Angel9058 Mirtazapine (Remeron) troubles

[Angel7366]

Thank you so much for getting back to me. I am still awake. The anxiety and nausea are also blocking my sleep. I am in terrible distress.

 

Do you not think though that by going back on it will. Be prolonging the agony and I might have to go through all this again even if I taper?

 

How much should I updose to?

 

Thanks again both of you. So grateful

[Angel7366]

I don't have any of the pill cutting equipment yet so have followed Tezza's advice and used to knife to approximate 2.5 but will go to chemist tomorrow. Thanks

[Angel7366]

Can you tell me what happens if reinstatement does not work? I have started but am terrified

[Narcissus]

Can you tell me what happens if reinstatement does not work? I have started but am terrified

 

It really depends on what your reaction is to it, and there's no way to predict that in advance. I'd take the 2 mgs like Tezza suggested, and see how you feel over the next few days, then we can decide where to go from there. Let us know how you do.

[Angel7366]

Thanks phd. I am still feeling nauseous and if I don't sleep to ought shld I increase it as I was on 15mg when I dropped. I ever going to feel well again on a taper?

 

Sorry but this is all new to me

 

Thanks

[dalsaan]

It takes a while for reinstatement to kick in. I'd give it four days at the reinstated rate and see what happens. If no good go up to 5 and see how you respond to that. In the mean time try and reassure yourself that's it's withdrawals, you will find a way forward and you are in good hands. Try meditation or anything else you find relaxing

[Yarule]

Sorry that should read 'I was on 15 mg ...

 

If the withdrawal is too hard on you (some people are more sensitive to withdrawal symptoms), you can reïnstate at half the dose 7,5mg.

You know now how a full withdrawal feels, if you think you can manage a week or a bit more at half this intensity, this is the dose you should be on.

Give yourself after that week some time to recover mentally (from sleep deprivation, extra anxiety, exhaustion, ..) and continue withdrawal.

 

I took many drugs (over 10) and this is by far one of the mildest drugs i've been on, didn't leave any long term symptoms afterwards and felt way better off it then on it. On it I felt sedated and a bit blunted.

Bear in mind that withdrawal from this drug is 60% withdrawal and 40% caused by thinking how bad withrawal is and stress about it. Be easy on your mind, don't stress about it and you will have a way easyer withdrawal.

[Angel7366]

Thanks

[tezza]

 

Sorry that should read 'I was on 15 mg ...

 

If the withdrawal is too hard on you (some people are more sensitive to withdrawal symptoms), you can reïnstate at half the dose 7,5mg.

You know now how a full withdrawal feels, if you think you can manage a week or a bit more at half this intensity, this is the dose you should be on.

Give yourself after that week some time to recover mentally (from sleep deprivation, extra anxiety, exhaustion, ..) and continue withdrawal.

 

I took many drugs (over 10) and this is by far one of the mildest drugs i've been on, didn't leave any long term symptoms afterwards and felt way better off it then on it. On it I felt sedated and a bit blunted.

Bear in mind that withdrawal from this drug is 60% withdrawal and 40% caused by thinking how bad withrawal is and stress about it. Be easy on your mind, don't stress about it and you will have a way easyer withdrawal.

 

 

Yarule,

 

The reason we suggest starting at a very small dose and waiting for four days is 1) it takes about four days for the drug to reach a steady level in your system, 2) sometimes WD causes people to become sensitive to medication they had taken before., 3) it may only take a small amount to alleviate withdrawals.

 

Angel won't know for a few days if or how the small reinstatement is working. If she has become sensitive to the medicine, a higher starting dose could throw her nervous system into chaos. If a small amount will stop the withdrawals, then she will have much less to taper from. These drugs are prescribed in much higher doses than is necessary. It's best to start low, give it at least four days and then if NEEDED, go up A TINY BIT MORE.

 

If someone has become sensitive to their med, it's much less troublesome if they have only reinstated a small amount.

 

Yarule, we are glad you've joined us but why don't you start your own thread in "Introductions and Updates" and tell us more about YOU. I recollect, in a post to Angel, you said you had a very easy time withdrawing from Remeron, unfortunately, that is not true for all of us. It doesn't seem to be the case for our friend, Angel.

 

Thanks!

 

P.S. Yarule, I apologized in your thread, I remembered reading your Intro after I re-read it

Edited April 10, 2013 by tezza
Added P.S.

[Angel7366]

Does anyone know if a slow taper guarantees no withdrawals at the end of it or is it still possible to have nasty withdrawal?

 

Thanks

[tezza]

For a minority, antidepressant withdrawal symptoms may continue after stopping medication, for weeks, months, or years. This can be distressing, debilitating, and even disabling. Those who quit without tapering off ("cold turkey") or taper too quickly are more likely to develop severe and prolonged withdrawal syndrome.

 

Gradually tapering off the medication is the only known way to reduce the risk of prolonged withdrawal syndrome. Don't risk the integrity of your nervous system -- unless you have intolerable side effects, do not risk suddenly stopping any psychiatric medication.

 

Hi Angel,

 

I copied and pasted the two paragraphs above fom the "Welcome" page. This is the only/best answer I can offer.

 

I hope you are feeling better.

[Angel7366]

Thank you Tezza. My doctor was over today and reinstated me on 7.5 mg This is before I saw your comment. I should have noted your comment and told him, but it is a difficult situation.

 

I am not feeling great, a bit floaty, out of it and restless. I hope I haven't messed myself up. And although I did not sleep the whole of last night and am tired, am quite wired and a bit nauseous. Do you think this will settle?

 

I hate this Mirtazapine so much

 

Angel

[dalsaan]

It will settle. Give it a little time. You have to be patient and try and relax a little. I know that's extremely hard but it's important. I'm sure you will find a dose to stabalise on and then you can taper off very slowly, slow enough so your system doesn't really notice - that's the goal

 

Dalsaan

[tezza]

Angel,

 

You haven't messed yourself up, you can still try a smaller dose. It will take some time to stabilize on whatever dose you take, whether it be small or great.

 

We do advise to start low and go up by very small amounts, if need be. You will stabilize, it will take time. Your CNS was 'shocked' when you came off the med so quickly. Your brain is trying to achieve homeostasis and given time, it will.

 

Be very gentle with yourself. You can try a smaller dose tonight. It may not make you sleep well from the start but you will start to sleep better once you find the dose you need and stay consistent with it.

[Angel7366]

Ok thanks for this information. I know I tend to panic. I think I will try and stay on this dose for a while as I don't have any cutting or measuring equipment and it is easier to split my 15mg tablet for now.

 

I have ordered everything I need for titration online but won't need it for a while until I dry cut down to a lower stable dose.

 

Thanks for all your help. I think the thing is that I have already one set of withdrawals (from the benzo) - then I had about 6 good months before I started to take these stupid tablets which the doctor should never have let me go on. So I am just devastated I have yet another withdrawal problem on my hands.

 

Hope everyone coping okay.

 

Angel

[tezza]

Angel,

 

I'm tapering Mirtazipine, myself, and I crush my pill and mix it with water in order to make very small and accurate cuts/dosages. You only need to get an oral syringe from a pharmacy or veterinarian.

 

It's easiest to mix equal mg and mL, so you could mix your 15 mg pill with 15 mL water. I still have some 30 mg pills and have been mixing them since July. It's not hard to do at all, you just need to keep your mixture in the fridge. A 30 mg pill is lasting me about a week, now.

 

I hope you are starting to feel better!

 

Here's a couple of links you may find helpful:

 

http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/

 

Hugs

[Angel7366]

Thanks Tezza, that is very helpful. I have just been checking and discovered in the UK they do a Liquid Mirtazapine. I think that would be easier for me to be honest, as I do a lot of travelling and this would be a more portable way. I have just been calculating measurements etc and done myself a taper schedule.

 

My doctor here in Spain wants to be to reduce from 7.5mg to 3.75 in 10 days and then jump!! He says I won't have any withdrawal problems! Honestly they have no idea! I only need to remind myself of the suicidal thoughts and insomnia, the stomach cramps and the nausea to convince myself I am doing the right thing.

 

I am a bit concerned that you wrote you have tapered off the in the past and you still had terrible withdrawals. How long and how much did you taper and did you have a really terrible withdrawal even after that?

 

Also as you are tapering now, do you have any terrible problems and insomnia so that you can't get on with your life?

 

I am a bit worried about all of that.

 

Thanks again Tezza.

 

Angel

[tezza]

Hi Angel,

 

I haven't tapered off in the past, unless one would consider that I halved my dosage of Risperdal, then left it off at half the original dose, a taper. That was the most horrible WD I've experienced.

 

I reinstated at the dosage I had left off before I found this forum. I might have been able to reinstate at a lower dose and stabilize, then, begin tapering more slowly. I'll never know now.

 

When I found this site, I was on .375mg Risperdal - now on .19mg ; 30mg Remeron - now on 3.6mg ; 200 mg Lamictal - now on 6.25mg ; 3mg Xanax - now on .5mg ; 350mg Soma - now on 262.5mg.

 

I've come a LONG way! Alto is much more knowledgeable than ANY doctor I know of. Even the docs that write the books advise a taper schedule that is too fast for a lot of people.

 

We have to learn what our own nervous system can handle. Since I have done this by listening to my body, I've not had any unmanageable symptoms. I have an occasional sleepless night or an occasional low mood but this usually happens when I'm having stressful situations to deal with. This has been pretty much normal for me all of my life.

 

Any time in my life that things were not 'peace and harmony', I would get somewhat ill. It is typical for Librans, whose sign is the balance scale. In my case, I am a 'true Libran'.

 

I hope this will ease your worries.

[Angel7366]

Ugh poor you! That sounds like a lot of meds to taper from. That Xanax was the cause of my benzo saga. I was only on it for one week ( then did a fast Valium taper) so it's so good you're getting off that.

 

Thanks again for helping me out on this, you are so kind.

 

Angel

[tezza]

Thank you for your kind words, Angel! I'm very glad to help in any way I can.

 

Oh, BTW, I don't get into reading horoscopes and such but I do fit the description of Libra.

[Angel7366]

I am on my 2nd might of 7.5 mg and can't sleep at all. Very restless and hyper.is this normal? You said I could reduce the dose to find one I am comfortable with but I don't know what dose I am comfortable with! How do I find that out?

 

Can I reduce to say 5mg tomorrow so I can becloser to my tapering point of 3.75 mg or is that a bad idea?

 

Will my sleep get normal again?

 

Thanks

[tezza]

Your sleep will get better gradually. Remember, I told you that it will take a while to become stabilized no matter what dose you decide to take. Your nervous system is still in shock, so to speak.

 

Yes, you can try a smaller dose since you've only taken 7.5 for a couple of days. It's going to take some time for your system to settle down. You will stabilize but you really need to decide what dose you want to take and stay on tat dose for a while. Changing dose up and down is destabilizing also.

 

There is no way to predict how long it will take before you stabilize, everyone is different. Some people get scared when they don't stabilize upon reinstatement. It will happen, don't worry.

[Angel7366]

Thanks Tezza. Well in for another night awake I guess

[Angel7366]

I'm not thinking of doing it, honestly but I just wondered if I do cold turkey again what could be the implications?

[tezza]

Some people go into protracted withdrawal syndrome that lasts for months or years. There are some on here that have been suffering for as long as seven years.

[Angel7366]

Is this from mirtazapine? I am so scared Do you know of people who had an easy time after their taper?

[tezza]

I think Compsports withdrew from Mirtazipine, I'm not sure how long ago. She's not seven years out, just can't remember how long ago. She posted in your thread right after I did, on your first page. I think it's in her signature how long since she stopped. She also has a thread of her own.

 

Another mod is also trying to come off mirtazipine and got to a very low dose and had to go back up in dose. This doesn't mean the same will happen to you or me, it just shows us how excruciatingly slow we MUST go when we get to a small dose.

 

It's great that you can get it in liquid form, it's not available in liquid, here in the US. The other mod has hers made into a liquid at a compounding pharmacy.

 

Just decide what dose you are going to stick with and then get as stable as possible, meaning you will be sleeping satisfactory. Then taper very slowly from there on. This gives the best chance for success. Your brain needs time after each cut to adapt to less medicine.

 

I Did a CT switch in June '12 from 30mg of mirtazipine. After a week I realized the switch didn't work. I reinstated at 7.5mg which was 1/4 of my original dose. It took me three or four weeks to level back out so I could start tapering again. I've been mixing my own since then. At first I was able to taper .2mg every two weeks but below 4mg, I've had to slow down and now I have been holding at 3.8mg for over four weeks.

 

It's worth going slow because I want to do whatever it takes to get off successfully with the least problems. I'm also tapering Risperdal at a snail's pace.

 

You won't be able to compare your WD journey to anyone else's because everyone is different. Your CNS may handle changes totally different from any other person. Stabilize and then go slowly by listening to your own body.

 

We can do this!

[tezza]

I just noticed your second question. Yes, Yarule had an easy time, remember, he was telling you to tough it out. I don't think he has added his signature yet (signature's are very important in helping any wishing to offer advice, otherwise we have to go back and read the whole thread, sometimes). Then, there are people who do fine off a medicine for several months and are hit by awful WDs down the road,.Many times when this happens, reinstatement doesn't work because they have become sensitized to the medicine. Then they have no choice but to tough it out and they are usually the ones that suffer protracted withdrawal syndrome for years.

 

My daughter stopped taking four psychotropics a little over a year ago and had no issues at all. This proves we are all different. Before I CTd the Risperdal in Sept. '11, I had no trouble leaving meds off either. I had CTd Celexa a few times with no problems. The CT from Risperdal has made me sensitive to even small dose changes.

[Angel7366]

Thanks again Tezza.

 

I am so scared by some of the stories I read. I know I need to change my attitude. I just worry about feeling ill every day for the length of my taper and I would love to hear that some people have recovered and are fine after their taper.

 

And Tezza what do you mean reinstatement didn't work for some people, what happens when it doesn't work?

 

Angel

[tezza]

Angel,

 

That tends to happen to people who've left their medicine off for an extended period of time. For instance, someone who doesn't experience withdrawal until a few weeks or months after discontinuing. You don't need to worry about this, you were not off your med very long. You are going to be fine.

 

It may take some time but you WILL stabilize! I understand your fears, I've been there. I was in harsh WD from mid Sept. '11 until Mar. '12 before I really felt much better overall. I did start sleeping better much sooner than that, though. Still, you can't determine a definite time it will take you to stabilize in comparison to ANYONE else.

 

You will likely stabilize much faster than I did. Most people don't take as long as I did. I only told you how long it took me so you don't lose hope if it takes longer than you would expect. I know it will take longer than you'd hope for, that is the case for all of us. We want it YESTERDAY!

 

Try to do anything that will take your mind off the situation. Play solitaire or something of that nature. You will be gently exercising your brain. I know how difficult this is but remember, you WILL stabilize and things WILL get better.

 

I'm sorry you are in so much distress. You are going to pull out of this. You weren't off the med too long and that plays a huge role in stabilization. Many people who left meds off for extended periods have recovered.

 

You asked what would happen if you decided to CT again and I've told you worst case scenarios. You don't fit into those categories! You are going to be fine.

[tezza]

I have an appointment and will gone for a while. I will come back and check on you. Try real hard not to worry. You are going to be fine!

 

Hugs

[Angel7366]

Thanks so much Tezza. I have decided I am going to try to stablise on a lower dose and leave it for quite a long while and feeling well enough to start the taper. I have so much happening in the next few weeks and months and I want to be well for it. I think it will all be too much for me otherwise.

 

I assume you mean by stablising you achieve homiostasis and feel okay again? Can you please confirm this and I will be happier. These first few days of trying to stabilise are very difficult for me.

 

Am going to print off what you just wrote for reassurance.

 

Luv ya!

 

Angel

[Altostrata]

The risk of quitting 7.5mg now is that you haven't given reinstatement a chance, and you will have to deal with withdrawal syndrome for however long it takes.

 

7.5mg might be too much for you. To review:

 

....

Even 1mg-2mg mirtazapine might ease your withdrawal symptoms, see http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/

 

Yes, Angel, we recommend going back on a small dose of the drug rather than trying to wait out withdrawal symptoms -- as we've noted above.

 

See http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/ for suggestions on how to measure out small doses.

 

Thank you Tezza. My doctor was over today and reinstated me on 7.5 mg This is before I saw your comment. I should have noted your comment and told him, but it is a difficult situation.

 

....

 

Angel,

 

You haven't messed yourself up, you can still try a smaller dose. It will take some time to stabilize on whatever dose you take, whether it be small or great.

 

We do advise to start low and go up by very small amounts, if need be. You will stabilize, it will take time. Your CNS was 'shocked' when you came off the med so quickly. Your brain is trying to achieve homeostasis and given time, it will.

 

Be very gentle with yourself. You can try a smaller dose tonight. It may not make you sleep well from the start but you will start to sleep better once you find the dose you need and stay consistent with it.

 

[Angel7366]

Hi Alto I am in a difficult position because I cannot do this on my own - I need my doctor to know what is happening but cannot tell him what to do. He was the one who told me to go on the 7.5, perhaps he made a mistake but I cannot tell him what to do. I decided not to proceed with a dose change and have spoken to my doctor who wants me to stay on this and we will review in a couple of weeks.

 

To be honest, I really want the reinstatement to work and for me to feel settled again - I have messed around with the meds too much. And then taper sometime in the future when I am well again.

 

Angel

[Angel7366]

Please don't tell me he made a mistake, it's too late now and I will feel very bad!

[Altostrata]

Angel, if you must do what your doctor wants, there's no point in asking us here what you should do.

 

Doctors know very little about dealing with withdrawal syndrome, it's possible 7.5mg is too much for you.

 

Very sorry to make you feel bad. Unfortunately, that is what every single person visiting this site is dealing with. If doctors knew what they were doing, no one would have to be on the Internet asking advice from strangers.