ColdTurkey1: Tapering mirtazapine(Remeron)

[ColdTurkey1]

Hi All

 

I have been taking SSRI for the last 4 years, last 2 years I tool Sertraline 20mg.

I really wanted to stop them !

3 months ago, I went to a water fasting retreat, and at the advice of the instructor I stopped them cold turkey. Big mistake !

The first 2 months were great ! I felt good, alive, and happy that there are no withdrawal symptoms.

But last month the withdrawal started kicking.

I had severe insomnia, few days of rage, depression and feeling of anxiety in the solar plexus coming and going. 

I didn't know what to do, so decided to see if I can handle it without going back to medications.

I am quite self aware, went to quite a few body\mind treatments, started doing body exercises, started taking Omega 3, and tried to do good things for myself. 

These things help, but the symptoms persist, and it is hard.

 

The situation now is that I have:

Severe insomnia, quite sensitive emotionally, mild depression sometimes, the anxiety in the solar plexus comes in the evenings, weak memory, and I worry\think a lot about the situation - how long will it persist, and what should I do. 

My day-to-day functioning is OK for now. and sometimes I also feel happy.

 

My question to you in this amazing forum is what should I do now ?

Should I go back to taking Sertraline and start tapering it off very slowly ? to what dosage should I return ?

Or, if I already did the stupid cold turkey withdrawal, and am already 1 month into the withdrawal symptoms, maybe I should just hang on the best I can until the finish ?

Edited April 28, 2023 by manymoretodays
fixed title in introduction to reflect user name, with caps

[dalsaan]

Hi CT1

 

Welcome to the forum and thanks for filling out your signature. We recommend a very conservative trial and error approach to recovery. Reinstatement is better done sooner rather than later. We have a thread on reinstating here. http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/page-2

 

3 months out its possible that your system has become very sensitive in withdrawal so if you consider reinstatement you want to start on a very low dose eg 2 mg

 

It's difficult to say how long things might take to settle either way (whether you reinstate or not)

 

Perhaps you could read the above thread and then come back here to ask questions, talk through your options

 

Dalsaan

[ColdTurkey1]

Thank you Dalsaan

 

1) Are there instructions in the site on how to turn a 50mg pill into 2mg ?

 

2) I don't understand from the posts what is the meaning of becoming very sensitive after 3 months. what may happen if I reinstate by taking 25mg (half a pill) ?

 

3) After how many days should I decide weather I should go up from 2mg ?

 

4) The withdrawal stories here on the site are very frightening. Would love to get some reassurance that the withdrawal can also be not so bad, and that even if I stopped cold turkey, there are chances that the symptoms will subside in not a long period (with 

[dalsaan]

We go into withdrawal because our nervous system has become used to functioning with the drugs in our system.   Our brain has kind of remodelled itself around the presence of the drug.   If we take the drug away our brain has to adjust to this absence.   If the drug isnt in our system and our brain hasn't fully adjusted to that it becomes a bit unbalanced or destabalized.   This is what generates withdrawal symptoms.

 

Within this destablized state, our systems get very sensitive to stressors.   Reintroduced the drug can be experienced as a stressor by our nervous system therefore some people have an adverse reaction when they reinstate.   The more you throw at it the greater the risk so we suggest very small amounts.  

 

We don't have a crystal ball so we can't say that your symptoms will resolve in x amount of time.   Some people have very little trouble coming off these drugs, some people have a moderate degree of difficulty coming off and it resolves over a few months, some people have significant trouble and it is prolonged.

 

We cant know which category you will fit in.   Stopping cold turkey isn't great because you have given your brain no chance to adjust.   That's why reinstatement is an option that people consider.

 

Your symptoms are not horrendous and unrelenting so that is cause for some optimism. The fact that your functioning is ok and you can feel times of happiness is a good sign.

 

If you are going to try to reinstate to enable you to taper off slowly, you need to do that asap.  here is a link on tapering off sertraline and how to make a liquid (which is the easiest way to control your doses and take very small amounts) http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

 

I'm sorry there are no black and white answers.   Our general advice to people is to taper slowly.   That's why we recommend reinstatement.   However, the longer it is since you last took a dose the more risky that becomes - your brain has changed since the last time you took your drugs.   You can mediate the risks of a negative reaction somewhat by taking an extremely low dose and listening to your body in terms of how to respond.   Whether you want to try this or wait out the symptoms is up to you.

 

Dalsaan

[ColdTurkey1]

Wow, I really appreciate your long and caring responses.

I will try to reinstate

But I don't understand something about tapering off after reinstating - if I reinstate only 3mg, it seems that the tapering will be very short

And another thing - how long should I give the 3mg dosage a try, before you raise the dosage ? (in case the 3mg doesn't help)

[joey122]

The memory gets better for me it has at least hang in there . I am like 5 months in the first few months were brutal for cogniton and memory now it has improved.

[Altostrata]

Hello, ColdTurkey, did you reinstate?

[apace41]

Would love to get some reassurance that the withdrawal can also be not so bad, and that even if I stopped cold turkey, there are chances that the symptoms will subside in not a long period (with 

 

Hi ColdTurkey1. Welcome to the site.  As Dalsaan said, it is impossible to predict how any one person will react to getting of SSRIs because (i) we are all so bioindividual and (ii) it is impossible with current testing to ascertain what level of affinity for the drug your serotonin receptors have developed.  Based on my experience, I would say the factors that tend to lead to better outcomes are:

• shorter duration of usage
• lower dosages during usage
• younger age at time of attempting to get off the drug

I don't know your age but 50mg is a relatively low dose of Zoloft and 4 years is not extremely long by comparison to many (myself included).  While I would test the reinstatement (please answer Alto's question as to whether you did), I would find optimism in how you have reacted so far and would be hopeful that you will have a good recovery.

 

But I don't understand something about tapering off after reinstating - if I reinstate only 3mg, it seems that the tapering will be very short

 

This site recommends tapering no more than 10% per month so even at 3 mg the tapering process will take a while.  It is the safest way to come off with the least amount of adverse effects.

 

Best of luck and let us know how you are doing.

 

Andy

[ColdTurkey1]

Hi Friends

 

Sorry for not answering, I don't get notifications for responses

 

I still didn't reinstate. I'm taking some amino acid supplements - 5HTP, Gaba, Same-e. and also Omega 3

Things are not getting better.

I'm getting depressed from small things in my life.

 

I'm starting to think about going back to Sertraline 50mg for a few months to stabilize, get my life in order, get a therapist, start doing sports

and then to start tapering down in the right way, not cold turkey as I did

 

What do you think ?

[bubble]

Since you have been off the drug for over 3 months there is a risk that the full dose will be too much.

 

That's why you have been advised to start much lower such as 2 mg.

[Altostrata]

Please read the links we have given you.

[ColdTurkey1]

Face + Scalp spasm\contruction due to Lexapro\SSRI\Benzo ?

 

Hi

 

A year ago a went off Prozac, in the beginning I was fine, but then got severe Insomnia and depression, and had to go back to meds.

I have started taking Lexapro 3 months ago, after a very long and Anxiety\Depression period of trial and error of various meds that didn't help

For the severe anxiety that I had, that was probably increased dramatically due to starting Lexapro. I was given Lorazepam (benzo)

I'm now taking 20mg Lexapro, 30mg Mirtrazapin, 2mg Lorazepam (twice daily), and Ambien

I'm not suffering from anxiety or depression now

I'm slowly going off Mirtrazapin because Lexapro was the med that really helped

 

My problem is that I have facial\scalp spasms that are suppressed only when I take Lorazepam

At about 10am I start feeling the scalp muscles contract (not twitch, just contruct and stay that way), and also the right upper side of my face and rmuscles around the right eye

This is very worrisome to me

I don't know if it's because of the Lexapro, because of anxiety, becuase of trauma, or because of the benzo

I don't know how to get oof the benzo if I get these cramps if I don't take it

I don't know if the benzo is "hiding" the size effects of the Lexapro

And I don't know if indeed it's a sizez effect of Lexapro, will it go away if I wait enough

 

I wish I could get off all the meds, but currently it's not possible for me

 

Does anyone know of such side effects ?

 

Edited December 18, 2020 by ChessieCat
added topic title

[ChessieCat]

Hello and welcome back,

 

Please update your drug signature so that we can see your history at a glance.  Follow these instructions.  Please remove the spaces and also the last 2 lines.  We only need to see drug name and supplement name, doses and dates for dose changes and the last date and dose you took before stopping a drug.  Thank you.

 

Instructions:  Withdrawal History Signature
Account Settings – Create or Edit a signature

 

2011-2013 - Prozac/Fluoxetine 20mg

2013-2015 - Sertraline 50mg

9.7.2015 - stopped Sertraline cold turkey

Got withdrawal symptoms 

Breaking my head what to do now 

 

 

Please put all the drugs/supplements you are currently taking in the Drug.com Interactions Checker and copy and paste the report OR copy and paste the URL for the report here in your topic.  Please ensure that if you copy the report that the duplications at the bottom of the screen are included. Thank you.

 

Q:  Are you getting any of the symptoms which are described in the drug interaction?  If yes, what?

 

The enable the mods to assess your situation please provide 3 consecutive days of daily symptoms notes, posting a 24 hour period in one go.  This post explains what is required and how the notes can help:

 

Keep Notes on Paper

 

Edited December 18, 2020 by ChessieCat

[ChessieCat]

Please note that the spelling needs to be correct to use the drug interaction checker:

 

Mirtrazapin --> mirtazapine

[ColdTurkey1]

On 12/18/2020 at 2:15 AM, ChessieCat said:

Please note that the spelling needs to be correct to use the drug interaction checker:

 

Mirtrazapin --> mirtazapine

Thank you ChessieCat

 

Sorry it took me time to answer, it's hard for me to enter this site as you can understand

I edited my signature, could you tell me if it looks fine ?

Also, Do you think that I should post a new topic ? my main problem is still the pressure\tension\pain on the right side of my head, that is relaxed with Lorazepam

[ColdTurkey1]

On 12/18/2020 at 2:12 AM, ChessieCat said:

Please update your drug signature so that we can see your history at a glance.  Follow these instructions.  Please remove the spaces and also the last 2 lines.  We only need to see drug name and supplement name, doses and dates for dose changes and the last date and dose you took before stopping a drug.  Thank you.

Thank you ChessieCat

 

Sorry it took me time to answer, it's hard for me to enter this site as you can understand

I edited my signature, could you tell me if it looks fine ?

Also, Do you think that I should post a new topic ? my main problem is still the pressure\tension\pain on the right side of my head, that is relaxed with Lorazepam; And Tiredness & Foginess in the mornings probably because of the Mirtazapine 

[ColdTurkey1]

Right sided scalp and face pressure pains

 

Hi All

 

I am cuurently on 3 drugs: Mirtazapine 30mg, Escitalopram 10mg, Ativan 2-3mg

I suffer from right sided pressure pains in my scalp and right side of the face

The pains are releived by Ativan, and slowely increase as the Ativan influence decreases. after 5-6 hours I usually need to take another Ativan

I was on 20mg Escitalopram and lowered to 10mg hoping this was the cause of the pains. the pains stay the same

 

So now I need to decide what is my next step, and would appreciate your help

I need to decide which of the 3 drugs most probably cause the head pains, and start withdrawal from it

 

 

If anyone has (or read about someone else who have) suffered from these one sided head pains , I would appreciate it if you tell me from what drug you think it was induced

 

Thank you very much

 

Edited January 16, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[ChessieCat]

I did a search in this topic for "left side" and "right side".

 

migraine-headache-neck-ache-pain-and-head-pressure

 

These are the search results for those two terms:

 

https://www.survivingantidepressants.org/search/?q="left side"&quick=1&type=forums_topic&item=1785

 

https://www.survivingantidepressants.org/search/?q="right side"&quick=1&type=forums_topic&item=1785

[ColdTurkey1]

I hope this topic is appropriate for my question

I am preparing for remeron withdrawal, but not yet

I have discovered that I feel lethargic for at least half a day every day becuase of this stupid pill (my dose is 30mg)

I tried not taking it for 2 days and the lethargy just dissapers !

I'm going on vacation soon for 1 week, and am wondering if I could handle not taking it for 1 whole week in order to enjoy more, and then return to the full dos (and start withdrawal after I stabilize

What do you think ?

[ColdTurkey1]

Can I stop Remeron for 1 week in order to enjoy a vacation more ?

 

Hi All

 

I am preparing for remeron withdrawal, but not yet

I have discovered that I feel lethargic for at least half a day every day becuase of this stupid pill (my dose is 30mg)

I tried not taking it for 2 days and the lethargy just dissapers !

I'm going on vacation soon for 1 week, and am wondering if I could handle not taking it for 1 whole week in order to enjoy more (since I will not be tired for half a day), and then return to the full dose (and start withdrawal after I stabilize)

What do you think ?

 

Edited June 27, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

It's not something that I would do.  You could end up feeling worse after a few days of not taking it.

 

Please carefully read the following:

 

Cold Turkey and Too-Fast Tapers

 

And from the reinstatement topic:

 

  

On 10/9/2012 at 10:17 AM, Altostrata said:

Don't suddenly go off a psychiatric drug assuming that reinstatement is a safety net

 

This is one of the reasons we advocate gradual tapering to minimize withdrawal symptoms. Once the nervous system is destabilized by withdrawal, all bets are off. Humpty Dumpty the egg has fallen off the wall.

 

[ChessieCat]

And from ever-skip-doses-to-taper

 

Many people come here with severe withdrawal symptoms after following their prescribers' or their own misguided plan to skip doses in order to taper.

 

You may hear of people who got away with skipping doses to taper. That is possible, some people cold turkey without a problem. However, after cold turkey, skipping is perhaps the most risky way to come off psychiatric drugs. Both can result in terrible, severe withdrawal symptoms that might not fully be reversed by reinstatement of the drug.

 

Skipping doses causes the level of the drug in your bloodstream to go up and down, even with long-acting drugs such as fluoxetine. This puts stress on your nervous system, potentially causing withdrawal symptoms. It's like playing ping-pong with your brain.

 

NEVER SKIP DOSES TO TAPER.

 

If after seeing this, you decide to skip doses to taper and get withdrawal symptoms, do not come back here asking for help.

[ChessieCat]

15 minutes ago, ColdTurkey1 said:

I hope this topic is appropriate for my question

I am preparing for remeron withdrawal, but not yet

I have discovered that I feel lethargic for at least half a day every day becuase of this stupid pill (my dose is 30mg)

I tried not taking it for 2 days and the lethargy just dissapers !

I'm going on vacation soon for 1 week, and am wondering if I could handle not taking it for 1 whole week in order to enjoy more, and then return to the full dos (and start withdrawal after I stabilize

What do you think ?

 

I have responded in your topic:

 

See the following 2 posts:

 

AND

 

[Ariel]

Hi @ColdTurkey1

I am not a mod but based on personal experience and from what I've read on SA, stopping a psych drug cold turkey is never a good idea, whether it's for one week or forever. 

 

Cold turkey is very hard on your brain, body, nervous system; it can have a traumatic effect on your physiology. 

 

Every time we go on and off a drug we risk withdrawal, destabilization, hypersensitization, and kindling, all of which can be uncomfortable in and of themselves, as well as making it much more difficult and unpleasant to quit completely at a later date. 

 

In my opinion it's not worth it. 

 

P.S.

ChessieCat beat me to it while I was still writing the above.

I agree with ChessieCat's advice. 

[ColdTurkey1]

Thank you @ChessieCat & @Ariel

You advice is very logical, and I will follow it

 

[ColdTurkey1]

Hi

in the past months I have tries a few times to taper down Mirtrazapine from 30 to 7.5 with no success, each time going back.

This happens because I get very fatigued and this causes depression and then anxiety because I'm depressed  (I have a kind of post traume from a complete meltdown I had 3 years years ago that started me on all these drugs)

I saw in the posts that A LOT of people suffer from this fatigue side affect.

I guess that in lower doses this horrible drug is more sedating

 

I am now stabilized on 22.5mg and fear going down again

 

I have started thinking of another approach and would love to hear any comments:

Maybe it's better to do a FAST taper with this drug

 

Maybe it's better to take a retreat from life for 3 months (that's about how much off time I can take) and taper 10% a week, stop at 7.5mg (this dose does not make me fatigued), go back to life and taper the rest in a slower rate

By retreat I mean stopping work, preparing myself for a rough time, having friens and therapists support me. And most importantly, not expecting to feel good or function good for 3 moths.

This way, I will finish with the fatigue when I don't need to function in life, when I'm on a retreat were I will take good care of myself.

 

What do you think ?

[manymoretodays]

Hi ColdTurkey1,

@ColdTurkey1

Would you check above that this is all you, and welcome back.

You don't need a separate Introduction even though, it is now different drugs you have to taper.

 

I think HOLDING right now with the mirtazapine might be a good idea while planning the next taper.

 

If mirtazapine is your choice, then you should at least start with a 10% taper from the previous dosage, so first taper would only be from 22.5 mg to 20 mg, and then a nice at least 4 week HOLD.  You might have just gone too fast thus the resultant WD symptoms.

 

If it is the more sedating AD now, the mirtazapine, you might consider tapering Escitalopram first so that you can preserve sleep.  I know the fatigue is not great but the alternative worse symptom of possible insomnia occurring might also not be great at all.

 

Here's a topic that helps one decide which drug to taper first:

Taking multiple psych drugs? Which drug to taper first?

 

And then the tapering topics on the new drugs you are on, versus what you had been on when last here, or when you started here on site, after having come off sertraline too fast in 2015.

 

Tips for tapering off escitalopram(Lexapro)

 

Tips for tapering off mirtazapine(Remeron)

On 4/17/2023 at 1:31 PM, ColdTurkey1 said:

I am now stabilized on 22.5mg and fear going down again

 

I have started thinking of another approach and would love to hear any comments:

Maybe it's better to do a FAST taper with this drug

 

Maybe it's better to take a retreat from life for 3 months (that's about how much off time I can take) and taper 10% a week, stop at 7.5mg (this dose does not make me fatigued), go back to life and taper the rest in a slower rate

By retreat I mean stopping work, preparing myself for a rough time, having friens and therapists support me. And most importantly, not expecting to feel good or function good for 3 moths.

This way, I will finish with the fatigue when I don't need to function in life, when I'm on a retreat were I will take good care of myself.

 

Well, you haven't tolerated a FT with this drug, mirtazapine though.  You might do okay with alternating tapers.  Doing escitalopram at 10% or less from each previous dose and then after a hold of at least 4 weeks...... then doing a just 10% taper down from present 22.5 mg of mirtazapine, and again holding at just 20 mg for 4 weeks.  And then.......deciding if you want to go with escitalopram again or mirtazapine.

 

I don't see any advantage to a FT of mirtazapine from what you are saying in your post above.  And then planning for a tough time while tapering may or may not be.  Anyway......I'm not following your logic at all.  It's great to be able to taper and continue with your work and life.....it really is.  And you have to evaluate how each taper goes-with each drop in dose before really knowing how you, your case, is going to go.

 

How long have you felt stability now?

 

Okay all for now.  Welcome back.  Review again what general information you had gotten when here before too.  And then ask any questions right here, in your one and only Introduction topic over time.

 

Love, peace, healing, and growth,

mmt

 

And oh me, oh my!

When do you take each of your drugs each day?

Can you access Drugs.com and put your drugs in the interaction checker please.

Then please give us the link to the results or copy and paste in a reply.

 

I was surprised, not pleasantly.  If for some reason you can't get there to Drugs.com, do try Medscape.  You'll have to google that one, and do an interaction check there and then share with us.

 

Edited April 20, 2023 by manymoretodays
check interactions

[Go2zero]

On 4/17/2023 at 9:31 PM, ColdTurkey1 said:

I have started thinking of another approach and would love to hear any comments:

Maybe it's better to do a FAST taper with this drug

A fast taper will never work out OK. The faster one tapers, the more withdrawal symptoms may occur. And the whole WD process usually lasts much longer if one has tapered too fast. The risk for a heavy withdrawal process is high.

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

Why do you take 2 antidepressants? The combination of both can lead to serious problems like serotonin syndrome. Furthermore the total dosage of 10 mg Escitalopram and 22,5mg Mirtazapine is very high.

 

Do you want to stay on one of the both antidepressants? Or do you want to taper both?

 

Please answer these questions. Then we can advise you further.

[ColdTurkey1]

Thank you so much @manymoretodays @Go2zero for thinking deeply about my question

 

Do you think it’s a good idea to post a topic in the ‘Tapering’ forum ?
I would really like to have a post dedicated to the Fatigue Mirtazapine withdrawal symptom

 

I’m holding the 22.5mg dosage for 2.5 months and I’m stable for about 2 months, so it’s time to continue the tapering

 

On 4/21/2023 at 1:22 AM, manymoretodays said:

You might have just gone too fast thus the resultant WD symptoms.

Actually I did go fast, from 30mg to 15mg and then one time after 1 month to 7/5 mg, because of the severe fatigue I was experiencing.

On 7.5mg there was no fatigue, but of course it was too fast and I got emotionally unstable

Do you think that a too fast taper can cause fatigue ?

 

On 4/21/2023 at 1:22 AM, manymoretodays said:

I don't see any advantage to a FT of mirtazapine from what you are saying in your post above.  And then planning for a tough time while tapering may or may not be.  Anyway......I'm not following your logic at all. 

 

My logic:

I saw in many posts aboth Mirtazapine, that this drug is more sedating in lower doses

And this is indeed what happened to me, on 15mg I was quite faigued for about a month. The fatigue was hard to bear and caused depression. I'm quite sure that the depression is not only related to the reduced AD dosage , but due to feeling fatigued all the time

And on 7.5mg I was not fatigued.

So my logic is that if I hand the emotional consenquenced of a fast taper from 22.5 to 7.5, I will be able to be less time with the fatigue, thus be able to withstand the withdrawal without the depression that comes because of being so tired.

 

On 4/22/2023 at 12:14 AM, Go2zero said:

Why do you take 2 antidepressants? The combination of both can lead to serious problems like serotonin syndrome

I had a complete collapse on May 2020, went out of this collaple with multiple drugs.

On March 2021 I was on 12.5mg Ambian, 3mg Ativan, 20mg Escitalopram and 30mg Mirtazapine

I will post a more complete update to my story soon

 

On 4/22/2023 at 12:14 AM, Go2zero said:

Do you want to stay on one of the both antidepressants? Or do you want to taper both?

 

My main drug related symptom now is facial and scalp pains, only on the right side of the face and scalp

It started on Jan 21, I think because I started Escitalopram but I'm not sure

It's not related to WD becuase it started before my WD
Do you know of such symptom ?

I didn't find anything similar althoug I searched extensivly on the website

It could happend becuase of the Ativan , although I completely withdrew from it on Spe 2022.

Or it could happen because of Mirtazapine or the combination on Escitalopram and Mirt

So I'm thinking about tapering \ Withdrawing from Mirtazapine, hoping that it will remove the facial pain symptom

I think that currently I will not be able to live without one AD, so I'm hoping to stay on Escitalopram if the facial pain will stop

 

 

On 4/21/2023 at 1:22 AM, manymoretodays said:

You might do okay with alternating tapers.  Doing escitalopram at 10% or less from each previous dose and then after a hold of at least 4 weeks...... then doing a just 10% taper down from present 22.5 mg of mirtazapine,

What is the advantage of altering taperings between the 2 drugs as you suggested ?

 

Drug interactions from Drugs.com:
https://www.drugs.com/interactions-check.php?drug_list=1013-0,1640-0

 

 

[Go2zero]

8 hours ago, ColdTurkey1 said:

Actually I did go fast, from 30mg to 15mg and then one time after 1 month to 7/5 mg, because of the severe fatigue I was experiencing.

On 7.5mg there was no fatigue, but of course it was too fast and I got emotionally unstable

Do you think that a too fast taper can cause fatigue ?

A fast taper can cause a lot of symptom. Fatigue, but also heavy sleeping problems (insomnia) may occur.

 

The best way to taper is maximum 10% per month. This will take time, but this is the only way to prevent serious withdrawal problems.

I understand you went up and down in dosage several times. Please do not do so anymore. This may cause an effect called kindling, which may make withdrawal more difficult and lengthy.

 

Pleas read this: 

https://www.survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/?tab=comments#comment-525233

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

8 hours ago, ColdTurkey1 said:

My main drug related symptom now is facial and scalp pains, only on the right side of the face and scalp

It started on Jan 21, I think because I started Escitalopram but I'm not sure

It's not related to WD becuase it started before my WD
Do you know of such symptom ?

I am not aware of such symptoms. But it may be a WD symptom from any of the drugs or an adverse reaction.

 

It is clear that the combination of high dosages of mirtezapine and escitalopram could cause serotonin syndrome. It would be best to continue tapering one of these drugs as soon as possible (but taking in mind the 10% per month).

 

8 hours ago, ColdTurkey1 said:

What is the advantage of altering taperings between the 2 drugs as you suggested ?

I suggest you would taper only 1 drug at a time.  Often WD symptoms can show up after some months and no one would have a clue than which drug is causing the problems...

 

8 hours ago, ColdTurkey1 said:

I think that currently I will not be able to live without one AD, so I'm hoping to stay on Escitalopram if the facial pain will stop

What is the reason you prefer Escitalopram over mirtezapine?

[ColdTurkey1]

Thank you @Go2zero

 

2 hours ago, Go2zero said:

It is clear that the combination of high dosages of mirtezapine and escitalopram could cause serotonin syndrome

I don't think that the dosages I'm taking are not high... 10mg escitalopram and 30mg mirtezapine are the minimal dosage pills where I live. I'm taking 10mg and 22.5mg...

 

2 hours ago, Go2zero said:

What is the reason you prefer Escitalopram over mirtezapine?

Because I suspect that mirtezapine causes my facial+scalp pains...

The problem is that the escitalopram causes night sweat, and I fear that if I don't take mirtezapine that is really sedating at night, I will wakeup from sweat and will have sleeping problems. I've been having problems falling asleep since the age of 16 

Also if the facial pains don't dissapear when I withdraw from mirtezapine, they may also interfere with falling asleep

So maybe I will try going down to 3.75mg mirt and then start tapering escitalopram

The problem is that I don't think I will be able to live completely without any AD in my current life situation

 

So in conclusion i'm trying to figure out how to navigate these problems - 

facial pains due to adverse affects from one of the drugs

fatigue duing withdrawal of mirtezapine (maybe becasue I tapered to fast)

historical troubles falling asleep , and also severe insomnia that cause me to start taking mirtezapine 3 years ago

emotional withdrawal symptoms that I will have when I resume my withdrawal

 

[Go2zero]

1 minute ago, ColdTurkey1 said:

I don't think that the dosages I'm taking are not high... 10mg escitalopram and 30mg mirtezapine are the minimal dosage pills where I live. I'm taking 10mg and 22.5mg...

 

 

 

It is the combination. These drugs should not be combined. Combined the dosages are very high!  

 

Please check for drugs interactions 

https://www.drugs.com/drug_interactions.html

 

5 minutes ago, ColdTurkey1 said:

So maybe I will try going down to 3.75mg mirt and then start tapering escitalopram

The problem is that I don't think I will be able to live completely without any AD in my current life situation

 

 

This could be an option if you want to stay on a AD. Mirt can help with sleeping at low dosages.

 

 

8 minutes ago, ColdTurkey1 said:

So in conclusion i'm trying to figure out how to navigate these problems - 

facial pains due to adverse affects from one of the drugs

fatigue duing withdrawal of mirtezapine (maybe becasue I tapered to fast)

historical troubles falling asleep , and also severe insomnia that cause me to start taking mirtezapine 3 years ago

emotional withdrawal symptoms that I will have when I resume my withdrawal

 

 

Hard to say which drug (or combination of drugs) causes facial pains.

 

Fatigue could very wel be caused by too fast tapering mirtezapine. Fatigue is a very common symptom when using or withdrawing psychotropic drugs.

 

[manymoretodays]

Thank you Go2Zzero, and you as well CT1.....

I did see you got to drug interactions here:

On 4/23/2023 at 3:46 AM, ColdTurkey1 said:

Drug interactions from Drugs.com:
https://www.drugs.com/interactions-check.php?drug_list=1013-0,1640-0

 

What did you think when you saw that?  I can't help but think that some of your symptoms once remedicated with this particular combination, way back.......might have been somewhere on the serotonin syndrome spectrum if you will.

 

When you you take each of your drugs now?

In your reply to this.....just note the time on the left, o'clock, military or note am or pm, then the drug by name, and then the current dose

 

I'm hoping Lexapro is am and Remeron(mirtazapine) is pm so that at least they are divided from each other.  We often hope a division or moving drugs that interact strongly apart will minimize interactions, but I don't know for sure.  It's not a good combination you are on.

 

Do study the mirtazapine tapering topic with an eye for how you might do your first 10% taper, looking for ways to get a dose of 20 mg from what you have on hand.

 

We do have others tapering mirtazapine here, and there may be a FB group as well.  Let me see if I can do a general search for mirtazapine taperers here for you to see, and then you could kibbitz with any who are active here now.

Results of a search offsite......survivingantidepressants.org mirtazapine

Looks like quite a few came up.

And now your title and tags reflect the mirtazapine and lexapro too, so others can find you as well

 

Best, thank yous,

L, P, H, and G,

mmt

 

 

[ColdTurkey1]

Hi  @manymoretodays 

 

14 hours ago, manymoretodays said:

What did you think when you saw that?  I can't help but think that some of your symptoms once remedicated with this particular combination, way back.......might have been somewhere on the serotonin syndrome spectrum if you will.

I saw that the same text is shown for any combination of 2 anti depressants

I read about serotonine syndrom. even mild, and it seems to be much more acute and dramatic compare to the one sided facial pains that I have. I also didn't see any reference to one sided pains, only generalized body pain combined with other symptoms.

 

14 hours ago, manymoretodays said:

When you you take each of your drugs now?

~23:00 - Mirtazapine 22.5mg

~07:00 - lexapro 10mg

(Do you suggest I write lexapro+remeron instead of Mirtazapine +escitalopram  ?)

 

14 hours ago, manymoretodays said:

It's not a good combination you are on.

Why do you think it's not a good combination ?

I want to quit remeron anyway, but interested to understand

I'm so happy I'm not on the drugs I was on May 2021 - 30mg Mirtrazapine, 3mg Ativan, 12.5mg Ambian, 20mg Escitalopram (!!!😱)

 

I must admit that I'm still entertaining thoughts about fast tapering 70% of Mirtrazapine in 3 months in a retreat center that will give me the best conditions for tapering. I think that being in a retreat will greatly diminish my anxiety about not performing in life, about not being able to work (I'm a psychotherapist), and about being alone (loneliness was always my biggest depression trigger, and I'm not in a relationship)

I 'm thinking about this method because as I wrote before, I experienced severe fatigue when reducing from 30mg to 15mg (for one month), and when I reduced to 7.5mg the fatigue vanished (but of course I was depressed and anxious and couldn't handle the too fast taper)

(see my signature for exact dates)

Are you sure that it's not a good idea ?

 

About the topic, could you change it to:

"Tapering Mirtazapine\remeron and suffering fatigue, also on Escitalopram "

Actually way back I wasn't successful in CT of sertraline, and reinstated

 

I want to write a summary of my whole journey with ADs since the sertraline CT till now.

Should I update the first post in my introduction ? or write a seperate reply here ? or something else ?

 

Thank you so much for taking the time and effort to answer me

[manymoretodays]

On 4/25/2023 at 4:50 AM, ColdTurkey1 said:

I must admit that I'm still entertaining thoughts about fast tapering 70% of Mirtrazapine in 3 months in a retreat center that will give me the best conditions for tapering. I think that being in a retreat will greatly diminish my anxiety about not performing in life, about not being able to work (I'm a psychotherapist), and about being alone (loneliness was always my biggest depression trigger, and I'm not in a relationship)

I 'm thinking about this method because as I wrote before, I experienced severe fatigue when reducing from 30mg to 15mg (for one month), and when I reduced to 7.5mg the fatigue vanished (but of course I was depressed and anxious and couldn't handle the too fast taper)

(see my signature for exact dates)

Are you sure that it's not a good idea ?

 

Hi CT1,

Okay thanks for the further information.

Why not......I propose, just study the mirtazapine tapering topic a bit more.  And go more conservative or less possibility of harm.......and just do a 10% taper next, off your current dose of mirtazapine.  Getting the non-standard dosing can be tricky sometimes, so decide on your method, and then do just a 10% drop from present 22.5 mg dose. 

I get that as being a dose of 20.25 mg.

Then, at least at first, HOLD for 4 weeks.  Let us know if noticing anything in terms of WD symptoms.  And also when they might let up.

And if still fairly stable, WDstable, then do another 10%.

20.25 mg X .90 = 18.23 mg

 

If all goes well, you might be able to do 10% at lesser intervals, like 2 weeks.....until you get to your desired 7.5 mg.........but time will tell.

AND, if you get hard hit with WD symptoms then you can just go back up to the previous dosage and stabilize again.

 

With the mirtazapine  I think it works on more receptors than just the serotonin ones, just meaning that it's properties may vary too at different doses.  I'm not too familiar with that all, just what I read, not what I have experienced.   So I'm thinking you might want to learn more about that too, from some of the other mirtazapine taperers......here or on FB.

 

Anyway......we are going to always promote a more conservative taper than what you have in mind.  If you had just wanted to go from 22.5 mg to 15 mg.......I'd say don't.  It did not work before......try our way.

 

 

If you need a little break from work and the mental health system too......by all means take a stay at home vacation.  Or go on a retreat. As long as it is just promoting emotional well being, and isn't some kind of rapid detox center......that's fine.  It would be nice if you had your system for getting the in between doses for tapering mirtazapine shored up before then.  And leave it open as to whether you have reduced all the way to 7.5 mg of mirtazapine by the end of it.  We often have to guide our tapers by if symptoms come up or not.  Trying, trying to give our bodies a chance to recalibrate between tapers.  Everyone is different too.  You'll need to find just what you tolerate.

 

As far as the serotonin syndrome goes, when I looked back.......I had to wonder if maybe you felt a little of that at any time.  That was where I was going......thinking on that.

 

It's okay if you want to work the taper on mirtazapine first by me.  And see how you might less drastically get down to 7.5 mg of that.  And maybe once you get to 7.5 mg of mirtazapine, more normal sleep and less all the time fatigue, you could begin to taper the Lexapro(escitalopram) conservatively again, to a lower dose.  Just don't do any decreases by more than 10% of the previous dose.  Just don't jump from 22.5 mg all the way down to 15 mg in one swoop.  I am getting repetitive, I know.

Why taper by 10% or less of my dose

 

Thoughts on that plan?

I'll get your title changed now.  I just went with Tapering Mirtazapine(Remeron) as that is where you are at now.

Put the sertraline in your signature, so we know this isn't your first go round with psychiatric drugs.   Dates.  It's in your first posts here, but should anyone else look in on you, and not have time to read from the beginning.  That whole experience may have led to where you are now with medications.   And then just bold the Lexapro, or make clearer that you are on that now still.  I think if you bold it, it will be clear that you are on that, and may be working on the mirtazapine now though.

 

I put the specific tapering topics for your drugs up in my first post to you.

I'm fine with calling mirtazapine mirtazapine.

 

I'll get back ASAP too, I wanted to link you to topics that might help you see others with facial pains, even one sided ones and that those could well be WD still lingering from your last taper attempt.  Use the Drugs.com to check side effects of your drugs too, sometimes one can find odd symptoms as a side effect too.

Sorry......I am a bit tired myself today and although it is early here I am fading...........  I'll check back when I get a day to really focus better while I'm here.

 

Okay and hope you are sitting in some stability still.

 

L, P, H, and G,

mmt
 

 

Edited April 28, 2023 by manymoretodays

[ColdTurkey1]

Hi @manymoretodays

Sorry for the late response, I took the time to think of my next steps

I really really appreciate you kind thorough and thougtful responses

 

So good work and thank you, you convinced me to first do a 10% taper for a month 😇, and see how it goes

 

If you will, I would like to write the history of the one sided facial pains, maybe you will have thoughtful inputs for me that I didn't think of:

They started before I did any tapering, so it's not related to WD

On Mar 2020 I had a complete breakdown after a CT of Prozac (I slow tapered until 1/3 a pill and then very stupidly CT)

On May 2020 I started Fluvoxamine that started incredibly severe anxiety and muscle cramps in my stomach and forehead+eyes+scalp (it wasn't one-sided, but symmetrical on both sides), stopped after 3 weeks.

On Jun 2020 I started Remeron (the symmetrical cramps due to anxiety continued)

My very partial records from that time show that the first time I wrote aboput one-sided pains was on August 20 - when I was taking 1-2 times a day 1mg Atival pills for anxiety (and also mirt, ambian).

I started Lexapro on Sep 2020. 

Sadly I'm not completely sure if they started before or after I started Lexapro.

Since then the anxiety subsided, but I realized that the Ativan was greatly REDUCING the cramps\tensions\pains.

So I started taking 3 1mg Ativan daily for the pains... I know... it's crazy... but I was after a complete breakdown and trying to build my life again.

So when I discovered that, I started tapeing the ativan.I completely withdrew on Feb 22, no WD symptoms !

And actually the facial pains rithm changed - not increasing 3 times daily 3 hours after taking ativan, but slowly increasing through the whole day until only at about 9pm they sometimes bother me

It's important to say that they also increase when I'm more stressed

I was hoping that withdrawing from benzos will stop the pains, but 14 months afterwards they still exist and are not decreasing in intensity

 

a while ago I searched this site and the whole internet for a very long time for similar pains. The closest thing that I found was one sided pains (not in the head) due to benzos.

BUT! Wow! I just found this symptom for escitalopharm in Drugs.com:
"pain or tenderness around the eyes and cheekbones"

It party describles what I have, but it doesn't indicate one-sided pains.

 

 

So in summary, I think but not sure that the pains started before Lexapro, but drugs.com has a similar symptom to mine that happens because of Lexapro

But I guess that all sorts of pains can be caused by all drugs...

 

I also updated my signature to reflect all my history

 

Thank You !