Transitioning from Mirtazapine to Trazodone → Help with Tapering and Dosage?

[James Randall]

I started 7.5 mg of Mirtazapine two months ago and recently went to the eye doctor with concerns of increased floaters but mainly seeing what is hard to describe, all in my right eye. Kind of like a line somewhat horizontal and a little wavy. I usually see it in "just the right light" so I don't notice it all of the time. I have increased pressure in that eye but the eye doctor said I didn't need to stop taking the medication yet and wait to see in a month when he checks my eye again. The "visions" are a little worse and I will go back to him sooner but decided I want to get off Mirtazapine anyway. Eye issues are a possible but rare side effect and I have no other health reasons to not believe it is the medication.

After research I am going to talk to my family doctor about coming off Mirtazapine and start Trazodone.

I have read about coming off Mirtazapine slowly and will discuss it more with the doctor but I am looking for any advice on how low I should go as I reduce from 7.5 mg, to then start taking Trazodone.

What dosage is suggested for Trazodone? I have read a few posts saying 25 mg to 100 mg for sleep.

Prior to Mirtazapine I was only sleeping 2 or 3 hours a night for several weeks and was miserable. Mirtazapine at 7.5 mg helped me sleep all night the first night and every night since then. Occasionally I do wake up around 2 am but can always go right back to sleep. Amazing. I would not get off this drug if I wasn't worried about my eye. As others have written, I too gained weight but that was an acceptable trade-in for better sleep. Of course it has only been two months and if I keep gaining weight, I might change my mind.

 

[Joe Cuber]

I started Trazodone at 50 mg for a couple of weeks, then went up to 100 mg for a few weeks since I was still getting less than 4 hours a night.

Once I was getting regular sleep, I dropped to 75 mg for a couple of months, then weaned off when I felt I could sleep without the help.

 

[DeanD]

Back in November last year I went on Mirtazapine, and by December I had started getting eye issues. Mild at first but gradually worsening and by January it included high pressure and severe photophobia.

I was also on Propranolol at the same time. It was so bad I couldn't look at a mobile phone screen on the lowest brightness wearing sunglasses without my eyes hurting.

I immediately came off Mirtazipine and Propranolol in January cold turkey (I don't advise this) the moment the photophobia came on and the photophobia cleared up three days later.

I can't say if it was the Mirtazapine or the Propranolol, both or neither, but the timeframe was rather a coincidence.

As I came off cold turkey, I can't advise what I did in terms of tapering.

I was given Zopiclone for sleep but I didn't really like it and it can be habit forming.

Have you tried herbal based tablets to try and help sleep? In the UK we have Kalms which contain Valerian Root, it may be good enough for you that medication isn't needed once you have tapered.

 

[James Randall]

Thanks for responding. 50 mg does seem like a reasonable starting point for Trazodone and I appreciate how you increased and then decreased the dosage.

I just read that Propranolol can be associated with eye issues and photophobia. With Mirtazapine also having eye problems as a potential side effect, I can see the potential for problems.

I do need to ween off soon as my left eye now has the halos (best word I can think of to describe). I am at 7.5 mg and have an appointment with my doctor to discuss switching to Trazodone. I haven't tried Valerian root or other herbal meds. I will research that more. My anxiety is bad enough during the day but nights are, as I suspect for most of us, hardest. Before Mirtazapine I could fall asleep okay, just woke up with terrible anxiety at 2 AM and couldn't go back to sleep.

Can anyone share how they tapered off Mirtazapine while switching to a new drug? Wondering how low I need to go from my current 7.5 mg before start taking something like 50 mg of Trazodone. I will talk to my doctor but really want to do my homework on this before going in.

 

[Óscar PP]

Thanks for responding. 50 mg does seem like a reasonable starting point for Trazodone and I appreciate how you increased and then decreased the dosage.

I just read that Propranolol can be associated with eye issues and photophobia. With Mirtazapine also having eye problems as a potential side effect, I can see the potential for problems.

I do need to ween off soon as my left eye now has the halos (best word I can think of to describe). I am at 7.5 mg and have an appointment with my doctor to discuss switching to Trazodone. I haven't tried Valerian root or other herbal meds. I will research that more. My anxiety is bad enough during the day but nights are, as I suspect for most of us, hardest. Before Mirtazapine I could fall asleep okay, just woke up with terrible anxiety at 2 AM and couldn't go back to sleep.

Can anyone share how they tapered off Mirtazapine while switching to a new drug? Wondering how low I need to go from my current 7.5 mg before start taking something like 50 mg of Trazodone. I will talk to my doctor but really want to do my homework on this before going in.

If you've only been on it for two months, you could taper really quick, like taking 0.5 mg less every day.

Just cut the pill in 8 pieces and each day take one piece less and you'll be out of it in a week.