LiaJ: overwhelmed by deluge of information, mirtazapine tapering, ? updose

[ChessieCat]

Q:  Was the contrast dye the only thing that was different?

 

Q:  Where you taking any new drugs, eg antibiotics or pain killers?

 

It's very easy to overlook other things when there has been a major variable; it causes a bias in our thinking.

 

Q:  Did you make a reduction on 3rd November?  If yes, then it could be related to that and nothing to do with the dye.

 

If this is correct then you made the reduction very close to the time you had the contrast dye.  SA recommends making only one change at a time.

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

If you did make a reduction around the same time then it is difficult to know what is causing the current symptoms.

 

Q:  Did you reduce from 2.85mg to 2.3mg?  If yes, that is more than 10% reduction.  = 19.2982% decrease

 

A 10% reduction would have been 2.565mg

 

Also the symptoms you are experience might be related to the reason you had the CT scan.

 

 

 

 

 

 

[LiaJ]

Thank you for your quick reply!

Yes, the contrast was the only thing different.

No, I am not taking any new drugs at all. Didn’t even take ibprofen. 
I last made a reduction about 4-5 weeks ago. My signature doesn’t reflect exactly how I’ve been tapering. I’ve been making about 5% reductions every 6-8 weeks. 
 

I think last night I accidentally took twice the amount of magnesium. I think I took it, went to brush my teeth, etc, came back to bed and took it again, forgetting I had already taken it. Still, would that really cause a reaction like this? 

 

Edited November 9, 2020 by ChessieCat
removed quote

[ChessieCat]

4 minutes ago, LiaJ said:

I last made a reduction about 4-5 weeks ago. My signature doesn’t reflect exactly how I’ve been tapering. I’ve been making about 5% reductions every 6-8 weeks. 

 

Could you please add this info to your drug signature.  It is very confusing to know what you are taking and how you are tapering and means that the mods are trying to guess.  We also don't have time to check back through your posts to try and find the information, which may not be there anyway.  Thanks.

 

Well it could be related to this.  Q:  Did you do more physical exertion that you usually do?

 

On 11/3/2020 at 8:44 PM, LiaJ said:

I was having vision disturbances after lifting weights at home. I called my PCP (the doc more or less supporting my taper) who is in another city, and he suggested I go to the ER to be evaluated. My vision was blurry w/strange blinking lights. Everything from the test was normal and fine and they diagnosed me with a migraine, which I’ve never had before. Now I’m of course mad at myself that I potentially complicated my WD for absolutely no reason. I laid in bed all night awake with gut wrenching anxiety and a racing heart. 

 

If you think it was an adverse reaction to the contrast dye then I suggest that you discuss it with your doctor.  SA doesn't advise on general medical issues.  However, we do understand that it might have an effect on your withdrawal symptoms.  But they are really two different things.

 

Whatever the cause, I suggest that you do a nice long hold on your current dose and get nice and stable before reducing again.  And when you do reduce again you might consider doing a tiny reduction as a test.

 

14 minutes ago, LiaJ said:

I think last night I accidentally took twice the amount of magnesium. I think I took it, went to brush my teeth, etc, came back to bed and took it again, forgetting I had already taken it. Still, would that really cause a reaction like this? 

 

I doubt it.  You were getting symptoms before the possible double dose of magnesium.  And at least it wasn't double Zyprexa!

[LiaJ]

38 minutes ago, ChessieCat said:

 

Could you please add this info to your drug signature.  It is very confusing to know what you are taking and how you are tapering and means that the mods are trying to guess.  We also don't have time to check back through your posts to try and find the information, which may not be there anyway.  Thanks.

 

Well it could be related to this.  Q:  Did you do more physical exertion that you usually do?

 

 

If you think it was an adverse reaction to the contrast dye then I suggest that you discuss it with your doctor.  SA doesn't advise on general medical issues.  However, we do understand that it might have an effect on your withdrawal symptoms.  But they are really two different things.

 

Whatever the cause, I suggest that you do a nice long hold on your current dose and get nice and stable before reducing again.  And when you do reduce again you might consider doing a tiny reduction as a test.

 

 

I doubt it.  You were getting symptoms before the possible double dose of magnesium.  And at least it wasn't double Zyprexa!

No more physical exertion than normal. I am hesitant to discuss with my doctor. What would they do, after all, other than more drug treatments I wouldn’t accept anyway? Very distrustful of doctors, and increasingly more so after this event. 
 

I did quit caffeine cold turkey four days ago. I’m not sure if that would have anything to do with this. I have never had these symptoms before the contrast dye, nor the difficulties with magnesium, so I am assuming it was the contrast. Am I the only one who has had a bad reaction to contrast dye in WD? 
 

also I updated my signature. I made my last cut early October. It was 10% then I had issues with 10% so I bumped back up to 5%.

[Hanna72]

Hi @LiaJ

28 minutes ago, LiaJ said:

Am I the only one who has had a bad reaction to contrast dye in WD? 

No I have had bad reaction to the dye contrast. What I have experienced is this bad reaction when I was off the drugs, never had it when I was on my med. I link it to very sensitive central nervous system and being afraid of everything I consume now regarding medication. 
 

[LiaJ]

3 minutes ago, Hanna72 said:

Hi @LiaJ

No I have had bad reaction to the dye contrast. What I have experienced is this bad reaction when I was off the drugs, never had it when I was on my med. I link it to very sensitive central nervous system and being afraid of everything I consume now regarding medication. 
 

Glad to know I’m not the only one. I had another like reaction to magnesium I took last night and have been up with gut wrenching anxiety. I’m afraid I’m even more sensitive than I was before. Setbacks are so discouraging. 
 

Did you tell your doctor you had a bad reaction to the dye?

[Hanna72]

@LiaJ

2 minutes ago, LiaJ said:

Did you tell your doctor you had a bad reaction to the dye?

No I haven’t. But I will address it next time I have my scan. Might want to see if I can have it without the contrast dye. Or maybe I will have a stronger nervous system by then 😉

 

4 minutes ago, LiaJ said:

Setbacks are so discouraging

Yes they are, but I believe our system gets stronger in time, we just need to be patient. 
You will be fine🙏

[LiaJ]

4 hours ago, Hanna72 said:

@LiaJ

No I haven’t. But I will address it next time I have my scan. Might want to see if I can have it without the contrast dye. Or maybe I will have a stronger nervous system by then 😉

 

Yes they are, but I believe our system gets stronger in time, we just need to be patient. 
You will be fine🙏

I am losing hope today. I’m worried about the future. How are you doing today? I would like nothing more In the world than to just talk to someone who knows what’s going on. 

[Hanna72]

@LiaJ

I know this journey can be hard and scary at times. I am right here to support you. Everyone in here understands. You are not alone 
 

1 hour ago, LiaJ said:

I am losing hope today

Please don’t loose hope, it’s very important to have faith. Some days will be better then others, that’s just how this path goes. 
Make a decision that you will do everything you possibly can to work on your end goal. Sometimes we fail and that’s ok. We can look at our setbacks  as pointers that another option is available and might work better then the once we have tried. There is no perfect way through this WD, but we always have a choice to work as best we can to learn from every obstacle we face. 
Never quit, keep on going no matter what, that will lead to your success 🙏

 

 

 

[LiaJ]

51 minutes ago, Hanna72 said:

@LiaJ

I know this journey can be hard and scary at times. I am right here to support you. Everyone in here understands. You are not alone 
 

Please don’t loose hope, it’s very important to have faith. Some days will be better then others, that’s just how this path goes. 
Make a decision that you will do everything you possibly can to work on your end goal. Sometimes we fail and that’s ok. We can look at our setbacks  as pointers that another option is available and might work better then the once we have tried. There is no perfect way through this WD, but we always have a choice to work as best we can to learn from every obstacle we face. 
Never quit, keep on going no matter what, that will lead to your success 🙏

 

 

 

Thank you for your kind words. I really needed to hear this today. 

[Krisseyb]

@LiaJ Don't give up....you are giving hope to people like me who is just starting my journey. Hang in there!!!

 

[LiaJ]

Accidentally dosed twice?

 

 

Hi everyone,

 

I think I might have accidentally taken my Mirtazapine twice tonight. I am so bad at remembering sometimes. 
If I did take a double dose, it would mean I took 4.6 mgs and not 2.3 mgs. 
Does this mean I have set myself back in my taper? It’s taken me a year and a half to reduce that much. 
 

 

Edited November 19, 2020 by ChessieCat
added topic title

[ChessieCat]

You just go back to your normal dose from the next time you are due to take it.  You aren't the first and you won't be the last to do it.  I have a system set up for taking my dose and even with that I mess it up sometimes.

 

Things might be a bit unsettled for the next week or so, but it should gradually settle down.  At least you know about the possibility of your double dosing so if your symptoms change you know the cause.  And sometimes that is half the battle.  When we don't know the cause it adds more stress which can make things even worse.

 

The main thing now is to accept that you have done it and that you cannot change it so try not to stress about it and get mad at yourself.  What's done is done.  What you need to do now is to try and stay as calm and stress free as possible and "go with the flow".

 

If you notice a change in your symptoms just remind yourself that it's because you double dosed and that it will settle down again soon.

[LiaJ]

Ok, thank you for responding so quickly. I appreciate it.

 

Edited November 19, 2020 by ChessieCat
removed quote

[LiaJ]

Tinnitus suddenly worse in one ear?

 

I feel as though lately I may be concentrating a bit too much on my symptoms. I have recently developed tinnitus in my right ear that is unremitting and quite a bit louder than normal. Typically I would have ringing in my ears that came about after drinking coffee, or running, or sex, or showering, and would typically calm down in the evening. In the last four or five nights this kind of ringing has been relentless. 

Is this common to develop this suddenly? I have stopped taking magnesium recently too, because I took it one night and it seemed to be bothersome, but I had a bad reaction after a CT scan nearly a month ago due to contrast dye and I’ve been slightly off since. 

My anxiety has been more intense lately too. Particularly at night. Is it possible that my taper (which I think is painstakingly slow already) has caught up to me and now my body is freaking out? I’m starting to have quite a bit of health anxiety and just being plain sick of the tapering, the worrying, the fear of the future, the lack of understanding from friends and family, the wondering if this will ever end...

 

Thanks for listening. Hope everything is ok on your end out there.

 

Edited November 22, 2020 by ChessieCat
added topic title

[ChessieCat]

8 minutes ago, LiaJ said:

I have stopped taking magnesium recently too, because I took it one night and it seemed to be bothersome, but I had a bad reaction after a CT scan nearly a month ago due to contrast dye and I’ve been slightly off since. 

 

There have been at least 2 variables recently so it is difficult to know if either or both is causing the tinnitus.

 

And because symptoms can change even without any variations, it might have happened anyway.

 

tinnitus-what-does-all-that-noise-mean

 

From https://www.hearingyourbest.com/does-stress-make-tinnitus-worse/

 

Quote

 

For those with tinnitus, or constant ringing in the ears, there is a strong connection to stress. The human body can respond to stress in physical ways by tensing muscles, increasing breathing rate, and by producing chemicals consistent with a “fight or flight” response. The response to tinnitus and certain external sounds may also cause this same response.

 

 

[LiaJ]

Titled:  Determining target exit dose of Mirtazapine

 

Hello everyone,

 

I am reading the post (kindly written by Brass Monkey) to illuminate the process of determining when to jump at the end of the taper. My understanding is that these medications must be tapered to fractions of a dose due to a phenomenon known as SERT occupancy, or the volume at which the serotonin transporter protein binds to the medication. SERT occupancy, in my understanding, is what casts the rule of "there's no such thing as a small dose of a psych med".

I was reading an article in the Journal of Neuropsychopharmacology about SERT occupancy, and it explicitly states that Mirtazapine (drug I am taking) does not bind to the serotonin transporter at all.

 

Does this mean, essentially, that this drug does not have to be tapered to infinitesimally small dosages? 

I am having trouble determining, with this information, the appropriate exit dose. I am taking the drug in a liquid suspension, therefore it is also impossible to determine the active concentration, though there are 30 ml in each bottle and each ml doses 3 mgs. I am not taking a full ml, but rather 6.5 of the whole, and am at 1.95 mgs.

 

Please advise, and thank you!

Edited January 12, 2021 by manymoretodays
merged from tapering stand alone topic, back to member's Introduction

[manymoretodays]

Hi LiaJ, @LiaJ

 

I merged your stand alone question, topic, back here.  And this works well, as it keeps all your information, and progress together.

 

On 1/10/2021 at 2:59 PM, LiaJ said:

My understanding is that these medications must be tapered to fractions of a dose due to a phenomenon known as SERT occupancy, or the volume at which the serotonin transporter protein binds to the medication. SERT occupancy, in my understanding, is what casts the rule of "there's no such thing as a small dose of a psych med".

I was reading an article in the Journal of Neuropsychopharmacology about SERT occupancy, and it explicitly states that Mirtazapine (drug I am taking) does not bind to the serotonin transporter at all.

 

We generally use the same principle, and apply it to other drugs/medications as well.  Like say some of the drugs that mess with the Gaba receptor system, or those that mess with other receptor systems, like norepinephrine, or dopamine.

Remeron/mirtazapine- Drug class: Noradrenergic and specific serotonergic antidepressant

And so the difference is that it's not a reuptake inhibitor I think. 

 

The 10% principle still applies however, tapering by 10% or less of each previous dose.

On 1/10/2021 at 2:59 PM, LiaJ said:

Does this mean, essentially, that this drug does not have to be tapered to infinitesimally small dosages? 

I am having trouble determining, with this information, the appropriate exit dose. I am taking the drug in a liquid suspension, therefore it is also impossible to determine the active concentration, though there are 30 ml in each bottle and each ml doses 3 mgs. I am not taking a full ml, but rather 6.5 of the whole, and am at 1.95 mgs.

 

I think you still need to keep tapering, carefully, with observation from your present 1.95 mg dose.  And then, in general, you are not going to want to jump, until somewhere below 1 mg, from my understanding of Brassmonkey's work, and what they've put together from some of the literature, and experiential knowledge.  And it does tend to be just a fraction of the amount that you started out with. 

(It's late here, and I just wanted to do a little work, but now I'm flagging.......tired, screen weary too. Or I'd go check it out myself too again, brassmonkey's article, and figure it out)

 

So I'll @brassmonkey here too, to weigh in as well.  And thankyou brassmonkey, second @ tonight, and appreciate your taking a look, when you have a moment.

 

How are you doing LiaJ?  Looks like you just tapered to 1.95 mg on the 1st.  How are you doing since that taper.

 

Okay, sleepy time for me, 

L, P, H, and G,

mmt

 

 

 

 

 

Edited January 12, 2021 by manymoretodays

[LiaJ]

Hi there, MMT. I'm doing alright, thanks! I am feeling pretty good these days. 

I am wondering if it's possible to heal while still on a drug...

How are you doing?

Edited January 19, 2021 by manymoretodays
Took out large quote, and just put in members response

[manymoretodays]

Hi LiaJ,

Yes, I expect that healing is ongoing, as the nervous system, including the receptors, and neurotransmitters adjust. 

And then with tapering gradually and slowly, most times I think there is less interference, or less, in the way of symptoms that occur.

 

How psychiatric drugs remodel your brain

and then if you scroll down to the 4th paragraph there, you'll see how it could apply to any psychotropic drug really.

And then this one is good too, meant to support and encourage:

What is happening in your brain?

you'll have to just generalize it a bit, as it refers to GABA and glutamine......yet even this author states that it applies generally to the other NT's too.

 

Any symptoms of note LiaJ, right now?  I see tinnitus, and anxiety, in some of the above posts.  Have those improved?  Any non-drug coping that has helped?

 

And have you noticed any patterns to when/if symptoms occur in relation to your taper drops?

 

And best, L, P, H, and G,

mmt

 

 

Edited January 19, 2021 by manymoretodays

[LiaJ]

On 1/18/2021 at 10:18 PM, manymoretodays said:

Hi LiaJ,

Yes, I expect that healing is ongoing, as the nervous system, including the receptors, and neurotransmitters adjust. 

And then with tapering gradually and slowly, most times I think there is less interference, or less, in the way of symptoms that occur.

 

How psychiatric drugs remodel your brain

and then if you scroll down to the 4th paragraph there, you'll see how it could apply to any psychotropic drug really.

And then this one is good too, meant to support and encourage:

What is happening in your brain?

you'll have to just generalize it a bit, as it refers to GABA and glutamine......yet even this author states that it applies generally to the other NT's too.

 

Any symptoms of note LiaJ, right now?  I see tinnitus, and anxiety, in some of the above posts.  Have those improved?  Any non-drug coping that has helped?

Actually, I've noticed something new occur lately. My muscles feel weak and shaky, but they aren't visibly shaky. I am exercising more as I am feeling better, running and lifting. But there is a new muscle weakness that is happening that is unsettling. Of course, the emergence of any new symptoms is unsettling in this process and I never really know if I should attribute it to withdrawal (acceptance, waiting it out) or seek medical attention. I talk to my therapist and my husband. I learn to sit with discomfort. Massage has helped tremendously. Distractions, reading, walking, watching drag queens on television, lol. Tinnitus and anxiety seem to be constant companions. I am in grad school currently, which is definitely complicating things. 

On 1/18/2021 at 10:18 PM, manymoretodays said:

 

And have you noticed any patterns to when/if symptoms occur in relation to your taper drops?

 

And best, L, P, H, and G,

mmt

 

 

 

[LiaJ]

Just now, LiaJ said:

Actually, I've noticed something new occur lately. My muscles feel weak and shaky, but they aren't visibly shaky. I am exercising more as I am feeling better, running and lifting. But there is a new muscle weakness that is happening that is unsettling. Of course, the emergence of any new symptoms is unsettling in this process and I never really know if I should attribute it to withdrawal (acceptance, waiting it out) or seek medical attention. I talk to my therapist and my husband. I learn to sit with discomfort. Massage has helped tremendously. Distractions, reading, walking, watching drag queens on television, lol. Tinnitus and anxiety seem to be constant companions. I am in grad school currently, which is definitely complicating things. 

 

And I notice increased anxiety primarily following taper drops, which sometimes affects my sleep. But overall my sleep has improved tremendously in the last three years.

[manymoretodays]

Hi LiaJ,

On 1/28/2021 at 3:49 AM, LiaJ said:

Actually, I've noticed something new occur lately. My muscles feel weak and shaky, but they aren't visibly shaky. I am exercising more as I am feeling better, running and lifting. But there is a new muscle weakness that is happening that is unsettling.

 

A couple topics that I don't know if you have seen......and it's even got a special name:

Asthenia: Weakness, muscle fatigue in legs, arms or body

 

Exercise....Do more, do less, do nothing? What worked for you?

 

I too, have managed to up the physical exercise, lately......and it's been great really, but as I gain strength and endurance........I just find myself overall more tired lately.  I mean I am feeling some of the burn as I get in shape, and no real shakiness......but just overall, a bit more tired.  Could be the season as well.  For me, the mental benefit far outweighs any worry about over doing right now.  It seems to work like meditation, and keeps me more grounded, and awake, alert,  during my waking hours.  I'm feeling much more quick on my feet, and able to react and respond better I think.  I feel like I had been living out of body for awhile, odd, but true.

 

And so, I am doing really well and thank you for asking.  I just sometimes need to step back, just a bit, for just a short period......which makes me sad, as I've got more I'd like to be able to pursue sometimes......but just don't have the time, and do not want to overwhelm this system of mine.  It seems prioritizing, is something I still need to work on regularly.

 

On 1/28/2021 at 3:51 AM, LiaJ said:

And I notice increased anxiety primarily following taper drops, which sometimes affects my sleep. But overall my sleep has improved tremendously in the last three years.

 

LiaJ,  this is awesome.  That you can see and know the patterns after tapers.......and then subsequently know what to expect.  As well as when to expect improvement again after tapers.

 

And yay, on the sleep improvement. 

 

Also great on Graduate School, as well as having some supports there, on the ground.

On 1/10/2021 at 2:59 PM, LiaJ said:

I am reading the post (kindly written by Brass Monkey) to illuminate the process of determining when to jump at the end of the taper.

 

And then:  Ollie Ollie Oxen Free, Managing the Endgame Taper

Now, we'll have this here too ^, for easy access. 

 

 

On 1/12/2021 at 12:14 AM, manymoretodays said:

I am taking the drug in a liquid suspension, therefore it is also impossible to determine the active concentration, though there are 30 ml in each bottle and each ml doses 3 mgs. I am not taking a full ml, but rather 6.5 of the whole, and am at 1.95 mgs.

 

And it is okay to continue using your liquid all the way with your taper.

And right now with 3 mgai(for mg active ingredient) per each 1 mL:

I got 1.95 mgai per .65 mL

 

And best LiaJ,

L, P, H, and G,

mmt

[LiaJ]

Titled: Specific Mirt tapering question

 

Hi all,

 

Wondering if someone who is or has tapered off Mirtazapine specifically has some advice. I've read articles about SERT occupancy that claim that Mirtazapine does not bind to the serotonin transporter protein. This mechanism, from what I understand, is what makes psych meds potent at small dosages. I am wondering if the 2 mgs I am on is even doing anything for me. It's hard to tell. I am still having symptoms but I don't know if they're withdrawal related anymore, or hormonal, etc. I CTd off Celexa in 2017, reinstated with Mirt 7.5 mgs, and have been tapering off ever since. Extremely slowly. I wonder if I'm going too slow. 

 

I'm also terrified of developing akathisia. The anxiety I have about that is disturbing. I wish I didn't know what it is. I think the anxiety of it is why I am tapering so slowly. 

 

Please advise. 

Edited February 18, 2021 by manymoretodays
merged from tapering, title added

[LiaJ]

On 1/5/2018 at 8:55 AM, joy2730 said:

Hi

 

I am following your journey if that is alright with you.  I have a few questions, but do not feel you have to answered them, if you are uncomfortable with them.

 

How old are you, just roughly in decades is a guideline and how is your functioning regarding work and relationships.

 

It is just good to have a solid background to the struggle.  Do you have a lot of support from friends and/or family?

 

I can assure you that many people do get out of being polydrugged with different combinations and some people find it relatively easy to get off antidepressants, but others do struggle.

 

You must not lose hope by reading this site, as people without problems probably would not join this site.  I think it confuses the doctors that some have no trouble and others do.

 

It seems to be quite common that people can get off the drug but then have a set back a few months out that involves insomnia or panic.

 

You will find lots of good advice and support here but sadly no quick answers.  When antidepressant withdrawal has been investigated by different governments and the medical profession a new way forward may be found.  It is being worked on but it is early days.

 

Joy

Joy,

 

I'm checking in to see how you're doing? I noticed your drug sig indicates you are "drug free"!! Congratulations!

[LiaJ]

On 11/10/2020 at 10:39 AM, Krisseyb said:

@LiaJ Don't give up....you are giving hope to people like me who is just starting my journey. Hang in there!!!

 

Hi Krisseyb,

 

You left a kind word that I missed  couple of months back. How are you doing?

[manymoretodays]

On 2/14/2021 at 1:55 PM, LiaJ said:

Titled: Specific Mirt tapering question

 

Hi all,

 

Wondering if someone who is or has tapered off Mirtazapine specifically has some advice. I've read articles about SERT occupancy that claim that Mirtazapine does not bind to the serotonin transporter protein. This mechanism, from what I understand, is what makes psych meds potent at small dosages. I am wondering if the 2 mgs I am on is even doing anything for me. It's hard to tell. I am still having symptoms but I don't know if they're withdrawal related anymore, or hormonal, etc. I CTd off Celexa in 2017, reinstated with Mirt 7.5 mgs, and have been tapering off ever since. Extremely slowly. I wonder if I'm going too slow. 

 

I'm also terrified of developing akathisia. The anxiety I have about that is disturbing. I wish I didn't know what it is. I think the anxiety of it is why I am tapering so slowly. 

 

Please advise. 

 

Hi LiaJ,

There are similarities to this question here, in the below post.

 

On 1/10/2021 at 2:59 PM, LiaJ said:

Titled:  Determining target exit dose of Mirtazapine

 

Hello everyone,

 

I am reading the post (kindly written by Brass Monkey) to illuminate the process of determining when to jump at the end of the taper. My understanding is that these medications must be tapered to fractions of a dose due to a phenomenon known as SERT occupancy, or the volume at which the serotonin transporter protein binds to the medication. SERT occupancy, in my understanding, is what casts the rule of "there's no such thing as a small dose of a psych med".

I was reading an article in the Journal of Neuropsychopharmacology about SERT occupancy, and it explicitly states that Mirtazapine (drug I am taking) does not bind to the serotonin transporter at all.

 

Does this mean, essentially, that this drug does not have to be tapered to infinitesimally small dosages? 

I am having trouble determining, with this information, the appropriate exit dose. I am taking the drug in a liquid suspension, therefore it is also impossible to determine the active concentration, though there are 30 ml in each bottle and each ml doses 3 mgs. I am not taking a full ml, but rather 6.5 of the whole, and am at 1.95 mgs.

 

Please advise, and thank you!

 

 

And I'll try to answer again.

(moved your post from tapering on back here again too, as it is more specific to your taper, and some fears about it too now.

 

I think you definitely should go lower than the 1.95 mg dose you are on now, before you consider jumping off.  And I'll see if I can get another moderator to comment on your questions, as well.  As now, I'm a bit confused as to what your questions are.  Could be related to me having to get to my own work right now too.

 

And okay, best,  thanks for your patience

L, P, H, and G,

mmt

 

 

 

[Krisseyb]

@LiaJjust hanging in there....the tapering seems to be going well for now. This week has been crazy in Texas with all this snow, things shut down, electricity and water issues...and nothing to do! But I’m handling it as well as I guess I can (emotionally)

how are you? 

[Altostrata]

Hello, Lia. The SERT curve is representative of the way a drug saturates your system, whether it binds to SERT or not (mirtazapine affects other receptors). 

 

You may be getting withdrawal symptoms after reducing your mirtazapine dosage. Mirtazapine has a long half-life, so withdrawal symptoms might appear even a week or 10 days later. You might keep notes on a calendar to see if those symptoms are appearing regularly. You are also correct in that they may be related to your menstrual cycle. Keeping notes may help you see what's what.

 

Since you were taking 7.5mg, I would not go off at 1.4mg, that's nearly 19% of your original dosage. A more likely jumping-off point for you would be 2.5% of the original dosage, or 0.1875mg.

 

On 1/28/2021 at 2:51 AM, LiaJ said:

But overall my sleep has improved tremendously in the last three years.

 

This is such good news!

[LiaJ]

On 2/19/2021 at 1:10 PM, Krisseyb said:

@LiaJjust hanging in there....the tapering seems to be going well for now. This week has been crazy in Texas with all this snow, things shut down, electricity and water issues...and nothing to do! But I’m handling it as well as I guess I can (emotionally)

how are you? 

Hopefully the weather is back to normal for you, and the storm damage hasn't been too severe where you are...

I'm doing OK. Having a pretty good week, actually, with good sleep, no symptoms. 

 

 

[LiaJ]

On 2/19/2021 at 10:48 PM, Altostrata said:

Hello, Lia. The SERT curve is representative of the way a drug saturates your system, whether it binds to SERT or not (mirtazapine affects other receptors). 

 

You may be getting withdrawal symptoms after reducing your mirtazapine dosage. Mirtazapine has a long half-life, so withdrawal symptoms might appear even a week or 10 days later. You might keep notes on a calendar to see if those symptoms are appearing regularly. You are also correct in that they may be related to your menstrual cycle. Keeping notes may help you see what's what.

 

Since you were taking 7.5mg, I would not go off at 1.4mg, that's nearly 19% of your original dosage. A more likely jumping-off point for you would be 2.5% of the original dosage, or 0.1875mg.

Thank you for the clarity on this. It also gives me a finite end point for my doctor's information as well. 

 

 

Quote

 

 

This is such good news!

 

[Krisseyb]

16 hours ago, LiaJ said:

Hopefully the weather is back to normal for you, and the storm damage hasn't been too severe where you are...

I'm doing OK. Having a pretty good week, actually, with good sleep, no symptoms.

@LiaJ Not too bad here...we were very lucky...no damage.
Glad you are having a good week, and glad you are sleeping good. That is my biggest worry/issue....but I just take it day by day. Hoping it gets better....!

[LiaJ]

Hi everyone,

 

I am in the middle of what appears to be a wave. I made a dosage reduction (5%) three weeks ago, and my sleep has been worsening for the last seven days or so. I also incorporated Vitamin C supplementation about a week ago, which is a supplement I tolerated early in withdrawal, but of course things can change. Last night I had severe anxiety and only slept for about 4 hours. This morning my anxiety is still high. I have no other symptoms other than anxiety, and of course I am sleep deprived. The change came on abruptly last night immediately after eating dinner, and I thought at first (this is going to sound ridiculous) that maybe the lighter fluid hadn't burned off of the meat my husband and I consumed last night, and that was what brought this on. I don't know if I should wait it out, or increase my dosage again, or if that would even help at this point, one because the drop was weeks ago, and secondly because it was a small reduction. 

 

What is disconcerting the most is the inability to attribute the change to anything directly. I don't know if I over-exerted myself at the gym, or if the fact my husband and I have been at odds lately, or if it's a combination of all of it. I don't know why I'm suddenly anxious about lighter fluid, we grill dinner all the time the same way. 

 

Thanks for your help. 

[getofflex]

Previous post moved to your intro to keep your history in one place.  

 

Please stick to your intro topic here when you have any questions or wish to discuss issues related to your own story. That way all the mods can see your history in one place, and we can get an accurate picture of what is going on, and give you the best guidance. Thank you.  

Edited April 9, 2021 by getofflex

[getofflex]

@LiaJIt looks like you are doing a slow and gradual taper, which is good.  Yes, you could very well be in a wave.  I assume you've read the information on here about windows and waves.  

 

You said "I don't know if I over-exerted myself at the gym, or if the fact my husband and I have been at odds lately, or if it's a combination of all of it."  

 

Yes, either of these two things could throw you into a wave.  For me, any kind of major stress will usually throw me into a wave.  And when I'm having trouble in my marriage, or any close relationship, is is quite stressful.  A wave can also be brought on by exercise that is intense.  

 

If it were me, I would be patient, wait it out, and apply some non drug coping techniques.  I would cut back or cut out the exercise.  Personally when I work out at the gym I tend to overdo it and my WD ramps up.  So I like to take walks which are low intensity instead.  

 

Usually when I get in a mini wave such as you are describing, it tends to subside in a day or two if I slow down and take care of myself.  

 

Since you made your last decrease 3 weeks ago, your nervous system has already probably made some changes, and updosing now could increase your withdrawal symptoms.  

 

As for the vitamin C, I'm not sure if this caused anything, but I suppose it could.  Here is other people's experience with vitamin C during withdrawal:  

 

Vitamin C

 

[LiaJ]

On 4/9/2021 at 12:56 PM, getofflex said:

@LiaJIt looks like you are doing a slow and gradual taper, which is good.  Yes, you could very well be in a wave.  I assume you've read the information on here about windows and waves.  

 

You said "I don't know if I over-exerted myself at the gym, or if the fact my husband and I have been at odds lately, or if it's a combination of all of it."  

 

Yes, either of these two things could throw you into a wave.  For me, any kind of major stress will usually throw me into a wave.  And when I'm having trouble in my marriage, or any close relationship, is is quite stressful.  A wave can also be brought on by exercise that is intense.  

 

If it were me, I would be patient, wait it out, and apply some non drug coping techniques.  I would cut back or cut out the exercise.  Personally when I work out at the gym I tend to overdo it and my WD ramps up.  So I like to take walks which are low intensity instead.  

 

Usually when I get in a mini wave such as you are describing, it tends to subside in a day or two if I slow down and take care of myself.  

 

Since you made your last decrease 3 weeks ago, your nervous system has already probably made some changes, and updosing now could increase your withdrawal symptoms.  

 

As for the vitamin C, I'm not sure if this caused anything, but I suppose it could.  Here is other people's experience with vitamin C during withdrawal:  

 

Vitamin C

 

Thank you for the insight. I'm doing better today. 

 

I have another question. I am going into year number 4 of dealing with withdrawal challenges. My original drug was Celexa, which I essentially CTd from (tapered over two months). This was August of 2017. I reinstated with Mirtazapine in November of 2017, and have been tapering 7.5 mgs since. I'm now at about 1.85 mgs. Is this too slow a taper? I feel like it's taking so long. Some of the "original withdrawal" challenges have subsided, I feel, which was extreme fatigue and horrible insomnia. Now it seems that while some of the earlier issues have subsided, like insomnia and fatigue, irritability and restlessness, some things have gotten worse, like exercise intolerance and hormonal/reproductive issues. I also feel like I have aged 10 years in the last 3 years, in terms of my appearance. 

 

Has this been a typical experience, for you or others, that you are aware? I am also so sensitive to medical treatments of any kind. Does that sort of thing eventually resolve as well? I don't know if I should be prepared to be set back every time I need medical treatment for the rest of my life or not...

 

Thank you again for responding to my post.