Deano32: Medication merry go round/mirtazipine poop out/withdrawal

[Deano32]

Hi long story,but had a breakdown in 2006 due to bereavement was started on 20mg of fluoxetine which I stayed on for 9 months eventually decided to come off, and was off it for around 4 months.

 

In this time felt I was slipping backwards so was put back on to fluoxetine had a torrid time second time round made me suicidal with severe anxiety and insomnia. During this period was also switched to citalopram for a couple of days then switched backed to fluoxetine again. I managed to stay on fluoxetine until 2009 but was still feeling very poorly,so was then switched to 30mg mirtazipine.

 

I seemed to settle on the mirtazipine especially as it allowed me to sleep which I hadn't had much off the previous years, was ok until 2010 then had another breakdown out the blue no reason for it and amitriptlyne was added to mirtazipine stayed on both for around 2 months then dropped the amitriptlyne.

 

From the middle of 2010 I seemed to get my life back on track new job,etc felt best I'd felt in a long time, roll on to 2015 still dong fine until about May. Around this time started experiencing panic attacks again,loss of appetite,insomnia and lost enjoyment in everything. Doctor increased dosage to 45mg felt slightly better but kept changing from one day to the next, I would go from being ok to depressed the next and sleeping to no sleep etc.

 

I stayed on this dose until August but was getting worse,didn't feel in control of my mind and didn't feel right,returned to doctor told him I wanted off mirtazipine but he tried to add seroquel which I refused. So from August started first drop 45mg to 37.5mg felt worse at first then settled,around 6 weeks later dropped 37.5mg to 30mg got severe anxiety and felt manic, but settled then the beginning of December dropped 30mg to 22.5mg and was hit with no emotion could feel nothing no anxiety no happiness.

 

This lasted around a week then I improved again so stayed on this dose over xmas. Over xmas was very up and down but cope able. Started new year and symptoms seems to be getting worse keep going from having emotion to none sleep to no sleep, severe anxiety to no anxiety

and am really struggling as the last week symptoms have been getting worse and worse each day.

 

I feel I can't trust myself sometimes and feel trapped on this medication, too scared to drop again and to scared to go up or add something else, just wondering if anyone had any advice? Regards dean

Edited January 24, 2016 by KarenB
added paragraph breaks

[AliG]

Hi Deano . Welcome to S.A. You've landed in  a good place for help and support. Unfortunately , you've tapered, far too fast. We recommend a 10 % reduction of your previous dose , every month to 6 weeks. Some, go slower with a " micro - taper"

http://survivingantidepressants.org/index.php?/topic/2364-the-slowness-of-slow-tapers/

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

If you could add your drug history signature, it will help us to give you more exacting and concise answers.

Please put your withdrawal history in your signature

 

Possibly , an updose might decrease symptoms, or you might have to hold for a good while to let your symptoms settle.  Then do a very slow taper.  It would be a good idea to keep a note of your symptoms , from here on in , to get an idea of where things stand , and how to proceed . These links will help . Have a read , and see what you think .

http://survivingantidepressants.org/index.php?/topic/1779-rate-symptoms-daily-to-track-patterns-and-progress/

http://survivingantidepressants.org/index.php?/topic/5301-tips-for-tapering-off-remeron-mirtazapine/

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

This is your journal to ask questions and keep track of your progress. Please come back with any questions and concerns , you may have.

Best wishes,

Ali.

[Petunia]

Welcome Deano,

 

Thanks for adding your signature. As AliG wrote, it does sound like you have been tapering too fast. At what dose did you last feel stable?

 

Did you read any of the links posted above? Any thoughts on updosing?

[Deano32]

Thank you AliG and petunia for the information provided much appreciated.

 

And I haven't really been stable since May last year when the 30mg just seem to stop working over night I had slight improvements on increasing dosage but only for a short while, moods and anxiety would fluctuate daily.

When I decided to taper I had worsening of symptoms followed by slight improvement then same again moods and anxiety would fluctuate.

 

I haven't decided whether to up dose or not as have struggled so hard to get to the dosage I am at now, And am a bit worried that up dosing may worsen my symptoms,to be honest it's terrified me at how the meds can turn on you like this.I have been tapering by breaking tablets in half would u recommend that I buy some scales for further reductions so I can do a smaller taper?

 

Regards deano

[Altostrata]

Welcome, Dean.

 

Last May, did you take any antibiotics or other drugs? Are you taking other drugs now? If so, please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and copy and paste the results in this topic.
 

[Deano32]

Hi thanks for the reply, and the only med I used briefly was proctosedyle ointment, I've checked it on interactions and says no interactions found,my symptoms just seemed to come on over night last May and gradually worsened over a period of two weeks and have been up and down since.

 

So upped from 30 mg mirtazipine to 45mg symptoms improved initially but then would deteriorate again and it kept repeating this process until August when symptoms seemed to get worse at which point I started to taper down,each time symptoms would improve then slowly start to deteriorate again.

[Deano32]

 

Hi haven't posted in a while so here's an update.

 

I finally settled better on 22.5mg even tho had rocky patches inbetween good periods I decided to do my next drop at the end of February down to 18.75mg had some withdrawals initially but got better best I'd felt in a while managed to get a lot of things sorted out which I'd previously put to one side.

 

About four weeks in at the end of March I started to experience extreme burning in arms and hands followed by extreme dizziness this passed after a week and felt fine again.

 

Was ok ish through April since the beginning of May symptoms have increased and I have not changed dosage since February,I now have anxiety and burning in face and head,loss of appetite also mood has dipped and find it hard to motivate myself to do anything all gloom and doom,strangely my sleep is fine if anything I could sleep all day and night.

 

Just can't understand what's goin on with no dosage change in nearly 3 months and everything goin ok up until now, if anyone has had anything similar or can help me understand what's goin on id be thankful

 

Regards

 

Dean

[Deano32]

Hi haven't posted in a long time managed to get down to 4 mg of mirtazipine has been a bumpy road but somehow made it this far.

Am looking for some advice now though as had to have an operation two weeks ago and was prescribed metronidazole an antibiotic for infection since taking the antibiotic have been suffering severe withdrawals again plus new symptoms am really scared as feel I have gone back to the beginnng, and can feel myself coming apart at the seems can some one give me some advice at what I need to do to rectify my situation please am desperate 

[Starboy17]

Firstly Dean congratulations, with regards to dispensing any advice or suggestions can you provide more information on how you've conducted your tapering? ie were you tapering 10% monthly

[Deano32]

Hi another update and question,im down to 2mg of mirtazipine dropped in october was a normal routine drop with the usual withdrawal pattern,then around november things got alot worse extreme akathisia which lasted a week then dissapeared.

So from mid november to 3rd week of december things where up and down (mood swings)but still managed to cope with day to day things,then on xmas day had a lot of burning sensations in brain on left side which then has gone numb since,so since that day ive been suffering more and more each day.

 

Symptoms currently-

.slight depression

.lack of emotion(numbness left side on forehead)

.burning skin

.horrible taste in mouth 

.cant concentrate on anything

.dizziness

.insomnia

.lack of apetite

 

So i was wondering should i try an updose to relieve symptoms as am nearly non functionable currently?

 

Kind regards 

 

Deano

 

[Deano32]

Hi symptoms have worsened since last post am barely functional now 

My symptoms are-

.left side of brain numb

.right side of brain tingling

.cloudy mind

.needing to pace

.suicidal thinking

.little sleep and waking with burning arms and torso

.not being able to eat

I could really do with some advice and support as this is the worse ive been dont know what to do am desperate

[mstimc]

Hi Deano

I'm not sure I can give you technical advice but your symptoms of needing to pace, insomnia suicidal idealization, and lack of concentration are what I experienced when I was going through withdrawal.  Do you use any kind of coping or behavioral practices to help deal with the feelings?

[Deano32]

Hi mstimc

Im so thankful for the reply ive been going out of my mind,i can usually cope with the symptoms by working or excersicing etc,but this time i find it impossible to do anything to take my mind of it the numbness in my head with the lack of emotions is crippling me,

Do u have any other coping or behavioural practices that may help me?

[mstimc]

Hi

The key is separating your thoughts and feelings from any value.  You can't necessarily stop the thoughts, but if you don't attach any value or judgement to them, you rob them of their power.  One simple and fairly easy practice:  Put on some kind of soothing music you really like.  Lie down or sit comfortably.  Starting with your toes, take stock of your body; think about your toes.  How do they feel in your socks or shoes (or whatever)?  Focus your thoughts on your toes. Then move to your ankles and up your body, just thinking about how each part feels.  When negative thoughts or feelings intrude on yuor body inventory, don't try to ignore or deny them.  Just let them come, but then refocus your thoughts on your point in your body.  Stop when you get to the top of your head.

 

This practice ins't about controlling or eliminating your thoughts.   All you're trying to do is provide a point of reference for your thoughts that isn't negative.  Even if you can't finish the practice, don't treat it as something you need to be "good' at.  You're just telling your brain where to focus for a while,  I'm betting your lack of emotion, besides being a consequence of withdrawal,  may be due in part to the fact you're spending a lot of mental and physical energy on anxious and negative thinking.  Tell yourself you're giving yourself a short break from all the grief, even if its just a couple of minutes.  You are worthy of that. 

[Deano32]

Thank you for the reply i will try that,i really appreciate u giving up your time to reply to me.

I just want these symptoms to end so i can have some stability again

[mstimc]

24 minutes ago, Deano32 said:

Thank you for the reply i will try that,i really appreciate u giving up your time to reply to me.

I just want these symptoms to end so i can have some stability again

I know exactly what you mean and how you feel.  It seems the symptoms will never end or new ones just replace old ones.  But things can and will get better!

[Deano32]

I really hope so,ive had waves and windows while tapering down so far and managed okish but this one seems really harsh and has really floored me but im going to try and be more positive and take your words things can and

will get better,

 

Thank you again

 

[Deano32]

Hi can some one advise the brand of mirtazipine i am currently taking has been discontinued and have been given another brand am i going to be to  ok with this am a little worried ?

[Gridley]

Just now, Deano32 said:

another brand

Do you have any of the old brand left?  We recommend a gradual crossover:

 

3/4 old brand, 1/4 new brand for 3 to 7 days

1/2 old, 1/2 new for 3 to 7 days

1/4, 3/4 new for 3 to 7 days

 

Don't taper during the crossover.  If you don't have any of the old brand and have to do a cold switch, don't taper or make any other changes.  Wait a 2-3 months before continuing to taper.

[Deano32]

Thank you for replying gridley Yes i have just a few left, though bit of a worry as i am already a bit sensitised from previous drop in october.

Is this usual to have to swap brands?

 

 

[Deano32]

Hi just thought id put another update i updosed to 3mg of mirtazipine in january due to severe symptoms appearing and i improved and have been functional all the way to june.

However things have changed again now and symptoms have returned and am struggling again.

Currently i am experiencing

.lack of appetite and dry mouth

.burning skin

.depression and anxiety

.racing thoughts

So really could do with some advise on how to continue foward whether i should reduce dose and see if i improve or updose again?i have been on this dose fir 6 months currently.

[ChessieCat]

How's your sleep?

 

How are you being affected by the Covid-19 situation?  Have you been working from home?  Lost your job?  Been isolated from people?  Financial issues?

 

Is there any other thing that has changed or happened?  Have you been sick?  Have you been drinking alcohol and/or caffeine or consuming more of it than previously?  Any relationship issues?

 

When things worsen it's a good idea to try to work out what might have caused it not related to your drug before considering changing your dose.

 

 

[Deano32]

Hi thank you for the reply,My sleep is ok currently i am managing around 5 hrs a night,

I have been working throughout covid 19 but had the last week off due to bad back,so i have probably had more caffiene than usual,also i havent been excersizing as much due to covid 19,other than that everything has been the same 

 

[DataGuy]

Hi Dean,

 

Glad you are sleeping ok. Doesn't make a lot of sense that you would be stable on that dose for 6 months and then begin experiencing withdrawal symptoms, but it's very possible the caffeine could be an issue. It can really amplify withdrawal symptoms, especially in meds with strong sedative effects like mirtazipine. I am going to suggest you slowly decrease your caffeine intake to zero and see if that helps you stabilize. If you are able to stay away from caffeine for the rest of your withdrawal I think that might make life much easier. 

 

Exercising more is always a great idea if you feel like you can do more. That should help you sleep a bit better and may help to minimize withdrawal symptoms during the day. Just be careful to choose something that doesn't aggravate your back. Swimming might be an option, or biking? 

 

Hope you manage to feel better soon, Deano. Very impressive that you have been able to work through this. 

[Deano32]

Hi dataguy thank you for your response,and i agree it doesnt make sense to me either it feels similar now to when i had all my symptoms in 2015 which made me start withdrawing from mirtazipine just feel like im surviving every day again at the minute,i will cut my caffeine down and see if that helps 

 

Thank you

[Altostrata]

Hello, Deano. Did you accidentally skip any doses? Are you taking any other drugs? Recent antibiotics? Alcohol?

[Deano32]

Hi alto thanks for the reply and yes i did miss one dose just over a week ago,i didnt think too much of it and continued my normal dose the next evening,do you think this could be the reason why im having all these symptoms now?

And no im not taking any other drugs or had recent antibiotics,and i ocassionaly have a beer in the evening

 

[ChessieCat]

1 minute ago, Deano32 said:

yes i did miss one dose just over a week ago,i didnt think too much of it and continued my normal dose the next evening,do you think this could be the reason why im having all these symptoms now?

 

If things worsened after the missed dose, then yes it is most likely the cause.  Especially if that was the only thing different.

[Altostrata]

But do cut back on the caffeine if you have trouble sleeping!

[ChessieCat]

I've just posted this to another member.

 

One good way to reduce caffeine intake is to do a cross taper from caffeine to decaf.  You can make a cup of coffee with a combination of caffeinated and decaf coffee.  Then you don't have to reduce the number of cups of coffee you are drinking but you are reducing the caffeine gradually.

 

Instead of decaf coffee you could use coffee substitute.  I drink decaf during the day but if I have a cuppa after dinner I use a coffee substitute because decaf isn't 100% caffeine free.

[Deano32]

Hi back again with an update continued on same dose since June been up and down had some good days followed by bad days,stayed on same dose to try and stabilise again.

Since Xmas symptoms have ramped up again unfortunately to where they are with me 90 percent of the day and it is becoming a big struggle again to get through the days symptoms currently are

 

.waves of heat through body a few times a day but worse in the morning

. intrusive thoughts

.fast heart rate

.no appetite 

.slight depression and feeling anxious most of the day

.no concentration

.slight pressure above left eye

 

All doom and gloom really so could do with some advice should I updose or decrease med?

Not sure if it's withdrawals or the med making me feel this way some advice would be much appreciated

 

Regards deano

 

[mstimc]

Hi Deano

You made the right move by checking back in.  Support is vital to recovery.  Have you tried any coping/management practices like CBT or diverting your negative thought patterns?

[Deano32]

Thanks for the reply I've been trying to implement some techniques to try and stop the negative spirals but it seems to be getting harder the more symptoms that keep popping up I seem to spend the whole day in some state of anxiety at the moment no matter what I try and symptoms are seeming to increase daily I feel like I haven't made any progress since I started to taper as keep falling back to square one

[mstimc]

I was in very much the same  situation during WD and recovery.  I think all of us have at some point felt we weren't making any progress, or getting worse.  My advice is to keep trying coping skills, and more importantly, don't judge yourself in terms of success or failure.  The more you try to fight anxiety, the worse it gets.  It thrives on attention, and will do its best to drag your thoughts and feelings back to its negative thinking.  Even if you can spend just a few minutes a day practicing some management skills, that's a few minutes you're no longer fighting anxious thoughts; instead you're embracing positive skills.  When anxiety invades your thoughts, bring yourself back to the positive practice without telling yourself you won't recover or you're not doing it right.  I know it sounds way too simple and even a little trite, but over time it really does begin to take the edge off.  Your anxious mind wants you to think you'll never recover--that's what gives it its power. Take that away and it shrinks and eventually dies.

[Deano32]

Thanks for the response and yes I will keep trying it's just so hard when my symptoms ramp up like this.

When I started my taper I was optimistic as with each drop I felt better for a while but it has come to a standstill lately and seems to be going in the wrong direction I've been at this dose for around a year now holding for some stability so I could continue my taper

[mstimc]

It took me almost three years from the start of my taper to where I could say I recovered.  Not every day during the three years was torture--more like a series of gains and setbacks until I could handle everyday situations without excess anxiety.  Check out some of the success stories and you'll find recovery can be quite the roller coaster. You'll make it!