Psum4444: been on mirtazapine for 1 month at varying doses trying to taper

[Psum4444]

Hi,

 

I've been on Mirtazapine for 4 weeks, with side effects, I was put on this Medication for OCD and Anxiety and I started to feel a sense of despair and doom.  The Doctor suggest I taper off Mirtazapine and use Ativan to sleep to take Mirtazapine every other day for 2 weeks and every 3 days on the 3rd week. I know the alternating days isn't a good idea as I just took 1 day off Mirtazapine and feel terrible.

 

Please let me know if I can do a fast taper since I've only been on the drug for such a short time.. I find it difficult to sleep and the Ativan help but I'm worried I might be stuck with the Benzo later on..

 

Any tips with the insomnia and waves of dread and anxiety?

 

Here's my timeline:

 

Sept 22 - Sept 26: 15mg Mirtazapine

Sept 27: 7.5mg Mirtazapine <-- I wanted to wean off!

Sept 28: 1mg Ativan <-- tried to come off Mirtazapine 

Sept 29: no pill <-- Couldn't sleep!

Sept 30 - Oct2: 22.5 mg Mirtazapine plus 1mg Ativan

Oct3 - Oct4: 30 mg Mirtazapine plus 1mg Ativan

Oct5 - Oct16: 30 mg Mirtazapine

Oct 17 - Oct20: 15 mg Mirtazapine <-- Dr suggested I switch because 30mg made me depressed.

Oct 21: no Mirtazapine, 1mg Ativan <-- Doctor suggest I taper off Mirtazapine and use Ativan to sleep to take Mirtazapine every other day for 2 weeks and every 3 days on the 3rd week.

[Gridley]

Welcome to SA, Psum4444.  Thank you for completing your signature.

 

It's a close question as to whether you can do a fast taper. You've been on the Mirtazapine for one month, and that is the point where people are at risk of withdrawal symptoms if they stop the drug.  The fact that you felt terrible after skipping the drug for one day points to the possibility that you're already dependent.  

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

My recommendation would be that you taper conservatively to avoid the risk of withdrawal.  Once withdrawal sets in, there is no way to predict how long it will last.  While some recover fairly quickly, for other it can take months or longer.  We recommend tapering no more than 10% of your current dose every four weeks.  I would start at your current dose of 15mg.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Mirtazapine, including how to get the nonstandard doses you'll need for your taper.

 

Tips for tapering off mirtazapine (Remeron)

 

I'm going to bring your situation to the attention of the other staff to get their thought about the possibility of a fast taper.

 

Please be very careful with the Ativan.  Physiological dependency can set in after 2 to 4 weeks of regular use and also with intermittent use.

 

Here are some links to help you with sleep.

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Tricks and tips to fall asleep faster

 

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

This link contains helpful information, including insomnia and also non-drug coping skills.  

 

 Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.   

 

 Melatonin for sleep   It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  

 

 

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. Get supplements that ae single ingredient (not mixed with other types of supplements).

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited October 22, 2020 by Gridley

[Altostrata]

Hello, Psum.

 

If you're already have an adverse reaction and withdrawal symptoms, hold your horses.

 

You've been up and down with both mirtazapine and Ativan. Your nervous system needs to settle down. If I were you, I'd take 5mg mirtazapine every night at the same time, for a few days, see if that's enough to settle the situation. Your sleep may be patchy for a while.

 

You can take this small amount of mirtazapine by making a liquid from the tablet, see Tips for tapering off mirtazapine (Remeron)

 

You can use this liquid to taper mirtazapine later, maybe in a month if your sleep improves. Please let us know how you're doing.

[Psum4444]

But in on 15mg currently would it be too much of a drop to go to 5mg.. or would it be okay since I haven’t been on for that long?

[Altostrata]

Sorry, thought you were taking mirtazapine irregularly. How do you feel, taking 15mg? How long have you been taking 15mg this time around?

 

What time o'clock do you take it?

[Psum4444]

I’ve been taking 15mg since oct17 I usually take it around 10pm.  I’m not sure if I actually still need it.  I think my liver is the cause of my anxiety, I’m noticing my mood is more stable now as I’m increasing fibre and plants base in my diet. 

[Psum4444]

I worried the Mirtazapine is causing liver issues.. I would like a faster taper to see how I feel but I don’t want to shock my cns too much. 

[Psum4444]

Hi I notice I have an unnerving sense of dread feels like my brain is drowning feels almost numb and in need of some relief..  is that a symptom of a withdrawal?

 

 

[Santino]

Hi Psum...

Your story sounds similar to mine. You try and locate my topic and read it. What is more important at your position right now is to listen Altostrata and keep yourself with a very low dose of Mirtazapine. 5Mg and see how it goes. On the other hand please do not stick with Ativan for sleep. Benzos are very dangeorus and very tough to go off. I would prefer better 2 night of no sleep at all than to use benzos. The third night your system will get so much tired it will sleep naturally. 

All the best

Santino

[Psum4444]

Hi Santino,

 

yes, lastnight I had it really bad I cut from 15mg to 7.5mg of the Mirtazapine, couldn’t sleep because I kept panicking every time I doze off, I couldn’t take the dread so I took an ativan and only slept for a few hours. 
 

im just worried that the feeling I have is actually me and I need the Mirtazapine.  Can you share your story’s link if you have a thread, I need some guidance. It’s very unsettling and I feel everyday I’m just waiting for a good night sleep. 
 

I’m currently taking magnesium glycinate, omega3, and melatonin. 

[Psum4444]

Hi,

 

I've been on 7.5 mg for 2 days now from a drop from 15mg, the first day wasn't too bad. But today I feel unsettled, it's almost like an intense overwhelming feeling bubbling up inside.  I'm worried if these are my underlying symptoms or if they're withdraw symptoms... 

[ChessieCat]

  

7 hours ago, Psum4444 said:

Hi I’m tapering off Mirtazapine too and I have intrusive thoughts of self harm especially when I’m going to sleep.

 

Have you tried playing some soft music to help distract your brain?

[Psum4444]

I haven’t, but I’ll try that next time.. it comes in waves.. i try to put focus on me feet to distract my mind.  Sometimes it’s unrelenting. 

[ChessieCat]

I have an mp3 player (it has a timer) that I use and I download audio books to listen to.  I try to pick readers who have a nice calm voice and a story line that is not activating.  Something that is interesting enough so I can ignore my thoughts but not too interesting that I try to stay away listening to it.

[Santino]

On 10/26/2020 at 6:54 PM, Psum4444 said:

Hi Santino,

 

yes, lastnight I had it really bad I cut from 15mg to 7.5mg of the Mirtazapine, couldn’t sleep because I kept panicking every time I doze off, I couldn’t take the dread so I took an ativan and only slept for a few hours. 
 

im just worried that the feeling I have is actually me and I need the Mirtazapine.  Can you share your story’s link if you have a thread, I need some guidance. It’s very unsettling and I feel everyday I’m just waiting for a good night sleep. 
 

I’m currently taking magnesium glycinate, omega3, and melatonin. 

Hi PSUM.... 

This is exactly my symptoms. I would advice you to be very careful with adding the ATIVAN in the mix. Benzos are terrible in terms of withdrawal. Their WD is shorter in time but the wd symptoms are really really tough.

I think the best thing for you is to try to stabilize in a low dose of Mirtazapine ... maybe 7.5mg and try to avoid ativan as much as you can. Those cortisol spikes when you try to go off sleep are really terrible.

I am putting down my both topics for you to check.

https://www.survivingantidepressants.org/topic/12291-%E2%98%BC-santino-how-do-i-keep-on-the-sane-side/page/9/?tab=comments#comment-345198

 

https://www.survivingantidepressants.org/topic/19129-santino-made-it-and-stayed-sane/?tab=comments#comment-383696

 

All the best

Santino

[Psum4444]

Hi Santino

 

I have moment when I feel a deep sense of depression and despair.. I’m wondering if this is the Mirtazapine or if it’s me.. it’s almost unbearable.. and my mind can seem to feel joy or pleasure in anything and I feel tired and drained. 
 

 

[Santino]

18 minutes ago, Psum4444 said:

Hi Santino

 

I have moment when I feel a deep sense of depression and despair.. I’m wondering if this is the Mirtazapine or if it’s me.. it’s almost unbearable.. and my mind can seem to feel joy or pleasure in anything and I feel tired and drained. 
 

 

Hi PSUM

Those were exactly my symptoms, and i strongly believe they were related with the meds. I would have a morning full of terrible anxiety and than later a normal afternoon, than the next day i would have terrible dreading and depression and despair and in the afternoon i would feel drained and super tired. 

I believe you have to stabilize now, with as less changes as possible and than continue with the taper. There is nothing wrong with you if you did not have those same feelings before the meds. We all have problems and bad moments but need to deal with them in a natural way. 

Right now i am almost 99% normal.... and living a very normal live. Read my topics and you will understand.

All the best Santino

[Psum4444]

Yes I just read your story.  You seem to be able to do a lot more than me as you were tapering..   I’m on 7.5 right now, the depression waves are unbearable.. I notice it happens when I’m spending time with my newborn which make it even worst.. my brain can seem to be able to enjoy anything I can’t enjoy my friends, shows, and sometimes even my family. I find myself constantly on Facebook or SA trying to figure this out. 

[Psum4444]

The doctor gave me zopiclone for sleep to replace the Benzos.. those would be a better option probably?

[Psum4444]

4 hours ago, Santino said:

Hi PSUM

Those were exactly my symptoms, and i strongly believe they were related with the meds. I would have a morning full of terrible anxiety and than later a normal afternoon, than the next day i would have terrible dreading and depression and despair and in the afternoon i would feel drained and super tired. 

I believe you have to stabilize now, with as less changes as possible and than continue with the taper. There is nothing wrong with you if you did not have those same feelings before the meds. We all have problems and bad moments but need to deal with them in a natural way. 

Right now i am almost 99% normal.... and living a very normal live. Read my topics and you will understand.

All the best Santino

Hi Santino,

 

Thank you for the encouragement I really needed it.  I noticed my brain is foggy and my neck is stiff and it cracks a lot not sure if those were some of your symptoms as well.. I'm on 7.5mg, and I'm wondering what I should do, I'm haven't been on for long, only 1 month and 1 week, I've been up and down on the dosage as you can see in my signature, so I'm not even sure what stability feels like on this medication - therefore, it's difficult for me to decide if the drug is doing me more good or harm.  The waves of panic and depression are terrifying it makes me have really dire thoughts.  Currently, I'm just breaking the pills in half and I have a Gemini scale, as I'm not confident on make liquids.   

[Psum4444]

I have B complex vitamins but not sure if I should take those because I read it interacts with Mirtazapine.

[Santino]

On 10/29/2020 at 9:23 PM, Psum4444 said:

Hi Santino,

 

Thank you for the encouragement I really needed it.  I noticed my brain is foggy and my neck is stiff and it cracks a lot not sure if those were some of your symptoms as well.. I'm on 7.5mg, and I'm wondering what I should do, I'm haven't been on for long, only 1 month and 1 week, I've been up and down on the dosage as you can see in my signature, so I'm not even sure what stability feels like on this medication - therefore, it's difficult for me to decide if the drug is doing me more good or harm.  The waves of panic and depression are terrifying it makes me have really dire thoughts.  Currently, I'm just breaking the pills in half and I have a Gemini scale, as I'm not confident on make liquids.   

Hi Psum

My main advice is to stop taking Ativan for sleep. If you have taken it continuously for more than 10-15 days you might be already hooked in there so any destability might be connected with the Ativan. 

Anyway i would not recommend much breaking the pills in half and using the Gemini scale. The distribution of the med subject in the pill is not even so you never know the amount of med each half has. For me i would always make a liquid mix with one full pill by just using a small bottle and some warm water. It was very easy... and i ended up using it until the very end of my taper. Mixing 15Mg pill with 15Ml warm water in a small bottle and shake it well. That means that each 1ml=1mg so you can easily manage from there. So i would need just a bottle with me, some wram water a pill and a 5 mg syringe. In the begining it really looked like a complex process but after 2-3 trials i was able to do it all the time. Any mix can not last in fridge more than 4 days.

All the best

Santino

[Gridley]

35 minutes ago, Santino said:

The distribution of the med subject in the pill is not even so you never know the amount of med each half has.

In countries with a regulated pharmaceutical industry, the active ingredient is evenly distributed throughout the pill. 

[Psum4444]

16 hours ago, Santino said:

Hi Psum

My main advice is to stop taking Ativan for sleep. If you have taken it continuously for more than 10-15 days you might be already hooked in there so any destability might be connected with the Ativan. 

Anyway i would not recommend much breaking the pills in half and using the Gemini scale. The distribution of the med subject in the pill is not even so you never know the amount of med each half has. For me i would always make a liquid mix with one full pill by just using a small bottle and some warm water. It was very easy... and i ended up using it until the very end of my taper. Mixing 15Mg pill with 15Ml warm water in a small bottle and shake it well. That means that each 1ml=1mg so you can easily manage from there. So i would need just a bottle with me, some wram water a pill and a 5 mg syringe. In the begining it really looked like a complex process but after 2-3 trials i was able to do it all the time. Any mix can not last in fridge more than 4 days.

All the best

Santino

I’m suffering from insomnia.. I ct from 7.5mg.. and now I’m not able to sleep. The Mirtazapine is making me have suicidal thought because of sleep deprivation.  My anxiety and thoughts races at night. 

[Santino]

2 hours ago, Psum4444 said:

I’m suffering from insomnia.. I ct from 7.5mg.. and now I’m not able to sleep. The Mirtazapine is making me have suicidal thought because of sleep deprivation.  My anxiety and thoughts races at night. 

Thats wrong Psum4444 

Try reinstating some level of Mirtazapine, maybe 3.5 MG and than stick with that without using any other meds. See how would you do. If you are more stable than decide.

All the best

Santino

[Psum4444]

5 hours ago, Santino said:

Thats wrong Psum4444 

Try reinstating some level of Mirtazapine, maybe 3.5 MG and than stick with that without using any other meds. See how would you do. If you are more stable than decide.

All the best

Santino

I might still need meds at this point.  The Dr. Recommended I take an SSRI Paxil.  

[ChessieCat]

4 hours ago, Psum4444 said:

The Dr. Recommended I take an SSRI Paxil.  

 

Paxil is one of the harder drugs to get off.  Please do your research.

 

9 hours ago, Santino said:

Try reinstating some level of Mirtazapine, maybe 3.5 MG and than stick with that without using any other meds.

 

This is a much better idea.  Changing to a different drug when you are experiencing withdrawal from the old drug muddies the waters.  If issues arise you will not know if you are still experiencing withdrawal from the old drug, start up/side effects/adverse reaction from the new drug.

 

Reinstatement of the drug which your brain has adapted to is the better option.

 

Chemical imbalance was a theory, not a fact.  It was disproven at least 20 years ago.  The fact is that the psychiatric drug we take introduces chemicals to the brain, the brain adapts to them and when they are taken away too quickly the brain tries to regain homeostasis/factory settings, which is why we experience withdrawal symptoms.  Please see:

 

again-chemical-imbalance-is-a-myth-stop-the-lies-please

 

[Psum4444]

what if I need medication for my Anxiety the Mirtazapine hasn’t been working for me it’s made me worst. 

 

Edited November 4, 2020 by ChessieCat
removed quote

[ChessieCat]

When we start to panic we add more symptoms, feelings in our body, because of the anxiety.  Look at this labelled diagram which explains this:

 

https://www.getselfhelp.co.uk/anxiety.htm

 

Please listen to these:

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk
 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

And these might help too:

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

[Psum4444]

My anxiety is keeping me from sleeping..