Mirtazapine Withdrawal — Impact on Tinnitus?

[Andrew01]

Hi all,

I am coming off Mirtazapine in hopes that it alleviates some of the visual snow I developed while on it. Also long term I don't want to have it wear off for sleep and any benefits, and just make withdrawal worse or having to updose.

I've been on 15 mg for 3 weeks, 7.5 mg for two weeks, and 3.75 mg for two weeks.

My tinnitus has been better while I've been taking Mirtazapine, I don't know how much of that improvement to attribute to the Mirtazapine. I don't think my tinnitus has lessened in intensity, but I've been ignoring it better.

I tried coming off the Mirtazapine last week and had some rough withdrawal symptoms. My tinnitus did seem more intrusive but I am not sure if that is just a temporary spike due to the anxiety / withdrawal.

This week I am going down to 2 mg and then stopping. I'm going to try and get some benzos for any severe withdrawal moments but only for a week tops.

However, I am scared of making my tinnitus worse by coming off the Mirtazapine, or being in the middle of a withdrawal spike and not knowing if it is permanent.

Anyone have experience with Mirtazapine withdrawal and its impact on tinnitus?

Your thoughts are much appreciated.

 

[Andrew01]

As an update I have not taken Mirtazapine for the last 6 nights (took another week or so to taper down to 1 mg) and it feels much better than last time I tried to come off.

No impact on tinnitus so far, just mild itching. I have read that the withdrawal feels worst after it has fully cleared and then for a couple of weeks as your brain recalibrates, so certainly not out of the woods yet, but optimistic.

 

[ALS]

Glad to read you are not having issues thus far coming off. I hope it continues that way.

I'm in the middle of my slow taper (was at 15 mg, over a couple of months I am down to 7.5 mg), and my tinnitus is changing a bit. It's more shrill and piercing. At the same time the tones are more pure, less hissy, and I don't have as much sensation of "drilling" in my ears. My distress is significantly less than it was months ago, though. Sleep is okay even as I've been tapering.

I will cut down to 3.75 mg at the end of this month and take it for another month before trying to stop, and see how I go.

The worst part about Mirtazapine withdrawal for me is the emotional swings, especially anhedonia, where I can't feel Anything. It's rough. This drug affects everyone differently though, so I could be an outlier.

Anyway, I thought I would put this here for anyone searching the forum in need of anecdotes, because I was hungry for them when I first found this site.

 

[Brian P]

Based on my benzodiazepines experience, I wouldn't touch psych meds ever again.

 

[Sayeed]

As an update I have not taken Mirtazapine for the last 6 nights (took another week or so to taper down to 1 mg) and it feels much better than last time I tried to come off.

No impact on tinnitus so far, just mild itching. I have read that the withdrawal feels worst after it has fully cleared and then for a couple of weeks as your brain recalibrates, so certainly not out of the woods yet, but optimistic.

I take Mirtazapine as well and have been having eye issues. Are you sure the Mirtazapine caused your eye issues? From what I've read a high % of people with visual snow also have tinnitus. Maybe it's not the Mirtazapine? Maybe it is?

 

[Andrew01]

Fairly certain, though I think you have to be predisposed, maybe that is why lots have both.

I think it was the Mirtazapine as my tinnitus started unilaterally, and included ear pain and fullness with hyperacusis, which is indicative of actual damage. The tinnitus started months before the visual snow, but the visual snow started a couple weeks after Mirtazapine.

 

[Andrew01]

Further update, coming up on three weeks in a couple days.

No impact on hyperacusis or tinnitus so far, but honestly I NEVER try to measure my tinnitus (I have two loud tones and some number of quieter ones that I can only hear with ear protection), so maybe it has changed but not to a threshold it is more intrusive.

Only withdrawal sides so far are definite hypotension/dizziness, and maybe some mildly worse insomnia now, but overall still at a not pleasant but livable amount of sleep. I need to start sleep CBT however and I'm sure that will help.

Despite hyperacusis, tinnitus, and visual snow I can see posting a success story in the future now, which is crazy based on how I felt before. Will take some time of feeling good before doing so and not measure the drapes too early of course haha.

Mindfulness has been key I think, Full Catastrophe Living has been a great resource.

Be well everyone, thinking of you all.

 

[Andrew01]

Dropping by for some other questions, so thought I would update here as well.

Almost 5 weeks now, no impact on tinnitus/hyperacusis/visual snow positive or negative to speak of. But my mood and outlook is trending better, over an up an down pattern of course.

Only withdrawal symptom I have now is itchiness, which I understand will subside. I could take an antihistamine to reduce it I guess but seems counterproductive to my body resetting.

 

[Andrew01]

I had my longest lasting fleeting tinnitus incident last night, which reminded me to come back and update. I always think my tinnitus is loud (only inaudible in shower / busy diner) but I'm sure you're all aware how those fleeting spikes can put the fear of god into you haha. It was also a pure tone, different from my summer cicadas which keep me company, which made it even more intrusive. It lasted 30 minutes and then faded slowly.

8 weeks of Mirtazapine now. Symptoms are as follows.

Histamine reactions
Still happening, I did two weeks of low histamine that knocked it out but going back to normal, I have hive type reactions again. Slowly getting better though.

GERD / LPR
Okay this one has been kicking my ass lol. Started beginning of November ago as mild dysphagia, then two weeks later lump in throat, then one more week and burning throat, reflux in throat, some coughing now and other classic symptoms (no heartburn or lower esophagus issues I can detect). Actually getting a scope this week. Trying to sort out naturally without PPI, but hopefully the scope is illuminating somewhat. This is pretty tilting as without this problem I would be doing amazing all things considered. Posting this from the gym so I'll still doing my best haha. Is this from Mirtazapine withdrawal? If so I doubly regret taking it.

Insomnia
Doing 'timeless sleep window' approach. I'm confident it will work, was up to 5 hours pre-GERD and now back to 4 or so. Taking nothing for sleep!

Tinnitus
Not better or worse, but only causes annoyance now and not distress. It really is crazy how it can be so loud, and the same sound that caused me despair, but now it doesn't. Fleeting tinnitus aside I've mostly made peace with it.

Visual Snow
I feel my floaters are possibly reduced (at least my perception of them) but otherwise same story as tinnitus.

Hyperacusis
Much better, don't need to plug on street anymore but keep them on me in case going by construction or ambulance coming. Use them at the gym still. I don't plug doing dishes but I'm better at doing them quiet too haha.

Overall I was feeling almost recovered pre-GERD (and yes I have multiple other chronic conditions not discussed here) and it was a massive setback. Really hoping it is temporary but I'll do my best. Once I am past that I will consider myself 95% recovered even with the same tinnitus and visual snow. I know sleep will recover in time and I will continue my therapy and mindfulness.

I hope you are all well today.

 

[aura]

I had my longest lasting fleeting tinnitus incident last night, which reminded me to come back and update. I always think my tinnitus is loud (only inaudible in shower / busy diner) but I'm sure you're all aware how those fleeting spikes can put the fear of god into you haha. It was also a pure tone, different from my summer cicadas which keep me company, which made it even more intrusive. It lasted 30 minutes and then faded slowly.

8 weeks of Mirtazapine now. Symptoms are as follows.

Histamine reactions
Still happening, I did two weeks of low histamine that knocked it out but going back to normal, I have hive type reactions again. Slowly getting better though.

GERD / LPR
Okay this one has been kicking my ass lol. Started beginning of November ago as mild dysphagia, then two weeks later lump in throat, then one more week and burning throat, reflux in throat, some coughing now and other classic symptoms (no heartburn or lower esophagus issues I can detect). Actually getting a scope this week. Trying to sort out naturally without PPI, but hopefully the scope is illuminating somewhat. This is pretty tilting as without this problem I would be doing amazing all things considered. Posting this from the gym so I'll still doing my best haha. Is this from Mirtazapine withdrawal? If so I doubly regret taking it.

Insomnia
Doing 'timeless sleep window' approach. I'm confident it will work, was up to 5 hours pre-GERD and now back to 4 or so. Taking nothing for sleep!

Tinnitus
Not better or worse, but only causes annoyance now and not distress. It really is crazy how it can be so loud, and the same sound that caused me despair, but now it doesn't. Fleeting tinnitus aside I've mostly made peace with it.

Visual Snow
I feel my floaters are possibly reduced (at least my perception of them) but otherwise same story as tinnitus.

Hyperacusis
Much better, don't need to plug on street anymore but keep them on me in case going by construction or ambulance coming. Use them at the gym still. I don't plug doing dishes but I'm better at doing them quiet too haha.

Overall I was feeling almost recovered pre-GERD (and yes I have multiple other chronic conditions not discussed here) and it was a massive setback. Really hoping it is temporary but I'll do my best. Once I am past that I will consider myself 95% recovered even with the same tinnitus and visual snow. I know sleep will recover in time and I will continue my therapy and mindfulness.

I hope you are all well today.

@Andrew01, why did you take Mirtazapine in the first place? For depression, insomnia or for your tinnitus and hyperacusis?

Did you gain weight while taking Mirtazapine?

 

[Andrew01]

@Andrew01, why did you take Mirtazapine in the first place? For depression, insomnia or for your tinnitus and hyperacusis?

Did you gain weight while taking Mirtazapine?

Just for sleep, which it was effective somewhat, particularly sleep onset. My anxiety was still so high that I would wake early and lay there unable to get out of bed but not fall asleep either. It got more effective after a few weeks when my anxiety went down a bit but then I got visual snow about two days after my first okay sleep.

I don't think it affected the tinnitus or hyperacusis in any real way, but certainly the few times I stayed up after taking it I felt so out of it I really didn't care about the tinnitus. No negative impact to it coming off either.

I didn't gain weight but who knows if I stayed on it, I am pretty active in the gym but it really did increase my appetite to a crazy degree. Food looked and tasted so good haha. The real question is if it is just appetite or also a metabolic factor relating to the weight gain that is common on it.