Gijoeman: Need Remeron help

[Altostrata]

Well, prepare yourself, because you might not be able to drop by 10%. It may need to be less.

[Gijoeman]

Ok, I get it. Hard to believe but acceptance of one's circumstances is key to success I suppose.

[Gijoeman]

Having a horrible time. Burning nerves all over my body. I actually woke up yesterday morning feeling relatively ok. That hasn't happened in months. I was also ok the night before. But Thursday morning I was crying and praying on my morning walk. Yesterday my morning walk was fine. By noon yesterday stress at work pushed me over the edge. I woke up last night at 2:30 with the high anxiety, wanting to die, praying to God to make it go away. Managed to doze back off but was up for good at 6:30. Horrible morning. I just can't handle stress. Just like last Friday I thought, great, a weekened break. I will put my troubles out of my mind for 2 days. But it just doesn't happen that way.

 

Is this just a horrible wave? I have not had any "happy" thoughts in months. Not since I felt I "turned a corner" back in June.

 

I have stayed at 5mg remeron and I seem to be stable on that. It is just hard to know what is causing my problems since nothing helps just the severity goes up and down. I suppose this is all paxil withdrawal. I am now 16 months off paxil.

 

Any advice?

[Gijoeman]

Well, I seem to have managed getting to 4.5mg as of 9/15. So, almost three weeks. I did have issues last week. Can't remember exactly. I had been seeing a good day or two per week as of three weeks ago. That ended on the 19th. That was my last good day. Been pretty rough ever since. Not sure if it is the drop or just another paxil wave. There are times that I sleep just fine then during a wave I have nights where I wake early but usually not before 4:30am (to go bed at 10pm).

 

I guess the only solution with remeron is to go slow. I worry about the accuracy of my scale. It is one of those gemini scales from Amazon.com. I hope I am able to continue to heal from my cold turkey off paxil while still taking remeron. I assume that the reason it is so hard to get off the remeron is because my system is so jacked up by 13 years of paxil usage. Does that make sense.

 

My plan is to be off remeron by May 5th which will mark my 2 year annivasary off of paxil. Does anyone believe that the remeron usage will prolong my suffering from paxil withdrawal? Will I also be suffering from remeron withdrawal once off completely?

[Altostrata]

This might be a good time to hold on the Remeron taper and let your nervous system calm down.

 

Since you had a bad withdrawal from Paxil, your nervous system might be more sensitive to Remeron withdrawal. Unless you're having adverse effects from the Remeron, there's no need to push the taper beyond your tolerance.

 

When you get a flare up of symptoms, whether it's Paxil withdrawal or Remeron withdrawal, your nervous system is asking you to take care of it.

[Gijoeman]

This might be a good time to hold on the Remeron taper and let your nervous system calm down.

 

Since you had a bad withdrawal from Paxil, your nervous system might be more sensitive to Remeron withdrawal. Unless you're having adverse effects from the Remeron, there's no need to push the taper beyond your tolerance.

 

When you get a flare up of symptoms, whether it's Paxil withdrawal or Remeron withdrawal, your nervous system is asking you to take care of it.

 

Take care of it how? You mean just hold on the remeron? It's hard to tell exactly what causes the flareups because they have happened continually regardless of how fast or slow I taper. There is no way to pinpoint anything I do that might be causing issues short of just stopping the remeron all together. I know that would be catastrophic. I know thw paxil issues will persist pretty strong up to 18 months then I hope to see continual noticable progress up to 24 months. It's not being able to guage progress that is so frustrating.

 

I really thought I had turned a corner a couple of weeks back. Things just felt different for a couple of weeks. I still had issues up and down but I actually felt better on several occasions. Even though my job can be very stressfull there were times when I was engaged at work. That has not happened for over a year. So, this must still be paxil withdrawal as I am going very slowly on the remeron.

 

I think I have known for some time just how long this would take with the paxil withdrawal. But my mind can only seem to allow for 6 months increments to believe that I will be recovered. So, I am now waiting for 18 months to evaluate my progress (that will be on the 5th of November). I think 24 months will be the time when I will be able to see the biggest improvements to date. Then I hope to see improvements continually week after week.

 

Thanks for you advice and support.

[Altostrata]

Your nervous system may be vulnerable because of the Paxil withdrawal. Go as slowly as you need to in reducing Remeron. It's not a race, you don't have to be finished by a certain date.

 

Any changes affecting the nervous system may cause a flare-up of those symptoms first induced by Paxil withdrawal. It's like trying to run on a leg that hasn't quite healed from being broken.

 

People sometimes holding off tapering for a bit to allow their nervous systems to assimilate the new environment.

[dalsaan]

Hi Giojoeman

 

I understand myself to have a very stressed system that struggles to cope. How much my system struggles varies. Some times ok sometimes not.

 

It's not one thing that causes the stress, it's a combination of things, effects of medication, effects of withdrawal, situational stressors like work, illness, physical exertion etc etc.

 

any one of those things can be the straw that breaks the camels back at a given time and I will feel the effects physically and emotionally. I'm not broken, my system needs an opportunity to recover

 

I have worked this out for myself and therefore I have given up trying to identify the cause and effect underlying what I am experiencing. I don't think there is a magic answer that will explain and fix what's happening.

 

Now what I do is reduce the risks by eliminating potential stressors. This has meant getting rid of stuff in my diet that is stimulating or bad for my system - coffee, sugar alcohol. I have also tried to reduce my work stress, listen to my body on tapering, take stuff that's positive for stress fish oil and taurine

 

I have also learnt relaxation techniques and used sleep hypnosis apps on my phone. All of these things are about taking care of my system

 

Importantly when I gave up the hunt for the cause of my problems I let go of something that was dementing me. This in itself was a form of self care

 

I have found all of these things together have made a big difference. I am on the lowest level of remeron I have been since I started taking it (excluding prior ct attempts) and feel better than I have in years

 

I can't tell you what's right for you, I can only offer the things I have tried, what's worked for me and what hasnt. Take from it what you will

 

I wish you all the best

 

Dalsaan

[Gijoeman]

Hi Giojoeman

 

I understand myself to have a very stressed system that struggles to cope. How much my system struggles varies. Some times ok sometimes not.

 

It's not one thing that causes the stress, it's a combination of things, effects of medication, effects of withdrawal, situational stressors like work, illness, physical exertion etc etc.

 

any one of those things can be the straw that breaks the camels back at a given time and I will feel the effects physically and emotionally. I'm not broken, my system needs an opportunity to recover

 

I have worked this out for myself and therefore I have given up trying to identify the cause and effect underlying what I am experiencing. I don't think there is a magic answer that will explain and fix what's happening.

 

Now what I do is reduce the risks by eliminating potential stressors. This has meant getting rid of stuff in my diet that is stimulating or bad for my system - coffee, sugar alcohol. I have also tried to reduce my work stress, listen to my body on tapering, take stuff that's positive for stress fish oil and taurine

 

I have also learnt relaxation techniques and used sleep hypnosis apps on my phone. All of these things are about taking care of my system

 

Importantly when I gave up the hunt for the cause of my problems I let go of something that was dementing me. This in itself was a form of self care

 

I have found all of these things together have made a big difference. I am on the lowest level of remeron I have been since I started taking it (excluding prior ct attempts) and feel better than I have in years

 

I can't tell you what's right for you, I can only offer the things I have tried, what's worked for me and what hasnt. Take from it what you will

 

I wish you all the best

 

Dalsaan

 

Dalsaan, I am not at 4.2mg remeron and have been for three weeks. Going to 4.0mg tonight. Today my anxiety it throught the roof. It is effecting me physically. Heart palpatations, stomach tied up in knots. I really wonder if the remeron is causing me any grief. I am recovering from 13 years of paxil use with a pretty much cold turkey quit 18 months ago. My conditions seems to be very similar to others who have gone throught the paxil withdrawal. I just don't think this low dose of remeron is causing me all this grief. What were you on prior to Remeron? Why did you start Remeron? Did it ever help you at all?

[Altostrata]

Gijoe, is this a new symptom pattern since you went down to 4.2mg?

 

Do you take the Remeron at night? When do you get these symptoms?

 

Well, I seem to have managed getting to 4.5mg as of 9/15. So, almost three weeks. I did have issues last week. Can't remember exactly. I had been seeing a good day or two per week as of three weeks ago. That ended on the 19th.

It seems as though the decrease in Remeron dosage might be causing a flareup of symptoms. The next decrease exacerbated this.

 

You haven't tried a hold on decreasing to see if your symptoms go away. It might be a good idea to do this now.

[Skyler]

Hello GI. When drugs share some of the same withdrawal profile, withdrawal from one can bleed into withdrawal from the other. I have tinnitus which is made worse by either Lyrica or diazepam cuts, and even though I'm on a very tiny dose of diazepam I need be mindful, and same for the large dose of Lyrica. Your meds may be different, but don't minimize the degree to which they 'cross pollinate'.

[Gijoeman]

Gijoe, is this a new symptom pattern since you went down to 4.2mg?

 

Do you take the Remeron at night? When do you get these symptoms?

 

Well, I seem to have managed getting to 4.5mg as of 9/15. So, almost three weeks. I did have issues last week. Can't remember exactly. I had been seeing a good day or two per week as of three weeks ago. That ended on the 19th.

It seems as though the decrease in Remeron dosage might be causing a flareup of symptoms. The next decrease exacerbated this.

 

You haven't tried a hold on decreasing to see if your symptoms go away. It might be a good idea to do this now.

 

It's all very ridiculous. But keep in mind, I have had a horrible paxil recovery. I have read many, many stories about paxil cold turkey. I seem to be experiencing the worst of it. My emotions are magnified by 1000. I will be 18 months off paxil on November 5th. I started Remeron on July 28,2011. I have been up and down on the remeron but only above 15mg for a very brief time last September/October. My symptoms never really abate. I have decent evenings and horrible mornings. I had a day and a half decent last week. A decent day for me is one where I wake up with no anxiety or it goes away very quickly. Plus the depression will lift. I have had 3 days in the last 6 weeks where this was the case.

 

I take the Remeron at night around 10pm. Last night I forgot to take it and woke up anxious at 3am. Once I had determined that I forgot it I took it. This morning the depression has been at a critical level. Crying non-stop. I just can't believe how bad it can get. I have a lot of stressors in my life and they don't help as you could imagine. Having 4 teenage kids and a stressful business makes this that much harder. I have chosen to believe that the Remeron is not making me worse. My sensitivity to getting off the Remeron is because of the Paxil withdrawal. That has been the opinion of those on this board and a pdoc I asked. My windows are few and far between.

 

You asked if my symtoms are made worse by the drops in Remeron. I can't say that I see a direct relationship between the two but things do get worse a couple days after I drop but they were never good to begin with. I took the Remeron at 3am. Could that have caused this complete breakdown this morning? I want to stick with th 4.2 although I was planning to drop to 4.0 since its been three weeks. I feel like I am stuck in a real tough spot. The pdoc also believed I was still healing from Paxil even while taking the Remeron.

 

Any advice. The despair is crippling. 90% of my symptoms are mental. I never suffered from panic/anxiety/depression prior to taking paxil. Like I said before I have read many accounts of cold turkey paxil withdrawal and I guess I should feel lucky to have made it to 18 months. But did I really complicate my recovery by taking Remeron?

[Gijoeman]

Hello GI. When drugs share some of the same withdrawal profile, withdrawal from one can bleed into withdrawal from the other. I have tinnitus which is made worse by either Lyrica or diazepam cuts, and even though I'm on a very tiny dose of diazepam I need be mindful, and same for the large dose of Lyrica. Your meds may be different, but don't minimize the degree to which they 'cross pollinate'.

 

I completely understand this. I just can't believe I am this sensitive to such small drops in the Remeron. I think I will maintain the 4.2 for now. Many, many people including my therapist have told me to stay at this amount maybe as long as the whole winter. I guess it won't hurt to see if my symptoms settle down. I have been at 4.2 for 3 weeks now. I just want to be free of this stuff. Most people's accounts that I have read who cold turkeyed off paxil after long term use say that the acute portion of it can last as long as 18 months with big gains realized by 2 years. I hope and pray that is the case. I never took any other drugs. My experience with Xanax was very brief. I took the occasional .25 dose or half that for sleep during my last years on paxil (maybe 1.5 20 tab prescription in 2 years) and then I probably went through one 20 tab prescription prior to starting the remeron back in July of 2011. So, I just don't really have much history with these meds other then paxil. Surely I should be able to recover from this. There really is no other choice, LOL (doesn't typing LOL count as a positive remark?).

 

Thanks...

[dalsaan]

Hi Gijoeman

 

Please stay at your current dose until you stabilize I am on remeron and have to make small cuts to avoid withdrawal. I am currently on 4ml of liquid

 

Are you doing other things to help your stress/ depressive symptoms? Taking fish oil? Exercising if you can, avoiding stimulants like caffeine and sugar? There are lots of suggestions on being gentle with yourself in the symptoms and self care forums

 

Dalsaan

[Gijoeman]

Hi Gijoeman

 

Please stay at your current dose until you stabilize I am on remeron and have to make small cuts to avoid withdrawal. I am currently on 4ml of liquid

 

Are you doing other things to help your stress/ depressive symptoms? Taking fish oil? Exercising if you can, avoiding stimulants like caffeine and sugar? There are lots of suggestions on being gentle with yourself in the symptoms and self care forums

 

Dalsaan

 

Yes, thanks. I am walking between 3 to 6 miles a day. That has been critical. I do take fish oil plus magnesium. I do have one cup of coffee each morning and have throughout. Stopping that doesn't seem to make much of a difference. I eat lots of fruit and do stay away from sugar. I will stay at 4.2mg for now on the remeron. Even my therapist suggested I slow down through the winter or just stay put. I just worry that I am complicating my chemistry still with the remeron and may be impeding my paxil recovery. But that is the nature of my obsessive thinking and how I want to do whatever it takes to help fix myself.

[dalsaan]

I would give the no coffee a go for a while and see if this helps. I was a very dedicated coffee drinker and gave it up. It has helped a lot. If your system is sensitive even one cup could be sIgnificant for you

[Gijoeman]

I would give the no coffee a go for a while and see if this helps. I was a very dedicated coffee drinker and gave it up. It has helped a lot. If your system is sensitive even one cup could be sIgnificant for you

 

I know you are right about this. I think I quit for maybe 2 days. Probably not enough time to guage. I just so love my one cup of coffee. Wait, I can get decaf in the Keurig cups. Geez, that was my plan a month ago and I just forgot. That will satisfy the smell and taste needs! I do drink iced tea almost everyday but I think the caffiene level is small.

[dalsaan]

I drink decaf and am fine with that. Also check out how much caffeine is in your tea particularly if you drink a lot of it

 

I would give no caffeine a go for at least a month

[moonbow0202]

Hi Gijoeman,

Effexor WD kicked my but with physical and cognitive symptoms, Remeron is kicking my but emotionally. i can relly relate to wanting to be off of the meds. In July, when I was at 4.5mg Remeron, I forgot to take it one night, felt great next day; decided to stay off;started getting depressed, thought I could ride it out. The whole thing was a really bad idea! I resumed 4.5mg of Remeron and last week I increased it to 5.25mg. I think it will be quite some time before I am completely off of the Remeron.

[Gijoeman]

Kind of an SOS here. Dropped from 4.5 to 4.2 3 weeks ago. Not doing well at all but haven't been doing well at all in the last 18 months really. I can't believe my body can feel such low dose decreases. I don't want to overreact here. Should I go back to 4.5mg and hold for a long time? Can I really be recovering from paxil during all this? Will remeron at such a low dose be impossible to get off of and will the withdrawal be another protracted like with paxil?

[moonbow0202]

Hi Gijoeman,

I can't believe my body can feel such low dose decreases.

 

I know how you feel about such small decreases being so problematic. I've been trying to research Remeron WD specifically. Haven't found anything helpful yet but I'll let you know as soon as I do.

 

Can I really be recovering from paxil during all this?

 

i can say that I do believe that i'm recovering from the effexor despite concurrent Remeron usage and WD.

 

Will remeron at such a low dose be impossible to get off of and will the withdrawal be another protracted like with paxil?

 

I don't believe it will be impossible to get off of Remeron. I do believe that it is going to take a lot longer than I thought it would.

I am considering updosing the Remeron a little bit more.

[Altostrata]

Yes, it is possible you are that sensitive to small dosage changes.

 

As we've discussed before, the underlying Paxil withdrawal syndrome can make you hypersensitive to all kinds of things, including caffeine, alcohol, and changes in medications.

[dalsaan]

Hi gijoeman

 

How long are you holding between reductions? If you aren't allowing your body time to stabilise in between cuts your withdrawal symptoms will be piling up with each new cut exacerbating the last

 

Dalsaan

[Gijoeman]

Hi gijoeman

 

How long are you holding between reductions? If you aren't allowing your body time to stabilise in between cuts your withdrawal symptoms will be piling up with each new cut exacerbating the last

 

Dalsaan

 

3 weeks between drops.

[Skyler]

 

Hi gijoeman

 

How long are you holding between reductions? If you aren't allowing your body time to stabilise in between cuts your withdrawal symptoms will be piling up with each new cut exacerbating the last

 

Dalsaan

 

3 weeks between drops.

 

Hi GJ. I have not taken Remeron, but I need to drop on a 4 week schedule as 3 weeks is much too fast. When I'm unstable I have withdrawal from as little as a 1 mg drop (in my case tinnitus). I'm on 192 mgs of Lyrica and do not think my experience is all that unusual. Hold where you are now for at least two months. This way you can get a sense as to which withdrawal symptoms are ongoing from Paxil and which are from a too fast withdrawal from Remeron. Then go very slowly from there... hold for 4 weeks each cut, taking no more than a 5% drop off the previous dose. You may be able to cut more than 5% at some point in the future, but you are so sensitized by Paxil this may not be possible.

 

You may have asked this question previously? Stop intellectualizing about the tapering process, doing so is obsessive and only makes it harder to proceed cautiously. When thoughts of tapering are on the front burner all the time, you just want to get this over so you can stop thinking about tapering.. Instead, get your withdrawal symptoms to the lowest possible ebb, keep to what is a reasonable taper schedule for you, and put other taper considerations out of your mind as they are a no-win.

[Gijoeman]

 

 

Hi gijoeman

 

How long are you holding between reductions? If you aren't allowing your body time to stabilise in between cuts your withdrawal symptoms will be piling up with each new cut exacerbating the last

 

Dalsaan

 

3 weeks between drops.

 

Hi GJ. I have not taken Remeron, but I need to drop on a 4 week schedule as 3 weeks is much too fast. When I'm unstable I have withdrawal from as little as a 1 mg drop (in my case tinnitus). I'm on 192 mgs of Lyrica and do not think my experience is all that unusual. Hold where you are now for at least two months. This way you can get a sense as to which withdrawal symptoms are ongoing from Paxil and which are from a too fast withdrawal from Remeron. Then go very slowly from there... hold for 4 weeks each cut, taking no more than a 5% drop of Remeron. You may be able to cut more than 5% each drop in future, but you are so sensitized by Paxil this may not be possible.

 

You may have asked this question previously? Stop intellectualizing about the tapering process, doing so is obsessive and only makes it harder to proceed cautiously. When thoughts of tapering are on the front burner all the time, you just want to get this over so you can stop thinking about tapering.. Instead, get your withdrawal symptoms to the lowest possible ebb, keep to what is a reasonable taper schedule for you, and put other taper considerations out of your mind as they are a no-win.

 

Thanks for the advice...

[Gijoeman]

I am down to 3.5mg remeron as of last night. I went from 4.2 to 3.8 by cutting .1mg each week for 4 weeks then I held for 2 weeks at 3.8mg. I cut to 3.5 last night from 3.7. I am very impatient with this whole process. Was wondering how Daalsan is doing with the remeron drops. I really don't want to be tapering for another 40 weeks or more. I'm 20 months off my paxil C/T and things really haven't improved much.

[dalsaan]

Hi Gijoeman

 

I have just got to 2.2 ml. I'm finding I have to go a bit slower as I get closer to zero

 

I understand your frustration

 

The key question I have for you is how are you feeling? I think micro tapering is the way to go but it can catch up to you at different points and you have to have a longer hold to allow your system to stabalise

[Gijoeman]

dalsaan, keep in mind that I was on Paxil for 13 years and cold turkeyed off of 10mg on 5/5/2011. 99% of my ill health is due to that. The remeron never helped me with mood at all. It just got me sleeping. I had hoped it might help with mood and gave it 60 days (August/Sept 2011) but it never worked. The pdoc wanted me on 30mg and I only got to that amount for 2 days and was completely non-functional in the head. I began weaning at that point and was at 4mg or so in late November 2011. At that point I believe my Paxil withdrawal kicked into a higher gear (if that was possible) and I found myself back at the pdoc in January of 2012. She again insisted on 30mg. She was adamant that I do that. So, I played along and slithered out of her office never to return. I had already got a second opinion on all this from another pdoc in Oct of 2011. He just added Celexa to the mix. I had already tried that before the remeron. The side effects were scary. Again, I think all my troubles are due to paxil and my cold turkey which nothing really can help with that. I did updose to 15mg of remeron in February and got stable. I have been weaning from 15mg since March of 2012. I was a bit more agressive at first but pretty much did 10% all the way down to 3.5mg, yay!

 

My big concern is sleep of course. I read an account recently of a guy over at PP who was down to 1.5mg remeron and dropped it. He was desparate after not sleeping for 2 weeks. But he hasn't returned so I don't know what became of him. Maybe things settled down. I still have the 4:30 wake up calls like many complain about with paxil withdrawal. I just don't want to fall apart and end up going back up again.

 

What are your symptoms at such a low dose. You have done pretty well to go from 15 to 2.5 in 12 months. Is that correct? How did remeron help you over all the years? I know it is more for depression then anxiety. You were on it for 5 years?

 

So, you ask about how I'm feeling. I just take it one day at a time at this point.

[tgirl]

Hello,

Did u get off the remeron?

[dalsaan]

Hi Gijoeman

 

Just touching base and wondering how you are traveling.

 

Dalsaan