Mirtazapine Withdrawal

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My doctor has just recommended that after almost a year and a half worth of me taking different meds it is time for me to go clean. The medication I'm on at the moment is mirtazapine 30mg and I'm dropping down to mirtazapine 15mg on my next prescription. I'm pretty scared as I've been on ADs for so long and that I've heard real horror stories online about people having terrible withdrawal symptoms.
Has anybody been in a similar situation to me? What type of things did you experience upon withdrawal and how long did they last for?

Several years ago I was on an opioid pain med for a shingles outbreak. The drug left me drowsy, woozy, and stumbling around. I already have bad knees and an unsteady gait, partly from that, and partly from feet that have always turned out a little, so I was afraid that I might have a bad fall due to the med. As soon as I was able to handle the shingles pain on my own, I took myself off the med. I was surprised when I had withdrawal symptoms, as I had only been on the pain med about a week and a half. It caused me to be very emotional for a few days, but it was worth going through the withdrawal period to get off the med, and not be woozy, stumbling, and in danger of a fall. I live alone, so there is no one around to help if something were to happen to me.

Different meds can have different withdrawal symptoms, and each person will react their own way. But just remember, the worst period of withdrawal symptoms are temporary. Once past that they will decline in intensity, and usually go completely away. In some cases there can be some lingering effects, but it will be at a level you can handle. My mother smoked for over 50 years before she had her first heart attack. The docs kept her in the hospital for several extra days after her angioplasty, so they could keep her on strong sedatives through the worst of the withdrawal phase. They sent her home with strong sedatives, but after a few days we had to have her taken off the home ones, as they were endangering her. They made her stagger around all over the place, like a drunken sailor. We were living in a bi-level house at the time with an open stairwell. Her bedroom and the kitchen were upstairs, and she fell down the stairs several times as she passed the stairs in between her bedroom and the kitchen. The last straw for this tranquilizer was when I came into the kitchen and found my mother standing by the lit stove like a zombie, while holding a burning paper towel! Any withdrawals left from the tobacco, plus any from the tranquilizer were worth getting her off that dangerous medication! Due to her long addiction to cigarettes, my mother did continue to have mild cravings/withdrawals for the rest of her life, but she was able to handle them by chewing spearmint gum.

Generally the worst phase of any withdrawal period is in the first few days or week or two. After that people can handle it better. If you do need help in the first few days, have the doc prescribe a mild, non addictive tranquilizer. My younger brother gave my mother a half dose of a valium once after we had to put the dog we had at the time to sleep. He had inoperable, terminal cancer. My mother was very fond of him--we all were--and she needed the help of one or two half doses to get her through that first day after he died. But my mother only had it once or twice at that time. After a good rest and a day or two, she was better able to handle the sad event.

I wouldn't worry too much about possible withdrawal symptoms, as long as you talk things over with the doc. And if you do need help, just get that mild tranquilizer for a few days.

Here's an odd anecdote. I used to walk that dog three times a day, as we never had a fenced in yard while we owned him. A couple of years after the dog died, we moved a few blocks away to a one story house. Not long after we moved in I had a dream that the dog came to me for a visit and had me take him out for a walk in the new neighborhood. He wanted to see the new area where we were living, so he would know where we were, and so he could still be "connected" to us. I know it's silly, but it made me feel better when I woke up.

thanks for your reply. I enjoyed reading about the trials and tribulations of people you know coming off meds and I have a lot of sympathy for them. I certainly hope my path to being clean of ADs is a much easier one. I'll let you know how I get on. I certainly hope I can be completely withdrawal symptom free after a couple of months. I'd hate to have a few of those lingering effects you mentioned. And spending time with a dog sounds like a good idea! My dog always cheers me up when I feel a bit blue.
Thanks for the reply anyway man it's much appreciated

Agreed with previous answer that everyone is different, so you shouldn't worry about what I'm going to say TOO much. I had real problems withdrawing from mirtazapine 30mg to 15mg (2 weeks-not so bad) and then down to 0 (really bad). The main problem with me was insomnia, which Ive always suffered from and which I can live with normally, but, in combination with mirtazapine withdrawal, I regularly lost control of my moods, thoughts and feelings. I would get REALLY angry, lashing out in verbal tirades both at home and at work. I felt very low, and kept thinking about what it would be like to be dead (not active suicidal rumination, more passive I guess). None of which is like me at all. Lots of other symptoms, much worse than id ever felt BEFORE being prescribed the meds (which i never wanted). it lasted about 4 weeks, and everything was ok again. It was my choice to stop the meds, and id only been on them 3 months. My advice would be to take it more slowly than I did and tail off more gradually, and, if you trust them enough, tell the people you are closest to what is happening and ask them for a bit of understanding that you might not be the person they recognise for a short time....

thanks dude that's really helpful. I've just quit my job so as of now I have absolutely no commitments so I think now is the best time to knock the pills out my system. I seriously hope this isn't going to be horrible but I have the feeling it's going to be pretty bad considering how long I've been on ADs.
Thanks again.

I came off mirtazapine about 6 weeks ago from 15mg to 0, having gone down from 30 to 15 about 6 weeks before. I had trouble sleeping for a few nights and a lack of energy for a couple of weeks. I'm still on 2 mood stabilisers, Seroquel and Lamictal though so not completely without meds which no doubt makes a difference. Bonuses are I feel significantly less sedated during the day and I don't want to mainline sugar constantly any more (I've lost 7lb so far, mirtazapine is possibly the worst AD for weight gain which was a big issue for me).

There are a lot of horror stories about coming off meds and it can be difficult but some people have little or no withdrawal symptoms so don't panic. You can break mirtazapine tablets in half so if you're struggling you could try going down from 15 to 7.5 and then off completely. If it's really bad then it might be possible to take Prozac (fluoxetine) for a couple of days to help - it has a very long half-life so it doesn't disappear from your system so suddenly which can help ease the symptoms of AD withdrawal. Effexor (venlafaxine) has a reputation for having the worst withdrawal partly because it has an extremely short half life (4-6 hours, mirtazapine is 20-40 hours and fluoxetine is 2-3 days short term, up to a week long term).

Generally any withdrawal symptoms should decrease dramatically or disappear entirely after a week or two. If you're still having depression-like symptoms rather than physical symptoms after a month or so then it's possible your depression has returned and you might want to reconsider coming off meds. As I understand 18 months to 2 years is considered an appropriate time to be on meds after a severe episode, if you've had repeated episodes you may need to be on meds for longer and for some people being on meds long term or for life is the best course of action. I have bipolar disorder rather than straight depression so the likelihood of me ever being able to be completely off meds is very slim. My partner had 4 episodes of psychotic depression by her early 20s so she's not going to be med-free any time soon, if ever - it's whether the benefits outweigh the costs and for both of us being unmedicated would be simply too dangerous. What I'm trying to say is don't take it as a value judgement if you find out you may need to be on meds a while longer but hopefully everything will be fine.

I don't want to get a pet since it is destined to die. I might get a bird since they live long but that won't go well, because of my Hyper sensitivities.