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@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!
Doing my favorite things is a challenge right now because I’m living overseas for a year, away from friends, in a small apartment without my usual cooking/baking supplies, etc. I appreciate the broader point, though.
I had postpartum anxiety/insomnia. I encourage you to see your OB/GYN. Insomnia was the first clue that something was wrong. I went through 3 months of hell and got better by (a) going on an anti-depressant/anti-anxiety medication (Zoloft) and (b) taking mirtazapine (sleep medication) for 1 month so I could get some rest. Once the anxiety was under control, I could stop taking sleep meds and my sleep got back to normal.
I’ve had a recent setback (first one since 2009), but I am much more aware now of what is going on. Insomnia is about anxiety.
