Mirtazapine Withdrawal - 6 months on..

This weekend makes it six months since I stopped Mirtazapine completely, and I thought it quite fitting that I write some sort of blurb to mark the occasion!

There's not that much info out there on Mirtazapine withdrawal, so I thought I'd reproduce the bulk of the withdrawal diary I kept at the time.

Some of it is pretty boring and repetitive and occasionally there's the odd thing that could be classed as "too much information" which I'll spare you!

The diary did taper off after a while-not much was changing and I was sick of reporting the same things, but it gives you an idea anyway of what it's all about..

Mirtazapine detox Journal. 

12th September. 

Today I was told I can wean myself off my medication - a day I never thought I'd see!

This will be my first night of tapering off the drug and I've to note down all my side effects. It might be nasty. I have to be prepared, but if I keep my end goal in sight - my dream of a medication-free life will be realised!

Wish me luck!

13th September.

I've cut down from the maximum dose (45mg) to 30mg. I've been on this dose before, so not expecting much..

No trouble falling asleep last night (I was very tired), but I did have vivid and weird dreams. Woke up feeling refreshed.

I'm a bit sleepy now (1.30pm) and could do with a nap. Dry mouth feels slightly better an usual, but I may be imagining things!

14th September.

My night wasn't so great. I had insomnia, and when I eventually did get to sleep I had vivid dreams. My tongue is very itchy. Very weird and unpleasant. It's not anything I haven't had before though..

Bit anxious yesterday, and had to have two naps.

(Evening)

I've been irritable, moody, tearful, emotionally distancing, sarcastic..all PMT related probably. Very lethargic.

15th September.

Vivid dreams again, and the itchy tongue. Mouth is a bit wetter. No toilet trip during the night. A first for a long time!

It's been a surprisingly good day! Camomile Tea seems to work well. I'm very tired physically but not mentally. It may be a long night tonight.

The next few entries carry on in the same vein and include jaw spasms, tongue biting, insomnia and headaches.

Around this time, people were starting to comment that I seemed much more awake and present. Mental and physical stamina were beginning to increase.

21st September.

Slept well last night, but still very tired when I woke. Had a nap at lunchtime. Think I bit my tongue during the night, it's very sore and swollen. I keep having jaw spasms, and my body jerks when resting. No hangover effect. 

22nd September.

Slept well, but nightmares just before I woke up left me disturbed. Mouth a little dry, slight restless legs before I fell asleep. Body twitches and back spasms. I feel tearful and a bit vulnerable to negative thoughts this morning:(

Not noticed any deterioration in my mental health, and mentally I have much more energy. I feel better physically, but am getting a little lethargic with regards to my flat.

I don't want to get in the bath today..not a good sign..

26th September.

Restless legs is really bugging me. It seems to happen if I take my meds too early before I fall asleep. Must experiment with this.

Not getting much sleep..maybe 2 hours the last few nights?

Massive cravings for junk food. Very sleepy and dissociated. Very very tired, and stuck with a sore throat I can't shift. I'll definitely sleep tonight!

30th September.

Didn't get to sleep until after 3am. In the end I used a hypnosis app on my iPhone. Slept deeply and well.

Had an anxiety attack yesterday. Still anxious today but don't know why.

Getting bouts of restless legs and restless hands and I can't sit still. I'm up in the middle of the night jogging to see if it helps. (A little bit). The veins are swollen on my hands and it feels like they're going to burst, especially when I'm warm.

Now I'm not so thirsty all the time, I keep forgetting to drink - getting dehydrated.

5th November.

I didn't write again before now as there was nothing new to repeat in wathdrawal symptoms. Just much of the same.

I went down to 22.5mg on 3rd November. In general, I'm full of anxiety - a lot of things are supposed to be happening this month, plus I'm exhausted from the lack of sleep. I'm having great difficulty in staying in the real world. Keep dissociating and hiding away..not good.

22nd November.

I went down to 15mg on 15th November. The review with my consultant went well. She wants me off the drug by the next time I see her. Scary. 

She warned me that the 15mg dose might make me excessively drowsy and told me just to discontinue it if this happens.

Drowsiness kicked in a while ago, and I've spent all of it in bed. I can't do anything. I feel I could fall asleep standing up.

I stopped the drug completely two days ago. The drowsiness is still around though, but I know as time goes on, the insomnia is going to be brutal. It's going to take a long time for my body to adjust, I think.

The magnitude of stopping the drug completely hit me yesterday. It's really scary. Am I doing the right thing? What if I get ill again? Will I need more ECT? I don't think I could take any more.

25th November.

Thankfully the lethargy is wearing off! But the insomnia is terrible. Last night I had an "illusion" that a plastic bag in my room was actually a cat, and I spent ages trying to shoo it out of my room. Very odd dreams when I do get some sleep.

For the last few days, I've been having the same spiel of music going round and round my head constantly. It's very subtle but really annoying.

I haven't been able to cook, and I'm spending most of my days in bed. Not a depression, but just extreme tiredness.

On the plus-side, I'm beginning to feel more emotions. For a long time, I felt "dead".

Nowhere near as thirsty now, but I keep forgetting to drink. Best of all, my mind is a little clearer!

27th November.

Yesterday the full withdrawal syndrome kicked in. It's hell. I've totally lost my appetite. That started a few days ago. 

Other things include:

Vertigo and dizzy spells,

Nausea, insomnia,

Flu-like symptoms,

Odd dreams,

Illusions,

Cold sweats,

Anxiety and aggression, 

Electric shocks in my brain,

Repetition of songs in my head,

Lethargy,

Irritability,

Constant low blood sugar,

Stomach cramps,

Diahorrea,

Sleeping a lot.

Thankfully I'm not getting any depressive symptoms!

I phoned my consultant but she wasn't that helpful to be honest. I also phoned my pharmacy who were excellent. She said everything I was describing was "textbook" for Mirtazapine withdrawal.

They told me to consume ginger to relieve the nausea, and to eat a high protein diet as withdrawal does something to the blood sugar if you eat a lot of carbs.

I didn't get up till 5pm today. D__ came by and dropped off lots of high protein snacks. Really nice of him.

I'm concerned about the lack of appetite. If I eat more than a few mouthfuls I feel very sick.

I'm determined to do it though. I must keep my end goal in sight.

30th November.

Mentally I still feel good. Physically, tired, but yesterday the major itching kicked in. It feels like ants are crawling all over my skin. I've broken the skin on both hands and one leg with my scratching. The sweat is pouring off me and I'm having to change my night clothes several times.

I've only allowed myself to sleep for half an hour today and I'm really hoping tonight I'll get some sleep. Wish me luck!

1st December.

A pretty shit day. The itching is driving me demented. Still no appetite.

I'm beginning to tire of all of this now. When is it going to get better? I must keep going.

2nd December.

No sleep for days. I feel like a zombie. Today I'm starting to get really pissed off. I had restless legs for hours last night, and I was up, jogging on the spot to try to relieve it. It didn't really work and I spent ages looking up RLS home remedies on the Internet. One suggestion that seems to work is changing the temperature of my legs. I put the electric blanket on, and it worked! I wouldn't wish RLS on my worst enemy. It is pure torture.

I feel very sick today. Lost about a stone in weight. Going to ask the chemist for some build up drinks.

My friend keeps telling me to go back on the drug. That really annoys me. She doesn't realise it's only temporary..

My withdrawal diary ends here. It was pretty much the same story for quite a number of weeks after that. It is all a bit boring, I agree, but it gives you a vague clue as to what it was like..

I hit a really bad depression during the new year, but that was circumstances in my personal life than a chemical thing, plus I'm not a fan of new year at all. Even in the best of times I get very down about it, and look back to my past mistakes rather than looking forward to a better future.

It got to about February when I realised that all of the niggly withdrawal symptoms had gone, eg the itching, the restless legs syndrome, the nausea, the dizziness, the sweats etc.

The lasting problems have been insomnia and loss of appetite, though after 6 months my sleep has finally balanced out. I'd had another bad depression a few weeks ago which made me take to my bed. Again I slept all the time, but having come out the other end, my bad sleep patterns have suddenly been restored.

Valerian tea is also great for sleep, but quite potent! Beware if you have a cat - it will go crazy trying to get into the tea box! (I later read that the tea has the same smell as cat pee, and the same effect as Catnip). Pretty amusing to watch!

My appetite is another thing. It's still non-existent. I saw my doctor the other day about it and she said an option was to go back on the medication. No Way! The alternative was to put me on steroids which she said would cause more problems than any therapeutic benefit. I've been told to just eat regularly, get into a routine, and supplement my diet with protein/vitamin shakes. 

As I've said in other posts, increased anxiety has been prominent since coming off the drug. It does pull me down sometimes, and I get sick of it. I'm trying to use this time to explore relaxation methods and see it all as a challenge, but that's not always easy!

Just got to soldier on and hope that in a few months, things will have sorted themselves out.

I may write a follow-up post in 3-6 months' time. 

Kerry.