I have interacted with some of you Benzo buddies

I’m in a real pickle with mirtazapine. Changes to medications have sensitized me incredibly, including a dose increase of mirtazapine that has left me very destabilized

It was already activating me at times at 15 mg after coming off Depakote after being stopped abruptly off of Ativan.

I’m not sure why I agreed to let someone increase my dose. I guess I was just desperate.

Since that increase December 1, I’ve been struggling but nothing like I’ve struggled in the last few weeks, especially the last week

I’m trying to hold 15 mg because of all the changes, but I also feel like mirtazapine is increasing my overall nervous system load and my symptoms are getting worse even though I am having moments of relief at times.

I used to need to pace when I was activated and now I feel like the activation is just going deeper into my nervous system and causing deep pounding and heat, dread, and terror.

My vestibular symptoms are on almost all the time when they used to just be intermittent. Disassociation is a huge symptom now and it didn’t used to be. The million dollar question is should I keep holding it 15 mg or try again to come off slowly?

Edited February 20Feb 20 by Finni

Hi @Finni

 

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

 

34 minutes ago, Finni said:

I’m in a real pickle with mirtazapine. Changes to medications have sensitized me incredibly, including a dose increase of mirtazapine that has left me very stabilized

I can see from your footer you have some history with a variety of drugs. Could I ask you update it with dates nice a clear for me like this:

 

01 January 2022 Ativan xmg

30 January 2022 Ativan CT

01 January 2025 Mirtazapine 15mg

And so on.......

 

34 minutes ago, Finni said:

It was already activating me at times at 15 mg after coming off Depakote after being stopped abruptly off of Ativan.

I’m not sure why I agreed to let someone increase my dose. I guess I was just desperate.

Since that increase December 1, I’ve been struggling but nothing like I’ve struggled in the last few weeks, especially the last week

I’m trying to hold 15 mg because of all the changes, but I also feel like mirtazapine is increasing my overall nervous system load and my symptoms are getting worse even though I am having moments of relief at times.

Im sorry to read this. Very common for more drug to be offered as a solution to a problem often caused by drugs.

I cant quite follow you drug history at the moment based on what you've given us.

Why were you prescribed Mirtazapine? Could you tell us a bit more clearly and in some chroniclogical detail about what led you to meds in the first place and your experience with them up until now? Would be helpful for us to understand more.

 

I can see from your footer you have tapered down very quickly and this is certainly part of your problem. You shouldn't taper more than 10% of your last dose per month. Tapering Information

 

34 minutes ago, Finni said:

I used to need to pace when I was activated and now I feel like the activation is just going deeper into my nervous system and causing deep pounding and heat, dread, and terror.

This sounds like Akathisia to me. Im really sorry a truly awful symptom.

 

34 minutes ago, Finni said:

The million dollar question is should I keep holding it 15 mg or try again to come off slowly?

Holding is a good idea for the minute for sure.

 

If you could update your signature as I said above and give us better story of your journey so far it would help us understand whats been happening with you and what we think you might want to do now.

 

We wait your response. 

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

 

Chippy

@ChippyI cleaned up my signature a bit. Do you get a better idea now?

 

What if mirtazapine is also becoming paradoxical? I think it added to my kindling for sure.
 

 

Welcome to the forum, I'm sorry to hear about the difficult time you've been having.

 

  

1 hour ago, Finni said:

The million dollar question is should I keep holding it 15 mg or try again to come off slowly?

 

It is very difficult to unpick once multiple drug changes are involved. It didn't go well when you tried to reduce by a small amount.

 

23 minutes ago, Finni said:

@ChippyI cleaned up my signature a bit. Do you get a better idea now?

 

What if mirtazapine is also becoming paradoxical? I think it added to my kindling for sure.

 

It is very difficult to say, only you are in your body and feel how you feel and determine whether you're reacting adversely to staying on Mirtazapine.

 

Were you tolerating Mirtazapine somewhat ok before introducing and removing ativan and depakote? If so, I'd probably lean towards trying to stabilise on Mirtazapine for now, but it is hard to unpick what is an adverse reaction from Mirtazapine and what is issues from having introduced and withdrawn other drugs in the last year.

3 minutes ago, Luke said:

Were you tolerating Mirtazapine somewhat ok before introducing and removing ativan and depakote? If

Thank you so much for your response ✨

Yes, I was tolerating even 15 mg really well before those destabilizing events

and I was doing incredibly well compared to this before I allowed the Dec 1st increase.

I would give anything to go back to November 30th. 

10 minutes ago, Finni said:

Thank you so much for your response ✨

Yes, I was tolerating even 15 mg really well before those destabilizing events

and I was doing incredibly well compared to this before I allowed the Dec 1st increase.

I would give anything to go back to November 30th. 

I think it unlikely you started having an ADR if you tolerated fine before.

 

I think your nervous system has been made angry through all the drugs and changes you have suffered over the last few years. It is a common story. The CNS will cope with so much but that increase was the last straw in my opinion. It was made worse by some fast dose changes.

 

I think you should hold where you are and wait to stablise.

 

How were you making your dose reductions? Do you have scales?

Thank you for answering.

 

So, it would seem that Mirtazapine isn't a universally intolerable drug for you, however you've really struggled to tolerate an updose after going through other drug changes. It's important to consider that they may well have a part to play.

 

Really, you've two main options I can see (others may feel differently):

 

• hold at 15mg and hope that you stabilise from the multiple changes and updosing over time
• attempt to taper down again, and accept that this likely will cause at least some ramping up of symptoms

It is very difficult to say which is the "right" choice, and often once harmed by these drugs there is no obvious "right" choice.

 

It is ultimately on you to weigh up whether staying on Mirtazapine is ultimately harming you more than tapering would, although you have tolerated this dose in the past. Personally (as a stranger on the internet who is not a doctor, who you must decide whether is worth listening to or not), in your shoes I'd hold on 15mg for a little while and see you begin to stabilise further.

 

5 minutes ago, Chippy said:

I think it unlikely you started having an ADR if you tolerated fine before.

 

I think your nervous system has been made angry through all the drugs and changes you have suffered over the last few years. It is a common story. The CNS will cope with so much but that increase was the last straw in my opinion. It was made worse by some fast dose changes.

 

I think you should hold where you are and wait to stablise.

 

How were you making your dose reductions? Do you have scales?

Thank you so much for your responses ✨

When coming down off of the higher dose that I was on only briefly, I was using quarters of 7.5 mg tablets.

When I tried to reduce to 14.7 I used scales. 

 

How long do I hold to see if I stabilize?

 

It scares me that the extreme vestibular symptoms have come on only in the last week. Way more head involvement than ever before. The autonomic nervous system surges are more extreme when they happen but I also have a worse baseline overall.

11 minutes ago, Finni said:

When coming down off of the higher dose that I was on only briefly, I was using quarters of 7.5 mg tablets.

When I tried to reduce to 14.7 I used scales. 

Cool so you have scales. Thats good. Use them for sure. Pill cutters just are not accurate enough even for half and quarter cuts.

 

11 minutes ago, Finni said:

How long do I hold to see if I stabilize?

This is hard to say. It can take a long time for some. Wish I could be specific. 

 

11 minutes ago, Finni said:

It scares me that the extreme vestibular symptoms have come on only in the last week. Way more head involvement than ever before. The autonomic nervous system surges are more extreme when they happen but I also have a worse baseline overall.

Sorry this is not good, I hate this for you. Could you be more specific with these symptoms? What do they actually look like for you?

 

What is your baseline like now and what was it like before?

1 minute ago, Chippy said:

Could you be more specific with these symptoms? What do that actually look like for you?

 

My nervous system is sensitive to vestibular changes anyway because I have mal de debarqument syndrome, but I was at a stable place before mirt changes. 
so as I was trying to get back down to 15 mg, I would sometimes have periods where I felt like my head was in an earthquake like my head was shaking and sometimes the floor would look slanted and feel unsteady. The walls would look slanted and I would feel like I was rocking and bouncing, but it didn’t last very long.

This last week, I often feel that the floor is shaking, and that My head is shaking and that like I’m falling through the floor I feel so bouncy when I walk. I have a lot of squeezing sensations in my head and pins and needles feelings in my head.
Sometimes it feels like there’s a motor going around and round in my head. These symptoms are worse in the morning, but I’m way more floaty and bouncy throughout the day than I was a week ago. Yesterday, a lot of it resolved, but it started again after I took mirtazapine at 8:15 PM. I get different symptoms sometimes around 20 minutes to an hour after I take mirtazapine. 
My baseline is different because I just do not feel all the way here. And I have horrible, horrible anxiety, this deep, deep nervous system anxiety. It’s not just an anxious thinking type thing it’s like my body feels dread and terror and pulling  on a very deep level. I don’t think I can even describe it. For a lot of the day I’m having deep nerve sensations that I never had before. Sometimes it even hurts especially in my stomach and back.

During the whole time that I that I was trying to get back down to 15 mg I had little periods of time where I felt really really anxious and that horrible dread and sensations in my stomach but now it just happens way more.

13 minutes ago, Finni said:

My nervous system is sensitive to vestibular changes anyway because I have mal de debarqument syndrome, but I was at a stable place before mirt changes. 
so as I was trying to get back down to 15 mg, I would sometimes have periods where I felt like my head was in an earthquake like my head was shaking and sometimes the floor would look slanted and feel unsteady. The walls would look slanted and I would feel like I was rocking and bouncing, but it didn’t last very long.

This last week, I often feel that the floor is shaking, and that My head is shaking and that like I’m falling through the floor I feel so bouncy when I walk. I have a lot of squeezing sensations in my head and pins and needles feelings in my head.
Sometimes it feels like there’s a motor going around and round in my head. These symptoms are worse in the morning, but I’m way more floaty and bouncy throughout the day than I was a week ago. Yesterday, a lot of it resolved, but it started again after I took mirtazapine at 8:15 PM. I get different symptoms sometimes around 20 minutes to an hour after I take mirtazapine. 
My baseline is different because I just do not feel all the way here. And I have horrible, horrible anxiety, this deep, deep nervous system anxiety. It’s not just an anxious thinking type thing it’s like my body feels dread and terror and pulling  on a very deep level. I don’t think I can even describe it. For a lot of the day I’m having deep nerve sensations that I never had before. Sometimes it even hurts especially in my stomach and back.

During the whole time that I that I was trying to get back down to 15 mg I had little periods of time where I felt really really anxious and that horrible dread and sensations in my stomach but now it just happens way more.

Im so sorry @Finni this sounds awful. 😞 

 

We often feel symptoms through our existing self IMO, its like the dysregulation is manifesting through your mal de debarqument syndrome.

 

It's good you felt some relief yesterday.

 

It's common to see up ticks in symptoms when stabilising and also to experience windows and waves.

 

I do note you said things worsened after your dose. I would keep a diary and post it here to track things.

 

A simple one like:

07.00 Woke up and felt sick

08.00 Had Breakfast

08.15 Took Mirt

And so on till bed

 

Be helpful for you and us on here to see if there are patterns. But I think really as horrible as this is it just needs lots of time. Think about all the stress your system has been through since your up dose. I think it's not surprising (although very upsetting) that you are experiencing all of this.

I’m posting to a little bit more information about my reactions to mirtazapine since I haven’t really talked about that
When I tried to increase to 22.5 mg I didn’t sleep at all that night and felt like I was being electrocuted in my stomach and back. I know that sounds dramatic, but it was very painful.
My face burned, the membranes in my nose burned,  my mouth burn burned.

I was very, very agitated, just basically flopping and thrashing around in bed.

And yet I tried it one more time and experience the same thing the second night.

The second day of that dose, I felt like I was in cold turkey withdrawal. Horribly horribly activated, pacing and crying.

But because I thought I wasn’t just supposed to jump back to 15 mg I went to 18.75 and being electrocuted feelings continued throughout the day.

They didn’t go away until I went down to 16.87 mg and after a few days, I started getting really activated and shaky again.

So I dropped down to 15 mg but I didn’t get the same kind of relief. I did get a relief from being electrocuted sensations, but I think I also started feeling more true withdrawal and my nervous system had just had it.

Vestibular symptoms showed up about 10 days after being back at 15 mg but things really started calming down after about four weeks until I tried to taper, and then took the extra bit in the middle of the night. And now I’m having electric deep nerve issues again plus vestibular symptoms that are staying on. Many times,  I’m still activated by mirtazapine 20 to 30 minutes after I take it feel really nauseated and that sense of dread and sometimes the vestibular symptoms start.

I sweat a lot in the middle of the night and usually wake up by two or 3 AM, vibrating and buzzing, and sometimes feeling the anxiety and terror.

2 minutes ago, Finni said:

Vestibular symptoms showed up about 10 days after being back at 15 mg but things really started calming down after about four weeks until I tried to taper, and then took the extra bit in the middle of the night.

Yeah I think here is the key. You started to stabilise but didnt wait long enough. It can take months to be ready for a taper.

 

I see a lot of typical Mirt reactions in there. You are not alone.

Do people start another thread to keep a diary or keep it all in same thread? @Chippy

19 minutes ago, Finni said:

Do people start another thread to keep a diary or keep it all in same thread? @Chippy

 

Ideally keep it in your thread.

 

That way, your story and situation is all in one place.

 

 

As for how long it takes to stabilise, that can be very unpredictable. However, it's been a month since you got back down to your current dose, with many other drug changes in the last year. So, it's not that surprising that your body is struggling a bit.

 

Hopefully in some more time, this will improve.

Hi @Finni I am glad you came here. So many are dealing with mirtazapine and will be able to give there experience. I do think the fast tapers are probably catching up with your CNS. Our poor bodies can only handle so much. Sometimes doing nothing is the best thing at present.

❤️🙏

Thank you ❤️❤️

I’m blown away by the ways my cns is expressing itself.

I didn’t even know I could feel this.

2/20/26-2/21/26

6:00 pm burning tailbone on and off throughout day along with rocking and bouncing sensations and Derealization and crying (feelings of doom and hopelessness) 

8:15 pm Mirtazapine 

8:35 severe burning tailbone and burning nerve pain abdomen

9:00 pm severe bouncing, rocking, moving sensations 

10:00 pm -2:00 am

adrenaline rushes, heart pounding, sweating soaked pajamas 

2:30 am head pressure, burning, deep head pain 

2:40 am took 1 regular strength Tylenol 

5:00 torso muscles tightening, rocking, bouncing, terror rising, internal shuddering, pounding in lower back, need to get up to walk/pace

I really think this is kindling! Not sure if I’m going to stabilize. 

1 hour ago, Finni said:

2/20/26-2/21/26

6:00 pm burning tailbone on and off throughout day along with rocking and bouncing sensations and Derealization and crying (feelings of doom and hopelessness) 

8:15 pm Mirtazapine 

8:35 severe burning tailbone and burning nerve pain abdomen

9:00 pm severe bouncing, rocking, moving sensations 

10:00 pm -2:00 am

adrenaline rushes, heart pounding, sweating soaked pajamas 

2:30 am head pressure, burning, deep head pain 

2:40 am took 1 regular strength Tylenol 

5:00 torso muscles tightening, rocking, bouncing, terror rising, internal shuddering, pounding in lower back, need to get up to walk/pace

Having most of the symptoms you mentioned plus a few new ones since yesterday, like you I have my doubts about stabilization but the majority manage to balance out however it takes so all that remains is to wait and to keep hope alive. hang in there, stay strong.

37 minutes ago, Finni said:

I really think this is kindling! Not sure if I’m going to stabilize. 

@Finni I’m so sorry. I can see from your diary post you are having some terrible symptoms. They are all very typical, many many have stabilised before you and had similar doubts. The biggest thing I’ve seen with all this, is it can look like it will never end until slowly it does. Remember your body is working hard for you and all these symptoms are evidence of this.  
 

Keep posting these updates like you are. They may well be very useful for you and us once we have a few days to look at. 
 

Im going to ask @getofflex if she wouldn’t mind popping by and having a read of your thread too.

 

Chippy

Thank you so much 🙏

On 2/20/2026 at 8:07 AM, Finni said:

Yesterday, a lot of it resolved, but it started again after I took mirtazapine at 8:15 PM. I get different symptoms sometimes around 20 minutes to an hour after I take mirtazapine. 

 

On 2/20/2026 at 8:25 AM, Finni said:

Many times,  I’m still activated by mirtazapine 20 to 30 minutes after I take it feel really nauseated and that sense of dread and sometimes the vestibular symptoms start.

I sweat a lot in the middle of the night and usually wake up by two or 3 AM, vibrating and buzzing, and sometimes feeling the anxiety and terror.

 

This sounds like you may be having an adverse reaction to your current dose of mirtapazine.  There is a possibility you may be sensitized from all the drugs and drug changes you have gone through in the past several years.  

 

On 2/20/2026 at 8:25 AM, Finni said:

They didn’t go away until I went down to 16.87 mg and after a few days, I started getting really activated and shaky again.

So I dropped down to 15 mg but I didn’t get the same kind of relief. I did get a relief from being electrocuted sensations, but I think I also started feeling more true withdrawal and my nervous system had just had it.

Vestibular symptoms showed up about 10 days after being back at 15 mg but things really started calming down after about four weeks until I tried to taper, and then took the extra bit in the middle of the night. And now I’m having electric deep nerve issues again plus vestibular symptoms that are staying on.

This paragraph above shows that you are j umping around on your dose too much.  This is very confusing to your nervous system, and will further destabilize it. No more trying extra little bits in the middle of the night, etc.  What your body craves is stability.  It doesn't mean never changing your dose, it just means, only change your dose after careful and thoughtful consideration.  Never jump up and down on your dose based on reactivity to a bad night or desperation, etc. 

 

This is a complex case, since you have been dealing with multiple drugs, and drug changes over the past couple of years.  It may be a combination of withdrawal, and adverse reaction.  If it were me, this is what I would do.  Please continue to do a daily drug and symptoms journal, as requested earlier.  Look for symptom patterns.  It sounds to me like you are having an adverse reaction to your current dose of mirtazapine.  Please for right now, stick with your current dose of mirtazapine (15 mg), and be very consistent with it.  Completely avoid alcohol, caffeine, sugar, processed foods, any other mind altering substances.  Do whatever you can to calm your nervous system.  If you are having worse symptoms in the hours after you take your mirtazapine, you can try another reduction, and see if this helps you.  If after a few days, you feel that you are having this adverse reaction to it, try dropping from 15 mg to 14 mg, and see if that helps.  This is tricky, because I believe you may be dealing with both an adverse reaction, plus withdrawal.  The trick will be to try and reduce the drug, to reduce the ADR (adverse reaction), but without making the withdrawal symptoms worse than those of the ADR.  

 

Thank you @getofflex I really appreciate you looking at this.

Thank you both so very much ❤️