lindarivendell: Mirtazapine cold turkey and reinstatement problems

[lindarivendell]

 

 

I was put on Mirtazapine for 9 months after getting anxiety and depression after breast cancer treatment.  I mistakenly did cold turkey 7 weeks ago. The first 4 weeks was total nausea lost stone in weight. At between 4 and 5 weeks I started to get abxiety. Decided after consulting doctor to reinstate to 3.9mg. Did this for 5 days then updosed to 7.5mg 5 days ago. It is still tough. I had a fairly good day yesterday but have been pretty poor today. Need to see a light at the end of the tunnel. How long will I take to stabilise should I just be patient on the 7.5mg or go up to what I was originally on which was 15mg. It has been a really tough 7 weeks. Would really appreciate some advise.

 

Edited July 14, 2018 by mammaP
removed mod note

[mammaP]

Hi Linda, welcome to SA. I apologise for the delay in replying. Staff are volunteers and a few are away right now. 

I hope your breast cancer treatment went well for you, it can be gruelling and it is devastating to go through. 

How did you feel while you were taking mirtazepine? How did you feel after reinstating to 3.9, before going to 7.5?  

It is a good sign that you had a good day, it means you are starting to stabilise. You will have had a lot of drugs with your treatment and then the mirtazepine, your body has to regain homeostasis and that takes time. I would stick with the 7.5,  people often become sensitive to the higher doses after being off a drug for a few weeks and can only tolerate lower doses.  It is impossible to tell how long it will take to stabilise, everyone is different, but hopsfully it will not be too long for you.  Can you tell us your symptom pattern? Starting when you get up for 24 hours?  This is so we can see whether you might be better reducing the dose slightly or holding for longer. 

 

We need all our members to fill in their drug and tapering history in their signature. You can find how to do this here.  

https://www.survivingantidepressants.org/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

About reinstating

https://www.survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

Windows and waves, this is when you feel better for a while then feel bad again, it is your body healing itself.

https://www.survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

 

 

[lindarivendell]

 

MOD NOTE:  Post moved from: Agony248: Mirt and What dose to reinstate?

 

On 6/8/2016 at 6:43 PM, bubble said:

I'm really happy to hear you are finally noticing some improvements. It's a very good sign. There wil still be ups and downs and it is very important to stay put because it is stability over time that heals.

 

Could you just put the date when you went to 7.5 mg in your signature?

 

I'm afraid I'm not aware of anything in particular to help with light headiness. People mention it a lot during withdrawal (just Google as Squirelly described and you will see you are not alone in that). It passes over time. It seems for you it was actually a side effect of the drug because you First experienced it when you started taking Mirtazapine. In that case it should also get better as you get stable on a much lower dose from the initial one and then start a slow taper. In the meantime find something that eases things for you whether it is resting as much as possible, taking things slow and easy and in general treating yourself gently in the same why you would treat your leg if it was broken. Don't make your brain jump around.

 

Luckily your history with psychiatric drugs is short but I'm a bit worried about zopiclone. Can you give more details about it? How long where you taking at, at what dose, when did you stop or if you are still taking it? This all might have impact on your current situation.

 

If you check the graphs in this thread yo will see how important it is to go slow on low doses: http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/.

 

Based on experiences of people here it is good to reduce even below 1 mg (you can Google other remeron/mirtazapine taperers). At the moment your biggest priority is to keep the dose steady and surf the waves of sympotms which are to be expected. I would recomment that you don't start tapering for at least 2 to 3 months. I know it sounds frustrating but your brain seems to be fragile and any attempts to rush the process will traumatise it further. But if you can feel well on 7.5 mg of a drug whiel you were taking 30 mg before, that's a big progress.

 

Any time frames in this process are very individual. The best thing is to listen to your body through the symptoms but also allowing enough time after the change of dose (at least 30 days) for the symptoms to play out.

 

I hope this helps and keep us posted on how you go.

 

Please bubble I really really need help and reassurance. Have put these comments of mine on other threads and not had any replies. Not very good at using forums. I don't know if this is the correct way to reply to you personally...

really need reassurance and support and would like to join this groupl.

I went off Mirtazapine cold turkey. 8 weeks ago had total nausea for 4 weeks lost a stone. Then anxiety started. At 5 and a half weeks off Mirtazapine I decided to reinstate-went on

a quarter tablet for 5 days not any better with anxiety. Then went on half a tablet for 8 days. Last Sunday was very poorly with anxiety decided to go on my original dose of 15mg. Have been on it a week now. Went to work 4 days last week. My mind was taken up every single minute with pricing, stocking and serving customers. At the start of each shift I was very poorly but as the day went on I started to feel better each day. I am very very poor on my days off as my brain is not filled every single minute with something to do- tidy, price or stock up. How long will it take before I can get back to normal. I am off today and tomorrow and very poorly as I am doing things but my brain is not occupied every single minute. Please please help!!!

 

 Report this

 

Edited July 22, 2018 by ChessieCat
added mod note and spacing

[ChessieCat]

On 7/14/2018 at 9:09 PM, mammaP said:

Hi Linda, welcome to SA. I apologise for the delay in replying. Staff are volunteers and a few are away right now. 

I hope your breast cancer treatment went well for you, it can be gruelling and it is devastating to go through. 

How did you feel while you were taking mirtazepine? How did you feel after reinstating to 3.9, before going to 7.5?  

It is a good sign that you had a good day, it means you are starting to stabilise. You will have had a lot of drugs with your treatment and then the mirtazepine, your body has to regain homeostasis and that takes time. I would stick with the 7.5,  people often become sensitive to the higher doses after being off a drug for a few weeks and can only tolerate lower doses.  It is impossible to tell how long it will take to stabilise, everyone is different, but hopsfully it will not be too long for you.  Can you tell us your symptom pattern? Starting when you get up for 24 hours?  This is so we can see whether you might be better reducing the dose slightly or holding for longer. 

 

We need all our members to fill in their drug and tapering history in their signature. You can find how to do this here.  

https://www.survivingantidepressants.org/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

About reinstating

https://www.survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

Windows and waves, this is when you feel better for a while then feel bad again, it is your body healing itself.

https://www.survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

 

 

 

Please answer mammaP's questions.

[Altostrata]

Hello, Linda.

 

8 hours ago, lindarivendell said:

Last Sunday was very poorly with anxiety decided to go on my original dose of 15mg. Have been on it a week now. Went to work 4 days last week. My mind was taken up every single minute with pricing, stocking and serving customers. At the start of each shift I was very poorly but as the day went on I started to feel better each day. I am very very poor on my days off as my brain is not filled every single minute with something to do- tidy, price or stock up. How long will it take before I can get back to normal. I am off today and tomorrow and very poorly as I am doing things but my brain is not occupied every single minute.

 

You've been taking 15mg mirtazapine for a week and gradually feeling better. This is a good sign.

 

Your nervous system has had a big shock, it may take some time to settle down. Please be patient and try to remain calm.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Try a little bit of one at a time to see how it affects you.

 

Are you taking any drugs other than mirtazapine?

[lindarivendell]

Hi Altostrata, this is my 13 th day on the reinstated 15mg dose but I just seem to be getting worse.please help?

[ChessieCat]

What is your current symptoms pattern?  What time do you take your dose?  What symptoms have worsened?

[ChessieCat]

On 7/14/2018 at 9:09 PM, mammaP said:

 

We need all our members to fill in their drug and tapering history in their signature

 

Please do this.  All drugs, dates and doses.  No symptoms or diagnoses.  Thank you.

[lindarivendell]

Hi Chessiecat I take my dose before bed and it is the anxiety that has worsened.  I am really poor in morning and struggle into work where my mind is totally taken up with stocking shelves pricing rearranging shelves and my mind has not got a minute to dwell on things. Last week in work I would feel really rough for the first few hours but by the time I went home the anxiety would be almost gone. And the days that I worked would result in good anxious free evenings. However this week I have followed the same pattern symptom anxiety wise but my evenings on these days are much less anxious free. I am feeling anxious this evening after work And I am not looking forward to tomorrow as I am not working and feel the whole day and evening I will be rather poor. My doctor says it's early days to feeling better as I have been only on my therapeutic dose for 12 days.

[ChessieCat]

2 hours ago, lindarivendell said:

therapeutic dose

 

This is an arbitrary term *(see definition below) used by the pharmaceutical companies.  It is better to think in terms of "lowest effective dose".

 

On 2/7/2016 at 5:16 AM, Altostrata said:

Although you'll see many references to "therapeutic doses" in journal articles, they are a hypothetical construct, the drug companies' best guesses at what will "work" for the largest number of people.

 

* based on random choice or personal whim, rather than any reason or system.

"an arbitrary decision"

synonyms:

capricious, whimsical, random, chance, erratic, unpredictable, inconsistent, wild, hit-or-miss, haphazard, casual

[ChessieCat]

Please create your drug signature.  The mods need to be able to see the drug history at a glance and not have to read through a member's topic to get the information.  Thank you.

[lindarivendell]

August 2017 started mirtazapine 15mg dose increased to 30mg for 8 weeks. Then back to 15mg

Mistakenly put on Lithium Sept 2017 for 8 weeks misdiagnosed  

Put on pregabalin  225mg Oct 2017 slowly tapered off for 6 months stopped beginning of May 2018.

Went cold turkey 5 weeks later on Mirtazapine  after stopping pregabalin. 

Had just developed anxiety after breast cancer operations and radiotherapy before I started all these drugs in 2017

[ChessieCat]

Please copy and paste this into the signature box here:  Account Settings – Create or Edit a signature  Remember to click Save.

 

[lindarivendell]

I am sorry my anxiety too bad to try to do this. Can you do it for me please?

[mammaP]

Hi Linda, 

On 7/23/2018 at 12:49 AM, Altostrata said:

At the start of each shift I was very poorly but as the day went on I started to feel better each day.

The post I quoted was a seek ago, are you gradually feeling worse, or is it just because you are not working and find that work is a good distraction? 

It is going to take time for your nervous system to settle down. You had so many changes, and treatment for cancer which is not a walk in the park.

In under a year, Mirtazapine 15 then 30 then 15,  On lithium, off lithium, on pregabalin then fast taper then C/T mortazapine and reinstated, 

It is such a lot of changes, no blame or criticism of you at all, you had no idea which is very sad because doctor's just do not warn people, they don't know themselves about the effects of all the drugs on the nervous system.  I am so sorry that you are going through this, but you WILL get better. 

[lindarivendell]

Thank you Altostrata for your support and reassurance.  Just wish I had a rough idea how long I will take to stabilise. 

[Altostrata]

On 7/27/2018 at 11:46 PM, lindarivendell said:

Hi Altostrata, this is my 13 th day on the reinstated 15mg dose but I just seem to be getting worse.please help?

 

On 7/28/2018 at 12:19 PM, lindarivendell said:

Hi Chessiecat I take my dose before bed and it is the anxiety that has worsened.  I am really poor in morning and struggle into work where my mind is totally taken up with stocking shelves pricing rearranging shelves and my mind has not got a minute to dwell on things. Last week in work I would feel really rough for the first few hours but by the time I went home the anxiety would be almost gone. And the days that I worked would result in good anxious free evenings. However this week I have followed the same pattern symptom anxiety wise but my evenings on these days are much less anxious free. I am feeling anxious this evening after work And I am not looking forward to tomorrow as I am not working and feel the whole day and evening I will be rather poor. My doctor says it's early days to feeling better as I have been only on my therapeutic dose for 12 days.

 

Hi, Linda, are you feeling worse on 15mg than you did on 7.5mg? if your anxiety increased as you increased the drug, you are taking too much of the drug. If I were you, I might try 12.5mg and see if that helps.

 

As Chessie noted, "therapeutic" is an arbitrary term. If a drug makes you worse, it is not therapeutic at that dosage.

[lindarivendell]

Still too frightened to reduce from 15mg it has been 3 weeks since on this reinstated dose. Doctor keeps telling me I will stabilise and if I reduce will make things worse. Not working now at the moment. Don't know what to do!

[lindarivendell]

Please Altostrata,  I am now on the initial dose for 4.5 weeks now . After the cold turkey when I went back on the 7.5 for 8 days I still managed to get to work and since taking the full dose again I have been worse. Should I try 12.5mg my CPN says to try going back to 7.5mg. Perhaps I hadn't given the 7.5mg long enough only 8 days? Or should I try the 12.5mg? I am really at my wits end with all this Altostrata but I believe you are right going cold turkey has possibly sensitized me to this 15 mg dose. Please please help and respond to my plea! Don't think i can go on like this!!

[ChessieCat]

On 7/30/2018 at 10:42 AM, Altostrata said:

if your anxiety increased as you increased the drug, you are taking too much of the drug. If I were you, I might try 12.5mg and see if that helps.

 

Reducing to 7.5mg would probably be too large a reduction at this stage.

 

Please keep daily notes notes on paper.

[lindarivendell]

Thank you Chessiecat I will try 12.5mg this evening. How long do you think it will take to notice any change? So grateful for your advice.

[lindarivendell]

Please please reply Chessiecat I am in a really bad way!!

[Altostrata]

linda, did you reduce to 12.5mg? How are you in a bad way?

[lindarivendell]

Altostrata I have been on the full dose for 4.5 weeks and I have been worse on this than the 7.5mg. I managed to get to work on the 7.5mg. I am going to reduce tonight to 11.5mg as it is a smaller dose. Hoping and praying this helps as I am getting very very bad in the afternoons on the 15mg but seem to be better in the evenings. It's thoughts like I can't take this anymore even though my head doesn't know what it is I can't take anymore. I really really hope I just am on too high a dose after cold turkey?

 

[Altostrata]

linda, you must have missed this 2 weeks ago.

 

On 7/29/2018 at 5:42 PM, Altostrata said:

Hi, Linda, are you feeling worse on 15mg than you did on 7.5mg? if your anxiety increased as you increased the drug, you are taking too much of the drug. If I were you, I might try 12.5mg and see if that helps.

 

As Chessie noted, "therapeutic" is an arbitrary term. If a drug makes you worse, it is not therapeutic at that dosage.

 

Yes, I would reduce the dosage a bit and see what happens.

[lindarivendell]

Thank you so much Altostrata I am hoping and praying it does. Thank you once again for your support. How long will it take to notice if there is a change,?

[Altostrata]

It will take 4 days or more for your body to fully recognize the change. However, you might feel some effects within hours of taking the reduced dosage.

[lindarivendell]

Thank you so much Altostrata you don't realise what a wonderful support you are to people going through this he'll. God bless you xx

[lindarivendell]

Altostrata I took a 1/2 tablet plus 1/4 last night. I thought this stupidly was 12.5mg but it is not it is 11.25mg. Is this too much of a drop? If so can I make up a solution-- but is Mirt soluble in water?

[lindarivendell]

Please reply Altostrata I promise I won't keep asking questions. Life is a nightmare at the moment after ct on this and reinstatement to my full dose.

[powerback]

Hi L since you seem desperate I will reply and you are in anxiety spiral that is going to run its course ,I see alto said yesterday it takes a few days for the body to register the change .

Please try and relax ,you will be ok ,our minds are extremely powerful ,trust me I know what you going through.

I've come through the worry you are experiencing so try find something to calm your mind .

No doubt Alto or a mod will be around to help in the coming days . 

[lindarivendell]

Thank you so much Power back. I hope and pray that the reduction helps. It has been torture as you probably can empathise.

[powerback]

Just now, lindarivendell said:

Thank you so much Power back. I hope and pray that the reduction helps. It has been torture as you probably can empathise.

 Your welcome  .only time will tell .keep learning about anxiety and what you can do and keep out of your body to help.caffeine,sugar,alcohol nicoteinne,stress,.reduce all these were it is applicable  .im a big proponent of staying away from social media and especially in a wave .

Take Care.

[lindarivendell]

Please Altostrata it is 6am in the morning woke at 4pm. Usually sleep all night. Think I am worse on this reduction. Had irrational and having irrational thoughts and thinking crazy thoughts about past things I was not happy about. But did not worry me but my brain is giving crazy intrusive thoughts like "you weren't happy then you think you were"  My brain is not making sense and  it is scaring me. Should I go back on to the 15mg dose tonight. I am still sobbing and crying episodes too during the day but it is these irrational thoughts now which are so scary. Please advise me!! I have only taken the lower dose 11.25mg for 3 nights.

[lindarivendell]

Please please Altostrata I need you help and advice. I went down to the 11.25mg for 3 nights and because you hadn't replied got scared and went back up to 15mg. However 8 days 9 days after the time I had reduced to 11.25mg I had a very good window a really good day and a half. Could it have been the reduced dose of 11.25mg that could have produced this effect. It did not last as I only stayed on the 11.25mg before going back on the 15mg. Even my husband says I was so much better when I was on the 7.5mg and still getting to work and no suicidal thoughts only all this started when put on 15mg. Been on this 1tmg for 7 weeks now and still no better.  I have now been put on 22.5mg 3 nights ago but don't think this is the right direction dosage wise. I have more and more sobbing bouts every day. I am scared to go back to the 11.25mg but those 1-2 days I had were the best I have. Please help!!!

 

[lindarivendell]

Ps I took the 11.25mg for 3 nights before going back to the 15mg