I was put on 15mg of mirtazapine by a doctor at a walk-in clinic in 2018. I was never warned about withdrawal, and no doctor that I’ve spoken to seems to know about it.

Since I had no supportive doctor, I created an account on SurvivingAntidepressants.org, and followed the advice on the website. I began tapering on November 27^th 2019. My username was Rapini, as it is here.

My current dose is 0.32mg. I was mostly asymptomatic last year, but over the last few months, I’ve begun getting new and worse symptoms. I’m not sure if this is due to work stress or my low dosage, but I decided to post here because I’m confused about how to handle the last stage of my taper.

I’ve been making my own liquid suspension by adding 15mL of distilled water to 15mg of mirtazapine.

I was tapering at 2.5% of my most recent dose every other week, but I can’t make cuts smaller than 0.01mg unless I add more liquid to my suspension, and change the conversion I’ve been using. I just wanted to know if making changes to the liquid suspension would be a good idea at this point.

I’ve had windows and waves over the years with some years being better than other. The following symptoms being my worst:

• Flu-like symptoms

• Burning feet (which has recently travelled to other areas of the body)

• Dizziness

• Malaise

• Brain Fog

• Insomnia

• Heart Palpitations

• Tremors

• Temperature Dysregulation

• Muscle Cramps

• Confusion and memory problems

• Irritability

• Worsened mood

Hi @Rapini

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.

 

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13 hours ago, Rapini said:

Since I had no supportive doctor, I created an account on SurvivingAntidepressants.org, and followed the advice on the website. I began tapering on November 27^th 2019. My username was Rapini, as it is here.

Thank you for linking your SA thread above for us.

14 hours ago, Rapini said:

My current dose is 0.32mg. I was mostly asymptomatic last year, but over the last few months, I’ve begun getting new and worse symptoms. I’m not sure if this is due to work stress or my low dosage, but I decided to post here because I’m confused about how to handle the last stage of my taper.

It is good you have been well the last year and not suffered many symptoms.

If your nervous system is sensitive stress can definitely be a factor.

14 hours ago, Rapini said:

I’ve had windows and waves over the years with some years being better than other. The following symptoms being my worst:

Did you generally hold and wait for WD Normal to come back before tapering when you got symptoms?

14 hours ago, Rapini said:

I’ve been making my own liquid suspension by adding 15mL of distilled water to 15mg of mirtazapine.

I was tapering at 2.5% of my most recent dose every other week, but I can’t make cuts smaller than 0.01mg unless I add more liquid to my suspension, and change the conversion I’ve been using. I just wanted to know if making changes to the liquid suspension would be a good idea at this point.

You have been tapering around 5% per month from what you are saying here. On the lower doses this can actually be too fast for some. We also see that symptoms can kind of 'stack' so you may think everything is going ok but 6 months later you get a sudden rush of problems seemingly out of the blue. Going a bit too quick at the end here may have caused this.

You can absolutely dilute your liquid further to make reductions easier. You are making a 1:1 solution atm, 1:2 is the 'standard' we suggest on here, and often the solutions needs to be more dilute by the time you get down to your current dose. If you made a 1:4 you would use 60ml of water with your 15mg pill, meaning to take your current dose of 0.32mgai you would need to draw 1.28ml of liquid. If you need more control you can dilute even further if required.

Your last monthly drop from 0.34-0.32mgai was around 6%. (5.88%)

You could consider updosing to 0.33gmai to see if this helps. If not I would hold here and wait for things to settle down for you.

I would actually consider an extended hold to let your system recover from the taper before proceeding more cautiously.

I think it is really important to be careful at this final part of a taper. Don't be in a hurry to come off. Get your symptoms under control and taper more gradually. I would aim for 0.01mg as a final dose before zero.

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.

Have you been noticing that the increased symptoms are flaring up after dose cuts or is there no discernible pattern?

As @Chippy said, the last part of a taper at low doses can be quite tricky for some people even if the preceding tapering was ok.

My symptoms have been improving since I last posted, but I've been struggling to find a jar that's large enough to hold 60mL of liquid that won't leak when shaken. I've bought mason jars and amber cosmetics jars, but nothing has worked thus far. I just want to know if there's something that you can recommend.

Thank you.

To answer your earlier questions:

On 5/31/2026 at 8:13 AM, Luke said:

Have you been noticing that the increased symptoms are flaring up after dose cuts or is there no discernible pattern?

They usually increase after dose cuts, but sometimes there is no discernible pattern.

Did you generally hold and wait for WD Normal to come back before tapering when you got symptoms? (Sorry, I couldn't seem to quote this post properly for some reason)

I generally hold and wait for WD Normal to come back before I continue tapering when I get symptoms.

1 hour ago, Rapini said:

Did you generally hold and wait for WD Normal to come back before tapering when you got symptoms? (Sorry, I couldn't seem to quote this post properly for some reason)

I generally hold and wait for WD Normal to come back before I continue tapering when I get symptoms.

yeah, after each cut you want to generally wait until you stabilize before making another cut (unless you are micro tapering and you are less sensitive, then it's a bit of a different story but you still need to have lines of when to pause the taper or when to wait longer between cuts)

22 hours ago, Rapini said:

amber cosmetics jars,

These are the ones I have tried and they seem ok, perhaps try a different brand. It will be all based on how good the seal in the lid is. Perhaps others have other thoughts for you.

22 hours ago, Rapini said:

Did you generally hold and wait for WD Normal to come back before tapering when you got symptoms? (Sorry, I couldn't seem to quote this post properly for some reason)

I generally hold and wait for WD Normal to come back before I continue tapering when I get symptoms.

I did not do a safe taper, unfortunately. If anything my story is a lesson in why one is necessary. I didn't know anything about this until it was too late.

Generally though, it's thought that waiting for symptoms to die down and get to "WD normal" is a sensible decision as @Lighty said.