Fergerburger: withdrawing vs having recurrent depression?

[Fergerburger]

i was on various ssri’s/snri’s continuously for 25+ years, my last med was mirtazapine. these meds never really helped. b/c of this, with the ”help”

of my doctor i tapered off mirtazapine a year ago. i did a slow taper until i got to 11.75mg & then i just abruptly stopped b/c i was just over it. the last year has been hell. i am terribly depressed & anxious; anxiety was never an issue until i got off meds. i am still constipated (never had this before mirtazapine). i have insomnia (never had this before mirtazapine). 

 

my doctor thinks i have recurrent depression, no one on my care team (dr, therapist) believes i could still be recovering from decades of antidepressants. is this still withdrawal or are these symptoms proof i really am depressed & need meds forever? are there things i can do to ease this? should i go back on mirtazapine & taper over the next year? do supplements help? help!

[Gridley]

Welcome to SA, Fergerburger,

 

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.  Just a list and (if you remember) dosages of the early drugs.  Include the date you stopped at 11.75mg.

 

Account Settings – Create or Edit a signature.

 

Doctors don't believe in protracted withdrawal.  That's what they learned in schooling that's what the pharmaceutical companies tell them.  Because of this, they will invariably tell you the depression is a "return of the underlying condition." Doctors commonly misdiagnose withdrawal as mental illness and throw more drugs at you, perpetuating the cycle and putting you on what is called the drug merry-go-round.

 

 Your situation seems pretty clear to me that the symptoms you're suffering are due to withdrawal for several reasons.  First, jumping to zero from 11.75mg is an extremely high dosage to stop at, making withdrawal a very likely consequence.  Second, depression is one of the most common withdrawal symptoms.  Third, the fact that you're suffering from three symptoms you never experienced before stopping the drug points to withdrawal; all three, as well as depression, are common withdrawal symptoms. 

 

Reinstatement of a very small dose of the drug is the only known way to alleviate withdrawal symptoms.  To reinstate a year out from stopping the drug is risky (reinstatement works most predictably within 3 months of stopping the drug).  It might work or it might make things worse.  There's no way to tell.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If you decide you want to reinstate, let us know and we can suggest a dose to reinstate.  Please don't reinstate without letting us suggest a dosage.  Reinstating too much can overwhelm your system and make things worse.

 

So that you have a better idea of what you're experiencing, here is some information on withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Protracted Withdrawal or PAWS (post-acute withdrawal ...

 

When we take psychiatric 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. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

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 are single ingredient (not mixed with other types of supplements).

 

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

 

 

 

 

 

 

 

 

 

 

[Fergerburger]

thank you for this reply. i will edit my profile, sorry about that.

 

i think trying reinstatement is the right choice. my md did suggest this, but she suggested 7.5mg. what dose should i start at? mirtazapine comes in 7.5mg tablets, i couldn’t find the somution previously. i read about making my own solution. would ~1mg be ok to start?

 

Edited November 12, 2020 by ChessieCat
reduced font size

[Gridley]

52 minutes ago, sehfergy said:

she suggested 7.5mg. 

During the year you've been off the drug, your brain has made adjustments to being off the drug, and 7.5mg would likely be too much for your brain to handle.

 

52 minutes ago, sehfergy said:

i read about making my own solution. would ~1mg be ok to start?

1mg would be a good dose to reinstate.  It takes 4 days for a reinstated dose to reach full strength in your bloodstream and a few days more to register in the brain, so be patient and give the reinstated dose a chance to work.  If it's not enough it will be easy to slowly increase using the solution you mentioned.  

Please keep in mind that the purpose of reinstatements isn't to eliminate all symptoms (though it does for some) but rather to bring them down to a tolerable level.  If the reinstatement helps, you would stay on that dose for several months to stabilize, then begin a slow 10% taper down to zero.

 

Why taper by 10% of my dosage?

 

The following link explains how to make your own liquid.

 

 

Tips for tapering off mirtazapine (Remeron)

 

If you feel worse after the reinstatement, stop immediately.

 

 

[Fergerburger]

thank you for all this info. the link on tips for tapering mirtazapine doesn’t work, however & my search wasn’t helpful.

 

do you think 1.875mg (1/4 of a 7.5mg tab) would be too high? i am not confident in making a solution. sorry so many newb questions, i appreciate the guidance. i am not sure if i just want to push through or try reinstating, keep going back & forth. i’ve come so far. going back on something feels like defeat.