MNMOM - Withdrawing from Mirtazapine

[MNMOM]

Hi All,

I am currently trying to stabilize on Mirtazapine after too quick of a taper.  I started on Mirtazapine in October and felt great at first, but then noticed over time that I always felt groggy and had blurred vision.  At first, I thought that these symptoms were due to anxiety and so I increased my dose from 15 mg to 22.5 mg.  I felt worse right away, with increased anxiety.  I went back down to 15 mg for 4 days and wasn't feeling any better and so I tried to taper off over 1.5 months.  I felt pretty horrible throughout the taper but thought that I was getting side effects from the medication so I kept going.  On the 4th day of going off, full withdrawals hit me.  I felt flu-like with extreme joint pain, burning feet, numb tongue, brain fog, adrenaline surges, nausea, blurred vision, increased heart rate...I can probably think of a few more.  I also felt very anxious and depressed, and had to call the crisis line here.  I went back on 3.75 and have been on that amount for 3 nights.  The achy joints are gone but I'm still struggling with some of the physical withdrawals symptoms.  I'm planning on staying on this dose for a long time, until I stabilize, before even thinking of reducing.  I'm concerned though that I'll never stabilize and would just like some reassurance that this won't happen.  My life is on hold right now and I have a toddler to take care of.  

 

Also, A little background info: I have been on Celexa and Zoloft for 7 years on and off.  I was on Celexa while pregnant and after having my daughter in the fall of 2013, started getting strange physical symptoms, especially burning legs (possibly paresthesia), brain fog, nausea.  And so I decided to taper off.  I felt somewhat better after going off but may have had some protracted withdrawal symptoms since then.  So it appears that I am very sensitive to medication now.    

[Petunia]

Welcome NNMOM,

I'm glad you found us, this is the best resource on the internet for help and support for coming off psychiatric drugs safely.

 

You have 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 good that you have reinstated and it sounds like 3.75 is helping, this may be enough to stop the symptoms, or you may need to updose a little higher, but time will tell. Stabilization can take anywhere from a few weeks to several months. Then when you are ready, you will be able to begin a proper taper. Here are a few more links which will be helpful:

 

About reinstating and stabilizing to stop withdrawal symptoms

 

Tips for tapering off Remeron (mirtazapine)

 

Please feel free to write whenever you want, and ask any questions here in your thread, you will find a lot of friendly help and support here. Thank you for filling in your signature.

 

Petunia.

[MNMOM]

Thank you Petunia,

I'm now on my 4th day of 3.75 and feel like I'm slowly feeling better.  I feel slightly spacey/brain fog and some physical symptoms (burning foot nerve pain, restless legs, nausea).  I have been sleeping though since reinstating.  I guess I could use some hope though that I will eventually stabilize.

[AliG]

 M.   The fact that you were only off for a week , and them reinstated , is a positive move.  Also , that you are already feeling better , is a good sign .  You might have to updose , a little , in the future  but not necessarily .   Keep track of your symptoms over this period of time , and hopefully if you stay even  you can taper off slowly after a good period of stability . You will stabilize. It might take some time, though . 

 

Rate symptoms daily to track patterns and progress

 

http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

Ali

[MNMOM]

Thanks AliG,

I hope that I keep feeling better. It's interesting how the symptoms can wax and wane.  I'm currently having some body chills.  How long do you give it before up-dosing?  A few weeks?  I was just reading the reinstatement topic, which has been very enlightening.    

[AliG]

M.    I would hope that you don't have to do that .   Maybe, look at  6 weeks, to stabilize , a little.  That would be a last resort .  ( updose ) .  I would think more about your tapering schedule , for getting off ( tapering ) in a slow & steady fashion , using the 10% taper method .

Symptoms do " wax & wane " .  That is the pattern .

 

The Windows and Waves Pattern of Stabilization

 

Ali

[MNMOM]

Quick question: I'm currently taking 3.75 mg by splitting an unscored 7.5 pill in half.  Is this accurate enough or would switching to liquid give a more exact dose?  My psychiatrist will prescribe me a compounded liquid when I start to taper, which I'm not planning on anytime soon.

[Fresh]

Hi MNOM ,   good question.   Cutting unscored tablets  isn't really accurate enough at these small doses.  

If you're off by 1/2 mg either side  , it means you're bouncing between 3.25 and 4.25 day to day.

 

You can make your own liquid for precision dosing , or weigh it on a digital jewellers' scale.

To make a liquid solution , you dissolve one 7.5mg tablet in 7.5mls of water , and draw up 3.75mls with an oral syringe.

See "How to Make Liquids From Tablets or Capsules" here http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

Here's the thread on Using Digital Scales  http://survivingantidepressants.org/index.php?/topic/1596-using-a-digital-scale-to-measure-doses/

and this may be helpful too , http://survivingantidepressants.org/index.php?/topic/235-using-an-oral-syringe-and-other-tapering-techniques/

 

bw ,  Fresh

[MNMOM]

Advice please...I've reinstated Remeron at 3.75 for 9 days after too quick of a taper. I'm still feeling spacey with blurred vision, foot burning nerve pain, restless legs, and very anxious. I'm getting constant adrenaline surges during the day and am trying everything I can do to calm them down - meditation, magnesium, lots of water, etc. I guess it feels like akathesia and it's making it hard for me to do anything - I feel like I'm constantly having a panic attack. I'm thinking about increasing my dose but am not sure. I have some vistaril that my primary care doctor gave me which I've never tried. I am sleeping ok once I take my Remeron dose at night.

 

I'm wondering if I should try to ride this out awhile longer, updose, or try the vistaril?

[ChessieCat]

Hi MNMOM,

 

I sent through a request for the more experienced mods to offer their opinion on this.  I suggest you hold off changing anything until you get a response.

[Fresh]

Hi Mnmom ,  

On 23 March you wrote: "I'm now on my 4th day of 3.75 and feel like I'm slowly feeling better "

 

Since then , have things continued to improve , stalled , or gotten worse?  

Are you taking a liquid dose ?

 

Re vistaril , this is the interaction report from www.drugs.com:

 

Interactions between your selected drugs

Moderate hydroxyzine  mirtazapine

Applies to: Vistaril (hydroxyzine), Remeron (mirtazapine)

Using hydrOXYzine together with mirtazapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.

[MNMOM]

I feel like my symptoms have stalled.  I'm not having the flu-like symptoms (joint pain, temp dysregulation) or insomnia that I have when I jumped off.  But I'm having adrenaline surges and akathesia that seems to hit during the day, early afternoon.  It feels like a panicky/jittery sensation.  It seems to start when it feels like the Remeron is wearing off.  When I first wake up in the morning, I'm pretty groggy which wears off as the day progresses.  I also get burning foot pain and restless legs that seems worse with the adrenaline surges. 

 

I've been making my own liquid.  

[MNMOM]

Advice please?

[Fresh]

" It seems to start when it feels like the Remeron is wearing off"

 

That would indicate to me that you may need to go up a little higher , maybe to 4.25?

This is where it's an advantage to be using liquid , you can go up in tiny increments.

You'll need to give it 4 days to reach a steady state in your blood stream then reassess.

 

How does that sound?

 

Please could you add the dose you were taking when you started tapering in February.

 

Thanks , Fresh

[MNMOM]

Thanks Fresh  - I think I'll try up dosing.  I thought maybe I could stabilize at 3.75 but it doesn't seem to be enough.  

 

I just added that I was on 15 mg to my signature - sorry I missed that1