Amanda23: in desperate need of advice

[Amanda23]

I started Mirtazapine in March 2020 at 7.5mg. After a month or two I told my pcp about increased appetite and was told to take 15mg. In June I said it’s not giving me any benefits only side effects and was told to discontinue which made me very sick. I went back on after 1 week at 15mg. I did get relief after a few days but I’ve had bouts of depression I’ve never had, weird physical symptoms. I haven’t been the same since. About 2-3 weeks ago I started 15 every other day for about a week and a half then 7.5 every other for a few days now ive taken 7.5 the last three nights consecutively. I don’t know what to do and I really need help. I was prescribed this for panic attacks. Weird thing is each time I’ve either stopped or cut dosage my anxiety/panic have decreased since the first time CT in June. I have a weird dry skin type rash around my mouth, it’s not itchy at all though. The last 2 nights my sleep is a bit better but I’m exhausted all day. Should I just stop so my body can actually recover? I’m so lost and desperately need help. 

[Gridley]

Welcome to SA, Amanda23.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

As I understand it, your drug history is as follows:

 

March, 2020  Mirtazapine 7.5mg

April or May, 2020 Mirtazapine 15mg

June, 2020 CT Mirtazapine 15mg.  Reinstated 15mg after 1 week.

Approx. mid-August, 2020 began taking 15mg every other day for 1 1/2weeks, then 7.5 lor a few days

August 26, 2020 began taking 7.5 every day

 

If this is correct, please put this information in the link above and press "save."  If you've been on any other psychiatric medication, please include that in your signature, with doses and dates.

 

You are suffering from withdrawal from your cold turkey of 15mg in June, your skipping doses and changing doses.  You mentioned depression and "weird physical symptoms."  Please describe these physical symptoms.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Right now you need to stabilize on a constant dose, taken every day.  Never dose every other day.  This makes the amount of the drug in your blood stream go up and down, battering your nervous system and making withdrawal worse.   I suggest you stay at 7.5mg until you feel stable.  I would not just stop.  

Your body has become dependent on the drug at this point, and a cold turkey cessation will make withdrawal worse.

 

After you have stabilized, you can taper slowly off the drug.  We recommend tapering by no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Mirtazapine, including how to get the non-standard doses you'll need for your 10% taper when you're ready to start it.

 

Tips for tapering off mirtazapine (Remeron)

 

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). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

[DinaDina]

Hi Amanda!

How is your problem with urination now? I have the same problems. I can’t sleep on abdomen because of pressure