Mcat: reinstated Mirt, now coming down again

[Mcat]

Hi @Faure - I hope you're still going swimmingly with your taper. Mine is going okay, though I've been holding on 3.64mg for a bit; it will be 6 weeks on this dose on Friday. The reason is that when I did that last 10% drop, my sleep deteriorated a bit. For example, I had been getting solid 8-9 hr sleeps for the most part throughout the taper, but I started feeling that 'on' feeling during the night and getting a bit of those early morning cortisol wakes. Nothing unbearable, but a few weeks of 7hr sleeps with maybe one or two 6.5 or a bit less. It's hard to know how much was the taper WD or if it's just a return to my less medicated sleep pattern now that my dose is getting lower (you may recall that dogged insomnia was the reason I went on Mirt in the first place), but it freaked me out a bit as I went through hell with insomnia last year. It's also hard to know what might have contributed because I had a bad patch of work stress at the same time and we're coming into spring here so are having warmer nights and more light coming in etc. I got a blackout blind for my window and upped my Melatonin, both of which have helped and I seem to have stabilised back to the good sleeps again. So, I'm wanting to do another drop, but I think it's time to go more slowly and gently now, so would like to jump onto the Brassmonkey slide. I'm on liquid and have been getting help from the chemist to work out my dose reductions each drop, but they view the slide as too fiddly and said 2.5% is too small an adjustment to work out on a 1ml syringe, but it must be possible since people like you do it, no? As you know, I am mentally challenged when it comes to numbers, but you mentioned that a friend showed you how to do it and it's not too hard once you get around it. Would you be willing to teach me how to do it? I really want to keep tapering and get off this drug altogether, but I want to play it a bit safer at this stage. 

PS: my liquid is 5mg active ingredient in 1ml liquid.

[Faure]

Hi mcat, glad things are going well and that you took a break when you needed it. I’m really sorry but I am nowhere near good enough at numbers to be able to help you with this. I have essentially been “banned” from doing so by said friend who sadly doesn’t have the time to help anyone else. 
 

@brassmonkeymight be able to help you with how to move to the slide. There is also an extensive topic on it here. 

[Mcat]

Thanks for that. I managed to find a calculator that does exactly what I need - yay, and this would be my next dosage if I do the 2.5mg weekly drop for 4 weeks then hold: https://www.omnicalculator.com/conversion/mg-to-ml#:~:text=Therefore%2C there must be 1%2C000,mL %3D mg %2F 1000. My question now is, how the hell do I work out how to take 0.7098ml on the syringe? The chemist said each tiny rung on the syringe = 0.2ml, so I'd either need to round up to 0.72ml, which is the dose I've been on for the past 6 weeks, or down to 0.7ml. Am I correct that I would round down even though that would make the drop a bit over 2.5%? This is what confounds me about the slide - how to do these very small drops on the syringe. The other option I guess is to drop by 5% instead of 2.5. @brassmonkey do you think 5% drops every fortnight then holding for 2 wks would work if it's a bit easier for dosing and I tolerate it in terms of WD? And I presume it's okay to round down a bit with these teeny numbers because if you round up you'd barely make any progress. Grateful for any advice that anyone who knows more about the smaller dosing can give me.

[brassmonkey]

Rounding is fine, in fact it is quite common.

 

5% every two weeks would work but could lead to stronger symptoms. But it is a workable plan.

 

If you add 4mL of water to 1mL of your regular medication you would get a 1:1 solution (1mgai per 1mL liquid) that will make measuring your dose a lot easier and more accurate. 

[Mcat]

Thanks ever so, much appreciated. I'll try the 5% drops and see how I fare. If that's too much, I'll move to a 1:1 mix and the 2.5% drops.

[Faure]

Glad this is sorted for now, I’m sorry I no help with numbers and dosing 🙁

 

I hope you get on better with lower drops. 

[Mcat]

Thanks @Faure. I'm doing okay overall, and after close study and a bit more research and that calculator (I hope others find it useful), I think I've finally worked it out to do it myself. You said ages ago that you don't rely on chemists etc., and only on yourself. I still get them to compound the liquid, but I'm not going to rely on them as much for tapering advice because they don't always get it right. For example, the chemist said each little rung on my syringe was 0.2 - it turns out it's 0.1. So, I'm feeling a bit more tentatively confident about my ability to calculate for the slide and have decided to try the 2.5% drops after all. That means I'm basically dropping one teeny rung at a time for the next couple of drops, which is I guess along the lines of what you've been doing, yes?

[Faure]

2 hours ago, Mcat said:

I think I've finally worked it out to do it myself. You said ages ago that you don't rely on chemists etc., and only on yourself

Well done!  You have come so far since you first joined SA. The only person we can rely on is ourselves, with others on here to help and guide when they can 👍 thank goodness for BrassMonkey who is always ready with number help! I’m also lucky with my highly numerate friend! 

 

2 hours ago, Mcat said:

have decided to try the 2.5% drops after all. That means I'm basically dropping one teeny rung at a time for the next couple of drops, which is I guess along the lines of what you've been doing, yes?

Yes, this is what I’ve done all along with minimal WD effects. In the first year I would take quite a long time to get to sleep in weeks 3,4,5, but these days I usually fall asleep fairly fast regardless of the week.  I do find recently I’m waking up around 3-4am which is unusual (usually) for me, but generally manage to either get back to sleep or put the radio on and force myself to lie there and rest. Not a big deal and I get enough sleep / rest. That seems to come and go. 
 

Also in the first year or so I’d usually feel a bit anxious / scared (for no reason) the day or two after a drop. It only lasted an hour or two. That’s mostly gone away too although I wonder if recently it’s coming back a bit again, I’m not sure yet. 
 

Overall I am loving the BrassMonkey slide. Life continues to improve on a regular basis as my dose reduces and I get more and more back to my old self. 

Edited September 28, 2023 by Faure

[Mcat]

Thanks for those details. I did the first slide drop last night, BUT I've realised I think that mg/ml calculator might not be quite right for my purposes, and I wanted to come on here and say that as I don't want others getting messed up. For example, it gave me a different reading than a simple 2.5% deduction from my last ml dose, which means I think my drop last night was less than it should be. I think the simplest way for me to go about it is not to worry too much about my active ingredient mg calculations at this stage and just to reduce 2.5% off whatever ml dose I'm on. That, at least, is fairly easy to work out using a basic calculator. If I was on a 1:1 mix, it would be a lot simpler, but I don't want to move to that just yet because I'd have to take too much liquid on the dose I'm on. When I get much lower, e.g., down to a 1ml dose with the current 5:1 solution, I might beg Brassmonkey to help me work out what active ingredient mg I'm on (I'm sure that's a simple enough calculation for someone who is good at maths and not me ) and then I'll switch to a 1:1 solution, and even I will no longer be confused by the calculations. I remain very grateful for this site and that there is somewhere to soundboard all this. It's so great that people like Brassmonkey hang around to help even though they've long shaken off these nasty drugs.

[Mcat]

Hello to anyone still reading my thread, which I think is probably only @Faure (thank you very much for that). As I'm now in the mid-2mgs on the Brassmonkey Slide, I just did some calculations to map out my drops for the coming months, as I was keen to know whether I'd hit 1mg this year or next. What I noticed is two things: how much slower the progress gets as you go down (nothing to do about that, though, innit) and, more perplexingly, that once I hit a certain point, a 2.5% drop doesn't equate to a full drop on the syringe, which stymies progress altogether. I figure there must be some trick your older hands know about dealing with this, and I would love to be enlightened so that I know how to handle it when the time comes.   

[Faure]

Hi @Mcat You can overcome this by increasing the dilution of your medication I.e. adding water. But don’t ask me how that works😂😂😂 my mathematical friend is going to do it for me and as you may know has forbidden me from giving any sort of number related advice. Not that I even can at the moment as I haven’t seen what he’s going to do. When it’s done (in a few weeks) I’ll let you know if I feel any wiser🙄 
 

In the meantime you might like to read this thread about syringes etc and ask your question there ☺️

[Mcat]

Thanks, and yes, I hoped there might be some trick to do with syringes.

 

[RKroos]

By what amount do you plan to jump to 0?

0.1?
0.01?

[Mcat]

Not sure - I haven't given it much thought as it's still so far off and I'm busy dealing with the tapering process itself. I thought when I first came on here that once you're down to 1mg or so, you could probably jump off, but then I read a post by someone who had tapered down to 1mg with no significant side effects, jumped off, and got hit hard. My thinking is, that once you've gone the hard yards to 1mg and below, you may as well just stick to the textbook till you reach 0.

[Faure]

On 1/31/2024 at 8:51 PM, Mcat said:

you may as well just stick to the textbook till you reach 0.

You never reach zero with an exponential taper 😜 but you reach close enough!

[Santino]

On 1/31/2024 at 9:51 PM, Mcat said:

Not sure - I haven't given it much thought as it's still so far off and I'm busy dealing with the tapering process itself. I thought when I first came on here that once you're down to 1mg or so, you could probably jump off, but then I read a post by someone who had tapered down to 1mg with no significant side effects, jumped off, and got hit hard. My thinking is, that once you've gone the hard yards to 1mg and below, you may as well just stick to the textbook till you reach 0.

Hi Mcat

it is good that you are reaching such low doses in your taper. Anyway at the very low doses below 1mg it becomes difficult to meassure the drops. In my case after 1MG i started droping by 0.1mg and in cases when i was feeling axhitated would stay at that level for more time. You can check my signature for details.

Do not get yourself over scared you can have a drop and see whether you continue to be stable or not. If yes you can keep up that rythm, if not you can simply stay there for a while and then continue with your normal rythm.

Apart from this the life is truly beautiful on the other side. I am free for so many years right now and have a very normal and happy life. 

All the best

Santino

 

Edited February 12 by Santino

[Mcat]

Thanks for this welcome note, Santino. I'm so looking forward to being completely drug-free. Can I ask what 0.1mg looks like on a syringe and which syringe you were using at that point? 

[Mcat]

Hello to anyone still following/reading. I don't come here much because things have been intense - life dramas, hellish new job, etc etc., but I've kept up my taper, apart from an 8-week hold recently, as things were too chaotic to face a taper. I moved to the Brassmonkey Slide a while back and am now around 2.25mg. I've got a bit of a health challenge that makes me want to get down to 1mg faster, so I think I'll try the 10% monthly drop again next round. The health issue that I'm subclinical hypothyroid - have been for years, so it is not new news, BUT what's new is that I'm more decidedly symptomatic, so I think it's becoming more of a problem, and I'm now engaging more actively with it (not rushing to get on the meds as they can be problematic, but I'm researching and exploring options for treatment). I was just wondering if anyone here knows anything about how ADs, and especially Mirtazapine - my poison - affect the thyroid. I imagine it won't be helpful since it slows the metabolism, which already slows with hypothyroidism. No wonder I've put on so much weight and can't shift it - I've got a double whammy. I'm also wondering if anyone can direct me toward threads or content about how people handle that last 1mg and when to jump off, and how people make that decision. I know I'm too far away to start focusing on that too much, but I'd still be interested to read up on it. 

[Faure]

Hi @Mcat, here you go (go to the first post in the thread)

 

My target exit dose is 0.375 mg, I think; 2.5% of 15mg = 0.375mg.  I’m currently on 1.3mg, soon to enter the 1.2s. It now takes an entire 4 weeks to just get through .1 mg 🙄. Fortunately I am getting no WD symptoms (and I never got many using this method) so I might be able to stop sooner, but any speeding up never seems worth the risk when I’ve got this far.  The other day I opened the fridge to get my pill (now a liquid) and found I had completely forgotten to make them up 😂😂😂 that really seems like a sign I might be able to stop soon. Although I think I’m about 18 months away from stopping if I follow all the instructions on here. 
 

I too had a long hold recently (8 weeks) after a family tragedy and am about to finish my first cycle of tapering since restarting. I think the hold was good for me, it allowed my body to catch up with things.  I had started to ‘feel’ weeks 3&4 which I hadn’t done for several months. 
 

Sorry to hear your life isn’t so good at the moment. What a shame about the new job. I hope things improve for your soon and you get your thyroid under control 😊

 

[Mcat]

Thanks, @Faure—your plan sounds sensible. Thanks, too, for the link. I'll be interested in exploring other people's strategies and experiences. 

[RKroos]

14 hours ago, Faure said:

Hi @Mcat, here you go (go to the first post in the thread)

 

My target exit dose is 0.375 mg, I think; 2.5% of 15mg = 0.375mg.  I’m currently on 1.3mg, soon to enter the 1.2s. It now takes an entire 4 weeks to just get through .1 mg 🙄. Fortunately I am getting no WD symptoms (and I never got many using this method) so I might be able to stop sooner, but any speeding up never seems worth the risk when I’ve got this far.  The other day I opened the fridge to get my pill (now a liquid) and found I had completely forgotten to make them up 😂😂😂 that really seems like a sign I might be able to stop soon. Although I think I’m about 18 months away from stopping if I follow all the instructions on here. 
 

I too had a long hold recently (8 weeks) after a family tragedy and am about to finish my first cycle of tapering since restarting. I think the hold was good for me, it allowed my body to catch up with things.  I had started to ‘feel’ weeks 3&4 which I hadn’t done for several months. 
 

Sorry to hear your life isn’t so good at the moment. What a shame about the new job. I hope things improve for your soon and you get your thyroid under control 😊

 

I recommend you jump to 0.15 mg or less.

0.1 seems to be the magic number

I am currently on 1.10 mg but I am clear that more than 0.15 could be problematic