Mirtazapine 30mg want to come off

Hi Tony, I replied to your other post about mirtazapine. Thing about most antidepressants (including Mirtz) is that they make you feel neutral about everything, like you're just going through the motions and you can't be bothered with anything. They also take a month or two for your brain to adjust so 3 weeks isn't really giving them time to be effective so feeling dizzy, numb etc is just what happens till then. IMO 30mg is too high a dose. For sleep and anxiety 15mg or even 7.5mg would be more effective and a better starter dose and won't have you zombied out as much. Have you resolved the issues that lead to your breakdown? Sounds like you need to make a decision; 1. Give the Mirtz a chance (if so, I would use a lower dose and see how you get on) 2. Quit the Mirtz and look at alternatives to medication. Eg resolve your issues, practice mindfulness, and simply time. Time always makes things better. Good luck mate

Hi Tony, I feel for you, mate, as a fellow Mirtazapine sufferer (I've been tapering off it for over three years and was only on it for six months before wanting to come off). What you're describing sounds like something they call 'Antidepressant-Induced Emotional Blunting' or 'anhedonia'. The conventional thinking on that is as follows: it could either be due to residual depression that the drug isn't doing a good enough job on, or due to being the wrong type for you or the wrong dose, or it could be a side effect of the drug, in which case it won't likely get better while you're on the drug. You face a difficult decision: jump off ASAP and ride out the inevitable kickback, probably both from the Mirtazapine and possibly the lingering withdrawals of the first drug (and there's no way of knowing how long that will last), or do what most of us here are doing: long-haul hyperbolic tapering on a schedule that aims to make withdrawals tolerable and avoid protracted withdrawals (and if you do it as most of us do - in 3-10% reductions every four weeks - that will take years). It's a tough spot you're in, and no one can make that gnarly decision for you. You say the anxiety has improved, but it sounds like you hate how you feel on the drug generally and don't feel like yourself - I guess you'll have to weigh up what's most important to you. In your shoes, I'd choose having myself and my feelings back because there is SO much help out there for anxiety, and you don't have to be alone. Frankly, I'm pissed off with that counsellor for putting you on Mirtazapine; there are way better ways you could have been helped to ride out the bumpy patch after that first AD. For example, here are two killer resources - one for sleep and one for anxiety (though it must be said that if insomnia is related to AD withdrawal, there are things that can help, but it's a brain receptor thing that nothing is a total match for). Bye Bye Panic: https://www.youtube.com/@AnxietyRecoveryStories The Sleep Coach School: https://www.youtube.com/@thesleepcoachschool8192/videos So, back to that difficult decision: listen to your gut. Try to connect with your intuition through the haze of the drug. We're here for you if you want to come off it, whether you choose to jump ship or taper. But Cosmic is right: 30mg is commonly prescribed for anxiety/depression but is not the right dose for insomnia - a standard dose for both is 15mg and you can get away with less for sleep alone (my pre-taper dose was even less at 7.5 as I went on it for brutal stress-related insomnia).

Thanks for the advice, much appreciated. The insomnia was due to the same issue as the breakdown. I believe. And the first antidepressant I was on led to further insomnia. I’m learning to live with what happened as in the nervous breakdown if it was that it could have been burn out I’m unsure. Trouble with the lower doses of Mirt is that I’m so so sleepy the next day and I drive for a living so when I was on 7.5 1st dose, I had to constantly have coffee to do my job. It was a bit better at 15mg but still so sleepy most of day didn’t wear off till 3/4pm. My anxiety which followed the depression after the incident was crippling and I really needed something to ease it as I could hardly function. I cut back to 22.5 last night and hope to stay there for a bit. I’m aware I might well start feeling low and get anxiety again. So we will see. I’ve had few life events which led me to the incident, breakdown of 22 year relationship 2 years ago, my older son leaving to start his own family, etc etc which I don’t think I fully resolved. I think I just made sure I was busy which I was but now being winter and no one around I started to feel very isolated and low until one day I just couldn’t do it any more. I felt I didn’t want to continue. I fought that feeling every day till I went to Drs unable to fight it anymore. I really didn’t want my boys to be without their dad.

Tony, you're in the right place and getting some great advice! And you are the rule here, not the exception. We're all a bunch of insomniacs! 😵 At some point - it's now - you confront your fearful thoughts and negativity and begin the long sigh road of suffering to get off your meds. Ask for support when you need it, we're always here lol TC has some excellent articles you should read to prepare yourself. You can do it! You will still live an abundant life, with plenty of good advice for your kids and others too 👍

I feel for you Tony. I had 2 years of severe stress both domestically and at work due to a critical project that all rested on my shoulders. I was totally burnt out and just wanted to feel nothing. From experience the tiredness, grogginess from taking mirtazapine goes away after a few weeks so maybe you didn't give the 7.5 dose time to do that or cut to a lower 1/4 of a tablet which would make you less groggy. I used 3.75 and found it very effective and the optimum dose. Also, withdrawing from a previous drug would give you increased anxiety so all you may have done is swapped one med for the other. Looking back now, most of the anxiety I suffered over my 'bad' 2 years was because a few weeks earlier I had stopped Mirtz because I thought I was fine, it tricks you like that. In your shoes I would go down to 7.5 and hold to see how you feel and if the grogginess fades. You will feel anxious, be strong. It's actually a good sign, because your brain is adjusting back the only way it knows how.

One final thing, practice mindfulness. I thought it would bea waste of time but it really does help and can be more effective then drugs When I suffered from insomnia, it got so bad I just excepted I wasn't going to sleep as a simple fact, stop giving a shit about it, just give in and accept as God's will. I looked at breathing exercises and this really works for me. Breath as slow and deep as you can. Count every slow breath in and every slow breath out. Concentrate on nothing but your breathing. If any thoughts pops in your head, just focus back on your breathing and nothing but your breathing, deep and as slow as you can. Even if you count to the 1000's it doesn't matter. Eventually you'll lose count, that's good, it's working start from zero again. I guarantee that will get you to sleep better then most sedatives. I've gone to bed some nights certain I ain't getting a wink of sleep, my anxiety is through the roof, my chest is on fire, then amazed myself that I dropped off for 6 hours.

Hi I’m only 2 nights into my decrease of 30mg for last 3 weeks to 22.5mg and I woke this morning with immense fear and anxiety and struggled to get up & do my usual stuff. It’s not really gone away. I was just going through the motions. Now at 3.30 I feel totally lost and bewildered at what to do. Maybe I need to meds to get me through this very difficult period. It’s like my nervous system has hit back back today. I have work tomorrow but unless I feel meter doubt I’d be able to function. I’m aware the longer I’m on the meds the harder it’s going be to eventually come off. Which scares me as right now I don’t feel strong enough to cope on my own. Any advice would be welcome. I’m in Counciling fortnightly and next week got a call from talk therapy to try and help with the anxiety,

Hey Tony, We've all been where you are, so you're not alone. You're in panic mode, but it will pass. There's a right time and a wrong time to come off meds, hence my comment if you resolved the issues that got you into it in the first place. The longer you're on the meds doesn't mean you'll find it harder, it'll just take longer if you take your time so stop panicking about that. Mirtazapine worked well for me, I only took 1/4 of a tablet and it got me through some really tough months which allowed all the issues I was facing to come to a head and get resolved. Once resolved, I started to taper but went too fast so I'm having to go even slower now. If you've loads of shit on right now and really need a crutch then take the medicine, the same dose every night, till it starts to work. Leave tapering off it for another day, but learn from our mistakes and do it the right way. You'll be fine. If you really want off it no matter what, and you've loads of background stuff to resolve, then you'll just have to come to terms with anxiety as part of the deal.

Thanks for advice I’ve gone up to 30 again for now. How would I when ready taper to 27 as I can easily get to 22.5 by breaking pill in half. Thanks in advance.

If the side effects are making things worse than the original problem, start tapering off them now. They say side effects ease, but rarely to they completely disappear once they e shown up, especially blunting, activation and sexual dysfunction. If however your symptoms were worse pre-med, then stuck it through and give it time.

Some time ago I watched a Josef Witt hyperbolic tapering video where he shows that drops from high doses to even low doses don't typically have much effect at the receptors, even if the occupancy is less; ie there is still plenty of drug at the receptors to do most of the job. The point where lower occupancy is an issue is at the low to very low doses. It appears 30 is considered approaching a higher dose, with maybe 15 a typical, and 7.5 or less a lower dose. So I fully understand @Cosmic1973 strategy. Of course this is fully individual dependent - some are more sensitive and want to suffer less, others are ready for a challenge. It is easier for us who have already been through it and see plenty of light at the end of the tunnel. But don't let being anxious get you in a hurry...

PS: if you decide to go 7.5, you should be able to get 15mg tablets and just cut them in half.

Hi Mcat I tried going to 22.5 but only lasted 2 nights before I woke with terrible fear and anxiety which did wear of later in day and managed to go out for Sunday lunch with friends, though I was ever so slightly paranoid. And my friends all said something is different about you. I have lost a stone which is weird on Mirt as I’m told it increases people appetite. So I have took 30mg for last 2 nights and today I had most awful dizzy spell where I thought I’d have to quit work and go home but I saw it through and ended up feeling exhausted and had big headaches. I must say I was suicidal before I started meds back in September. and I’m not now, I feel sad sometimes , I’m scared and anxious about things, lot of fear in mornings. I get lots of night sweats and then am very cold in daytime. My doctor said I could go down to 15mg when I told them about my side effects and was struggling. Surely going down to 15 would increase the WD and be unbearable? If going down to 22.5 had that affect. I need to be able to function and go to work I am self employed and live on my own apart from every other week I have my youngest with me. I’m going try going down to nearer 27 for next couple of days to see where that takes me. Beyond doing 27 from dry pills I really need to k ow how to taper with liquid is there any videos or advice on this? I’m due my Drs review next Monday morning. Thank you so much.

Yo yo ing your dose every other day ain't helping mate.

What are my options then? Today was very hard after 2 days on 30mg? I’m just trying to find the right dose that can help my anxiety and depression without the harsh side effects.