Bruin

[Bruin]

Hi I am new to the forum and only just getting to grips with the damage that AD s have wreaked on my life. 

I took Effexor and Mirtazapine, AKA Californian rocket fuel, for nearly fifteen years before deciding to come of the Effexor. 

About one month after my much too quick taper....150 mg to 0 in six weeks. I started having dreadful symptoms..nausea, vomiting, weight loss, feeling that my essence had been completely taken away from me. I put some of this down to a successful chemo I had undertaken the previous year.

 

I am now certain it was the withdrawal from Effexor. I was presenting at the Doctor with symptoms of anxiety, insomnia, pain etc and was given pregabalin AKA Lyrica. This was a horrible experience and I managed to get off it after just under 3 months but in that short time it wreaked even more havoc on my CNS.

 

It is over a year since I quit Effexor but am still taking 30 mg of Mirtazapine a night. I desperately want to get off that too but am only sleeping 3 or 4 hours a night as it is.

 

I am going to have to be very gentle with myself and incorporate natural healing and healthy into my life. I have cut out wheat, dairy, sugar, alcohol and take probiotic. multi vit, vit D, magnesium and try to do some Yoga and swimming. Am self employed but essentially not able to work at present . I am frightened that I will never come back.

 

I look forward to being active on this forum and very best wishes to all

Edited July 2, 2016 by scallywag
add whitespace and tags

[AliG]

Hi Bruin . Welcome.  

 

That does sound like a fast taper , off the Effexor . ( 6 wks ).  How long ago was that ?   When were you on Lyrica ? ( dates).

 

We recommend the 10 % taper method .

Why taper by 10% of my dosage?

 

It would be helpful if you would put your drug and withdrawal history in your signature. Doing this helps us to understand and give more concise advice.

Please put your withdrawal history in your signature

 

What is withdrawal syndrome?

 

What symptoms are you having now ?  This is your thread to ask questions and journal your progress. Have a read , and come back with any  more questions that you might have .

Ali

[Shep]

Hi, Bruin. Welcome to the forum from me, too.

 

And congratulations on your tapers so far and your successful chemotherapy. Sounds like you've already been through a lot.

 

The insomnia can be brutal. I've dealing with that myself.  This is a good thread with many helpful links for insomnia:

 

http://survivingantidepressants.org/index.php?/topic/53-sleep-problems/

 

Lyrica is a rough drug for many people to come off, so some of your symptoms may be coming from that, as well as the Effexor. 

 

Do you have a simple timeline you can put down for your different meds and the dates you came off? 

 

It looks like you're only dealing with Mirtazapine now.  Here is a thread on how to withdrawal from this medication:

 

Tips for tapering off Remeron (mirtazapine)

 

Although you're already off of Effexor, this thread may have some useful information specific to the Effexor / mirtazapine combo:

 

About going off mirtazapine plus venlafaxine (Effexor) aka "California rocket fuel"

 

According to that link, it's best to come off Effexor first and use the mirtazapine to help with sleep, so it looks like you are going in the right direction. But you may need to stabilize first and let your CNS recover before making any more changes. 

 

Best of luck on your taper. You'll find a lot of information and support here. 

[KarenB]

Hello Bruin,

 

Sounds like you've had a pretty tough year or two - I'm sorry things have been so hard.  I'd like to reassure you that healing does happen, if more slowly than we'd like.  With time and some good self-care you'll start to find yourself again.  That multi-vitamin might be too activating for your Central Nervous System. 

 

Ali gave you some good links, and when you've given us a bit more detail we can help you pull a plan together.

 

You might also like to read through these:

California Rocket Fuel

Tips for tapering Mirtapazine

 

It's good to have you here,

Karen

 

EDIT:  Posted same time as Shep, so there's some overlap.

[Bruin]

Thanks everyone for such warm welcome.....

[Bruin]

whoops ..hit the return button by mistake. How do I enter my withdrawal/drug history as a signature.?Iwill try following the link I did not add that I am also taking Zopiclone. This is an added complication and more serious than I was led to believe. I started taking it for insomnia during Interferon treatment. So am dealing with that as well. I was on Lyrica between Dec 18th 2015 to March 8 th of this year. 75 mg a day with 5 days on 150 mg which convinced me that I had to get off it or it would kill me. Again I tapered way too fast but the side effects were becoming dangerous. I tapered over 2 weeks. I am definitely suffering withdrawals from the Lyrica as well as the Effexor and hangover from treatment. I have been on Anti depressants for over 25 years in all so from here on in I am going to take things very slowly. I have always just accepted what Doctors told me and it was only the experience with Lyrica which caused me to look into things further. Karen B it would be so wonderful if you did help me put a plan together. That is the kindest thing to hear. I feel very alone and frightened at the moment. I have many responsibilities which I  cannot manage in current condition. Thank you Shep and Ali G also for welcome and links.

[Bruin]

still struggling how to add my signature.....the instructions says to click on the small downward arrow next to my name.....cannot find this but do have quite bad brain fog...

[AliG]

Bruin.   CLICK on your name . Top right. ( of this page ) .  Go to MY SETTINGS. ( top right. ). CLICK .   On the left , 2 down  - PROFILE SETTINGS. CLICK  - Put in your Signature. SAVE CHANGES. 

 

Ali

[Bruin]

Hey Ali ....Thank you very much ! 

[AliG]

Bruin.         You did it !      We can help you taper off all the drugs. What are your symptoms now ?  As you have done a fast taper , it is probably best to let your nervous system settle, for a little  bit . Keep notes on your symptoms , in the meantime. We are here to answer any questions that you may have .

Ali

[Bruin]

You are a star Ali......I think you may be right that I should let things settle for a month. Still a bit close to the Lyrica experience.

My symptoms are insomnia, nightmares,fatigue, anxiety, de personalisation...I feel like my essence has been surgically removed.

I feel no joy on things which were my passion....I have brain fog and bigs gaps in memory...forget names of people I have known for ages.

I think the Effexor withdrawal was the major culprit but the Lyrica excursion was vile too.

Would so love your suggestions for taper.  At present it feels if the horrors will last forever but know they will pass with patience and tenacity...

a lot of both !   Your kindness is very much appreciated.

[Shep]

Thanks for adding more information, Bruin.

 

I have experience with z-drugs like Zopiclone. The z-drugs can be very similar to coming off a benzo. There's a link that might be helpful:

 

Tips for tapering off Z drugs for sleep (Ambien, Imovane, Sonata, Lunesta, Intermezzo, etc.) 

 

Like AliG said, it would be best to let yourself get stable before doing anything. You've been through so much, your CNS is going to take awhile to process it all.

 

All I can tell you is it gets a lot better in time. 

[Bruin]

Shep ....thank you very much. I am going to try and stabilise before attempting another withdrawal. I have some experience coming off Valium after 6 months. I hate to think of the Z drugs as bad but beginning to realise that they are. So encouraging to hear that it gets a lot better with time. It seems like you also have a long history......congrats on being off nearly a year ! How are you doing now ? All the best .

[Shep]

Shep ....thank you very much. I am going to try and stabilise before attempting another withdrawal. I have some experience coming off Valium after 6 months. I hate to think of the Z drugs as bad but beginning to realise that they are. So encouraging to hear that it gets a lot better with time. It seems like you also have a long history......congrats on being off nearly a year ! How are you doing now ? All the best .

 

You're very welcome, Bruin.

 

Please give more details about your Valium use, including the dose, length of time on it, and the rate you tapered. Also, what was the date of your last dose? You may want to add that to your signature, as it will help the moderators know your complete background.

 

I'm doing much better, thanks. A lot of my memory problems were benzo and z-drug related and even after rapid tapers, I'm seeing improvements. It's definitely worth it to get off these drugs. You'll be fine in time, too. 

[Bruin]

I am slowly beginning to piece together the story of the damage  wreaked on my CNS. I have been unwell for over a year since quitting Effexor too fast 

but put it down to the after effects of a harsh medical treatment I had completed in the previous year. I kept presenting at the Doctors with symptoms of nausea, vomiting , high anxiety etc and in December of 2015 the Doctor gave me Lyrica at a dose of 75 mg. This sent my already sensitised CNS system into meltdown. I had to stop the drug ,again too abruptly, on the 8th March 2016. It was only then that I started researching withdrawals from Psych Meds.

 

 I am currently taking 30 mg Mirtazapine and 11.25 mg of Zopiclone at night and would like to taper off both but am frightened after my experience with Effexor and Lyrica. I am not feeling very good at all.Though I feel at this stage any kind of reinstatement would be a bad mistake.  I am in withdrawal experiencing depersonalisation , insomnia, brain fog, anxiety etc. 

Am currently in a supportive environment but soon have to return home where I live alone and am not sure how I will  cope. I would love some guidance.

My instinct is to try and stabilise the best I can before attempting further withdrawals.. My aim is to be Meds free and know I will get there one day.

[Shep]

 

My instinct is to try and stabilise the best I can before attempting further withdrawals.. My aim is to be Meds free and know I will get there one day.

 

I would follow your instinct and get stable before doing anything else. Your CNS has been through a lot. 

 

How is your insomnia? Are you able to sleep? 

 

If you can add information on your Valium use, that will help the moderators as they set up a taper strategy for you. 6 months use is definitely long enough to have caused dependency. When was your last dose? You may want to add that information to your signature, too. 

 

I think your aim at being med free is definitely going to happen. It's just going to take some time. 

[Bruin]

Insomnia is pronounced. Even with Mirt plus Zopiclone am only managing 3 hours a night. I have not slept since 

my treatment with Interferon in 2013/14. It got worse when I quit Effexor. March 2015.   It is said that Mirt does not 

help sleep for people in protracted withdrawals. This mess feels like it is going to be a long tough road. 

I know I am not alone ! 

 

best 

 

Bruin

[Shep]

You are definitely not alone. I only got about 3 hours of sleep last night, myself. But I got 10 hours Friday night, so it's a very strange ride.

 

I stayed on Seroquel in hopes it would help with sleep as I came off the z-drugs and benzos, but in the end, it really didn't, but I found that I was able to survive on really small amounts of sleep.

 

Periodically, I would take a day off from work and simply stay home and rest. Even if I couldn't sleep, my mind / body was getting enough downtime to make this survivable. 

 

Hope you get a better night's sleep tonight. 

[Bruin]

Very sound stuff Shep. Realistic and practical. It is easy for me to tell myself that lack of sleep will stop me getting any better.

However this is easily the hardest thing I have tried to do.

[Bruin]

I am feeling pretty wretched at the moment with very little sleep....usually 3 hours a night. I am thirteen months since taking my last dose of 

Effexor after a too rapid taper. Withdrawal kicked in at about 6 weeks and has been going on since.I did not identify it as withdrawals and 

had numerous tests to explore what might be wring with me.I put my illness down to a treatment with Interferon the previous year. 

In December of 2015 the DR prescribed me Lyrica at 75 mg which I took for 3 months. The experience was a nightmare.....it brought 

on Akathisia and severe depression, anxiety etc. My Dr prescribed for what I now know to have been symptoms of protracted withdrawal. 

I took my last dose 6 weeks ago ....I had to stop more quickly than I would have liked as it was nearly killing me.

 

My question is whether a small reinstatement of Effexor followed by a very slow taper might help  ? My sense is that the run in with Lyrica 

may have rendered that option as one less likely to work......I would very much appreciate some input. With many thanks and best wishes to all.

[mammaP]

Hi Bruin, I'm sorry that you are feeling so bad. You have been through such a lot with chemo. which can have some effects that take time to settle. Plus the effexor and lyrica withdrawals it is natural that you will be very fragile.  I'm not sure that reinstating is the way to go for you. I also had withdrawal from effexor with that awful insomnia so know how that feels!  Can you keep notes on your symptoms and when they get worse, ease up etc. We can then see what is withdrawal and what is side effects. They can mimic each other so making note of the times they appear and the times you take the drugs will help. You don't take any benzos now? 

How about supplements, do you take any at all? Many people find fish oil and magnesium helpful in withdrawal.  You will get through this but takes time. You have beaten cancer and will beat this too! 

[Shep]

Hi, Bruin. So sorry you're getting hit with insomnia. That's one of my worst symptoms, too.

 

This link may help:

 

Important topics about symptoms, including sleep problems

 

Like mammaP said, fish oil and magnesium can sometimes help. I use epsom salts to get magnesium because it's less likely to cause stomach problems.

 

 

King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

Again, be careful of benzo use as they can cause rebound anxiety and turn paradoxical. 

[Bruin]

Thank you Mamma P.....Am sorry that you are still suffering from the accidental Effexor....that is so unfortunate.

 

I understand that reinstatement is probably not the way to go for me........am slightly grasping at straws. 

No I do not take Benzos anymore.....

 

My symptoms are pretty much constant and every day. Fatigue, DP and insomnia.

 

I do take Magnesium and Fish Oil.....Magnesium took away the nausea and vomiting.I find  it very helpful.

 

Thank you for the input Mamma P and the welcome encouragement.

[Bruin]

Hi Shep...good to hear from you. Am sorry that you also have the dreaded insomnia.

 

The links are very useful......am not taking any Benzos and am taking Magnesium and Fish Oil. 

 

I think that I have to get discipline around sleep hygiene and have a routine. 

 

Thank you for the input Shep and all the best.

[Bruin]

question.....how do I edit community stats on my profile.......I can edit profile but cannot find a way to edit community stats which is now incorrect.

many thanks ! 

[SquirrellyGirl]

Hi Bruin, 

 

When you say community stats, do you mean your signature block where you list your drug history?  Go to your username at the top of the page and click on your name; a panel of options will come up.  Click "settings."  This will give you a nave bar on the left, and you can then select Signature.

 

What is your sleep pattern like, Bruin?  Are you able to fall asleep normally?  What time do you wake?  Is it a sudden start awake, a cortisol spike?  Have you tried epsom salt baths before bedtime? You can take your magnesium upon waking in the night.  Some have found inositol powder helpful, about 15-15 g spread throughout the day.  Goes well in herb tea.

 

Meditation upon waking can be helpful  I have used Emotional Freedom Techniques (tapping) for insomnia, and though it takes a few rounds of tapping I usually can fall back asleep.  There are sleep meditation audios that some have found helpful.  I have a friend who uses a pillow speaker to listen to such audios.

 

Also be sure to block out all light from your bedroom, including from electronic devices.  Some go as far as to get the black-out curtains, or you can try a sleep mask.

 

I hope you get a break from this insomnia soon :-)

 

SG

[Bruin]

Thanks very much SG !   I can edit my signature but underneath that is a section in my profile called community stats in which it says that I am taking 

20 mg of Fluoxetine as well....this was accurate about a year ago when I first joined but not now. I am not sure if this bit is visible to everyone 

or just me.

 

Very helpful tips for sleeping. Yes..I get the cortisol spike thing in the early morning....usually about 3 or 4 hours after going to sleep. 

Why does WD cause this ?   I started doing tapping a year ago but did not get very deep into it...will revisit. I suppose there will be 

good videos on youtube.  I do spray Magnesium on my body before going to bed .....I think what I need to do is get more disciplined and 

organised around these practices so I have a proper sleep routine. 

 

I so appreciate your support and ideas SG......a real godsend. 

 

All the best 

 

Bruin

[SquirrellyGirl]

Hi Bruin, 

 

I found my community stats and can't modify them either, don't see an edit button anywhere.  It is not displayed with your posts so it would only be significant if someone clicked on your handle and that profile popped up.  I'll ask the senior mods about that!

 

SG

[SquirrellyGirl]

Here is a link that might prove helpful about the cortisol spikes, Bruin:  Waking with panic or anxiety -- managing cortisol spikes

 

Another member, Rockingchaircat, has been experimenting with taurine to help control cortisol spikes:  

 

http://survivingantidepressants.org/index.php?/topic/10847-rockingchaircat-recovery-from-psychotropic-drugs-that-were-prescribed-willy-nilly/?p=222489

 

How are you doing, Bruin?  What is your symptom pattern of late?

 

SG

[Bruin]

Hi SG.....Thank you for the helpful links. I am back in UK now and have had 5 hours sleep both nights I have been back.

This is good for me .......My DP is also slightly better but physically  feel pretty wretched. My body has been through 

 a lot in the past couple of years. So I celebrate that which is getting a  better and am hopeful that I can make 

further progress. 

 

Bruin

[Shep]

I'm glad your home safe from your trip, Bruin. Give yourself well-deserved credit for traveling during withdrawal and still having a positive attitude. 

 

I hope you have a good weekend and can get some sleep. 

 

 

[Bruin]

Just updating where I am with my withdrawal and recovery. Would love input and tips if anyone has ideas. 

 

It is hard for me to disentangle what has caused what side effect as my history is convoluted. I did not understand 

WD until a couple of months ago when I was forced to abruptly quit Lyrica due to horrid side effects. 

Unquestionably still have protracted withdrawal from Effexor and also WD from Lyrica. 

This manifests in poor sleep , DP, and generally feeling like I cannot cope. 

 

However my sleep has improved a bit as has the worst of the DP though I still feel in a bit of a bubble and 

do not find pleasure in things that I used to be passionate about. Anhedonia covers it pretty well. 

However I must celebrate some real signs of healing and remember that once we get a glimpse of improvement

and a decent window it means that things are getting better.  

 

About 2 years ago I was prescribed Zopiclone as I developed insomnia during an Interferon treatment. 

I have reduced from 15 mg at night to 11.25 at night. I did not understand, nor was I told, that Z drugs have a similar profile to Benzos. 

However they have a very short half life. I have begin to track that I get into quite serious interdose WD.

I have been going through the day feeling quite odd in a new way which I now ascribe to Z withdrawal. 

Today I did an experiment. At 12.30 pm I took 3.75 mg of Zopiclone and the result is that I feel better. 

This indicates that I have been getting into Z withdrawal during the day, indeed by circa 5 am when I usually wake 

and cannot go back to sleep. This evening I will take 3.75 mg at 6 pm and 3.75 mg at 10 pm before sleep. 

This should give me an idea about what is going on. My plan , if the Mods think it a good one, is to switch 

over to the far longer lasting Diazepam and taper from that. I think that the equivalent of 11.25 mg Z is about 8 mg 

of Valium. I have tapered quite easily from more than this before so am hopeful that I can do it again if I go very slowly. 

However since the misadventures with Effexor and Lyrica my CNS has become far more sensitive so I am anticipating 

needing to go super gently. 

 

Any input would be gratefully received. All the very best to each and everyone of us in our journey to healing. 

We will all get well and recover. It does get better and the waves are just waves to be ridden on the way to better window.

[Shep]

Hi, Bruin.

 

The fact that your sleep has improved is great news. Coming off both Effexor and Lyrica are both major accomplishments. And your positive attitude is great to see and really helps everyone on the forum.

 

Definitely get some input from Wellness on the benzo section about the crossover.  You may also wish to go ahead and set yourself up a thread in the benzo forum:

 

Members-only benzo forum

 

I'm also going to give you a link to the Ashton Manual:

 

The Ashton Manual - How They Work and How to Withdraw

 

My only issue with Dr. Ashton's work is she advocates using antidepressants to handle benzo withdrawal. This manual was written before much was known about AD discontinuation. But the sections on symptoms may help you understand issues specific to benzos and z-drugs.

 

My only take on your specific question about switching over to Valium is this:

 

1.  If splitting up your z-drug dose is solving the problem, I would be hesitant to switch over to another medication. Even if you handled Valium in the past, your CNS may be more fragile now and re-introducing Valium may cause problems.

 

2.  Some people find Mirtazapine to be more sedating at lower doses. So you may want to consider lowering the Mirtazapine first.

 

 

 

From Malhi, et al 2003 Dual-Action Antidepressants: Mechanisms of Action and Clinical Use
 

Mirtazapine has a high affinity for histamine receptors and is therefore sedating at low doses. This is countered to some extent by its enhancement of noradrenergic neurotransmission at higher doses, making mirtazapine less sedative as its dosage is increased. In comparator studies and controlled trials the most common side effects of mirtazapine (occurring in 10% to 30% of patients) were somnolescence, weight gain, and constipation. The weight gain associated with mirtazapine use is equivalent to that seen with TCAs and significantly more than that which occurs with SSRIs.40,45 Furthermore, despite having little affinity for cholinergic receptors, mirtazapine can cause dizziness and dry mouth. However, unlike venlafaxine, it rarely causes sexual dysfunction and does not have any significant cardiovascular side effects. Agranulocytosis is a serious but rare adverse effect that can be easily reversed by withdrawing the antidepressant.57,58 Treatment should therefore be stopped in any patient that develops an infection and leucopenia. In overdose, mirtazapine is relatively safe, resulting mainly in somnolescence.59 Of note, it does not result in any serious cardiovascular, respiratory, or neurological sequelae and patients usually recover without incident.60

Mirtazapine is metabolized by CYP 2D6 and CYP 1A2. As a weak inhibitor of the latter and having no affect on the other CYP isoenzymes, mirtazapine has few significant drug interactions.

 

Please read over this link for more information:

Tips for tapering off Remeron (mirtazapine)

 

I've sent Wellness a PM on your behalf, as it's always good to get feedback from a benzo moderator before setting up a game plan.

 

I hope you're feeling better soon.

[Bruin]

Thank you Shep, 

 

That is a very good suggestion to set up a thread for myself on the Benzo forum.

 

I am beginning to piece together my history with Benzos and remembered that I was give some 2 mg ones 

when I was at the worst of my Lyrica withdrawal recently. I somehow have not put that into the equation .

I will try to work out how many I actually took. I am not sure how I have not taken this into account..

I am now realising that even these seemingly small things are  significant when one has a sensitised CNS.

 

Re splitting the Zopiclone dose over the day, I will find out more if it is a good idea tonight . Hopefully will sleep !  

 

Still in a rather chaotic period and working out a strategy. However I have seen enough glimpses of normality 

to know that recovery is inevitable for us all in the end. Gosh how sweet just feeling OK is in those little glimpses. 

I Will never take ordinary pleasures for granted again..  

 

Feel like the bones of a plan are forming. Tapering Mirt may be a good idea as I do not think it works as an AD for me anymore 

but is  still helpful for its sedating properties. And it is more sedating at a low dose as you said. 

 

Many thanks Shep and best wishes to all in this healing journey.

[Wellness]

Hi Bruin,

 

Welcome to SA, I'm glad that you have found us.

 

The half-life of zopiclone is approximately 7 hours so you can see that you can go in full withdrawal before your next dose and that could be part of the reason that you are experiencing intense withdrawal symptoms.  Zopiclone can have really nasty interdose withdrawal and switching to diazepam is a good way to get rid of the variation in blood concentration and interdose withdrawal from zopiclone.  

 

You are right in saying that your withdrawal is convoluted by being in Effexor withdrawal, Lyrica withdrawal, and quite possibly zopiclone interdose withdrawal.  Changing to diazepam could trigger zopiclone withdrawal, because they are different drugs and the diazepam might not cover completely the zopiclone withdrawal symptoms, and I wonder whether you are up to more withdrawal symptoms than you already have.  But a cross-over would get rid of the interdose withdrawal.  Before doing a cross over you may want to see whether spreading out the dose of zopiclone throughout the day can help you.   

 

Regarding sleep, mirtazapine can put a horse to sleep, so it might be a good idea to keep mirtazapine for sleep.  You idea to try to split the dose of zopiclone to see if you can get some relief during the day is very good, and let the mirtazapine knock you out at night.  

 

My personal experience with mirt is that it seems to cover withdrawal symptoms from benzos, so it might cover the withdrawal symptoms from zopiclone.  You may not have to do a switch to diazepam but if you feel you need to switch, I will most certainly help you with that.  

 

15 mg of zopiclone is 10 mg diazepam. So 11.25 mg zop is 7.5 mg diazepam.

 

The cross over is done over several weeks because diazepam has such a long half-life that it takes almost a week before it builds up in your blood, but a cut in zopiclone causes a rapid decrease in zopiclone concentration in your blood over a day.  So you have to do a gradual cross-over.

 

It seems that the option that you are currently working on, that is to see whether splitting your zopiclone dose during the day will bring you relief is excellent.  Once you determine whether you can get relief from splitting your dose, you will be in a better position to re-asses whether you want to attempt a direct taper from zopiclone or cross-over to diazepam.

 

If you want me follow your progress, please consider starting a thread in the benzo forum, that is where I hang out unless flagged.

 

Regards.

[Bruin]

Thank you very much Wellness . I will start a thread in the Benzo forum. Am pretty sure that I am in Z interdose withdrawal.

 

Regards 

 

Bruin