Griff: introduction

[Griff]

Hi all, found this forum via google searches many a night on how to cope with withdrawals!

 

Like many others on here and I am sure everywhere in the world, I started on on anti-depressant and it just spiraled into larger and larger doses then multiple meds and meds on top of that for side affects.

So a general summary was that I went to the Dr around 14 years ago for depression. I was put on Cymbalta 30mg straight off the bat. The side affects were unpleasant but I don't recall specifics of what they were, just that I did NOT like how they made me feel and I stopped them cold turkey. Withdrawals for several months of course, though fairly mild with major brainzaps being the one I most remember.

 

Somewhere along the way I then went onto Mirtazapine. 15, 30 and then up to 45mg over a short period of time, maybe a year or so ramping up? Basically a result of going to the Dr, saying that I wasn't feeling the best on these meds, so they just increased them. I stayed on 45mg for probably 5 years or thereabouts. During that time my personality changed a lot (on retrospection I see how much). I became anxious, paranoid, ALWAYS tired, I started having panic attacks, grumpy, short temper making me snap at people for little, and isolated myself a lot. This went on for years. Each time the Dr would just tell me 'its not a magic pill' and leave it at that. Along the way my marriage fell apart and I moved to a new city. To 'cope' with the enormous increase in anxiety and stress, Dr gave me Olanzapine.... I took maybe 3 doses ever, as that stuff turned me into a zombie.

 

 

I found a new doctor who I discussed how I felt on Mirtazapine and was switched over to Effexor XR. Ramped up from 37.5 to 150mg in the space of a few months. Generally felt 'good' but then noticed side affects that were persistent, sexual side affects galore, my BP sky rocketed, and hey look my anxiety was still very much around and panic attacks were a semi frequent occurrence. Dr's response was to switch to Paxil - which resulted in a heightened state of anxiety and rolling panic for days until I stopped them completely. Went back onto Effexor, despite the side affects and stabilized. Mirtazipine was then added to the Effexor for 'californian rocket fuel' - still anxious, still having panic attacks..

My BP was now concerning my Dr so was given a Blood Pressure pill, which then became two sets of BP meds, then three. My Blood Pressure still stayed high. Propranolol was added on top to reduce the heart rate and stress on my heart in general.

 

This year was the hardest, I was referred to a psychiatrist, who every 6 weeks would get me to start a different drug. So I went from Effexor to Pristiq 50, then 100mg, Pristiq + Mirt, then onto Pristiq plus Seroquel at night (which made my anger turn into rage), then over to Luvox and some Respiradone and Valium to 'help' with the panic. Luvox basically kept me in a state of permanent nausea for 5 or 6 weeks - the dose was also increased to 100mg. So I spent around 4 months going through a cycle of drug withdrawal and startup over and over. I couldn't cope with being nauseous and feeling awful ALL the time anymore. At which point I had my next appointment with my Psychiatrist who just told me to 'just take half a dose for a few days and then stop them'. I asked that just ceasing any and all anti-depressants after FOURTEEN YEARS on them sounds very dangerous, she just shrugged.

 

So I cancelled any future appointments with that practice, and after much research decided to cross taper from Luvox over to 15mg Mirtazapine and taper down from there. I chose Mirtazapine for several reasons - one was it stopped that permanent nausea everyday from the Luvox immediately, two it was a med my brain and body knew well and would tolerate almost immediately (which it did) and three i knew precisely what I would feel and how it would change me. After around 4 weeks of brainzaps and mild gastro issues as my body cleaned the last of the mix of drugs out of my body, I started to work my way down on Mirtazapine. Have currently gone from 15 > 7.5 > 3.75 with 6 or so weeks between drops. I will stay here until I stabalise again. So far the steps down have been very mild and tolerable (brain zaps for a day or two then fine), so my body is tolerating the 50% drops ok. 10% is recommended here, but so far for me personally its been ok dropping at 50% each time and stabilizing. The only noticeable (and expected) WD would be insomnia. My sleep quality has really tanked. Though interestingly enough despite low doses of Mirt meant to INCREASE your sleepyness, it has had little affect at all.

 

So thats where I am currently at. I'm taking supplements like Vit C, Fish Oil and Vit B in the mornings and the small dose of Mirt at night. From here, I may need to look at a compounding chemist to begin tapering more slowly on the lower dosages, as cutting a tablet into 8th's is getting very difficult, even with a pill cutter. So the methods of diluting in liquids or a compound chemist will be the plan for the taper slow down (if needed) from here and my goal of being drug free hopefully within the year the final target.

Edited August 15, 2022 by getofflex

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  

 

On 8/10/2022 at 10:36 PM, Griff said:

At which point I had my next appointment with my Psychiatrist who just told me to 'just take half a dose for a few days and then stop them'. I asked that just ceasing any and all anti-depressants after FOURTEEN YEARS on them sounds very dangerous, she just shrugged.

Wow.  I think you were right to stop seeing that psychiatrist.  You were right, stopping them suddenly after 14 years would have been pretty risky.  I'm glad to hear that you tolerated the reinstatement to 15 mg of mirtazapine well.  The 45 mg dose of it was too high for you previously.  You must have a strong constitution, because considering all the drug switches you've made recently, it sounds as though you are doing quite well overall.  However, please be very cautious in the future, because these things can catch up with us later.  

 

On 8/10/2022 at 10:36 PM, Griff said:

Have currently gone from 15 > 7.5 > 3.75 with 6 or so weeks between drops. I most recently dropped to 1.875 and will stay here until I stabalise again.

It would really help to see the specific dates you made these reductions.  

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.  Use this example:

 

Feb 15 2020 - June 30 2020 - 25mg citalopram, 2mg xanax

July 1 2020 - Sept 7 2020 - 50 mg citalopram, 4 mg xanax

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  It's especially important to taper very slowly and gradually as we get to the lower doses.  At the lower doses, these drugs have an especially powerful effect upon us.  At the low doses, the drug affects an inordinately high number of receptors in our nervous systems.  The third link below explains this. 

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering mirtazapine

 

SERT Transporter Occupancy Studies

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

My suggestion for you now is to hold for a while, as in several months (3-6) at the 1.875 mg of mirtazapine, even though you say that the 50% reductions have not caused you any major issues.  Fast tapering tends to be cumulative, and can sneak up on us several months down the road.  You don't want to crash your nervous system.  This can cause major discomfort that can take a very long time (many months to years) to recover from.  Please read this link about fast tapers: 

 

Cold Turkey and Fast Tapers

 

Please keep in touch, and let us know how you are doing. 

[Griff]

Thank you for that. I have updated my signature to show the journey I have been on! Some dates I had to guesstimate, but as it gets closer to the present, they become more specific.

 

I wanted to edit my original post, but I am unable to. The main change was I was incorrect in that I had dropped to 1.85. I am actually still on 3.75. Which is a quarter of a tablet.

 

I agree that the lower dosages seem to hit harder, and as such have paused on my current dose until stabilize completely and  I can sort out one of the methods to be able to slow it down to a 10% taper from here on. Especially as cutting a qtr tablet in half is proving very difficult, so will need to look at liquid or other forms like a compounding chemist to be able to slow the taper right down and go at a much slower rate. The 50% drops were mild until now, but with everything I have read on here, its a good indication that from here down will where it could become more difficult and so I will be slowing it right down. I actually tried to jump off at 7.5mg at one point, lasted 5 days before I began having leg tremors and intense insomina (i went back on to 7.5 immediately after that to stabilize), so those WD's are definitely sitting there in the background.

 

The main struggle was definitely within the time frame of seeing my Psychiatrist, as I was swapping meds every 4-6 weeks so it was a non stop withdrawal and start up side affects rollercoaster (with the Psych just offering more pills to cope). Going back to a low dose and tapering down on Mirt was a tremendous relief on my body and mind.  Fun fact, since reducing my medication down to its current level, my anxiety is maybe 10% of what it was when I was on the big doses, so those large doses were making it WORSE, not better!

[getofflex]

21 hours ago, Griff said:

I wanted to edit my original post, but I am unable to. The main change was I was incorrect in that I had dropped to 1.85. I am actually still on 3.75. Which is a quarter of a tablet.

I've made the edits for you.  

 

21 hours ago, Griff said:

I agree that the lower dosages seem to hit harder, and as such have paused on my current dose until stabilize completely and  I can sort out one of the methods to be able to slow it down to a 10% taper from here on.

This is a good solid plan.  My link in my first post "How to Taper Mirtazapine" will go into detail on how to measure the smaller doses.  Give us a holler (midwest USA speak for "ask us") if you have questions.  

 

21 hours ago, Griff said:

The main struggle was definitely within the time frame of seeing my Psychiatrist, as I was swapping meds every 4-6 weeks so it was a non stop withdrawal and start up side affects rollercoaster (with the Psych just offering more pills to cope).

These doctors just don't have a clue.  

 

21 hours ago, Griff said:

Going back to a low dose and tapering down on Mirt was a tremendous relief on my body and mind.  Fun fact, since reducing my medication down to its current level, my anxiety is maybe 10% of what it was when I was on the big doses, so those large doses were making it WORSE, not better!

That's wonderful to hear.  I also feel much better off of the psychiatric drugs.  I'll never go back on them again, for any reason.  

 

It sounds like you are doing great!  Keep up the good work. 

[Griff]

So its now been a couple of years since my last post. I'm completely med free (apart from melatonin for sleep)!

 

I thought I would come back and give an update so that others can see my journey through getting off all these meds.

 

So I sat on 3.75mg of Mirt in August 2022. I was getting sick of it more and more (I was always tired, grumpy etc) and my brain and body was just over it and apart from the fear of WD, I was done with these pills.

 

By Mid September I was taking 3.75mg every other day. I did this for a week then realised I was forgetting to even take it. My therapist suggested that this might be a good time to just ditch them. If you aren't desperate for that alternate day dose, you might be ready to try none. So from 25/09/2022 I stopped entirely on Mirt.

 

My anxiety was of course increased a few weeks after that and I was getting panic attacks, so I would take 2.5mg of Valium only when things got really bad and unmanageable. I even made sure to be really careful with Valium, I DID NOT want to be stuck on another pill! So I would only take one every 3-4 weeks when I absolutely needed it.

 

There was some real hard times for a few months, I was struggling a lot. My emotions were all over the place and I could tell my brain was freaking out about the lack of chemical support to 'numb' me. I persisted. I supported myself with journal writing, a drink of alcohol (only one when things go bad) to try and take the edge off a bit and even tried some CBD oil for a short time to make things a little easier. It was still rough, with panic attacks once or twice a month, high levels of anxiety and depression taking turns every few weeks. But with just the occasional drink, the occasional attempt at CBD oil, I was managing to cope with this new more intense level of emotions. Some weeks i would be extremely anxious for days, so I just get out the door and start walking until I am physically exhausted, this helped a little bit. I kept busy with work or tasks, kept moving, kept doing things to try and use all that anxious energy up. I would tidy, clean, work, walk, or potter around with things until I was completely exhausted.

 

I could tell my brain was trying to make sense of it all, after being on anti-depressants since 2009 - it had been a long long time since I have had to deal with actual raw emotions. So I have had to relearn what these more intense and pure emotions felt like and how to cope with them. I tried to have the headspace of a toddler, learning about emotions for the first time, as it was very much like that. I had to relearn what pure raw emotion felt like and how to cope and manage it. I noticed for about 6 months through 2023 and 2024 that I was going in cycles, usually a week or so of feeling 'ok', then a big ramp up in anxiety, then a crash into depression for 3 days.

 

As the months went on, this cycle became more and more spaced apart, often going several weeks before a ramp up and crash cycle happening. My sleep cycle was also all over the place, so I began taking melatonin every night for months to try and help me get to sleep. For several months I would get an add on to the ramp up crash cycle of several days of insomnia (usually at the same time). So my brain was really all over the place. I would take a sleeping pill (first gen antihistamine) if I went more than 3 days without a decent sleep to help me reset and this helped a lot. I'd be dopey and grumpy for most of the next day, but it helped reset me. It was obvious my brain and body needed rest after so many years of being completely wired from anxiety, pills and constant tension.

 

I could tell my brain was healing, adapting and improving as the months have gone on. My Valium usage went from every two to three weeks to once every few months, to nothing at all in the space of 18 months. Last time I needed Valium would have been March 2024 to get through one major stress and anxiety day (wedding).

 

Its now just over 2 years since my last dose of anti-depressants. I still have anxiety, still have depression, but the cycles of it are almost gone and now its just 'bad days' or usually due to something coming up that is causing me extra stress, or lack of sleep that makes it worse. I haven't had a panic attack in 10 months (on Effexor I would get them weekly). I can get overwhelmed, and can't cope with noise or stimulation sometimes, and in those times, I put on some headphones with some music, try to slow my breathing, ground myself and wait for things to settle down in my body. If they don't, I get up and move, or pour ALL my concentration into something (often work), where I will work at superspeed and use my anxiety and hyper alertness as a ability, not a hindrance. This helps burn off that excess adrenaline.

 

I think I am getting close to my new normal. I don't need valium, anti-depressants and rarely if ever need to have a drink to unwind or relax. I dont really know how to relax, I'm either 'on' or 'exhausted' - but that's been the normal for as long as I can remember. I know and will avoid or manage situations (like big social things) where I know I will be anxious (I have always been socially anxious and introverted). I can manage 2-3 hours of heavy social or loud/busy places before I completely crash and end up with the only thing in my mind being 'leave now' (pre medication, I remember doing this anyway, so I think that's normal for me!). So I will always try to be out of there within that window. If its somewhere I know will set me off, then screw it, I'm not going. I've been through enough in my life to know that damaging my own mental well being is not worth it, just to appease someone else. Maybe in the future that time will extend to more than a few hours, but based on my very distant memories before anti-depressants, I don't think so, I think that is just who I am as a person. My social fuel tank is just much smaller, and that's fine.

 

If my body and brain are telling me its bad (and ramping up anxiety hard) and will make me feel awful, then its not worth my mental well being. While I would probably be able to 'cope' with those situations a lot better being numbed with a handful of pills, I'd rather be not trapped and have to battle side affects and everything else that goes with them also. I'm learning my limits and what I can cope without being in a bad place and that's good enough for me. I'm introverted, so forcing myself to be somewhere, for longer than I can manage is bad for my mental health - without pills this is much more obvious! I'm not locking myself away (as that's just as bad), but I'm also not going to go along somewhere for more than I can deal with, if its going to be bad for my mental well being. I have my safe spaces, my safe people and places where I feel comfortable enough for several hours.

 

I'm still getting there, but the last 12-18 months seems to have the been the worst of it and I'm now in recovery and adapting to a med free brain function. Its OK to make mistakes, its OK to freak out sometimes and its OK to say 'I cant cope with that situation right now' and bail. Being kind to myself has helped a lot, even the little bit of kindness I do show myself. Otherwise I work myself to exhaustion, and use that immense anxious energy on something other than fueling awful thoughts and emotions that would have just tortured me instead (and made a thought loop of bad).

 

I saw in a few other posts questions about how long on meds vs how long in recovery - so maybe my posts can shed some light on the process for my journey.

 

Rough timeline I think was:

 

- On pills since 2009 to 2022 so 13 years! 

- Late Sept 2022 - zero anti-d meds, anxiety, panic and emotional turmoil for about 15 months (needing some intermittent chemical assistance when things got real rough), poor sleep and overly emotional 

- instability for several more months mid 2024, with long term side affects (physical/sexual symptoms) starting to fade away slowly.

- Slowly coming to baseline 2 years later.