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Hello all, New here. After some traumatic life events (including diagnosis with an autoimmune disease) was put on mirtazapine nov 2018 during a day clinic program. They said it was a strong depressive episode with symptoms of anxiety. It was never pushed on me though most other places it might have been. Here they felt I had clear reasons and grief. In any case, I started mirtazapine 7,5 mg and slept for the first time in months. Then 15 mg and finally 22,5 when 15 wasn’t cutting it. This was the right dose. Yes I gained a bit of weight and had vertigo at times but that went away. I was given this med because I also take baby aspirin to think the blood to due a clotting antibody that was found. They felt this was the least risky. Who knows? Last month found out we have to start the process to have kids faster than I wanted due to diminished ovarian reserve and my psychiatrist who I will now fire gave me no real directions about the med and pregnancy. Said better not to look back and wonder if any issues with the kid were your fault. So I decided to taper down to avoid adding another med to my list and I have been feeling better and working, disease more well controlled. I asked for taper tips. She said in theory you can stop tomo but maybe try over a few weeks. No more tips. So I reduced a quarter every 10 days. Was pretty ok with one day (second day after reducing) usually being tough. Irritability, fatigue, sadness, a bit of anxiety. Then it would level out mostly. I was traveling this week, and figured I would be in a good mood and tapered mid break but forgot and did a half instead of a quarter (15mg to 7,5 mg) and BOY what a catastrophe. I had all those symptoms but magnified x10 and went back up to 15 mg the next day and felt almost immediately ok again. However today I felt headachey, sad and a bit anxious again and am afraid after some things I read that I have somehow permanently busted my already shaky brain and nervous system. With fertility treatments coming in the next months, I’d like any hope or advice on how to manage the taper? Or to hear from anyone who used it during pregnancy at a lower dose. Thanks for having me and for doing this! What a relief that this group exists.

Last year in April/May I was diagnozed with a psychosis / schizophrenic disorder. My symptoms were accustic hallucinations (hearing voices) as well as severe paranoia and suspicion. I thought people in the workplace and also in public were spying on me and engaging in conspirations against me. I started to shut down my shades in the apartment and changed my wlan password every day. I came to a state of absolute mental exhaustion when I wandered through the city without having any orientation at all and being a danger to myself. Luckily I agreed to see a doctor who put me into a psychiatric clinic (after my consent) where they treated me with risperidone (the first four weeks with pillls and then with the risperidone consta injection). In the beginning they accidently overdosed me (they also admitted to that) so that I could not function anymore at all, was constantly salivating huge amounts and got problems with my jaw which they tried to short-term fix with Akinon. After two to three days the negative side effects were not so severe anymore, but I got significantly numbed down. Five to eight days after my submission my symptoms (hallucinations/paranoia) were gone and I was relieved from the clinic around four weeks after submission and continued to go there only during daytimes for another two months. In December last year I shifted back to oral medicamentation (4mg risperidone per day, 2mg in the morning and 2mg in the evening) because my new psychiatrist said that I dont have any compliance issues and I am more flexible this way. The shift was not so easy, I was mostly tired for about a month or so. After that and under supervision of my new psychiatrist I was gradually tapering down the risperidone over the last months (February through now). The first step was shifting down from 4mg to 3mg, then from 3 to 2 mg, then from 2 to 1,5mg and finally from 1,5 to 1 mg with always waiting four weeks until the next step of tapering down. Except fro the second tapering down phase (3mg to 2mg) where I got very tired for about two to three weeks I was withdrawal symptome free. However, risperidone numbs me really down, I am not so much emotionally engaged anymore, being around people exhausts me. Before I was working out a lot, but I just feel it is not worth the effort. I also experience a TD in form of my leg moving up and down when I am sitting down and having my legs crosssed. Except for the TD I dont know whether the symptoms all come from the medicine or are also partly induced by the negative symptoms of my psychosis. The buildup of the psychosis was really heavy, it came to the point where I did not trust anyone anymore, including my family and significant other and was completely exchausted (psychologically and physically). However, ever since I am down to 1mg I am generally feeling more awake now. I can take care of my life and of myself and also work fulltime. I still have concentration issues and cognitively I am not where I was before, but I can function quite well (I just lack motivation and excitement for a lot of things). I read from quite some people that the lower the dosis, the more functions I would be getting back. But I also experienced the windows and waves pheonomena. There are hours when I am doing extremely well and others when I am just blue and lethargic. Now, I have been on 1mg for six weeks now and my psychiatrist said I can taper down by 0,25mg. However, I also got pregnant about six weeks ago, which changed my life a lot, also to the degree that I am more careful about anything. I spoke with my psychiatrist about it because of the impact of neuroleptica on the fetus. Whereas Quetiapin is generally given to women who are pregnant as risperidone could have a slightly higher negative impact during pregnancy, my doctor advised me not to change the medicine becasue the higher risk is not to a high degree and switching neuroleptica might result in more complications (withdrawal symptomes from risperidone, adverse effects of Quetiapin, etc.). But when he told me to reduce my risperidone by 0,25mg, which did not sound like a lot, I was trying to get more information about it from forums such as like this, where people constantly pointed out the danger of cutting down on the medicine too quickly. That is also why I chose to sign up here and engage in discussions to learn from one another. In general with risperidone, but especially with my situation I have a couple of questions, and maybe someone with similar experiences can share with me. 1) Regarding pregnancy-induced morning sickness, I throw up occasinally. Now I also wait until 10 o clock to take my medicine, until the biggest wave of neausa is gone, but there were one or two times where I had to puke two hours after I took the risperidone pill. In this respect, does anybody know how long it takes until the substance has fully absorbed by the body? 2) Would you advise taking the medicine once per day instead? The prescription says you can do it either way and so did my psychiatrist. He pointed out that so far it has worked, so why not stick with it. I read that when it comes to lower dosis it might be easier to split the dose up to two dosis a day, but 1mg is not so low yet. It would make things a lot easier, but I dont know about how to transition (how long should the transition period be and whether or not to start shifting the morning dosis (completely or in parts) from hour to hour over several days). It would be great if there is someone out there who has experienced the difference between one and two dosis a day. 3) With focus on tapering down I am thinking about shifting to the liquid version of risperidone. Do you know by experience whether the 1mg/1mL solution dillutes, so that I can drop 1mg/1ML into lets say 10mL of water and take out 9,5mL to get to my dosis of 0,95mg. Does anyone know if this tapering technique works especially for the risperidone liquid because it seems that some compounding pharmarcists do not share the same opinion. 4) While my pychiatrist said it is good to reduce my dose, I also read that withdrawals (e.g. drugs) have a negative impact on the fetus as for shock (rule of thumb: if the mother feels fine, the baby feels fine). The past days was the first time I read that after tapering down it is not necessarily the original symptoms that come back, but rather withdrawal symptoms. So I try to be really careful here, because I dont see a big difference between the impact of withdrawal systoms of different substances (be it drugs, antidepressents, neuroleptice, ect) on pregnancies. Therefore, the question is whether or not it would make sense to keep everything status quo over the time of the pregancy and then start tapering down again in the next year or whether it would be more beneficial to start already tapering down. Regarding all the aspects I know that I involve my psychiatrist and dont do any "experiments" on my own, particularly with the special situation of my pregnancy, however it would be extremely helpful to learn from your experiences of other sources (links, etc.) you might know because even though I have the feeling that I get along with my psychiatrist really well and he wants to minimize my medication as much as possible, it seems that also his knowledge has limits. My gynecologist knows about everything, I have a biweekly appointment for check-up on possible issues and I looked up a clinic nearby which specializes on neonatology as for this speical situation. Last but not least, I apologize for the mediocre English in my posts, but I am not a native, so I hope it is ok. I am happy to keep you posted and cannot stress enough how much hope and strength this forum has given me already throughout the last couple of days. Best wishes, Sunny

Hello to the community, I've been reading and browsing this site for a while, but hadn't ever formally joined. I've been taking medication (Paxil then Effexor) for the past 15+ years. In the past year or two I've become much more emotionally healthy and have entered a stable place in my life. From many different discussions with different medical professionals (and from personal experience!) I know it is best to taper from a position of strength and relative good mental health and I've fought so so hard to get to where I am. I want to taper off of my medications to recover my emotions and to potentially try to become pregnant. I find that I've become much more emotionally blunted - I am neither happy nor sad about things that would be joyful/upsetting for most people. I am also at the age where many of my friends are having children, and would also love to have a child. From the literature searching that I have done, I've found many conflicting opinions on whether or not a pregnant woman should take mental health medications - Effexor XR in particular. I've consulted 3 MDs and one naturopathic doctor and have connected with MotherRisk at SickKids Hospital in Toronto. I have been told the following: My GP: you should switch to Celexa ( less side effects/ lower risk of birth defects/) 2nd Doctor: keep taking your medication (Effexor) - don't worry about it. Naturopathic doctor - difficult decision - there is no one right answer and each person must decide the level of risk that is acceptable to him/her and also balance your own mental health needs. SickKids RN - Keep taking your meds. Internet research - conflicting opinions, scary stories etc. Some children of mothers taking Effexor are born and have withdrawal symptoms. I want to stay out of judgement - I think everyone needs to do what is right for them. Right now, for me it feels right to try and taper. In the past 7 months I've tapered slowly down with the assistance of a mental health RN and Naturopathic doctor who advised supplements for the brain zapps. I feel like there are so many people who take medication for mental health, and so many women getting pregnant - but the issue of the two together is very rarely talked about, at least in my experience. If there is anyone out there who has gone through this issue, or has some experience I would love to hear about it. I have found a few articles, and I believe there was recently a film made called "Moms and Meds" although I haven't seen it yet... possibly because I don't want to sob quietly for 30 or 40 minutes before bed. https://broadly.vice.com/en_us/article/pg75mg/for-pregnant-women-with-mental-illnesses-medication-can-be-a-minefield Taking things one day at a time. Whee... Cokemachineglow

If you or a loved one had a child with a birth defect after taking antidepressants during pregnancy and you are willing to be interviewed about your experience, PM me and we'll talk. I am a free-lance writer specializing in medical harm.

Hi everyone, my name's Clare and I'm a 35 year old female with a longstanding dependency on Paroxetine (Seroxat here in the UK). I take 20mg daily, having first been prescribed it in January 1997 as a 17 year old girl. I was prescribed it for depression with anxiety, after having what I would now describe as a breakdown of sorts. I was bullied quite severely between the ages of 12 and 14, which led to what would probably now be diagnosed as PTSD. I spent a lot of time feeling ridiculously socially anxious, which made forming and maintaining friendships very difficult. I still experience problems in this area now. Things weren't great at home, either. My parents (now long since divorced) had a volatile relationship and my dad had a drink problem. I didn't talk to anyone about how I felt (I tried to pretend it wasn't happening to me and instead reinvented myself as a bit of a "too cool for school" grunge chick). Inwardly, I was crumbling, though, and I ended up being referred to CAMHS (Child and Adolescent Mental Health Services) when I was 16 for individual psychotherapy and family therapy. Unfortunately, the therapy wasn't of much help to me at the time because I wasn't emotionally mature or open enough to engage with it and it was too short lived. Fast forward a year and I had my "breakdown". In subsequent years, I've described what happened to a CPN (Community Psychiatric Nurse) and he thinks I may have had a hypomanic episode, followed by a depressive episode, brought on by stress. I was studying for 3 A' Levels and hoping to go to university, but I suddenly changed my mind about one of the subjects (History) halfway through the course, dropped it to pick up a Law A' Level instead, withdrew my UCAS application and fell madly and obsessively in love with one of my teachers - a married man 25 years' my senior. Sadly, he eventually reciprocated (after initially rejecting my advances) and the whole situation - without going into too many details - became incredibly messy, emotionally destructive, etc, etc. After 8 months of being on Paroxetine (September 1997), I decided to stop taking it, so I sought guidance from my GP (now retired), who told me it was fine to stop taking it abruptly (Patient Information Leaflets at the time claimed it was "non addictive"). I experienced 4 weeks of moderate 'flu-like symptoms (aching limbs, nausea, dizziness, brain zaps), followed by a return of my original symptoms of depression. Both my GP and I assumed it was because I wasn't ready to stop taking it yet and he suggested I try again in a few months. Lots of things happened in 1998 (both my grandmothers died, my parents split up, my dad started drinking again, I left one job and started another and my 17 year old sister and I ended up at threat of being made homeless), so it wasn't a good time to try to stop my medication again. The following June, however, my sister and I starting buying a house together (a small, cheap 2 bed terrace) and I felt a lot more positive about doing it. Cue another attempt at CTing the meds! Again, I lasted about 4 weeks, but this time the depression and anxiety were so much more intense! I couldn't stop crying, I lost my appetite, had thoughts of suicide, etc, etc. Kudos to my GP for failing to advise me to taper slowly (even the patient info leaflets advised a gradual reduction by mid '99!) At some point later on that year, I tried to taper again by splitting my pills into halves and quarters (with a butter knife of all things!) and spreading my doses out. A friend of mine advised this method as she'd managed to withdraw that way. Again, it didn't work. Just over 2 years later, in early 2002, I tried to do it again using this method. I was in my first year of university at the time, working part time, and I considered myself to be happy and settled. Bizarrely, I was using this method for some months before it all started to go wrong for me. I'm not sure what happened, but I suddenly found myself crying on the Head of the School of English (I studied English Literature at university) because I hadn't done any of my work for semester 2 and I needed to defer my studies. He was amazingly helpful, very sympathetic and sorted it all out for me. After that, I decided I didn't want to withdraw from my meds until I'd finished university, so I duly spent the next 3 years engrossed in studying, working part time and - I'm ashamed to say - smoking cannabis on a regular basis. It wasn't until 2007 that I again decided to withdraw, but this time I took the sensible option, spoke to more than 1 GP, conducted some internet based research, and obtained Seroxat liquid (and used a very sharp knife this time for accurately dividing pills across the score line!). I devised a tapering regime, which went 20-19-18-17-16-15-14-13-12-11-10.5-10. Beyond that, I played it by ear. The reduction from 20mg to 10mg took about 4 and a half months and wasn't too much of a challenge. I had some withdrawal effects, but fortunately no head zaps whatsoever and only occasional dizziness and feeling unsteady on my feet. Tiredness, aching, irritability, an occasional headache, hot and cold flushes and nausea were the main symptoms I noticed. After that was a bit more of a challenge (more on that later) The main reason I've decided to withdraw at this point in my life is future motherhood. My partner (Mike) and I would like to start a family and I've decided that I'm not prepared to put my unborn child at an increased risk of congenital heart defects, lung problems or neonatal serotonin syndrome. Realistically, with a gradual taper, holistic measures and a support network in place, I know I can reduce my dose to below 10mg before we even start trying. Ideally, I would like to taper off over a long period (years potentially), but I'm realistic about my chances and both my partner and I have done a cost-benefit analysis (severe depression and anxiety in pregnancy is probably more harmful than a low dose of an antidepressant). The plan is to get a GP appointment and commence withdrawal at the beginning of September (I'm going to a festival during the last weekend in August, so then's not a good time) - all being well. I'm sorry for going on for so long (thanks to anyone who's managed to get this far - lol), but I thought it'd be good to put everything into context before I start my withdrawal log. I'll add my email signature as soon as I begin my withdrawal. Thanks for reading Clare.x

My two children were exposed to my (25mg/day) dose of generic Prozac (Fluoxetine) during our pregnancies and through years of breastfeeding. My 8-year old daughter experiences severe mood swings and complains multiple times a day about stomach or headaches, usually in conjunction with dreaded activities like school. I found out my seratonin levels were half what they should be, and my dopamine levels twice that of normal during a urinalysis. I'm considering testing her neurotransmitter levels, and am also needing advice on how else to support her. I've taken her out of school and we are now homeschooling. So many of her symptoms/complaints were mine as a child, which makes this situation extremely difficult for me. Also, I'm worried about withdrawal symptoms when I wean my little boy.