trusttheprocess: I have come so far, looking for some guidance on how to proceed!

[trusttheprocess]

Hello!

 

I have been coming on this site for about a year looking for guidance on my situation, and it has been enormously helpful. I am so impressed by the dedication of this community to its members. I have been on many medications as you can see from my signature, and it feels like I have spent more time healing from medications than from healing from PTSD itself. Things are going pretty well now, I am back to working full time, and mostly able to manage the stresses of everyday life. There are a few bothersome things though. One is that mirtazipine has caused me to gain about 40 pounds. I have lost around 18, but every pound is a struggle. I was formerlly a very active person, and so this extra weight is very impactful to my leisure time and lifestyle. Secondly, around 4-5 months ago, I realized how numb I had become, and how little personality I feel like I had. I was going through the motions of life, but not really feeling anything. I decided these meds probably needed to go. I have tried over the past 1.5 years to taper mirtazipine (due to weight gain), but I admit it is very difficult to do while working and having a young family. Even cuts of 0.3mg have increased OCD symptoms, made me feel weepy and depressed, making it hard to function, and just given me this feeling of my brain being scrambled. After reading through the SA topics, it seems like it's best if the Paxil goes first (accelerator). Making cuts to the Paxil has been easier, and my body and brain seem to get back to baseline pretty  quickly. 

 

I am wondering, does anyone have any knowledge about this combination of drugs? Will discontinuing the mirtazipine be easier after stopping the Paxil? At the rate I'm going with the mirtazipine, it feels like I may never get off it, and to be honest from a health standpoint (mirtazipine can cause issues with insulin and blood sugar and I believe it has in me), I am quite desperate. I know slow and steady wins the race. I do work in a school so I have some extended time off around school holidays. I was planning on timing my withdrawls around those times. Any advice or encouragement is weclome. 

 

I currently use Magnesium and Fish oil as recommended by SA. 

[Jane318]

Greetings @trusttheprocess and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications and their associated withdrawal syndromes. 

 

Thank you for completing your signature.

 

I am sorry you are experiencing such as hard time getting off mirtazapine.  Both mirtazapine and paroxetine are antidepressants and thus classified as accelerators.  Mirtazapine is known to be very difficult to get off of.  That said, so is paroxetine.  But since paroxetine seems to be a bit easier for you to taper, it makes sense to taper it first.  

On 11/23/2024 at 5:02 PM, trusttheprocess said:

I am wondering, does anyone have any knowledge about this combination of drugs?

Perhaps current members who do will pipe in here.  You can also search the site using the drug names as keywords.

 

On 11/23/2024 at 5:02 PM, trusttheprocess said:

Will discontinuing the mirtazipine be easier after stopping the Paxil?

The two drugs operate on totally different receptors, so it is unlikely that stopping Paxil will make stopping mirtazapine any easier.  

 

On 11/23/2024 at 5:02 PM, trusttheprocess said:

At the rate I'm going with the mirtazipine, it feels like I may never get off it, and to be honest from a health standpoint (mirtazipine can cause issues with insulin and blood sugar and I believe it has in me), I am quite desperate. I know slow and steady wins the race. I do work in a school so I have some extended time off around school holidays. I was planning on timing my withdrawls around those times. Any advice or encouragement is weclome. 

The encouragement is that you can get off these drugs, and I commend you for wanting to do so.  The advice is to URGE you to do it slowly, especially with the mirtazapine.  This takes time and patience, but is the only way to make sure you keep withdrawal under control so that you can continue to function and be able to take care of your family.  

 

Here at SA, we recommend the hyperbolic taper method, which you can read about here:  Why taper by 10% of my dosage?  Also, the lower you go the slower you need to go.  This is because it is at the low doses that changes in the brain are happening the fastest. Many people use The Brassmonkey Slide Method of Micro-tapering.  We have some great tools to help you calculate doses at:  https://www.survivingantidepressants.org/forums/topic/9167-how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators/.

 

As you taper, and even in protracted withdrawal, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization.  This is actually a good sign of healing!  Read more about windows and waves here:  The Windows and Waves Pattern of Stabilization

 

It’s important to keep tabs on your symptoms and adjust your taper amount and schedule as needed.  This will help you identify your windows and waves and reveal your progress, which is encouragement we need! 

You can use the following list of typical withdrawal symptoms to track the severity of your symptoms over time:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF)

 

You may choose to also track your foods and activities to identify things that trigger symptoms as well.  We do encourage people who are tapering to avoid caffeine, alcohol, and recreational drugs.  Many prescription and OTC drugs can cause problems too and should be avoided as much as possible.   We have many threads on how to cope with symptoms – I encourage you to check out the various forums / links on the SA.org home page.

 

 

There are a few things you can do to support your body's healing process as you taper.  Eat a balanced, whole foods diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep.  Avoid all neurologically active substances, like caffeine, alcohol, nicotine and recreational drugs- these are like pouring gasoline on a fire for your symptoms.  Avoid adding any further psychiatric medications to deal with your withdrawal from psych meds- the effects of these meds on a destabilized nervous system is unpredictable, and taking something else could make you worse.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

So if you decide to try a supplement, even those we recommend here, Add in one at a time and at a low dose in case you do experience problems.  If you tolerate it well, you can increase the dosage slowly over time.  

 

This is your introduction topic.  Each member gets one intro topic- please post updates and questions here, in this thread.

 

I hope this helps.   Keep us posted on what you decide and how we can help.  Best wishes.

[Jane318]

How are you doing @trusttheprocess?  Have you decided on a course of action?  Wishing you the best for the holidays.