The worst part about anti-depressant withdrawal (in this case withdrawal from mirtazapine), is the fact that it can feel like we need to put our lives on hold for months, sometimes years, before we are able to function. I get the sense that it can be like watching life float by. While the person who is tapering or in withdrawal goes through the exceptionally challenging raft of mirtazapine withdrawal symptoms.

If you were thinking of starting this antidepressant, would you be turned off by the long list of mirtazapine withdrawal symptoms? I was surprised by the list of symptoms I found in a Facebook support group. We can experience GI issues of all kinds, terrible insomnia, anhedonia, visual disturbances, itching skin, lack of appetite, lack of interest in any kinds of activities. As well as anxiety, lethargy and fatigue. Furthermore, some people report brain zaps and low blood pressure. So far I have experienced a significant reduction in appetite, and a lack of motivation to do anything at all. It makes life so challenging.

26th March 2021 – a window in mirtazapine withdrawal symptoms

And then, out of the blue, I begin to feel more like myself again. And I am so incredibly grateful for this wide window that has opened up in my mirtazapine withdrawal. And yes, I am only 6 mg down (24 mg down from 30 mg). There is a huge journey to go. But I am hopeful that the journey has been doable so far.

Sure, getting my period can throw a spanner in the works, but as the others in the support group suggested, we just have to wait it out. And that is what I had to do. A couple of alcohol-free days worked their magic and I feel pretty good today. Even though my morning was filled with soul-crushing sadness and my tummy hurts after almost every meal that I eat.

31st March 2021 – another wave – and considering reinstating

Today I felt so listless, so awful. I couldn’t get into anything at all, and considered reinstating at 30 mg until I have my life in order – delay the perhaps two year duration of mirtazapine withdrawal symptoms that seem so hard. The point is that once I DID get into the day, life wasn’t so bad. And so I am wondering if I would feel better with more alcohol free days, or if I just force myself to get up and dance in the mornings. To get moving. If I am able to work in the evenings, then it is possible that I could still work on business while I am doing this taper. And that makes it seem like it might be possible.

If the mirtazapine withdrawal symptoms are so awful, why do doctors prescribe this?

It is a good point. As far as I can tell, doctors and psychiatrists are not aware of how hard it is for people to come off this medication. The NICE guidelines were only released in October 2020 and psychiatrists are mostly clueless, suggesting a blunt withdrawal of half the dose, then quarter, then off. This is so disastrous for so many people who can suffer from serious withdrawal symptoms from this method for up to two years after coming off mirtazapine.

Mirtazapine is a pretty effective antidepressant, and it does have lots of off-label uses such as supporting people from quitting other addictive substances, such as alcohol, nicotine or other drugs, as well as social anxiety, and even some of the negative symptoms of schizophrenia.

And while it has many great uses, the fact that it can take people up to two years to taper safely from this drug makes the costs of the drug considerable.

Potion making – making a liquid dose of mirtazapine for tapering

I am excited to let you know that if you want to taper mirtazapine using a liquid dose, you do have some options. One option is a compounding pharmacy. I was using this for a while, and it is definitely worth the increased cost of the medicine. The only drawback from this perspective as far as I am concerned is the fact that your prescriber needs to write an exact number of tablets on the script if you request capsules (they are cheaper). And so, you may be left with excess if you feel you can drop before the full duration of the script. Or worse, you may want to hold for longer than your script and if you only have 30 days supply at that dosage, you may not be able to hold for 45 days or longer if necessary.

The good news is that the ‘Mirtazapine: support, withdrawal, recovery’ group on Facebook has some good resources for how to make your own liquid suspension of mirtazapine. With a few pieces of equipment, you could make yourself four days supply of your desired dose of mirtazapine. And this would allow you to hold and drop as quickly or slowly as you are ready to.

I am beyond excited about this, as it gives me the flexibility to try and live a functional life while going through mirtazapine withdrawal. And that means that it might be doable to actually come off mirtazapine. I would love to do this because I have some concerns about the long term effects of antidepressants such as these on my brain and body health.

A long process

I will keep updating this blog article as I get more anecdotal information. I hope it helps you to learn more about how to taper slowly – 5 – 10 % of your last dose is recommended, and avoid the worst of mirtazapine withdrawal.

Time is a great healer.