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Claire4: Mirtazapine taper


Claire4

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Hi

 

Thank you in advance for your advice, I know you are volunteers so I appreciate your time!

 

First off, I seemed to have made every mistake going and now I’m very scared I’ve caused myself some real damage.

 

I was poorly advised by my gp how to get off of Mirtazapine which caused my first two terrible attempts at getting off. The second attempt I was trying to push through the withdrawals, they were getting worse and worse and I scared myself how low I became and in panic I reinstated at my original dose. I’ve then attempted to taper slower by dry cutting pills. I’ve realised now this is still far too fast. I naively thought with this being my first antidepressant I would get away with going fast, how wrong I was. I felt fine tapering until I got down on the smaller doses. So as you can see from my list of doses I updosed to 0.8mg 11 nights ago, I thought I had stabilised and planned to stay here for a while before very slowly tapering the rest. The last 24 hours withdrawal has hit as hard as it’s ever been. I don’t know what to do now, I’m scared of up dosing in case of kindling but equally I’m scared to stay where I am and spiral like before, I feel weaker and more scared this time around. 
 

I’m a Mum of two beautiful boys and I have a great husband, they are my motivation to get well again. 


So I guess my aim is to stabilise as soon as I can and stay there for a long time to give my body a break. The question is what should I updose too if at all. I think I’d like to up dose. What’s your opinion on this plan? From your experience am I at big risk of kindling? 
 

thank you 

 

oops forgot to add on the medication list that I take magnesium and fish oil

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

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  • KenA changed the title to Claire4: Mirtazapine taper

Hi

 

Thank you for approving my post.

 

I have decided to updose tomorrow, I can’t take this anymore. Am I wise to go back another step? So I’m on 0.8mg and tomorrow start 1.8mg? When I up dosed to 0.8mg this gave me immediate relief for 10 days. If I had kindled would this have happened? I’m absolutely petrified. I’m praying I can stabilise. If I can stabilise I’m committed to staying there for however long it takes before I even think about tapering again. 


I think my rapid taper has caught up with me and I’m fearful if it will keep getting worse. 
 

Sorry to keep writing so regularly, I know your all busy.

 

Another night with zero sleep, would it be a bad idea to try some melatonin? I’m struggling to eat, sleep when I try and lay still my whole body feels buzzing if that makes sense. I can’t stop overthinking what direction to take. 
It’s like torture.

 

I’d be so grateful if anyone has any advise? Thank you 

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

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Please can somebody help me. I’m feeling suicidal 

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

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I don’t know who I’m writing this too, maybe I’ve set this up incorrectly as nobody has commented. Maybe you’re just understandably very busy. 
 

So I felt I had to do something. Last night I took 1.8mg Mirtazapine instead of 0.8mg. I slept great and have woken up feeling an upturn in my mood, phew! 
My plan is to stay on this for 3-6 months and allow my body to rest from all the changes. Would you recommend that approach?
 

With my little knowledge I have a lingering worry that I could still have kindled by changing the dose yet again. When would I know if I had? Would I have an immediate bad reaction to the updose or could it be delayed? Any reassurance would go a long way. 
 

I’m praying I level out on this current dose and concentrate on eating healthy food doing some exercise being kind to my body.

 

All being well I can get some help further down the road with tapering. 
 

 

 

 

 

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

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  • Moderator Emeritus

Hi @Claire4

so great that you are feeling much better! Given that you had lowered your doses quite fasr, it made sense to updose. I am glad it is working. 

 

I would not worry at all about kindling. We don't see that with small updoses and especially if you still had a substantial amount of the drug in your body. Lots of people do updoses and they are fine - I reinstated myself after a month off and it was a great relief at the time. 

 

If you do need to updose more if things get worse, do not worry about it but go slow. 

Withdrawal can be harsh so do not worry if severe symptoms come again, they may go away on their own after a few days. If that doesn't happen you can think of updosing. 

 

Wishing you good luck and hope you get better quickly!

OMW

 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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@Onmyway

Thank you for replying, the reassurance that I won’t have kindled means a lot. I had a harder night last night before I’d read your message and spent the night wondering if I’d done the right thing. 
I’m feeling far from normal but I’m not as bad as a was. 
How long would you give it in between if I needed to up dose again and at what dose? 
 

I see you have been slowly tapering the last couple of year, how have you been feeling whilst doing this? If you don’t mind me asking.

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

Link to comment
  • Moderator Emeritus

Hi @Claire4

I would give it a good 2 -4 weeks before deciding to updose again. Let's check in in two weeks to see how things go.

The ups and downs are to be expected in this process. One of the biggest skills you learn in withdrawal is that it is OK to have ups and downs and not be too worried about it. Oh, our old friend insomnia is back. Oh, look, I am having cortisol mornings. Oh, I am too angry at my child/husband/wife/mother/co-worker, this looks like withdrawal. 

 

The one thing that makes withdrawal worse is getting anxious about the withdrawal symptoms, that puts the brain on hyper alert and creates a vicious cycle of more and more anxiety. 

 

My journey is a bit convoluted. I have practically stopped tapering for a good year now. But in my case things have been really slow because I have had an extreme amount of external stressors during that time, including other health issues. I am now dealing with erosive gastritis for the last 5+ months - caused by all the external stress. My timeline is not the usual timelines, so please don't be discouraged by that. I am doing things as slow as necessary so as not to topple a very precarious "cart". Self care, when you can manage, is extremely important. 

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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I really do appreciate your advice, thank you. 
 

I’m very to sorry to hear about your stresses over the past year. I really hope it settles for you soon. 

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

Link to comment

Hello, Claire!  @Claire4 I'm sure, with time, you'll be fine.

 

The symptoms will gradually become more and more tolerable, until you fully recover to normality.

 

Specifically regarding medication reinstatement, Onmyway's @Onmyway recommendation is wise: controlled, strategic and measured restitution is usually more convenient. Kindling episodes follow a pattern: typically, after rapid discontinuations, followed by an abrupt, significantly higher reinstatement. The plan you are currently following, of controlled increase and recording your evolution after a few weeks, seems perfectly reasonable. 

“never saved anything for the swim back ” ❤️  –  Vicent Freeman
Between 2020 and 2023, I underwent numerous drugs commercially labeled as antidepressants. All the symptoms I had prior to treatment were aggressively perpetuated by the prescribed drugs, a myriad of completely new symptoms not existing before treatment appeared.
September 2023: Indication of a dose of 50mg of sertraline / February 11 2024: Transition from 50mg to 43.75mg / February 20 2024: Transition from 43.75mg to 37.5mg. / March 15 2024: Transition from 37.5mg to 31.25mg.
April 4 2024: Discovery of Survivingantidepressants  End of madness / April 4 2024: Discovery of liquid preparation and regulation of 5% in each reduction.
April 5 2024: Transition from 31.25mg to 28.125mg. / May 1 2024: Transition from 28.125mg to 29mg. /June 10 2024: Intensification of discontinuation syndrome (after surgery).
July 1, 2024, transition from 29 milligrams to 32 milligrams.

September 25, 2024, transition from 33 mg to 33.75 mg

 

 

 

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@Franco12Thank you for your message.

 

I’ve made those very mistakes not so long ago so I’m petrified of messing it all up yet again and hoping my body isn’t already over sensitive from what I’ve put it through this last year. Yours and Onmyway’s reassurance goes along way. 
 

Hope you are staying well

Sertraline 50mg 14 days (bad reaction),
Mirtazapine 15mg for 6 weeks,(ct 4 weeks off),
 7.5mg for 3 weeks,
Mirt 3.75mg for 1 week,Stop for 14 weeks (server withdrawal),

Mirt 15mg for 5 weeks,11.5mg 7 days no Wd,
7.5mg 14 days no Wd (felt better with each drop),5mg 7days no Wd,3.1mg 8 days no Wd,
1.8mg 10 days no Wd,0.8mg 14 days no Wd,0.4mg 9 days no Wd,
0.2mg 10 days withdrawal start day 8,19th Sept updosed to 0.8mg because of insomnia.
Felt better on 0.8mg until day 11, zero sleep and all the withdrawals suddenly come again.

i take magnesium and fish oil

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