Mirtazapine Withdrawal - 2 Years on.

Hi Guys,
This past week saw 2 years since I came off Mirtazapine.
It's still hard to believe, but also it seems such a long time ago - I'm forgetting what it was like to be on psychiatric drugs.

I don't regret coming off the medication. But it hasn't been easy. What reassures me is that I've not been any better (or worse) than when I was on the drug, but I don't get all the crappy side effects that come with taking it..

However, the last few months have been pretty bad...a combination of surgery, complications after the surgery, an unsuccessful job hunt and of course, the descent in to the dark winter days hasn't helped either. 

My sleep never got quite sorted out after the withdrawal, so 2 years on, I still find myself waking in the wee small hours racked with anxiety, tossing and turning. I have family members the same way so maybe it's just something I've got to live with.

I'm currently focussing on my fitness in the hope it'll combat the depression that's been hanging around, and in a couple of weeks' time, I fly off to Egypt for lots of sun, sea and flumes. Cant wait!

Send lots of positive vibes my way!

Kerry x 

The Ludicrous side of Mental Health.. #11

Since my mirtazapine withdrawal I've noticed something really strange. 

Just before I get a depressive episode, my sense of smell goes very acute. At first I thought it was me or my house smelling a bit fusty, but after asking some (very close) friends to give me a sniff, they said I smelled fine, and it was then I realised my sense of smell was heightened.

Then the next day, or the day after that I will end up in bed for several days with a bad depression.

It happens too often to be a coincidence. Sometimes it's so overpowering it drives me crazy and I end up spending a fortune on perfume and room fragrances!

I'm kind of curious as to what's causing it..

Has anyone else found this or heard of this before?

Kerry.

Mirtazapine withdrawal - 1 year on..

This week made it a year since I came off the psychiatric drug Mirtazapine. I can't believe how quickly the year has flown by - a huge roller-coaster of highs and lows, disasters and triumphs.

Has it been easy?

No. The withdrawal from the drug itself was horrible and took much longer than I ever thought it would - about 9 months, and even now it still takes a lot of fine tuning to balance my mental health week in, week out.

It's been quite a learning curve coming off the drug. I've had to relearn how to live my life without the drug and get to know what my body is telling me - what triggers bad episodes..what makes them better..what to do in a crisis, how to maintain good mental health and so on..

I still get huge crashes and depressions from time to time, but I've had to learn to cope with them medication free. 

Yes, they are very scary when they happen, but I also know that they're the result of something in my life that isn't right. That might be stress, exhaustion, stuff at home, work, eating too much junk food, not enough exercise, too much or too little sleep, not having proper structure to my day or not enough meditation and "Me time".

Despite the difficulties, I've never regretted coming off the drug. Sometimes when the big crashes came I wondered if I had done the right thing - there were two instances where I seriously considered going back on it again. But I'm glad I didn't because like most of my crashes, they passed eventually.

All in all, I'd been on various forms of psychiatric medication since I was 19 and I think it will be some time before I work out how my body and mind function without the drug.

I'm still trying to work out a sleep pattern that a) doesn't leave me mentally exhausted but physically fine, or b) leave me physically exhausted but mentally alert.

Diet is another source of constant experimentation. If I succumb to an illicit bar of chocolate, I know I will pay for it a few days later with my crashing mood and lethargy which can take weeks to recover from. Likewise caffeine, bread, alcohol and anything with sugar.

I hope to have many more years medication-free, and I don't see how that shouldn't be a reality if I take extra care. 

The hardest thing for me is finding the strength to overcome my "One won't hurt" frame of mind, because I know fine well that it only takes one!

Kerry.

Other posts of interest: Mirtazapine Withdrawal, Mirtazapine Withdrawal - 6 months on, Mirtazapine Withdrawal - 9 months on.

Mirtazapine Withdrawal - 9 months on..

Hi Folks,

It's nice to be back again after a wee break. Unfortunately, I wasn't sunning myself on a beach somewhere or hiking in the hills.. Rather, my choice of destination was in fact my bed, where I have been practically living for the last month.

Mirtazapine Withdrawal - 9 months on and things haven't been so good...Lots of tears, feeling like a dead statue, plans to do a runner and feeling suffocated and hemmed in with stress.

I think I'm starting to pull out of it now, but mind you..every time I say that, the next day turns out to be terrible!

It's been pretty bad, and I've been shit scared about the possibility of having to go back on the drug. It's not made any easier by friends and family telling me to restart it..'It doesn't matter how bad the side effects are dear' (Yes, but you don't have to put up with the bloody side-effects) ..'You were much better on those pills'... (You obviously have a very short memory!)

Considering how I was affected by the medication, (see my previous posts Mirtazapine Withdrawal and Mirtazapine Withdrawal - 6 months on.. for more info), I don't see restarting it as an option. Although I've been feeling bad, I still enjoy the perks of 'freedom' from Mirtazapine. My mind is clear(er), I don't have the terrible thirst I once did and my sleep is so much better.

The way I see things..in the last 9 months I have given up my flat and moved in with my partner, my financial circumstances have changed, I started my first job in over a decade, I gave up that job, got a new therapist, have an ongoing battle with "the Establishment", changes in support staff, one of my dearest friends passing away, the mirtazapine withdrawal and a big and exciting (but stressful) project at my other work. When I look at the above..it's no wonder I've crashed! Anyone would. Nothing in my life is the same as it was 9 months ago. Everything is different and I don't have that familiarity I once had to fall back on for reassurance and stability. 

Thankfully, things seems to be getting better and after a month of trying to get me to the gym, my boyfriend finally succeeded 2 days ago by resorting to bribery. Surprisingly it worked, and what do you know?! I actually felt much better after it!

My therapist has always advised me that if I am experiencing a depression, I need to take a look at my life (or my way of coping with life), identify what is wrong and do something about it.

In this case, I knew my job wasn't right for me, and I don't regret giving it up. Sad, yes. But it was the right decision. 

People around me didn't really understand, and were extremely disappointed, but I know that it doesn't take a lot to tip me over the edge and I came very close.

Now the job situation is out of the picture, I'm much better and don't feel the threat of medication anymore. I'm still wrestling with the "what the hell am I supposed to do with my life" thing, but I guess I have to take that in baby steps..

As for withdrawal symptoms from the Mirtazapine - They are over now. My appetite is pretty much back to normal and it's nice to feel hunger again and to have cravings for certain foods.

I had depressions when I was on the drug, but it's very easy to forget that! I've got to expect that depressions will come along, but the key is not to panic when they do. 

Kerry.

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.

Mirtazapine withdrawal.

I had been on Mirtazapine, (also known as Remeron or Zispin) for well over 5 years. I never felt it did very much and the side effects of the drug were hellish.

Much to my despair I was told I'd be on the stuff for the rest of my life because my depression had been so treatment resistant. I hated being on it - the side effects were worse than the depression! My mouth was so dry I could literally go for hours without the need to swallow which put an end to my singing activities. I had vivid and disturbing dreams. I felt drowsy most of the time and couldn't get through the day without napping. I had the famous hangover effect in the morning. I kept involuntarily biting my tongue when my jaw went in to spasm. I had terrible food cravings for all the stuff that was bad for me, but I think the hardest to cope with was the continual thirst which accompanied the dry mouth. I got through at least 4-5 liters of water a day just to get by, and even then it wasn't enough. As a result I was peeing all the time, up through the night 5-6 times to go to the toilet and I never got a good refreshing sleep. I also wanted to have children in the future and I wanted to be off the drug before this situation even came up.

Summer 2012. I was told I would be getting a new consultant. The thought of somebody new was scary but I grabbed my chance. I explained all the trouble I was having with it. I had my arguments prepared and was ready to go to battle over it, but she astounded me 2 minutes into my plea saying that the drug obviously wasn't tolerable and that if I wanted to come off it, I could. I couldn't believe my ears! I'd been trying to persuade doctors to allow me to come off it for years. (I think if she had refused, I would have resorted to doing it on the quiet. I was so desperate). Amazing what a fresh pair of eyes can do! She did say that she wanted to see me regularly and for me to keep a diary and to withdraw slowly.

I've heard that Mirtazapine withdrawal is awful. Before I started cutting down, I looked at online forums so I would know what to expect but I didn't really find what I was looking for. Most people had been on it for much shorter periods than I had and more often than not the majority of people had given up with the withdrawal because it was just so awful. I knew what the possible withdrawal effects would be but nobody said how long this would last. Weeks? Months? Years even?

Despite knowing this particular drug is difficult to come off, I wasn't prepared for the hell it turned out to be.

I was on the maximum dose of 45mg. I got down to 15mg over four months without any trouble but as soon as I went down to 7.5mg it completely floored me. I ended up in bed for 2 weeks - I just had this huge urge to sleep all the time and I couldn't physically do anything. The consultant told me just to stop the drug completely and skip the last phase. She said that sometimes this happened with this dose although it's not known why.

Things got much better after that. The first night without any medication for nearly 15 years was terrifying. It was about a month sooner than I'd anticipated. What if I got ill again? Was I doing the right thing? I remembered all the side effects I was having and my desire to live a medication free life. My determination kicked in and I took the plunge.

I thought I'd escaped the withdrawal syndrome during weeks one and two. I felt great and much more energetic and alert! It was amazing, but it made me realize how much a zombie the medication had made me.

By the end of week two, I noticed my appetite going. Then a few days later - BAM! The full force of withdrawal winded me. For the first month after I couldn't eat. I couldn't sleep. I had vertigo when I stood up, restless legs when I was in bed and I felt sick all the time. This was accompanied by flu-like symptoms and cold sweats.

My doctor wasn't all that interested, but it was my local pharmacy who helped me the most. They gave me medication to stop the nausea, build up drinks as I was losing a lot of weight and they advised me to keep a continual supply of high protein snacks and water by my bed.

I had to cancel all my engagements for the next 6 weeks. Thankfully things were winding down for Christmas and not much was happening anyway.

I'll be straight with you - it was utter hell. There were several occasions where I felt I couldn't go through with it and nearly gave up. I kept remembering the reasons why I wanted to come off the drug and that the withdrawal was only temporary and this gave me the courage to go on.

Gradually things got better but I'd no idea that the process would take 4+ months. Some days were better than others and I felt I'd made an improvement, then I seemed to go back to square one again which was disheartening.

Often I lost sight of my end goal but I'm glad I persevered with it.

Five months on and I have no regrets about coming off the drug. I feel so much better and my psychiatrist has agreed that I made the right decision to come off it. I have since been discharged from mental health services.

Any lasting effects? Yes. It took a long time for my sleep and eating patterns to return to something resembling normality. It's only in the last few weeks that these have got better and I've had to adapt to a whole different schedule.

I used to need 10+ hours' sleep a night plus daytime naps and I never felt refreshed when I woke in the morning. Now I'm tending to get 6 or 7 hours' sleep a night. Sometimes I feel really refreshed, sometimes I don't. I'm hoping this will eventually increase to 8 hours' sleep a night but it is much better than the zero sleep I got once the full withdrawal kicked in. I had a lot of excitement when I started dreaming naturally again. It took a while and for me it was a sure sign that my brain was adapting without the drug and beginning to heal.

My appetite is nowhere near what it used to be and I've never regained the weight I lost during that time. I'm now the same lanky shape I was as a teenager which is my natural body type. When I was on the medication I would put on weight even if I sniffed a delicious cake or bun, but now I find it very hard to put on weight.

Mentally I am much more alert and my friends say that I am actually 'present' now whereas before I tended to have a vacant glaze in my eyes. My memory is slightly better but this can go again when I'm stressed.

The main lasting downside is that I am more anxious than I used to be. It's annoying at times and if it gets very bad, I go to the gym and burn it off on the treadmill which is very effective.

I've not had the complete mental collapse I was expecting. Depression-wise I'm not any better or worse than I was when on the drug which confirmed my belief that the drug had no effect whatsoever.

If you are considering coming off Mirtazapine, be warned. It is not easy. Talk to your doctor about the options. It was better for me to come off the drug, but this might not be a suitable option for another person. Often, other antidepressants can be found which can be as effective without the same side effects. If you are wanting to come off antidepressants altogether sometimes switching to a drug with fewer withdrawal symptoms will make things much easier.

If you are really determined to come off the drug, hang in there and keep going - it WILL get better, I promise! You just have to keep your end goal in sight and remember why you are doing this. Give yourself plenty of time for the whole withdrawal and expect that some days will be a lot worse than others. Be very kind to yourself. Try to eat well if you can. I couldn't eat for the first month, but I had a stream of friends bringing in nutritious snacky supplies which kept me going.

If you are considering withdrawal, it's wise to let people know that you might be out of action for a while. Before I came off Mirtazapine, I was very stressed and busy. I used the initial month to have a complete break from everything which was nice as this window of time doesn't often come up, and I went back to "life" refreshed and rested.

Good luck!
*NOTE: This link was recommended in the comments section by a fellow poster. It covers many aspects of withdrawing from antidepressant medication and looks very helpful. I'll put it HERE to save scrolling! 


(See also Mirtazapine withdrawal - 6 months on.., Mirtazapine withdrawal - 9 months on.., and Mirtazapine withdrawal - 1 year on..