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NikG: verifying tapering strategy

NikG

By NikG
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NikG Contributor

NikG

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Posted

Hi all,

I am new to this wonderful community. I have to say that it is an amazing place with so many interesting information! Thanks for making this possible!

I read already a bit of things that are interesting to my personal situation.

I am 41, from Belgium, and taking 3 different medications, all of them are psycho narcotics. I would like to get rid of them. I have adapted a new lifestyle the last couple of years and have been working on that and on myself and I hope that I am strong enough to taper the 3 medications that I am taking. Now my question.

I am taking 30 mg Mirtazapine, 150 mg Effexor XR and I just came down from 60 mg Diazepam to 7 mg. Now 14 days on this 7 mg and somehow intuitively I felt that I need to stop withdrawing with the benzo's now and start tapering with the Effexor XR. And keep the benzo's stable for a while. The benzo tapering has been going well till the last couple of steps and the step from 8 to 7 mg now hit me pretty hard. I have to slow this tapering down and make smaller steps, but before doing that I would love to taper off Effexor XR first, at least to 75 mg ?

I think the Effexor XR somehow neutralises my emotions big time and as well makes me very active. I do not sleep much, and still I am so active and never tired. I think that is caused by the Effexor XR.

I would like to know advice on that ? Is that the good way to go ? I think it is. But here another question : would it be wise to wait tapering Effexor till I feel more stable after having tapered the Diazepam now. And maybe keep all my medication stable for another 2 weeks before I start tapering Effexor XR?

I have had made by the pharmacy 145 mg and 140 mg Effexor, each 30 gelules. I can't make a mistake by starting now 140 mg and do it for a month ? Or better wait a few weeks till more stable ?

Thanks for the advice on my last question and also about the further tapering strategy!

Many regards,

Nik

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • ChessieCat changed the title to NikG: Verifying tapering strategy
  • Administrator
Altostrata Grand Master

Altostrata

Posted
  • Administrator
Posted

Welcome, @NikG

 

1 hour ago, NikG said:

I think the Effexor XR somehow neutralises my emotions big time and as well makes me very active. I do not sleep much, and still I am so active and never tired. I think that is caused by the Effexor XR.

 

We suggest tapering Effexor first for this reason -- it can be activating. Why are you taking a benzo and mirtazapine?

 

Have you had any odd symptoms while tapering diazepam?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

Posted
  • Author
Posted

thank you so much @Altostrata. I was prescribed a benzo for anxiety, but that is much better now since I am practising a.o. the Wim Hof method and i am doing energetic healing ( amanae ). I was prescribed mirtazapine for sleeping as well as a combination with effexor for feeling better ( californian rocket fuel ).

I did not have any odd symptoms from tapering benzo, only more difficult to sleep well...short nights, light sleeping,...

I started today to take 140 mg Effexor XR. I hope for the best, i feel comfortable to be here on this forum and to be advised by experienced people. Thank you!

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Administrator
Altostrata Grand Master

Altostrata

Posted
  • Administrator
Posted
12 hours ago, NikG said:

I did not have any odd symptoms from tapering benzo, only more difficult to sleep well...short nights, light sleeping,...

 

When was the last time you reduced diazepam? What is your current sleep pattern?

 

When you are getting withdrawal from tapering, it's best not to make any changes in any drugs until those symptoms fully settle down.

 

Please summarize your drug and withdrawal history in your signature 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

Posted
  • Author
Posted

hi,

thanks so much for getting back to me ! i appreciate it so much !


I reduced diazepam the last time 15 days ago. I just reduced effexor to 140 mg today. Is it an idea I stay on 140 mg now ( i came from 150 ) till i have no symptoms at all, or do you think i better take 150 again tomorrow ?

Best regards,

Nik

 

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Administrator
Altostrata Grand Master

Altostrata

Posted
  • Administrator
Posted

Do you still have symptoms from reducing diazepam, or did your sleep go back to normal?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

Posted
  • Author
Posted

Hi Adele, because of the time difference, i only reply now. My sleep did not really go back to normal. Should i then stay on 150 mg ? thanks

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

NikG Contributor

NikG

Posted
  • Author
Posted

I took 150 mg again today. So only one day 140 mg. I think it is better till i am more stable ?

 

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Administrator
Altostrata Grand Master

Altostrata

Posted
  • Administrator
Posted

If you have not fully recovered from sleep disruption connected with your diazepam taper, I would not add to the neurological chaos by reducing Effexor.

 

This is important: Please summarize your drug and withdrawal history in your signature 

 

 

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

Posted
  • Author
Posted

thank you so much ! how long do you think i should be stable before tapering effexor ?

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Administrator
Altostrata Grand Master

Altostrata

Posted
  • Administrator
Posted

Until you are confident that your sleep has recovered.

 

Please do get to that signature. It saves the staff from having to read your entire topic over and over.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

Posted
  • Author
Posted

Adele, thanks !

What do you mean by please do get to that signature ? You mean that i need to implement a signature under my posts ?

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Moderator Emeritus
ChessieCat Grand Master

ChessieCat

Posted
  • Moderator Emeritus
Posted
24 minutes ago, NikG said:

What do you mean by please do get to that signature ? You mean that i need to implement a signature under my posts ?

 

SA uses the signature for a member's drug history, which is different from the drug history you provide when you join, which is only visible to staff.  The drug history will appear below every post you make, enabling it to be seen at a glance.

 

Please keep it simple (drug name, dose, date of that dose) by following these instructions:

 

Instructions:  Withdrawal History Signature

 

This link goes directly to your signature.  Remember to Save.


Account Settings – Create or Edit a signature

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

Posted
  • Author
Posted (edited)

thanks a lot, i hope now my signature is fine.

 

Edited by ChessieCat
extracted response from quote

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Administrator
Altostrata Grand Master

Altostrata

Posted
  • Administrator
Posted

Thanks for your signature.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

Posted
  • Author
Posted

I am in big doubt now. I am now still on Effexor and Mirtazapine and also on 7 mg Diazepam. My plan was first very clear to taper the diazepam to 0 and then start with the effexor. But now the advice here has confused me about brakes and accelerators. I still have an accelerator (effexor) and a brake(mirtazapine) if i would go first down with the benzo. Or should i stay on 7 mg diazepam and go down on effexor first. Thanks a lot for your advice!

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

  • Moderator Emeritus
ChessieCat Grand Master

ChessieCat

Posted
  • Moderator Emeritus
Posted

Please put all the drugs your are currently taking in this drug interaction and copy and paste the results.  Thank you.

 

Medscape Drug Interaction Checker

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

Posted
  • Author
Posted

thanks !

Monitor Closely

  • venlafaxine + mirtazapine

    venlafaxine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

  • diazepam + mirtazapine

    diazepam and mirtazapine both increase sedation. Use Caution/Monitor.

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

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about-going-off-mirtazapine-plus-venlafaxine-effexor-aka-california-rocket-fuel

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

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thanks a lot, i saw that post about califorinian rocket fuel, would you therefore advise me first to get off the last 7 mg diazepam first and then start effexor tapering or first the effexor and then continue diazepam ? thanks so much for your advice!


PS : I donated 500 Us to this community  because it is so valuable  !

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

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I think you need to reduce one of the serotonin drugs first.  If you were only taking Effexor and mirtazapine then the suggestion is to taper the activating (Effexor) first.

 

However, because you are also taking diazepam, I have ask the other mods for their opinion on whether it might be a good idea to start tapering the mirtazapine first.  The reason for me thinking that this might be the better option is because Effexor is activating, so if you reduce Effexor first you might end up being too sedated.  Taking too much sedating drug/s can have a paradoxical effect, where the drug/s do the opposite thing.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

Posted
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thanks, my intuition is to taper Effexor first, because i feel more active then I feel sedated. But i would first try to find a situation where i am stable on 7 mg diazepam. I tapered from 60 mg to 7 mg now and i think i need to be withdrawal symptom free of diazepam before i start to taper effexor.

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

NikG Contributor

NikG

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@Altostrata what would be your advice ? thanks !

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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Altostrata Grand Master

Altostrata

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On 4/9/2022 at 12:50 PM, NikG said:

I think the Effexor XR somehow neutralises my emotions big time and as well makes me very active. I do not sleep much, and still I am so active and never tired. I think that is caused by the Effexor XR.

 

Sleep problems are a very common adverse effect of Effexor XR. Combination with mirtazapine may be additionally stimulating,

 

I would not change anything until your sleep recovers from the diazepam reductions. It takes about 12 days for a change in diazepam dosing to take full effect. In the last week, how has your sleep pattern changed?

 

When your sleep settles down, I agree with @ChessieCat if I were you, I would taper Effexor XR rather than diazepam. 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

NikG Contributor

NikG

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1 minute ago, Altostrata said:

 

Sleep problems are a very common adverse effect of Effexor XR. Combination with mirtazapine may be additionally stimulating,

 

I would not change anything until your sleep recovers from the diazepam reductions. It takes about 12 days for a change in diazepam dosing to take full effect. In the last week, how has your sleep pattern changed?

 

When your sleep settles down, I agree with @ChessieCat if I were you, I would taper Effexor XR rather than diazepam. 

Thanks so much ! My sleep pattern is now that I sleep really deep like 3-4-5 hours and then sleep light...and I am like 7-8 hours in bed. I don't feel tired during the day, i think that's the stimulating effect of the California rocket fuel ( effexor + mirtazapine )... I am now 23 days on 7 mg diazepam and it hits me pretty hard as i felt very down yesterday and today, i even had to cry yesterday... My plan would be to get stable now on this 7 mg diazepam and then taper on Effexor. Intuively it is for me the very best step, I am happy you also think so. I am confident that it will help me sleep better, but the condition is to get stable first.

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

NikG Contributor

NikG

Posted
  • Author
Posted

@Altostrata I guess when i will taper down to 75 mg Effexor XR over time, there is a big chance my sleep pattern will get better ?

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

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4 hours ago, Altostrata said:

 I agree with @ChessieCat if I were you, I would taper Effexor XR rather than diazepam.

 

I suggested reducing the mirtazapine before the Effexor.  From my understanding of mirtazapine, it will become more sedating at lower doses.

 

And the reason:

 

13 hours ago, ChessieCat said:

I have ask the other mods for their opinion on whether it might be a good idea to start tapering the mirtazapine first.  The reason for me thinking that this might be the better option is because Effexor is activating, so if you reduce Effexor first you might end up being too sedated.  Taking too much sedating drug/s can have a paradoxical effect, where the drug/s do the opposite thing.

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

Posted
  • Author
Posted
7 hours ago, ChessieCat said:

 

I suggested reducing the mirtazapine before the Effexor.  From my understanding of mirtazapine, it will become more sedating at lower doses.

 

And the reason:

 

 

Thank you! @Altostratawhat do you think? As I would think tapering effexor Is the best when you take and effexor and mirtazapine? 🙏

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

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24 minutes ago, NikG said:

As I would think tapering effexor Is the best when you take and effexor and mirtazapine?

 

You are not just taking Effexor and mirtazapine, you are also taking diazepam, so that needs to be taken into account.

 

If you do taper the Effexor first you might find that as the Effexor (activating drug) gets lower you start feeling too sedated or the 2 sedating drugs turn paradoxical then you might need to taper one of the sedating drugs for a while.

 

These are the things to remember for future reference.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

Posted
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Posted
2 minutes ago, ChessieCat said:

 

You are not just taking Effexor and mirtazapine, you are also taking diazepam, so that needs to be taken into account.

 

If you do taper the Effexor first you might find that as the Effexor (activating drug) gets lower you start feeling too sedated or the 2 sedating drugs turn paradoxical then you might need to taper one of the sedating drugs for a while.

 

These are the things to remember for future reference.

Thank you so much @ChessieCat. So i would start with tapering effexor XR now and then evaluate. My problem now is am too active. Thanks! 

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

Posted
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Posted
21 minutes ago, NikG said:

My problem now is am too active.

 

It is good that you are aware of this.  It is probably because of this that Alto suggested reducing the Effexor first. 

 

22 minutes ago, NikG said:

and then evaluate

 

It will be very important to keep notes of your symptoms so that you can notice if something changes.  And if things change then yes, you would need to reassess at that time about what might be the better way to go.  That is why I have provided my thoughts on things and what might possibly happen so that you can keep them in mind and hopefully be able to stop any issues from happening or at least noticing them straight away so that they don't get too bad.

 

The main thing is to try and protect your sleep.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

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Posted

@ChessieCat you can't imagine what a relief it is to be able to get this kind of advice from you and @Altostrata here in this forum. I think indeed priority is sleep and I do hope and think that once i am stable on diazepam and my sleep gets back to normal and I start to carefully taper Effexor it is the right step.

One more question. To taper effexor XR, I would maybe do it really in micro steps, like i am now at 150 mg. Does it make sense to have 145 mg made, and do that for 2 weeks, then 2 weeks like 140 mg, just in order to minimize the risks of withdrawal.

 

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

NikG Contributor

NikG

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@AltostrataI am now day 25 on my same dose of diazepam 7 mg. It hit me hard and i feel down and have not much energy. My sleep got better, that I am really happy for. Would it be an idea to first decrease the benzo's to 0 mg. As I am afraid more periods of feeling down and depressed will come and then it is probably not a good time to go down with the Effexor first ? Thanks for your advice

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

Posted
  • Moderator Emeritus
Posted
11 minutes ago, NikG said:

My sleep got better,

 

On 4/19/2022 at 4:11 PM, NikG said:

My problem now is am too active.

 

This is good.

 

4 minutes ago, NikG said:

have not much energy.

 

Q:  Are you feeling less activated now compared to how you were on 19th April?

 

5 minutes ago, NikG said:

Would it be an idea to first decrease the benzo's to 0 mg.

 

No.  Alto said:

 

On 4/19/2022 at 3:17 AM, Altostrata said:

if I were you, I would taper Effexor XR rather than diazepam. 

 

I don't think you understand how dangerous the Effexor mirtazapine combination of drugs is.

 

It would be better to reduce either Effexor/venlafaxine or mirtazapine because of the MAJOR DRUG INTERACTION between them.  I have already explained my thoughts on which of these two drugs you might reduce first.  Please go back and reread all the posts that Alto and I have made.

 

I also suggest that you reread Post #1 of this topic:

 

about-going-off-mirtazapine-plus-venlafaxine-effexor-aka-california-rocket-fuel

Interactions between your drugs

Major

venlafaxine

mirtazapine

Applies to: venlafaxine, mirtazapine

MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, cyclobenzaprine, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

NikG Contributor

NikG

Posted
  • Author
Posted

thanks @ChessieCatI feel indeed less activated, i feel down, it is for sure benzo withdrawal symptoms, it is similar to when i withdrew from Clonazepam. I have been succesful before on Effexor 150 mg and Mirtazapine 30 mg. I just visited my pscyhiatrist and told him about my suggestions and he is a very nice open minded guy. I spoke to him about this forum and about all the pro's and con's about what withdrawing first and finally we made the decision of finishing of the benzo from 7 mg to 0 mg. And then start tapering the effexor and keep the mirtazapine as a brake. So i am relieved as this is now the final plan. I hope i get stable on the 7 mg diazepam now soon 🙂 i hope you also agree on my strategy ? thanks !

2000 First time use of antidepressants - after failed exams and then studying too hard causing mental overload.
I have been using paroxetine, fluoxetine, xanax, staurodorm (flurazepam), finally i ended up initially with 20 mg fluoxetine - 100 mg trazodone - 0.5 mg Xanax And I could reduce that for many years to the doses described as below in the next line :
2004-2017 10 mg fluoxetine in the morning - 0.25 mg Xanax morning and 0.25 mg xanax in evening - 10 mg trazodone in evening
Switched to Effexor XR and Mirtazapine instead of Fluoxetine and Trazodone because it did not help anymore (fluoxetine + trazodone)
2017  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam
2018  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg 0.5 mg Clonazepam ( completely tapered succesfully Clonazepam in 2018 )
2019  Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg ( tapered Effexor XR and Mirtazapine gradually till Effexor 70 mg and Mirtazapine 15 mg, not many withdrawal problems but then increased again after a while because waking up at night again. I should have only tapered Effexor XR?)

2020 Effexor XR 150 mg Mirtazapine 30 mg Xanax XR 3 mg
2021  Effexor XR 150 mg Mirtazapine 30 mg Diazepam 60 mg
2022 Effexor XR 150 mg Mirtazapine 30 mg Diazepam tapering, 7 mg now, went up to 10 mg again, and will do micro tapering later on, but first get stable and I want to first taper Effexor before going any further on benzo's.
2022 Effexor XR 150 mg Mirtazapine 30 mg and Diazepam 20 mg since 13 days back on 20 mg Diazepam (on 24/07/2022)
2023 Effexor XR 125 mg (i went down in small steps per 5 mg) and stayed the same with Mirtazapine 30 mg in the evening and 15 mg Diazepam in the morning and 15 mg in the evening. - Supplements : Magnesium, Vitamin D, L-Tryptohan, Vit B12

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ChessieCat Grand Master

ChessieCat

Posted
  • Moderator Emeritus
Posted

It seems like you have a medical professional who you can work with.

 

You have formulated a plan of action with him which is different from the suggestion made by SA staff.  This is your decision and you have the right to do this; SA staff do not force members to follow the SA suggestions.  However, please understand that SA is a very busy site with a lot of members wanting assistance.  The small number of SA staff, who are not paid, prefer to spend their limited and valuable time working with members who choose to follow the advice of SA.  From now on, please refer any concerns to your medical professional.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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