pianoblueman1000: Need help on when to keep reinstating or to get off the antidepressant

[pianoblueman1000]

So I got on Mirtazapine back in July last year.  Started at 7.5mg for 2 months and then went to 15 mg.  I decided to get off in March of this year which I did a quick taper of only 2 weeks.  I started having higher anxiety on and off for about a month and then I started losing my appetite about a month after I had been off them.  And then I noticed my emotions were getting numb about 2 months after getting off. I found this site after 2 1/2 months of me being off Mirtazapine and decided to reinstate at a low does of 1.9 mg( 1/8 pill)  for about 3 weeks and I didn't seem to feel a difference so I went up to 3.75 mg  3 days ago.  Last night I had really strong food cravings, which for me right now is a good thing since I have had appetite loss. My question is how long do I wait to up the dose or to decide to just get off it?  And would I end up going back to the full 15 mg Mirtazapine eventually, if things aren't improving with the emotional numbness?  Thanks!

 

Edited September 21, 2023 by FireflyFyte
name to topic title

[Altostrata]

Welcome, @pianoblueman1000

 

On 6/29/2023 at 11:30 PM, pianoblueman1000 said:

I went up to 3.75 mg  3 days ago.  Last night I had really strong food cravings, which for me right now is a good thing since I have had appetite loss.

 

It sounds like the amount of mirtazapine you're taking is starting to have an effect. It will take at least 8 days of daily dosing for this to have maximum effect.

 

How was your sleep affected after you went off mirtazapine? 

 

It could be that 3.75mg is enough to resolve your withdrawal symptoms. You would stabilize on this dosage for some months, then very carefully taper off. FYI Tips for tapering off mirtazapine (Remeron)

What is withdrawal syndrome? 
 
About reinstating and stabilizing to reduce withdrawal symptoms 
 
The Windows and Waves Pattern of Stabilization

 

Please let us know how you're doing. 

 

[pianoblueman1000]

Thanks for the reply.  So My sleep suffered when I got off of Mirtazapine for a few weeks but it was slowly starting to get better. 

I then started to reintroduce mirtazapine to try to see if it would help with the numb emotions and the appetite.  So the last few nights I have woken up extremely hot and sweating in the middle of the night and then having a hard time going back to sleep this is when I rose the dose to 3.5 mg.  So do you think I should go back down to the 1.9mg that I was doing for a few weeks?  Or to stay on the 3.5mg?  I know its hard to know what to do for sure.

[Altostrata]

 @pianoblueman1000 you may wish to go back to 2.5mg instead. Small differences can have an usually large effect.

 

Reinstating the drug would not resolve numb emotions, that's an effect of the drug that persists for a while after you go off. 

 

Please let us know how you're doing. 

 

 

[pianoblueman1000]

Ok thanks for all you do with helping all of us out. 

[pianoblueman1000]

So if I just hurry and take the 15 mg mirtazapine which is what I was originally taking with that help with the emotional numbing?  Or is it better just to allow that to heal on its own. 

[Faure]

6 hours ago, pianoblueman1000 said:

So if I just hurry and take the 15 mg mirtazapine which is what I was originally taking with that help with the emotional numbing?  Or is it better just to allow that to heal on its own.

Do not reinstate the full 15mg. Unfortunately there is no “hurrying” with this process. The opposite - patience - is what is required. A whole lot of it. It is something every single member who has been on here any length of time has had to get very good at. 

 

Your system has had a shock with a too fast taper and you are very lucky you are generally feeling ok (able to eat and sleep and I assume function?).  It sounds like the reinstatement is already helping and you should give it time to take full effect. 
 

Do not reinstate the full dose. I did this after a terrible crash several years ago now and was fatigued the whole time. Could barely walk around my flat, had a few months completely off work and when I did return to work could only do very part time. 4 years later I am still not back to my old self, I still suffer with fatigue and can’t do the things I used to do. My life is more limited than it used to be albeit things are better since I started tapering over 2 years ago now.
 

So I’d suggest you put up with the emotional numbing, wait until you are stable and have been for a while (depending what the mods advise) and then start a 10% every 4 weeks taper or the BrassMonkey slide. These are very powerful drugs and should be treated with a great deal of caution. 
 

 

[pianoblueman1000]

Thanks for your feedback. So when I got off of mirtazapine too fast my symptoms were lack of appetite and emotional numbing. I then reinstated at 1.9 mg ( 1/8 of a pill) for a couple of weeks and slowly my appetite was coming back. But it did not help with the emotional numbing so I went up to 3.75 mg (1/4 pill) for the last week now. When I went up I started to get hot flashes at night and it has messed up my sleep with me having a hard time going to sleep now. So since it's only been a week should I go back to the 1/4 pill since now I am having the sleep issues with the higher dose? Or do I need to got down 10 percent each month?  

[Altostrata]

Taking any amount of mirtazapine will not help with the emotional numbing, it's an effect of the drug as well as a post-drug effect.

 

2 hours ago, pianoblueman1000 said:

But it did not help with the emotional numbing so I went up to 3.75 mg (1/4 pill) for the last week now. When I went up I started to get hot flashes at night and it has messed up my sleep with me having a hard time going to sleep now.

 

If I were you, I'd go back to a lower dose than 3.75mg.

[pianoblueman1000]

Ok thanks 

[pianoblueman1000]

So  even if I would have tapered off of mirtazapine very slowly, which I did not know about until I found this site, emotional numbing could have still happened?  

Is this a common thing that happens after getting off an antidepressant?

 

 

[Altostrata]

1 minute ago, pianoblueman1000 said:

emotional numbing could have still happened?  

 

That is correct, it arises from long exposure to the drug. Off the drug, it will fade.

[pianoblueman1000]

Thanks

 

[pianoblueman1000]

Also just to restate my emotional numbing came after I got off the mirtazapine. It was about a month after I got off. Is this still normal?

[Faure]

2 hours ago, Altostrata said:

That is correct, it arises from long exposure to the drug. Off the drug, it will fade.

Alto has told you a few times that this is normal and the effects of the drug.  These drugs affect our entire bodies and the mods have seen all the effects.  The best healer is time which requires patience ☺️ you will start to feel again, you just need to be patient. 

[HopefulToHeal]

Hey Pianoblueman. I just stopped in to read your intro since you had asked me some questions on my intro. After reading through I want to share a bit of my experience. I just want to say that I can totally relate to how devastating the delayed onset of complete emotional blunting/anesthesia can be. For me I was off Zoloft/Sertraline almost exactly 3 weeks and woke up and it was as if a light switch had been turned off. This was the most terrifying experience I have ever had. The worst part was the lack of any perceived connection to my 2 year old son who is the most important thing to me in this life. There are no words to describe the horror of this experience and I don’t wish it upon any other human being. I can totally relate to your efforts of wanting to be reassured that this is normal. I can assure you that you and I are not the only ones to have this experience and there is some comfort in that. You are not alone my friend! 
 

Now as for my experience since that day I can tell you I have had moments where I have been able to laugh true knee jerk gut laughter on 2 or 3 occasions. It should be noted I’m only 12 weeks off my AD. I also was unable to cry at all for the first 2 months and now I am able to cry on a somewhat normal basis. What helped me to cry the first time was to not force it and have no expectations in the moment where it felt right to cry and the tears just started abruptly much to my relief. It was as if I had to be ok with the possibility of never being able to cry again for that blockage to release. As for my other emotions that’s much more complicated. I have whispers of anger and anxiety in brief moments. I have a cognitive rendition of joy and happiness when I’m truly in the moment with my son and soaking up his laughter and his true joy.

 

 As many on here have experienced these emotions tend to come back over a long  period of time. How long? I surely can’t answer that question and I don’t think anyone can. I’ve heard figures that exceed a year and I don’t think that’s uncommon. These are just figures I’ve pieced together in my readings and are not hard numbers. Another important thing to remember is that these changes are usually so subtle that they are imperceivable until we get some time in recovery and look backwards. There are also windows which can give us glimpses of things coming back. That’s been my experience where I was able to have true laughter during those windows but also I’m able to see the baseline subtle changes to my emotions looking back from the day that switch flipped. 
 

I hope what I have shared about my experience makes you feel less alone and more “on track” with this withdrawal process. As terrible as this is we are right where we are supposed to be today meaning we can’t force progress but we can ease our suffering by practicing acceptance wherever possible (that is so extremely difficult most of the time for me). I hope you start to get some relief very soon. There are so many that have endured this hell before us and for their wisdom and experience I am grateful! Hang in there and reach out anytime.
 

 

[pianoblueman1000]

Hopeful to Heal,  Thank you very much for responding back to me!  Yes this is one of the craziest things that I have experienced in my life.  I don't understand it.  Like you said that I am grateful for those that have already gone through this and got better.  I also think there may be some great truth to your statement "It was as if I had to be ok with the possibility of never being able to cry again for that blockage to release."  I wonder if we did this more often and practice this with our situation if that would help us?  It looks like they are going to shut down the website on sept 1 until oct 1st so hopefully I will still hear your updates.  Thanks again for continually posting!!!

 

[HopefulToHeal]

Hey Piano. How have things been with you these past few weeks?

[pianoblueman1000]

So I reinstated my anti- depressant a few months ago to see if it would help with the protracted withdrawal , which for me it did not. I started getting insomnia after I did, which gradually went away. I then started tapering 10% of the previous dose I was taking every 4 weeks.  This last one that I did 10 days ago, I have been having insomnia a lot of nights so my question is: Do I go back to my previous dose (about 10% more), Go up about 5% more, or Just hold onto what I have until the insomnia goes away?

[LotusRising]

Hi @pianoblueman1000,

 

We moved your tapering question over here to your personal thread. Rather than creating a new topic, you can post your personal tapering questions right here so all your info is in the same place and easy to follow.

 

Could you please update your signature to reflect your latest reductions? See Account Settings – Create or Edit a signature to update.

 

What dose are you currently at?

 

On 7/1/2023 at 10:18 AM, Altostrata said:

It could be that 3.75mg is enough to resolve your withdrawal symptoms. You would stabilize on this dosage for some months, then very carefully taper off.

 

It looks like Alto suggested this back in July - did you feel stabilized when you made your last reduction?

 

 

 

 

[pianoblueman1000]

Yes I stabilized on it and have been getting off now.  Just wondering when you notice problems do can you add to the previous taper or no?

[pianoblueman1000]

Anyone please help thanks

[manymoretodays]

7 hours ago, pianoblueman1000 said:

Yes I stabilized on it and have been getting off now.  Just wondering when you notice problems do can you add to the previous taper or no?

 

What are your recent tapering changes?  And what is your question?

If you are noticing WD symptoms I would not taper down any further right now.

 

Can you summarize what is going on?  What you are worried about?

 

And.  Update your signature with recent changes as well.

 

Hang on pianoblueman1000.  I've got to sign out now.  Look over in symptoms and self care for ideas to calm.  Breathe.  Try and ease into sleep soon.

[pianoblueman1000]

I am having insomnia since this last 10 percent taper. I am wondering if I should go back to the dose before I adjusted down. I just wonder if it's ok to go back up?

 

[LotusRising]

@pianoblueman1000

 

Since you made the reduction 11? days ago, I would hold. Your body will have already made adaptations to accommodate the new dose.

 

As mentioned, it would be helpful if you updated your signature, so we don't need to read through the whole thread for updated reduction info.

[manymoretodays]

Also see:  Tips to help sleep: so many of us have that awful withdrawal insomnia

 

It's definitely in your favor to begin trying non-drug coping now, to find practices and things that help.

 

More here: Important topics about symptoms, including sleep problems

 

11 hours ago, pianoblueman1000 said:

I am wondering if I should go back to the dose before I adjusted down. I just wonder if it's ok to go back up?

 

I agree with MedRN.  I'd sure stay put, and try some non-drug coping.  Pay attention to when improvement might occur as well.  This will help you figure out your own patterns too, for when you continue to taper, and help to manage it.

 

Easy access to update/edit your signature:  AccountSettings/update/edit signature 

We need to see recent changes with date, drug name, dose in there.  Thank you.  The last I see in your signature is a change to 3.75 mg Mirtazapine back in June, the 28th.

 

Any other symptoms of WD since your last change or ongoing?

 

Hey, maybe you are sleeping now?  That would be awesome.  Do get your information in order and keep us updated.  Right here, in this thread, your Introduction.  This is the best place to post for you right now.

 

L, P, H, and G,

mmt

[manymoretodays]

You can also taper by less than 10% of each previous dose, and or microtaper.

Here's more of the basics to that:

Why taper by 10% of my dose?

Micro-taper instead of 10% or 5% decreases

 

Have you worked out a method to get non-standard doses, other than pill splitting?

I'll refer you back to the mirtazapine tapering topic, which is above to see what has been found to work best with your med/drug.  You'll find the link above now in Alto's post to you.

 

Any further questions, best go right here.  And we'll see them.

 

Hoping further stability, WD stability, is on it's way for you.

Edited September 22, 2023 by manymoretodays
link added

[HopefulToHeal]

How are you doing now? Is your insomnia improving? Did you end up sticking it out at your most recent taper dose? Are you taking melatonin for sleep or doing Epsom salt baths before bedtime? Those both help me but I was already on melatonin for years before going into withdrawal. I believe there is a link on here for melatonin if you decide to add that in. I’ve read that melatonin can help with inflammation in the brain as well which can’t hurt the healing process. I would check in with a mod before adding melatonin though. I hope you’re doing better since your last post. Hang in there brother!!

[pianoblueman1000]

Thanks for reaching out!  Yes my insomnia is getting better.  I ended up going up about 3% higher on the antidepressant and that seems to be helping me out better.  I'm going to not taper as much each month.  I don't take epsom salt baths or melatonin.  I will look into this.  Thanks for the advise!  Keep going strong.  I feel like I am getting a little bit better.  As I look at 3-6 month increments, I can see I am better now in a lot of ways than then.  We will make it!  I can't wait to get through this!  We will be so much more appreciative for the small but most important things in life!  

[HopefulToHeal]

Glad to hear you're doing better after going back up on your dose a bit. That sounds wise to cut by smaller amounts since you know how the previous cuts are effecting you. Hopefully you get some much needed rest before dropping again.

 

I am hopeful for some healing and normalcy someday. Right now it's hard to imagine that.

[pianoblueman1000]

Thanks!