@namastejen1 how long did you wait to up dose and how severe were your symptoms when you made the decision?
How much did you increase by?

Did it help and if so how long did it take to notice any improvement?

My big fear is kindling or making things even worse as my nervous system is now sensitized after 3 months of escalating waves and my fear level is through the roof but I am totally unable to function right now and have been housebound for a week now.

🙏 Thank you

59 minutes ago, Emsy said:

Hey @Fullhealing yesterday was a bit easier for some reason but today I’m back to really bad nausea, not being able to eat, panic and shivering. 

I'm sorry @Emsy it's such a crooked line, glad you had some relief yesterday though.

Just keep supporting yourself and wait, it will get better with time, waiting for the storm to calm for me as well, take good care.

On 1/5/2026 at 3:00 AM, namastejen1 said:

I have a nervous system regulation exercises post that Luke put up for me. Perhaps the exercises will be beneficial for you. I find they help me feel more centered and calm.

@namastejen1

Thank you for mentioning the nervous system regulation exercises. Can you direct me where to find it? 
I am a fan og the Poly Vagal teori. Did you read The body keeps the score? 
🙏💕

2 hours ago, Emsy said:

Hey @Luke he basically said - these are your options which one do you want to choose as holding wasn’t stabilising me and I’d tapered too much too quickly - which is a bit rich when I tapered significantly slower and lower than I was told to.

 

I've experienced the same. A psychiatrist who costs what would normally be a mortgage payment for a consultation gave me a bunch of options to counter the adverse reaction mirtazapine was giving me (none of which were a safe taper off, and most of which involved combinations of multiple, even more dangerous drugs), and when I queried which was best and what the choices were based on he shrugged and said "trial and error".

4 hours ago, Emsy said:

@namastejen1 how long did you wait to up dose and how severe were your symptoms when you made the decision?
How much did you increase by?

Did it help and if so how long did it take to notice any improvement?

My big fear is kindling or making things even worse as my nervous system is now sensitized after 3 months of escalating waves and my fear level is through the roof but I am totally unable to function right now and have been housebound for a week now.

🙏 Thank you

Hey Emsy, this is a long one.

 

Back in June of 2024, my func chiro at the time thought I was ready to stop at 1/4 of 7.5mg Mirt--said she applied kinesiology tested it--this was her only "mistake" in that type of testing that she has made in the plus years I have worked with her. So I did, and it was the worse month. I prayed about it and went back on SA.org from a decade of not being on because I remembered their help back in 2013. I was given some very spot on info and went back on at 1/8 of the 7.5mg, so 50% of where I jumped off. With taper brain, I had forgotten about hyperbolic tapering rules. It helped me to get my life back. I won't go into how bad it was other than I was not sleeping more than a few hours, there were a few nights of no sleep towards the end of the month trial of no Rx. It probably took me a couple of weeks to recover to a decent baseline. Maybe I am super lucky or with all the somatic work I do and provide, my nervous system has more flexibility or maybe it's all the praying I do. Who knows, I am just grateful that I was able to get to a functioning level again.

 

Then, God helped me again, as I tapered linearly and too quickly in March-May of 2025, hit a brick wall and updosed from 0.4mg to 0.45mg (weighted, not dosage) at end of May. Because 0.9 to 0.8 to 0.7 to 0.6 to 0.5 to 0.4 over 3 months was not a great idea. I did it because my doctor was retiring at end of August, he was hoping I could end my Rx while he was still with me (he was supportive but not guiding me with the taper--he had me doing it on my own/limited understanding of hyperbolic tapering), and I was not clearly thinking about how quickly I was going. I had very bad symptoms around 0.5 to 0.4, because the effects were catching up and becoming more and more problematic and stronger-- crying spells, mood swings, feeling vulnerable, not able to concentrate, gut issues, heart palpitations, vision issues, etc. It helped tremendously to updose and took a week or so to feel better. It becomes fuzzy. I am just happy I have been better for a long time. 

 

Since end of May 2025, I will only do hyperbolic tapering and my care team is well-versed in it. No going back and probably some time in 2027, I will finished--God willing. My care team is looking to get me to just under 10% occupancy rate and see if I ready to stop there. If not, I will updose by tenths of a mg to wherever is best. It is a moot point now as I am at 0.44mg dose and will drop to 0.41mg (not weighted) starting some time next week--quite a distance away from discontinuing decisions. I hope this helped and was not too long.

 

It is up to you if you would like to go up by a tiny increment especially if you are not functional. I cannot give you any medical advice and am sorry to hear how badly you are doing right now. I will pray for wisdom in making a decision that is perfectly right for you. Where did stop in terms of dosage?

 

 

3 hours ago, Haa said:

@namastejen1

Thank you for mentioning the nervous system regulation exercises. Can you direct me where to find it? 
I am a fan og the Poly Vagal teori. Did you read The body keeps the score? 
🙏💕

@Haa I have Bessel vander Kolk's book but have not read it yet--I have so many books waiting for me to read! Or many half-read--taper brain. I am fully trained in Somatic Experiencing with Peter Levine, though and other modalities that are off-shoots/related. Thanks for asking about the exercise. Here is the link and hope you are doing well! https://antidepressantrecovery.org/topic/59-nervous-system-regulation-exercises/#comment-3611 

 

Emsy, you can try these too, if you are inclined. It can take the edge off of sympathetic/high arousal or dorsal/shut down brain states.

54 minutes ago, namastejen1 said:

I am fully trained in Somatic Experiencing with Peter Levine

Hi @namastejen1

Thanks for the link. Nice to get some new ideas on how to lower the activation of the sympatric part of my nervous system. 

Almost at my baseline today. I am hopefull, and believe, that I might have turned a corner, as I have had a couple of small windows lately. 

As long as I stick to my diet, lean in to the emotions/ feelings and accept them, for what they are instead of trying to fight them, they evaporate slowly but surely. It is new to me being  able to do so under these conditions. Thats another sign telling me, that I am moving forward. 

 

Sending you lots of care and kindness. On we go 🙏💕

Edited February 11Feb 11 by Haa

16 hours ago, Emsy said:

@namastejen1 how long did you wait to up dose and how severe were your symptoms when you made the decision?
How much did you increase by?

Did it help and if so how long did it take to notice any improvement?

My big fear is kindling or making things even worse as my nervous system is now sensitized after 3 months of escalating waves and my fear level is through the roof but I am totally unable to function right now and have been housebound for a week now.

🙏 Thank you

Sending you some love Emsy xxxxxxxx

11 hours ago, namastejen1 said:

Hey Emsy, this is a long one.

 

Back in June of 2024, my func chiro at the time thought I was ready to stop at 1/4 of 7.5mg Mirt--said she applied kinesiology tested it--this was her only "mistake" in that type of testing that she has made in the plus years I have worked with her. So I did, and it was the worse month. I prayed about it and went back on SA.org from a decade of not being on because I remembered their help back in 2013. I was given some very spot on info and went back on at 1/8 of the 7.5mg, so 50% of where I jumped off. With taper brain, I had forgotten about hyperbolic tapering rules. It helped me to get my life back. I won't go into how bad it was other than I was not sleeping more than a few hours, there were a few nights of no sleep towards the end of the month trial of no Rx. It probably took me a couple of weeks to recover to a decent baseline. Maybe I am super lucky or with all the somatic work I do and provide, my nervous system has more flexibility or maybe it's all the praying I do. Who knows, I am just grateful that I was able to get to a functioning level again.

 

Then, God helped me again, as I tapered linearly and too quickly in March-May of 2025, hit a brick wall and updosed from 0.4mg to 0.45mg (weighted, not dosage) at end of May. Because 0.9 to 0.8 to 0.7 to 0.6 to 0.5 to 0.4 over 3 months was not a great idea. I did it because my doctor was retiring at end of August, he was hoping I could end my Rx while he was still with me (he was supportive but not guiding me with the taper--he had me doing it on my own/limited understanding of hyperbolic tapering), and I was not clearly thinking about how quickly I was going. I had very bad symptoms around 0.5 to 0.4, because the effects were catching up and becoming more and more problematic and stronger-- crying spells, mood swings, feeling vulnerable, not able to concentrate, gut issues, heart palpitations, vision issues, etc. It helped tremendously to updose and took a week or so to feel better. It becomes fuzzy. I am just happy I have been better for a long time. 

 

Since end of May 2025, I will only do hyperbolic tapering and my care team is well-versed in it. No going back and probably some time in 2027, I will finished--God willing. My care team is looking to get me to just under 10% occupancy rate and see if I ready to stop there. If not, I will updose by tenths of a mg to wherever is best. It is a moot point now as I am at 0.44mg dose and will drop to 0.41mg (not weighted) starting some time next week--quite a distance away from discontinuing decisions. I hope this helped and was not too long.

 

It is up to you if you would like to go up by a tiny increment especially if you are not functional. I cannot give you any medical advice and am sorry to hear how badly you are doing right now. I will pray for wisdom in making a decision that is perfectly right for you. Where did stop in terms of dosage?

 

 

Thank you so much for this.

I went from 1.5mg to 1.2mg 14th Nov. Since then I’ve been getting 2 week waves followed by a slight easing for 2 weeks but the waves have got progressively worse and I have been in a constant state of anxiety and panic for just over a week and struggling to eat much and very little sleep. It’s a constant chemical anxiety.

im finally getting liquid mirtazapine soon and i hope that will give me a more stable dose than dissolving tablets. Im guessing i need to transition across slowly though?

26 minutes ago, Emsy said:

im finally getting liquid mirtazapine soon and i hope that will give me a more stable dose than dissolving tablets. Im guessing i need to transition across slowly though?

Hey Emsy Some do have issue moving brand/across to liquids. Might be worth sticking to what you know for the minute until you feel better.

A lot of folk have to use suspensions and have no choice. The advantage is that they can use the same driug the whole way down and it takes that variable out of the equation. 

 

Transitioning from pills to liquid For your information about best practice for switching xx

Hi @Emsy I am very sorry to hear of your rough patch. MIRT is a VERY nasty drug, you are right liquid

will have a different affect to pills. I even noticed moving from pills to solutabs, SO very very slowly swich

over. I fully understand your Anxiety and panic and housebound as I am living it every day. 

 

Stay very close to AR, the people on here are FANTASTIC with wealth of knowledge and experience, you will

NEVER be alone on here. I am just so so sorry you have hit such a BAD spell, the drug is a huge amount more

powerful than anyone could ever believe. The Doctors don't even realise the power of them. 

But go sloooooooowly and you will stabilise and get back to your former self, then just keep going ultra slow.

WE are with you all the way.

Take care,      B.🙏🙏🙏🤞 

Thanks @Chippy I’ve actually found by accident that north wales has a NHS prescribed drug support service that works with GP surgeries to support people coming off benzodiazepines and pain meds and they now support antidepressants. My surgery should have referred me but I called them and they have messaged my GP about the liquid. They said that at 1.2mg dissolving the tablet isn’t going to give me a very consistent dose every night as the mix of filler and drug could be slightly different when I draw up my dose every night. Unlike the GP they are very keen to get me on liquid asap to ensure I’m getting a stable dose as they think this could be adding to my issues.

waiting until I’m stable to make the switch doesn’t seem an option but I followed your link and will try the 25/75, 50/50, 75/25, 100/0 method outlined there.

If the liquid doesn’t stabalise me after that then they recommend a small up dose.

its all very scary either way but I’ve lost all functionality now except basic survival and need to try something.

Thanks for your support x

2 minutes ago, Emsy said:

Thanks @Chippy I’ve actually found by accident that north wales has a NHS prescribed drug support service that works with GP surgeries to support people coming off benzodiazepines and pain meds and they now support antidepressants. My surgery should have referred me but I called them and they have messaged my GP about the liquid. They said that at 1.2mg dissolving the tablet isn’t going to give me a very consistent dose every night as the mix of filler and drug could be slightly different when I draw up my dose every night. Unlike the GP they are very keen to get me on liquid asap to ensure I’m getting a stable dose as they think this could be adding to my issues.

waiting until I’m stable to make the switch doesn’t seem an option but I followed your link and will try the 25/75, 50/50, 75/25, 100/0 method outlined there.

If the liquid doesn’t stabalise me after that then they recommend a small up dose.

its all very scary either way but I’ve lost all functionality now except basic survival and need to try something.

Thanks for your support x

That sounds like a positive step forward. I think they have a good point here don't they! Nice to see the NHS coming through 🙂 

 

Yeah ok makes sense do the switch but just gradual as described on SA. Hope that helps some. A stable dose is so important......

 

Honestly my pleasure mate, wish I could do more......

On 2/12/2026 at 2:27 AM, Emsy said:

Thank you so much for this.

I went from 1.5mg to 1.2mg 14th Nov. Since then I’ve been getting 2 week waves followed by a slight easing for 2 weeks but the waves have got progressively worse and I have been in a constant state of anxiety and panic for just over a week and struggling to eat much and very little sleep. It’s a constant chemical anxiety.

im finally getting liquid mirtazapine soon and i hope that will give me a more stable dose than dissolving tablets. Im guessing i need to transition across slowly though?

I agree the compounded liquid will probably give you a more stable dose - we do compounding here too in the States. When I attempted to do my own liquid, as I got to smaller doses under 1mg, I gave up after 3 nights of barely any sleep. I knew something was not right with how I was making the solution. So I continued to weigh crushed pills. But now I am on a crushed compounded pills vs crushing it myself with pills from a regular pharmacy--both are the same manufacture. Under 0.5mg gets tricky when I relied on my own measurements because it's almost dust. 

It looks like you received some reference material from @Chippy and support from @NT1100B. Just take it slow and do one thing at a time. What I mean by this is do a 1:1 switch--same dosage but different type of Mirt. Then, a month or so later, you can start your hyperbolic taper. Hopefully that make sense. 

Be well, my friend!

 

Edited February 14Feb 14 by namastejen1

Thanks @namastejen1 the liquid only comes in one size which is 1ml =15mg so not really compounded and I’ll still have to dilute it to get an easily measured dose as if I take it without diluting I’ll be trying to measure 0.08ml in a syringe which looks really difficult as the lines are so close together. But it should hopefully dissolve more easily than the tablet in theory.

im nervous about the swap if im honest as im 3 months out from my last drop and still not stabilising and in fact getting worse and worse.
This current wave is now day 10 of barely any sleep, constant panic, gut clenching and nausea and barely eating anything as it makes me gag. I’m scared of upsetting things even more but if I’m not getting an even dose every night that won’t be helping either 

That’s really rough. I’ve been there with insomnia for a few months—that was PAWS from Zoloft. You are not alone in this. I’ll pray for the liquid dosing to work correctly for you. I truly believe you’ll get relief reinstating. I did about 3 months out with the Zoloft but the doctor at the time (fired) wouldn’t help me with the below “therapeutic dose”—hence all these years later, tapering Mirt. Take care, my friend.

Thanks @namastejen1 for your kind words.

So did you fully come off Zoloft and then reinstate Zoloft after 3 months off?

i would be reinstating Mirtazapine as I’m still on 1.2 so I would just try going to 1.3 but my nervous system is so sensitised from the withdrawal symptoms from the dose reduction in November that I’m too scared to do a slight increase in case it worsens me.

On 2/14/2026 at 11:37 AM, Emsy said:

Thanks @namastejen1 the liquid only comes in one size which is 1ml =15mg so not really compounded and I’ll still have to dilute it to get an easily measured dose as if I take it without diluting I’ll be trying to measure 0.08ml in a syringe which looks really difficult as the lines are so close together. But it should hopefully dissolve more easily than the tablet in theory.

im nervous about the swap if im honest as im 3 months out from my last drop and still not stabilising and in fact getting worse and worse.
This current wave is now day 10 of barely any sleep, constant panic, gut clenching and nausea and barely eating anything as it makes me gag. I’m scared of upsetting things even more but if I’m not getting an even dose every night that won’t be helping either 

Hey Emsy

 

There are several different dilutions that you can get for Mirtazapine. In the guideline I sent you it shows 1ml=2mg and 1ml=0.5mg as the required dilutions to complete most of the tapers.

 

I suspect it's cheaper for the doctors/pharmacy's to offer you the stronger version, but if the Maudsley Guides have it written you should be able to get it.

 

Alternatively there are notes about proper procedure for diluting down Liquid ADs at the end of this topic here you might want to read:

 

Preparing Doses for Tapering - Weighing & DIY Liquids

 

Chippy

Hey @Emsy

 

Just thought id drop by and see how you’re doing? 

39 minutes ago, Chippy said:

Hey Emsy

 

There are several different dilutions that you can get for Mirtazapine. In the guideline I sent you it shows 1ml=2mg and 1ml=0.5mg as the required dilutions to complete most of the tapers.

 

I suspect it's cheaper for the doctors/pharmacy's to offer you the stronger version, but if the Maudsley Guides have it written you should be able to get it.

 

Alternatively there are notes about proper procedure for diluting down Liquid ADs at the end of this topic here you might want to read:

 

Preparing Doses for Tapering - Weighing & DIY Liquids

 

Chippy

Thanks @Chippy I had another look but what it seems to be giving examples of is how you make up your own dilution for the 1ml - 2mg and 1ml - 0.5mg from the standard strength bottle. I still think diluting a liquid into a liquid is going to be more accurate than dissolving a tablet into a liquid.

6 hours ago, Emsy said:

Thanks @Chippy I had another look but what it seems to be giving examples of is how you make up your own dilution for the 1ml - 2mg and 1ml - 0.5mg from the standard strength bottle. I still think diluting a liquid into a liquid is going to be more accurate than dissolving a tablet into a liquid.

Yes I think your right it is saying on p239 the available versions in the uk and only states 15mg/mL version. It then states underneath the ratio to achieve the required dilution. 
 

Yes diluting the liquid down isn’t a compromise and will be much better than what you are doing currently. The key is to get the procedure correct to maintain accuracy. 
 

In the other link I gave you, at the end of the topic there are very detailed instructions how to achieve this. 

https://antidepressantrecovery.org/topic/240-preparing-doses-for-tapering-weighing-diy-liquids/#comment-4207

 

[edit there is separate document covering this now:

https://antidepressantrecovery.org/topic/251-using-manufactured-liquid antidepressants/]

 

Chippy 

6 hours ago, NBJ71 said:

Hey @Emsy

 

Just thought id drop by and see how you’re doing? 

Hey @NBJ71 I’m hanging on in there thanks for checking in.

Had a lift yesterday afternoon and was able to have a 20 Min walk (far cry from me 4 months ago being in the hills all day) - I’m sure the sunshine helped - but every time I get symptoms easing a bit and I get a bit of relief I end up getting no sleep that night and then back to square 1 the day after 🙄 so today has been rough again. 

Hows it going with you?

Hi @Emsy Sorry you are still in a rough patch, here's hoping you start to lift.

Hang on in there girl. Keep taking it slow.

Take care,        B.🙏🤞 

Hey @Emsy

 

Hanging on in there is all you have to do, as rough as it is for you at the moment. Just one day at a time. You’re doing really well Emsy, don’t forget that. Given time I’ve no doubt things will improve for you. I remember those 20 minute walks, at least they get you out of the house and add to giving you a little structure. 
Looking  at your posts I see you’re reluctant to up dose to 1.3. I can’t say I blame you, I guess if you’re coping then things should hopefully start to stabilise soon. 
Im ok thanks, I’ve had a few symptoms come back over the weekend but I’m still functional so can’t complain. 
 

Take care 

 

Nick. 

1 hour ago, NBJ71 said:

Hey @Emsy

 

Hanging on in there is all you have to do, as rough as it is for you at the moment. Just one day at a time. You’re doing really well Emsy, don’t forget that. Given time I’ve no doubt things will improve for you. I remember those 20 minute walks, at least they get you out of the house and add to giving you a little structure. 
Looking  at your posts I see you’re reluctant to up dose to 1.3. I can’t say I blame you, I guess if you’re coping then things should hopefully start to stabilise soon. 
Im ok thanks, I’ve had a few symptoms come back over the weekend but I’m still functional so can’t complain. 
 

Take care 

 

Nick. 

Thanks Nick for your really supportive message.

I never thought I’d say this but if I could just do my own grocery shopping that would be such a win for me! One day I’ll be doing it I know and climbing in the mountains again and I will never ever take being able to that for granted.

Sorry to hear you had symptoms over the weekend. They are persistent little beggars aren’t they but functional is good. 
Take care 

Emma