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REALNAME?: major insomnia issues


Rosatoffolo

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Hello everybody, 

I started using ambien at the end of december last year and mirtazapine march 19th. The mirtazapine doesn't help me with sleeping. I am currently tapering ambien 10 % per 2 weeks, the method recommended by Benzobuddies. At first, I decided to also taper the mirtazipine to 12 mg. I knew it is not the smartest thing to taper two drugs at the same time. However, i did not know that you have to taper AD's even slower than benzo's. This went well for about 2 weeks. After this i decided to taper both drugs again. So i took 8,1 mg ambien and 10.5 mg remeron. I think this cut was made a month ago. I got hit by a sudden wave of insomnia that lasted for a week. I updosed to 12 mg and the insomnia went away. However, now i have horrible insomnia again. I slept max 3 hrs a night for the last week. I don't know what i should do. Go back to 15 mg and just focus on tapering ambien? Or should i stay at 12 mg? 

The insomnia is the main reason for my depression. I never had depression before the insomnia battle, but now the depression is getting really bad. I'm at a point that i would not really mind if i got hit by a bus and died. The only reason i want to push through this is because of my sweet and loving boyfriend. He is my only hope at the moment. 

 

Aside for insomnia, i dont really have any other sxs. Except for POTS. However, I had this prior to starting ambien and it is getting a little bit better (if i sleep well tho). It seems like i get a fast heartbeat from mirtazapine tho, and that is the reason i wanted to taper. 

Dec '23 24th: started ambien 5mg 

March '24 18th: started mirtazipine 15 mg 

April '24: updosed ambien to 10 mg 

April '24 30 : tapered ambien to 9.1 mg and mirtazipine to 12 mg 

May 14 '24: tapered ambien to 8.3 mg and mirtazipine to 10.5 mg 

Couple days later: updosed mirtazipine to 12 mg 

May 24' 18: ambien 7.6 mg , mirtazipine 12 mg 

June '24 1: ambien 7.3 mg , mirtazipine 12 mg 

June '24 15: ambien 6.76 mg , mirtazipine 12 mg 

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  • Erimus changed the title to REALNAME?: major insomnia issues
  • Moderator

Hi @Rosatoffolo, and welcome to SA!  We are a community of volunteers providing peer support for the tapering of psychiatric medications, and the associated withdrawal syndromes. 

 

I know Erimus has already sent you a warning, but if you could kindly complete your drug signature, we would greatly appreciate it.  Click the following link, fill in your drug history in the box, and click save.  That's it!  Please include dates and dosages to the best of your ability, along with any supplements you might be taking.  

 

Your Drug Signature

 

It is always wise to only taper one medication at a time.  Tapering both your ambien and mirtazepine at the same time could certainly lead to confusion about which drug is causing you problems.  Here at SA, we recommend tapering the most activating medication first- in your case, that would be the mirtazepine.  The reason for this is that the ambient may help temper some of the withdrawal effects from the mirtazepine, making your journey a little bit easier.  Check out this link for further information: 

 

Taking multiple psych drugs?  Which drug to taper first?

 

It sounds to me like you have been tapering a bit fast in general, however.  We recommend no more that a 10% taper of the current month's dose every four weeks.   So, as an example- 10mg- 9mg- 8.1mg, 7.3mg, and so on.  This is known as a hyperbolic taper, and works quite well for most people to minimize withdrawal symptoms.  Some people (myself included) need to taper at even slower rates.  You can read more about hyperbolic tapering by clicking this link:

 

Why taper by 10% of my dosage?

 

It sounds to me like you may need to hold your tapering for a while to stabilize before proceeding.  You absolutely cannot keep functioning on 3hrs of sleep per night!  That must be terrible. If you hold at your current doses of both medications for a while (weeks to months), until you are stable, and proceed with a slower taper, you may be able to avoid such severe withdrawal effects.  These links can help you understand the importance of stabilizing:

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

How long does it take to stabilize after reinstating or updosing?

 

Many of us here have terrible sleep issues.  I get adequate sleep, but it's quite broken, and filled with vivid dreams and nightmares.  But most people, like you, have terrible insomnia.  We have many threads on SA about coping with sleep issues.  I'll link them here to give you a starting place on how to cope:

 

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

Magnesium, nature's calcium channel blocker

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Melatonin for sleep

 

If you do decide to try any supplements, I would caution you to start slowly, with a very low dose, to see how you react.  It is not uncommon for people to develop hypersensitivities and adverse reactions to supplements that affect the nervous system while in withdrawal.  I am a good example- magnesium is an absolute no-go for me!  The last time I tried it, I woke up a whopping 25-ish times that night.  No thank you lol!

 

In summary, holding for a few weeks or even months might be a good way to go for you.  Then resume a slower taper, as described above.  Try some non-drug methods of coping with your insomnia.  And most of all, be patient!  Recovery takes time.  Sometimes a lot of time.  But you are strong, and you can do this!  We are here to help- please keep posting updates, explore the site, and engage with others here.  It is always helpful to know you are not alone! ❤️‍🩹

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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15 minutes ago, Catwoman73 said:

Hi @Rosatoffolo, and welcome to SA!  We are a community of volunteers providing peer support for the tapering of psychiatric medications, and the associated withdrawal syndromes. 

 

I know Erimus has already sent you a warning, but if you could kindly complete your drug signature, we would greatly appreciate it.  Click the following link, fill in your drug history in the box, and click save.  That's it!  Please include dates and dosages to the best of your ability, along with any supplements you might be taking.  

 

Your Drug Signature

 

It is always wise to only taper one medication at a time.  Tapering both your ambien and mirtazepine at the same time could certainly lead to confusion about which drug is causing you problems.  Here at SA, we recommend tapering the most activating medication first- in your case, that would be the mirtazepine.  The reason for this is that the ambient may help temper some of the withdrawal effects from the mirtazepine, making your journey a little bit easier.  Check out this link for further information: 

 

Taking multiple psych drugs?  Which drug to taper first?

 

It sounds to me like you have been tapering a bit fast in general, however.  We recommend no more that a 10% taper of the current month's dose every four weeks.   So, as an example- 10mg- 9mg- 8.1mg, 7.3mg, and so on.  This is known as a hyperbolic taper, and works quite well for most people to minimize withdrawal symptoms.  Some people (myself included) need to taper at even slower rates.  You can read more about hyperbolic tapering by clicking this link:

 

Why taper by 10% of my dosage?

 

It sounds to me like you may need to hold your tapering for a while to stabilize before proceeding.  You absolutely cannot keep functioning on 3hrs of sleep per night!  That must be terrible. If you hold at your current doses of both medications for a while (weeks to months), until you are stable, and proceed with a slower taper, you may be able to avoid such severe withdrawal effects.  These links can help you understand the importance of stabilizing:

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

How long does it take to stabilize after reinstating or updosing?

 

Many of us here have terrible sleep issues.  I get adequate sleep, but it's quite broken, and filled with vivid dreams and nightmares.  But most people, like you, have terrible insomnia.  We have many threads on SA about coping with sleep issues.  I'll link them here to give you a starting place on how to cope:

 

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

Magnesium, nature's calcium channel blocker

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Melatonin for sleep

 

If you do decide to try any supplements, I would caution you to start slowly, with a very low dose, to see how you react.  It is not uncommon for people to develop hypersensitivities and adverse reactions to supplements that affect the nervous system while in withdrawal.  I am a good example- magnesium is an absolute no-go for me!  The last time I tried it, I woke up a whopping 25-ish times that night.  No thank you lol!

 

In summary, holding for a few weeks or even months might be a good way to go for you.  Then resume a slower taper, as described above.  Try some non-drug methods of coping with your insomnia.  And most of all, be patient!  Recovery takes time.  Sometimes a lot of time.  But you are strong, and you can do this!  We are here to help- please keep posting updates, explore the site, and engage with others here.  It is always helpful to know you are not alone! ❤️‍🩹

Thank you so much Cat for your answer. 

I have decided that i will not taper the mirtazipine further for now. I agree that i tapered way too fast. 

I will still continue tapering the ambien, but just at a slow pace. This seems like the best option for me at the moment. 

The reason my GP prescribed mirtazipine for me is because a lot of people take it for insomnia. However, i can not sleep on it. So now i'm stuck with both ambien and mirtazipine. This makes me really sad sometimes, because i hoped that i could drop the ambien once i was on mirtazipine. 

I have learned however that ambien and mirtazipine can also work against each other. I don't know the english word for it, in Dutch it is called wisselwerking. 

So maybe the mirtazipine will start to work when i taper the ambien further. 

I'm also a little bit hesistant at the moment about supplements. For now, i don't think i will take any. However, i will defenitely look at all the topics you linked. Thank you very much. 

 

As for the warning, i hope that i did it correctly now. 

Dec '23 24th: started ambien 5mg 

March '24 18th: started mirtazipine 15 mg 

April '24: updosed ambien to 10 mg 

April '24 30 : tapered ambien to 9.1 mg and mirtazipine to 12 mg 

May 14 '24: tapered ambien to 8.3 mg and mirtazipine to 10.5 mg 

Couple days later: updosed mirtazipine to 12 mg 

May 24' 18: ambien 7.6 mg , mirtazipine 12 mg 

June '24 1: ambien 7.3 mg , mirtazipine 12 mg 

June '24 15: ambien 6.76 mg , mirtazipine 12 mg 

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  • Moderator

You know what is best for you, and I definitely would prefer to see you tapering one or the other.  Just take it slow.  It can be very helpful to keep a symptom journal, so you are aware of when to expect the windows and waves with each taper.  I typically have an unpleasant week after a drop, then get another wave around 12-14 days afterwards.  Of course, that can vary, based on my stress levels, illness, diet, exercise, and probably a whole lot of things I have yet to identify.  Slow, steady and stable is the way!  Hang in there! :)

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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