Quick question - how long to wait after stopping mirtazapine until I can take DXM?

[raphaelvize]

Hey I just would like you guys advice on how long to wait after stopping mirtazapine until I can take DXM? Because mirtazapine is kinda in its own class (separate from ssris/snris) and has a different safety profile when combined with DXM, aswell as having a shorter half life, I am wanting to find out how long to stop until it would be safe to take DXM again.

I've searched around a bit and I know you should wait at least 3 - 4 weeks after ssris (probably longer to be absolutely safe) but mirtazapine is not an ssri, however it does increase serotonin. I've found out that mirtazapine leaves your body in around 3 - 5 days after last dose, but serotonin levels would still be higher than normal for quite a while longer so I don't want to risk serotonin syndrome by taking DXM too early. Also, I've read that mirtazapine is metabolised by the same enzyme that metabolises DXM so there is another risk factor.

I am stopping mirtazapine in a week (I have to be weaned off it) and I would like to know when I could take DXM again, soon as possible after my last dose (Note: I'm not stopping my antidepressant just because I want to take DXM - I've been having quite bad side effects from mirtazapine such as nightmares and sleep paralysis - but I have been wanting to do at least one more DXM trip again for a while but I couldn't while on antidepressants.)

I would just like to see your advice on how long to wait. I haven't found a post on this exact question - sorry if there has been one on this site or another site, please direct me to it. You don't have to post anything long, just an approximation on how long to wait and why. Thank you very much.

 

[HeadHigh]

short answer: 2 weeks is the average time period to wait after taking an anti-depressant

Mirtazapine actually has an incredibly long average half-life of about 30 hours. and although it isnt an SSRI, it does have a strong action on the 5HT2 and 5HT3 sites which are serotonin sites. It is always best to be safe than sorry and believe me, if you had serotonin syndrome, you would be very sorry. Not to scare you, just be careful and wait as long as possible just to be safe.

 

[raphaelvize]

Okay thank you very much I'll make sure to wait 2 weeks, I definitely do not want serotonin syndrome I've heard it's incredibly unpleasant. Thank you very much for the information.