Hanley: Remeron/Klonopin Unsuccessful Tapers

[hanley]

Hello,

 

I'm on what seems to be an unstoppable cycle of ups and downs for many years. Been with same PsyDoc the whole time except for brief 2nd opinion, which was disaster. Says my issue is I'm wired to be anxious and high stress job doesn't help - just wants me to take meds as prescribed. Says A/D not addictive. Good person and do trust, but do question unwiilingness to consider meds are having negative effects. Says meds not cause of any of my symptoms except tiredness/fatigue from Remeron. Symptoms that seem to have surfaced and seem to be worse on meds over the years - anxiety, low self esteem, low confidence, fear, panic attacks. Can't seem to shake the meds (see sig). Under lots of work stress. Unsure if time to try taper again, but firm belief meds have had some negative effects, more than positive. Panic attacks are awful (really horrible) and never had those before meds.

 

Question in mind is do I continue meds or try yet another taper? Im miserable on them and miserable off/when tapering. Each time ends in failure. Dont know if should taper benzo or A/D first as have had no success either way. Feeling defeated and hooked.

[KarenB]

Welcome Hanley,

 

So many of us could have written your intro - all those stuck and uncertain feelings, and wanting to be able to trust the doctor but seeing he maybe doesn't have the whole picture.  I'm really sorry you are now in this position. 

 

In answer to your question, we do consider it best to taper than to stay on meds.  Anatomy of an Epidemic is an excellent read for understanding why. 

 

Thank you for your detailed signature.  When was your most recent taper and up-dose for each drug?  The reason I ask is because it would pay to have a settled time before beginning another taper.  You could have a read of Which Drug to Taper First - usually people do the a/d first because it's more activating. 

 

Because your Central Nervous System is already quite sensitised by all the ups and downs, when you do begin to taper again you may want to be extra cautious.  Usually we recommend tapering by no more than 10% each month.  You may want to try 5% and see how that goes.  It's better to start slow and be able to speed up than start fast and crash again.  Keeping symptom notes on paper helps when it comes to making decisions.  

 

Here are the Tips for Tapering Remeron

 

That's a lot for starters - have a read and then you can come back to this thread to ask any questions you may have.  This can be your journal to record your tapering progress. 

 

Best,

Karen

[Petunia]

Welcome hanley,

I'm sorry you've been having a hard time getting off your medications. Thanks for giving details and for filling in your signature, that makes it easier.

 

When was the last time you tried tapering? How long have you been at your current doses?

 

It sounds to me like you've been tapering too fast. We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising. Please read through this which will explain why:

  

Why taper by 10% of my dosage?

 

Its also important that you begin a taper from a place of stability, so if you have been on these kinds of medications for a while, changing doses and drugs, with symptoms getting worse, this is likely due to nervous system instability as much as withdrawal. With two or more drugs involved, it becomes more complicated.

 

If you tend to be an anxious person and have a stressful life, coming off the drugs isn't going to solve these problems, so having a plan to address this would also be a good idea. Looking for non-drug ways to manage stress and anxiety and having these in place before beginning a taper would be something else to look at.

 

Over time psychiatric drugs can make our health worse and lead to the development of other conditions. Evidence has shown that long term, they tend to do more harm than good. You might want to get hold of a copy of Anatomy of an Epidemic by Robert Whitaker.

 

Here are a few more links which help you decide where to go from here and how:

 

Taking multiple psych drugs? Which drug to taper first?

 

Tips for tapering off Remeron (mirtazapine)

 

Karen has replied while I was writing and has provided the same links, thanks Karen.

 

I'm glad you found us Hanley, you will get a lot of friendly help and support here.

 

Petunia.

[hanley]

Thank you KarenB and Petunia! I'm looking at the helpful resources and information you have provided. Recent tapers have been an unsuccessful Remeron taper early 2015 for 4 months only to jump up to 22.5 mg/day on May 17, 2015. I had also tried to taper Klonopin as well, not at the same time but close enough that may have caused issues. I recently dropped the remeron from 22.5 to 18.75 on 12/18/15 and havent had any major issues to note.

 

After reading which drug to taper first, I'm thinking that the Klonopin may actually make more sense in this particular case. This is becuase the Remeron seems to be the least activating of the two, especially at doses of 15 mg and lower- that's been part of the issue is it's hard to drag it out too long because the fatique is so bad the lower you go, even at just 3.75 mg. tapering the Klonopin first would remove any sedating effects of the benzo as the Remeron fatique increases the lower I go. That's my hypothesis anyway! It's clear to me that I've been going too fast of a taper on both drugs every time (I'm impatient). Thanks again.

[hanley]

Hello,

 

Two updates for the group:

(1) I have successfully tapered off Klonopin as of August 2016.

(2) I have tapered down to 3.75 mg per day of Remeron and held at this for the last 7 weeks.

 

I'm feeling okay sometimes and very bad at others, and have and had a lot of continued work stress, which is continuing to cause me many issues. I've been unsuccessful with Remeron previously so I'm very unsure of making another dose decrease- probably to 1.875 mg/day if I do. just not sure if this is the right time. Remeron has always been the more difficult drug to taper for me (vs. the Klonopin) and I'm a fearful of failing again.

[Aelius]

Hi Hanley,

 

congratulation on being benzo free. Don`t think too much about Remeron taper, you`ll make it this time!

[Madeleine]

Congratulations on being benzo free!