Tapering Mirtazapine

Introduction to Tapering

• Slow tapers over 10-14 days help limit withdrawal symptoms, especially for medications affecting serotonergic systems 1

Monitoring and Support

• The National Comprehensive Cancer Network recommends maintaining good sleep hygiene practices and considering non-pharmacological approaches for sleep if needed, such as cognitive behavioral therapy or relaxation techniques 2, 3
• Temporary supportive medications may be considered for specific withdrawal symptoms if severe, as suggested by the Mayo Clinic 4

Tapering Approach

• If withdrawal symptoms occur, the Mayo Clinic suggests maintaining the current dose for an additional 1-2 weeks before attempting further reduction, and consider a more gradual taper by reducing by 1.875 mg every 2 weeks instead 4
• The Mayo Clinic also recommends using liquid formulation for more precise dosing during taper, if available 4

Tapering Mirtazapine

Discontinuation Symptoms

• Flu-like symptoms may occur as a discontinuation symptom in patients tapering off mirtazapine, as reported in Clinical Gastroenterology and Hepatology 5
• Sleep difficulties, such as insomnia or sleep disturbances, can be anticipated in patients tapering off mirtazapine, which is commonly used for sleep at a dose of 7.5mg, as noted in Clinical Gastroenterology and Hepatology 5