FoxTail95: Mirtazapine withdrawal help

[FoxTail95]

28 minutes ago, FoxTail95 said:

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. 

I wonder if it's worth mentioning also that during the day, my heart seems to be ALOT calmer than it would have been before all of this. It's almost a bit tight.

Before all of this, if I went out, I could feel my heart beating faster in certain situations. whereas in these last few days, I haven't even been able to feel my heart when I go out hardly at all. It's very calm to the point of tightness. This occurs after I take the propanalol 40mg (which I take every morning). The propranolol is somehow alot more potent than before the withdrawal period. It used to work with far less potency. 

 

I don't know if this is worth mentioning. 

 

I also remember on Tuesday the 20th (reinstatement 7.5mg day 3)feeling almost a sense of elation during the day. I just felt very positive during the day. A bit drunk and hazy mentally but very emotionally positive overall. The haze I feel has been lifting a little. I don't feel that it's getting worse, anyhow. But I do somehow seem to have a fair amount of energy during the day despite only sleeping 3 hours a night and eating very little. My appetite is gone. I've only been eating breakfast and supper in the evening. I've obviously also had massive feelings of fear and despair also. But that's more from the uncertainty of whether im making myself worse or not. 

 

Just more details, in case it helps. 

[LukeUK]

12 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.

 

I'm giving you information about the drugs you are taking. There is a good chance that waking up in the early hours with a racing/irregular heartbeat is related to high cortisol.

 

I'm not telling you to do or not to do anything. 

 

 

 

[getofflex]

13 hours ago, FoxTail95 said:

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? 

The pattern we see so often here, is that someone goes into withdrawal.  They tell the psychiatrist their symptoms.  The psych wrongly assumes the person is having a mental illness, and puts them on new drugs, and/or increase their doses.  The person gets worse, and again tells this to the doctor.  The doctor does more drug changing and switching, making them even worse off.  The best way to get out of the trap of psych drugs, is to very carefully and gradually taper off each psych drug one at a time, and when symptoms hit, using non drug ways of managing them, and not trying to fix withdrawal with more drugs.  We do use a small temporary reinstatement when the withdrawal is severe, when appropriate. 

 

I think it is fine to take the propranolol for your palpitations. 

Edited February 23 by getofflex

[getofflex]

Now, you've answered my questions.  May I suggest you take the quetiapine and mirtazapine 2 hours apart, since there is a moderate drug interaction which includes irregular heartbeat?  I wonder if this is possibly what is causing your racing heart.  

 

A few posts ago, you said you were about the same after your reinstatement of mirtazapine, but now, you are saying you feel worse in the several hours after you take it. 

 

15 hours ago, FoxTail95 said:

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. 

In this case, it may be that the timing of the palpitations is a coincidence, or it could be an adverse reaction. 

 

Q: Do you have any other additional symptoms in the 4-5 hours after you take the mirtazapine other than palpitations?  

 

I would suggest that you keep a daily drug and symptom journal, to see if you are having an adverse reaction to the mirtazapine.  

Keep track of taking your drug, symptoms, eating, sleeping, etc.  Write the time on the left, and describe the event on the right.  Pay attention especially to how you feel before, and then after, you take your drug. Please do this for 24 hours, and post an entry in here for each 24 hour period.  Here is an example: 

 

January 31, 2023

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

 

 

Edited February 23 by getofflex

[getofflex]

12 hours ago, FoxTail95 said:

I wonder if it's worth mentioning also that during the day, my heart seems to be ALOT calmer than it would have been before all of this. It's almost a bit tight.

Before all of this, if I went out, I could feel my heart beating faster in certain situations. whereas in these last few days, I haven't even been able to feel my heart when I go out hardly at all. It's very calm to the point of tightness. This occurs after I take the propanalol 40mg (which I take every morning). The propranolol is somehow alot more potent than before the withdrawal period. It used to work with far less potency. 

I wouldn't worry about this.  You had your heart checked out a year ago, and it was fine.  It's probably the propranolol.  I believe that there is some significant health anxiety going on here.  It is important to try to focus less on your symptoms, because the anxiety and worry about it is likely to worsen your withdrawal, and send you into downward spirals of anxiety.  In 99% of cases, symptoms are from withdrawal, and just need time, and natural self care to resolve themselves.  Please find ways to distract yourself from thinking about your health and symptoms.   

 

Health Anxiety

 

 

 

 

 

 

 

[FoxTail95]

2 hours ago, getofflex said:

Now, you've answered my questions.  May I suggest you take the quetiapine and mirtazapine 2 hours apart, since there is a moderate drug interaction which includes irregular heartbeat?  I wonder if this is possibly what is causing your racing heart.  

 

A few posts ago, you said you were about the same after your reinstatement of mirtazapine, but now, you are saying you feel worse in the several hours after you take it. 

 

In this case, it may be that the timing of the palpitations is a coincidence, or it could be an adverse reaction.  

 

Q: Do you have any other additional symptoms in the 4-5 hours after you take the mirtazapine other than palpitations?  

 

I would suggest that you keep a daily drug and symptom journal, to see if you are having an adverse reaction to the mirtazapine.  

Keep track of taking your drug, symptoms, eating, sleeping, etc.  Write the time on the left, and describe the event on the right.  Pay attention especially to how you feel before, and then after, you take your drug. Please do this for 24 hours, and post an entry in here for each 24 hour period.  Here is an example: 

 

January 31, 2023

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

 

 

@getofflex I'm sorry if I was unclear. 

I said that the last few days have felt similar in that I've been having palpitations/ racing heart at night that have lasted all night long. This started on Sunday 18th BEFORE I took my first reinstated dose of 7.5mg. This the night after the 14 days of taking 15mg every third night. Making it the 15th night. 

I documented thatt I took 7.5mg at 3:45am in response to these palpitations that night. 

 

The other major symptom I notice 4-5 hours afterward is an inability to sleep which has seemed to be worsening rather than improving. 

That being said, I was really dreading the nightly palpitations yesterday evening. But then last night when they came on, they weren't as bad as I recalled them being on other nights. They were very unpleasant, but they didn't feel as bad as previous nights, as far as I could tell. I didn't even feel compelled to take the propranolol I planned to take if they got too bad. 

 

I was, however, unable to sleep until around 7:15am. And I only slept until 8:45am. then I just drowsed half awake, half asleep till around 12. 

On previous nights I was getting between 3-5 hours of sleep. So this looks like it's getting worse. But the palpitations last night didn't feel as bad as other nights, as far as I could tell. Which I would hope is a good sign that perhaps this isn't an adverse response but rather a withdrawal response? 

[FoxTail95]

2 hours ago, getofflex said:

The pattern we see so often here, is that someone goes into withdrawal.  They tell the psychiatrist their symptoms.  The psych wrongly assumes the person is having a mental illness, and puts them on new drugs, and/or increase their doses.  The person gets worse, and again tells this to the doctor.  The doctor does more drug changing and switching, making them even worse off.  The best way to get out of the trap of psych drugs, is to very carefully and gradually taper off each psych drug one at a time, and when symptoms hit, using non drug ways of managing them, and not trying to fix withdrawal with more drugs.  We do use a small temporary reinstatement when the withdrawal is severe, when appropriate. 

 

I think it is fine to take the propranolol for your palpitations. 

So there aren't any drugs that actually help me here? Any more drugs prescribed would make me worse? What about something for sleep? My sleeping is really bad right now.

Also I'm being told that if I go back to 15mg it will help me back to how I was before. Which is all I want. 

[getofflex]

Please, please do a daily drug and symptoms journal, as described before.  You need to be very diligent about writing down the specific time you take each and every drug. Also, write down your symptoms, etc, and everything as I've laid out in a my previous post.  What you need to do, if figure out your symptom pattern.  We are trying to figure out if you are having an adverse reaction to a drug, and which drug it is, or if you are having a drug interaction, or if it's withdrawal.  

 

I'm going to have to pass this on to another member of the staff, as I am sick myself at this time.  Someone else will be getting back to you.  

 

 

[FoxTail95]

Just now, FoxTail95 said:

So there aren't any drugs that actually help me here? Any more drugs prescribed would make me worse? What about something for sleep? My sleeping is really bad right now.

Also I'm being told that if I go back to 15mg it will help me back to how I was before. Which is all I want. 

@getofflex About 18 months ago, I came tapered Zopiclone too quickly and had a massive withdrawal response and didn't sleep for months. I was completely desperate to sleep and was put on Mirtazapine 15mg nightly which put me to sleep instantly. It probably saved my life at the time. I then was able to later taper SLOWLY off of zopiclone months later. 

I don't understand how prescribing an appropriate drug could only necessarily be harmful. It defiantly helped me at the time. I was desperate to sleep and it worked. 

[LukeUK]

29 minutes ago, FoxTail95 said:

@getofflex About 18 months ago, I came tapered Zopiclone too quickly and had a massive withdrawal response and didn't sleep for months. I was completely desperate to sleep and was put on Mirtazapine 15mg nightly which put me to sleep instantly. It probably saved my life at the time. I then was able to later taper SLOWLY off of zopiclone months later. 

I don't understand how prescribing an appropriate drug could only necessarily be harmful. It defiantly helped me at the time. I was desperate to sleep and it worked. 

 

Every time you do it, you're taking a risk.

 

Poor sleep is a fraction of the harm these drugs can cause.

 

If that risk paid off for you, that's good. Remember that you're here because of having a massive withdrawal response in the first place. These drugs are not to be taken lightly.

[FoxTail95]

10 hours ago, getofflex said:

Please, please do a daily drug and symptoms journal, as described before.  You need to be very diligent about writing down the specific time you take each and every drug. Also, write down your symptoms, etc, and everything as I've laid out in a my previous post.  What you need to do, if figure out your symptom pattern.  We are trying to figure out if you are having an adverse reaction to a drug, and which drug it is, or if you are having a drug interaction, or if it's withdrawal.  

 

I'm going to have to pass this on to another member of the staff, as I am sick myself at this time.  Someone else will be getting back to you.  

 

 

I am sorry to read that you are sick. I hope you will be well. And hope someone else can respond to the questions I have asked here. Take care. 

[getofflex]

Propranolol has a short half-life and if it's not extended-release, is taken more than once a day.  The fast heart rate may be rebound from a high dose of propranolol wearing off.  Please discuss this with your doctor.    

 

Just wanted to briefly pass this along, now I'm off to recover from my vertigo and nausea. 

Edited February 24 by getofflex

[FoxTail95]

4 hours ago, getofflex said:

Propranolol has a short half-life and if it's not extended-release, is taken more than once a day.  The fast heart rate may be rebound from a high dose of propranolol wearing off.  Please discuss this with your doctor.    

 

Just wanted to briefly pass this along, now I'm off to recover from my vertigo and nausea. 

Sorry to hear about your vertigo and nausea. I hope it gets better for you. 

 

I hope that somebody else can respond to me in the meantime. 

 

I'm relieved to report that I had a better night last night. The palpitations felt far less intense and I was able to fall asleep at 5am and slept till 9am (big improvement).I lay awake then unable to sleep and so observed my symptoms. My heart didn't feel as fast as other nights/mornings. It was a relief to get a bit of sleep and not feel besieged by palpitations. I'm hoping it means I'm improving. Would that suggest that I'm not having an adverse response??? Would that suggest that it's withdrawal symptoms I'm experiencing??? Presumably if it were an adverse response or a drug interaction then symptoms would be getting worse??? They appear to be getting slightly better, not worse. 

 

I'm being advised that what I am experiencing is a withdrawal response and that if I go up from 7.5mg back to original dose 15mg that I'll go back to how I was before all this. I'd really appreciate if somebody could chime in on this. 

 

Sorry again that you are unwell. 

[Altostrata]

On 2/23/2024 at 7:59 AM, getofflex said:

Please, please do a daily drug and symptoms journal, as described before.  You need to be very diligent about writing down the specific time you take each and every drug. Also, write down your symptoms, etc, and everything as I've laid out in a my previous post.  What you need to do, if figure out your symptom pattern.  We are trying to figure out if you are having an adverse reaction to a drug, and which drug it is, or if you are having a drug interaction, or if it's withdrawal.  

 

I'm going to have to pass this on to another member of the staff, as I am sick myself at this time.  Someone else will be getting back to you.  

 

 

 

@getofflex is requesting these notes for a good reason. We cannot interpret symptoms in isolation. Please help the staff by posting the requested notes.

[FoxTail95]

1 hour ago, Altostrata said:

 

@getofflex is requesting these notes for a good reason. We cannot interpret symptoms in isolation. Please help the staff by posting the requested notes.

 

@Altostrata

--[14 days of taking 15mg Mirtazapine every 3rd night]

--{Didn't have any anxiety or palpitations. Just sleeplessness and cognitive issues.]--

Then:

 

Day15:Sunday

Sunday night:

Had horrific night on Sunday night

Didn't document if I took Quetipaine 25mg at night as I was supposed to

Palpitations came on around 2am. Got worse as time went on. 

Took Mirt 7.5mg at 3:45am in response. (I read about Kindling which scared me into taking a lesser dose)

Palpitations got faster and harder progressively through the night until I fell asleep at 8am- 11am. Horrifically bad palpitations.

 

Monday

11am- Very anxious. Heart pounding but not as bad as last night

Very anxious all day

7:30pm- Still feeling very anxious. Took 25mg Quetiapine to see if it would help.

8:30pm- Feeling alot calmer now thanks to the Quetiapine. Heart still beating but overall alot more calm.

11pm- Feeling a bit calmer now in terms of my heart. 

12- Took 7.5mg Mirt. 

1;30am- took Quetiapine 25mg. 

2:30am- heartbeat going faster

3:30am: Very, very fast

4:30am- very, very fast heart

5am-9am- Fell asleep. 

 

Tuesday

9am-woke up

Afternoon- Felt alot calmer during the day today. No palpitations so far. Feel calm overall

Nighttime- 1am- took quetiapine 25mg

2am- took 7.5mg Mirtazapine

3am- Heartrate going up

4am- Heart going very fast

4:30am- Took 2mg Diazepam to relieve palpitations. Heart was pounding awfully. Diazepam 2mg helped a bit. 

5:30am-7:30am slept

 

Wednesday

1pm- Heart has been beating. Not as hard as other days but beating. I'm now taking 40mg Propranolol

2pm- Feeling reasonably calm now but exhausted. 

4:30pm- Don't have palpitations now but feel very anxious and overstimulated. 

6pm- Feeling a little less anxious overall

9pm-Feeling okay overall

11pm- feeling okay overall

1am- Took 25mg Quitiapine. Feeling not too bad overall. 

2am- Heart feels okay. Now taking 7.5mg Mirtazapine

3am- Heart is beating a bit

4:30am- Heart beating quite hard but not as bad as other nights

5;30am- Heart beating very hard; can't sleep

5:45am- Took 25mg Quetiapine out of desperation to stop the heart pounding. 

6:45am- Heart still pounding hard. Unable to sleep despite exhaustion

7:30am- Heart still pounding. Still awake

9:30am-12:15am- fell asleep

 

Thursday

2pm- Heart beating but not as hard as last night. But it's quite hard. Gonna take 40 mg propranolol

3pm- Heart not racing anymore feels calm now. 

4pm- Heart currently feels very still. Propranolol seems to be acting very powerfully. It never felt this powerful before. Chest feels tight. 

6pm- Feel very calm all day. 

1am- took 25mg Quetiapine. 

2am- Took 7.5mg Mirtazapine

3am- heart feeling ok

4am- heart is beating quite hard but not as hard as other nights

5am- very tired, can't fall asleep; heart is going faster but not as bad as other nights

6am- Palpitations are going faster but not as bad as previous nights; cannot fall asleep though

7am- still awake; very tired; can't fall asleep; palpitations a bit faster but not as bad as previous other nights (haven't felt compelled to reach for a pill to stop it like other nights)

7:15-8:45am- slept

 

Friday:

8:45am- woke, heart beating

12:30-been drowsing a few hours; heart going quite fast and hard

1:15pm- took 40mg propranolol 

2:30- Pretty calm now. Heart isn't pounding at all. Calm.

3:30pm- Heart is calm. Mentally spaced out. Brain fog. A bit dizzy/ disoriented. Mild tinnitus

5pm- Feeling anxious but heart is calm.

1am- took Quetiapine 25mg

2am- Took 7.5mg Mirtazapine

3am- Feeling fine, heart feels fine

4am- Feeling fine. Feeling tired. Heart feels ok

4:30am- heart beating but only a little. 

Fell asleep--

 

Saturday-

9am- woke (slept 5am-9am)

9:30am- Can feel my heart beating; but it isn't pounding or racing like other mornings

10:30am-Heart still not pounding

1:30pm- Fell asleep again from 12-1pm

2:30pm- Heart going quite hard and fast but less than previous days. Gonna take 40mg propranolol 

4pm- Heart feels calm now

5pm- heart fine

6pm-heart fine

7pm- heart fine

11pm- heart a little faster but fine

12pm- took 25mg Quetiapine

1:30am- Feeling okay overall. Heart beating a little bit. But only a little. Chest a bit tight on the left side though. 

2am- Took 7.5mg Mirtazapine

2:30am- I have alot of energy. Right now and all of this reinstatement period I have ALOT of energy. 

3am- Heart feels fine. Not beating hard at all. Starting to feel sleepy and quite disoriented

4am- Heart still calm. Beating only a small amount. Feel tired too and disoriented mentally. 

5am- Heart feels fine. Not pounding or palpitating. Feels calm. MUCH better than previous nights. 

5:15am-6:45am-- fell asleep

6:45am- woke up. Heart not racing. Feel calm. 

7am-11am- fell asleep again. 

 

Sunday-

11am- woke up

11:30am- Can feel my heart beating but its much less than previous mornings. Feel tired. 

12:30am- Can feel my heart beating. It's a bit harder than before but alot less than previous mornings.

1pm-2pm- Fell asleep again. 

2:30pm- Heart going quite fast. Faster than earlier. Not as bad as other days though. Going to take 40mg propranolol

4pm- Heart feels calm now.

[FoxTail95]

@Altostrata I've provided the documentation I made of my symptoms of the last 7 days. 

I had another good night last night. The palpitations were minimal and I slept better too. 

My symptoms seem to be improving overall. 

Would this suggest that what I am experiencing is withdrawal and that the reinstatement of 7.5mg is helping that? 

If I were Kindling, wouldn't my symptoms be getting worse and not better? 

If my drugs were interacting, wouldn't my symptoms be getting worse and not better? 

 

My aim at this point is to go back to where I was before this whole experience. I want to go back to how I was when I was on the 15mg. When I achieve Homeostasis, then I'll consider a slow taper in the future. If I attempt to move back up to 15mg, do I risk Kindling? Or is the fact that my symptoms are improving show that this is simply withdrawal and a full reinstatement would return me to Homeostasis? 

 

Would appreciate your advice here. thanks 

[getofflex]

It appears you are taking various psych drugs inconsistently, which will lead to problems.  It does seem the drugs are becoming more consistent in the recent several days, which is good.  I don't suggest you vary your dose of quetiapine - I see some days you took two 25 mg doses, instead of just one 25 mg dose.  And throwing in the occasional diazepam (benzodiazepines) may confuse your brain even further.  

 

I suggest that you take your drugs very consistently, at the same dosages and times each and every day.   Again, I would suggest you gradually space apart your quetiapine and mirtazapine, since they have a bad drug interaction.  Take then an hour further apart each night, ie, 2 hours apart tonight, 3 hours apart tomorrow, etc.  That will also help you see what drug may be causing what. 

 

Your sleep issues could also be from the previous Zoplicone withdrawal. 

 

As stated before, Propranolol has a short half-life and if it's not extended-release, is taken more than once a day.  The fast heart rate may be rebound from a high dose of propranolol wearing off.  If it were me I would split the dose and take 20 mg 12 hours apart.  

 

I see you took a Benzo, but it's not in the drug signature.  Please add this to the signature.  

 

It does sound like the 7.5 mg mirtazapine reinstatement may be helping you.   

 

 

Edited February 25 by getofflex

[getofflex]

t would help a lot of you could bold the lines where you give the time and dosage of your drugs.  Also, put "Feb 18" instead of "Day 15".   And it would really help if you could start each day's notes at the same time of day, instead of at different times of the day.  That makes it confusing and hard to understand.  I would suggest starting at 12 AM until 12 PM for each post.  Thank you. Please don't forget to put all your drugs in, including propranolol. 

Edited February 25 by getofflex

[FoxTail95]

49 minutes ago, getofflex said:

It appears you are taking various psych drugs inconsistently, and self-medicating, which will lead to problems.  

 

I suggest that you take your drugs consistently, at the same dosages and times each and every day.   Again, I would suggest you gradually space apart your quetiapine and mirtazapine, since they have a bad drug interaction.  Take then an hour further apart each night, ie, 2 hours apart tonight, 3 hours apart tomorrow, etc.  That will also help you see what drug may be causing what. 

 

Your sleep issues could also be from the previous Zoplicone withdrawal. 

 

As stated before, Propranolol has a short half-life and if it's not extended-release, is taken more than once a day.  The fast heart rate may be rebound from a high dose of propranolol wearing off.  Please discuss this with your doctor.    

 

I see you took a Benzo, but it's not in the drug signature.  Please add this to the signature.  

 

I cannot tell what is causing what, because of the inconsistent dosing.  I cannot really advise you or figure out what is going on at this time, because the drugs and symptoms are all over the place. 

 

It does sound like the 7.5 mg mirtazapine reinstatement may be helping you.   

 

 

I'm sorry if it comes across that way but I don't think there is any inconsistent dosing. 

 

Drug Regimen:

I take 40mg Propranolol when I get up (I'm getting up at different times because my sleep is inconsistent).

I take 25mg Quetiapine midnight 

I take Mirtazapine (7.5mg this week) at 2am. 

 

Also the symptoms are not all over the place. I was having palpitations at night. That was more or less it. And some sleeplessness. And some high anxiety in the first couple days. 

Both of these appear to be getting better. 

 

I also only took an extra Quetiapine a couple of times to see if it would help. I took 1x2mg Diazepam on one occasion. But this is ancillary to my actual drug regimen. 

 

My question is basically that if my symptoms appear to be getting better, and this is simply a withdrawal response, then do I risk Kindling if I move back up to 15mg? 

 

Also I don't see why the palpitations would have been a response to Propranolol as I've been taking them this way for 12 years and never had an issue like this. 

 

I am sorry though if my notes weren't clear enough. I'll try to amend them and make them clearer. I'll also add the Diazepam to my signature. 

[FoxTail95]

--[14 days of taking 15mg Mirtazapine every 3rd night]

--{Didn't have any anxiety or palpitations. Just sleeplessness and cognitive issues.]--

Then:

 

Sunday 18th February (Day 15):

Sunday night:

Had horrific night on Sunday night

Didn't document if I took Quetipaine 25mg at night as I was supposed to

Palpitations came on around 2am. Got worse as time went on. 

Took Mirt 7.5mg at 3:45am in response. (I read about Kindling which scared me into taking a lesser dose)

Palpitations got faster and harder progressively through the night until I fell asleep at 8am- 11am. Horrifically bad palpitations.

 

Monday

11am- Very anxious. Heart pounding but not as bad as last night

1pm- 40mg Propranolol

Very anxious all day

7:30pm- Still feeling very anxious. Took 25mg Quetiapine to see if it would help.

8:30pm- Feeling alot calmer now thanks to the Quetiapine. Heart still beating but overall alot more calm.

11pm- Feeling a bit calmer now in terms of my heart. 

12- Took 7.5mg Mirt. 

1;30am- took Quetiapine 25mg. 

2:30am- heartbeat going faster

3:30am: Very, very fast

4:30am- very, very fast heart

5am-9am- Fell asleep. 

 

Tuesday

9am-woke up

11am- 40mg Propranolol

Afternoon- Felt alot calmer during the day today. No palpitations so far. Feel calm overall

Nighttime- 1am- took quetiapine 25mg

2am- took 7.5mg Mirtazapine

3am- Heartrate going up

4am- Heart going very fast

4:30am- Took 2mg Diazepam to relieve palpitations. Heart was pounding awfully. Diazepam 2mg helped a bit. 

5:30am-7:30am slept

 

Wednesday

1pm- Heart has been beating. Not as hard as other days but beating. I'm now taking 40mg Propranolol

2pm- Feeling reasonably calm now but exhausted. 

4:30pm- Don't have palpitations now but feel very anxious and overstimulated. 

6pm- Feeling a little less anxious overall

9pm-Feeling okay overall

11pm- feeling okay overall

1am- Took 25mg Quitiapine. Feeling not too bad overall. 

2am- Heart feels okay. Now taking 7.5mg Mirtazapine

3am- Heart is beating a bit

4:30am- Heart beating quite hard but not as bad as other nights

5;30am- Heart beating very hard; can't sleep

5:45am- Took 25mg Quetiapine out of desperation to stop the heart pounding. 

6:45am- Heart still pounding hard. Unable to sleep despite exhaustion

7:30am- Heart still pounding. Still awake

9:30am-12:15am- fell asleep

 

Thursday

2pm- Heart beating but not as hard as last night. But it's quite hard. Gonna take 40 mg propranolol

3pm- Heart not racing anymore feels calm now. 

4pm- Heart currently feels very still. Propranolol seems to be acting very powerfully. It never felt this powerful before. Chest feels tight. 

6pm- Feel very calm all day. 

1am- took 25mg Quetiapine. 

2am- Took 7.5mg Mirtazapine

3am- heart feeling ok

4am- heart is beating quite hard but not as hard as other nights

5am- very tired, can't fall asleep; heart is going faster but not as bad as other nights

6am- Palpitations are going faster but not as bad as previous nights; cannot fall asleep though

7am- still awake; very tired; can't fall asleep; palpitations a bit faster but not as bad as previous other nights (haven't felt compelled to reach for a pill to stop it like other nights)

7:15-8:45am- slept

 

Friday:

8:45am- woke, heart beating

12:30-been drowsing  half asleep/ half awake for a few hours; heart going quite fast and hard

1:15pm- took 40mg propranolol 

2:30- Pretty calm now. Heart isn't pounding at all. Calm.

3:30pm- Heart is calm. Mentally spaced out. Brain fog. A bit dizzy/ disoriented. Mild tinnitus

5pm- Feeling anxious but heart is calm.

1am- took Quetiapine 25mg

2am- Took 7.5mg Mirtazapine

3am- Feeling fine, heart feels fine

4am- Feeling fine. Feeling tired. Heart feels ok

4:30am- heart beating but only a little. 

Fell asleep--

 

Saturday-

9am- woke (slept 5am-9am)

9:30am- Can feel my heart beating; but it isn't pounding or racing like other mornings

10:30am-Heart still not pounding

1:30pm- Fell asleep again from 12-1pm

2:30pm- Heart going quite hard and fast but less than previous days. Gonna take 40mg propranolol 

4pm- Heart feels calm now

5pm- heart fine

6pm-heart fine

7pm- heart fine

11pm- heart a little faster but fine

12pm- took 25mg Quetiapine

1:30am- Feeling okay overall. Heart beating a little bit. But only a little. Chest a bit tight on the left side though. 

2am- Took 7.5mg Mirtazapine

2:30am- I have alot of energy. Right now and all of this reinstatement period I have ALOT of energy. 

3am- Heart feels fine. Not beating hard at all. Starting to feel sleepy and quite disoriented

4am- Heart still calm. Beating only a small amount. Feel tired too and disoriented mentally. 

5am- Heart feels fine. Not pounding or palpitating. Feels calm. MUCH better than previous nights. 

5:15am-6:45am-- fell asleep

6:45am- woke up. Heart not racing. Feel calm. 

7am-11am- fell asleep again. 

 

Sunday-

11am- woke up

11:30am- Can feel my heart beating but its much less than previous mornings. Feel tired. 

12:30am- Can feel my heart beating. It's a bit harder than before but alot less than previous mornings.

1pm-2pm- Fell asleep again. 

2:30pm- Heart going quite fast. Faster than earlier. Not as bad as other days though. Going to take 40mg propranolol

4pm- Heart feels calm now.

5pm-Feel a bit disoriented but ok overall. 

8pm- Feel a bit drunk and disoriented mentally (zero alcohol) but otherwise okay. Heart feels fine. 

[FoxTail95]

I have put in bold where I took my meds. 

I was unable to structure it hourly though, unfortunately, as this is just the way I documented my symptoms. 

I hope this is at least a little more clear than before. 

[getofflex]

Thank you for making the notes clearer.  I was having a hard time reading and understanding them. I did go back and edit my previous post after I reread your notes to say it looks like you are more consistent with your drugs and dosing and getting better which is great!    
 

if you are improving then there is no reason to updose to 15 mg mirtazapine. Is your goal on this site to eventually reduce or get off psychiatric drugs?   
 

yes there is still a chance you could kindle by increasing your mirtazapine dose to 15 mg.  

[getofflex]

2 hours ago, FoxTail95 said:

Also I don't see why the palpitations would have been a response to Propranolol as I've been taking them this way for 12 years and never had an issue like 

 

as we go on and off drugs our nervous systems tend to become more sensitized and we react differently.  It’s very common to react more to things that didn’t bother us in the last.  

[getofflex]

2 hours ago, FoxTail95 said:

I also only took an extra Quetiapine a couple of times to see if it would help. I took 1x2mg Diazepam on one occasion. But this is ancillary to my actual drug regimen. 

Even these inconsistencies can cause major symptom uptick in a nervous system in withdrawal.   

[Emonda]

3 hours ago, FoxTail95 said:

I take 40mg Propranolol when I get up (I'm getting up at different times because my sleep is inconsistent).

 

I set a medication alarm when I know I will be up to ensure consistent timing.

 

I used to be pretty casual about the timing, but then I learnt from this site how important consistency was. Consistency has proven very helpful for me.

[FoxTail95]

2 hours ago, getofflex said:

Thank you for making the notes clearer.  I was having a hard time reading and understanding them. I did go back and edit my previous post after I reread your notes to say it looks like you are more consistent with your drugs and dosing and getting better which is great!    
 

if you are improving then there is no reason to updose to 15 mg mirtazapine. Is your goal on this site to eventually reduce or get off psychiatric drugs?   
 

yes there is still a chance you could kindle by increasing your mirtazapine dose to 15 mg.  

I am very glad that these major symptoms seem to be improving. Would that indicate that I have been in withdrawal and that the reinstatement is working? Rather than the symptoms being the result of a drug interaction/ kindling?

 

The reason why I want to return to 15mg is that whilst my more worrying symptoms seem to be improving (palpitations, insomnia), I am still very "out of sorts." I still have other secondary symptoms that I want to move out of - very activated nervous system, very mentally disoriented, drunk with brain fog etc. My desire at the moment is to return to the Homeostasis I was at whilst on 15mg. And then once I become more stable in the future to then do a VERY slow taper off of mirtazapine. 

 

If it is the case that my symptoms are a withdrawal response, is it possible for me to return to 15mg without Kindling? Could I not try and take 3/4 tablet and see how I got on with that? 

If I were to Kindle, what would it feel like? what would I need to be cautious of in terms of onset of new symptoms? What would I need to look out for?

 

And if I found I was Kindling, could I not just come back down to 7.5mg? 

thanks 

[FoxTail95]

2 hours ago, getofflex said:

Even these inconsistencies can cause major symptom uptick in a nervous system in withdrawal.   

Don't people get taken off of drugs though and then put on other drugs to cope with the withdrawals? I'm sure I've heard people doing that and being okay. Forgive my ignorance here. I'm just trying to understand this stuff. People have been saying I'm paranoid about my drugs since I learned about kindling. And I have been very paranoid admittedly since I learned that it was a thing. I can't help but think of the people who were fine in these scenarios, though. 

[Emonda]

42 minutes ago, FoxTail95 said:

The reason why I want to return to 15mg is that whilst my more worrying symptoms seem to be improving (palpitations, insomnia), I am still very "out of sorts."

 

It takes time for the drug to have its full effect. It's great that you've seen improvement after 9 doses. Why not give yourself a little more time to see if there is further improvement? 

 

As you increase the drug, you may end up with side effects / a response you've not experienced before (speaking from personal experience). When I reinstated Lexapro many years ago, I was in a hurry to feel stable, and I went faster than perhaps I should have (desperate for relief). I almost immediately experienced tinnitus for the 1st time, which I have to this day. I experienced other symptoms, too.

 

I regret reinstating as quickly as I did, but that was before I knew this website existed. I stopped the Lexapro immediately (maybe a week back on the stuff- I can't recall), but the tinnitus did not go away.

 

You can read about Kindling here. I suspect I experienced kindling from going on and off CT several times. With the benefit of hindsight, I can relate to the following quote from the link I have given you: Generally, kindling is an activation reaction -- a sense of overstimulation, which may be an inner electrical feeling, anxiety, nervousness, panic, or at the extreme, akathisia, which includes an urge to move to relieve intense inner agitation.

 

 

 

[Emonda]

53 minutes ago, FoxTail95 said:

Don't people get taken off of drugs though and then put on other drugs to cope with the withdrawals?

 

Taking a pill to mask a side effect / WD of another pill can be risky and problematic.

 

54 minutes ago, FoxTail95 said:

I can't help but think of the people who were fine in these scenarios, though. 

 

Some people may be fine, but many are not.

 

You don't want to be one of those who are not. 

[getofflex]

14 hours ago, FoxTail95 said:

I am very glad that these major symptoms seem to be improving. Would that indicate that I have been in withdrawal and that the reinstatement is working?

Yes, believe so.  

 

14 hours ago, FoxTail95 said:

The reason why I want to return to 15mg is that whilst my more worrying symptoms seem to be improving (palpitations, insomnia), I am still very "out of sorts." I still have other secondary symptoms that I want to move out of - very activated nervous system, very mentally disoriented, drunk with brain fog etc. My desire at the moment is to return to the Homeostasis I was at whilst on 15mg. And then once I become more stable in the future to then do a VERY slow taper off of mirtazapine. 

I still do not suggest you return to 15 mg, or even 3/4 of a pill (11.25 mg).  As I've said many times, stick with the 7.5 mg reinstatement.   I've already told you several times, this will put you at risk of kindling.  With kindling you would experience similar symptoms as with WD.    You can do what you want of course, but don't expect us to rescue you if this happens.  Please don't keep asking me about going to 15 mg.  Here is a list of search results with links to threads about kindling, please read them. 

 

Search Results for Kindling

 

In the future, please use the site search.  This link explains how: 

 

https://www.survivingantidepressants.org/forums/topic/25981-how-to-do-a-site-search-on-surviving-antidepressants/#comment-561534

 

14 hours ago, FoxTail95 said:

And if I found I was Kindling, could I not just come back down to 7.5mg? 

If you kindle, it could take many months for you to recover from it.  

 

As stated previously, what you need right now is just time, time, and more time.  Stick with this current drug regimen, and do not change it, even if you have a wave (uptick in symptoms.).   The only way to heal from this is to allow you body and brain to heal itself, not to keep playing with your dose, and trying to make all your symptoms go away.   

 

 

 

 

Edited February 26 by getofflex

[getofflex]

I've given you plenty of information, and done all I can for you at this time. Please go back over your thread, and read where several of the staff have suggested you try not to think and worry about this as much.  I'm going to be less responsive to your posts and your questions.  Please do not keep seeking reassurance, and asking the same questions over and over.  Read these quotes from "What Will Get you Warned or Banned" in the Read This First Forum: 

 

"Please be aware that the staff is all unpaid volunteers, who often have worries, jobs, families, and health issues of their own. While we do our best to help, none of them can fulfill the role of therapist or social worker. You cannot expect them to fulfill your emotional needs."

 

"If you want to go off psychiatric drugs, you must learn to manage habits of mind that might have led you to seek psychiatric treatment originally. These habits of mind may include: Irrational worrying, health anxiety, perseveration (repeating the same thing over and over again), rumination, inability to make decisions, needing constant reassurance, chronic pessimism, chronic hostility, finding fault with everything."

 

"These habits of mind might have caused you a great deal of distress in your life, as well as causing distress to your family, friends, and employers, who may have urged you to seek psychiatric treatment. While we are sympathetic to the pain these problems have caused you, there is no way around your responsibility. If necessary, you may need to engage the services of a psychotherapist or other counselor to learn those self-management skills."

 

"The staff here cannot meet the emotional needs that overwhelmed your family, friends, and employers, and it is unfair and exploitative of you to expect them to."

 

"If a staff member communicates to you that you are wearing them out, please do not continue to demand their attention. We require you to respect the time, and dedication of the staff and limit tagging them to important questions about tapering or withdrawal symptoms. "

 

"Be mindful not to exhaust the patience of a volunteer staff member. They may refuse to respond to your posts. They are people too, and too much can be too much."

 

"If your demands for attention are extreme or if you overuse tagging, you may get warnings and eventually be banned from this site."

[FoxTail95]

9 hours ago, getofflex said:

I've given you plenty of information, and done all I can for you at this time. Please go back over your thread, and read where several of the staff have suggested you try not to think and worry about this as much.  I'm going to be less responsive to your posts and your questions.  Please do not keep seeking reassurance, and asking the same questions over and over.  Read these quotes from "What Will Get you Warned or Banned" in the Read This First Forum: 

 

 

"Please be aware that the staff is all unpaid volunteers, who often have worries, jobs, families, and health issues of their own. While we do our best to help, none of them can fulfill the role of therapist or social worker. You cannot expect them to fulfill your emotional needs."

 

"If you want to go off psychiatric drugs, you must learn to manage habits of mind that might have led you to seek psychiatric treatment originally. These habits of mind may include: Irrational worrying, health anxiety, perseveration (repeating the same thing over and over again), rumination, inability to make decisions, needing constant reassurance, chronic pessimism, chronic hostility, finding fault with everything."

 

"These habits of mind might have caused you a great deal of distress in your life, as well as causing distress to your family, friends, and employers, who may have urged you to seek psychiatric treatment. While we are sympathetic to the pain these problems have caused you, there is no way around your responsibility. If necessary, you may need to engage the services of a psychotherapist or other counselor to learn those self-management skills."

 

"The staff here cannot meet the emotional needs that overwhelmed your family, friends, and employers, and it is unfair and exploitative of you to expect them to."

 

"If a staff member communicates to you that you are wearing them out, please do not continue to demand their attention. We require you to respect the time, and dedication of the staff and limit tagging them to important questions about tapering or withdrawal symptoms. "

 

"Be mindful not to exhaust the patience of a volunteer staff member. They may refuse to respond to your posts. They are people too, and too much can be too much."

 

"If your demands for attention are extreme or if you overuse tagging, you may get warnings and eventually be banned from this site."

I'm sorry you felt the need to post these quotes from the 'grounds for banning' section. It has not been my intention to bother anyone. You can ban me if you really want to, but that seems drastic, honestly. 

 

I don't think I've demanded anything of anyone, though. A few posts ago you said you were sick and couldn't reply anymore. I wished you well and told you to take care. Then another admin told me to post my documentation so I did. And then you just came back.  I never demanded anything of anyone. 

 

If I have asked a similar question multiple times, it's because 1.) I didn't get an answer when asked. 2.) I wasn't able to understand the answer due to my extremely bad cognition. 3.) I tried searching this site for it but couldn't find it. 

 

This is all very new to me. I've only tried to understand what might be happening and what my options are. 

 

I appreciate the time you have spent in trying to help me as best you could. But I don't think my actions warrant these quotes. 

Thanks anyway, though. 

[FoxTail95]

9 hours ago, getofflex said:

Yes, believe so.  

 

I still do not suggest you return to 15 mg, or even 3/4 of a pill (11.25 mg).  As I've said many times, stick with the 7.5 mg reinstatement.   I've already told you several times, this will put you at risk of kindling.  With kindling you would experience similar symptoms as with WD.    You can do what you want of course, but don't expect us to rescue you if this happens.  Please don't keep asking me about going to 15 mg.  Here is a list of search results with links to threads about kindling, please read them. 

 

Search Results for Kindling

 

In the future, please use the site search.  This link explains how: 

 

https://www.survivingantidepressants.org/forums/topic/25981-how-to-do-a-site-search-on-surviving-antidepressants/#comment-561534

 

If you kindle, it could take many months for you to recover from it.  

 

As stated previously, what you need right now is just time, time, and more time.  Stick with this current drug regimen, and do not change it, even if you have a wave (uptick in symptoms.).   The only way to heal from this is to allow you body and brain to heal itself, not to keep playing with your dose, and trying to make all your symptoms go away.   

 

 

 

 

I will take a look at these, thanks

[FoxTail95]

22 hours ago, Emonda said:

 

It takes time for the drug to have its full effect. It's great that you've seen improvement after 9 doses. Why not give yourself a little more time to see if there is further improvement? 

 

As you increase the drug, you may end up with side effects / a response you've not experienced before (speaking from personal experience). When I reinstated Lexapro many years ago, I was in a hurry to feel stable, and I went faster than perhaps I should have (desperate for relief). I almost immediately experienced tinnitus for the 1st time, which I have to this day. I experienced other symptoms, too.

 

I regret reinstating as quickly as I did, but that was before I knew this website existed. I stopped the Lexapro immediately (maybe a week back on the stuff- I can't recall), but the tinnitus did not go away.

 

You can read about Kindling here. I suspect I experienced kindling from going on and off CT several times. With the benefit of hindsight, I can relate to the following quote from the link I have given you: Generally, kindling is an activation reaction -- a sense of overstimulation, which may be an inner electrical feeling, anxiety, nervousness, panic, or at the extreme, akathisia, which includes an urge to move to relieve intense inner agitation.

 

 

 

I'm very sorry to read that you've had tinnitus ever since that reinstatement. That's very tough. 

I'm still suffering with other symptoms (horrible cognition etc) but it gives me great pause when I read this. 

So kindling can basically be permanent, then? That's scary. I hope you're doing ok nowadays otherwise, though.

[Emonda]

Hey FoxTail95

This can be a tough/draining voluntary job (not seeking any sympathy or kind words from you 🙂). Nor do I want any sympathy regarding my symptoms 🤒. I shared my experience to try and explain why getofflex and I were urging caution against returning to 15mg.

 

There are very few volunteers, which is why getofflex kindly kept trying to assist even though she was unwell herself. The volunteers aren't doctors, either. We are all walking down the same path, trying to taper.  I will do what I can to assist, too.

 

As you've learnt, it's not easy. There is no magic bullet/pill, sadly. It's horrible to hear/read, but true. Time and much patience are required to succeed.

 

Keep fighting, mate, and you'll succeed.