Can stopping Remeron (Mirtazapine) 15mg cause sweating around day 4?

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Sweating After Stopping Mirtazapine 15mg

Yes, sweating can occur around day 4 after stopping mirtazapine 15mg due to withdrawal symptoms, which typically begin within 1-4 days after discontinuation and may last 10-14 days. 1, 2

Withdrawal Syndrome from Mirtazapine

Mirtazapine (Remeron) discontinuation, especially when stopped abruptly, can lead to withdrawal symptoms including:

  • Sweating (a common symptom)
  • Dizziness
  • Irritability and agitation
  • Anxiety
  • Nausea and vomiting
  • Problems sleeping
  • Headache
  • Abnormal dreams
  • Electric shock sensations (paresthesia)
  • Tremor

The FDA drug label for mirtazapine specifically mentions sweating as one of the withdrawal symptoms that can occur when the medication is suddenly stopped 2.

Timing of Withdrawal Symptoms

According to clinical guidelines, withdrawal symptoms from antidepressants typically follow this pattern:

  • Begin within 1-4 days after discontinuation (depending on the medication's half-life)
  • Usually peak around days 4-7
  • May last approximately 10-14 days in total 1, 3

Mirtazapine has a half-life of approximately 22 hours, which means that withdrawal symptoms can begin to appear as the drug is cleared from your system, typically within a few days of stopping 4.

Severity Factors

The severity of withdrawal symptoms, including sweating, depends on several factors:

  • Duration of treatment (longer use increases risk)
  • Dosage (higher doses increase risk)
  • Method of discontinuation (abrupt stopping versus tapering)
  • Individual patient factors

Proper Discontinuation Approach

To minimize withdrawal symptoms like sweating:

  • A gradual reduction in dosage is strongly recommended rather than abrupt cessation 2
  • Tapering over 10-14 days is recommended to limit withdrawal symptoms 1
  • For patients who have been on mirtazapine for longer periods, an even more gradual taper may be beneficial

Clinical Significance

Case reports have documented significant withdrawal symptoms after abrupt discontinuation of mirtazapine. One report described a patient who developed recurrent panic attacks beginning on the second day after abruptly stopping mirtazapine 30mg after 10 weeks of treatment 5. This highlights the importance of proper tapering when discontinuing the medication.

Management of Withdrawal Symptoms

If you're experiencing sweating or other withdrawal symptoms:

  • Consult your healthcare provider
  • Consider reinstating a lower dose and implementing a more gradual taper
  • Stay hydrated
  • Avoid triggers that may worsen sweating (hot environments, spicy foods, caffeine)
  • Monitor for more severe symptoms that may require medical attention

Important Considerations

  • Sweating may also be a symptom of returning anxiety or depression
  • Distinguishing between withdrawal symptoms and recurrence of the original condition can be challenging
  • Withdrawal symptoms are generally time-limited, while recurrence of the original condition tends to persist

If sweating or other symptoms are severe or persist beyond 2-3 weeks, this may indicate a recurrence of the original condition rather than withdrawal, and medical reassessment would be appropriate.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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