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what is Mirtazapine Withdrawal?

K.C. Bruning
K.C. Bruning

Withdrawal from the antidepressant medication mirtazapine can cause a wide array of effects, from mild to severe. They include both physical illnesses, such as diarrhea and nausea, and emotional problems, including anxiety and depression. The number and intensity of mirtazapine withdrawal symptoms is part of the reason why the drug is usually only prescribed when other medications have failed to have a beneficial effect on a patient. The most effective way to minimize the chance and severity of withdrawal symptoms is to gradually phase out the use of mirtazapine.

Some of the emotional disturbances associated with withdrawal include anxiety, aggression, crying spells, and irritability. Patients may also experience intense internal restlessness, disturbing thoughts, and deepening depression. Hostility, paranoia, panic attacks, and the tendency to over-react to situations have also been reported as withdrawal symptoms.

Withdrawal from mirtazapine may cause worsening depression.
Withdrawal from mirtazapine may cause worsening depression.

There are also several unusual physical sensations and illusions that can arise as a result of mirtazapine withdrawal. Patients can find themselves having repetitive thoughts, thinking constantly of the same songs, or experiencing other uncharacteristic disturbances of the senses. Some individuals may have a tingling sensation, or feel like they are receiving an electrical shock; when the shock is felt in the head, it is called a brain zap. Vivid dreams and hallucinations are also possible.

Crying spells may be common during mirtazapine withdrawal.
Crying spells may be common during mirtazapine withdrawal.

The body can also become physically impaired due to mirtazapine withdrawal. Patients may have balance issues, vertigo, and dizziness. Some individuals experience changes in the ability to see or speak. It is also possible to have tremors or suffer from lack of coordination as a result of discontinuing use of the drug.

Common physical discomforts that can arise as a result of mirtazapine withdrawal include flatulence, constipation, diarrhea, and indigestion. Patients can also experience symptoms similar to the flu. Stomach cramps, nausea, and migraine headaches are also possible.

Withdrawal symptoms of mirtazapine may include paranoia.
Withdrawal symptoms of mirtazapine may include paranoia.

Mirtazapine is usually prescribed to treat depression. The drug works by encouraging brain activity that can improve and help to maintain a healthy mental balance. It comes as either a regular or disintegrating tablet. Mirtazapine is taken once a day, usually at bedtime. The medication can take many weeks to become completely effective.

There are some conditions which may make taking mirtazapine is too risky or at least requires an adjusted dosage or additional patient observation by a medical professional. Previous experiences with low blood pressure, liver or heart disease, high cholesterol, or heart attack should be reported to the prescribing doctor. Women who are nursing, pregnant, or planning to become pregnant are usually advised not to take the drug.

Discussion Comments


I took mirtazapine when I was going through a difficult period in my life. The drug didn't help me emotionally at all, but it did make me fatigued, irritable, fat, and suicidal. I hadn't had suicidal thoughts before taking the medication, and they felt alien to me, so I knew that it was the pills.

It is difficult to get off of mirtazapine. I initially tried cutting at 10% of my dose, but this left me with terrible withdrawal symptoms. Cutting at 5% has been more tolerable, but not painless. My main symptoms are dizziness and flu-like symptoms. I find that movement triggers this, so I try to minimize movement as much as possible. I also have digestive issues and insomnia at times. Emotionally, I feel better than ever.

Please keep in mind that it can take years for some people to get off of these drugs because you are forced to taper very, very slowly in order to avoid experiencing severe withdrawal symptoms. 10% of your most recent dose is the most you should cut if you are trying to get off of your medication.


I took the drug for about six months, and just stopped immediately. I've been clean for about two weeks now and feel nauseated, dizzy, and have been having diarrhea. My doctor told me that the first doses would amplify the depression emotions until my body accepted the drug, but six months went by and I thought about killing myself just about every single day for the past six months.

I've been off it for two weeks now and they have been the best two weeks of the past year, so my main question is, if it doesn't help right away and it has withdrawal symptoms, why would we keep taking this? This is a drug comprised of chemicals that the body doesn't want to consume, but once consumed, doesn't want to let go, Is that really something you want to put into your body? There has to be a better way to help people than knowingly poisoning them for a desired effect. It's ridiculous.


I'm currently 7 days since my last Mirt pill and the first time I've experienced the withdrawals. All of my confidence has gone. Today I was supposed to meet some friends but am overwhelmed with anxiety and therefore staying inside! I hope this doesn't last long as I'm supposed to be studying in University. Going back on Mirt is not really an option because the meds almost killed my long-term relationship. Will I ever be able to get my confidence back?


I'm going through withdrawal myself. Stopped taking the 30s a while back and just taking half pills, so 15s. Helped initially with a problem I was having waking up anxious and restless. I took them for the better part of the last two years (stopped briefly but then went back due to side effects). But now I want off of this and the side effects are very obvious this time: diarrhea, lack of appetite, gagging, nausea, and just feeling anxious all the time. No fun. Hoping that it will all be out of my system in another week or so, but who knows?


I was on mirtazapine for about 18months and gained quite a bit of weight. I did not find it to be so helpful and had increased suicidal thoughts, paranoia, bouts of crying and decided to come off it. My skin felt like it was crawling with stinging ants and I became even more paranoid and the suicidal thoughts increased. Thinking I was never going to be able to come off anti-depressants I asked for another script. Again I became flat, gained weight, but the depression did not seem to improve and I was still having frequent thoughts of suicide and some paranoia. I started researching and found that the symptoms of discontinuation can be quite severe including paranoia and increased suicide ideation. The stinging skin sensation is another symptom. I have been on many antidepressants and have not found them to be a solution.

I finished my last dose of 15mg mirtazapine last night and I am determined to come off this drug and let my brain relearn how to produce it's own chemicals once again. I am on 1mg of diazapam daily to help me ride out the discontinuation symptoms and will stop that over the next couple of weeks. I will not go onto mirtazapine again. The drug can be just as bad as the depression, worse when you try to come off it. I wouldn't recommend it to anyone. But this is my experience and it may be very different for someone else.


I am so glad that I found this site. I am 61, and after over 7 years on Mirtazapine, today makes four weeks off, cold turkey. I was originally put on 15 dissolving tabs, and then went straight to 45. I had no idea what I was getting into, and the doc who prescribed them moved out of town a year later, and my PCP said that he would continue the drug refills. Nothing else was mentioned about it until last year when I had been sick for quite a while, and we figured out that it was Mirtazapine side effects.

We decided to titrate me off of them, 30 mg x 2 weeks, 15 mg x 2 weeks, stop. That worked fine until about a week afterward, and I became quite ill. The first, worse symptom was digestive cramps. I called my GI doctor, who put me back on 7.5, which helped. That was a year ago. Four weeks ago I decided to try it again, and I figured since the first doctor stopped me at 15, then stopping at 7.5 wouldn't be too bad. The wisdom of a fool.

Six days after the last pill, I started getting every symptom of withdrawal in the book. I am still sick, although the sleep has improved, I was in the bathroom with the dry heaves twice this morning. I took 1/2 Phenergan for nausea, and it helped. As stated by a previous post, going back on them to stage it out is not an option. I have made it too far.

Please do yourself a favor, and like previously advised, come off Mirtazapine at a snail's pace if you can, and it helps. I have been to the ER twice in the last two weeks. I never thought that at 61 years old I would be sitting in my bed in the middle of the night, my wife's arms around me, crying uncontrollably from prescription drug withdrawals. I am still quite ill, and it was an effort to write this.

Thanks for all the previous posts, as they are my support group.


I was on mirtazipine 15 mg for wretched insomnia/anxiety/aggression this summer; now I am situated better in life and wanting to step of, been cutting my 15 mgs down to 7.5 mgs. Even at such a low dose, after two days cold turkey I am unable to sleep. This is the very last anti-depressant medication I will ever take. I am willing to learn how to manage my emotions and reactions to the demands of life without these god-forsaken pills.


My mom prescribed me this medicine. When I told another provider, she was shocked. What mental illnesses does this medicine treat?


I have taken mirtzapine for nine years and it works for me. I have tried going off in the past but I just get mentally ill again, but after nine years of being on and off meds it was good to find something that worked.


I took sertraline for almost three years then recently found they weren't working anymore. I was prescribed Mirtazapine just over a month ago. I put on so much weight in an instant and had the craziest effects that I have now come off the whole lot.

It's been four days with varying effects, but not too bad. The worst thing so far is the amount of dizziness. I feel like I'm on a ship at sea rocking back and forth, although I'm not physically moving anywhere. I'm starting to wonder if I really should be driving my car, but I need it for work and don't want to risk losing my job, as that would no doubt send me straight back into the depression hole again.

I'm hoping that the short length of time I've been on Mirtazapine will mean that the withdrawal doesn't last too long, however it is compounded with total Sertraline withdrawal at the same time, so goodness only knows what effect going cold turkey on the two together will have.


I quit nearly cold turkey after six weeks at 30mg. I came off in three days. I was fine for first week and now it's gone pear shaped. I'm having flu like symptoms, brain zaps, insomnia and the worst is persistent anxiety! I'm two weeks off, so please tell me it gets better!


1) Go slow. Your brain's natural capacities to deal with stress and depression have to "grow back" after being overshadowed by meds. Too Many people are trying way too fast. See "Ashton Protocol" for getting off benzos. I've been on most everything and the withdrawal symptoms are remarkably similar for most everything.

2) Try to stay away from long term (over six weeks) bezno use. I have been titrating down for six months and have another four months to go (starting from 6mg of xanax - the worst of the worst) and that's faster than the protocol suggests.

3) A doc who is not a benzo fan is a smart doc.


I take mirt 15 mg for depression and anxiety. I stopped haldol two weeks ago due to horrific depression, and started feeling better a week ago, but after a few more days, started feeling depressed and more anxious. It turns out that I had forgotten (!) to put mirt in my weekly pill container, and I didn't realize this until just now, six days later. Therefore, I've effectively (and unwittingly) performed a withdrawal test, going 15mg to zero cold turkey. After three days, I not only began to feel increasingly depressed, but was waking up in the middle of the night with worry/panic, and unable to go back to sleep. I also had little appetite, and felt completely listless.

I know this med has helped me with depression, not sure about anxiety. I'm normally an extremely organized person, so I'd caution all to be careful not to forget your dose as I did.


I've been on mirtazapine for one year. I originally got on it to help me through a depression spell. It helped me for a while but now I'm trying to get off of it and when I miss a dose I have bad panic attacks!

I went to the hospital and they told me to take the meds and in about an hour I was fine. Now how am I going to get off of it if withdrawal causes panic attacks? I do not suggest anyone take this medication.


I have been taking 30mg Remeron (Mirtazapine) for about two months. During that time, I have gained more than 10kg (about 20 pounds). Felt none to mild improvement. Actually, my black and white mood swings have just gotten worse during the time of taking it.

I stopped taking it about a week ago, and since then I have been experiencing mood swings of the same intensity, with added heavy sweating (5+ completely sweaty shirts per day) and what seems to me like anxiety-induced nausea as well as episodes of extreme calmness vs inexplicable irritability in a very short time span.

Having taken various medications throughout the years (Rivotril, Xanax, all the -Zepams out there, Miansan, Eftil, Flormidal, etc.), I have realized Remeron (Mirtazapin) is among the more useless ones, at least for me.


I started taking mirtazapine 30mg at the peak of my depression. It resolved my emotional issues three months later, then two or three months after resolving, I went cold turkey, and felt sweet for about three days.

Now I haven't taken it for a week, I'm having mad headaches, aches in my body, light sensitivity, difficulty concentrating, emotional overreaction and anxiety that I have never experienced before. No depression though. Still positive, but it's uncomfortable.


I've been on mirtazapin for six months, and it really helped me with my depression and panic attacks.

I stopped taking it two weeks ago and now am having very bad withdrawal symptoms, including insomnia, feeling disconnected, almost no emotions, feeling completely dead inside. The depression is worse than before I started taking mirtazapin. I'm feeling like I've lost some part of myself. When I wake up it feels the worst. It's very hard to get motivated to get some things done. I'm feeling brain dead without a soul and totally confused.

I do not recommend taking any antidepressant!


I was on mirtazapine for six months and have been off of it for three weeks. It was a wonderful drug for me, but the weight gain, memory issues, and general lethargy were just too much.

I'm pretty shaky and have been emotional and suicidal. I've been at zero dose for almost four weeks. I'm hoping this levels out soon. I may need to go back on it.


I have been feeling strange, and had a terrible headache and gastro problems all week. I put my pills in a weekly container, and I have not had my remeron since Monday, six days ago. I just noticed tonight! I weigh 127, and am taking 30mg per day. The song "killing in the name of" by rage against the machine was stuck in my head all week! this is a very accurate assessment of the withdrawal symptoms.


I'm withdrawing from taking 45 mgs. I've been on them for seven years. The shaking I am experiencing is unreal, and I'm so dizzy. I'm hoping the shaking stops. It's so embarrassing. I just want to hibernate. Is this normal?


I used to take Citalopram to treat severe depression and GAD, but had to switch to Mirtazapine after Citalopram knocked me to the ground and kept on kicking me to the point that I almost couldn't function due to the side effects. Mirtazapine, in this respect, has been a much kinder drug to me.

A few things that I have found helped me on Mirtazapine:

1) I was very upfront with my management and set expectations about what they could and couldn't expect from me very early. The lethargy is a nightmare to handle, but I knew that I would routinely sleep for 12 hours per day and had to plan around that to make it easy on myself. It also left me very tired during the day, so I explained that and they were very supportive.

2) For a change, I actually had to plan to put on weight. I found that going swimming regularly helped to stabilise my weight, but had to also judge each time whether I was actually safe (i.e., not too tired) to get into the water. More often than not, though, I was fine.

3) I had to slow my life down -- a lot. This was probably the hardest thing for me to do. But it needed to be done.

The nice thing about stepping down from 30 to 15mg for me was that I got a lot of my energy back. Unfortunately, I stepped down prematurely (without first solving all of the underlying issues that led to my depression in the first place), and found that I had to step back up again.

I am now about to step down to 15mg again, having put a lot of ground work in place (mostly to do with setting realistic expectations). So, I'll see how it goes. Hopefully it will go well. My doctor is not a big diazepam fan (unlike my old doctor), so anxiety could be interesting to handle.

I think I will need to manage my own expectations (I'm not expecting to be able to step off with no side effects), and will have to manage each side effect as it comes along.

My doctor is usually good at putting things into perspective for me. In this case, it was a balancing act between definitely feeling depressed to the point of almost being suicidal with no medication to manage it, and an increased mortality risk as a result, versus a possible mild addiction which, in time, can be beaten. Personally, I still prefer to risk the mild addiction with all of the benefits that the medicine has given me.


I've been on Mirtazapine for the last five years. The side effects of the were so hellish that I decided to come off it (with medical supervision). It's been done very slowly (since August), the drug was completely stopped three weeks ago as the lowest dose floored me with lethargy. I was fine for a week, then bam! I had insomnia, lethargy, nausea, lack of appetite, vertigo, flu like symptoms, weird dreams, restless legs etc etc. It's horrendous, and two weeks later all I'm really left with is an extreme lethargy. I'm able to sleep a bit more at night now, but it's a case of one step forward, two steps back.

Going back on the drug is not an option due to the side effects, and despite the physical hell, mentally I feel so much more 'awake and alert'.

I was prepared for what would happen and have cut back on activities to take care of myself.

It will get better eventually. It's frustrating at times, but I'm looking forward to a medication free life!


I have been on venlafaxine and Mirtazapine for eight years. I came off 225 ml Ven OK and have reduced the Mirt from 45 to 30ml. I am very nauseated and have some anxiety, but will stick it out, but decrease slower on the next reduction. I am waiting to try Noni juice to see if this helps. Hang in there because deep down you know you will feel better in the end.


I was prescribed mirt but felt it wasn't working so I went back to citalopram. I found I couldn't sleep, so I started taking half a tab at night, 22.5mg, instead of 45mg of merit in addition to the citalopram. I had two months worth left in my cupboard but have now run out.

Even though I'm still taking the cit, I have been awake now for three straight days and my stomach is going crazy. I know it was stupid to self medicate. When will I sleep?


I quit taking mirtazepine because my blood pressure was so low. When taking it, I felt lousy for weeks after and my blood pressure took over a month to return to normal.


@SZapper: Anti-depressant medications are not worth it. Particularly Mirtazapine. The side effects are terrible. It stops working or ‘poops out’ after about six months in all but a few patients. The withdrawal is even worse.

Avoid starting them at all costs. In my case, they only made things worse. They also create false symptoms of other mental illness. For example, if you take Mirtazapine for depression, you will likely end up with anxiety, and then a psychiatrist will prescribe a pill to treat the anxiety instead of removing the medication that causes the problem.

You could spend years trying different medications to get the right ‘balance’, when in reality, 100 percent of medications fail in 100 percent of patients beyond the three to five year mark.

A “successful” FDA approved medication only requires a 50 percent reduction in symptoms, in 50 percent of patients after six weeks of starting medication. If those numbers are increased to two-thirds (66 percent), and the period is doubled to 12 weeks, all antidepressants fail. In fact, a placebo is 82 percent as effective as prozac in the most favorable clinical trial of that drug.


Mirtazapine withdrawal is one of the nastiest kinds. Even if you were on them for a couple of months. Standard tapering schedule for mirtazapine is reducing the dose 10 percent every three to six weeks, depending on how you feel. Some people have to go 5 percent or less. I made a mistake of reducing the meds 30 percent and have been ill for two weeks. I still don't know whether it is a withdrawal or if my original stomach condition has returned. It is very debilitating. Good luck.


Considering this information, I think if you're taking mirtazapine and you want to stop, you probably need to plan ahead. It sounds like it would be very difficult to function while dealing with all these mirtazapine effects. I don't think I could work while dealing with depression, anxiety, and physical symptoms!

And I definitely think anyone considering going off of this medication should consult a doctor! I feel like a doctor could help you decide how to go about stopping this medicine and maybe give you something to help with the symptoms.


@JessicaLynn - It is disturbing, but don't forget that depression is a debilitating illness. For many people, the possible risk of withdrawal is outweighed by how much depression affects their life.

I've struggled with depression before, and it makes it difficult to do, well, anything. Even to get out of bed. I'm better now, and at the time I decided against medication. However, if I ever sink into a deep depression again, I think I will just take the medicine. Even with the side effects, mirtazapine is probably better than dealing with depression.


Am I the only person that thinks this is disturbing? I don't understand how it's safe to take an antidepressant that will make you depressed and anxious if you stop taking it!

I don't know how the side effects of other antidepressants compare to mirtazapine side effects, but I know a lot of other antidepressants cause withdrawal symptoms. In fact, I had a friend who missed about a week of work because of antidepressant withdrawal.

I think I would be scared to even take an antidepressant! Or if I started, I wouldn't want to stop and deal with the crazy side effects!


@ysmina-- I quit mirtazapine recently as well and I didn't have any withdrawal symptoms at all. And I was on it for a year and a half.

From my experience with other antidepressants though, it does sound like you are experiencing withdrawal symptoms. I think what happens is that people adapt to mirtazapine and other antidepressants very differently. That's why some people have a hard time when quitting them and others don't.

What you can do is try to treat the symptoms you are having. For example, if you're having flu-like symptoms, a pain-reliever might be helpful. For depression symptoms, you can talk to your doctor and see if you can temporarily go on a light antidepressant or anti-anxiety medication to easy the antidepressant withdrawal effects. Some herbal/natural antidepressants might be help as well.


Do you think that mirtazapine withdrawal symptoms get worse the longer you are on it?

I was on mirtazapine for only two months but I'm having withdrawal symptoms regardless. And I have been decreasing the dose slowly. I was on 45mg and I've been decreasing the dose by 15mg per week. But the withdrawal symptoms are getting worse and worse.

I have terrible insomnia, anxiety and depression symptoms and suicidal thoughts. I was not expecting this at all since I was only on the drug for two months!

I always thought that withdrawal symptoms get worse when it's used for longer periods of time. But from what I understand, the intensity of my symptoms is not too different than people who have been on the drug for years. I'm wondering if I'm confusing actual depression symptoms with withdrawal symptoms. But I don't think so because I didn't have them while I was on mirtazapine.

Has anyone else been in this situation while quitting mirtazapine antidepressant?


I took mirtazapine for about six months last year and made the mistake of quitting it cold turkey. I had really bad side effects for several weeks after that. The biggest one was nausea. I was so nauseated that I really couldn't eat anything without vomiting. I had a lack of appetite on top of that and lost several pounds until the symptoms got better two weeks later. I still had fatigue for another week or so though.

I will never make the mistake of quitting any anti-depressant cold turkey again. I will quit it slowly, decreasing the dose over weeks. I've heard that when it's done that way, there are little to none medication withdrawal symptoms. The article also mentioned this and I suggest everyone to take this warning seriously!

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