boohoo: to switch or not to switch

[boohoo]

Hello, and thank you a million times for the site, I am gutted to be here.

I'm so sorry I didn't fill in my history, I thought it went in the signature and didn't want to do it twice, I'm in something of a rush and feeling utterly terrible. I realized I should have but don't seem to be able to go back and fill it in. Apologies for any inconvenience. One of a thousand stupid decisions I seem to make all the time on these meds.

So I'm hoping for some advice about switching. I've been on Mirtazapine for approximately 8 years and I'm reaching the point where the Gemini scales won't be accurate so I'm looking to switch. However, I switched to Prozac a couple of years ago and had a terrible time. I was manic, couldn't sleep or eat, and so went back. At the time I thought it didn't agree with me but I now realize it may have been withdrawal from the mirt that was causing the problems. I'm really sensitive, which is why I've had to change pills in the past after reactions like skin rashes so I'm worried about trying something new. I'm hoping you guys might have an idea of what I could switch to that's soluble and hopefully, easier to get off than Mirt.

Also, over the 2 or 3 months I'm starting to feel depression creeping in, which I haven't had before as a withdrawal symptom, so I don't know if it's withdrawal or relapse. I can't take anything else for the depression as it'll interact so I'm thinking of going back up to 7.5 and staying there but the thought of staying on this medication makes me feel suicidal. This is complicated by the fact that I stopped drinking completely 3 weeks ago which can apparently cause depression although the depression starting earlier but it could be exacerbating it.

I realize there's a chance, a good chance, that, having been on these meds for so long, and having swapped about along with being so sensitive, I might well have to stay on them forever. I'm trying to come to terms with this, but I don't want to give up giving up too easy.

Many thanks again for the site, I wish I'd found you earlier, and for any advice you can offer.

 

 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I agree with you, I too suspect that your symptoms after you switched from mirtazapine to prozac were probably withdrawal from mirtazapine.  Let me give you some basic info, then some suggestions at the end. 

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements 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.

 

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.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Mirtazapine

 

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

 

On 10/24/2022 at 1:33 PM, boohoo said:

I'm hoping you guys might have an idea of what I could switch to that's soluble and hopefully, easier to get off than Mirt.

 

I would not suggest that you switch to another drug in order to taper off psych drugs.  That is riskier than just doing a very slow and careful taper off of mirtazapine.  According to the link above on tapering mirtazapine, a liquid is available in the UK.  

 

On 10/24/2022 at 1:33 PM, boohoo said:

I can't take anything else for the depression as it'll interact so I'm thinking of going back up to 7.5 and staying there but the thought of staying on this medication makes me feel suicidal.

We need to see your drug history, as requested, before we can give you feedback on whether or not this is a good idea.  

 

On 10/24/2022 at 1:33 PM, boohoo said:

This is complicated by the fact that I stopped drinking completely 3 weeks ago which can apparently cause depression although the depression starting earlier but it could be exacerbating it.

Had you been drinking daily and heavily?  It is quite possible that you are going through withdrawal from alcohol at this time.  Please be extremely careful about making any changes to your mirtazapine at this time.  It's a good thing you stopped drinking, as it's not good to drink while we are on psych meds. 

 

On 10/24/2022 at 1:33 PM, boohoo said:

I realize there's a chance, a good chance, that, having been on these meds for so long, and having swapped about along with being so sensitive, I might well have to stay on them forever.

I seriously doubt this.  I believe that if you do an extremely slow and careful taper, that you can get off the mirtazapine eventually.  

 

 

Edited October 30, 2022 by getofflex

[boohoo]

Hi all, hope you're doing as well as can be expected and belated best wishes for 2023. Hope it goes well for us and this process.

 

Getofflex, thanks so much for coming back to me. Sorry it's taken so long for me to answer, I'm really struggling with functioning but still astonished to see how long it's actually been. Also I was a bit stumped by your request for history because I thought I'd done it, but although I did put it in somewhere its not in my signature so I'll get that done, hopefully more precisely. So thanks for your response, everything you said made sense.

I decided against reinstating to 7.5 and reading up here showed me the depression is a WD symptom so I'm carrying on although I haven't made much progress lately. I'm currently at 5.3 and planning to swap to  solubles soon and boy do I have questions. I'm posting this to get my second post approved while I do my history and get my head around what I need to know to move forward.

In the mean time, can someone please tell me if its the same story for amitriptyline as my mum's taking it and wants to stop. Her doc has told her to taper by taking it alternate days. I said this wasn't a good idea so shes talking about halving it, don't think she really gets what I'm saying. Should she be sticking to the 10%? I believe it's a mild one?

Thanks in advance and Ill be back very soon.

[getofflex]

   

14 hours ago, boohoo said:

can someone please tell me if its the same story for amitriptyline as my mum's taking it and wants to stop

Please have your mum create her own account.  We will need to work with her directly.  She should not take it on alternate days - that puts her at major risk of destabilization and painful symptoms.

 

Again, we will need your drug signature. No more discussion on your case until we get that information.  If you can't post it in the signature, post the drug history in a regular post, and we can transfer it to the signature. 

 

 

[boohoo]

Hi all, hi Getofflex, thanks for your response.  Sorry it's taken so long to respond. I've finally managed to do my history. I should also mention I gave up alcohol in May 2023. Before that I was drinking quite a lot,  certainly every day. I haven't altered my dose for a year as I've been struggling with symptoms, and reactions, I've completely stopped all supplements now as I can't tolerate anything but I've had mishaps eg. Drinking earl grey (decaf) which interacts with Mirt. I assume this is destabilisation rather than withdrawal. Also I missed a dose a few weeks ago which was bad for about 10 days. (And the same a few months ago, although I don't think it was so bad that time. I guess this means I'm moving in the wrong direction. 

I'm hoping someone can give me some advice.  I'm away from home in Portugal and I have the beginning of a tooth infection.  I am absolutely terrified of taking an antibiotic as I'm reacting so badly to things. I can't even drink a decaf coffee at the moment.  I had amoxicillin last year for a chest infection but that was before I stopped drinking snd I'm worried that I'm more unstable since then. I know antibiotics can cause problems and I've no idea what might be safest. I'm alone here, and scared. Any ideas? Thanks all. 

[getofflex]

Thanks for doing your drug history.  So you are currently on 5.3 mg mirtazapine, and have been since Jan 2023?  Are you on any other drugs at this time?  If so, please list these too in your signature.  

 

About how often, on average, did you take nitrazepam?  This is a benzodiazepine. 

 

How often on average did you take cocodomol?  This has codeine, and is an opioid drug.  

 

I understand your fear of taking antibiotics.  However, if you have a tooth infection, it is important to get this treated.  Some antibiotics are worse than others.  The ones you want to avoid are the fluoroquinolones.   I have taken cephalexin in WD for UTI's, and had no trouble with it at all.  Here is our topic on antibiotics.  

 

Antibiotics

 

 

 

[boohoo]

Thanks for coming back to me on this. Yes, 5.3 since Jan 2023. No, I don't take anything else,  I no longer can. The nitrazepam I took more in the beginning. But not every day. I'd maybe take 2.5 mg once or twice a day 2 or 3 times a week. I started using it less and less after finding SA. Cocodomol I used quite alot but again,  not all day every day, and again, less and less after finding this site. I never felt  dependency with either. But they both began to just make me ill during withdrawal.  Thanks for the link. I've been reading up on the site regarding antibiotics. Of course we're all different so it's moot but I've read alot about people reacting to amoxicillin so although I got away with it last year (it did make me a bit nauseous which it never had before) I'm wondering if I should avoid it. I guess anythings a gamble.  I'm using high quality,  high price to match, honey to try and stave off the infection but I know it'll have its own impact too. And salt rinses. Thanks again 

[getofflex]

15 hours ago, boohoo said:

Yes, 5.3 since Jan 2023.

Thanks, please clarify your signature by putting "Jan. 2023 - current: 5.3 mg mirtazapine".  Thank you. 

 

Good luck with your tooth infection.  Keep us posted.  

[boohoo]

Alternative to amoxicillin?

 

Thanks Gettofflex. I've changed my signature.

 

I took the first pill of amoxicillin last night and felt some symptoms. I'm wondering if I should ask for an alternative.  The doctor suggested something else and I asked how it differed from amoxicillin and once he knew I'd had that before,  that's what he wanted to prescribe. But I had it before I stopped alcohol and things are different now. 

Is it bad to switch? Would something else be safer? Is amoxicillin particularly bad? 

Any ideas anyone?

[getofflex]

5 hours ago, boohoo said:

Alternative to amoxicillin?

You will need to talk to a doctor about this.  I think amoxicillin is pretty benign.  

[boohoo]

Thanks Getofflex, hope you're doing well 🙃

[boohoo]

Hi,

Could someone please explain this to me. The drug checker says there's a potential interaction but then it says there isn't?

[getofflex]

The first sentence says that there are no interactions between your drugs.  I suspect they put the second sentence in there, more to cover themselves and protect themselves from a possible future lawsuit more than anything.  It's sort of like a liability disclaimer, I would guess. 

[boohoo]

Gotcha. Thanks Getofflex

[savinggrace]

Hi Boo Hoo,

 

How did you do with the amoxicillin?  
 

BTW, to piggyback on the “interactions” discussion, I do look for known interactions before I take something, but with many people so many more interactions exist. These known interactions assume normal metabolism with normal and most commonly used and needed CY450 enzymes. For example I am (genetically) a “poor metabolizer” of CYP3A4/5 and 2D6 which affects me tremendously and causes induction or inhibition of other drugs. Also, though it is getting better, there are so many drugs. It’s hard to know if the interaction you are looking for has been studied.  These tables are good for posting the most common and/or dangerous interactions though. 

 

Grace

[boohoo]

Hi Grace, I hope you're doing ok. 

 Sorry it's taken so long to reply, I've been struggling the last few days with motivation and clarity.  

 

The amoxicillin was a host of symptoms. The worst, and the ones that have stayed,  but reduced, are big cognitive impairment,  tendon pain, particularly in my feet, and poorer sight in my right eye. 

I realised after I'd taken it that it was probably what made things so much worse last year. I hadn't put the two together,  unbelievably. 

I completely understand what you're saying about people being different,  and results being unpredictable.  My doc said the tendon pain was all in my head, because that's not a side effect of amoxy. I'd made the mistake of saying 'antidepressant withdrawal website' and that's my file marked. 

I'm not sure the infection is gone, I read that colloidal silver doesn't inhibit enzymes. At least, that was my understanding. So I might try that as a mouthwash. I know it could have been worse but I really don't want to take antibiotics again if I can possibly help it. I should have had that tooth taken out, I knew it would cause problems.  Guess I've been in denial,  but there's no hiding....

 

 

 

 

 

 

[boohoo]

Hi all, 

I went to have the problem tooth out but the dentist suggested referring me to a specialist to have the root filling redone. I've let him go ahead and refer me.

Has anyone else had teeth out to avoid antibiotics? I feel like I'm playing with fire. 

 

 

[boohoo]

Can anyone advise me? 

I have to have more antibiotics as the tooth infection isn't completely gone.  Having had symptoms with the amoxicillin I don't know if I should have it again or ask them to give me something else. 

Is any antibiotic likely to cause problems? Is it just pot luck?

 

[getofflex]

It is important to have the tooth infection treated, as it can lead to more serious health problems.  If it were me, I would ask them to give me a different antibiotic, but definitely avoid the fluoroquinolone class of antibiotics.  

 

On 3/6/2024 at 10:47 AM, boohoo said:

Is any antibiotic likely to cause problems? Is it just pot luck?

Everyone's system is different.  I'm not sure how you will react.   

[boohoo]

Thanks so much Getofflex, and Grace too. Thank you both. 

The dentist managed to take the tooth out so I haven't had to take anymore AB's. This is such a relief.  

I'm sorry if I made a fuss. I read something on the site that gave me the idea that medical history and liver function etc could somehow be related to medications and with the right knowledge a deduction made as to the best AB, but it was way above my level of understanding. I just hope I don't have to take them again. Onwards and upwards,  thanks again. 

[boohoo]

Is withdrawal hell after 4 or 5 mg?

 

I get the impression that once one goes below the threshold for full receptor occupancy, things will go, and stay, haywire, regardless of how slow the taper. 

 

This is supposition on my part so please don't anybody assume its true and be disheartened. 

 

Anyone's impressions, or indeed knowledge on this would be very welcome.

 

Thanks.