Mirtazapine Startup and Withdrawal

Mirtazapine Startup and Withdrawal

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Disclaimer: The information contained within this blog post does not constitute medical advice and is for informational purposes only. While I have a PhD, I am not a licensed medical professional. Any questions you have regarding your health should be discussed with your treating physician. Also, the experience described below is my experience only. Just because the medication didn’t work for me, doesn’t mean it won’t work for you.


I’ve debated for a long time on whether or not I should write this post. By writing this post, I am choosing to let people in on my medical history, which might come back to haunt me and it might affect my future job prospects on account of discrimination against those with mental illness. But at the same time, I feel that there are not enough open and honest discussions of psychiatric medication experiences, particularly with what to expect going on the medication and how to safely get off. So in the end, I think the positives outweigh the negatives in sharing my experiences on mirtazapine, so I am going to go forward with it. In this post I will discuss my reasons for choosing mirtazapine (Remeron) and the startup, long-term, and withdrawal side effects.

Why I Chose Mirtazapine

When I was first in the market for choosing a medication for my anxiety, my psychiatrist gave me four choices: escitalopram (Lexapro), duloxetine (Cymbalta), mirtazapine (Remeron), or amitriptyline (Elavil). A note on the conventions: the name outside the parentheses is the generic name and the name inside the parentheses is the brand name. After a nasty experience with the fluoxetine (Prozac) prescribed by my primary care doctor, I immediately wrote off trying any other selective serotonin reuptake inhibitors (SSRIs) which meant that escitalopram was out of the question. Regarding duloxetine (a serotonin and norepinephrine reuptake inhibitor or SNRI), I had heard multiple horror stories of start-up and withdrawal side effects so I steered clear of that one. This narrowed down my choices to mirtazapine (a noradrenergic and specific serotonergic antidepressant or NaSSa) and amitriptyline (a tricyclic antidepressant or TCA). After scouring through the scientific literature for adverse events and side effects, I settled on mirtazapine because it was safer than amitriptyline from a cardiotoxicity standpoint [1-5].

Startup Side Effects

Going on mirtazapine was a cakewalk compared to the SSRIs that I tried. The only start-up side effects that I had were stomach pain, burning eyes, dry mouth, and extreme fatigue (I slept for 40 hours in 3 days). These startup side effects only lasted about a week or so. Every night when I would take it, within an hour, I was out cold sleeping like a log. I am generally a light sleeper and take a long time to nod off, so this was a very welcomed side effect. If you are about to start this medication, then check these 12 tips for starting new medications.

Long-term Side Effects

I was on 7.5 mg of mirtazapine for about a year, and there were some longer-term side effects that I noticed as time went on. The list of side effects below are ones that developed after a month or two of being on the medication and persisted for the duration of treatment:

  1. Carbohydrate/sweets cravings
    • These got to be pretty intense. I remember a few nights they were so bad, that I actually had to lock myself in my room, chew on a piece of gum, and distract myself so that I wouldn’t stuff my face!
  2. Weight gain
    • Thankfully for me, this was only 6-8 pounds. Some, but not all of it, came off when I discontinued the medicine. I am not sure if it has permanently altered my metabolism and/or if I am just not as active as I used to be (my new medicine also makes me tired). I wrote a separate post on how I kept my antidepressant induced weight gain under control.
  3. Random twitching of hands and feet
    • This was annoying. I would be sitting and watching TV when all of a sudden one of my hands would randomly jerk. I think mirtazapine has a weak affinity for dopamine receptors [6], so this was likely the cause.
  4. Grogginess for several hours upon waking
    • This was obnoxious. I would wake up in the morning and instead of feeling refreshed, I just wanted to keep sleeping for the rest of the day. It would generally clear up by the afternoon, but it was never completely gone.
  5. Dizzy spells/lightheadedness
    • I am not sure if the mirtazapine caused this, or if this was just due to my anxiety not being taken care of by the medication. I still have dizzy spells on my new medication, so I am leaning more towards it being anxiety-driven.
  6. Fatigue
    • This persisted all day long unfortunately. I would feel it the most when I went running, or when I went to go and do a cardio workout.
  7. Memory loss
    • Again, this might be anxiety-related but I noticed my short-term memory was going. Mirtazapine does hit the histamine receptors like a Benadryl [6], and Benadryl is known for its long-term detrimental effects on memory.
  8. Elevated cholesterol levels
    • After reading that this could be a potential side effect, I made sure to get my cholesterol levels checked before I went on the medication and also while on it. While the numbers were within the normal limits, they definitely were not good. Once the mirtazapine is cleared out of my system for a while, I will have my levels retested to make sure they went back to baseline.
  9. Anxiety around meal times
    • I never quite figured this one out. I never read anywhere that mirtazapine could interfere with blood sugar levels but that is the only thing I could think of that would cause something like this. Thankfully this mostly went away when I came off of it.
  10. Vivid dreams
    • This is a side effect I actually enjoyed. I hardly ever remember my dreams, but thanks to mirtazapine, I remembered them pretty well. Now, I am not prone to nightmares so the dreams were mostly pleasant, with some that were a bit odd. If you are prone to nightmares, this might end up being a really scary side effect for you.

Withdrawal Side Effects

From what I’ve heard from doctors and pharmacists about mirtazapine, withdrawal is not all that common. The medical community asserts that mirtazapine is one of the easiest antidepressants to taper off of. In fact, if you look through the scientific literature, there are very few recorded case reports of withdrawals [7-9]. This is surprising, given the extensive documentation on severe withdrawals from all other classes of antidepressants. However, after perusing the internet and partaking in some support groups related to mirtazapine withdrawal, it appears that this hasn’t been thoroughly researched. One of the group participants (who also has a Ph.D.) directed me to a recent case report that will hopefully start the discussion on mirtazapine withdrawal within the medical community, and how severe it can be. Unfortunately, when my doctor and I decided to taper me off of mirtazapine, I had a pretty rough time the first time around. This was greatly mediated by slowing down the taper. During my taper, I experienced the following withdrawal side effects:

  1. Increased anxiety
    • This would generally happen a few days after a dose decrease, but only in the pill cutting phase of the taper. Then, once completely off the medication, I experienced a surge of anxiety that would not dissipate. I am not sure if this was because my brain chemicals needed to find a new equilibrium or if the original problem had returned. Regardless of the cause, I increased the dose of my new medicine to calm it down. It may have since subsided, but I decided to keep the dose of my other medication at a higher level for the time being.
  2. Itching
    • Because mirtazapine acts on the histamine receptor (e.g., acts like a Benadryl), it makes sense that when coming off, you are going to itch. And itch I did, all over. It was most persistent on my scalp, arms, and legs. It was severe enough that I would bleed at times. It was horrible. Regular application of lotion did nothing to alleviate it. The only thing that helped was to take a cold shower or apply cold compresses if the itching was local. The other type of itching I experienced, which only happened once I was completely off the medication, was itching when I exercised. This was severe enough that I would have to cut my exercise short and run home and take a cold shower. Thankfully this eventually stopped.
  3. Insomnia
    • This is unfortunately an ongoing issue with me. Again, because it acted like a Benadryl and knocked me out at night, my body became dependent on it for sleep. It was at its worst right when I came off of the medicine. I had trouble drifting off to sleep and then I would wake up in the early morning hours because of nausea or I would wake up at 5 am because of the sunrise and chirping birds. My sleep seems to be much more easily disturbed by external factors like noise and sunlight. I have since remedied these things for the most part with a sleeping eye mask and some earplugs. As for drifting off to sleep, I’ve had to practice really good sleep hygiene. I will be writing up a separate post on that, so stay tuned.
  4. Brain fog
    • This could be from the medication or because of unresolved anxiety. It just seemed like I had trouble thinking and concentrating. My head wasn’t as clear as it used to be when I wasn’t on any medication.
  5. Nausea
    • When I went off the medication the first time, this is what drove me to reinstate. The nausea was HORRENDOUS. Not even Zofran could touch it. I am on the thin side to begin with, so the rapid weight loss that ensued from not being able to eat was worrisome. After doing a slower taper, it was much more manageable. It would come in waves as opposed to being present 24/7. Because of this, it was easier to combat using Tums and Zofran. Of course sometimes it would come at an inopportune time like in the middle of the night, and I wouldn’t be able to get back to sleep. What I found also helped, was drinking ginger tea on a regular basis. Ginger is an antiemetic, which means it will help in the prevention of nausea and vomiting. After checking the ingredient lists of several brands, I settled on the Harney and Sons Ginger Tea because it was the only one that had real ingredients. You can also make your own at home with fresh ginger. I am not sure why nausea happens upon withdrawal, but my suspicion is that it has to do with mirtazapine’s strong antagonist effects on the 5-HT2 and 5-HT3 receptors, some of which affect the GI tract.
  6. Dry heaving
    • Naturally, this came about as the result of the nausea reaching the tipping point. I never actually vomited, but I clutched a bucket pretty tightly for a few weeks.
  7. Diarrhea
    • This also comes with the territory of just general GI disturbances. Basically, you can expect a lot of GI disturbances coming off of mirtazapine. From the forums I am a part of, this seems to be a common complaint when coming off in addition to severe nausea.
  8. Chills
    • At the height of my nausea experiences, I had some pretty bad chills. I would fluctuate between shivering so badly that I needed to be under a pile of blankets to being so hot, I wanted nothing on my body. I checked my temperature and it was fine, so I chalked it up to the withdrawal. Thankfully, this passed pretty quickly (a day or two).
  9. Electrical shock sensations and bone pain
    • When I was in the pill cutting stages, after the first drop from a whole pill down to a 3/4 of a pill I experienced what felt like electrical shock sensations traveling up my arms. They were pretty painful, but not so bad that I couldn’t just ignore them. These lasted only for 2-3 days. Now, the more concerning pain was the bone pain I had. It was in my foot and above my left elbow. That was excruciating. One night it woke me up out of a sound sleep and I was writhing in agony and massaging the areas to try and relieve the pain. Nothing worked, so I just had to wait it out. Thankfully, that only lasted 2 days.
  10. Brain zaps
    • So, this one I only figured out what it was after I googled the symptom I was experiencing. Basically it felt like the electrical shock sensations traveling up my arms but in my brain. They were pretty intense and hurt quite a bit. I didn’t experience these until I had been off of the medicine for some time, and they lasted about 5-7 days.

It is important to note here, that because everyone’s body and genetic makeup is different, the withdrawals will also vary from person to person. I am part of a mirtazapine support group on Facebook, and there are several people on there that report having no withdrawals, despite tapering really quickly. There are also people like me on there, who have a horrible time getting off mirtazapine. And then there are also people that aren’t able to get off mirtazapine at all, due to chronic severe withdrawal side effects. It’s important to keep in mind that yes, while most medications will be eliminated from the body within a week or two (depending on the medication half-life), the changes of the brain and of the body occur on a longer time scale. To the people who would tell me it was all in my head, I would kindly reply back that antidepressants generally take 3-4 weeks to notice any benefit and 6-8 weeks or even 8-12 weeks to reach full efficacy. So, it would be reasonable to assume that withdrawal, if present, should occur on a similar time scale. The bulk of my withdrawal effects from tapering the second time occurred within weeks 1-4. The insomnia and the nausea were longest lasting withdrawal side effects, but thankfully, they went away with time. After a few months off of the medication, I was free from all side effects.


I hope those of you that are interested in starting or discontinuing mirtazapine find this post useful. The intention of this post wasn’t to scare people away from trying it, as this medication has been a game-changer for many people for a whole range of conditions ranging from non-psychiatric conditions (e.g., insomnia, appetite stimulant) to psychiatric (e.g., anxiety, major depressive disorder). I felt it was important to give an honest account of my experience, in case someone else was going through something similar. At the end of the day, you need to listen to your body and perform a risk/benefit analysis of the medication with your doctor. For me, the risks of this particular medication outweighed the benefits, so it wasn’t worth continuing. After genetic testing, I have since transitioned to a different medication.

Additional Support Resources

1. Stopping Antidepressants – written by a psychiatrist in the UK

2. Mirtazapine Facebook Support Group

Additional Literature References

Cardiovascular Effects

[1] Smith, Ward T., et al. “Mirtazapine vs. amitriptyline vs. placebo in the treatment of major depressive disorder.” Psychopharmacology bulletin (1990).

[2] Montgomery, S. A. “Safety of mirtazapine: a review.” International clinical psychopharmacology 10 (1995): 37-45.

[3] Fawcett, Jan, and Robert L. Barkin. “Review of the results from clinical studies on the efficacy, safety and tolerability of mirtazapine for the treatment of patients with major depression.” Journal of affective disorders 51.3 (1998): 267-285.

[4] Yekehtaz, Habibeh, Mehdi Farokhnia, and Shahin Akhondzadeh. “Cardiovascular considerations in antidepressant therapy: an evidence-based review.” The Journal of Tehran University Heart Center 8.4 (2013): 169. (FULL ARTICLE)

[5] Watanabe, Norio, et al. “Safety reporting and adverse-event profile of mirtazapine described in randomized controlled trials in comparison with other classes of antidepressants in the acute-phase treatment of adults with depression.” CNS drugs24.1 (2010): 35-53.

Remeron Mechanism of Action

[6] Davis, Rick, and Michelle I. Wilde. “Mirtazapine.” Cns Drugs 5.5 (1996): 389-402.

Remeron Withdrawal

[7] Berigan, Timothy R. “Mirtazapine-associated withdrawal symptoms: a case report.” Primary care companion to the Journal of clinical psychiatry 3.3 (2001): 143. (FULL ARTICLE)

[8] Cosci, Fiammetta. “Withdrawal symptoms after discontinuation of a noradrenergic and specific serotonergic antidepressant: A case report and review of the literature.” Personalized Medicine in Psychiatry 1 (2017): 81-84. (FULL ARTICLE)

[9] Ikenouchi-Sugita, Atsuko, Reiji Yoshimura, and Jun Nakamura. “A case of discontinuation syndrome following the discontinuation of low-dose mirtazapine therapy in malignant lymphoma.” Clinical Neuropsychopharmacology and Therapeutics 2 (2011): 30-31. (FULL ARTICLE)

26 thoughts on “Mirtazapine Startup and Withdrawal”

  • Thank you so much for posting this. As an avid researcher of Mirt’s side effects (in the midst of an entertaining taper) I can humbly admit this is one of the most thorough, candid and valid posts on one’s experience with Mirt. The graph/visualization with the taper schedule/survival curve is impressive as well.

    Curious where you found the liquid mirt? I am currently on 3.75mg and don’t think I can go much lower with the actual pills.

    P.S. You should be my psychiatrist because this post helped 10x more than my current MD.

    • Hi David! I’m glad you found my post helpful. I was worried about sharing such personal information, but this post actually turned out to be my top performing post!

      I am not sure what pills you have, but I had 7.5 mg pills, and was able to roughly cut that into quarters. If you have the same pills, you can likely get one more taper step out of them.

      As for the liquid formulation, where you get it depends on your geographic location. I believe in the UK they have a liquid version readily available without the use of a special compounding pharmacy. If you are US based, you have to ask your doctor to send a script to a compounding pharmacy and they will make a suspension for you. What they basically do, is grind up the mirtazapine and suspend it in a liquid. Which means you can also ask the compounding pharmacy to use the same pill manufacturer used on your current pills to maintain consistency (it should say on the bottle).

      And yes, from what I’ve heard from others, a lot of doctors are not well versed in how to properly taper a patient off of these types of medications. To be fair, the literature actually really say there are withdrawals for mirtazapine. A few case studies started coming out on it showing withdrawals, and I hope a more comprehensive study about mirtazapine withdrawals is completed soon (I should just do it myself!). And the doctors use these studies as a guideline, along with other guidelines that suggest a rather fast tapering schedule imo.

      Like I always tell people, finances and health insurance permitting, you are in control of your taper at all times. Always check your proposed taper schedule with your doctor, but you can taper at whatever speed works with your body. For me, I had to slow it down because it became debilitating.

      Also, if you’re not a member already, the Facebook group I linked in the article was a great support group for me when I was doing my taper.

      Best of luck, and let me know if you have any other questions!

  • Thank you for writing this as it nice to read what I m going through right now.
    I cut from 15mg to 7.5mg a week at ago and it has been pretty grim to say the least.

    Can I ask which medication you have found useful?

    Kind regards

    • Hi Derek! Yes, Mirtazapine withdrawal is often underestimated by the medical community. While many people come off without incident, there are still many others that struggle through withdrawal. If the withdrawal is interfering with your ability to get through the day, I would request a slower taper from your treating physician. As for the medication I am on, I’m not comfortable disclosing that. But I will say that it is not a traditional treatment option. I wish you luck with your taper, and you are not alone in your withdrawal struggles!

      • Thank you for the reply. Another interesting few days over and from tonight I will be free from taking this drug. Quite prepared for some resistance but that will be it done.
        After much thought no more medication for me having tried several anti depressants. I will go back to my old self…slightly depressed and anxious but that is a better person I am leaving behind. I know now good food , positive attitude ,exercise and faith in what ever you believe in is the answer.
        Glad you have found your answer.

        • Hi there, Thanks for this article. I’ve been on Mirtazapine for 8 weeks (after switching from Paroxetine). Am currently on 45mg (have been for 3 weeks) but having some horrible side effects at this dose, so physchiatrist bringing me back down to 30mg. Am freaking about that drop (which he knows) but will go with the program (I am under a care team that are monitoring me and I have access to 7 days a week). I guess he can see the state I’m in at this dose so figures the pros of quick drop outweigh the cons? I might need to read more of the success stories!
          I see that you aren’t comfortable disclosing the medication that you are now on. Can I instead ask if you or any other anxiety sufferers on the forums have been down the lamotrigine track successfully?

          • Hi! I hope the transition is a smooth one for you! If you aren’t comfortable with that drop, you can always ask if you can add in an additional step or two. I’ve done this with a lot of medications, and it really helps. Always listen to your body on this, and be your own advocate.

            Regarding the lamictal, I know a lot of people on it and they have had a lot of success with it for bipolar, depression, and generalized anxiety. I actually just recently gave it a trial run, and had zero start up side effects other than a runny nose. I am in the process of coming off, because it might’ve given me motor tics (this is VERY rare) and my body feels restless. While it obliterated my depression and helped with day-to-day anxiety at home, it did nothing for my panic attacks and agoraphobia. So it really depends on what you are taking it for. If you are interested in it, definitely check with your doctor. It has great reviews online, as compared to the antidepressants.

  • Dr. A, you rock – thank you for this article! My Dr. put me on melatonin 3mg + Mirt 7.5 to swap out for Xanax .5mg nightly to turn off my brain so I could sleep. She was concerned about liver issues and Xanax dependency, but it only took one night to stop Xanax. The 7.5 Mirt was too strong for me so I’ve been cutting it in half and all works well with one major exception.. I had gastric sleeve 11 mos and 80# ago, and now am GAINING WEIGHT on Mirt (YIKES), so I must get off it and will try melatonin alone and gauge results. My plan is taking Mirt 3.75 every other day for one week, then nothing. I’ve only been on Mirt two mos so don’t expect complications. I deal with GAD and OCD “features” and by day take Venlafaxine 112.5mg which has been working well for me. I must say the VIVID dreams will be missed in a way, but o well. It is very interesting to read experiences of others here, and I look forward to reading more posts from you on this and other topics! Best regards, J

    • No problem! 🙂 This post is actually one of my top performing posts, and has helped a lot of people. And your doctor is right about the Xanax dependency. I’ve heard a lot of horror stories about it. I am glad that you found something that is working for you, the Venlafaxine. That is often half the battle on the road to recovery, finding something that works. Best wishes!

  • Thanks so much for this. I am currently tapering off and this was the only article I readthay put my mind at ease. Thank you

  • Thank you for this wonderful article.

    I have recently stopped this medication, as part of a recent blood test, it was noted that my Cholesterol levels were elevated.

    Did you ever get your levels rechecked? It has been around 6-7 weeks since stopping this medication and wondering whether I could still be subjected to Cholesterol fluctuations that are referenced in the leaflet.

    I am extremely concerned because my levels are outside of normal, I suffered with major weight gain and my super levels have increased. I’ve never had issues with Cholesterol numbers in the past and I’m only 35.

    Thank you.

  • I’m really glad you posted this. Congrats on getting off so quickly. I’ve been tapering myself off of vaious medications for many years (my decision, not my doc) . I’ve been pretty successful. I decided Mirtazapine was next. I didn’t feel that it was helping me at all. I’ve been on it for over 20 years. Yes, you read that right. My doses were increased over the years until I was up to 45mg a day. After reading of all the negative side effects of Mirtazapine, I decided it was time to get off of it. I know how sensitive my body is to medication dosage changes and have followed the 10% a month rule on some more difficult tapers without intolerable withdrawal symptoms. Three years ago I started the Mirt withdrawal, but as my life was in a state of upheaval, I decided to ask my MD for a script for 15mg and dropped only one 15mg pill a week – less than 5%. I tapered only once a month.. I experienced virtually no withdrawal symptoms. Would I have like to do it more quickly? Of course! But past experience has told me that slow and steady wins the race. I’ve had some very miserable (understatement) withdrawal symptoms when I’ve tried to discontinue a drug too quickly. The percentage taper increases as I lower my dose, but I got down to 30mg a day and then to 15mg. Each felt like a triumph. Then I had a number of unrelated physical illnesses, and decided to stay at 15mg until things improved. It’s been 3 years since I started (again, yes, 3) and I’m down to 11.25mg a day by splitting a 15mg tablets into quarters. I’m looking forward to eventually getting down to 7.5mg. That’s where you started! I’ll keep going and listening to my body as to the pace and percentage of my taper. To take years to get off a drug may seem nuts, but it’s better than not getting off it at all. When you consider how many years I’ve been taking this drug, it makes sense that my body needs more time to adjust. I’m not advising that others do it as slowly as I. Nor am I advising pill splitting unless you have consulted a pharmacist. We all have to listen to our bodies and find what works for us. Doctors seem oblivious to the suffering caused by too rapidly tapering psychotropic medications. You did the right thing in sharing your experience. Kudos!

  • Thanks for sharing – it is so useful. I have gone from 15mg to 7.5 mg without major problems. 3 weeks ago I reduced to 3.75 mg – by week three I have a major digestive response which is very painful and debilitating. I have had this for 8 days and it is getting worse and worse. So I am going to listen to my body and go back to 7.5 and then go for a10% Taper. I was going to try and stick it out but this level of response cant be right – and my body is crying out for me to do something different. I didnt want to give up at this point but I cant function and can hardly leave the house. So thanks again for such a helpful article.

  • Thank you for this post. I was also on 7.5 mg for mild anxiety and the med did work. First, I started having vertigo. The doctor that prescribed it did not think it was connected and instead prescribed ear crystal exercises.10 months after starting, I had dizziness, ringing in ears and nerve tingling. Again the prescribing doctor did not connect these symptoms with the drug as I was on a low dose.

    After reading about side effects, I thought to eliminate this drug. My doctor said I could stop cold turkey. I tried to stop taking it and had a physical meltdown. By 2 pm the day after not taking my nighttime dosage, I was reaching in my bag for the pill. I then did a lot of research on tapering. I am very appreciative of your post that got me – on my own – to reduce this drug – with the doctors OK – to see if my symptoms persist.

    I did not do the pill cutter or the liquid but did taper from 7.5 to 6 to 5 to 4 to 3 every fourth or fifth day and then finally 1 mg and then skipped a day. I went down each level after 4-5 days depending on how I felt. My pill cutting by hand was not precise. 30 day total taper that finished one month ago. I am felling better and normal, symptom free. Still having some dizziness but it could be allergies.

    Once I was determined to stop this med, your post built my game plan.

    Thank you again. A life changing experience. I do still have tinnitus – ringing in ears. I can live with that.

    • I’m glad you found this post helpful, and that you were able to have a successful tapering experience!

  • Hi,

    I was on Mirtazapine 15mg for around 8 months to treat my insomia, and then i tapperred down to 7.5 for one month and then I stopped.. I can still sleep with no issues, however sometime my insomia kicks in after one or two weeks, so I take it just to break this insomia cycle for couple of days, and then my sleep issue is resolved for another few weeks and then whenever my insomia kicks I do the same. So need to know whether taking mirtazapine 15mg as needed basis is OK to use or not.

    • Nosh, you need to direct your specific questions at your prescribing physician. All medication changes, tapers, etc should always be done under the guidance of your physician.

  • This is such a great post! Thank you for sharing it — yes awareness is quite important (though I do hope you don’t receive any ridiculous backlash for MH). This kind of information will help many folks who may not know what they are struggling with.

    So glad to find others that know about the 10% advice — like you said, one can always go slower or a bit faster. It’s very personal, but 10% is a good rule of thumb. Helps you get control of a withdrawal syndrome that can quickly get out of control.

    Glad that you were able to manage the process ok, though sorry to hear you had remaining issues. I have a remaining condition from my SSRI use, so I feel you.

  • I’m currently tapering off mirtazapine (due to weight gain) and am getting very discouraged. I started at 3.75mg (1/4 of a pill), got it compounded into liquid and started tapering a month ago…. I’m now stuck at 2.3mg and feeling horrible (insomnia, nausea, diarrhea, fogginess, sadness, low energy). This is day 6 on 2.3mg and I’ve been very tempted to go back to the 3.75mg and get my life back. My psychiatrist doesn’t understand and thinks 3.75mg should be super easy to get off so I feel three’s no support from anyone.. How many days should I suffer before I give up and go back? If it doesn’t resolve in 1 or 2 weeks?

    I’m so glad I stumbled upon your post – this could give me the push I need to continue!

    • Hi Marilyne! I am so sorry you are struggling through this. I remember how brutal the taper was. Regarding your questions, you need to direct them towards your prescribing physician. Best of luck with your taper, and I am glad you found the post helpful!

  • Have you heard if anyone has had any luck with tapering strips? They are available from a pharmacy in Holland and allow a gradual daily taper over 3 months. I have been on 15mg of mirtazapine for 8 months to treat insomnia. Initially I tolerated them fine but they then started making me feel feel very jittery so I decided to taper off but did so far too quickly (I had no idea how potent this drug is!). I have reinstated at 15mg but frustratingly my withdrawal symptoms have not stabalised. It’s relentless physical and emotional torture. Thank you for writing so bravely about your experience.

    • Hi Phil,

      I personally do not know of anyone who has used the tapering strips. I have heard of them though, and it sounds like a great idea. And yes, some people really struggle with the tapering (I was one of them, and I struggled to come off of a really small dose). It’s certainly worth a discussion with your prescribing physician. And you’re very welcome! I hope you found it helpful, and I hope it made you feel less alone in your experience.

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