All You Need to Know — Talkspace

Mirtazapine (also known as the brand name Remeron) is a tetracyclic antidepressant that’s FDA-approved for major depressive disorder (MDD). It’s also used off-label to treat a variety of other mental health conditions, like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized and social anxiety disorder, and insomnia. It’s not uncommon for someone to switch the type of antidepressant they’re on or for them to quit taking it altogether. The decision can come from many places, including unwanted side effects, not getting the results you want, feeling like you don’t need it anymore, or for personal reasons — like wanting a more holistic treatment plan. 

Whatever the reason, abruptly discontinuing any drug, including mirtazapine, can cause a range of physical and emotional changes. That’s why it’s so crucial to talk to your doctor before you stop taking this drug. A qualified and experienced mental healthcare professional will help you find a safe and effective way to stop using it while minimizing withdrawal side effects. Keep reading to learn more about mirtazapine withdrawal​. 

Can You Stop Taking Mirtazapine Immediately?

No, you should not stop taking mirtazapine suddenly. Like most antidepressants, mirtazapine works by altering neurotransmitter activity in your brain. Sudden discontinuation can cause uncomfortable withdrawal symptoms, including: 

• Nausea and dizziness
• Insomnia or vivid nightmares
• Restlessness 
• Anxiety and irritability
• Flu-like symptoms
• Electric shock sensations (also known as “brain zaps”)
• Mood swings and depressive symptoms

To minimize or prevent mirtazapine (Remeron) withdrawal effects, your doctor will devise an appropriate tapered plan that outlines how to reduce your dosage slowly. This helps prevent any discomfort you might experience during the withdrawal process. Tapering off a drug also reduces the risk of relapse from the symptoms you were treating.  

Withdrawal Symptoms of Mirtazapine

Mirtazapine withdrawal symptoms can vary in duration and intensity from person to person. 

Severity can depend on factors like: 

• Dosage
• Your age
• Your weight
• How long you were on it
• How severe your symptoms were 
• Whether or not you have other health conditions 
• Use of other medications
• Individual physiology, like metabolism
• The tapering schedule you use

There are two categories of withdrawal from mirtazapine symptoms​ you might experience — physical and emotional. 

Physical symptoms:

• Nausea
• Vomiting 
• Headaches
• Dizziness or vertigo
• Flu-like symptoms
• Gastrointestinal issues like diarrhea and constipation
• Sweating
• Chills

Emotional symptoms:

• Mild anxiety or irritability
• Mood swings
• Increased anxiety or depression
• Depression relapse
• Panic attacks
• Concentration issues
• Sensory disturbances

How Long Does Mirtazapine Withdrawal Last?

In most cases, symptoms of mirtazapine withdrawal typically begin within 2 to 4 days of discontinuing the medication, and they might last up to two weeks. In very rare cases, symptoms can last up to a year. If you’re switching medications, symptoms can often resolve within 1 to 3 days.

Much like the length of time it takes mirtazapine to work, the timeline for mirtazapine withdrawal symptoms can vary from person to person based on factors such as dosage, duration of use, and individual differences.

A general timeline for mirtazapine withdrawal might look like this:

• Days 1 – 3: Initial symptoms like dizziness, nausea, irritability, or headache.
• Week 1 – 2: Withdrawal effects typically peak here and can include mood swings, sleep disturbances, and flu-like symptoms.
• Week 3 – 4 and beyond: For most people, symptoms gradually subside during this period, although it’s possible to have lingering effects like mild anxiety or sleep disturbances longer than a month.

In rare instances, withdrawal symptoms can persist for up to a year, especially if you’ve taken 

mirtazapine for a long time or at higher doses.

Managing Mirtazapine Withdrawal Symptoms

Fortunately, there are several actionable and effective ways to minimize or manage mirtazapine withdrawal symptoms, including: 

• Gradually reduce the dosage you’re taking under medical supervision: Tapering off this medication gives your brain time to adjust and helps reduce withdrawal severity.
• Focus on hydration and a balanced diet: Nutrition and hydration support physical recovery as you wean off a drug while minimizing symptoms like dizziness and fatigue.
• Engage in stress-reducing activities: Meditation, yoga, and deep breathing exercises offer relaxing benefits when managing anxiety and mood swings while adjusting to not taking a drug.
• Prioritize sleep hygiene: To improve sleep quality, maintain a healthy, consistent sleep routine by avoiding stimulants, reducing screen time, and practicing relaxation techniques before bedtime.
• Seek emotional support: Talk to friends, family members, or a therapist for support, emotional guidance, and reassurance.
• Consider professional counseling: Cognitive behavioral therapy (CBT) and support groups are excellent ways to address mood changes and anxiety — both during the withdrawal process and in the long term.
• Use over-the-counter (OTC) remedies for symptom relief: Multiple OTC products can help relieve the most uncomfortable symptoms of withdrawal. Ask your doctor about anti-nausea medications, pain relievers, and melatonin supplements to help manage specific symptoms.

“Gradually tapering Mirtazapine by reducing the dose by 50% every few days will minimize withdrawal effects. Of note, Mirtazapine withdrawal symptoms have not been commonly reported. When they do occur, possible withdrawal symptoms can include insomnia, decreased appetite, and abnormal dreams.”

– Talkspace therapist Dr. Dion Metzger, MD

How Do I Safely Come Off Mirtazapine?

You can safely come off of mirtazapine by using a personalized tapering schedule created by your doctor. They’ll give you a plan to gradually reduce your dose in a way that minimizes withdrawal symptoms while allowing you to remain emotionally stable.

“It is essential to check in regularly with your healthcare provider when you are discontinuing this medication. Your provider can slow down the medication taper to lessen the intensity of the withdrawal effects or even make these effects fully resolve”

– Talkspace therapist Dr. Dion Metzger, MD

Tapering lets your body and brain adjust to the reduced serotonin and norepinephrine levels. In some cases, your doctor might suggest what’s known as a “bridging strategy,” which is when you transition to a new medication with a longer half-life before you completely stop taking mirtazapine. 

Talk with a Licensed Psychiatrist

Navigating mental health needs and altering treatment plans can take time, particularly when it comes to antidepressants. If you try to do it alone, the process will likely seem overwhelming. Seeking professional guidance and working with a licensed, experienced mental health professional ensures you’ll take the safest approach when starting, changing, or stopping any part of your care plan. A doctor can offer guidance on how to discontinue use while minimizing the risk of mirtazapine withdrawal discomfort.

If you take mirtazapine but are considering stopping, make sure you talk to a mental health professional or doctor who can help you explore mirtazapine alternatives, come up with effective coping strategies, and create a withdrawal plan that works for you. 

Talkspace has online psychiatry services that provide convenient access to licensed professionals who are ready to support you through any mental health needs, including medication changes. If you’re seeking guidance on how to discontinue mirtazapine or transition to a new treatment plan safely, reach out to Talkspace today.

Connect with an online psychiatrist at Talkspace to learn more about starting or managing a mirtazapine prescription.