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cactussunset: Nightly Adrenaline Surges after Remeron


cactussunset

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I was posting on another board and it was suggested I join and post here. I was on Remeron/Mirtazipine for about 5 years and then started getting what seemed like severe hypoglycemia especially at night. My doc stopped me way too quickly saying the drug had pooped out and then started me and stopped me on tons of other antidepressants and benzos. I've been off everything for a year and a half but still get horrible adrenaline surges at night and in the morning... Every single night, many times a night. Has anyone had this or know anything about them?? How to manage them? It is very, very debilitating.

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Remeron is a good med, but over time, it will downregulate the alpha-2-receptors, leading to 'enhanced' norepinephrine levels, one way to offset this burst, would be to decrease the overflow of norepinephrine with something like theanine. So that would be my recommendation.

 

http://www.ncbi.nlm.nih.gov/pubmed/14628003

http://www.ncbi.nlm.nih.gov/pubmed/9007838

https://www.researchgate.net/publication/19393044_Effect_of_theanine_on_norepinephrine_and_serotonin_levels_in_rat_brain

 

 

 

Effect of theanine on norepinephrine and serotonin levels in rat brain
ArticleinCHEMICAL & PHARMACEUTICAL BULLETIN 34(7):3053-7 · July 1986with108 Reads
Impact Factor: 1.16 · DOI: 10.1248/cpb.34.3053 · Source: PubMed
 
Abstract

The effects of i.p. administered theanine (L-N-ethylglutamine), a constituent of Japanese green tea, on the levels of norepinephrine (NE) and serotonin (5-HT) in the brain of rats with or without coadministration of caffeine were investigated, and compared with those of glutamine.Theanine decreased the NE level, whereas no change was observed with glutamine or caffeine.The decrease of NE induced by theanine was reversed by caffeine. In rats pretreated with pargline, a monoamine oxidase inhibitor, theanine significantly increased the NE level compared with the control. However, it did not enhance the NE levels increased by caffeine. Thus, theanine may decrease the NE levels by releasing this neurotransmitter.Theanine did not alter the levels of 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) in rats pretreated with or without pargyline, indicating that this amide affects neither 5-HT synthesis nor its degradation. Caffeine increased the levels of 5-HT and 5-HIAA in normal rats to similar extents.This effect was depressed by theanine. In rats pretreated with pargyline, the levels of 5-HT and 5-HIAA were not altered by caffeine, and theanine did not modify the outcome. It may be concluded that the action of theanine is related to the possible inhibition of 5-HT release by caffeine. The effect of glutamine on the levels of 5-HT was somewhat different form that of theanine.

Past AD Experiences : (Fluvoxamine 3 years, D/C'd @ age 15).

Light thinks it travels faster than anything but it is wrong. No matter how fast light travels, it finds the darkness has always got there first, and is waiting for it

~Terry Pratchett~

 

WITHDRAWAL REGIMEN/STORY

Originally for OCD, the luvox took about 6 months to taper off.

Withdrawal supplements; lemon balm, Vitamin B3, black water/fulvic acid, high-protein diet to restore neurotransmitters, aniracetam to counter memory issues, deprenyl for persisting anhedonia.

Regimen still maintained til this day. Lemon balm, generally as capsules, however, as I suffer chronic Insomnia, I often use essential oil or as aromatherapy before bed , in combination with magnesium and lysine on bad nights.

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  • Moderator Emeritus

Hello cactussunset, 

 

I moved your post to create an Intro for you since you are new here.  Your Intro will be seen by more eyes and get more responses.  This is your place to ask questions about your situation, give updates, express concerns, etc.   By clicking Follow above, you will be notified of any responses.

 

Please fill out your signature block so that we can all see your history at a glance; it will show up underneath your posts.  Please put your Withdrawal History in Signature

 

Congratulations for making it to 16 months off Remeron!  What you are experiencing is a very common withdrawal affect.  Has this been going on the entire time, or has it come and gone?  It is actual due to cortisol spikes.  More info on that here:  Sleep problems - that awful withdrawal insomnia

 

There's tons of good info in that topic, so please give a read and then come back here with more questions!  You are definitely not alone!

 

Here's a thread on theanine:  http://survivingantidepressants.org/index.php?/topic/1032-l-theanine-for-anxiety-insomnia/

 

If you try it, try a very tiny amount to start with to be sure that your nervous system doesn't respond with an adverse reaction.  We have found here that a lot of supplements may be great for ordinary folks, but those of us with destabilized nervous systems in recovery may respond paradoxically.

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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Thank you. This has been going on the whole time. It varies it intensity and number of surges a night (sometimes every 45 mins - more frequent at the beginning, other times every few hours). But yes, every single night. :( I had my cortisol tested and it is pretty low due to adrenal fatigue. Could this still be related? Could this ever go away and I get peaceful sleep?

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  • Moderator Emeritus

Interesting point about adrenal fatigue.  I will ask our mod JanCarol about that as she has that, too.  She responded to another member's thread, as he has had a terrible time with night-time surges:

 

http://survivingantidepressants.org/index.php?/topic/10847-rockingchaircat-recovery-from-psychotropic-drugs-that-were-prescribed-willy-nilly/?p=226874

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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  • Administrator

Welcome, cactus.

 

That pattern of surges is very typical of post-acute withdrawal syndrome. How is your sleep otherwise? Do you have any other symptoms?

 

Compared to 6 months ago, how has your symptom pattern changed?

 

Please see our Symptoms and Self-care forum  http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/for suggestions about how to cope with symptoms. There is a topic about theanine there.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

As with anything, try a little bit of one at a time to see how it affects you.
 

 

(Area, what you might find in theory does not always apply to people whose nervous systems have been sensitized by withdrawal. Please don't make such recommendations without appropriate cautions.)
 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator

Hey Cactus - love your name!

 

I'm the "adrenal fatigue" person, and one low cortisol reading does not mean you have adrenal fatigue.  "Adrenal Fatigue" comes in four stages, I, II, III, IV, with the III and IV being life changing.  I lost my thyroid and ovaries to surgeries, which means that my adrenals are really struggling to cover for the deficits.

 

You, however are in withdrawal.

 

Withdrawal, and these drugs, can change all kinds of endocrine numbers, including thyroid, melatonin, pituitary, hormones, adrenal -  well - just about all of them.  In the process of re-regulating from your time on mirtazapine, there may be a period where your adrenals are "acting up."

 

This can manifest as low cortisol, then spikes of cortisol.  Was this a blood test?  Whether you are low or high depends on time of day that you had your blood test done, as cortisol naturally cycles at different times of the day to help you function.  Usually there is a spike just before waking, a lull in the afternoon.  I'm still learning, and being guided by my doctor on management of this.

 

I'm guessing (and I'm really guessing) that a normal, natural adrenal cycle would be gently curved, and a dysregulated cortisol cycle would be spikier, with more extreme peaks and valleys.

 

I reckon that is what you are getting.  Low energy during the day, spikes in the early morning.

 

Like Alto said, this dysregulation is very common in withdrawal, and may not have anything to do with actual difficulty in the adrenals.  Time is the best healer, but you can help with sleep hygiene, diet (no sugar or caffeine, and especially not in combination!), even exercise - walking is the best thing you can do!

 

You may wish to read what others have written about cortisol spikes here:  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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No change in sleep compared with 6 months ago. I do take fish oil but can't handle magnesium. I don't see any benefit to sleep.

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