How to taper off mirtazapine 7.5mg?

Tapering Mirtazapine 7.5mg to Discontinuation

Gradually reduce your mirtazapine dose by approximately 1.875 mg (25% of your current 7.5mg dose) every 2 weeks until discontinued, which will take approximately 6-8 weeks total. 1

Recommended Tapering Schedule

Since you're currently taking 7.5mg (half of a 15mg tablet), here's the specific approach:

• Weeks 1-2: Reduce to approximately 5.625 mg nightly (this requires either liquid formulation for precise dosing or cutting tablets into smaller pieces) 1
• Weeks 3-4: Reduce to approximately 3.75 mg nightly (quarter of a 15mg tablet) 1
• Weeks 5-6: Reduce to approximately 1.875 mg nightly 1
• Week 7+: Discontinue completely 1

The FDA label emphasizes that you should "gradually reduce the dosage of mirtazapine rather than stopping abruptly whenever possible" to minimize withdrawal reactions 2

Optimizing Your Taper

• Use liquid formulation if available for more precise dosing during the taper, as recommended by the Mayo Clinic, since cutting 7.5mg doses into smaller increments with tablets is challenging 1
• Slow tapers over 10-14 days between dose reductions help limit withdrawal symptoms, especially for medications affecting serotonergic systems like mirtazapine 1
• If withdrawal symptoms occur at any step, maintain your current dose for an additional 1-2 weeks before attempting further reduction 1

Monitoring for Withdrawal Symptoms

Watch for these potential discontinuation symptoms 2:

• Anxiety or agitation
• Insomnia or sleep disturbances (ironic given mirtazapine's sedating properties)
• Irritability
• Dizziness
• Sensory disturbances
• Flu-like symptoms

Managing Sleep During and After Taper

Since mirtazapine at 7.5mg is commonly used for sleep, anticipate potential sleep difficulties 3:

• Maintain good sleep hygiene practices throughout the taper and after discontinuation 1
• Consider non-pharmacological approaches such as cognitive behavioral therapy for insomnia or relaxation techniques 1
• Temporary supportive medications may be considered for specific withdrawal symptoms if severe 1

Common Pitfalls to Avoid

• Never stop abruptly: The FDA explicitly warns that adverse reactions can occur upon discontinuation, and gradual reduction is essential 2
• Don't rush the taper: If you experience withdrawal symptoms, this indicates you're tapering too quickly—slow down rather than push through 1
• Don't assume you can skip steps: Even though 7.5mg is a low dose, it still requires gradual reduction since you've been on it long enough to warrant tapering 1, 2