GemP: mirtazapine 22.5mg tapered wrong ttc

[GemP]

Hello all, 

 

New here. After some traumatic life events (including diagnosis with an autoimmune disease) was put on mirtazapine nov 2018 during a day clinic program. They said it was a strong depressive episode with symptoms of anxiety. It was never pushed on me though most other places it might have been. Here they felt I had clear reasons and grief. In any case, I started mirtazapine 7,5 mg and slept for the first time in months. Then 15 mg and finally 22,5 when 15 wasn’t cutting it. This was the right dose. Yes I gained a bit of weight and had vertigo at times but that went away. I was given this med because I also take baby aspirin to think the blood to due a clotting antibody that was found. They felt this was the least risky.

Who knows?

 

Last month found out we have to start the process to have kids faster than I wanted due to diminished ovarian reserve and my psychiatrist who I will now fire gave me no real directions about the med and pregnancy. Said better not to look back and wonder if any issues with the kid were your fault. So I decided to taper down to avoid adding another med to my list and I have been feeling better and working, disease more well controlled. I asked for taper tips. She said in theory you can stop tomo but maybe try over a few weeks. No more tips.

 

So I reduced a quarter every 10 days. Was pretty ok with one day (second day after reducing) usually being tough. Irritability, fatigue, sadness, a bit of anxiety. Then it would level out mostly. I was traveling this week, and figured I would be in a good mood and tapered mid break but forgot and did a half instead of a quarter (15mg to 7,5 mg) and BOY what a catastrophe. I had all those symptoms but magnified x10 and went back up to 15 mg the next day and felt almost immediately ok again.

 

However today I felt headachey, sad and a bit anxious again and am afraid after some things I read that I have somehow permanently busted my already shaky brain and nervous system. With fertility treatments coming in the next months, I’d like any hope or advice on how to manage the taper? Or to hear from anyone who used it during pregnancy at a lower dose. 

 

Thanks for having me and for doing this! What a relief that this group exists. 

Edited June 17, 2019 by Shep
updated title with new username.

[manymoretodays]

Hi GemP,

And welcome aboard!

You may have gone a bit fast with your mirtazapine taper.  Let's get a better idea of your tapering.  And then sometimes, less of a dose, can be effective and probably lessens any risk to an unborn child or fetus.....once that all happens.  It looks like, from your post, that you may be on 15 mg now.  You can note the dates of changes in the signature. 

 

Please put your withdrawal history in your signature

Putting a SHORT version of your recent history of reducing or discontinuing drugs in your signature, with the drugs you are currently taking, when you started taking them, and their dosages, helps people understand your context when they read your posts.

 

Your signature appears under all your posts.  Unless you are viewing from a phone device.  You can still, however, create a signature using a phone device.

 

If your drug history is very long, the last few years will do. FOR READABILITY, SHORT LINES ARE BEST.

 

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Please use actual dates or approximate dates (e.g. mid-June) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

 

Example:

2001–2002 paroxetine 
2003  citalopram 
2004  paroxetine
2008  paroxetine slow taper down to 2016 Aug off paroxetine
2016  citalopram May 20mg  Oct slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg

 

If you edit your signature, the new one replaces any prior signature. It will appear in your signature under all your posts, even your old posts. If you want to save the information in the old signature, copy it and save it in a file on your computer or in a post in your Introductions topic.

 

(As of 12/31/13: Signatures are limited to 12 lines of text.)

How to add or edit your signature

1. Click on this link to open the correct page in User Settings:
   Create Your Signature in "Account Settings". 
   2017-June 12 update: link works on desktop, tablet and mobile phone versions
    
2. Enter your signature in the space provided.
3. When you are done, Click on the big black Save button at the bottom.

Edited June 17, 2019 by Shep
additional (MMT), edited out old username and updated with new username (Shep)

[manymoretodays]

Okay and hi again and welcome.

 

Here at Surviving Antidepressants, we often recommend that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  And of course, a case by case approach is also kept in mind. 

Why taper by 10% of my dosage?

 

Tips for tapering off mirtazapine(Remeron)

 

More about withdrawal and common symptoms of:

Brain Remodelling

What is withdrawal syndrome.

The windows and waves pattern of withdrawal

 

Dr.Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil).

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil)

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.  As well as communicate with other members and mods.   Hopefully finding others in a similar situation will help a lot.

 

All for now.  We do offer a lot of support as well, as far as non-drug coping with WD symptoms go.  We can get to some of that soon, too.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

[GemP]

Thank you for the guidance and detailed response! I have now added in my withdrawal history into my signature. 

I have recently learned from a pharmacist NOT my team of doctors that mirtazapine and a medicine I take for an autoimmune issue (plaquenil/hydroxychloroquine)  

has a moderate to major interaction for a heart issue that should have been monitored but isnt. I would like to continue the taper again even though 

I had decided to stay on 15 mg even if pregnant. 

 

Looking to start the 10 percent taper soon. 

[GemP]

Thanks to advice from I tapered from 22.5 mg of Mirtazapine over a few months to half a tab of 7.5 mg still probably faster than I should have but I was pregnant, ended in miscarriage sadly. I have stayed stable at this dose for a couple months now. Recently I have been getting migraine attacks that last weeks every month. In past I only ever got one a year. MRI showed an all clear and I do have autoimmune disease which could be comorbid. However I just realized the increase in frequency roughly correlates to the reduction of dose. I remember a few times when I was tapering too fast I got anxiety, headaches, sobbing etc. which would be relieved once the dose was reinstated. 

 

Has anyone had any experience with this? I wonder if upping my dose again might help them rather than having the neuro put me on the migraine standard tricyclics.

Help would be appreciated! 

[manymoretodays]

Hi GemP, and welcome back, @GemP

 

Oh, so sorry to hear that about your miscarriage.  (((((GemP))))))

I just merged your most recent post back here to your Home introduction.  Best to bookmark it, for easy access.  Just one introduction per member.  And so much easier if your information is all in one place, for us mods.

 

On 7/4/2019 at 2:10 PM, GemP said:

I have recently learned from a pharmacist NOT my team of doctors that mirtazapine and a medicine I take for an autoimmune issue (plaquenil/hydroxychloroquine) 

 

Are you still on the Plaquenil?

It's possible the migraines have come about with your Mirtazapine taper, or as a WD symptom, hard to know exactly......and you have had some hormonal shifts too.

 

What is your present dose of mirtazapine?  And then how do you measure it out too?

How long have you been on it?

 

About reinstating and stabilizing to reduce withdrawal symptoms

Keep in mind that we'd recommend a much smaller reinstatement than just going all the way back up to where you had been at with your previous dose.

 

Yes, I agree with you that doing a small updose with the mirtazapine might be a better option now, than adding a completely new drug.

 

Good to see you and your update.  And so sorry for your loss.

 

L, P, H, and G,

mmt