[Ele]

Hi, New in the forums I just started to follow Martin`s class
I have to take remeron/mirtazapine for sleep. Did anybody experienced withdrawals from this drug after, say, 1yr use of 7.5mg or less ? I read some horror stories on Internet ?
Also: if I am really disciplined can I avoid the weight gain or it is impossible ?

• This reply was modified 4 years, 9 months ago by Ele.

[Daf]

My reduction off Mirt is described in posts above.

I can update you now that I had no serious issues coming off using the method described above.

The only thing was that 3 to 5 days after reducing and then later when stopping, my sleep was quite broken up, so I’d wake up a lot. But I’d always get back to sleep OK.

So, yeah no problem.

I had suffered for 2 years with nil sleep nights at least once a week.

Now, have not had nil sleep night for 5 months.

[Ele]

Thank you Daf, I will take your example. It looks like it takes at least 6 months to improve our sleep and get off meds.

Did you loose the weight after stopping mirt ? I am a woman and sensitive to gaining weight.

[Daf]

Hi Ele,

Good question. I put about 8% weight on.
Once it was on, it is hard to get the weigh off, even after stopped taking Mirtazapine.

Still about 5% overweight now – and the last pill I had (a one off of 1.95mg was about three months ago). But I feel as fit as ever, which is odd.
Luckily I was not overweight to start with.

Have you also read the Success with CBTI/ ACT Mindfulness video interview Martin did with me, published in the Success Stories. Worth a listen!

Kind regards
D

[Daf]

Most folks seem to put 8 percent or so weight on.
For me it is all round tummy. Was 81kg, went to 88kg, now down to 85kg.im 5 ft 11 inch man. Age 57.
But feel as fit as ever.
And would take the weight gain over the past horrors of not sleeping. Not that I think Mirt was essential, but it helped at times.

[LCF]

Ele,

Mirtazapine made me very hungry for the first month and I found that eating a big protein and high-fat breakfast really helped with the hunger pangs. Loads of salad and water, too. Over time the hunger diminished and in the end I only gained 3-4 pounds.

As for the withdrawal, it wasn’t difficult. I was taking the full 15 mg pill for 6 months and then it stopped working for sleep, so I just cut the pill by 1/4 every three or four days. It was no trouble at all.

Interestingly, once it stopped working for me, I was still able to use it on a one-off basis as long as it wasn’t more than once or twice a week.

[Ele]

Hi, Thank you LCF, I will try to do the same : take it when I need it.
I am less afraid of taking it now after reading your experience.

Did you take Martin”s course ? Or : how did you improve your sleep ? In my case I try to walk 1 to 1.5 hours a day after dinner to calm down and I am in week 1 of Martin”s class.

[LCF]

I haven’t taken Martin’s full course yet. My personal circumstances are pretty bad right now, and my GP wants me to sleep as much as I can so I do use the antidepressants at least twice a week, as well as one other one that works on a one-off basis.

I have in the past overcome a very bad, long bout of insomnia, following withdrawal from over 15 years on a benzodiazepine, and that was by convincing myself not to worry so much about it. It took a few very tough months but I did get back enough sleep to have some quality of life. I was generally sleeping between 6 and 8 hours a night, with a couple of 5-hour nights each week. That lasted until my husband’s cancer diagnosis, and then it all went out the window, needless to say.

I do plan to do the course at some point. I’m pretty sure that CBT is the only way for any of us to get back our sleep naturally. Yes, the pills work, but most doctors here won’t prescribe them (though under the circumstances I’m lucky to have such a supportive doctor) and I hate being at the mercy of medication.

[Daf]

I thought I would just comment more on Mirtazapine.

So, here I am and now it has been over a year since I had a nil sleep night. I used to get regular nights of no sleep at all – and how I dealt with that problem and how I overcame it is explained in a video shown under the success stories.
It is called “Success with CBTI and ACT/Mindfulness” – and was put up here on October 16, 2019. Do please look it up!

One of the things that I used to help me sleep when I had those nil sleep nights was a drug called Mirtazapine, sometimes also known as Remeron, which I wrote about before here.

Now I must be clear, it was not the drug that got me better, it was the techniques I talked about in the video. However, when I was in in a very dark place, I did use Mirtazapine to help me – and I have sympathy for anyone who does take drug help. It did help me.

I explained in the notes in this discussion that it became clear from my research of User Reviews of this drug and also from my own experience that very small doses worked much, much better than the normal doses that they give to people for its main line use – which is for depression. (Relatively few doctors know it can be used also for insomnia, however). In fact, many people at User Review sites report that normal doses -like 15mg – may not work to help folks sleep or that if they do, they stop working.

As I explained here, I would break down the pill into eighths or sixths (though it is hard to get less than sixths often, as they are so small anyway, you tend to get powdery!)

Naturally, the makers of the drug must know how, counter-intuitively, that it works better in v small doses for insomnia, but I guess being the lovely profit driven, Big Pharma that they are, they are not keen to share this knowledge. (As I said, I only found out from User Reviews and from personal experience).

I also found that by far the best way to take it, (and for far better results), was to stick it on your tongue and let it slowly dissolve. It does not taste of anything, makes your tongue a little bit numb for a bit, but that numbness does not last.

The rest of the notes – and my experience with this drug are in the preceding discussion here – on this thread – so I won’t repeat it here.

The only 2 things I would add are this to my previous comments are about drowsiness next day and effects on libido.

Drowsiness, first, This drug makes you very drowsy most of the next day too. Not only drowsy but also I would describe it as a little bit “dissociated” if that makes sense – and that effect lasts for about 36 hours after taking it, though the most drowsiness is in the first 12 to 18 hours after taking it.

As someone else noted here – it can be damn hard to wake up and get up after it, it can be a real struggle. You may need a few alarm calls and a brisk shower!
I noted before that I had put weight on – but was still fit.

Well, many months after having last taken Mirtazapine, I STILL have that excess weight that I put on with it. Still 8% excess weight. In my view, as I still do regular exercise and only consume same type and amount of food and alcohol, the increase must be due to this drug.

What I am saying is that the excess weight has been hard, well impossible so far to shift.
The other effect is on your libido. It seems to reduce one’s libido for about 3 days. I’m a man, not sure if it has the same effect on the libido of a woman.

My experience with it has made me rather wary of the side effects of all drugs – and topically –that wariness would apply to vaccines too – but hey, let’s not go there.

Do I regret having taken it?
No, I don’t because it helped me get over a very dark place when I would not sleep at all as many as 9 or ten nights in a period of a month.

But as I said, I think the techniques I was leaning here and eventually, combined with my realization that insomnia is an obsession problem, would have got me better in the end. It just would have taken me a bit longer.

I hope the interview I did with Martin under the Success Stories helps you to put insomnia to sleep for ever – as it did me. Martin’s emails were a great help too.

I wish you all the best – and I hope this post and this thread helps you too.
Best wishes Daf

[larana]

@Daf, not sure if you’re still on this forum, but I was interested in your experience tapering off mirtazapine. I’ve previously had success with stopping it cold turkey with no side effects. But this time around, no such luck. I know the issue is 99% (or maybe 100%) psychological. I reduced from 15 to 11.75 to 7.5 to 3.75 every 2 weeks and slept well with only a few blips. I thought that once I was on the lowest dose for 2 weeks I would just stop. That did not go well! Despite 3 weeks of sleeping great nearly every night, I couldn’t fall asleep. (I’m sure it was because of the subconscious – or maybe conscious – pressure I was putting on myself and “watching” to see if I was falling asleep.) After 3 hours, I panicked and took more meds to get to sleep. I felt really guilty and disappointed in the morning for not being able to stick with my plan.

Now I’m thinking that the approach you described may help me be more successful. I.e., plan on taking mirtazapine on specific nights and then slowly reducing the # of nights. My questions for you:

-how long did each phase last (e.g., when you were taking mirtazapine two out of every 3 nights, did you do this for a week? 2 weeks?)
-At what point did you just stop taking it? You mentioned going from 2/3 nights to 1/2 nights to 1/3 nights. Did you reduce further from there (1/4 nights, 1/5, 1/6, 1/7) or just stop when you felt like you were ready?

My problem is that I’ve been taking mirtazapine or Ambien contingently (albeit not that often) for 13 years, ever since I had postpartum anxiety/insomnia. I would sometimes go as long as a couple weeks without taking meds, but usually once, maybe twice a week. So obviously, in retrospect, this meant I could completely avoid the unpleasantness of a bad night of sleep. And now I have a reinforced pattern of behavior that when I have trouble sleeping, the solution is to take sleep meds! Extinguishing this behavior is very difficult, since I’m trying to give up sleep meds for good, not even having them as a back-up option *just in case*.

Anyway, it would be helpful to know more about the specifics of your tapering approach. I did read your success story and really resonated with what you said about successful, driven people having insomnia and that insomnia is a form of obsession. That’s where ACT has also been helpful for me, even though I’m still a long ways from doing it successfully!

[DannoM]

It hasn’t done much for me. Even the lower doses. I take it with trazodone. The only reason I don’t stop them now is because I don’t want to have rebound symptoms that make sleep harder. I’m really working on my thoughts towards sleep.

[Daf]

Here is my advice:

Trust your body knows how to sleep – it has not forgotten and you will sleep in the end.
You do not need drugs. It may take a while for the effect of the drugs to leave your system, but they will. You may have a few bad nights in the interim.

If you do not sleep much one night (or at all on some nights as I regularly used to), you will get through the next day. You may not get as much done, but you will be OK.
If you do not sleep, you won’t die and your body will sleep the next night or in the end.

You have to trust your body.. It has not forgotten how to sleep, the drugs you are taking is just confusing your system a bit.

See the podcast I did with Martin for more.

Oh, and don’t expect to sleep like other people do with 7 or 8 hours, you probably don’t need that much, after all can you wear their shoes if they are two sizes smaller than you?!

[mistered]

This is an awful drug. 7.5 helped for about 6 months with my ability to fall back asleep when awakening at 4 am. Then it stopped working, but stupidly kept taking it for another year. When I stopped taking it cold turkey I couldn’t sleep at all and developed wild anxiety during the day — I had to reinstate to my previous dose and do a slow taper. There are many stories like this on the Facebook mirtazapine tapering group.

I am down to about 3.75 mg and it seems like I’m on the right track. I think CBTI is making a difference by keeping my sleep window shorter and getting me more tired when I do go to sleep.

[Author]

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