Jams: I hope to survive Remeron!

[Jams]

During my fifth week of a long hold of Remeron at 4.6, I was suddenly hit with massive anxiety, insomnia, weeping, fog and fatigue.  Now after 5 days of it, I wonder if it could be tolerance withdrawal to Vistaril (Hydroxazine) as I stopped using it after heavy usage for two weeks last month.  I've taken it the last two nights hoping I would feel better but not so.  I've tried to find directions for tapering it but to no avail.  Do you have any here?  And how do I tell if the culprit is Remeron or Vistaril?  Thank you so much.  This has me scared!

[ChessieCat]

I've added vistaril and hydroxyzine tags to your topic.  If you click on them you can find other members with the same tags.

 

Edited September 17, 2017 by ChessieCat
correct spelling

[ChessieCat]

Have you considered that the vistaril may have been masking Remeron issues?

[BuddhaMama]

Hi Jams, Just wanted to connect and let you know I am right there with you in the yucky Remeron taper. Oh man do I hate this drug. Today I found out I have sleep apnea due to the 45 pounds I gained on this drug. I read the beginning of your intro and then jumped to the last page to see how you are now.  I'm sorry you're having such a rough go. 

I'm down to 8.2mg, doing 2% cuts every week. I too experience rage and wanting to throw things. I'm trying lately to really slow myself down when those moments hit me and BREATHE. It's hard, but I've managed to get through the last few without yelling at my daughter or slamming dishes around. Wishing you well in this journey!

[Hibari]

Hi Jams,

 

You have my sympathy regarding getting off Remeron.  It's a powerful medication and it also has strong antihistamine properties.   When I first started tapering it, I was bouncing off the wall with anxiety even though I was on a high dose of Lamictal at the time.   I cried uncontrollably throughout my taper, which was just horrible at times.  I looked up Vistaril and see that it is a strong antihistamine as well.  You may be right that getting of that med this medication maybe momentarily compounding your wd.  

 

It can feel scary but I wanted to share that for a chunk of my withdrawal, I tapered both of my medications at the same time.  And one month I cut both of them twice in one month (not recommending this but I was so frustrated).   It was rocky for about a week and then I did stabilize.  Our bodies and brains can stabilize even after going through traumatic and scary wd symptoms. 

 

You may be at what I've heard called an "oh, oh', point with your med.  I found that I hit certain points of my Remeron journey where it seemed harder to get under a certain dosage than others.  For me it was at 30, 15 and then maybe at 3.  It was like my brain really noticed there was not the same amount of medication at that point.

 

You will get through this and you doing everything you can.

 

Hibari

 

[Hibari]

11 hours ago, BuddhaMama said:

Hi Jams, Just wanted to connect and let you know I am right there with you in the yucky Remeron taper. Oh man do I hate this drug. Today I found out I have sleep apnea due to the 45 pounds I gained on this drug. I read the beginning of your intro and then jumped to the last page to see how you are now.  I'm sorry you're having such a rough go. 

I'm down to 8.2mg, doing 2% cuts every week. I too experience rage and wanting to throw things. I'm trying lately to really slow myself down when those moments hit me and BREATHE. It's hard, but I've managed to get through the last few without yelling at my daughter or slamming dishes around. Wishing you well in this journey!

Hi BuddhaMama,

 

I wanted to offer encouragement about Remeron weight gain.  It was something that upset me so much and worried me during my taper.   I gained 30lbs on the drug and since coming off, I have lost 22lbs without effort.  It started to shrift when I got below 10mgs and then picked up after I stopped the med.   The last 8lbs may take a little more effort or they may drop too when I get off the remaining amount of Lamical I am on.  Both drugs are sedating so it makes sense that would occur. 

 

There is hope. 

[Jams]

Thanks for your encouragement, Bhudda Mama!  I've been thin all my life...eat like a horse without much weight-gain to show for it.  So I'm actually pleased with the small gains I've made during my Remeron taper.  But that's the ONLY good thing about Rem for me!!  Sounds like you're doing great on your taper. to come down to 8.2 from such a high dose!  I, too, tapered off Klonopin but had such excruciating w/d at the end, I went to a center where they added FOUR meds, Rem being one of them.  Wish I'd known about Lamictal.  Oh well.  Thanks again, and I wish you well!

 

I just read your other comments about your Remeron taper and how hard it was.  Thank you so much for taking the time to share your difficulties with me as they confirm that I'm not alone with these problems.  How did you feel after finally stopping Rem at .025??  Oh, and I wondered if you know how best to taper off Vistaril, 50 mg.  I'd like to do a relatively quick taper if possible.  I don't want to drop both at the same time cuz then I wouldn't know what was causing what.  Thanks again!! 

[Jams]

19 hours ago, ChessieCat said:

I've added vistaril and hydroxyzine tags to your topic.  If you click on them you can find other members with the same tags.

 

 

Hi, Chessie Cat.  Thanks for the tag.  I did a search but found nothing so far about how to taper vistaril, so I'll make up my own liquid taper.  Last night after retaking Vistaril for 7 days, withdrawal finally began to slow to a stop.  So it's clear to me that my unwitting cold turkey of it caused my symptoms...thank God.  My worst fear is not knowing what is causing severe w/d.  PEACE.  

[Hibari]

5 hours ago, Jams said:

Thanks for your encouragement, Bhudda Mama!  I've been thin all my life...eat like a horse without much weight-gain to show for it.  So I'm actually pleased with the small gains I've made during my Remeron taper.  But that's the ONLY good thing about Rem for me!!  Sounds like you're doing great on your taper. to come down to 8.2 from such a high dose!  I, too, tapered off Klonopin but had such excruciating w/d at the end, I went to a center where they added FOUR meds, Rem being one of them.  Wish I'd known about Lamictal.  Oh well.  Thanks again, and I wish you well!

 

I just read your other comments about your Remeron taper and how hard it was.  Thank you so much for taking the time to share your difficulties with me as they confirm that I'm not alone with these problems.  How did you feel after finally stopping Rem at .025??  Oh, and I wondered if you know how best to taper off Vistaril, 50 mg.  I'd like to do a relatively quick taper if possible.  I don't want to drop both at the same time cuz then I wouldn't know what was causing what.  Thanks again!! 

When i stooped at 0.025 I had about a week of nightly sweating where I woke up drenched.  My mood was low and I almost reinstated because it was hard.  It might have been better for me to jump off at a lower dose but my spirit was despondent.  I don't mean wd despondent, I mean I was worn out from the process and made the choice to ride out the consequences.  I also do ongoing acupuncture treatments, which was very helpful. 

 

The early morning (about 3am where I thought I was going to reinstate) was a night of anxiety and deep sweating.  I fell back asleep and when I work up at about 8am, something had lifted and shifted.  I wasn't on top of the world but I felt I had made it through the storm.  I was functional, and that's how I was for about 3 weeks.  It got better and better.   I waited about 3 months and then started down on my Lamictal (had tried to start it earlier but it was too much for my nervous system).   

 

I have remained functional, with periods of despair shortly after cutting my current medication but I know I will not have to reinstate Remeron. 

 

I can't advise you on coming of of Vistaril, it's unfamiliar to me.  I was always advised to cut the medication that was making me the sickest.  In my case, it was Remeron.

 

Hibari

 

 

 

[Jams]

So good to hear about your healing only a week after stopping at .025.  Gives me hope...although that's a long way off for me.  And the problem is that I'm already tired of the process having been at this for 9 years in total.  But I'm a fighter and won't let it stop me.  I feel so much better today, I know I'll be okay for now.  Thanks again for you time ... and kind replies, Hibari.

[Jams]

Regarding Remeron, I keep hearing from admins of other groups that an up-dose must be made within 3 weeks of the most recent cut.  However, I know of people who have up-dosed successfully after that time frame.  I understand everyone's different, but what's the consensus about that here?  Thanks so much!

[ChessieCat]

Please read Post #1 of this topic.  It is about reinstating but is applicable to updosing:

 

About reinstating and stabilizing to reduce withdrawal symptoms

[Jams]

Thanks, ChessieCat.  Very helpful information!

[Jams]

I'm down to 4.4 Rem, but experiencing some peripheral edema in my feet and ankles due to Gabapentin, I believe.  I've had pins and needles and numbness in my feet since day one of GP.  If I hold Rem and begin to taper GP, will it cause problems with Remeron?  I read an article from The Road Back that advised we taper the antidepressant that follows the fewest brain pathways, and that would be GP.  What do you think?  I'm pretty sensitive and don't want to make things worse.  I'm doing okay right now, other than the edema.  Thank you.

[ChessieCat]

3 hours ago, Jams said:

I've had pins and needles and numbness in my feet since day one of GP.

 

I've just checked up the side effects of gabapentin https://www.drugs.com/gabapentin.html

 

Under the heading:  Gabapentin side effects

 

Call your doctor at once if you have:

• severe tingling or numbness;

• kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;

 

It could well be that it is the gabapentin which is causing both issues.

 

Q:  How is your sleep?

 

Please update your signature with date and dose for your last reduction.  Thanks.

 

If it's been at least 4 weeks since your last reduction of Remeron, you could always try a very small reduction of the gabapentin.  I can't see what dose of gabapentin you are currently taking so I can't make a dose suggestion.  However you could try 1% or 2% reduction and see how things go for you.  If it were me, I'd be doing no more than 1%.  This topic has some helpful suggestions.

 

Rhi's "Start Small, Listen to Your Body" Taper Plan

[Jams]

Thanks, Chessie.  I plan on doing a small drop of Gabapentin this week.  I'll let you know how it goes.

 

I added my last drop and my earlier dose drop of GP to 200 mg.

 

My sleep is good because I'm using cannabis.

 

Appreciate all your help!

 

Jo

[Jams]

Hello....

 

I hope someone sees this and responds.  I feel kind of isolated, and I still have trouble using the site.  Always takes me a while to find this spot to post a question, and I don't know if my replies reach the people they're for.

 

I've had increased anxiety, agitation, insomnia, and frightening visions of death/dying (I'm 70) every other day since 12/28.  Also, a new SCARY symptom, a pounding heart, at night a few nights, the worst 1/3/18, for which I took a 20 mg Propranolol that calmed everything down with sleep still difficult.  I'm not sure what caused it all.  I know I fiddled with things mercilessly in December, but I've since backed off and come to my senses.  Many told me Gabapentin was easier to taper, so I plunged right in...mistake.  I've also been concerned for a while now that Kavinace Ultra PM might be causing serotonin syndrome or a precursor to it since it contains 5HTP. The literature is so vague on frequency and types of S.S. symptoms, it's hard to decide.  My symptoms are intermittent but horrendous.  I'd like to taper off it, but don't know how.  And now my symptoms are forcing me to stop tapering at all.  

 

Thank you in advance for any helpful suggestions.        

[brassmonkey]

Hi Jams-- sorry to hear that you're feeling isolated here.  From time to time the traffic on an individual thread can fall off and give that impression.  Dropping in on other peoples threads and saying Hi is a great way to increase traffic here. At the top of each page of any thread just click "reply to this topic" or at the bottom of the page there will be "reply frame" that you can click in and that will post directly to that thread. Most members have automatic notifications set up so they will know if you posted there.  

 

At the top of any page of your intro thread (this thread) is a box marked "follow".  Click that.  Then when you want to find this thread again go to Activity/Activity Streams/Content I Follow and you should be able to find it right away, or click on your name/manage my followed accounts and you'll find it. That's how I keep track of my intro thread.

 

How long have you been taking the Kavinace Ultra PM?  I'm betting that it's a large part of the problems you've been having lately.  All the changes you've done in the past several months aren't helping either.  The Kavinace has three main ingredients. The amino acid is commonly referred to as Phenibut and is a big no-no for people tapering psych drugs. It's almost a direct replacement for the Gabapentin and it interacts badly with just about everything and can cause many of the symptoms that you talk about.  5HTP should also be avoided by people tapering  psych drugs for the same reasons.  It's not as strong a Phenibut but very unpredictable in how people react to it. We recommend that members avoid taking either of these.  Melatonin is fine to use, but must be handled with care as it is also unpredictable in it's affects. We don't have any direct experience tapering anyone off of the Kavinace but I would think a straight taper of 25% every two weeks should work.  I would then allow several weeks to a couple of months for things to stabilize before continuing any sort of taper.  That would give time for the Kavinace to settle out along with the effects of the past several months of playing with your dose.

 

The symptoms that you describe sound quite distressing, I've had most of them and didn't enjoy it in the least.  But I think if you make the changes I suggest things will stabilize and calm down quite a bit.

 

Brassmonkey

[Jams]

Hi Brassmonkey,

 

Thanks for your kind reply.

 

I've used Kavinace Ultra PM for 4 years now...through my Klonopin, Valium, and Trazodone tapers.  It's helped me sleep like nothing else would.  That, along with my severe withdrawal when I cut it in half recently make me hesitant to taper the supplement.  But if it will make my Remeron taper easier, then I guess I have no choice.  People warned me about it, but I clung to it for dear life.  Since I've used it so long, perhaps I should taper more slowly.  I feel somewhat better, but still on edge, and the smallest of things can trigger me.  I'm feeling pretty hopeless - that I'll never taper off this drug completely but die in harness.

 

Thank you for helping me navigate the site better. 

[Jams]

May I take Remeron in the morning???  I have so much anxiety/fear in the evening after I take it.  Is there a way to gradually shift my nighttime dose to the morning?  Is it okay to take with food (breakfast or lunch)?  Thank you so much!

Jolene

[Jams]

Is it okay to take Remeron in the morning or at lunch (with or without food?)?  And is there a way of gradually shifting the evening dose to morning without withdrawal??  I get too much fear/anxiety at night to fall asleep!  Thank you!

[ChessieCat]

Hi Jams,

 

Not sure about taking with/without food.  If you wish to change your dose time the best way is to move it by 1 hour each day until you are at the time you want to take it.

 

Just putting this forward as a "thinking outside the box" thought (with the idea that it might help to reduce the anxiety by not taking the full dose at one time):  only moving 1/2 the dose forward by 1 hour each day or every few days, and keep notes on paper to see if there is an improvement in the anxiety.  As I said, this is just a thought which I have put forward.

[Jams]

Wow!  Great minds think alike!  I thought of the hour plan, too.  But splitting the dose hadn't occurred to me, and it might be the safer option.  Any fiddling with Rem scares the heck out of me, so I'll approach this change cautiously.  Thanks for thinking 'out of the box' with me!

[ChessieCat]

The moving by an hour is an SA recommendation.  But that probably won't help with the anxiety that taking the full dose causes, it's just going to change the time you get it but at least it would not be at bed time.

 

Before making any dose time changes I suggest you check out this topic because good sleep hygiene can help:  Sleep problems - that awful withdrawal insomnia

 

Whatever you decide to do, I suggest setting a reminder on your phone so that you don't miss doses.  You don't want to add that problem when trying to fix another!  Also, ensure you only make 1 change at a time.  And keep daily notes on paper of dose times and symptoms so you can see if there is a pattern.

 

More thinking out loud:  You might find that even just taking doses 1 hour apart might be enough so if you do try splitting the dose if it were me I'd give 1 hour earlier a few days try.  If after trying splitting the dose you still experience issues with anxiety at night you could always move the later dose forward by 1 hour and you could join it back to 1 dose if that worked and was more convenient for you.

[samanthaelizabeth]

On 8/16/2016 at 8:21 PM, Hopefull said:

Hi Jams,

Mitrazapine is a tricky customer.

I have been tappering off Mirtazapine for almost 2 years.

Soltab 15mg tablets are the easiest way to get off Mirtazapine.

You can make your own liquid Mitrazapine using Soltab tablets.

Dissolve 15mg tablet in 15mls of water.

Draw out with a syringe the amount that you need.

I also chrashed when I got down to 5mg.

Hold the current dose that you are on until you feel stable.

I gave my self a break from tappering for about 5 months.

You will get there, it might take a while.

Best of luck, Hopefull.

How do you measure 15mls of water?  Where do I get the syringe.. I have been on Remeron also.  Thank you!

[Jams]

Thanks for your ideas, Chessie.  I'll consider the dosing split by an hour as I'd do that anyway to start the process, and I'll give it a few days.  I already keep detailed notes.  I'm familiar with sleep hygiene and use white noise, but I appreciate the mention of additional noise devices in the thread you posted for me.  It IS okay to take Rem with food, but I don't know if it will have a different effect from my normal empty-tummy dosing.  Time will tell.  

[Survivor1]

Hello Jams,

 

I wanted to reach out to you because I am in a similar situation to yours.  I am on Trazodone and a small dose of seroquel.  Together they are causing me a lot of suffering with SS issues.  Severe body twitching, rapid heart rate, insomnia, sweating,  I was also on remeron and all together caused me such hell that I ct' remeron at 2.4 mg.  By some miracle I was able to sleep on the remaining trazodone and seroquel, until I stabilized a week ago (took 8 months).

 

 Now though, not so lucky.  The SS has returned (well it was always there but I was able to sleep through it somehow), although not as severe as when on the remeron.  My seroquel dosage is so ridiculously small, it is hard to believe it is causing SS with trazodone.  I tried decreasing trazodone, but no luck; I am now in WD from that.  Through some frantic research, I only figured out yesterday that it is the combo that is the issue.  So, last night I did not take the seroquel, and guess what, the twitching, racing heart, sweating were gone!!  I still had insomnia though, I guess because I was missing the seroquel.  Now, I too am trying to shift the seroquel to the morning.  This morning I took the first morning dose of seroquel after missing it last night (had faint SS issues during the day).  Tonight I will be able to tell definitively if it works.  (May have to updose the Trazodone and stabilize also.)

 

I wanted to let you know that earlier I too tried splitting the remeron dose, but for me it did not work.  I think splitting is the issue. Still had SS.  I believe that as long as you take two serotonergic drugs at the same time you will have issues.  Since you will be taking the Kavinace and part remeron at the same time, you may still have the SS.  

 

Is it easier to shift the kavinace (all of it)?  That way you could keep the all the remeron at night and hopefully sleep.  Also you may have less WD from the Kav shift than the remeron shift. Just a thought.

 

When I shifted 1 mg remeron to morning, I was quite sedated during the day.  I think you should shift whichever is less sedating (I would assume that to be Kav, but you know better).  Whichever you decide to shift, I would advise do all of it, not part.

 

I feel for you.  I am going on my 5th day of 2-3 hour sleep.  Don't know how I'm doing it since I also have two teenagers.  

 

Take care.

[Jams]

Oh, my goodness, Survivor!  Thank you so much for taking the time to reply with such detail!  And I'm sorry you've had to endure a rough road, too!  I've been concerned about the possibility of SS but didn't think my symptoms qualified.  I only get fearful and anxious after I take Remeron, so I've assumed it's the adrenaline component kicking in.  Occasionally, I'll get the heart pounding and a brief bit of sweating...maybe warning signs?  Clinically speaking, how do you tell if you have it?  I hadn't thought of shifting the Kavinace to an earlier time, but I think I need to do that.  I tried cutting it in half but suffered horrendous w/d.  Tried a tiny bit later...but no go.  So I'm definitely going to try shifting it to breakfast or lunch...not sure which...and see how I do.  Thanks for the idea.  This whole ordeal is ridiculous, isn't it?  Thanks again.  You might be a life-saver!  Oh, and PLEASE let me know how it goes with your shift.  Thanks!  

[Survivor1]

Jams,

 

Last night, I slept 6 hours!  No racing heart, jerking and twitching reduced by 80%.  Did have some sweating.  I still want to wait a few more days before I declare victory, but things are definitely looking up 

 

After a few days of this, I will make a detailed post in my thread.

 

Another piece of advice:  move the Kav to as early as possible.  That way, more of it dissipates by the time you are ready to take the remeron.  Hope it works for you!

[Jams]

Thanks for the update...wonderful news!  I understand your cautious optimism, but it does seem to be your answer.  I realized that I can't take the Kavinace too early because it contains melatonin.  I took it at 7:45 last night and felt its extreme sedative effects, but later I felt them start to wear off, and I kept waking up.  So tonight I'll take it at 9 and see how that goes.  The good news is that I had 90% less anxiety last night and feel less fog/fatigue today, so I think we're onto something.  I also take 200 mg Gabapentin and wondered if taking it earlier in the day might help or hurt.  I promise I won't keep asking questions.  I do seem to need a boatload of supps/meds to sleep, maybe because my brain is dependent on them now.  Thanks again for your kind help.

[Survivor1]

If taking the Kav at 9 does not improve the symptoms, go back to earlier.  If at the earlier time you are still getting insomnia, it means that the two drugs are still interacting and you will have to eliminate one or try moving even earlier (despite one having melatonin). 

 

Note that I feel a bit groggy on the minute seroquel dose when I take it in the morning.  This may be something you will have to deal with until you are able to eliminate one drug.  I also still have some SS issues during the day; I guess there is enough trazodone remaining in the morning from the night before, to interact with the seroquel.  But since I am not trying to sleep during the day it is not as much an issue.  (I tried napping one day, and could feel strongish jerks.)

 

I don't know if the gabapentin is the issue. It acts on different receptors (gaba instead of serotonin).  

 

Let me know how it goes.

 

[Jams]

Survivor, I just wanted to tell you that the good anxiety-free sleep continues.  9 PM seems to be the 'sweet spot' for the Kavinace.  Such magnificent relief after YEARS of needless suffering.  But it's a new dawn.  Thanks again for your help...I am so grateful to you!  And I hope you're doing equally as well.

[Survivor1]

Great news Jams!

 

I wanted to caution you that this relief could be short-lived if you continue with the Kav.  My advice would be to start reducing Kav as fast but as safely as possible.  The Remeron dose you are on should be enough to be sedating.  Do not risk any more interaction.

 

All the best!

[Jams]

I wondered if my current HORRIBLE withdrawal (TONS of anxiety/insomnia) could be the result of a too large cut (3%) May 26 followed by an updose of 1 1/2% on June 6th to correct.  I've had a few rough nights since then but not too bad until June 23 (about a month after the mistake 5/26).  Now I shake with anxiety all night long with zero sleep and feel trashed and anxious all day, too.  At 70, this is incredibly hard on me.  

 

I haven't moved Kavinace Ultra PM to an earlier time since my experiment with that back in February.  And as you expected, the relief was short-lived.  But then I started feeling better, so I went back to my old schedule.  I still don't know if I have serotonin syndrome or not.  Seems if it was SS, I'd have symptoms everyday, but I don't (or didn't til my last updose.  I already take the Kavinace 1 hour earlier than Rem and GP, and I still have crazy anxiety after my Rem dose.  If I start reducing the Kavinace while my symptoms are still so volatile, won't it make everything even worse? 

 

There's also cannabis in the mix...oy vey!  I vape once and take only 7-10 mg THC edible (cookie) about half an hour after the Kavinace and about an hour prior to Gabapentin.  Not sure if that's interfering or not, but I suspect that it may.   Although I've used it for a few years, in recent months I've been forced to reduce it a few times.  I used to have to vape 4-6 times and eat 30+ mg edible, but I'd get too high and couldn't sleep, so I guess I'm gradually weaning off it.  However, some nights I feel like I haven't had enough cannabis to sleep...I'm so CONFUSED!  

 

I hope this made sense...I'm completely out of it!  I'd appreciate your opinions...thank you!

Jams    

 

  

 

   

[ChessieCat]

It's best to only make 1 change at a time:  Keep it Simple, Slow and Stable

[Jams]

Thanks Chessie.

 

Is it common to experience w/d 3 weeks after a correction of a mistake?

 

Is anxiety common after each dose of Remeron, apart from tapering?

 

Does cannabis interfere with Remeron?

 

I should have worded my concerns this way...simply.  Thanks again!