Mirtazapine - Tapering down, trying to find the sweet spot for sleep.

[Bleaney]

I've been on Mirtazapine for literally years now, it's been so long I can't remember when I started. It had been helping me for sleep for a long time, but it hasn't been helping much, if at all, recently.

I read or heard somewhere that sometimes increasing the dose too much can make Mirtazapine less beneficial for sleep.

This has gone against what I would have expected, and so this has meant that over the years and due to tolerance my dose has increased in steps from 15mg to 45mg where I have been for a while.. I think this is too much, especially as it doesn't seem to be doing anything for anything.

It's hard to say if it has ever helped my mood, but it was also supposed to good for anxiety. I don't think it's ever come close to doing anything at all for my anxiety, but it has helped my mood indirectly by helping me sleep at night.

At the moment the plan is to reduce my dose by 5% every couple of weeks, just going by the weight of the pill, and cutting bits off until I get the desired total weight. I'm a couple of weeks into this and it's not making any difference. I'll probably keep going with the gradual taper and see how low I can get the dose. Maybe even quit completely. There's no point taking it, if it's not doing anything.

Is there anybody here who has been using Mirtazapine mainly for sleep? Did you find that it eventually stopped working?

Did you find a particular dose that worked best, and that going above that dose made sleep more difficult?

 

[bingey]

I took 15 mg's for sleep and after about 3 months it stopped doing anything so I discontinued it .

 

[plumbus-nine]

Higher doses of mirtazapine antagonize 5ht2c receptors which causes a disinhibition of norepinephrine and dopamine similar to higher doses of fluoxetine which in theory is stimulating but my bet is on tolerance for why mirta stopped working.

I didn't take any for years and it worked exactly once for sleep, now it again does nothing for me, not at 15 and not at 90mg.
Same with other antihistamines (mirtazapine is the strongest H1 antagonist we have around) like hydroxyzine or doxylamine. They don't cause addiction but only work so and so long before becoming inert. But this should reverse itself after a couple of weeks.

 

[Pissed_and_messed]

I think also the alpha-adrenergic receptor antagonism also causes disinhibition of norepinephrine and serotonin release.

There is study out showing 15 mg saturates 80 % of h1-receptors which seems to deliver most of knock-out effects, but probably not all of it.

Yes, I get tolerance to that effect quickly because half-life is 30-50 hours so it is pretty much always kicking in daily use. Which further causes significant caffeine use.

I have given up daily medicating and daily strictly scheduled sleep. And work-life.

You can try drugs having antihistamine function with shorter half-life if decreasing dose doesn't seem to do the job.

 

[Pissed_and_messed]

And it seemed to cause tolerance slower in the beginning. Our nervous system seems to get it pretty fast and gives response when it recognizes familiar pattern. Dumb fuck.

 

[Bleaney]

Higher doses of mirtazapine antagonize 5ht2c receptors which causes a disinhibition of norepinephrine and dopamine similar to higher doses of fluoxetine which in theory is stimulating but my bet is on tolerance for why mirta stopped working.

I didn't take any for years and it worked exactly once for sleep, now it again does nothing for me, not at 15 and not at 90mg.
Same with other antihistamines (mirtazapine is the strongest H1 antagonist we have around) like hydroxyzine or doxylamine. They don't cause addiction but only work so and so long before becoming inert. But this should reverse itself after a couple of weeks.

A couple of weeks? If that's true that would be happy days,

I'm not convinced that it will be., tolerances to most other pharmaceuticals seem to take months for tolerances to reset and for the brain to return to it;s former equilibrium.

If it's true it would be amazing. I guess a relevant similar experience I had was falling over headlong into benzo abuse and addiction to crazy does. Circumstances that arose meant that I had to quite them, and so I tapered off. I then endured the most excruciatingly difficult 6 months of rebound symptoms. Everrything the benzos had helped with now came back twice as bad as it ever was originally. But after 6 months of abstinence my tolerance was reset and I was ready for round 2.

If Mrtazapine tolerance really can be rest in 2 weeks that would be amazing. I'd reckon on more like 6 months tbh though.

A couple of people have mentioned 15mg as perhaps the most optimally efficent dose. It may be an idea to reset to 0, resume to 15mg. When that stops working try something else. I'm not sure how long one can keep doing these sort of cycles.

Thanks to everyone who has responed. 15mg is the goal now. But in order for that to work I'd have to do a period of 0 Mirt to reset tolerance. Whether this would be 2 weeks or 6 months I'll have to find out.
I

 

[pf100]

I took 15mg mirtazapine for a couple of years for sleep, then I cut it in half to 7.5mg on my own because it was getting a tolerance and the lower dose helped me sleep better, then it stopped working so I tapered off and it wasn't an issue for me other than not sleeping well.
I was off of it for about 3 years and started taking it at again, about a week ago, due to poor sleep. I have a lot of left over amitryptiline and mirtazapine and mirtazapine has far fewer side effects for me.
I started off with the least amount that worked for sleep which for me was around 1mg at night. I think I'm hyper sensitized to it though. I'll continue to take the least amount that works. If 1mg continues to work I have enough to last about 20 years.
Mirtazapine works great for me for sleep but it lasts too long. The half life is 20 to 40 hours. So the trick for me is to find the least amount that works for sleep so I'm the least sleepy during the day.
Mirtazapine works the best of anything I've ever tried for sleep besides xanax but with xanax it isn't real sleep although it feels like it, so mirtazapine is the best for me.