PortugueseSea: metoclopramide, akathisia and mirtazapine

[PortugueseSea]

10 hours ago, Altostrata said:

You're feeling better after you take 3.75mg in the afternoon? Suggest you move it an hour earlier each day until you're taking it at about 9 a.m.

Yes, specially when I feel worse in the morning! Will do and keep you guys posted! Thanks!

[PortugueseSea]

Started moving the dose up; ; Slept well; 6/10 well being.

09:30 Wake up and eat breakfast: blueberries, smoked salmon and hot milk. Magnesium Carbonate 500mg and Vitamin E (200 IU)
10:00 - 13:00 Post-surgery appointment. Felt restless in the waiting room, agitated. Doctor confirmed I am recovered.
13:00 Take Mirtazapine 3.75mg.
14:00 - 15:30   Eat a kebab with salad for lunch, Magnesium Carbonate 500mg and Vitamin E (200 IU)
15:30 - 21:00 Play video-games and watch soccer. Feel generally uncomfortable throughout the afternoon
21:00 Take a shower and eat meat with vegetables. Take mirtazapine 11.25mg, Magnesium Carbonate 500mg, drink herbal tea and watch a movie.
01:00 Go to bed.

[manymoretodays]

Yay!  Fingers crossed for smoother sailing.

[PortugueseSea]

Slept well; 7/10 well being. It was an okay day where I was able to distract myself. I also got my mirtazapine liquid taper tools. That gave me a sense of agency somewhat, that I can start when I feel it is best and am not depending on the medical system.

09:30 Wake up and eat breakfast: blueberries, smoked salmon and hot milk. Magnesium Carbonate 500mg and Vitamin E (200 IU).
10:00 - 13:00 Stayed home and played video-games, felt restless and uncomfortable as usual.
12:00 Take Mirtazapine 3.75mg.
14:00 - 15:30   Meet up with friends and eat pizza for lunch, Magnesium Carbonate 500mg and Vitamin E (200 IU)
15:30 - 18:30 Chat with friends and watch soccer. Feel generally uncomfortable throughout the afternoon, not better, not worse
18:30 - 22:00 Go back home, eat meat with vegetables with mom. Feel a bit better, watch soccer and chat away with mom and partner. 
21:00 Take mirtazapine 11.25mg, Magnesium Carbonate 500mg and Vitamin E (200 IU).
00:00 Go to bed.

[PortugueseSea]

Slept well; 6/10 well being. It was an okay day where I was able to distract myself. The discomfort is often focused around my neck area, like I am being tickled from the inside.

09:30 Wake up and eat breakfast: blueberries, smoked salmon and hot milk. Magnesium Carbonate 500mg and Vitamin E (200 IU).
10:00 - 13:00 Stayed home and played video-games, felt restless and uncomfortable as usual.
11:30 Take Mirtazapine 3.75mg.
14:00 - 15:30   Went out for lunch with mom, ate octopus salad, Magnesium Carbonate 500mg and Vitamin E (200 IU)
15:30 - 18:30 Watched soccer and played video-games. Feel generally uncomfortable throughout the afternoon, not better, not worse
18:30 - 22:00 Eat meat with vegetables with mom. Feel a bit less activated and restless, watch soccer and chat away with mom and partner. 
21:00 Take mirtazapine 11.25mg, Magnesium Carbonate 500mg and Vitamin E (200 IU).
00:00 Go to bed.

[Lauren90]

Hi! I’m not sure I’ve ever said hello on here but I’m also an akathisia sufferer :/. Anyways, in solidarity!

[PortugueseSea]

7 hours ago, Lauren90 said:

Hi! I’m not sure I’ve ever said hello on here but I’m also an akathisia sufferer

Hi Lauren! What caused yours and how are you faring? Nice to make your acquaintance!

[PortugueseSea]

Slept well; 4/10 well being. It was a bad day where I was not able to distract myself very much. The discomfort was mostly diffuse, a general sense of dread, unease and inability to relax.

09:30 Wake up and eat breakfast: blueberries, smoked salmon and hot milk. Magnesium Carbonate 500mg and Vitamin E (200 IU).
10:00 - 13:00 Stayed home and played video-games, felt restless and uncomfortable, this time really bad, it led to fidgeting and despair, was in tears most of the time.
11:30 Take Mirtazapine 3.75mg.
14:00 - 15:30   Went out for lunch with mom, ate a cheese and ham sandwich, Magnesium Carbonate 500mg and Vitamin E (200 IU). Went for a walk afterwards and it seems it soothed me to a degree...
15:30 - 18:30 Watched soccer and played video-games. Feel generally uncomfortable throughout the afternoon, not better, not worse, it was exhausting
18:30 - 22:00 Eat meat with vegetables with mom. Feel a bit less activated and restless, watch soccer and chat away with mom and partner. 
21:00 Take mirtazapine 11.25mg, Magnesium Carbonate 500mg and Vitamin E (200 IU).
00:00 Go to bed.

[PortugueseSea]

Happy to announce my taper tools have arrived so have started liquid mirtazapine today! 

[Lauren90]

4 hours ago, PortugueseSea said:

Hi Lauren! What caused yours and how are you faring? Nice to make your acquaintance!

Mine was caused by withdrawal from Sertraline. I have been on Sertraline over twenty years, made some really big jumps, followed by a slow taper, and I think over the years it was just too much for my body because then the akathisia hit. 

[PortugueseSea]

6 hours ago, Lauren90 said:

Mine was caused by withdrawal from Sertraline. I have been on Sertraline over twenty years, made some really big jumps, followed by a slow taper, and I think over the years it was just too much for my body because then the akathisia hit. 

Yeah, tapering with akathisia seems so overwhelming. It is crazy... Hoping I can taper mirtazapine without too much trouble.

[PortugueseSea]

Slept well 7/10; today was a relatively good day. The activation/akathisia was not so bad.

09:30 Wake up and eat breakfast: blueberries, smoked salmon and hot milk. Magnesium Carbonate 500mg and Vitamin E (200 IU).
10:00 Take Mirtazapine liquid 3.75mg.
10:00 - 13:00 Stayed home, worked online and played video-games, felt relatively okay, some head pressure.
14:00 - 15:30   Had lunch at home, beef with salad, Magnesium Carbonate 500mg and Vitamin E (200 IU). 
15:30 - 18:30 Watched soccer and played video-games. Feel mildly agitated, pretty decent,
18:30 - 22:00 Eat meat with vegetables with mom. Feel a bit less activated and restless, watch soccer and chat away with mom and partner. 
21:00 Take mirtazapine liquid 11.25mg, Magnesium Carbonate 500mg and Vitamin E (200 IU).
00:00 Go to bed.

[PortugueseSea]

On 11/26/2022 at 8:26 AM, Altostrata said:

You're feeling better after you take 3.75mg in the afternoon? Suggest you move it an hour earlier each day until you're taking it at about 9 a.m.

Done moving and feeling better, on average. I have only had a really bad day this week. The activation/agitation/akathisia, I am not sure anymore, has toned down. I have also changed to DIY liquid mirtazapine so I can manipulate dosage without relying on a pill cutter! All in all, I think I have done well. Thank you so much for your suggestions Alto, it means a lot to me.

Will keep posting daily notes, I wonder if I should try a small cut, say 3,75 to 3 and 11,25 to 11, 6,7% total. I wonder whether my "akathisia" is "just" activation from being on 15mg after all the shenanigans with drug changes in Spring, it could perhaps be reduced with a careful lowering of the dose?

 

[PortugueseSea]

I have decided to make an exploratory cut to both my dosages, from 3.75mg to 3mg in the morning and from 11.25 to 11mg in the evening. As I am on the liquid now this is way more feasible than before. If I feel substantially worse will hold, if not will keep reducing little by little every two weeks. Hopefully, this will improve my symptoms rather than worsening them and will not be too hard on my nervous system.

If my activation actually improves that would be a green light for further reductions. Will report how things chug along! Pray for me.

[Altostrata]

1 hour ago, PortugueseSea said:

I have decided to make an exploratory cut to both my dosages, from 3.75mg to 3mg in the morning and from 11.25 to 11mg in the evening.

 

This is reasonable, it's a reduction of only 1mg from 15mg daily dose.

[PortugueseSea]

Broken sleep; average day 6/10

Morning

Felt mild activation, burning sensation on the back of the neck, teary, uncomfortable.

Wake up 7:00
Teach class from 7:00 to 8:00
Eat yogurts for breakfast, magnesium and vit e

Stay half asleep on the sofa until 11:00; take mirtazapine 3mg.
Teach another class from 11:00 to 12:00
Eat meat and beans for lunch at 2, magnesium and vit e

Afternoon

Symptoms remained the same 

Felt mild activation, burning sensation on the back of the neck, teary, uncomfortable.
Binged video-games and series for distraction.
Had an emotional but good conversation with mom; 

Evening

Symptoms remained the same 

Ate octopus and beans for dinner.
Mirtazapine 11mg at 11:00
Watched some more series, went to bed, symptoms stable.

-----------------------------------------------------------

I think this is my "ADR/withdrawal normal", felt a little more teary than usual but given the conversation I had with my mom that might be situational. I think this format for my daily notes is a bit easier and filters the unimportant better.

[Altostrata]

Short-lived symptoms that are tolerable are acceptable.

[PortugueseSea]

3 hours ago, Altostrata said:

This is reasonable, it's a reduction of only 1mg from 15mg daily dose.

For my next cut I was thinking about only reducing the evening, or would it be better to cut both to a degree to maintain some kind of balance?

Thanks you so much, activation hasn't worsened since the cut. Actually, had a very good morning the other day. Hoping that the activation/agitation actually improves on the lower dosage, Don't want to drop too much too quick though...

[PortugueseSea]

14 minutes ago, Altostrata said:

Short-lived symptoms that are tolerable are acceptable.

Activation, burning sensation on the back of the neck, teary, uncomfortable... I have had these for almost a year, though they have gotten better slowly over time since my updose. I guess it's part of my ADR/WD normal and will only go away slowly long term... or maybe they will improve on a lower dose of mirtazapine?

I have also been having some mild occasional muscle spasms, easily the mirtazapine too I guess so...

Only recent short term symptoms I have noticed are a decrease in sleep quality and occasional itchiness, very mild, very tolerable.

[Altostrata]

You're taking the morning dose to address interdose withdrawal. I'd reduce the nighttime dose part-way first.

[PortugueseSea]

On 12/9/2022 at 11:21 PM, Altostrata said:

You're taking the morning dose to address interdose withdrawal. I'd reduce the nighttime dose part-way first.

Thanks, it has been almost one week since the reduction and I feel... well... better. I still have all the symptoms I reported but they have not gotten worse in any shape or form, in fact, they have decreased in intensity around 1 week after the cut. It might be that my mirtazapine dose is too high, perhaps it has become paradoxical to an extent?

I am considering doing another small cut, say another one mg to the night dose, to see how I react.

[Altostrata]

11 hours ago, PortugueseSea said:

It might be that my mirtazapine dose is too high, perhaps it has become paradoxical to an extent?

 

Why do you think this?

 

11 hours ago, PortugueseSea said:

I am considering doing another small cut, say another one mg to the night dose, to see how I react.

 

If I were you, I'd allow more time for stabilization. You've been making dosage changes constantly this month.

[PortugueseSea]

18 hours ago, Altostrata said:

Why do you think this?

It has been almost two weeks since my cut, I feel better, not worse, maybe I have seen a 20% improvement in symptoms. While on 15mg Mirtazapine I was getting better maybe 3% to 5% a month. If a small 10% cut led to a 20% decrease in symptom intensity I have to wonder, is it just a coincidence or is my dose simply too high?

There is the possibility that a further decrease will further improve my symptoms.  It could just be that my system has gotten better naturally and might not have anything to do with the dosage change too...



 

 

18 hours ago, Altostrata said:

If I were you, I'd allow more time for stabilization. You've been making dosage changes constantly this month.

I have only done one cut this month, no further dosage changes. Yet, you are right. It is too soon. I will wait a bit longer, maybe a couple more weeks?

Thanks for everything.

[Altostrata]

On 12/14/2022 at 11:00 AM, PortugueseSea said:

I will wait a bit longer, maybe a couple more weeks?

 

Correct.

[Elaine5]

Hello, happy to hear you are doing better and better, albeit slowly. A big improvement in symptoms after the last cut is very encouraging! Just remember to keep going cautiously. 
 

i hope you are feeling better and feeling hopeful. 
 

thanks for popping in on my thread.

[PortugueseSea]

Hello, yes! I have been slowly tapering and am due an update. Things have been looking up, I am also more capable of dealing with symptom spikes, like right now. I can now put things in perspective. My reductions have gone well and that has brought me a lot of peace of mind!

I would say I am 40 to 50 per cent healed and oof, I feel I will be able to actually pull this off!

[Lauren90]

Hi! How are you doing lately??

[PortugueseSea]

Hello Lauren!

I am actually just recently off; had a honeymoon phase of about 3 weeks where I felt okayish and now I am in a bit of a wave!
I am very happy to have finished my taper successfully and know that a temporary worsening of symptoms is to be expected.

I also committed the crucial sin of drinking a coffee for the first time in a year so that might be it; my son also makes it a little bit hard to get enough sleep! I am sure when I am done adjusting to life back in Japan things will stabilize!

I am going to read up on sleep related resources to see what I can do about this!

I went a bit faster than I wanted as I was facing difficult side effects, those faded, and now I am facing what I think is mild to moderate withdrawal akathisia.

I am 80% functional and looking forward to healing!

My current regimen is only vitamin e (anti oxidant) and magnesium!

How have you been?

[Altostrata]

Good to hear, please continue to tell us how you're doing.

[PortugueseSea]

1 minute ago, Altostrata said:

Good to hear, please continue to tell us how you're doing.

Thanks Alto, if you will bear with me, I will make a long post with a full update. I feel much better and am extremely thankful for all the support I found here!

[ColdTurkey1]

@PortugueseSea

I'm very happy for you that you had such a smooth withdrawal, smoother than most stories here!

And that you withdrew in a much quicker pace than what is recommended here. Good to know it's possible (I guess it's also because you didn't take it for a long time)
I'm also suffering from head pain\pressure, only on the right side of my scalp and face, and I think it's mecause of the mirtrazapine

Did your head pain dissapear ?

Did you also suffer from it only on one side, or both sides ?

Thank you

 

[PortugueseSea]

11 hours ago, ColdTurkey1 said:

And that you withdrew in a much quicker pace than what is recommended here. Good to know it's possible (I guess it's also because you didn't take it for a long time)

I believe so too, I started at less than 10% cuts and as I felt better after two weeks after each cut I kept increasing the %, until I reached low percentages, that is when I slowed down again.

 

11 hours ago, ColdTurkey1 said:

I'm also suffering from head pain\pressure, only on the right side of my scalp and face, and I think it's mecause of the mirtrazapine

Did your head pain dissapear ?

I have never had pain per se I think, it is either head pressure or a piercing or burning sensation, either in the neck or different sides of the head. It is not consistent...

Cheers!

[PortugueseSea]

Making sense of symptoms

Around one month after my last dose of mirtazapine things have been a mixed bag:

 

+ My mood has improved considerably, so has my ability the enjoy the good things in my life.
+ My ability to cope with symptoms has improved substantially
+ Have had a great window and my WD/ADR normal has slowly improved.

- Intermittent neck and head pressure are still a major source of discomfort ----
- Burning or piercing sensation on head and or neck -----

Would the two above be best described as somatic sensations? Not really sure how to classify them.

- The worst of all; lingering sense of discomfort/restlessness/ anxiety that makes it very very hard to relax.

Like I have acid running through my veins.  It varies in intensity but, except on the best of windows, never truly goes away. I am not sure if I would classify this as mild akathisia or simply amygdala fight or flight issues. I am trying to exercise, stay busy, sleep properly and do some meditation to counteract this but I have had questionable results. That said, it seems to be improving 5% a month on its own. I would be very happy to learn any non-medication techniques to try with this issue.

My current regime is as below vitamin E and Magnesium, I am also taking Quercetin for one week to see if it helps.

Bless you all

[PortugueseSea]

Wave pattern and current wave

Since I stopped the mirtazapine I have had short 3/4 day waves every other week. This ultimately just means an intensification of the symptoms I have been suffering from.
 

The current wave I am in has started after I stupidly ingested jasmine and green tea, even though I knew caffeine is a terrible idea (it triggered my previous wave), and has gone on for 6 days and counting. It has been the worst one so far. It is also relevant that I have been suffering from a cold and or allergies concomitantly, which might be relevant.

[ColdTurkey1]

8 hours ago, PortugueseSea said:

I have never had pain per se I think, it is either head pressure or a piercing or burning sensation, either in the neck or different sides of the head. It is not consistent...

 

And had the sensations changed and stopped since you're off Mirtrazapine ?

edit: sorry, I see that you answered this question above

[ColdTurkey1]

8 hours ago, PortugueseSea said:

I would be very happy to learn any non-medication techniques to try with this issue.

@PortugueseSea Acupuncture or Herbalism might be a good idea
These sensations might be related to high levels or Cortisol