Eric39: mirtazapine and klonopin short term

[Eric39]

Hello

I became depressed after stopping sleeping out of blue during a mild covid infection...I had been depressed once before 2019 to early 2021. Never healed til off all meds...was completely thriving til July 10th stopped sleeping out of blue. Now on klonopin. 75 and 15 mirtazapine. Desperate to get off both asap. Mirtazapine has been 15mg for 5 weeks...klonopin 2.5 months jump between 1mg to nothing to .5...right now I settled on .75 and want to start water taper  from here...problem is I couldn't  sleep before and afraid natural sleep will never return. Depression still strong but I blame meds for worsening it.

[Frogie]

@Eric39

 

Welcome to SA. We are a volunteer ran site helping people taper off psychiatric medications or have tapered off and are now healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that you only have one introduction page so we can keep all your information in one place.

 

 

Here is some information on tapering Mirtazapine. 

 

Taking multiple psych drugs? Which drug to taper first?

 

Why taper by 10% of my dosage?

 

The Brassmonkey Slide Method of Micro-tapering

 

Tips for tapering off mirtazapine (Remeron)

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

 

We don't suggest you taper off the benzo (Klonopin) first, as that can help with the withdrawal symptoms you might experience with the tapering of the Mirtazapine. You could try splitting the dose of the Klonopin, taking it every 12 hours so you don't have withdrawal symptoms from that. To do this you would take 1/2 the dose an hour earlier each night until you read the time you want to take it on a regular basis. Example: 37.5 mg at 6 pm and 37.5 mg at 5 pm, then the next night you would move the 5 pm dose to 4 pm, and keep moving it until you get to 6 am. 

 

 

 

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications:

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

 

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

 

Keep It Simple, Slow, and Stable

 

 

 

Here are some links you may find useful also.

 

The Windows and Waves Pattern of Stabilization

What is withdrawal syndrome?

 

Withdrawal Normal Description

 

Sleep problems - that awful withdrawal insomnia

 

Melatonin

 

 

We don't suggest supplements here as they can be stimulating to the central nervous system (CNS), except 2. If you would like to try one, try a small amount and wait a few days before introducing the other.

 

 

Magnesium

Omega 3 Fish Oil

 

 

After you have read the links provided please reach out with any questions you may have.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Eric39]

Thanks for reaching out...I don't really get any withdrawal from the klonopin. It doesn't really help much with sleep either...I just take it to prevent withdrawal effects...I really want to micro taper off asap. As for the mirtazapine I want to get off asap too. I know here you recommend 10% a month but my god after only 5 weeks use...I'm so sick of this...Dr. wants me to start welbutrin before tapering mirtazapine as well...I don't know what to do.

[Frogie]

@Eric39

 

Since you have only been on the Mirtazapine 5 weeks, you could try 25% a week taper and see how you do. But if you start feeling really bad, then I would suggest you hold until you become stable again.

 

I would not start the Wellbutrin. You would just taper off the Mirtazapine. I don't think you want to add drugs at this time, do you?

 

How do you talk to a doctor about tapering and withdrawal?

 

I would not taper the Klonopin until you are done with the Mirtazapine. And then let your body rest a little while before tapering off of it.

Edited October 3, 2022 by Frogie

[Eric39]

Thank you for the insight..I really want to stop the mirtazapine but my Dr. Wants to add welbutrin first. I desperately don't want to do this and add yet a third drug. I'm sure she will insist but I'm quite sure adding this will not make a difference and all of a sudden make me feel great..I really don't know what to say to her to get her onboard to taper mirt before adding anything else as I know In the past I got better after being off everything and beginning to sleep..thats when I returned to myself

[Eric39]

I reduced mirtazapine to 11.25 last night and had zero sleep... .75 klonopin doesn't even make me drowsy at all. No clue what to do...Dr. said reduce to 7.5 but I went to 11.25

[Eric39]

I'm wondering what you think about the fact that I can't sleep even with taking klonopin. This has been going on the whole time. At first I had some nights of sleep on the 15mg mirtazapine and I would skip the klonopin. Seems whenever I take it..it almost blocks my sleep...I hate it so much...doesn't give me any relief from insomnia...I really stuck

[Eric39]

I've been taking the 11.25 since Monday and feel no different except I can't sleep at all..my Dr. Said drop to 7.5 as it is more sedating. I also take the .75 klonopin but it does nothing for me..I wonder if I drop down to 7.5 mirt if my sleep will improve or get worse?

[Eric39]

I too am trying to get off the mirt. I have been on 6 weeks at 15mg and reduced to 11.25 for a few days and then to 7.5 last night..I ended up getting some sleep at the 7.5..I have felt the mirt has worsened my depression the whole time. Will I feel less depressed as I reduce?

[Altostrata]

Hello, @Eric39 I moved your post here, to keep your progress in your own topic.

 

On 10/3/2022 at 11:16 AM, Eric39 said:

Dr. wants me to start welbutrin before tapering mirtazapine as well...I don't know what to do.

 

First off, substituting Wellbutrin for mirtazapine when someone is having trouble sleeping makes no sense at all. Wellbutrin tends to be stimulating, with insomnia as a frequent adverse effect. 

 

Depression is a common adverse effects of benzos such as Klonopin. It may also be an aftereffect of covid, which appears to have triggered the insomnia to start with. Covid is known to have neurological effects.

 

Why do you want to stop mirtazapine? Good to hear you find 7.5mg more helpful for sleep than 11.25mg. Suggest you hold on further reduction for a while.

 

What times o'clock do you each of your drugs, with their dosages?

[Eric39]

Thanks for getting back to me..I agree about the welbutrin I have been stimulated by it before. I had zero sleep last night on my second night dropping to 7.5. I just have no clue what to do as my sleep has disappeared even thought I take mirt at about 9pm then I take klonopin. 75 at about midnight when I can't sleep or wake up if I'm lucky enough to fall asleep on mirt. I wanted to stop mirt because I feel horrible on it and klonopin which are doing nothing for me. Please advice...I need help...thx

[Eric39]

2 hours ago, Eric39 said:

@Altostrataany advice on timing the meds differently...I'm completely tolerant to the .75 klonopin and it doesn't make me sleepy at all. Just take it at mid night and mirt at 9 when I go to sleep. I just take it so I don't go into wd. I feel like it has always blocked my sleep. In the beginning I would skip a night if I fell asleep with mirt. My Dr. Wanted to keep consistent so I just started taking it every night as if I missed a nite or 2 I would start feeling it.

 

[Altostrata]

It sounds like mirtazapine does help you sleep a bit.

 

Do you take Klonopin every night on an irregular schedule?

 

Do you have any odd symptoms during the day?

[Eric39]

No..the mirt is very inconsistent in its effectiveness...I'm pretty regular in taking the klonopin at midnight..just reach over to night table and swallow .75...no odd symptoms during day..just can never fall asleep nap or anything without taking a med. Last night both were completely ineffective as I had zero sleep. Tonight I'm thinking of doubling the klonopin because I have a big day tomorrow and can't afford a zero sleep night again...as much as I hate the idea of a benzo I'm desperate 

[Altostrata]

From what you've reported, it doesn't seem the 0.75mg Klonopin hasn't been effective for sleep, is that correct? More likely, you're getting a paradoxical effect from it, and if you take a larger dose, you'll get more of a paradoxical effect.

 

If you've taken Klonopin every night since August 3, it's likely you are adapted to it. Taking it off-schedule may cause odd symptoms hours afterward.

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show what the Klonopin is doing.

 

 

[Eric39]

9pm mirt 7.5

12 midnight klonopin. 75

6am wake up depression incredibly strong.

 

No other meds. Feels like depression is present throughout the day. I'm dying to taper this klonopin because it doesn't do anything for sleep. I was never better when I was off all meds and sleeping naturally. I feel like absolute hell on mirt and klonopin. Especially in morning upon getting out of bed..only sleeping every other night right now.

[Altostrata]

Please post 24 hours of notes at a time and note your symptoms before and after each dose of each drug. How do you feel after taking mirtazapine, but before you take Klonopin? How do you feel during the day? Are there times you feel better or worse?

 

Why do you take Klonopin at midnight? A very common adverse effect of benzos is depression.

[Eric39]

10.13.22 @Altostrata

 

6 a.m. Woke with depression
6:30 a.m. ate cereal and coffee
6:35 a.m. Stool softener 
10:15 a.m. depressed..hopeless
11:30 a.m. eat lunch
12:35 p.m. Ate lunch
3 p.m. bannana 
5 p.m. Apple
6:30 p.m. Ate dinner
8:30 p.m. mirtazapine 7.5 ..went to sleep
10:20 p.m. took 2.5 .25 klonopin (cut .5 of 1 pill out)and 10mg melatonin 
12:00 a.m. woke up went back
2:30 a.m. woke up went back
2:45 a.m. woke up went back
5:00 a.m. Woke for good..very depressed and body feels dead..get out of bed at 6am

 

Overall felt slightly better 5pm to 7pm..just never excited or distracted from my depression..only fixate on getting off meds cuz I felt so great for 2 years med free.literally thought I would never deal w this again..then one day just went sleepless and it all came back..my worst nightmare

[Santino]

Hi Eric

Try to read my Intro topic and my success story as well.

It seems our stories are very similar and as i have been where you are right now rest assured you have not damaged yourself and you can sleep again naturally in the future.

If i was you i would try to tackle the klonopin first. I went very fast with my benzo and it was terrible but i had such strong will and made it. After my acute withdrawal from the benzo things started to look brighter. Anxiety diminished and i started to sleep more hours.

From what you write i understand you are already obsessed with the amount of sleep you are having right now. It is close to impossible for you to have zero sleep as you mention cause right now you would suffer big time. Try to keep all the watches away from you at night and if you wake up to go to the toilet try to do it with you eyes closed. Even a single ray of light that enters into your iris at night starts to trigger the waking up process so be aware of this fact. Practicing such simple tricks were a life saver for me. 

Try not to overdo melatonin. On very bad days i would wake up and drink a mix of chamomile and linden flower tea... That would always do the trick and would earn me 4-5 hours of sleep. 

There is no quick getaway from your situation. You have done wrong to start medications after one sleepless night which does not make much sense to me. Anyway you will be great. Just stabilize yourself now and start tapering clonopin by water titration.

Let me know.

All the best

Santino

 

[Eric39]

@Santino..it all seems pretty hopeless with this depression that I was driven into by insomnia...taking the klonopin .625 and the 7.5 mirt makes me think ill never sleep naturally again..your right about the melatonin..i usually take 5mg but last 2 nights i took 10mg and got some hours but i wake up constantly..I will look into passionflower tea..I heard it can be good..all I know is this happened once in the past in 2019 and I never healed the depression until I slept naturally..Then it was a distant memory and I was feeling amazing...all of a sudden during a covid infection I stopped sleeping and boom..all came back after 2 years never even taking a advil..depression from insomnia is brutal

[Santino]

Eric

Nothing has changed from those two years. You have just disbalanced your nervous system with the meds you poured in lately. All will settle if you have the good will to be calm and acceptive of your own situation. There is not a quick fix for your problem. Try to stabilize and do not play with meds at this level. Raising and lowering all the time does nothing good to your fragile nervous system. 

Convince yourself that this situation is temporary and push forward. Depression is caused by Klonopin at this level i believe. Benzos are terrible, but the good news is that depression and anxiety from benzos is hard but short lived once you go off them.

Just be calm and push forward. You will be good i believe if you start to stabilize your med's level.

Santino

[Eric39]

@Santino I appreciate your words..I'm in a bad way..I believe the benzo contributes to my depression...when this first happened I was put on z drugs and those didn't help either and probably started pulling me into depression too along with the insomnia..sometimes i dont know what to think..i know i healed last time when i was drug free so go figure

[Eric39]

@Santinoby stabilize what do you mean...I was planning on trying to taper the benzo..I just cut half a .25 klonopin in half for the last 2 nights and was going to stay there for 2 weeks min. To see how I do...I guess I should leave the mirt for now at 7.5?

[Altostrata]

On 10/14/2022 at 4:43 AM, Eric39 said:

10:20 p.m. took 2.5 .25 klonopin (cut .5 of 1 pill out)and 10mg melatonin 

 

How much Klonopin are you taking at this time, in milligrams? Do you take it at the same time every night?

[Eric39]

Last 3 nights went down to .625 from .75..first 2 nights I slept ok but last night zero minutes of sleep..feeling very depressed with no sleep..horrible..yes I take at the same time each night

[Altostrata]

I would have suggested something else, but if you want to keep changing the Klonopin, it's up to you.

[Eric39]

Please I would love a suggestion

[Eric39]

I'm about to try and go to sleep so any help is welcome

[Altostrata]

It's possible that you are now feeling withdrawal from your recent clonazepam reduction to 0.625mg.

 

I might have suggest 0.75mg clonazepam was too high a dose all at once and, in combination with mirtazapine, causing a paradoxical reaction preventing you from sleeping. In these situations, we would have suggested moving perhaps 0.25mg clonazepam an hour earlier each day until you're taking it at perhaps noon.

 

This maintains your total daily clonazepam dosage and forestalls withdrawal symptoms.

 

You would continue taking 0.5mg at night. This may enough of a reduction at night to enable you to sleep. You'll have to give it several days to take full effect. 

 

Since you cut 0.125mg (to achieve your current 0.625mg), you might restore it back to noon tomorrow after taking 0.625mg tonight. Then your benzo schedule would be 0.125mg at noon with 0.625mg at night, daily total 0.75mg. Hopefully, the 0.125mg at noon won't make you sleepy.

 

After that, we'd figure out how to taper clonazepam further. Ordinarily, we'd look at your dosing schedule first, then work out a more comprehensive schedule, but your ad hoc reductions make this a moving target.

 

 

[Eric39]

So I ended up just taking the .75 last night...didn't see your last post til this morning...I was able to sleep last night and took 10mg melatonin along w my klonopin. I'm desperate to regulate my sleep schedule and could not have another sleepless night. I guess I would consider backing up a .25 an hour each day til I got it back to noon. It is so hard to know what to do as I was feeling depressed before I started klonopin but it was all because I lost my sleep first...no depression was present before sleep was lost. That's why I am desperate for some way to be med free and still able to sleep cuz I know my depression will lift if I can achieve that.