Chispa: about to start tapering of Mirtazapine

[Chispa]

Hello👋everyone,

I was on Flouxetine for 20 years as part of managing a chronic health condition known as ME/CFS 1999-2019. The drug suited me (no obvious side effects) but i developed fatty liver disease (NAFLD) which led to a treatment protocol involving a medically designed ketogenic diet. About two and half months into this, i accidentally stopped taking the Flouxetine and didn't realise for 3 weeks (March 2019). No withdrawal symptoms. I spoke to my doctor (GP) as i knew you weren't supposed to just stop taking anti-depressants. She said see how you go. I never looked back...till the pandemic and lockdown forced me into a level of isolation that devastated my mental well-being. Then my cat went missing which tipped me into a severe anxiety state and insomnia (Sept 2020). After tinkering with Diazepam which did nothing for me, for a couple of weeks, i stopped taking it and tried to manage with Propranolol, OTC herbal and antihistamine sleep remedies. I am an experienced meditation practitioner, and in other techniques for calming the nervous system, but this was a tsunami of anxiety. With the help of counsellor i realised that some of this was de-repressed anxiety from trauma relating to an incident where i nearly drowned. My cat returned after 9 weeks but i was still in a bad way and my physical health was deteriorating... so i turned to Mirtazapine 15mg. It helped.

 

My anxiety levels appear to have reduced considerably and i am sleeping better. I don't like how i feel now, it's like my system is being punched. The standard line is you should stay on the drug for 6 months after you start feeling better. But i feel slightly sedated with a heavy feeling in my head/mind, a background low grade headache, and i just want off the drugs. Also it is interrupting and disrupting my treatment for my other health issues. My functional doctor really did not want me to take prescription drugs. He recommended a gadget i find very effective called Sensate which helps relax the nervous system. So i have that in my tool kit now as well. I don't know how much he knows about tapering but he will be supportive. I speak to him next Tuesday about this.

 

I heard about withdrawal woes initially in an ME support group on FB. So i knew there was the conventional approach and another one favoured by patients, tapering much more slowly using the 10% method. I googled withdrawing from Mirtazapine and found SA. This will be my first attempt at tapering and being aware of the risk of withdrawal symptoms. I don't want this drug in my system any longer than it has to be. I realise reading your many stories that mine is not the difficult experience you've all been through. I thank you that your honesty and this forum mean i get to the chance to do it right first time. Hopefully🙏

Love to you all x

Edited March 10, 2021 by Gridley
Spelling

[Gridley]

32 minutes ago, Chispa said:

This will be my first attempt at tapering and being aware of the risk of withdrawal symptoms. I don't want this drug in my system any longer than it has to be.

Welcome to SA, Chispa.

 

We recommend, as you may know, tapering by no more than 10% of your current dose every four weeks. I know you want this drug out of your system but I wouldn't go any faster than that.  This link explains why.

 

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)

 

The purpose of the 10% taper is to eliminate or minimize withdrawal symptoms.  Here is some information about with withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

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

 

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

 

 

 

 

 

 

 

 

[Chispa]

Thank you, Gridley. I am very much persuaded by the 10% approach😊 i have started reading and reflecting on the other links you posted. Thank you for that orientation.

 

What i mean is: i want to get started tapering sooner rather than wait till I've been on the AD for the conventionally recommended six months. My circumstances have stabilised. My sleep is much better recently. Is there such a thing as starting to taper too soon? My understanding so far (which may change upon further reading) is that tapering is potentially a destabilising process, and to be prepared and have strategies in place to cope and manage these. I know i mustn't just stop, and i won't. I also don't want to sit twiddling my thumbs whilst i wait for the calendar to reach the six month mark all the while knowing the drug is likely inflicting further damage.

 

You picked up on my impatience which i feel. I resisted the AD option till other options failed (as i saw it) and reluctantly took the AD route. The 10% tapering method gave me hope that i could safely start to taper sooner. As the rationale behind the "six month minimum" may be fallacious. More reading!

[Gridley]

2 hours ago, Chispa said:

whilst i wait for the calendar to reach the six month mark all the while knowing the drug is likely inflicting further damage.

There's no need to wait six months. Yes, it is fallacious.  The less time you're on the drug, the better.   As long as you're in a good spot at the moment (and it sounds like you are) the sooner you start tapering the better.  Just keep reading about the coping skills.  Keep with the 10% and you're good to go.

[Chispa]

Hello reporting on progress. I bought a pill cutter as other options weren't available to me here in UK. The taper was going smoothly so i tried to go a bit faster and increased the taper amount...but that resulted in symptoms so after a few days went back to previous dose and my system calmed down and i stabilised. I stuck to the approx 10% and shortened the time window a bit...and came off last dose 4 weeks ago smoothly. By smoothly i mean symptoms were tolerable and manageable. Then the Windows and Waves phenomenon kicked in. I found it such a relief to know these are physiological symptoms. Overall, i could feel my mind clearing, the grogginess gone. Underneath the surface symptoms something felt good. I had one bad acute crisis last week. I reached out for support from friends and others and was helped. I decided to take a product called Calm by BodyBio. This has helped without any bad side effects, except one night i maybe took one too many in an attempt to get more sleep and felt a bit of a hangover the following morning. I was in the midst of a nutritional protocol when i started Mirtazapine and carried on with that throughout. My doctor (integrative physician) suggested additional support at my request in the form of PEA (Palmitoylethanolamide)

I turned to the Calm product when i ran out of PEA. As well as using  Havening Technique for reducing anxiety, lying on my back with legs up against the wall which is effective to my surprise. All this usually when awake in the night. I fall asleep easily but do not stay sleep. I was averaging 2-3 hours sleep which improved to 3-4 hours. Once it was 3am no hope of more sleep...until last few days when i have got back to sleep and experienced a deeper quality sleep for an hour or two. My daytime background anxiety level is reduced considerably too today. I am tired, but not wired, as the saying goes.

[Chispa]

Edited because I found answer to my question

Edited August 17, 2021 by Chispa
Found answer

[Chispa]

7 weeks off mirtazapine. I'm experiencing a window! Oh the bliss. I feel I don't want to move or do anything that might disrupt this! The 'waves' have made for a rocky time lately. Especially after i had a fall. I suffer those morning cortisol spikes. Some days mild ones, other days severe. I relate to that jolt feeling described by others on here. Practising being in the moment, letting it wash through my system without panicking... I've started using tapping technique (EFT) not necessarily Also Havening Technique which i find soothing; it involves stroking the arms, hands and face. Some early mornings have been so grim, then there is the exhaustion from not sleeping. Feels so good to be having this better day. 

[Escitalopram21]

Hello @Chispa!

how are you doing?

[Chispa]

On 12/6/2021 at 7:51 PM, Escitalopram21 said:

Hello @Chispa!

how are you doing?

Hello @Escitalopram21

Thank you for asking😊 it's made me think and review.

The short answer is very much better. Post-withdrawal effects have diminished to the point i don't think about the drug any more or the waves and windows. I started sleeping better, as in there has been improvement on the very bad pattern i was in. Still a way to go sleep-wise. I don't feel my brain chemistry is being scrambled anymore. I am still experiencing anxiety  generally triggered by circumstances and life's challenges (including pandemic stress). It is possible that supplements i introduced at the recommendation of my integrative doctor have helped. The timing coincides. Early mornings are still difficult sometimes but not every day nor as severely as before.

I am using herbal valerian tablets 385mg most nights. I took double the dose at first some nights but now just the one as i began to find 2 tablets have me a sedated hangover feeling the next day.

I am experiencing calm days from time to time where I barely need to manage my mood or anxiety state. Which is bliss. Interspersed with difficult days where sleep deteriorates and i struggle. Needing to make decisions seems to increase anxiety levels. And certain situations don't have easy answers. How to care for my mum, for example.

i started reading the book Dare which i found helpful then stopped as i was managing okay. I haven't gone back to it so far. 

I am using some EFT tapping again. And the Havening stroking technique. It's been great to have a break from using the meditation apps. Sometimes they get on my nerves. Listening to regular podcasts or other material works in getting to sleep or relaxing too. Trying to engage in real world activities that have the side effect of reducing anxiety, rather than the previous focus on activities primarily about reducing anxiety so i could function. Switching between both approaches as necessary.

Best wishes, Chispa