Hi everyone,

I’m posting because I’ve had a strange set of symptoms for around two years and I think mirtazapine withdrawal is to blame.

Before this I was well apart from insomnia that started early 2023. I started mirtazapine June 2023 just for sleep but stupidly took it quite inconsistently sometimes only a couple of times a week, with the dose varying quite a lot between like 0.5 tablets and 2 tablets. I didn't know how dangerous this medication was, I was taking it like a sleep aid when I felt my sleep could be rubbish for that night and would take more if it was really bad.

For the first few months I still just had insomnia that the medication helped with. I then had a viral illness which was probably covid and, about two months later, developed way more symptoms. I still remember the first episode where I woke up sweating and aching in the middle of the night after very vivid stress dreams. Since then I have had severe insomnia/wired feeling, burning and electrical skin sensations, pin-pricks/ant bites all over, internal vibrations, muscle aches, joint pains and bowel slowing with constipation, bloating and right-sided low down abdominal pressure.

I later took mirtazapine regularly again for about five months trying to stabilise, but the waves continued and it felt like the medication itself was making everything worse. I think I was well a truly kindled by this point having essentially withdrawn and reinstated the drug like 20-30 times over the last year. I eventually tapered off more gradually and have now been off it for around two years.

I still get quite marked waves and windows. I can feel almost normal and then suddenly have a bad few days with:

• very disturbed sleep or near-total insomnia

• vivid and stressful dreams - it feels like I have been asleep for hours and hours and then I look at the clock and it's been like 2 hours.

• Waking up constantly during the night.

• burning skin all over - this one is horrible

• widespread muscle and joint aches

• constipation

• bloating and this weird right lower abdomen pressure/pain. can't be appendicitis as I had it out before and it seems to get better when I physically push gas out of that area with my hand

• occasional headaches flu-like feeling

Often the bowel symptoms seem to come first, which are then followed by bad sleep and then the widespread pain. Waves can last a few days to a week or two.

I’ve had a fair amount of medical investigation including brain MRI, CT, GI tests and bloods, but they mostly come back fine. I have been so unwell I am sort of reticent to assume everything is withdrawal. I had that covid like illness and sometimes wonder if it is long covid or something similar.

I’d be interested to hear from anyone who had similar symptoms - especially the whole body pain and the ridiculously vivid dreams which feel like they last a day but actually are only like 2-3 hours. Psychologically I am pretty much fine except the symptoms themselves make me feel quite anxious and down.

Edited September 7Sep 7 by Lighty

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

10 hours ago, insomniac said:

For the first few months I still just had insomnia that the medication helped with. I then had a viral illness which was probably covid and, about two months later, developed way more symptoms. I still remember the first episode where I woke up sweating and aching in the middle of the night after very vivid stress dreams. Since then I have had severe insomnia/wired feeling, burning and electrical skin sensations, pin-pricks/ant bites all over, internal vibrations, muscle aches, joint pains and bowel slowing with constipation, bloating and right-sided low down abdominal pressure.

I wouldn't be suprised if covid caused some more complications and issues as it can in times.

10 hours ago, insomniac said:

I later took mirtazapine regularly again for about five months trying to stabilise, but the waves continued and it felt like the medication itself was making everything worse. I think I was well a truly kindled by this point having essentially withdrawn and reinstated the drug like 20-30 times over the last year.

that sucks, the constant changes must have not helped with your nervous system !

10 hours ago, insomniac said:

Often the bowel symptoms seem to come first, which are then followed by bad sleep and then the widespread pain. Waves can last a few days to a week or two.

yeah, we all have our own different patterns with how our nervous systems are aligned.

10 hours ago, insomniac said:

I’ve had a fair amount of medical investigation including brain MRI, CT, GI tests and bloods, but they mostly come back fine. I have been so unwell I am sort of reticent to assume everything is withdrawal. I had that covid like illness and sometimes wonder if it is long covid or something similar.

yep you are unlikely to find anything if it is withdrawal.

10 hours ago, insomniac said:

I’d be interested to hear from anyone who had similar symptoms - especially the whole body pain and the ridiculously vivid dreams which feel like they last a day but actually are only like 2-3 hours.

I had myself whole body pain, vivid dreams aren't uncommon from what I know especially with mirtazapine.

10 hours ago, insomniac said:

Psychologically I am pretty much fine except the symptoms themselves make me feel quite anxious and down.

It's important to remember symptoms are not symptoms, usually with withdrawal they are just illusions and distractions, they are temporary and they will get better with time, you might want to learn practicing acceptance and other coping methods.

Acceptance is key - Why does acceptance feel impossible?

Being a human, and dealing with emotions in WD

I personally think meditations can help as well with clearing out the mind, especially if you have no neruo emotions: Breath And Meditation

 

Overall you are on the right track, just keep being gentle on yourself, listen to your body and you will heal ❣️

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.

After a week just gone where I had a lovely window I feel right back to square one. My symptoms telling me a wave is coming is always the same - in the evening I start to get this odd bloating sensation, my bowels slow down, and I get these weird shock like “antbiting” sensations all over my body. Then I have very broken sleep with vivid dreams and wake up constantly feeling physically unwell. It’s definitely worse when I’m lying in bed as there is nothing to distract from the unpleasant bodily sensations that are going on. Now today all my skin feels uncomfortable to be in, like I have a full body sunburn. It is so draining to keep getting this after two years. I accept I took the medication in a stupid way by taking it as PRN sleep aid but I never thought this would be the result.

When you live with a chronic illness for a few years it becomes harder and harder to remember what life was like before all of this, and there is a grief that you feel you are losing that memory. I want to believe each wave is another way in which my body is healing but increasingly it just seems like a dysregulated system that from time to time doesn’t know how to interpret normal physiological nerve signal correctly, and is instead just firing off bizarre messages that I should be in pain or my bowels should slow down or I should not be asleep. I wish I could turn my brain off and on again and just reset back to factory default. I wish it was better understood in the scientific community what taking these meds actually does to the brain, then there may be better ways to treat the different phenotypes of symptoms and difficulties people here experience.

My window was so nice - though even in my windows I don’t quite feel normal. Sometimes I almost feel too good, like hypomanic if that makes sense? And my sleep never goes back to how it used to be, it is always vivid dreaming and more shallow but windows at least I don’t wake up feeling unwell.

Hey @insomniac It is so good you had a nice window. The fluctuations are a good sign. Unfortunately waves are part of the process. 2 Years off and still having issues is not uncommon. Time will heal this, hold that faith. I can empathise with much of what you have said with your sleep as a fellow Mirt sufferer. Hope a nice long window comes very soon for you!

Welcome to the forum.

Pretty much everything you've described is absolutely classic mirtazapine symptoms.

Having fluctuations in the symptoms is a good sign, and the windows are particularly encouraging.

I have taken a different approach with this wave and decided to lean into it and almost get angry at it. I used to be really fit and active but this has really fallen away being ill so frequently. But yesterday I said f* it and went and did some weight training. I was absolutely rubbish and couldn’t do a 1/4 of what I could before but really pushed myself as hard as I could and actually felt a bit better afterwards. My skin allodynia seemed quieter and it was like my sympathetic nervous system was firing but appropriately rather than for no reason. Today the symptoms have also been a bit milder - not quite window like but nowhere near peak wave - and so I have just pushed myself again.

I know that some people have a sort of CFS/ME picture and so pushing yourself is probably a very bad idea but I have never suffered from post exertional malaise luckily. I’ll keep updating this thread with how the exercise regimen goes. So grateful this group exists and to see so many other similar experiences. I’ll try and bring my positive times as well as negative as I think we all need to see and hear about both!

Bad news from last night. In the evening I felt really well but then just before bed I felt a wave of terrible fatigue- not like a normal fatigue it’s an odd feeling and I know it indicates a bad night ahead. Low and behold after lying in bed for 30 minutes that way the fatigue gave way to total wiredness and then I could not sleep at all. This isn’t a sleep anxiety it’s a total inability to get to sleep, I’m no longer anxious about it as I know the drill. I finally got some sleep with very vivid stressful dreams at like 5:30 but I have to be up at 6:45am so now feel awful. This severe sleeplessness was an old symptom at the beginning but has made a comeback over this year which has been most unwelcome.

I wish I had taken better notes of my symptoms in year 1 and 2 as now I enter year 3 I don’t have much to compare to. Every step back feels like a major regression to the beginning. I feel awful now and can’t remember feeling worse. I know I have had windows throughout but impossible to say if these are more frequent or better now than they used to be. I’m going to lay off hard exercise today but try to restart tomorrow.

I’ve got a 10 month old baby and a job to juggle and feel an invalid 50% of the time it is utterly miserable. I was going through some old notes though and saw when I reinstated mirt (way too high) at 15mg it made all these symptoms worse so I know it’s due to that evil drug.

We usually recommend try to stay active at a low, manageable level if possible- things like gentle walking.

You've got a lot on your plate already with withdrawal and a family, I understand the desire to return to hard exercise (which I'm also not capable of), but you might find it easier to not add things to deal with and just do gentle movement that promotes wellbeing and hope that this is not too taxing.

Good advice. The initial response I had though to the hard exercise does make it alluring. It really turned down the amplitude on my dysaesthesia and skin burning and made my body feel more comfortable. But it is probably ramping up my activating symptoms like inappropriate night time wakefulness. I think I’m just desperate to find something that can hard reset my neurons, feel like I need an IT guy to unplug me and turn me back on again in safe reboot mode.

1 hour ago, insomniac said:

Good advice. The initial response I had though to the hard exercise does make it alluring. It really turned down the amplitude on my dysaesthesia and skin burning and made my body feel more comfortable. But it is probably ramping up my activating symptoms like inappropriate night time wakefulness. I think I’m just desperate to find something that can hard reset my neurons, feel like I need an IT guy to unplug me and turn me back on again in safe reboot mode.

Hi @insomniac as @Luke said, please take it easy with your body in regards to exercise. I went back to the gym a few weeks ago and did a leg workout which has unfortunately set me back

All the best

J

On 9/14/2026 at 7:32 PM, insomniac said:

Good advice. The initial response I had though to the hard exercise does make it alluring. It really turned down the amplitude on my dysaesthesia and skin burning and made my body feel more comfortable. But it is probably ramping up my activating symptoms like inappropriate night time wakefulness. I think I’m just desperate to find something that can hard reset my neurons, feel like I need an IT guy to unplug me and turn me back on again in safe reboot mode.

Perhaps a light level of activity will provide some benefits but without the downsides that come from pushing yourself too hard?

Having a bad flare today after some better periods recently. My symptoms are predominantly full body allodynia and muscle aches. At their worst they feel truly inescapable and drive some unpleasant SI thoughts. It helps slightly to think that my body is still ok its just my nervous system firing off inappropriately but this generally is overwhelmed by the pain. I sometimes think I could have fibromyalgia, but then I developed it very suddenly whilst also being on this new medication. It’s hard to untangle it all in my head and decide exactly what destabilised what. Sometimes I think about taking duloxetine as that is a treatment for fibro and nerve pain which is my predominant symptom, though I am loathe to interfere with my brain any further.

It can be so hard inn the midst of a flare to think you will ever feel well again, and I also frequently wonder if I am really doing any better than I was two years ago when I last took it.

@insomniac Sorry about your wave. This is common, worse days after better days. Hold tight a window will come along I am sure.

In WD it is encouraged to test for things that could also be going on at the same time as WD. However most of the time it is just WD. it is very unlikely you have both happening at the same time.

Trying to treat WD with additional drugs is never wise. Trying to treat other conditions with more antidepressants would be a bad idea IMO. Your nervous system is now very sensitive and it really needs peace from these substances, I suspect Duloxetine would make your WD much worse.

I know bad patches can seem like you are moving backwards, it feels like this for us all, but we are not, always moving forwads in the normal windows and waves pattern seen so frequently round these parts.

Chippy

Had a better 2 ish weeks until today. I slept around 5 hour blocks then woke but could usually get a few more hours. However the vivid dreams persisted throughout.

Then last night I had all the warnings of a wave. I got really bloated and nauseous. When I tried to go to sleep I felt awful and basically was in and out of sleep every hour. Now today have no energy at all (and have to parent an 11 month old) and have the aches and pains all over. Very depressing. I am trying to track things to reassure myself I am gradually getting better but when it comes back it just feels like square one again. I last took the meds 25 months ago and 36 months since I started to have adverse effects on the meds. Feels endless.

2 hours ago, insomniac said:

Had a better 2 ish weeks until today. I slept around 5 hour blocks then woke but could usually get a few more hours. However the vivid dreams persisted throughout.

Then last night I had all the warnings of a wave. I got really bloated and nauseous. When I tried to go to sleep I felt awful and basically was in and out of sleep every hour. Now today have no energy at all (and have to parent an 11 month old) and have the aches and pains all over. Very depressing. I am trying to track things to reassure myself I am gradually getting better but when it comes back it just feels like square one again. I last took the meds 25 months ago and 36 months since I started to have adverse effects on the meds. Feels endless.

I'm sorry you're back in a wave @insomniac. We've all had the experience of doing better for a bit then getting thrown right back into the trenches. It can feel incredibly demoralizing -- but the progress you made is still real. I hope your next window comes soon and is even brighter than the last 💜