Alex3: total insomnia after 6 months reinstatement

[Jools44]

@Alex3 have you considered using pharmacy scales and tapering with the tablet instead?

 

Not everyone gets on with the liquid (although it is still early days and you would likely stabilise on the liquid in time). 

 

I understand your weariness with it all though, I feel much the same way. 

 

[Faure]

I don’t think making a decision based on one night is a good idea. Not being a Mod I don’t know what to recommend but my thoughts are to give it a week on the liquid to see how you get on. Or, as Jools44 says get a pill grinder and make up tablets. I’ve gone from 15 to 4.8 grinding and weighing. It’s all gone very smoothly. At some point I’ll need to switch to a liquid but I’m not sure when. First I’ve got to get through a brand switch.  I’d suggest tagging a mod who has helped you before to ask for their opinion. 

Edited October 7, 2022 by Faure

[Alex3]

Hi both, thanks for responding

 

I've never been happy with the liquid, even during the first failed taper 2020-2021. Tiny syringe of a few drops fired into the back of the mouth and then washed down with some water. Something very unconvincing about it

 

I really think I'd be better sticking with the Accord pill brand I've been stuck on for much of this time and then manipulating that into a powder and doing what's necessary.

 

What about when I get to the very tiny doses? Is it still viable then with a spreadsheet and maths?

 

Can you help myself to get the ball rolling with this? Medical, digital scales, a pestle and mortar and then use a liquid suspension or can the weighted powder be dispensed in a capsule for consumption?

 

Does your Dr agree to finely grinding the pills down? I fear my Dr may not and insist on the liquid

[Jools44]

@Alex3 you don't really need to have your doctors permission to taper using the tablets. As long as they keep prescribing them you can taper your own way. You can just say that now isn't the right time to attempt to taper and ask to go back on the tablets. That's the cheaper option for them so they shouldn't put up a fight.

 

Unless you're very lucky you'll find the advice from your GP is not based on reality. They don't understand withdrawal, period. 

[Jools44]

@Alex3 I truly sympathise with your situation. I'm not sure I have the strength for this journey but the thought of staying on this med purely because I can't stop it, well that bothers me immensely too.

 

If you take it super slowly with no particular end date in sight, just go at a pace that you can manage, you might surprise yourself. 

 

Have you thought about contacting the Bristol tranquilliser project? Their phone lines are often very busy but they may be a life line for you for when you need help and reassurance. They've helped thousands of people off benzos and antidepressants. 

[Alex3]

@Jools44

Thanks Jools. How's your own journey btw?

 

Yeah, it's a bit tricky. Doctors just look at you with an incredulous face when you talk about withdrawal, beggar's belief and of course your family members are nonplussed

 

I may head round now to the Docs and say that I'm sensitised and that I'd be better doing my homework on the Accord pill to turn into a weighted powder that can go into a gelatinous capsule...

 

Slight tangent, but can we access the likes of Moncrieff and Horowitz for a consultation? Or are they fully booked

[Alex3]

@Jools44

 

Thanks again Jools and excellent advice regarding Bristol tranquilliser and going at my own pace

 

I just fear I'll never have my old sleep back. Even when I was stressed and wide awake for hours, my circadian rhythm would always kick in and send me off to sleep for many hours. More of an owl than a lark, but the sleep always came. Since starting these meds I'm absolutely terrified that the sleep issue will be permanent....

[Alex3]

@Faure I think grinding and weighing the Accord to place in a gelatinous capsule will be best for continuity. Back later, going round to the Dr's for a chat with dispensary. On annual leave this week

[Jools44]

@Alex3 yes that’s one of my biggest concerns too, but it does seem like sleep returns for most if not all that are able to get off it. 
 

But insomnia during tapering is a major issue for those coming off this drug, there’s no avoiding that unfortunately and it’s developing coping mechanisms to deal with it. Not easy.

[Alex3]

Just back from the dispensary

 

Tried to be concise!

 

I think that ultimately, I'll be far better placed by sticking with the Accord pills and converting it into a powder that can go inside a gelatinous capsule.

 

Waste of a new Mirt bottle, but I think this seems a far more stable, continuous way to taper.

 

Taper down using own solution and can revert to splitting the pill at 7.5mg, all the time sticking with the same brand

[Faure]

Sounds like a plan. Try to stock up on Accord brand. They don’t get the same ones in over time and switching brand is also tricky.  Let me know if you want links to scales, pill grinder etc that I got and am very happy with ☺️

[Alex3]

Thanks @Faure I've just been discussing it with my patient mum and (she also works at a local Dr's surgery) and having broken it down she says it does make sense

 

So, back to the 15mg Accord tonight during this period of due diligence and then we'll look to taper once all the pieces/components are in play

 

Feel a sense of relief to have reached a conclusion, thanks all for being a sounding board. That 6 week liquid Mirt never convinced myself (anyone else the same/similar?) and my CNS is far more comfortable with the Accord. Will ask about stocking up on that brand (the label changed in recent times, but the pills are the same as ever)

 

Please fire over all necessary links to equipment, many thanks once again

 

 

[Faure]

Pill grinder - I treated myself to a nice one as I’ll be doing this for several years!

Capsules

Scales

 

Be sure to calibrate the scales every time you use them. Also, as you seem very sensitive it would probably be good to consider the BrassMonkey slide. I haven’t looked to see if I’ve mentioned this before, but I’m doing it and it’s been pretty smooth. WD effects all mild and short lived for me. No loss of stability, no days off work, only small and steady improvements. (It was harder at first, but has got much easier as time went by)

 

Let me know if you want chapter and verse on making up the pills!!! 
 

I’m glad you seem to be feeling better about things ☺️👍

[Faure]

Btw have I mentioned meditation? Do you do it?  It’s the best thing I ever did, really helps me start calm when I can’t sleep. I don’t even mind much these days if I take a couple of hours to get to sleep! It has impacted *so* many areas of my life for the better, I’m calmer, more patient, nicer to other people and to myself!

[Alex3]

Thanks @Faure a) I've come to a decision (phew) and b) I'm taking a course that really tailors to my own circumstances and allows myself to go at my own pace too. Converting these pills to powder is clearly working very well for yourself and I can see why

 

Meditation, yes. I spend a lot of time in solitude, walking in the countryside, trying to lead a quiet peaceful existence. I'll often lie there at night during the insomnia and sometimes play some binaural beats. Meditation v overthinking can be a battle I'll admit (the battle itself is really the antithesis of meditation), but accepting step by step that there's a way beyond this with patience and fortitude is essential. I don't have a mortgage and family so I can do this at my own pace as @Jools44 says above, don't have too much of an end goal to fixate on, just take it day by day, step by step

[Alex3]

Very reassuring stuff @Faure thanks. Interesting that it was tough for yourself at first, but then got easier. I believe this SERT Occupancy means 90% of the 15mg Mirt lies in the 7.5mg segment. Another reason for the failed taper. It would be great to at least get to 7.5mg, almost feels like that would be the edge of the frontier!

 

I will patiently and painstakingly make sure these powder weights are on point. One thing, the scales and pulveriser are already in m Amazon basket, but the gelatine capsules are no longer available... please could you link myself to the nearest ones to your recommendation?

[Faure]

You want size zero capsules, you’ll have to decide what price you want to pay, but something like:

 

https://www.amazon.co.uk/Empty-Gelatin-Capsules-Size-1000/

 

☺️

[Alex3]

Thanks again @Faure Is it worth getting two scales in the same way one may buy two carbon monoxide detectors?

 

Just messaged Bristol Tranquiliser Project

 

Only slept between 10-2ish, not great, but shows how one night of the liquid can disrupt. I know the drill now and in the coming days the 15mg Accord (Used to be a purple North Star box, now a navy box, but the actual pills and pill packets are the same) will kick in again

 

James Moore seemed to relatively quickly at the end? Can see myself going v slowly at the likes of 1.5mg (for example) than jumping off

[ChessieCat]

Many members find that the lower their dose gets the slower they need to go, reducing less and/or holding for longer.

 

Why taper paper: dose-occupancy curves

 

When to end the taper and jump to zero?

[Faure]

2 hours ago, Alex3 said:

James Moore seemed to relatively quickly at the end? Can see myself going v slowly at the likes of 1.5mg (for example) than jumping off

When I heard James Moore speak at a webinar sometime in the last year it struck me that he was still struggling post finishing his taper. My thoughts were that it sounded to me like he went too fast (using tapering strips from The Netherlands) and might have had an easier time had he gone slower. Of course I don’t know his circumstances and whether there was a medical reason he needed to get off faster. Perhaps there was. 
 

Speaking from my own experience things have got better and better as my dose has reduced. To the point that now, at 4.8mg I am feeling the best I have felt for about 4 years (possibly better than I felt pre taking mirtazepine and before I got very ill leading to me starting to take it). I have been very impatient since I started the taper in June 2021.  Always thinking about going faster, always wanting to reduce the 2 week hold to 1 week. A close friend and BrassMonkey have encouraged me to stick to the plan and I am so glad I am. Life gets better and better and I can do more of the things I want to do (only 16 months into a 4-5 year taper).  So for me I always end up concluding that it is not worth taking any risks and I stick to the plan (despite my regular speeding up debates- I’ve accepted it’s part of my process!!!). I am better, life is better and I take no risks. It’s the safest way. I’m finally starting to build up some extra work that means I can at last do more than just take care of life’s essentials. I don’t want to put any of my wonderful progress at risk. I’ll be getting as low as I can before stopping. 
 

So my advice is to start, and stick to the plan. Hold if you need to.  The most important thing is to get off and stay well, not get off and have years of debilitating post WD symptoms. I’m glad you’re feeling optimistic about things ☺️. I hope things settle dow for you now you’ve decided against the liquid. Perhaps once your sleep is settled for a few weeks you could start? I will warn you, for me week 1 was by far the hardest, 4 nights after starting I barely slept, it was he worst though, from then on it took 2-3 hours to fall asleep and has got better and better since. I guess my point is don’t be put off if it’s hard at the start. I didn’t start till I was wholly committed and I’m glad I waited an extra few weeks to feel that way. I have not wavered since starting. Just done a few longer holds when life got a bit stressful as it does. 
 

I don’t think 2 scales are necessary, I just use the one and replace the batteries once a year. Taperoff.co is BrassMonkey’s website that makes a tapering plan automatically if you need it☺️

[Alex3]

@Faure

 

Brilliant post.

 

I'm pretty frazzled/sensitised at this stage (may be a case of also having to taper from the Citalopram month use too) and was doing very well up until the past week where the sleep pattern went off (annual leave) and the one night of the liquid. Will wait for a reset before starting the Accord/North Star taper. Do you pulverise the whole tablet or just one half of the 7.5?

 

I think in James Moore's case, he was struggling with insomnia pre-Mirtazapine and he possibly got fixated on "exposure time" and possibly got to the stage where holding on the lower doses wasn't good for him and thought that he needed to bite the bullet and get on with life beyond Mirtazapine. He'll get there over the years to come.

 

Great to hear how well you're doing. I remember getting to 7.5ish and people remarking how sharper and responsive I now was. I think being patient like you are now at the likes of 4.8 is the play and perfect balance

 

I'm going to settle back on the 15mg over the forseeable, do my homework and due diligence before a real slow micro-taper

 

Taperoff.com, excellent

 

Thank you for the heads up regarding the opening stages. Essential info

 

[Faure]

I make up 7 tablets at a time, so when you start you’ll need to pulverise all 7 and then weigh out 7 identical amounts. Much better this way as it’s all done in about 15 mins (when you get the hang of it) just once a week, rather than daily. I also like to believe doing it all in one go gives the best chance of getting identical weights with the calibration etc. These days I use just over 2 pills a week, so I usually pulverise 3.  Here is how I do it: 

 

Step 1, only necessary the very first time: weigh three whole pills and divide the total weight by 3 to get the average weight per pill. Put this into taperoff.co to get the reduction schedule. Print reduction schedule and if you’re at all bad with numbers change the decimal points so the schedule looks the same as the scale readout ***

 

Step 2 calibrate the scales

 

Step 3 grind 7 pills, I put the powder into an egg cup and stir it with a toothpick, including the outer layer of the pills (my outer layer is yellow and the powder is white). 
 

Step 4, open a capsule. Using a teaspoon scoop up some powder and using a toothpick knock it into the measuring tray till you get the right weight. I take off excess powder with the tweezers that come with the scale. 
 

Step 5 tip the powder into a folded small piece of paper and use this to transfer the powder into the capsule. Don’t worry about microscopic bits not making it into the capsule. 
 

Step 6 repeat till 7 pills are complete and store spare powder in a separate capsule for next time.  I then use this powder first in my next session. Be sure to keep pills in the dark. 
 

***Nb while your active ingredient weighs 15mg, the pills themselves weigh about 150mg because of fillers. Fortunately it’s a factor of 10 bigger so even I could manage the difference although I didn’t understand till a friend explained 😂😂. On the taperoff document I convert all the numbers so they match the scale readout. E.g your first reduction might be from 152mg to 148 and on the scales this will read 0.152 and 0.148 - if you’re good at numbers then I didn’t need to point this out!

 

Happy to answer any more questions when the time comes ☺️

[Alex3]

Amazing @Faure

 

Will study this this evening

 

Reassuringly you also seem to have a relatively similar history by the looks of things

 

Second night back on the Accord/North Star and slept well all the way through between 10-7 so that was a relief and much needed

 

Kit ordered via Amazon eu Sarl. Fingers crossed it’s the best £50 I’ve ever spent

 

Slight tangent, but check out this article:

 

https://www.dailymail.co.uk/news/article-11293873/amp/Brussels-ISIS-Brussels-airport-bomb-survivors-mother-BACKED-23-year-olds-decision-euthanised.html

 

11 anti-depressants and/medications a DAY, 11

 

I’d be begging for the euthanasia at that point

 

Trauma didn’t kill that girl, it was medication (I appreciate that‘s a hell of thing to say)

[Jools44]

@Alex3 11 antidepressants would be enough to kill every emotion. You would be left a total zombie. It’s no wonder she wanted to die, poor girl. 

 

When I read news stories now about people taking their own lives whilst they’re taking AD I now just assume it’s the drug that was the problem rather than the reason why the person was taking the drug in the first place. Pre withdrawal I would have put it down to the mental health “problem” but now I know better.

 

[Alex3]

@Jools44 it's lunacy, utter lunacy. Beggars belief and obscene

 

Think of the nightmare that is human history, particularly the last 1000 years. Horror show after horror show, though granted, people had religion as their base/protection. Even so, many found a way to exist in line with their trauma(s). They didn't have these horrific drugs plowed into them.

 

She needed a night or two knocked out with a benzo and then round the clock care to keep her emotionally safe and time to process when malevolence hits. Just my two cents

 

Random question, momentarily back to the original tangent, does anyone here take the Accord/North Star brand of Mirtazapine?

[Alex3]

Sunday evening and I’m suffering a blip, possibly a wave

 

Thursday - liquid

Friday - 10 - 2

Saturday - 10 - 7

Sunday - became drowsy, but had visual disturbances and now tingling all over. Seemingly from just one night of using the liquid comes this setback. All out insomnia once more, but I think when there’s a blip, it’s one good night then a poor one then a good one, then a poor one and so on for a few days.

[Alex3]

The CNS has seemingly calmed now at least. Another sleepless night

[PistolShrimp68]

@Alex3

 

Sorry about that…I have the same issues. No one understands unless your going through it. I wish you the best 

[Alex3]

@PistolShrimp68 Due back off annual leave tomorrow. May have to knock it on the head.

 

I’m okay compared with hours previously. Seems just one night of the liquid (the failed taper of mid 2021 coincided with a new bottle too) has caused a setback.

 

Will hold at 15mg Accord/North Star and consume just some rice and salmon tomorrow. 
 

One day of liquid = windows and waves possibly…

 

Just spent some time going over my comment history. Serves as a decent log for context

[Alex3]

Yet another torturous night, not a wink

 

May have to resort to a low dose Zoplicone tonight

 

All because of the liquid for 1 night

[PistolShrimp68]

I’m very sorry to hear that and I truly know what you’re going through. To me it’s like being trapped in a nightmare and I can’t wake up. Hang in there and I hope you get some relief.

[Alex3]

It truly is @PistolShrimp68, it truly is

 

S ideation becomes prominent

 

Anyhow, just had some food and walked in the sunlight for 24k steps

[Alex3]

I appreciate I'm doing a running commentary, but where we would be without this community?

 

Anyhow, just a note to say I've not touched any Zoplicone or Benzo since January 2022

 

Prior to that it was a small stretch in June 2021

 

Prior to that was autumn 2017 for a night

 

Very, very cautious with those. Sounds like the lowest depths of hell when they get their claws in

[Alex3]

Slept well last night 10-7/8 - quirky dreams, but hey ho

 

Thursday - liquid

Friday - 10 - 2

Saturday - 10 - 7

Sunday - Zilch

Monday - 10 - 7/8

 

This morning's headache has largely faded and I've had a decent walk with the autumnal sun

 

Back to WFH

[Alex3]

Thursday - liquid

Friday - 10 - 2

Saturday - 10 - 7

Sunday - Zilch

Monday - 10 - 7/8

Tuesday - stabilising / functioning

Wednesday - stabilising / functioning

 

slowly getting there. Brass Monkey, edging Micro Taper when the time comes. Will possibly wait till spring to even start. Was getting paranoid about "exposure", but at this point we have to accept that its claws are in and the only possible route is an indefinite, marathon taper

 

[Alex3]

Hello all, settling down to as much stability as can be expected on 15mg Mirtazapine

 

Just contacted Bristol Tranquilliser Project and had a good preliminary chat

 

Waiting for the scales off Amazon too

 

Best wishes,

Alex