It’s going well!
In March, I dropped from 60 to 45 mg with no ill effects whatsoever. In April, I went down to 30 mg, and that’s where things got a little hairy. First I had withdrawal symptoms, and stepping up to 37.5 mg temporarily made no difference, but just dragged out the whole process. Then I began to notice that my mood felt ‘wobblier’. I was getting upset more easily and having more intrusive thoughts, or perhaps it was just that the intrusive thoughts were ‘louder’ and harder to brush off. So it was with some trepidation (but my GP’s support) that I reduced the dose again to 15 mg last week.
The effect has been immediate. Despite some withdrawal symptoms in the first couple of days, from the start I’ve had more energy and drive. The concept of working full time and doing a little housework in the evening is no longer alien to me! It’s much easier to wake up in the mornings and I no longer need to mainline tea. Of course it makes sense that this has happened, as mirtazapine is a very sedating antidepressant, but this has been the first dose reduction where I’ve noticed a change in side effects, and these are adverse effects I’ve been living with for years. The last time I was on 15 mg was in 2006.
Even more excitingly, my mood has stabilised and the intrusive thoughts have stopped bothering me. This is harder to explain, as when I started taking mirtazapine, stabilising my mood and quietening down the ‘noise’ in my head were two of the ways in which it really helped. However, I think I’m more vulnerable to these symptoms when I’m tired, so it kind of makes sense that being on a less sedating dose has made a difference. 30 mg felt like an unpleasant no man’s land where the drug had stopped doing much for my mental health, but I was still getting all the side effects.
Of course, it remains to be seen what will happen when I come off mirtazapine altogether, currently scheduled for some time in June. Watch this space!