FoxTail95: Mirtazapine withdrawal help

[FoxTail95]

Dear SA team,  

  

Can you please help me/advise me regarding my issues with Mirtazapine?  

  

I was told by my psychiatrist that I simply stop taking 15mg Mirtazapine per night (I have been taking it for 18 months). He said that there shouldn't be a withdrawal period due to me also being  put on Quetiapine (25mg per night) around 6 months ago. 

  

17 days ago, I started to reduce my Mirtazapine intake from 1x 15mg tablet per night, to 1x15mg tablet every 3 nights. In the first 14 days I  had horrible withdrawal symptoms including significant cognitive impairments like brain fog, dizziness, inability to think straight, forgetfulness, loss of coordination, feeling very spaced out mentally. I also found it very difficult to fall asleep, being awake until 9am on some nights.  

 I then  experienced palpitations a few nights ago around 2am which persisted all night long. Out of desperation, I took half a tablet (7.5mg Mirtazapine) at about 4am. However it seemed to do little- the palpitations persisted and I didn't fall asleep until 8am and only slept a couple of hours here and there.  These palpitations stayed with me for several days. 

  

I rang my psychiatrist and he advised me to either stop taking the Mirtazapine entirely or to go back to taking it 1x15mg per night (my original dose). 

  

 I came across your section on Kindling and became afraid that if I take the original dosage again, it might have a bad effect. 

I tired to call my psychiatrist back to ask this question, however his secretary told me that he couldn't see me until April and that he'd already advised me on this.

 

3 nights ago, I started taking half a tablet each night. It seemed to do nothing for the first day. However yesterday I felt calmer during the day insofar as the palpitations stopped. They did re-appear last night though. Today also the palpitations seem absent. However I have been worried by how energised and overstimulated I feel despite existing on just a couple of hours of sleep. Whilst I'm very thankful that the palpitations have relented (at least during the daytime yesterday and today) it worries me that I still feel overstimulated. Could this lead to akathisia/ mania due to taking too much (half the original dose 7.5mg)? Or is it because I'm taking too little and this is simply anxiety? 

  

Can you please recommend me a reinstatement dosing amount? I don't know what else to do right now. I am terrified of this getting worse (and potentially becoming permanent?) and am not receiving any proper help from my psychiatrist.  

  

I really don't know what to do here. I just want to know how much I should take that is a safe reinstatement amount. Is half a tablet too much? Will it lead to kindling? Or is it too little and I need to go back to the full amount to get better? Is this overstimulation a sign of kindling or is it an anxious nervous system? 

Mirtazapine is also a unique drug in that it functions more strongly as a sedative at lower doses and as an anti depressant in higher doses. So shouldn't the half tablet be a stronger sedative for my nervous system than the full tablet?

 

Sorry if the information is a bit all over the place, my mind isn't coherent right now. 

 

I would greatly appreciate any advice given. 

 

Thank you very much,  

  

Brendan. 

[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'm very sorry to hear that your doctor is so negligent that he won't even talk to you until April.  First of all, the taper was too fast, and we don't suggest skipping doses to taper.  

 

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?  Please only give us drug names, dosages, and dates, as best you can remember.  Please read the link below for instructions.  

 

How to List Your Drug History in Your 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

 

Finally, going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

[getofflex]

By palpitations, do you mean a rapid heartbeat, or an irregular heart beat?  Please let us know if the heart palpitations are still an issue at times.   There is a possibility of the mirtazapine and quetiapine combination causing an irregular heartbeat.   

 

Question:  Did you have these palpitations before you started tapering mirtazpine, while you were on both the mirtazapine and quetiapine?  

 

Question: Did the palpitations start before you reinstated 1/2 tablet of mirtazapine?  

 

It would help if you could give us specific dates of starting and stopping and restarting your mirtazpine and other drugs, and then also a specific date when the palpitations started, so we can figure out if they are a withdrawal symptom, or a bad interaction between quetiapine and mirtazapine.  

 

According to drugs.com:  

 

Interactions between your drugs

Moderate

mirtazapine  QUEtiapine

Applies to: mirtazapine, quetiapine

Using QUEtiapine together with mirtazapine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Edited February 21 by getofflex

[FoxTail95]

By heart palpitations I mean my heart was going very fast. 

 

I started mirtazapine about 18 months ago and I started Quetiapine about 6 months ago.

 

The fast heartbeat came on a few days ago. But it stopped yesterday daytime and today, too. 

 

I am in a very bad headspace and find it hard take in all this information. 

 

 

For 14 days I took 1x15mg mirtazapine every third day. I had some cognitive symptoms only. 

On the fifteenth day, I had a fast heartbeat come over me in the evening. I took half a tablet of mirt but it didn't help to calm it. I had a fast heartbeat for the next day too so I took another half tablet that night. The next day my heart was calm during the day but it was faster that night. Today it has been relatively calm but I feel overstimulated. 

 

I find all of this very overwhelming. I just want to return to homeostasis. 

 

I don't have any heart conditions. 

[FoxTail95]

And no I didn't have this rapid heart rate before the taper. Only when I entered into anxious situations. Never just being alone. 

[getofflex]

I know it's hard for you with the cognitive brain fog, but I asked for specific dates.  That means something like "December 15, 2023".   If you don't remember the exact day, say "mid December 2023".  I need you to please put all your drug information, the dates you started, stopped any drugs, the dates you changes dosages, the dates you had these heart palpitation, in order by date.  Put it in a concise list format, in date order, in your signature field.   Just stick with drug names, dates, and dosages.  See my signature for an example.   Please follow the instructions in the link in my first post - "how to list your drug history in your signature".    Thank you.

 

 

Edited February 21 by getofflex

[FoxTail95]

My brain is indeed very spaced out and it is very hard to sift through information. But I have done my best to be accurate as possible in the signature now. 

[getofflex]

Thank you for your drug signature, this helps a lot.  

 

It looks like the racing heart coincided with your reinstatement of 7.5 mg mirtazapine.  That is what I was trying to figure out.  

 

Q: What time o'clock do you take your mirtazapine? 

 

Q: Does the racing heart happen in the 4-5 hours after you take mirtazapine? 

 

Here is what I would suggest.  If your heart does not race on the 21st of Feb, nor after this, then I think it would be safe to stay on the 7.5 mg of mirtazapine.  

 

Please let us know if you experience the racing heart symptom again.    

 

It takes up to a week for a reinstatement to reach steady state in your blood and register with your brain, so please give it time.  It will take longer than a week, up to a month or two, for a reinstatement to be fully effective.  It is important to take precisely the same dose each day, at the same time of day, not missing or varying any doses.  Also, completely avoid alcohol, and other mind altering substances.  

 

Please let us know how you are doing.  

Edited February 21 by getofflex

[FoxTail95]

The night before was the last day of the 14days of taking 15mg every 3 nights. So I had taken 15mg the night before. 

 

My diary says that the palpitations started at 2am on Sunday 18th Feb. Then I took 7.5mg Mirt at 3:45am. But this didn't stop the racing. It persisted all night. So it wasn't caused by the 7.5mg as far as I can tell. 

 

It says I had this racing heart all day Monday 19th Feb. I took 7.5mg Mirt at 12 midnight but it didn't do much to stop it. 

 

Then Tuesday 20th feb my heart was calm all day during the daytime. And started racing again in the evening. I took 7.5mg at 2am. 

 

Now today my heart has been very, very calm. Even now it's ALOT calmer than usual even before all of this withdrawal. I wonder if that's a bad sign, honestly. It has been too calm today, almost a little heavy. But it's preferable to unbearable racing heart. 

It might race agin tonight though. 

 

So I should take the same dose of Mirt at the same time each day? I shouldn't try to move it up to 15mg? My mum's a nurse and she's telling me to take 15mg tonight.  

And keep taking the 25mg Quitiapine every night, right? I'm told I can take it up to 5 times a day for anxiety. But I always take it at night. 

 

thanks again for your advice

[FoxTail95]

Keep in mind also that Mirtazapine functions paradoxically in that it is more sedating at lower doses. 

At what point should I think about moving up from 7.5mg to 15mg? 

When I first started mirtazapine (18 months ago) I spent the first 2/3 weeks on 7.5mg and it was unbearably sedating and disorienting mentally. I remember it was awful. 

But of course what im most concerned about is the stabilisation of my nervous system without damaging it. 

I am legitimately terrified right now and don't know what to do. 

I hope I don't have a heart attack from the med interactions and potentially destroy my nervous system from mismanagement. 

[FoxTail95]

I am desperate just to return to homeostasis. It's all I want at this point. 

I wish I never tried to come off of it. 

I am terrified that this lower dosage will do me harm. The psychiatrist has told me either stop taking it entirely or take 15mg. Because 15 mg is a 'therapeutic dosage'.  I might be scolded for taking a smaller dose. 

I'm terrified this isn't going to work due to the smaller dosage of 7.5mg and it will make me worse and I'll have to come off Mirt entirely and then the withdrawals will be much worse and just destroy me. I couldn't take the withdrawals to be worse than they were. 

[getofflex]

3 hours ago, FoxTail95 said:

My diary says that the palpitations started at 2am on Sunday 18th Feb. Then I took 7.5mg Mirt at 3:45am. But this didn't stop the racing. It persisted all night. So it wasn't caused by the 7.5mg as far as I can tell. 

 

It says I had this racing heart all day Monday 19th Feb. I took 7.5mg Mirt at 12 midnight but it didn't do much to stop it. 

 

Then Tuesday 20th feb my heart was calm all day during the daytime. And started racing again in the evening. I took 7.5mg at 2am. 

From what you tell me, you are not having an adverse reaction to mirtazapine.  I wanted to make sure the racing heart was not caused by the drug.  The racing heart is actually a common sign of withdrawal.  Dosing a drug every 3rd day is very hard on the nervous system, and I believe your CNS has been shaken up by this, and also by the fast taper.  I didn't want to overwhelm you in the first post with too much information, so at the end of this post, I'll give you some more links about withdrawal symptoms. non drug ways to cope with them, and some other info.  

 

3 hours ago, FoxTail95 said:

Now today my heart has been very, very calm. Even now it's ALOT calmer than usual even before all of this withdrawal. I wonder if that's a bad sign, honestly

Actually, a calm heart is a good sign.  

 

3 hours ago, FoxTail95 said:

So I should take the same dose of Mirt at the same time each day? I shouldn't try to move it up to 15mg? My mum's a nurse and she's telling me to take 15mg tonight.  

I would not increase the reinstatement to 15 mg.  You will run the risk of kindling, which would make you even worse.  

 

Hypersensitivity and Kindling

 

3 hours ago, FoxTail95 said:

And keep taking the 25mg Quitiapine every night, right?

Yes, it's important to try and be as stable with your drugs as possible, because when you change them frequently, it tends to confuse and destabilize your nervous system even more.    

 

2 hours ago, FoxTail95 said:

I hope I don't have a heart attack from the med interactions and potentially destroy my nervous system from mismanagement. 

This is highly unlikely, especially since you are very young, and have a history of a healthy heart.  

 

45 minutes ago, FoxTail95 said:

I am desperate just to return to homeostasis. It's all I want at this point. 

I wish I never tried to come off of it. 

I am terrified that this lower dosage will do me harm. The psychiatrist has told me either stop taking it entirely or take 15mg. Because 15 mg is a 'therapeutic dosage'.  I might be scolded for taking a smaller dose. 

First of all, I know you are in a difficult predicament.  However, making decisions out of desperation is likely to cause you to make a bad decision, and worsen your situation.  Please try not to panic about this.  Many, many people have been in your situation, and have recovered, and are now living normal happy lives.  No, the lower dosage will not do you harm.  Being scolded by the psychiatrist is much better than further destabilizing your nervous system, and making your symptoms worse.  You don't even have to tell him that you are only taking 1/2 dose.  Unfortunately, the vast majority of health care professionals (nurses, doctors, etc) have no clue how these drugs can affect people when they try to go off too quickly.  

 

Please just hold steady at this 7.5 mg dose, and give it a chance to work.  Please reread my prior post with info about reinstatement.  Do let me know how you are doing on the 7.5 dose.  

 

It is very important to try to work on not panicking about this situation.  I will give you some links to help you with panic and anxiety, and some other info below.  It will take some time to return to homeostasis, but it will take even longer if you panic and make rash decisions that may worsen you.  

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

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

 

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk

 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

video: Claire Weekes: Managing Anxiety

 

video: Claire Weekes on Anxiety and Panic

 

Claire Weekes - Hope and Help for you Nerves Audiobook  

 

Emotional Spirals

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Meditation

 

 

 

[getofflex]

I also suggest you take your 7.5 mg Mirt at the same time of day each day, so your blood levels don't go up and down.  This will help you stabilize and feel better.  

[Happy2Heal]

Hi @FoxTail95

welcome to SA.

 

do you mind if I ask how old you are? 

 

are you currently working?

do you live alone?

 

@getofflex is right, most, if not all, doctors do not know how to help people get OFF drugs, they only know how to prescribe them and add more drugs. Most do not even know anything about withdrawal from these drugs and will flat out not believe that you are having trouble from stopping them.  But you don't need them to get off safely, you have found the best place to learn how to go about it. We will help you as much as we can, but you will need to do things to help yourself.

 

 

Everyone on this forum has been where you are now, just as scared of what might happen if they make a change in dose and just as scared about when the symptoms will end.

we all GOT THRU IT! and you will too!! you will.

I hope that puts your mind at ease.

 

you are going be ok!

 

take a deep breathe, read thru the links you were given and try not to worry too much.

It is a hard thing to do when you are feeling lousy but it won't help you feel any better to  worry! 

on this forum, we learn to do the things that actually HELP us

 

you can learn this things too

 

 

I am not qualified to give dosing advice, but I can tell you that you do NOT want to be going up and down in it. 
That is not good.

Skipping doses is also not good.

 

keep things steady and go slow and you will be ok.

you may feel some discomfort from time to time but you will see improvements sooner if you follow those simple rules

 

What do you do for hobbies or work, if you're working?

 

 

 

[Catina7]

Hi @FoxTail95 and welcome! 

 

I had problems with palpitations when I updosed by too large an amount.  It took quite a long time to get better, but it finally did.  I'm now doing a very slow taper and my heart feels much calmer now.  I know how scary it can feel when your heart is beating like crazy.  There is a topic thread about palpitations that you may want to review:  https://www.survivingantidepressants.org/topic/1868-irregular-heartbeats-palpitations-tachycardia-bradycardia/

 

If you keep things slow, steady, and stable you're going to be okay.  Try to remain calm and know that things WILL improve!

 

Catina ❤️

[Greatful]

@FoxTail95 Please do not panic.  I know how scary and unsettling this is.  As hard as this is, you can rest assured that you can be  okay  if you don't panic and make rash decisions, you are not the first to feel this way....Educate yourself as much as you can.  It can be impowering for you to learn about these drugs,

big Pharma,... It will also take some of the scariness out of the way...These are chemicals and they will affect you both physically and mentally.  Also really look into finding ways to help cope with your symptoms. Try to remember your thinking can be really off.  So learning how to reframe your thinking is helpful ie. this is just happening because of the drugs, I am okay at this moment, I can heal and make it through this,   Your brain will try to fool you into think many negative things. Feeling scared is a big one for most of us. 

 

Take a look at symptoms & self-care ttps://www.survivingantidepressants.org/forums/forum/8-symptoms-and-self-care/  You can find most of your symptoms there and connect with others experiencing them.  It may help you get ideas on how to cope.  If nothing else you can find some relief that you are not alone and other  Have or are feeling the same things.  Reach to others helps to validate what is happening and get some comfort and support.

 

 

Shame on your doctor for abandoning you.  Mine did too.  

As my fellow travelers have said, most doctors are clueless when it comes to getting off these drugs.  I think they also guess on how to administer them.  They can have their drug of choice or whatever the newest one that big Pharma has sold them on.  As you can probably guess there is a fair amount of anger and frustration towards big pharma and the doctors.  Most do not open their ears to what their patients are telling them, they believe in what big Pharma tells them which is usually jaded and slanted to help line their pockets with money. 

 

May I ask why the doctor put you on Seroquel?  Does he feel you are psychotic?  Is it for sleep? 

 

 Take a deep breath, be extra gentle with yourself and learn, learn, learn.  You are stronger then you think. 🌞

 

[FoxTail95]

Thanks for the advice. 

I find all of this very overwhelming, it's very hard to understand all the information. 

 

Unfortunately last night the same thing happened. My heart started beating around 2:30 am. It got progressively harder and faster as the night went on. At 5;45am, I tried taking another Quetiapine 25mg out of desperation to make it stop and to try and sleep (I had already taken one at 1am as usual). But this seemingly did nothing and the palpitations persisted and got worse. I eventually passed out from exhaustion at 9am and slept till around 12am. 

 

Today I got up and my heart was beating hard. Not as hard as last night but hard and fast. I took a 40mg propronalol (as I've done every morning of the last 12 years) and within an hour it had stopped. 

It seems the propranolol is what is stopping the palpitations during the day. I don't know why it seems to have an increased strength all of a sudden? I went out today and had next to zero anxiety. It's been this way a few days now in the daytime. I'll take it tonight and see if it can stop the nightly palpitations. Although Quetiapine 25mg seemed to do nothing. They seem to be alot stronger at night. So we'll see. 

 

The main source of my fear has been the uncertainty of how much I should be taking. The fear that 7.5mg could be too much and I could be making things worse (and potentially permanent?) Or the thought that maybe this is a response to not getting the drug in the quantity I had taken it for 18 months (15mg). 

But mainly it's a fear that I could be taking too much and could make everything worse and permanent. Because apparently that can happen and is called Kindling? And yet nobody has heard of this from what I can tell. My therapist said that In her experience people who have withdrawal symptoms from antidepressants just go back on them again and they're fine. Never heard of Kindling. And the psychiatrist won't even speak to me till April. 

 

How would I know if I was taking too much? And if I was what would I do then? I appreciate the guidance here. It's very hard for me to sift through all the information at the moment. 

 

thanks

[getofflex]

19 minutes ago, FoxTail95 said:

My therapist said that In her experience people who have withdrawal symptoms from antidepressants just go back on them again and they're fine. Never heard of Kindling.

Unfortunately, the majority of people in mental health have been brainwashed to put people on drugs, and to believe that psych drugs are fine, safe, and effective.  Drug manufacturers have a great deal of influence in government, as well as in research, and in universities that train health care professionals.  However, many people have been harmed by them, and I've seen many people on this site go back up to a full dose of a drug, and end up getting kindled. I will tell you that this condition is temporary, but it often takes a long time for the brain to recover.   I suggest, if you have time, you read a book by Robert Whitaker called "Anatomy of an Epidemic".  It is very eye opening.  

 

19 minutes ago, FoxTail95 said:

How would I know if I was taking too much? And if I was what would I do then?

Please try and be aware of your symptoms, and how they have changed since you started the 7.5 mg reinstatement of mirtazapine on Feb. 18.  Overall, Are your symptoms improving since then, or are they getting worse?  Or are they the same?  Also, how do you feel in the 4-5 hours after you take the mirtazapine?  Do you have worse symptoms during this time?  If it turns out t he 7.5 mg dose is too high, we can lower it.  

 

What times o'clock do you take each of your drugs? 

 

I will confer with the other staff about your issue with the racing heart, and propranolol and quetiapine, and one of us will get back to you.  

Edited February 22 by getofflex

[FoxTail95]

@getofflex Symptoms don't really seem worse. They don't really seem better either. They seem about the same, overall. The last few days have felt quite similar.

[Happy2Heal]

"2012-present day-- Propranolol 40-80mg daily"

 

 

why were you prescribed a beta blocker?

 

when you say you have no heart issues, have you been checked out by  a cardiologist?

how old are you? there are some common heart "conditions" that occur more often when someone is older. It is entirely possible to have both withdrawal symptoms AND another medical condition that was either triggered by your withdrawal OR just happened to coincide by chance.  
Atrial fibrillation is very common in older people (typically 40 and up, the older you are, the more likely you are to get it)

 

please do not worry about permanent damage! that is highly unlikely to happen.

if you look at my signature you can see that I was on a LOT of medications  for over 4 decades and cold turkey'ed off most of them and here I am, 68 yrs young and doing fantastic off all meds!
there are at least several other members with similar stories who are also doing fine, no permanent damage at all. I did "kindle" and I am NOT permanently damaged, in fact I actually recovered from withdrawal much quicker than I could have dreamed was possible. 

I did almost everything wrong, went up and down in my dose, stopped and started, and EVERY SINGLE doctor I saw didn't know this was a bad thing. Not ONE. Some seemed to suspect that there was a problem, and would tell me to be careful to take the same dose and not skip any, but as far as having trouble with withdrawal, they denied that it could be a problem.  

 

xi know it's hard when you've been trusting your doctor all this time to help you and do what is best for you, but in THIS situation, most have NO CLUE what to do. 
You will get good advice here, but keep in mind that nothing is going to work quickly. YOU WILL GET BETTER but it will take some time. It will not be uniformly awful, though, over time the symptoms get less and less and most folks are able to function quite well, even while feeling less than great.

You can do this!! 

 

You are going to be ok. You need to believe us about that. It will help you to think more about just TODAY and dealing with the present moment. 
Don't look back, you can't change the past

Don't look ahead, you can't control or know the future

Your job right now is to live in the present and just handle that.

that is a big enough job all by itself, right?

 

remember that feeling awful does NOT mean that anything awful is actually happening, it is just a FEELING 

and like all feelings, they come and go

 

these feelings will go too, eventually.
TRULY you are going to be fine.  Just keep talking back to the anxiety  and tell it, you are just from withdrawal, my brain is adjusting to a change in medication dose. It does not mean that anything bad is happening

It actually means that your brain is in the process of HEALING, trying to get back to where it was before you took these drugs. 

I see that @getofflexhas posted while I've been writing this, I hope it reassures you to know that you've got folks on your side who understand what you're going thru and are working hard to help you.  

 

 

 

 

 

Edited February 22 by Happy2Heal

[getofflex]

In this case, I don't think you are having an adverse reaction to the reinstatement.  I really believe that you are dealing with withdrawal, your nervous system being destabilized by the very fast taper, and taking the drug every 3 days early in February.  Please continue on your current drug regimen until further advised.  Try not to panic about your fast heart beat.  This is a common WD symptom.  Many here have had this, and they are OK.   I realize it is unpleasant, but we will get all this sorted out, and eventually, this will get resolved.  In the meantime, do what you can to soothe and calm yourself.  Soon, one of us will advise you about the racing heart, quetiapine, and propranolol.  If it were me, I would not change my dose of quetiapine, and would stay on the same dose of you have been on, which is 25 mg, until further advised.  

[FoxTail95]

@getofflex Thank you so much for your advice. I have been terrified that I was kindling and it was all going to become permanent. I read that Kindling can induce a worse and even permanent state of withdrawal. Is that really true? 

I appreciate you very much for consoling me. 

[FoxTail95]

@Happy2Heal Thanks for your words of consolation. 

I don't have any heart conditions. They actually checked my heart out about a year ago. They were investigating to see if I had Marfan's syndrome. They didn't find ANY concerns around my heart. 

thanks for your consoling words. It eases the fear I have of permanent withdrawal xox

[LukeUK]

39 minutes ago, FoxTail95 said:

Unfortunately last night the same thing happened. My heart started beating around 2:30 am.

 

This is exactly what happened to me for months after stopping mirtazapine, except it was exactly 3am every night.

 

  

39 minutes ago, FoxTail95 said:

Today I got up and my heart was beating hard. Not as hard as last night but hard and fast. I took a 40mg propronalol (as I've done every morning of the last 12 years) and within an hour it had stopped. 

It seems the propranolol is what is stopping the palpitations during the day. I don't know why it seems to have an increased strength all of a sudden?

 

Propanolol raises cortisol in your bloodstream. I had elevated cortisol from mirtazapine withdrawal for 7 months.

 

Something to consider.

[FoxTail95]

13 minutes ago, LukeUK said:

 

This is exactly what happened to me for months after stopping mirtazapine, except it was exactly 3am every night.

 

  

 

Propanolol raises cortisol in your bloodstream. I had elevated cortisol from mirtazapine withdrawal for 7 months.

 

Something to consider.

I don't understand what you mean by this. Are you saying I should stop taking Propranolol? I've been on it for 12 years. And it's the only thing seemingly helping me right now.

[Happy2Heal]

17 minutes ago, FoxTail95 said:

They were investigating to see if I had Marfan's syndrome.

oh what made them think you might have that? 

 

 

[FoxTail95]

Just now, Happy2Heal said:

oh what made them think you might have that? 

 

 

Cuz I have a really weird physique lol Very long and skinny. I fit the profile physically but not cardiologically. 

[Happy2Heal]

are you taking the propranolol for high blood pressure or for anxiety or migraines or a hormonal issue?

 

of course your doctor must have told you to never stop taking that suddenly

I think LukeUK wanted to tell you that it might some how be related to your symptoms...? I don't really know 

 

and in fact I'd never heard that but I am now off to google propranolol side effects etc

I was on a beta blocker for a year but I don't recall which one, I think it was propranolol but there is another one with a similar name, atenolol I think?

 

that's interesting about you being tall and thin.

I've been told I have "piano fingers" very long fingers but I'm not tall, I'm short lol

[FoxTail95]

1 minute ago, Happy2Heal said:

are you taking the propranolol for high blood pressure or for anxiety or migraines or a hormonal issue?

 

of course your doctor must have told you to never stop taking that suddenly

I think LukeUK wanted to tell you that it might some how be related to your symptoms...? I don't really know 

 

and in fact I'd never heard that but I am now off to google propranolol side effects etc

I was on a beta blocker for a year but I don't recall which one, I think it was propranolol but there is another one with a similar name, atenolol I think?

 

that's interesting about you being tall and thin.

I've been told I have "piano fingers" very long fingers but I'm not tall, I'm short lol

I was put on it at 16 for anxiety. I'm 28 now and still on it. I've always found it helpful. I've taken it everyday as prescribed. 

 

Yes I have piano fingers but unfortunately cannot play the piano. 

[Happy2Heal]

Just now, FoxTail95 said:

Yes I have piano fingers but unfortunately cannot play the piano.

same here LOL 

Just now, FoxTail95 said:

I was put on it at 16 for anxiety. I'm 28 now and still on it. I've always found it helpful. I've taken it everyday as prescribed. 

that's interesting, I've never heard of it being prescribed for anxiety, I only learned that while googling it to try to figure out why you were prescribed it. Never knew anyone who took it long term unless they had high blood pressure or some cardiac issue

you learn something new every day I guess

 

[getofflex]

1 hour ago, FoxTail95 said:

I have been terrified that I was kindling and it was all going to become permanent. I read that Kindling can induce a worse and even permanent state of withdrawal. Is that really true? 

No, withdrawal is temporary.  However, in some people it takes longer to recover.  Did you read the link on kindling I gave you?  It means your nervous system becomes sensitized to prior drugs, and then you have an adverse reaction the next time you go on a drug.  I suggest, if you have the cognitive ability, that you read some success stories on our site.  Here is a list of links to people who recovered from mirtazapine. 

 

https://www.survivingantidepressants.org/search/?&type=forums_topic&tags=mirtazapine&nodes=28&search_and_or=and

 

Success Stories

 

I strongly suggest you do whatever you can to manage your anxiety around this situation.  Please try not to imagine the worst.   I suggest you avoid reading horror stories on the internet about psych med withdrawal.  There is lots of fear porn out there. Keep reassuring yourself that this is temporary, as long as you stay off the drug carousel, and you take proper care of yourself.  

 

 

[getofflex]

Here are some quotes that I hope you will repeat to yourself to help wit the panic.  

 

 

1. Say to yourself: "I am experiencing a symptom."

Its important when symptoms arise to name them what they are. When in a wave it is easy to lose perspective and believe that what we are experiencing is a sign that we are going crazy, mentally ill, that our brains are broken, or that we are dying. Symptoms are time limited experiences that will gradually resolve.

 

 

2. Remind yourself: "I would not be feeling this way if it was not for the medication."

Withdrawal/ADR symptoms are compelling and have a tendency to pull us in to a unique physiological reality characterized by interminable suffering. Neuro-emotions, ruminating thoughts, and unrelenting physical ailments feel so real it is sometimes hard to believe that we are experiencing is drug induced. Falling into this pit can send us into a spiral of googling symptoms, experimenting with remedies and endlessly theorizing about our condition. Reminding ourselves that it is the medication (or for withdrawal, its absence) that is causing this experience grounds us in the appropriate context for recovery. When we remind ourselves it is the medication, we open the door to taking the right action to promote recovery. 

 

4. Seek reassurance

When symptoms arise, they can be incredibly distressing and debilitating. Many people in withdrawal feel as though their lives are ruined and they may never feel better again. Seek reassurance from loved ones and compassionate others to remind you that you will heal in time.

 

 

5. Deconstruct eternity thinking

Withdrawal/ADR symptoms are incredibly compelling. Often when a wave of symptoms arises, one feels they will always feel this way forever. I know for me, when a wave of depression hits, I have a hard time believing it won’t last forever. The reality is that symptoms change over time. Recovery follows an unpredictable course, yet no feeling is final. Waves will always end eventually. Remind yourself that symptoms are not forever, and you will feel differently eventually. Symptom journals can be incredibly helpful in this regard, as when eternity thinking sets in, you can revisit past journals to see how your experience has changed over time. 

 

 

8. Resist drasticizing and catastrophizing

Withdrawal/ADR symptoms throw us into a state of high distress, where it is easy to begin catastrophizing (believing the world is ending) and drasticizing (believing that something needs an immediate and severe response). It’s important to forcefully resist this, as this kind of thinking only serves to increase distress and reinforce the notion that recovery is not possible. Use whatever strength you can to push back against this thinking, reminding yourself that symptoms are not life threatening, and that this is not forever. CBT techniques that challenge catastrophic thinking are particularly helpful in managing this dimension of symptoms. 

 

All these are from Techniques for Managing Withdrawal

Edited February 22 by getofflex

[FoxTail95]

2 hours ago, getofflex said:

No, withdrawal is temporary.  However, in some people it takes longer to recover.  Did you read the link on kindling I gave you?  It means your nervous system becomes sensitized to prior drugs, and then you have an adverse reaction the next time you go on a drug.  I suggest, if you have the cognitive ability, that you read some success stories on our site.  Here is a list of links to people who recovered from mirtazapine. 

 

https://www.survivingantidepressants.org/search/?&type=forums_topic&tags=mirtazapine&nodes=28&search_and_or=and

 

Success Stories

 

I strongly suggest you do whatever you can to manage your anxiety around this situation.  Please try not to imagine the worst.   I suggest you avoid reading horror stories on the internet about psych med withdrawal.  There is lots of fear porn out there. Keep reassuring yourself that this is temporary, as long as you stay off the drug carousel, and you take proper care of yourself.  

 

 

The reason I thought kindling can induce a permanent withdrawal was because I read the following in the section about reinstatement: " Once the nervous system is destabilized by withdrawal, all bets are off. Humpty Dumpty the egg has fallen off the wall. Sometimes reinstatement does not work." I also could have sworn I read something about it becoming permanent too. But my cognition is horrible right now so I'm very glad to be wrong there. 

 

 

[FoxTail95]

Just now, FoxTail95 said:

The reason I thought kindling can induce a permanent withdrawal was because I read the following in the section about reinstatement: " Once the nervous system is destabilized by withdrawal, all bets are off. Humpty Dumpty the egg has fallen off the wall. Sometimes reinstatement does not work." I also could have sworn I read something about it becoming permanent too. But my cognition is horrible right now so I'm very glad to be wrong there. 

 

 

Also what do you mean by keep yourself off the drug carousel? Can I still try taking propranolol at night to see if it helps with the palpitations? 

[FoxTail95]

3 hours ago, FoxTail95 said:

I don't understand what you mean by this. Are you saying I should stop taking Propranolol? I've been on it for 12 years. And it's the only thing seemingly helping me right now.

@getofflex what do you think regarding this? 

[FoxTail95]

4 hours ago, getofflex said:

Unfortunately, the majority of people in mental health have been brainwashed to put people on drugs, and to believe that psych drugs are fine, safe, and effective.  Drug manufacturers have a great deal of influence in government, as well as in research, and in universities that train health care professionals.  However, many people have been harmed by them, and I've seen many people on this site go back up to a full dose of a drug, and end up getting kindled. I will tell you that this condition is temporary, but it often takes a long time for the brain to recover.   I suggest, if you have time, you read a book by Robert Whitaker called "Anatomy of an Epidemic".  It is very eye opening.  

 

Please try and be aware of your symptoms, and how they have changed since you started the 7.5 mg reinstatement of mirtazapine on Feb. 18.  Overall, Are your symptoms improving since then, or are they getting worse?  Or are they the same?  Also, how do you feel in the 4-5 hours after you take the mirtazapine?  Do you have worse symptoms during this time?  If it turns out t he 7.5 mg dose is too high, we can lower it.  

 

What times o'clock do you take each of your drugs? 

 

I will confer with the other staff about your issue with the racing heart, and propranolol and quetiapine, and one of us will get back to you.  

My cognition is really bad right now so I completely missed half of your questions here. 

As I said my symptoms have been similar the last few days. 

 

My diary says that Sunday 18th was the first time I experienced the palpitations and it says they came on around 2am. It also says I took the 7.5mg at 3:45am. The palpitations persisted until I fell asleep at 8am it says. I always take the Mirtazapine at night. The palpitations have been starting around 3am. But the first night this happened, it seems to have happened before I took it. The next night I took it at 12 midnight and the palpitations came on at around 2am. The next 2 nights I took at 2am and they seemed to come on at about 4:30am. So I seem to have horrifically bad symptoms for 4-5 hours after I take the Mirt HOWEVER the first night this started was Sunday 18th, and the palpitations started BEFORE I took the 7.5mg Mirt. So this suggests they aren't caused by it? Which means it probably isn't an adverse reaction? Rather a withdrawal symptom, which I think you said already somewhere else. 

 

I'm going to be taking the 25mg Quetiapine at 1am and the 7.5mg mirt at 2am. I take the 40mg propranolol when I get up straight away in morning.