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  1. Kornyboyo1917

    Kornyboyo1917: Remeron 15mg

    Hello, I was put on remeron 1.5 months ago after being hospitalized for severe benzo withdrawal. I have been off benzos for 9 months after a rapid taper. My symptoms are horrific and 24/7. - Racing thoughts/ruminations - Ear-worms (things I watch/read and conversations repeat over and over all day long) - Racing negative thoughts - Intrusive thoughts/memories - Loud inner critic/voice - Sensorimotor Hyperawareness OCD (thinking/thoughts and occasionally other themes) The remeron seemed to help with the pacing akatheisa and terror but did nothing else for my mental symptoms. I started at 7.5 for a week or so and then went up to 15mg. At 15 I got his with depression. Went up to 22.5 for a few days but couldn't handle the anxiety and fear it triggered so went down to 15mg. I don't want to be on remeron anymore because It's interfering with my benzo recovery but my mind is tormenting me on how to come off of it. I don't know much about tapering and what would be the best thing for me since I'm already in benzo withdrawal. I think its making the OCD worse (compulsive researching, chain smoking). The problem is i'm not going to know if I am having new symptoms from discontinuing the remeron or if it was masking some of the benzo withdrawal and it's coming back. Unless i develop new symptoms like DP/DR (which i don't have). I am looking for advice on a taper. I know my situation is different but any help would be appreciated. Thanks
  2. Hi everyone Great to have found this website...I have been on SSRI's and more recently SNRI (mirtazapine) for past 17 years and the mirtazapine for past 5 - I have been depression free for past 5 years (previously had between 10 to 12 major breakdowns since age of 21 including whilst on the drugs..I am 38 now)...phew it's been tough but I have made it this far! I decided that, if I could go 5 years without a major depressive episode, that I would try and come off my meds as a I feel I have developed the coping skills and resilience skills to manage my mental health drug free...I reached 5 years and started in August 2019 - I managed to cut down from 30mg to 22.5 and then 22.5 to 15mg over the course of 5 months...I had a period of about one week of WD during both reductions and it was very unpleasant but I just toughed it out and it passed and I felt better again - so I made it to 15mg which I thought to be quite an achievement! With this in mind and also wanting to get off this drug as fast as possible (within reason) I decided to cut the 15mg pills and start on approx 11mg around 9 days ago (with my doctor approval who is, by the way, absolutely clueless)....I have been suffering WD since day 1 including anxiety, foggy head, insomnia, slight ringing ears and generally just feeling low and not myself - I thought that this will pass if I just tough it out again but now, 9 days in and after reading a lot of stuff online I'm not so sure...it seems that with mirtazapine (and possibly other drugs) it gets harder as the doses get lower...which is hard to believe when you see the size of the 11mg in your hand. I have now found this website and it's incredibly helpful and I'm so glad to be here and able to talk to others about this! My first and REALLY important first question to ask for advice is should I go straight back up to the 15mg where I felt ok and stabilise there before thinking about my next approach which could well be the 10% reduction advocated on here? I just want to feel better again so I can cope with stresses in my life...I would appreciate some responses ASAP as I may do this tonight! Could I possibly use a quality weighing scale and go to 13mg or will this just further confuse my nervous system more? I'm sure I'll have lots more questions in time but this will do for now Lovely to meet you all Big love and strength from Malbec37
  3. Hello everbody. I have been on BB remeron support group, but they tend to speak mostly benzo concerns. Now i need your help. My story is like that: i have been using prozac until last year with on and offs and i was supposing i had bruxism. In fact, it was ct but i didnt know. Last year in november a pdoc gave me abilify 2.5 mg. I took it for two months and didnt work and quit it. After that i had a bad anx., i tried many ads, but they didnt work. Lastly, i found myself in hospital in May. They gave me brintellix 10 mg, lamictal 100mg, remeron 30 mg. They brought me to the point i couldnt work so i stopped in hospital after 20 days. Then,my world turned into the hell. I lived dp dr,severe head pressure etc. Then, i started to remeron 15 for sleep issues within one month. My intention was starting to 100 day taper, but my buddies on BB said that, you were going too fast, first you should be stable. Then, after reaching to 12 mg, i listened them and now i have been holding it. I decided to go forward with that plan no matter how long it lasts. But, last week i started to take new sxs like nausea, diarrhera, gi issues, heart palps(1 months) which i never took them even in acute phase of my CTs. I think i lost the support from BB and came here to take some support. My anx. is bad and hardly i could go to the work. Every day, i consider to CT because of getting no stabilization. These drugs are terrible. Thank you for responses from now...
  4. Kornyboyo1917

    Kornyboyo1917: Remeron 15mg

    Hi. Is there a way to taper remeron using a daily liquid microtaper. Not necessariy making a big 300ml solution but taking 0.01ml a day or something like that? I have looked around and can't find anything.
  5. Hi All, I am new to the group--my name is Jennifer. I have had quite the journey post-partum with my 16 month old son. I was originally put on Zoloft 50mg about 3 weeks after my son was born and stayed on it until mid-March (so about 9 months). I was feeling great that I wanted to come off of the medication. I tapered off of it over a month...it was a difficult taper which makes me wonder if I should have stayed on it longer. But then 5 months after that I went on an intensive yoga retreat and came back with crying jags, anxiety, and insomnia. I went on some herbs for a while to help with adrenal function prescribed by a chiropractor and felt a little better energy wise but was not getting anywhere with the insomnia or crying jags. I discontinued the herbs. Then on the very next day, I went on a nasty ride with psychotropics again with my regular doctor. I wanted relief so I went back on Zoloft but it was so agitating, they needed to give me Lexapro (it's supposedly a little less activating) and Trazadone to sleep. Trazadone worked for one night but I still was so agitated. Then, they ordered me Xanax. After taking one, I felt I wanted to jump out of my skin. I called a psychiatrist and was put on Remeron and Klonopin right away and told to stop everything else. The Remeron helps me sleep but I still feel so overwhelmed at times since coming back from that intensive yoga retreat. The Klonopin helps at times too but I do not want to take it everyday. I am in therapy which is EMDR-based. It has helped but I find it focuses on the negative aspects too much. So we have done some CBT to keep me in the moment. What I am looking for is advice from anyone out there that has had a similar experience with antidepressants and what you did to help yourself. I will be taking saliva tests for cortisol and female hormones tomorrow. Thank God I can send them out on Monday. Other things : 1) I would like to know if anyone knows of a good doctor who understands conventional and holistic care that can help me to slowly get off the Klonopin. I only take 0.25mg twice a day but I am so sensitive to any movement in drugs right now. 2) I would like a doctor's viewpoint/knowledge person on this forum on how Remeron works with the adrenal glands. Could the Remeron be making things worse, better (because I am getting sleep), or is there no difference to the adrenal glands while taking it. 3) If the saliva tests come back with issues with both cortisol levels and female hormonal imbalances, how do I use herbs such Ashwagandha (adrenals) and/or Shatavri (balance female hormones) with Remeron? Or are there other suggestions out there? My biggest concern is adding these new herbs, if needed, while taking Remeron and Klonopin. I know I need my sleep but I also want to be as proactive as possible in finding the best solutions out there. And I have a feeling that there are some veteran people on the forum that could really help me. Thanks, Jennifer
  6. Hi All: I have been taking 3.75 mg. of generic remeron daily for the past 4.5 years. About a month ago, I thought I should taper off by reducing to 1/8 of the 15 mg. pill that I had been cutting into quarters for the 3.75 mg. dosing. Around day 26 of the taper, I started getting GERD, heartburn, insomnia, dizziness, all the usual suspects. I upped my dose back to 3.75 about 3 nites ago. I thought I was on my way to feeling stable again, but last nite came no sleep, with sweating, racing thoughts, and diarrhea. This a.m., I feel so terrible. My question is: how long to expect the withdrawal symptoms of the taper on the way back up to my pre-taper dose. I felt fine while taking this amt and was prescribed it for insomnia and post menopause symptoms. Now I realize I may be a life member of the remeron suckers club. Hope to hear from those who have had similar experiences.
  7. Moderator note: link to benzo thread - xyz: valium questions Hi, i am new on here. (english is not my first language so pardon the gramma) i was on various benzo for 9 months and stopped taking them once i read about depency. 10 months later i had a health scare and went onto a panic attack and had severe insomnia (5 days of 0 sleep), and akathisia- i was put on remeron for 10 weeks but it gave me tinnitus so i went into a really bad panic attack and was suicidal. at the hospital, they reinstated me on a low dose of valium (4mg) and put me on lexapro 10mg. my panic attack was so bad and my insomnia so severe that i had to take xanax 0.25mg to calm down with lunesta at night for sleep for 3 months. over several months, i was able able to ditch the xanax and lunesta and reduce my valium down to 2mg and i am still on 10mg of lexapro. i still have severe anxiety and insomnia. i have been holding my dose for 3 months now. i was reading on benzobuddies a thread on long long and that gave me hope that if i hold i can give my CNS time to stabilize. i have good days now but on bad days, i wonder how i can even lower my meds and i keep thinking that i have paradoxical effect on them. a term i kept reading on benzobuddies. will it get better if i hold longer? i also have 2 kids (6 and 2 years old) and i am going through early perimenopause- my panic attack, and insomnia get worse around my periods.
  8. I have been taking Trazadone since January 2014. I started with .75 Traz and have been slowly tapering the past six months. I am now down to .38 Traz after making a cut 2 nights ago from .45 Traz.. I take it at night to sleep along with 7.5 Remeron. I have been doing well with sleeping on the .45 which I have been holding the past 2 months. Last night my sleep was very light and fitful after the cut. I doubt I got that much sleep. Also, this October I will be on year off Ambien 10 mg. I am looking for some encouragement from folks who have been down this road before with Trazadone. Any success stories out there? How did you feel along the way with tapering? How was your sleep? How did you feel one week off Traz, three weeks off, a month off?
  9. Hi all. I have been on a combo of Risperdal and Zoloft since 2012. I reached 3mg risperdal and 200mg zoloft in early 2016, tried to taper off both starting in June of that year, and had a bout of insomnia in November, at which time I reinstated along with an additional 15mg remeron. Adding the remeron, I've learned, was a huge mistake and most likely unnecessary. Since then I've slept at most 6 hours instead of my usual 8. For the first 2 months on remeron I avoided caffeine and tobacco. Then, after picking up both again, my sleep suffered, and I eventually had nights with 2-3 hours. I've since learned that caffeine and tobacco induce the enzyme CYP1A2, which metabolizes remeron, explaining this. By abstaining from both, my sleep has returned. I have also tried shaving a sliver off my 15mg pill with no luck...getting a full night without sleep. I would like to be able to drink coffee and smoke again. That leaves me with 2 options, get off the remeron (seemingly impossible) or tolerate the lack of sleep. If I do the latter, will my sleep eventually not recover even when abstinent due to repeated withdrawals? I had been planning to use coffee and cigs only sporadically, letting my sleep return before using them again, or using only on the weekends. If I that is not sustainable, then how do you recommend I get off the remeron, given my sensitivity to even a small dose decrease? My doc has suggested trazodone as a replacement, but that med interacts with my other meds and a post about it here scared me away. Thank you so much for your help.
  10. Community of healing, hello. my name is dave. in february of 2012, things started going terribly wrong. i have always been a person with some anxiety and depression. in fact my parents began medicating me for this when i was in the first grade, when the nuns at the parochial school i attended informed them i wasn't "living up to expectations." at this time (early 80s), the medications were as heavy as they are today - in fact, many of the drugs that were put into my childhood body are currently considered barbaric in standard medical practice. nice. anyway, in my teen years and early 20s, i tried many different medications. prozac, paxil, zoloft, blah blah blah. i wanted to put out the fire - i wanted to mellow out and not feel the anxiety. i wanted to not feel the sadness. i was taught that those things were not ok to feel - that these human emotions were to be avoided at all costs. the line-up that my doctors settled upon were remeron and ativan. the remeron was 7.5mg daily, the ativan .5mg as needed. for over a decade, i kept the remeron between 3.75 and 7.5 - the ativan, between .25 and .5. i've always been a "little dab will do you" individual. when i still consumed alcoholic beverages, i was a totally cheap date. 1 drink felt good, 2 drinks was a nap on the couch. my system has always been highly sensitive, as so many of ours are. in late 2011, the ativan wasn't working anymore. the doctors threw in some xanax and bumped the ativan dose. it helped a little. in early 2012, i noticed some profound dizziness - like i was walking on a swaying ship. i had actually been noticing this for a year or more, doctors could find no pathology to explain it. but it was getting worse. i suspected it was the remeron. my doctor said, "well, stop taking it." so, i ditched the 7.5mg of remeron cold turkey YAHOOOOO! and my system went nuts. i could not eat, i could not sleep. i began losing weight - lots. in hindsight, i realize i was in full benzodiazepine tolerance withdrawal and remeron withdrawal. my doctors said it was "just the anxiety getting worse." they were just about ready to throw some klonopin into the mix when i bailed. i started a rapid taper that essentially amounted to a cold turkey from the ativan and began to suffer intensely. between the months of april 2012 and june 2012, i went from being a solidly built 162lb marathon runner to a 129lb human who could not lift his head off the pillow, barely acknowledged his wife and children, was confused as to who the president was and what month it was, and finally, began having intense violent intrusive thoughts - both suicidal and outwardly motivated. i checked myself into a hospital. i was so scared. i figured that was the thing i needed to do. get fixed. as soon as i got in, they tried to get me to reinstate the benzodiazepines. i refused. in my lucid moments, i had read too much online to do it. they put me on seroquil, which produced serious side effects. they switched me to risperidone and left me with that. i wanted out of the hospital. they became fairly insistent that if i were to do so, i would need to be on another medication. i mentioned reinstating the remeron. they liked that idea. they put me back on 7.5mg. a day later, they bumped me up to 15mg, a day later, they bumped me up to 30mg. my whole body was vibrating. i was having nocturnal emissions nightly in the hospital bed. the intrusive thoughts and all the other withdrawal symptoms skipped along merrily, unaffected by the drugs, but the hospital thought i was "good to go." so off i went. oh, and they handed me a script for valium on the way out "just in case." in the hospital, i mentioned both benzo and antidepressant withdrawal. even offering to show them the ins and outs of the ashton manual, which in the benzo world, is fairly revered. the doctors took a position that what i had to say was of little consequence. they were the doctors after all, they should know best. and any words on my part were greeted as a questioning of their authority. the next 8 to 12 months were essentially hell. i kicked the risperidone to the curb almost immediately. if anything, that anti-psychotic was making things worse. the 30mg of remeron was so damn activating, i wanted to jump out of my skin and climb up trees daily. but i felt stuck on it. when i began experiencing intermittent periods of gradually extending "windows" and "waves," i began to taper the remeron slowly. things were very bad for a very long time. very bad. did i mention that things were VERY VERY BAD? i managed to keep my job. it wasn't easy. when i was at my very worst, i would work from my bed at home. getting up to puke, sitting in a stupor, trying to answer e-mails and phone calls as if my brain were not a bashed-up mess. trying to put together sentences. when i was able to return to work, the intrusive thoughts were so bad, i either stayed glued to my desk, or else went back behind my office building and fought off the daily urge to throw myself into the waters. i wanted to die so bad. those waters were almost calling me into them. i fought back. and i am glad, beyond, that i fought. by the 8 to 9 month mark, things started improving somewhat quickly, the tapering of the remeron was becoming somewhat easier, the benzo symptoms were easing. the windows got longer and longer until the waves became basically a couple hours during a day or two per month. i need to cut this short. i could literally write a book about this whole experience, but i don't want to waste your time and i myself have to boogie. let me just say this. i am still tapering - i am now at 2mg of liquid remeron. i have a pharmacy compound for me. i make 10% cuts, hold for 4 to 6 weeks in between, and go in for another round. when i cut, i feel it the day after i make it - an intensification of the symptoms. things settle for a short while. around the 2 week mark after a cut, it kicks me harder. usually restless legs, nausea, intestinal disturbance, mild insomnia, intensification of anxiety and the desire to cry for no reason at all. the intrusive thoughts are totally gone. i don't experience these anymore. and i am thankful. they were my worst symptom. they plagued me and plagued me and plagued me and they are gone. i try to eat as clean as possible. higher protein, lower carbs, almost no refined sugars. i short-circuit the cortisol response by waking at 0345hrs each morning. i am at the gym very early, i put in a workout, i go to work. i could not exercise at all for the first year after withdrawal. it would activate my central nervous system to much. but now i lift weights and lift heavy and i do only enough cardio to keep that system as optimal as i feel it needs to be. i supplement with whey protein, vitamin d, b vitamin/folic acid, magnesium, and some occasional omegas in the form of either fish oil or hemp protein. i do not drink alcohol. i do not use pot. i consider these substances a colossal waste of time. i do not use any other chemicals that will interfere with my brain chemistry. i'm not sure how much of a hassle these last 2mg will be. i think i will probably be all done with the remeron by the end of 2015, if things keep ticking along. that is my goal at least. after benzo withdrawal, and the remeron withdrawal that followed, i know i can weather whatever storm. i'll own the pain. i'm not a tough guy at all. but withdrawal has showed me two things: that i can live through hell on earth and that the anxiety and depression that underlies my personal psychology is "normal," and manageable without the use of chemical substances. thanks for taking the time to read this. and no matter where you are on your own journey, hang in there. when i was 129lbs and barely able to move, barely cognizant of who i was, i doubted that i would ever heal. i am almost there, community. you will be too. hang in there...
  11. I want to know how to get off of this medication because I Dont like how it's making me feel it makes me feel so numb so I want out but I don't know how to. I've had this medication for 1/2 a month and I took it off and on during this time and now I'm worried that I might've ruin my nervous system from taking it at different times of the night .I don't know what to do My dad said just stop taking it but I know that's not safe at all I had went through withdrawal symptoms like around 3 days when I didn't take them which shows me to take it slow I guess I didn't take them again today but yesterday i did I only have 17 pills left I don't know what to do I'm really lost at this moment any advice would be nice thanks
  12. Hi everyone, I am writing to seek support during what has become a frightening experience for me. I have a history of severe depression and as I started to come out of the last one in the middle of 2018, I accepted the proposition put by al psychiatrist that I needed to be on high doses of psychiatric drugs. The two most significant were Lexapro at 45mgs and Mirtazapine at 90mgs daily. He also had me on Epilim and Propanolol to counter the impact of the benzodiazepines I was withdrawing from. The Lexapro was causing me to be uncomfortable with wind and I came off it over a couple of weeks at the end of last year without any difficulty. The Epilim and Propanolol were also removed. The massive dose of Mirtazapine remained, however. Even though it is prescribed off label for sleep, I was finding getting to sleep increasingly difficult. This is what led me to make a mistake seven weeks ago. Without consulting anyone I reduced the drug to 45mgs for three nights. This led to the onset of a nasty nauseous sensation in my body. I rang the psychiatrist and he told me that if I reinstated the dose the symptoms would go away. They didn't. So we reduced the dosage to 67.5mgs to see if that would enable me to stabilise on the drug. The symptoms continued. So we agreed to get off the drugs. Over the course of a week the drug was reduced to zero. Now after three nights the symptoms are worse and I am getting little sleep. This morning I was aching so much that I got up and tried to watch the cricket. My mistake was that I assumed as anti- depressants are not addictive and that because I had come off the Lexapro so easily that a reduction in my Mirtazapine dosage would cause me no problems. Moreover, I did come off 30mgs on another occasion with no problems. As as it looks as if reinstatement is not an option given the nature of my symptoms, I simply don't know where to turn. I fear that I am looking at an extended period of massive discomfort which could lead to a return of the depression.
  13. Hello: I survived c/t Xanax w/d 9 yeas ago ( with short term use of few other meds I quickly tapered from during the first 7 months off low dose Xanax use). Recently went into severe anxiety then depression and insomnia for few months. Put on low dose lamictal for 9 days along with mirtazapine, now 17 days, in hospital. Want off this drug too tho concerned about returning to depression and insomnia. Not taken lamictal for 7 days now. Never tolerated psych meds well and never had to take one for depression til now. Also have chronic health condition and no Sprng chicken! Thought I'd cut a bit of the MIT. Tonight, maybe a quarter. Any suggestions? Thanks EO
  14. Lookinup

    Lookinup's intro: please help

    I am feeling withdrawals. I made the change about a week ago when I was only able to get my Remeron filled at 5% reduction. It’s all I had because Dr. was adamant about tapering that drug before Valium. Pleaded with him to give me the regular dose of Remeron and the liquid for tapering Valium because I have lots of support and want to get on with it and he finally acquiesced. He also gave me liquid suspension for Remeron for flexibility and even said may want to taper both at same time—NO. My question is should I stabilize at 3.5 or go back to 3.75, my original reinstated dose of Remeron before Valium taper? I cannot believe all of that had to happen! That Remeron is a nightmare of a drug for me to come off.
  15. UPDATE for 6/2020: Wow, I read over some of my old posts and am remembering being so cloudy-headed and panicked back in 2013 due to all of the crazy things going on with the Rx. I truly feel bad for myself and others who have been caught in this broken system of Psych Rx. I don’t see that doctor any longer, who was abruptly taking me off Rx and putting me on the next Rx. And I think it was about 12 different meds in a 3 month period. Looking back, I should have reported him for malpractice or ignorance. I did end up in the hospital in 2013. It was awful and no one there seemed to think that what happened to me back then was a problem. They just labeled me with GAD, gave me a new drug to take as if that was going to fix everything (Cymbalta and Seroquel low dose-sleep), and called it a day. Not on either any longer. Did a stint with Ativan but that ship along with Seroquel has sailed a long time ago. So currently after 3.5 years of being off other ADs or any benzos, are the withdrawals effects from them basically over? Am I just dealing with coming off of 22.5mg of Remeron now in current times in 2020 (when I’m ready to start)? I hope so and hope the merry go round will finally stop when I slowly come off of the Remeron. I can look up info now on the forum and other suggested places and feel more level-headed doing it. I am glad for the Remeron but would like to be well on my own, thank you. So thank you for the kindness and support you showed back then and going forward.
  16. I tried to taper off of Mirtazapine in March by skipping pills; I was not aware how dangerous this was at the time. My withdrawal symptoms were mild because I was lucky. I had some anxiety in April, but nothing major. I went cold turkey after my prescriber told me that I didn’t need to taper Mirtazapine. He also pressured me into taking Effexor, which caused me to develop severe full-body itching. I was taken off of the pills immediately because it was suspected that I was allergic to them. I suffered from severe withdrawal symptoms during the week where I wasn't taking any medication (sweating, diarrhea, anxiety, heart palpitations, shivering, lack of appetite, nausea, dizziness, flu-like symptoms, and insomnia). I tried to speak with my prescriber about tapering and withdrawal symptoms, but he insisted that everything I was experiencing was my ‘anxiety’ and put me back on Mirtazapine. I am now preparing to taper off of Mirtazapine properly. I came here to learn how to do this as effectively as possible.
  17. Hello fellow travelers, I am a recovering user of many psychotropic prescriptions (which I at first thought were good for me). After finally being able to taper off and learning much more, I've revised my thinking a bit: about the drugs, about the doctors, about the medical profession in general and about what I can reasonably be certain is healthy. I've got pretty decent working knowledge of psychotropics now, but still have much to learn. I have read the Ashton Manual, a few scholarly articles by people like Guy Chouinard, and have some experience helping people with withdrawal and post-withdrawal. I also have a bit of an interest in general medicine. Drugs taken include: Remeron, Effexor, Clonazepam, Triazolam, Escitalopram, too much Olanzapine and a few other compounds with varying levels of harm. I am now around two years post-withdrawal of Clonazepam, having begun my odyssey taking amitryptaline for sleep, and am still recovering from extreme insomnia, gastro problems and general fatigue. I can't really say it was worth it, but you live and you learn.
  18. Hello, I had a hard time staying off any meds. I feel as if once they got it, it’s hard to be off of meds. As I’ve updated my profile recently, Remeron has been good to me for sleep. I’m ready to wean off in the coming year. I really want to find homeostasis on my own. Maybe I’m being too dreamy about this but I’ve done my own work on my traumas and am looking forward to touch work training. I really feel if I can help to regulate my nervous system well, I can deal with the withdrawals better. I need to figure out where I can have Remeron as liquid so I can safely titrate down the recommended 10%. I really feel that is the problem for me—not being properly weaned off meds. Having a brain that held a lot of trauma and from a very traumatized mom, any major switch freaks it out. Maybe that is why some people can quit cold turkey and others struggle so much. I’d like to have a private conversation with you regarding this from a more professional stance. Let me know if we can. Thank you.
  19. JanCarol

    Remeron88: greetings - need some help

    I haven't had a chance to read your whole thread - but why are you taking 22.5 mg remeron in the morning? This is a drowsy dose, and should be moved to nighttime (but separate from your risperdal). If you are having dizzy and drowsy during day, this could be a huge contributing factor. My doc gave me remeron to help me SLEEP, and it's one of those paradoxical ones that the lower doses are more drowsy inducing than the higher doses. It's my understanding that anything under 30 mg should be sleep inducing. And that 7.5 mg is positively a knock-out dose. So - while you are working on getting your daily symptoms up - this is the first change I would consider.
  20. Lookinup

    Lookinup's intro: please help

    I feel the symptoms now because of the reduction of Remeron one week ago by 5%. Didn’t expect this Remeron reduction when I wanted to reduce Valium. I know I have to get the Valium down, just didn’t know whether to feel better first.
  21. Lookinup

    Lookinup's intro: please help

    Thanks, Frogie. Yes, Alto wanted me to reduce the a.m. Valium then work on the evening dose. Now getting the Valium is not an issue, Remeron is! Two docs are more concerned with me getting off that and both are want to write it compounded. Have pleaded with them to just REDUCE the Valium first due to hr increase. Yes, Remeron is a very difficult drug for me to withdrawal from, but in time, I can do a long taper from that. I truly believe Alto has it right and I’m not giving up. She has been very helpful to me and so perceptive. Basically am being forced to get off Remeron. Yes, at least they know about tapering 5% a month. Thank you again. I was so settled on finally having a plan.
  22. leavingorganon

    leavingorganon

    Hello all. I've been on various meds since 2005 when I was 21. I was put on Remeron because of what I now see as situational anxiety due to then-undiagnosed ADHD. I think it's time for me to leave this state and move ahead. The trigger for this desire is a recent cognitive assessment I did where I found out that things that were once easy for me intellectually are now harder, which is especially concerning for someone who's always been over-achieving and has "being smart" as an integral part of their identity. My short term memory is really bad with all of those medications, and what drove me towards doing the assessment is struggles at work that have been going on for the last three years. Though the assessment was the acute trigger, there are larger themes at play that made me really struggle the last few years. My sense of self is vague and undefined. I used to be much sharper and brighter, passionate, and awake; qualities that I feel are lost under the haze of artificial neurotransmitter modulation. I'm at an impasse that simply can't be overcome by adding a new med every few months (believe me, I tried). I feel like I'm half the person I used to be at work and at life. I crave authenticity and clarity rather than an artificial sense of (over)confidence. Despite all of that, I really feel some gratitude for the journey. I did a lot in these 15 years in spite of/because of (can't tell at this stage honestly) these meds, including getting two master's degrees and meeting really wonderful people throughout. I try to avoid an attitude of being anti psych meds as they are really helpful in some life situations. I actually don't plan on going off the ADHD med I'm currently on, and I'm even open to the idea of being on an anti-depressant in the future if needs be and I can tolerate it. I recently gave stopping Remeron a try (jumped from 3.5mg dose or thereabouts, wasn't doing accurate cutting and weighing back then), and was actually doing fine (the most salient withdrawal symptom was itchiness, which is honestly fine). This went on until sometime in the second week when the usual acute withdrawal symptoms came at me (akathisia, insomnia, nausea, etc). Before that, I experienced a lovely sense of lucidity and intellectual playfulness that made me feel 20 again. I had the loveliest conversation with my best friend, without the recent robotic disinterest that these meds seem to cause me. I decided afterwards to reinstate, get off the other problematic meds I was on first (Klonopin and Latuda), regroup, then tackle the Remeron gently. For the last few months, I've been collecting stories of people who successfully overcame this mess as well as quotes from the Baylissa's book. I've also been training my faith, acceptance, and non-resistance/non-anticipation muscles. I am currently reading Hope and Help for Your Nerves, and determined to come up with a plan with my therapist to stock up on coping skills. This endeavor is, in essence, part of a greater desire to live a life that is built around my abilities (whatever those may be after I'm done with my tapering) and interests, instead of hysterically and aggressively going after situations that are overly ambitious but ultimately destructive for me. This, to me, is the reason I went on and continued to be lulled by these meds for a decade and a half. I really don't care about material ambitions at this point; I just want a pleasant and meaningful life. I've successfully got off Klonopin after a year of (low-dosage, 0.125mg every two or three nights) last month. I've also got off Latuda this week and I'm doing generally well. I do realize that I'm still not completely clear off of these meds, so my plan is to resume my tapering etc. after some weeks. When I started, my goals were as follows: 1. Stop benzodiazepines (DONE) 2. Overcome polypharmacy 3. Stop Remeron The order of 2 and 3 doesn't matter to me, though I'm currently leaning towards stopping Remeron first as I've been on it the longest and maybe staying on Brintellix while getting off of it can lessen the withdrawal symptoms. So yeah, this is my introduction post. Thank you for reading.
  23. Do you know when Shep will be back? That’s whom Altostrata said to contact about it. I see you’ve been tapering down. How do you obtain liquid Rx? I’d like to do that for Remeron so that I can avoid the rebound insomnia I’ve read about. And I don’t mind if it takes me a while to come off. I had some rapid tapering in the past and I believe it’s caused me a lot of problems. Thanks so much.
  24. Hi, all. Thank you so much for providing this site. I’ve been inspired by the stories here, and look forward to my own recovery and hope to help others as I can along the way. It’s been a hellish year… I have a rather long story – 99% of which takes place within the last year – so please bear with me. I’ll write this out in a timeline for organization’s sake. In essence, I have a history of anxiety and depression, and have OCD. I have been suffering from severe postpartum anxiety (PPA) and depression (PPD) since delivering my son in May 2018 – exacerbated by a move out East so I could start my PhD, the decline and death of my dog, dealing with childhood trauma, etc. I was on Prozac and Xanax as needed before I was pregnant and went off without any problems while we were trying to conceive. I had an uncomplicated pregnancy. Here we go… 1999ish – 2005 (6th grade – high school) (Zoloft, Lexapro, Wellbutrin) I was diagnosed with severe academic perfectionism and OCD and put on (I think) Zoloft first (not sure of dosage). In the years that followed, I was on Lexapro and Wellbutrin, all in various combinations. I don’t remember timing or dosages. I don’t remember having a hard time coming on or off any of the meds. I was chronically ill in high school, though, with fatigue, mono, sinusitis, shingles (to be fair, I had immunological issues before going on meds, too, and a complicated family situation). I took the year after high school off to recover, went off all meds. All I remember is feeling tired and my sleep being on a weird schedule. 2005 – 2009 (no meds) I started taking some community college classes, started volunteering, and then working full-time. Started paying more attention to my diet (went off gluten and most dairy after I realized it made me feel better). Was doing very, very well. Summer 2009 – Summer 2017 (40 mg Prozac daily, ? Xanax PRN rarely taken; occasional supplements - multi vitamin, vitamin D, fish oil, probiotics) Started on 40mg Prozac (slow taper to START it), as a ‘preventative’ measure against OCD and perfectionism (I know… probably wasn’t necessary, but I can’t prove a negative) as I was about to start at a university in the fall of 2009; I was pushed by family (also on psych meds) to start. I think it helped somewhat but it’s hard to know. Eventually, I had an Rx of Xanax, which I took maybe 5-10x/year as needed. I did well in college, though, started a great career, went to the UK on scholarship to do my Master’s and then decided to QUICKLY taper off the Prozac when my husband and I (we married in 2014) decided to conceive. I don’t remember having any issues coming off the Prozac. I was on it fairly consistently for 8 years. Summer 2017 – May 2018 (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Pregnant, more depressed than usual, especially after moving back home from the UK and being unsure of what was next. Still, did the damn GRE, applied to PhD programs, got into a great program out East, started setting up our life out there. Obsessive compulsive symptoms were worse than usual but not unmanageable. Late May 2018 (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Delivered my son. Epidural, long labor. Started breastfeeding. Early June 2018 (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Had a week of awful insomnia and anxiety and intrusive thoughts, but it went away. Early June – Mid-July (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Doing okay, just exhausted and depressed (I was breastfeeding around the clock). One week in mid-July 2018 (? Xanax, one-time dosage ~6mg Zoloft, and one-time dosage 2mg Ativan, one-time dosage ? Klonopin in hospital; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Then, at around 7 postpartum weeks - BAM - I was hit with a week of NO SLEEP. I just couldn't sleep and I lost my appetite. I had been given an Rx for Zoloft by my OBGyn and took a very small amount that Friday (I wanted to ease in). That night, all my symptoms were much worse – and I also felt this severe restlessness in my limbs. It was AWFUL. I even tried Xanax to calm me down (I gave to my son pumped breastmilk). My anxiety was so bad that I went to the ER that Sunday. They drew blood and it turned out that my blood sodium was dangerously low (126) - possibly due to not eating enough and drinking too much water. They gave me Ativan (2 mg – which was A LOT for my system), some Klonopin, too, eventually, and fluids overnight and I felt MUCH better the next day. I was given Ativan and Remeron as needed but didn't need to take it for a few weeks. Mid-July to Late Aug 2018 (0.5 – 1mg Ativan daily; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) I was fine for a few weeks, and then my family and I moved out East, where I was attending grad school (I’m now on medical leave). The anxiety and insomnia came back around the move in August. I took Ativan (0.5 – 1 mg) as needed each day and had some rebound anxiety but was able to get through until setting up care there. I was assigned an interim psychiatrist (before being placed with a regular one), who Rxed me 0.5 Ativan to take at night to sleep for 10 days. This worked for sleep, but not the overall anxiety and depression. Due to breastfeeding concerns, they switched me to Trazodone (25-50 mg), which worked ok for sleep. Eventually, I was able to fall asleep on my own for a couple/few nights. That would be the last time I could do that to-date. Late Aug to Late Sept 2018 (0.5 – 1mg Ativan daily, 1-5mg Prozac, 25-50 mg Trazodone; supplements: postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, probiotics?) I started seeing a regular psychiatrist in early September, and we agreed I should go back on the Prozac with 1 mg Ativan/day as needed. We started sloooow on the Prozac - 1mg, then 2, then 5. By week 3, I had lost my appetite completely, and my anxiety was through the roof - just on 5mg (I was on 40 before becoming pregnant, so I couldn’t understand why I was feeling so terribly). The Trazodone was no longer helping me sleep, and was giving me terrible dry mouth. My limbs felt like they were vibrating. My psydoc FINALLY directed me to go off the Prozac and Ativan, and Rxed me just Klonopin 0.75mg/day. In addition to the psychiatrist, I saw a primary care doc, who checked my thyroid, adrenal glands (several tests there), vitamin levels, and other things - all normal. My blood sodium has still been a little low, but they believe it's due to not eating enough. Oct 2018 (Klonopin 0.25 – 0.75mg/day; postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, I might have tried some hormone-balancing herbs – I don’t remember exactly, probiotics?) My appetite returned but it was never the same. I was sleeping better, but not well – maybe 6 hours at most, sometimes waking in a panic. I could only take one class. I was very depressed and frustrated, and deeply confused as to why I wasn’t responding to medications. But I felt BETTER than when I was on the Prozac, and was able to feel like I could sleep on my own again, and on just 0.25mg Klonopin/day – but the plan was to let me ‘settle’ and then try a new AD, sooo… Nov 2-4 2018 (25mg Anafranil at night, 0.25-0.5mg Klonopin/day; postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, I might have tried some hormone-balancing herbs – I don’t remember exactly, probiotics?) The psydoc suggested Anafranil, a TCA. The day I started it, we put my dog down and I stopped breastfeeding (I had been tapering on that for months). It wasn’t a great time to start something. But I did. I took it the night of the 2nd, fell asleep instantly, then woke up feeling SO GOD AWFUL about 3 hours later. I had a tremor, I vomited, I couldn’t eat. My husband had to hold me while I shook in bed. I called the psydoc and she told me to keep taking it, sounding annoyed with me. So I pushed through for three days – but that was all I could do. Until then, that was the worst I have ever felt. Nothing could calm me down. Things start heating up here, so I’ll spare some details and focus more on the med changes… Nov 5-8 2018 I barely remember these days. Sleep was poor, I felt awful. Then on a Thursday night, I was up all night with panic attacks. I called my therapist and made the decision to go into the psych hospital. Nov 9 – 15 2018 (In hospital, put on 0.5mg Klonopin 2x/day and worked up to 100 mg Seroquel at night) I didn’t start sleeping until I was put on a combination of Seroquel and Klonopin. BUT, I remember this creeping feeling of “buzziness” and restlessness when I woke up everyday. That feeling would continue to get worse over the coming weeks and stay with me to the present. Nov 15 – Early Dec 2018 (0.5mg Klonopin 2x/day → 0.25mg Klonopin 2x/day; 100mg Seroquel at night; some supplements – don’t remember) I left the hospital taking 100mg Seroquel at night and 0.5 mg klonopin 2x/day. I officially went on medical leave from grad school. I stuck with this doseage for 2ish weeks, was sleeping well but feeling horribly depressed and anxious, then started to quickly taper the Klonopin. I don’t remember how quickly – but I wasn’t taking anymore than 0.5mg/day by early December. I then tapered on the Seroquel after feeling SO much worse when an IOP psydoc tried bumping the dose to 125mg; I remember not being able to sit still – going outside to pace. No tremor – just pacing, fidgeting, and losing a lot of weight. Early December 2018 – Early Jan 2019 (1mg Ativan at night, 2.5mg Zyprexa at night, 25-100mg Lamictal; postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, I might have tried some hormone-balancing herbs – I don’t remember exactly, probiotics?) I made the decision to move back home to do a program specialized in PPD (we ended by moving back entirely later that winter). In the program, I was put on 0.5-1mg Ativan at night, 2.5 mg Zyprexa at night (for sleep – though it never helped), and titrated up to 100mg Lamictal (the psydoc suspected a bipolar spectrum diagnosis). I was still incredibly restless, unable to sit down and just enjoy a movie. And my sleep was growing worse and worse. It was awful – then my mood grew worse and worse as we went up on the Lamictal; I also had increasingly bad tinnitus and TMJ. I was hospitalized as my thinking became suicidal – just ideations, but I was ready to go back in… Early to Mid-Jan 2019 (0.5mg Klonopin 2x/day, 5mg Paxil/day, 50mg Benadryl at night; 0.25-1mg Risperidone 1-2x/day; some supplements?; THEN back to 150mg Seroquel) In the hospital, I was taken off the Lamictal and put on 5mg Paxil once/day, 0.5 mg Klonopin 2x/day, Benadryl 50mg at night (for sleep), and Risperidone 0.25mg once or twice a day (I don’t remember). I became increasingly orthostatic (low BP, high HR). I stabilized mood-wise – sorta – and left the hospital feeling off, but better… Within days, though, we tried increasing the Risperidone, and my HR went up to 140 (I think we tried 1 mg). I wasn’t sleeping AT ALL. I was taken off the Risperidone, stayed on 5mg Paxil once/day, 0.5 mg Klonopin 2x/day, Benadryl 50mg at night (for sleep). Eventually, as my sleep diminished, the PPD IOP doc put me back on Seroquel (I has actually asked to go back on) – but suggested as much as 150mg. After that, my mood really shifted and became erratic; I was really upset and angry at my husband and suicidal ideation returned. So it was suggested I go back in the hospital... Late Jan to Mid-Feb 2019: 3-week hospital stay (see below for crazy med changes) All the docs agreed I didn’t need to be in there this long (everyone kept asking why I was still there), but there I was so they could keep throwing stuff at me to see if something stuck. I was holding out hope SOMETHING would work this time...: First week: 0.5 mg Klonopin 2x/day, 100 mg Seroquel at night, 300mg XR lithium 2x/day (HORRIBLE stomach reaction, especially when the doc abruptly pulled the Seroquel) Second week: 0.5 mg Klonopin 2x/day, 50mg Seroquel at night, some amount of Depakote (I don’t remember – wasn’t improving, irritable), tried PRNs of 12.5mg Seroquel and became really depressed Third week: 1 mg Klonopin 2x/day, 50mg Seroquel at night, 1200mg gabapentin (taken as 300mg twice during the day, and 600mg at night). That’s how I left the hospital. Mid-Feb to Early-March 2019: (0.75mg Klonopin 2x/day, 50mg Seroquel at night, 300mg Gabapentin 2x daytime and 600mg at night, brief re-trial of lithium – 150mg; multivitamin, 1,000-2,000 mg vitamin D, ? fish oil, 1200mg evening primrose oil, probiotics?) Instantly went down to 0.75mg Klonopin 2x/day (fear of dependence). New trauma-based IOP. Was very constipated. Tried low-dose lithium (150mg) as lithium seemed to be the only med to be helping to-date (along with benzos); was improving somewhat mood-wise, but the stomach issues were SO bad, so we went off. After going off lithium, my restlessness SKYROCKETED, and was particularly bad for 10 days. My stomach was AWFUL; I was taking antacids all the time; seemed to be worse after taking gabapentin, so the new IOP doc cut THAT dosage in half. Developed a tremor. The new IOP psydoc diagnosed me with akathisia – FINALLY. I had NEVER heard of that before (although, in retrospect, I think it has been mentioned to me in the hospital as a possible side-effect of the antipsychotics – but I remember them saying “you can get this, but I don’t see that in you, so…” and so I ignored it (dumb)). When I read about it, I felt so frustrated; this had, no doubt, been plaguing me since at least the one-time Zoloft attempt in July - and in particular since the first Seroquel doseage in November. Doc suggested I reduce my Seroquel from 50 to 25mg; I couldn’t do that for a couple of weeks. Early to Mid-March (→0.25mg Klonopin during day and 0.5-0.75mg/night, 25mg Seroquel at night, 200mg Gabapentin 2x daytime and 300mg at night, brief re-trial of Depakote – don’t remember dosage; multivitamin, 1,000-2,000 mg vitamin D, ? fish oil, 1200mg evening primrose oil, probiotics) Continue reducing my Klonopin down to 0.25mg during the day and 0.5mg at night. We tried XR Depakote as a Hail Mary in the med department. It seemed to help a bit, but also increased some of the restlessness. At this point – and this should have come sooner for me – I was done – just DONE– with med changes. My body needed a break. I haven’t added or taken away and particular meds since (with one exception - the propranolol, see below) – though I have reduced the dosages… Early April (0.25mg Klonopin during day and 0.5-0.75mg/night, 25mg Seroquel at night, 200mg Gabapentin 2x daytime and 300mg at night, up to 70mg propranolol throughout the day; multivitamin, 1,000-2,000 mg vitamin D, ? fish oil, 1200mg evening primrose oil, probiotics) Was diagnosed with thyroiditis (my thyroid had been normal as recently as January) – a relatively common thing postpartum, but it was ‘late’ to arrive to be postpartum thyroiditis, so doctors suspected the lithium. B/c I was hyperthyroid first (usually follows a pattern of a few months in 'hyper'/overactive mode, followed by anywhere from 3 to 18 (or more) months underactive. I was put on propranolol (taking as much as 70mg throughout the day). That seemed to help the tremor, heart palpitations, and restlessness maybe 50-75% of the time. But it crashed my BP. Early-April to Present (see below) We’ve moved into a new, stable house (both good and really stressful). As of early June, I am off the Seroquel. I tapered from 25 to 0mg by reducing by about 6.25mg every two weeks or so. I tried re-starting it to do an every-other-day ending taper, and felt instantly WORSE, so I am done. But it was probably too quick a taper. I NEVER want to take another antipsychotic again, though; I can point to the beginning of the worst parts of this whole cluster to starting Seroquel, and the akathisia that ensues and continues. I reduced the daytime Klonopin to 0 (though I’ve had to take a 0.0625mg to 0.125mg PRN three times in June as things have grown worse). I still take 0.5mg Klonopin at night. In June, I also went off the propranolol – too quickly – and have been having heart palpitations, and have been orthostatic. My BP was just getting to be so, so low. Now, taking any amount of it seems to make me more agitated/restless or, at best, woozy. In June, I also got ambitious and reduced the gabapentin from taking 400 mg during the day (200mg 2x/day) to 0 at the end of June, mostly b/c I thought it was making me feel worse; I’m not sure on this STILL (or if it ever did much of anything). I still take 300mg at night with 0.5 mg Klonopin. May was my best month - not great (I was still constantly restless, struggled with my appetite, and was really disoriented and depressed), but it felt more manageable. I should have done a slower taper on all things when I felt more stable, then – but here I am. June started out okay but, after going off the Seroquel and trying a glass of wine again (out with a friend), it’s been awful; the akathisia is back in full swing. NOW I seem to have reached this point where my body won’t tolerate much of anything again – as if it’s saying “if you’re done with one, then you’re going to be done with them ALL.” I’ve also noticed that the first half of my menstrual cycle is FAR AND AWAY WORSE than the latter half – and am trying to explore ways to (as naturally as possible) balance my hormones. I tried bioidentical progesterone cream that an integrative MD Rxed and it helped somewhat, but caused cramping and spotting and an upset stomach – no go. Currently Taking 0 – 200mg gabapentin during the day; 300mg gabapentin at night 0.5mg Klonopin at night 5mg melatonin (+10mg B6 – combo pill) at night Fish oil (1400mg EPA + 480 DHA) in morning and afternoon 1500mg primrose oil morning and afternoon 200-400mg magnesium glycinate at night, and magnesium oxide throughout day 2000mg vitamin D afternoon Cal+Mag+Potassium supplement afternoon 2 kinds of probiotics morning Multivitamin morning What Makes Things Worse Alcohol; I haven’t been able to tolerate this since sometime early spring – makes me SUPER anxious. Any antihistamine; it used to help me sleep but something in the last 2-4 months has changed my brain so I now feel WORSE the next morning. Some vitamins (I say that b/c I sometimes feel more buzzy after taking a multivitamin; on the other hand, sometimes I feel better) Caffeine (not that I’ve tested this too much; the most I ever drink is a cup of green tea, and I haven’t been able to do that in weeks) Antacids (found that out the hard way) What Helps Epsom salt baths Sweating Crying (when I am able to) Walking (especially in sunshine) Melatonin (at night – for sleep) Klonopin (but I am trying not to go over 0.5mg/day – mostly at night; and want to taper off) Massage Stretching Kombucha (not too much, though b/c caffeine) Apple cider vinegar + lemon water (ahead of meals and when I have an upset stomach – at east once/day) Eating enough (really tough to do right now) Not Sure if it Helps (tried/trying it) Acupuncture (doing this for a few months now) Therapy – CBT, talk Gabapentin (want to taper off anyway) Primrose oil Multivitamin Fish oil Magnesium Calcium CBD oil What I Need Help With I’m here b/c I need to feel like I’m not crazy when the psydoc says this isn’t still akathisia. I KNOW it is – I KNOW it’s protracted withdrawal and the effect of such a brain-altering year. I know this b/c, even in my most anxious moments pre-postpartum medications, I never felt this protracted insatiable restlessness and dread. I was a champ at sleeping (though a night owl). And my appetite was always solid (too much so, at times). This is DIFFERENT. I also want to get off the gabapentin and the Klonopin – but do so in a smart way. I’m not sure the gabapentin is a net evil right now and shouldn’t be taken off altogether? And is the gabapentin the best thing to drop first? And I need help managing the akathisia. I've read some tips here, and will explore those. Any help on the hormone piece would be invaluable. There is something there. I feel the effects of akathisia/withdrawal/autonomic disregulation far more at the start of my cycle. And this whole postpartum period has been inherently hormonally disregulating (compounded by meds like Depakote, which altered my cycle). Anyone else? Anything help? I plan to keep a more focused journal as this site recommends and track my symptoms alongside food, supplement, and med changes. Of course, what sucks THE MOST is the lost time and what's been taken - from the joy of being a new mother, to what was supposed to be a fulfilling career move in pursuing my PhD (I might have to give up my place now b/c I'm so disabled), to feeling defective for not responding to the 'right treatments.' The worst year of your life should not also be the first year of motherhood. To those of you that read this monster of a post – or event 10% - THANK YOU.
  25. FYI Tips for tapering off Remeron (mirtazapine) Please update your signature with the mirtazapine information.
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