Hi everyone. I’m writing because I have reached my limit. My life has become a constant calvary of pain, and I no longer know how to proceed. All of this is the result of the "mess" created by the doctors who have handled my pharmacological path; after months of failed attempts and constant changes, I have lost all trust in traditional medicine. I cry all day, I suffer in unimaginable ways, and I don't know what is happening to me.

Clinical history (Complete timeline):

Jan–March 2025: Xanax use.

Late March 2025: Mirtazapine 15 mg for only two weeks.

May 2025 – December 2025: Rivotril (Clonazepam) use (8 drops at night, 5 drops in the morning).

December 1, 2025: Stopped Rivotril after a 4-month taper. Since then: chronic agitation, dizziness, labeled by psychiatrists as "automatized anxiety."

The final collapse (February 2026):

After stopping Rivotril, I suffered a "poly-pharmacy" trauma that triggered violent kindling:

Feb 6–16: Rapid switches (Mirtazapine, Olanzapine, Zoloft, Cipralex).

Feb 17: I decided NOT to take the dose because the tinnitus had become unbearable.

Feb 17 – March 22: Total suspension. The abyss: subjective akathisia, disabling panic attacks, constant chest tightness.

March chaos and damage from dose changes:

March 22–23: Reintroduced Mirtazapine 7.5 mg. Subjective akathisia improved, but severe chest pain started.

March 24–27: Reduced to 3.5 mg. Reintroduced Rivotril (1 drop on March 26 and 27). It was after this drop that immediate and violent physical pain exploded.

March 28: Stopped Rivotril and went back up to 7.5 mg of Mirtazapine.

Recent maneuvers that have devastated my system:

Two weeks ago: I reduced Mirtazapine to 5 mg, and was then forced to go back up to 7.5 mg.

Currently: I have reduced to 6.8 mg of Mirtazapine.

Post-maneuver symptoms: These continuous variations have reactivated a living hell of symptoms: I live in a state of extreme agitation, as if I have a motor running inside me. I have devastating tinnitus that I hear directly "inside my head" (accompanied by clogged ears), diffuse physical pain, atrocious headaches, a sensation of an "electric" or "strange" head, muscle fasciculations, tachycardia, and chest tightness.

My dilemma and suspicions:

I am terrified that Mirtazapine itself is hurting me, that it has become toxic, but every time I try to change the dosage—whether going down or up—my nervous system reacts with extreme violence. I am no longer looking for medical advice, as it was the doctors themselves who reduced me to this state. I am asking for help from those who have lived through this hell:

Histamine issues: Is it possible that Mirtazapine, by acting on H1 receptors, is creating a paradoxical toxicity effect on an already sensitized system?

Rivotril damage: Did the isolated doses of Rivotril taken in late March permanently damage my ability to tolerate any other change, making even the slightest maneuver on Mirtazapine now impossible?

Has anyone experienced this level of kindling after benzodiazepine use? How can one survive when every adjustment attempt is a torture? Is there a way to calm this system that seems to have no filters left?

Thank you from the bottom of my heart to anyone who has the patience to read this and the strength to respond.

Hi @Gilda

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.

Please use the format outline here Preferred signature/drug history format

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

It looks to me like you initially suffered Benzo withdrawal from stopping clonazepam too quickly. This unfortunately, but not unusually, was misdiagonised as a worsening of your 'mental health' condition, an attempt to treat these symptoms was made using polypharmcy. Im sorry you have experienced this, as I said it is very common.

Unfortunately, your prognosis of kindling at this point is correct. You have suffered further harm from drug and dose changes.

It also sounds like to me that you have either gained some dependence to Mirtazapine, although you have only been on it a short time this can happen, and are having WD effects from reducing the drug, or somehow Mirtazapine is helping your symptoms from your Benzo WD, which you suggest it does in your post above. Im not sure which it is. But it also appears, it is giving you paradoxical/adverse effects whilst taking it.

This is a tricky dilema that you are in.

You have a couple of choices imo. You could try to taper off Mirtazapine quickly at 25% linear taper per month, to reduce the time you are on the drug and further dependance, then wait to stablilse from all of this. Or if this is too fast a taper for you, which you suggest it is above, you could leave Mirtazapine where it is now, and hope your body settles down, so you can taper more slowly in a few weeks.

I would start to keep a diary and post it here. Helps you track your symptoms and see how the Mirtazapine is helping or worsening you at different times of the day.

09.00 Woke up

10.00 Had breakfast

11.00 Had a headache

12.00 Took my drug

and so on.......

One thing I would not do, is jump your doses around any more, or add in additional drugs to try to help this. Just make nice methodical choices and stick to them. The CNS hates these kinds of changes.

 

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

Welcome to the forum, I'm sorry you are having a very difficult time.

12 hours ago, Gilda said:

Histamine issues: Is it possible that Mirtazapine, by acting on H1 receptors, is creating a paradoxical toxicity effect on an already sensitized system?

It's not possible to answer this question with any kind of high level of confidence.

Often, after discovering that doctors have little regard for the potential harms of these drugs, and then being harmed and doubting their advice, often the next thing harmed patients come to learn is that scientific understand of how these drugs work and how the body responds to them is extremely limited, and that's when they work as intended.

12 hours ago, Gilda said:

Has anyone experienced this level of kindling after benzodiazepine use? How can one survive when every adjustment attempt is a torture? Is there a way to calm this system that seems to have no filters left?

Being harmed by a drug, and then experiencing "poly-pharmacy" as you put it to try to counteract symptoms of harm, and being made worse and worse until the patient no longer has any confidence in medical advice is extremely common. I'd go so far as to say it is one of the main ways through which people end up in prescribed harm communities looking for information.

It can be very difficult to unpick what is causing what, and how to proceed when so many changes are involved.

As @Chippy suggested, there are two main options that I can see:

• Taper off of mirtazapine and hope that once you are off, you improve in time. This might be some time.

• Stop making drug changes, and hope to stabilise on the dose of mirtazapine that you are taking in time.

Unfortunately, there is no obvious, right answer. You must balance the harm that mirtazapine may be doing (which is difficult for anyone else to evaluate from the outside), against the potential harm from tapering it too quickly.

Could you elaborate some more on why you believe that Mirtazapine is causing harm, instead of all of the poly-pharmacy and drug changes before it?

Hello, thank you. I forgot to mention that after all the medications I took in the week of March, the last two were Mirtazapine, and then I stopped everything. I started having visceral anguish, and two weeks later, panic attacks—something that had never happened to me before. Now that I am taking Mirtazapine again, I still get panic attacks. The problem is that when I tried to decrease the dose, I felt sick, and I still feel sick. On Saturday, I made the latest reduction, and now I have pain everywhere, a very strange feeling in my head, and I am very afraid that I will not get better. My back hurts, everything hurts. I am keeping a diary myself. Today, I have very loud tinnitus, back pain, I am not sleeping at night, my ears feel clogged, and I have depression. Should I stabilize on this dose and then reduce? My question is: if I am in a state of 'kindling,' can I still attempt a reduction of Mirtazapine? I have been taking magnesium chloride for months. I don't understand this atrocious back pain. I am afraid of staying like this. I am in Italy, and the doctors here have ruined me

@Luke "Hello, I have the impression—I'm not entirely sure, but when I started taking it, I began to feel very depressed, and at the same time, unfortunately, I had also introduced Rivotril drops, and ever since then, I started having a lot of pain. Mirtazapine has significantly worsened my tinnitus. Now I really don't know what to do; I feel hopeless. @Chippy I am wondering if the reason I feel so bad when I reduce Mirtazapine is that I have suffered from 'kindling'?

3 minutes ago, Gilda said:

Should I stabilize on this dose and then reduce? My question is: if I am in a state of 'kindling,' can I still attempt a reduction of Mirtazapine? I have been taking magnesium chloride for months. I don't understand this atrocious back pain. I am afraid of staying like this. I am in Italy, and the doctors here have ruined me

I would hold here and wait to stablise personally. Kindling is just a name given to the observed phenomena of a worsening of symptoms from drug changes, whilst destablised. Don't worry about the term too much. Just understand, that your CNS is now brusied and unhappy with you. Further attempts to taper off at this point will likely make things worse imo. Once you find your baseline 'WD Normal' not symptom free, you can look to reduce more slowly, in line with guidelines found here, and more importantly listening to your body. We can help with this. But for now I would hold this dose and give it some time.

I am truly sorry for what you are experiencing, it is awful what these drugs can do to us. We are all here for you and understand.

Chippy

7 minutes ago, Gilda said:

Should I stabilize on this dose and then reduce? My question is: if I am in a state of 'kindling,' can I still attempt a reduction of Mirtazapine? I have been taking magnesium chloride for months. I don't understand this atrocious back pain. I am afraid of staying like this. I am in Italy, and the doctors here have ruined me

As I said in my post, we cannot make this decision for you. You might want to attempt stabilising on this dose, but it is hard to say whether you can or will. You may also wish to attempt to come off of Mirtazapine, but as you have discovered, this can cause even more harm.

Unfortunately, timeframes of a few days are next to no time in the context of the effects of dose changes. I would suggest trying to accept that there is no magic dose change you can make today or tomorrow that just takes it all away.

Both choices involve sticking to a plan and hoping for improvement over time.

"I am currently taking 6.8 mg of Mirtazapine. I have read that at this dosage it acts more like an antihistamine, and I am worried that this might be the problem. I am so afraid of staying like this. My head feels very strange, I have terrible back pain, and impossible tinnitus. Before the Mirtazapine dose change, I wasn't feeling this bad. I hope to be able to stabilize at least to how I felt before the dose change. Why do I need to keep hydrated? What is the purpose of it, and how much water should I drink per day? I weigh 38 kg since I reduced Rivotril. I have been following a ketogenic diet for months."

@Chippy Thank you. I cannot find the guidelines for tapering. I have only been taking it for a month, and since I am evidently in a state of 'kindling,' every time I reduce now, I feel sick. So, you advised me to stabilize at this dose, and I thought the same. But then, how should I proceed with the reduction? I cannot find the guidelines, and I have the orodispersible tablet and a precision scale, so I cut the tablet slightly and reduce. This is how I do it; I have no alternatives. If I dissolve the tablet in water, small pieces remain.

1 minute ago, Gilda said:

@Chippy Thank you. I cannot find the guidelines for tapering. I have only been taking it for a month, and since I am evidently in a state of 'kindling,' every time I reduce now, I feel sick. So, you advised me to stabilize at this dose, and I thought the same. But then, how should I proceed with the reduction? I cannot find the guidelines, and I have the orodispersible tablet and a precision scale, so I cut the tablet slightly and reduce. This is how I do it; I have no alternatives. If I dissolve the tablet in water, small pieces remain.

If you are finding the reductions too difficult, this might be your only option to hold here and hope your nervous system will settle down. Holding and doing nothing is often the best move. As I said perhaps, post your diary entries here, and that might help us see whats going on. It could be that after a period of holding, things will settle a bit. If we can observe clear signs that the drug is causing you adverse reactions, then you may want to start to taper it down. For the minute, I would hold and see personally.

Our tapering guide is here: Tapering Information

And information on making small reductions here: Preparing Doses for Tapering - Weighing & DIY Liquids

16 minutes ago, Gilda said:

Before the Mirtazapine dose change, I wasn't feeling this bad. I hope to be able to stabilize at least to how I felt before the dose change.

When you say dose change, do you mean you felt better at 7.5mg before reducing to 6.8mg? What date did you make this reduction?

Also please can you fill in your signature in the format suggested in the intro post? We have hundreds of members on here and keeping track of each persons history is very hard. We need it at the bottom of your post so we can reference it easily.

@Chippy Last Saturday, I reduced from 7.5 mg to 6.8 mg. But two Saturdays ago, I had gone down to 5.5 mg; since I felt sick, the next day I went back up to 7.5 mg, and I felt sick anyway. Then, on Friday, I was feeling slightly better, and the following Saturday—which was last Saturday—I went down to 6.8 mg. I am feeling terrible again. I truly believe that it is the dose change itself that is hurting me. This week, I am worse than the previous one. When I learn how to use this site, I will update my signature.

11 minutes ago, Gilda said:

So, you advised me to stabilize at this dose, and I thought the same. But then, how should I proceed with the reduction?

If you go down the route of trying to stabilise on mirtazapine, tapering will be far down the line, and very slowly to try to keep that stability in place.

2 minutes ago, Gilda said:

I truly believe that it is the dose change itself that is hurting me.

Then perhaps it is worth considering making no more, and hoping to stabilise in time. Again, we cannot make this decision for you, only give you information and suggestions.

3 minutes ago, Gilda said:

@Chippy Last Saturday, I reduced from 7.5 mg to 6.8 mg. But two Saturdays ago, I had gone down to 5.5 mg; since I felt sick, the next day I went back up to 7.5 mg, and I felt sick anyway. Then, on Friday, I was feeling slightly better, and the following Saturday—which was last Saturday—I went down to 6.8 mg. I am feeling terrible again. I truly believe that it is the dose change itself that is hurting me. This week, I am worse than the previous one. When I learn how to use this site, I will update my signature.

Ok, well lots of dose changes adds to things for sure. You may find returning to 7.5mg will help you. It is your choice of course, we can't know for sure. Either way I would stay here and hold or return 7.5mg and hold.

.Thank you, but I don't understand why the change in dosage causes these effects. I can understand withdrawal, but I don't understand having such terrible problems. My back is better at the moment, but I have pain in my left side and unbearable tinnitus. That's why I don't understand if the mirtazapine is harming me. I really wish someone would write that one can heal. @Luke I read your story, and it seems to me that you haven't recovered. I'm afraid I've ruined my life. And I'm also trapped with a medication I can't stop because I feel terrible when I taper off."

1 minute ago, Gilda said:

.Thank you, but I don't understand why the change in dosage causes these effects. I can understand withdrawal, but I don't understand having such terrible problems.

Changes in dose cause wd symptoms. It can also further destabilise a destabilised nervous system. So increasing back might reduce your symptoms as you said they happened after your drop which could indicate wd. It might be you just irritated your system making the shift. It seems you responded to increasing the dose before indicating wd. Could be both. Of course this last drop might have been one step too far and going back doesn’t work. We just don’t know.

People can and do heal. Try to focus on your own journey. Everyone is different.

35 minutes ago, Gilda said:

@Luke I read your story, and it seems to me that you haven't recovered. I'm afraid I've ruined my life. And I'm also trapped with a medication I can't stop because I feel terrible when I taper off."

I am a huge outlier, and it is abnormal to be as badly harmed as I am, for as long as I am.

35 minutes ago, Gilda said:

.Thank you, but I don't understand why the change in dosage causes these effects. I can understand withdrawal, but I don't understand having such terrible problems.

Terrible problems and withdrawal are the same thing.

The mechanism behind it is very poorly understood, but these drugs are dependence-forming, so removing them quickly can have consequences. Also, we might not know the biomechanics behind why it happens, but you are one of many, many harmed patients who have found a series of repeated changes has kept harming and harming them, which is why we recommend not to keep making more and more with a clear and careful plan.

This is a community-run forum, consisting just of harmed patients. We don't have any secret knowledge of the human body, just a deep familiarity with what has happened to and harmed others, and what is risky and should be avoided.

I have Mirtazapine orodispersible tablets. I use a precision scale, but I'm definitely not precise when splitting them because they crumble. Do you have any advice on how to consistently maintain the exact same dose? If I dissolve it in water, there are small lumps that won't dissolve. I'm also afraid to switch from the 'dissolve in mouth' method to a 'liquid' method. I don't really know what to do. Since my nervous system is destabilized, I imagine that dose consistency is the key to stabilization

6 minutes ago, Gilda said:

I have Mirtazapine orodispersible tablets. I use a precision scale, but I'm definitely not precise when splitting them because they crumble. Do you have any advice on how to consistently maintain the exact same dose? If I dissolve it in water, there are small lumps that won't dissolve. I'm also afraid to switch from the 'dissolve in mouth' method to a 'liquid' method. I don't really know what to do. Since my nervous system is destabilized, I imagine that dose consistency is the key to stabilization

Youre not really supposed to cut into odt tablets is my understanding.

When you dissolve them in water what you are seeing is likely the fillers. You could get some ora plus suspension fluid to help making a liquid. We have another member who makes a liquid from odt Mirtazapine from memory. @Emsy

@Chippy Thank you, but I cannot find 'Ora Plus' in Italy. I don't know what I could look for instead. I would like to obtain it, but I have no idea how

8 minutes ago, Gilda said:

@Chippy Thank you, but I cannot find 'Ora Plus' in Italy. I don't know what I could look for instead. I would like to obtain it, but I have no idea how

You can add some maple syrup to the water instead.

I would start off by transferring over to liquid first.

So continue cutting your tablet as you are currently.

Then each night add 1/4 of your dose approx into the liquid (crush it up first). Take the rest tablet. Do this for a few nights then add 1/2. Then 3/4. Then all of it. Just to ease you over to liquid.

Then you can start to make the liquid properly. Does that make sense?

What strength is your tablet in mg?

@Chippy Hi, I want to thank you from the bottom of my heart for the advice about the maple syrup. I know you’re trying to help me find a solution, and I truly appreciate your kindness and availability.

However, I am still struggling quite a bit, and my nervous system—which is very fragile right now—is having a hard time finding peace. I’m writing to you because I have some doubts that are causing me a lot of anxiety, and I’d like to understand things better with your help, if possible.

I’ve noticed something that worries me: whether I try to crush the tablet or simply put it in water, the result is the same. There are always these 'pellets' left over that don't dissolve, and unfortunately, I can’t even crush them by pressing down hard. The fact that they are so resistant creates a lot of anxiety for me, because I fear that a part of the active ingredient is inside those residues, and if they don't dissolve, my dose won't be precise. Also, when I try to crush it, a lot of powder sticks to the parchment paper, which makes me feel like I’m losing precious parts of my treatment.

Please forgive me for asking so many questions, but I’m a bit confused:

• Could you explain the technical function of the maple syrup in this context? I’d like to understand exactly why it is used.

• In your opinion, would things change if I switched to hard capsules? In Italy, the orodispersible tablets I use are 15 mg, while the hard capsules are only available in 30 mg. I’ve noticed their composition is very different: the water with the hard capsules becomes much cloudier and full of powder compared to the orodispersible ones, which stay clearer despite leaving those same pellets. I really don’t know which one to choose to be sure about the dose.

• Also, can a solution prepared this way be stored for the next day, or is it better to prepare it fresh every time?

Thank you again for your patience with me. Right now, I feel the need to be as precise as possible to try and give my body some stability, but I realize I am feeling very insecure. Thank you for anything you can tell me.

Edited April 29Apr 29 by Gilda

18 minutes ago, Gilda said:

Hi, I want to thank you from the bottom of my heart for the advice about the maple syrup. I know you’re trying to help me find a solution, and I truly appreciate your kindness and availability.

Absolute pleasure.

19 minutes ago, Gilda said:

However, I am still struggling quite a bit, and my nervous system—which is very fragile right now—is having a hard time finding peace. I’m writing to you because I have some doubts that are causing me a lot of anxiety, and I’d like to understand things better with your help, if possible.

I completely understand. It’s hard to navigate complex things at the best of times, but when the nervous system is destabilised things are harder for sure. I’m so very sorry this must be very hard for you.

29 minutes ago, Gilda said:

whether I try to crush the tablet or simply put it in water, the result is the same. There are always these 'pellets' left over that don't dissolve, and unfortunately, I can’t even crush them by pressing down hard. The fact that they are so resistant creates a lot of anxiety for me, because I fear that a part of the active ingredient is inside those residues, and if they don't dissolve, my dose won't be precise. Also, when I try to crush it, a lot of powder sticks to the parchment paper, which makes me feel like I’m losing precious parts of my treatment.

I understand. I don’t have direct experience of dissolving the odt tablets. I suspect that anything that needs to dissolve will do so in water. I’m fairly certain Emsy uses these when she makes up her dose.

31 minutes ago, Gilda said:

you explain the technical function of the maple syrup in this context? I’d like to understand exactly why it is used.

Most use water alone. But adding in syrup makes the liquid thicker and helps ‘suspend’ the drug in the water for longer before it sinks to the bottom. normally 50/50 or 75/25 sometimes.

32 minutes ago, Gilda said:

In your opinion, would things change if I switched to hard capsules? In Italy, the orodispersible tablets I use are 15 mg, while the hard capsules are only available in 30 mg. I’ve noticed their composition is very different: the water with the hard capsules becomes much cloudier and full of powder compared to the orodispersible ones, which stay clearer despite leaving those same pellets. I really don’t know which one to choose to be sure about the dose.

you could switch. We find people can react to the switch so we suggest the same 25/75, 50/50, 75/25 0/100 protocol to help make the change less dramatic for the nervous system.

34 minutes ago, Gilda said:

Also, can a solution prepared this way be stored for the next day, or is it better to prepare it fresh every time?

Some keep it in the fridge for a couple of days. I suggest making it fresh each time. Safer that way.

35 minutes ago, Gilda said:

Thank you again for your patience with me. Right now, I feel the need to be as precise as possible to try and give my body some stability, but I realize I am feeling very insecure. Thank you for anything you can tell me.

It is honestly a pleasure. I hope my answers helped you make some choices. Any questions please ask. 😀

Thank you truly from the bottom of my heart for the time you are giving me. I am honestly desperate because I have an internal 'engine' of agitation running inside me that won't turn off. I have pains everywhere, my head feels 'electrified,' I have stomach and abdominal pain, and now I’m even breaking out in acne on my face. I have tinnitus so severe it feels impossible for a human being to endure, and I am also stuck with orodispersible mirtazapine. I read that at the dose I am taking, it acts as a very potent antihistamine, so it is ruining me.

I know that stability is important, but by dividing the dose this way, I am unable to achieve it. I imagine that for the time being, I must continue with the same method of intake; otherwise, I risk destabilizing myself even further. I want so badly to get off it, but I’ve seen that I react poorly to changes, yet at the same time, the drug is hurting me.

Everyone here thinks I am depressed. I explain what I am going through many times, but they don't believe me. I feel so alone in this battle. I live by myself, and I have to work. Every passing minute is a tragedy. I cannot afford not to work; otherwise, I risk losing my job. Currently, I am working from home, but from Monday, I have to go into the office. I even explained my situation to the company doctor, but she just wrote on the certificate that I am 'anxious' and have tinnitus.

No one believes what I am going through. No one believes that decreasing the mirtazapine dose by such a tiny amount could make me feel this ill. I cry every day. I am a woman who has a home, pays a mortgage, and has to work and cook for herself. Everything I do requires a superhuman effort. I’m sorry for the vent.