiatrist So, are you saying I can recover? Sorry for pressing the issue with certain questions; this is all new to me, and I’m looking for support and hope, but also a realistic perspective. Thanks to everyone for the support and for welcoming me into this community.

Mirtazapine — 5,4 — actively tapering | without clinician

Catina
Catina2mo ago
Community AnchorEffexor
"report it, but it was already too late" — @Nieves
It's never too late to report an adverse reaction. It's important for them to have an official record of what the eye drops did to you.
"By the sixth day, the akathisia was so unbearable... I started having urges to harm myself; I didn't know what was happening to me... Now, because I took more medication, I am even more damaged. I have no emotions—for me, that is the worst part of all, and it is the only thing..." — @Nieves
What you're describing sounds awful, and I'm so sorry you've been going through something so traumatic. We're here to support you during this difficult time, so reach out whenever you need to. 💝

Venlafaxine (tapering) - Current dose 17.92 mg
Trazodone - 50 mg
Levothyroxine - 25 mcg

“Your brain and body know how to heal. Trust the process and keep going.”

Please Note: I am not a healthcare professional. Any advice given is based on personal experience and that of others in the lay withdrawal community.

Based
BasedStaff2mo ago
Community AnchorEffexor
"So, are you saying I can recover?" — @Nieves
It really a case by case basis. considering that I didnt conduct a clinical exam with you it would be foolish to say one way or the other. But considering the vast recoveries that Ive seen I do not think that anyone is truly too far gone. I know that it doesnt help much, but either way it can take a long time. I know we dont have any clinicians in spain but we will work on connecting you to someone and try our best.

Creator of Taper Community, here to help you.

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