Tried to Discontinue Zispin
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Q:  Tried to Discontinue Zispin

I have been taking Zispin for 6 months and decided to come off it .My doctor reduced my dose slowly over 6 weeks and i was fine.when it came to half a tablet evry night i ended up not being able to swallow,i had no saliva in my mouth and couldnt eat.i am back on my normal 15g a day now and feel a little this a common thing to happen when being weaned off zispin? it certianly scared me im to scared to come off them now

Thank you

Dear Jane -- 
In my practice I've still not found a clear need to use mirtazapine (Remeron, Zispin) -- whatever niche it's supposed to fill seems adequately addressed by other medications we have more experience with, in my opinion --  so I'll confess I don't have much experience working with people who are stopping it.  Thus I haven't seen this problem; I haven't heard other doc's talking about it either, but that doesn't mean much.  The medication is known to have effects on two neurotransmitters that might be associated with salivation, namely acetylcholine and histamine.  Dry mouth is a relatively common side effect, but listed as "rare" (<1/1000) was salivary gland enlargement and excess salivation.  It sounds like you were getting the opposite of this relatively uncommon problem as your dose went down?  

I don't have any experience with trying to use less than 15 mg at a time.  As a worst case scenario, you could get a "compounding pharmacist" to make up pills with much lower doses per pill, e.g. 5 mg or even 2.5 mg per pill, and use those to slowly decrease the dose, if you and your doctor decide to have you go all the way off it.  

Dr. Phelps  

Published April, 2003


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