heatherjc: Mirtazipine withdrawal how long?

[heatherjc]

Note by ChessieCat:  heatherjc aka cakemaster - 3 topics have now been merged into one

_________________________________________________________________________

 

** merged from previously commenced topic  **

 

Hi I have been lurking here for a while, been on Seroxat for almost 20 years, last few months been doing ok then tonight out of the blue Severe ANXIety/panic, just recently picked up my latest script, now I KNOW I CANNOT tolerate any generic as its taken me to hell in the past so my script is always BRAND NAME SEROXAT & thats what I have, but feeling exactly like when I have taken generic in the past, just checked & I am on day 4 of new script, the day when any changes are felt, so have studied the patient Info leaflet, its all exactly the same except its was updated August 2014, the precious pack I had was updated Sept 2013.

 

I am convinced something is different, so just wanted to reach out in case anyone else UK based has noticed any difference??

Edited November 7, 2016 by ChessieCat

[dalsaan]

** merged from previously commenced topic  **

 

Hi Heatherjc,

 

Thanks for popping up.  I have changed the title of your post to make it your personal thread given you posted in the intro section.  This is where you can come to for advice, document what's happening to you etc.

 

We have a forum for UK members in the relationship section, you might want to copy and paste your post in there  - http://survivingantidepressants.org/index.php?/topic/6285-great-britain-members-please-check-in-here/

 

Can I ask you to fill out your signature - its a short hand version of your drug history that is visible whenever you post.  Makes it a lot easier for people to quickly understand where you are coming from.  Details on how to do that are here - http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Dalsaan

Edited November 7, 2016 by ChessieCat

[Petunia]

** merged from previously commenced topic  **

 

Hi Heather,

How are you feeling now? Is Seroxat the only medication you are taking?

Edited November 7, 2016 by ChessieCat

[oskcajga]

** merged from previously commenced topic  **

 

Hi I have been lurking here for a while, been on Seroxat for almost 20 years, last few months been doing ok then tonight out of the blue Severe ANXIety/panic, just recently picked up my latest script, now I KNOW I CANNOT tolerate any generic as its taken me to hell in the past so my script is always BRAND NAME SEROXAT & thats what I have, but feeling exactly like when I have taken generic in the past, just checked & I am on day 4 of new script, the day when any changes are felt, so have studied the patient Info leaflet, its all exactly the same except its was updated August 2014, the precious pack I had was updated Sept 2013.

 

I am convinced something is different, so just wanted to reach out in case anyone else UK based has noticed any difference??

 

I've heard of this sort of thing before.  It's not unknown.  Generic vs. brand.  20 years is a long time.  I'm sure you're aware of all the dangers related the the medication that you're taking and that the correct and least harmful way to stop taking it is by reducing very slowly over a very long period of time.  I wish you the best of luck.

Edited November 7, 2016 by ChessieCat

[Guest cakemaster]

** merged from cakemaster (nowHeatherjc) topic  **

 

Hello all, just wanted to know if it was possible to have symptoms after missing a single dose? Been ok for ages but feeling terrible today. anxious, shaky, headaches, head pressure & weakness, I missed my 15mg of Mirtazipine last night thats all I can think of but surely just forgetting one dose wouldn't cause all of this? Thank you in advance

Cakemaster x

Edited November 7, 2016 by ChessieCat

[FunkyBaboon]

** merged from cakemaster (nowHeatherjc) topic  **

 

Hey cakemaster

 

Welcome to the forum!

 

I'd have thought that the Paxil would buffer you somewhat against a missed dose on the Mirtazipine but in my experience a missed dose can certainly cause symptoms like the ones you're describing.

 

I'll wait for the mods to come along to give you some more advice.

 

Once your blood levels stabilise over the next few days you should start feeling better again.

 

Funky

Edited November 7, 2016 by ChessieCat

[brassmonkey]

** merged from cakemaster (nowHeatherjc) topic  **

 

Hi Cakemaster-- welcome to the group.  The other FunkyMonkey pretty well hit it. It doesn't happen to everyone but, yes missing one dose can really upset things.  Once you get back on your regular schedule for a few days things should settle down.

 

I am concerned that you are taking both Paxil and Mirtazapine at the same time.  They are well known to not play well together and your doctor should have known better than to combine them.  Other than the symptoms from the missed dose how have you been feeling?

Edited November 7, 2016 by ChessieCat

[heatherjc]

Hi I tapered off 15mg mirtazipine over 6 months been off now for 3 weeks felt great til last night now back to square one before I began taking it cant believe I am back here after everything I have taken up running given up alcohol did all right things is it my original symptoms or withdrawal?

Edited October 25, 2016 by scallywag
tags

[jmncrr]

You might of tapered too fast according to this website, its 10% of reduced dose every 3 to 4 weeks. From what i have read here withdrawal can be delayed. You also may have jumped off your last dose on too high of a dose. The experts at this website will know better. One of them will help you soon.

[scallywag]

heatherjc -- Welcome to Surviving Antidepressants (SA)
 
I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly?

• Please include all medications -- prescription, over the counter, or street drugs -- that you take for ANY reason.
• Any drugs prior to 18 months ago can just be listed with start and stop years.
• You don't need to include symptoms or diagnoses other than the initial condition that led to prescribing the first drug.
• We ask for this information in your signature so that we can see it at a glance. A list is easier to understand than one or multiple paragraphs.
• You can find instructions in this topic: Please put your withdrawal history in signature
• if you are using a phone, the phone instructions are in the same thread but in Post #8; and Post #9

You can read about withdrawal syndrome and its symptoms in this topic:
What is withdrawal syndrome
 
It's very common for people who have fast tapered off a medication to have a period of several weeks where they feel wonderful and then all of a sudden symptoms appear. "Fast taper," you say, "I took 6 months!" Although you took six months to taper off a dose of 15 mg of mirtazapine, you may have gone too fast for your CNS (central nervous system). Most people do well with a much slower rate of reduction -- reducing by less than 10% of previous dose monthly.
Why taper by 10% of my dosage?

The information at these 2 links might help explain what happens when your CNS has to "un-adapt" itself when a neuroactive medication such as mirtazapine is discontinued:
How your brain responds to psychiatric drugs - aka "Brain remodeling"
Youtube video, 4 minutes: Healing from antidepressants

The best way to deal with withdrawal symptoms is to reinstate a very small dose of the drug you discontinued, mirtazapine in your case. It works for many people but not for all. The likelihood is higher in your situatoin because your last dose was only 3 weeks ago and you only just now started having symptoms. Please read this topic to understand the potential benefits and risks of reinstatement:
About reinstating and stabilizing to reduce withdrawal symptoms
 
Please do not reinstate any mirtazapine, and especially not 15 mg. Let us know if you would to reinstate the mirtazapine. After we have your medication and withdrawal history in signature and a post from you saying you would like to reinstate, we'll suggest a dose for you to consider.  The decision to reinstate (RI) is always, always your choice.

You may find the posts in this topic informative:
Tips for tapering off Remeron (mirtazapine)

 

This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. 

 

Let us know how you're doing and what your thoughts and questions about reinstating.

[Hibari]

Hi I tapered off 15mg mirtazipine over 6 months been off now for 3 weeks felt great til last night now back to square one before I began taking it cant believe I am back here after everything I have taken up running given up alcohol did all right things is it my original symptoms or withdrawal?

Remeron wd for me and many people hits in a delayed fashion.  I used to feel the major symptoms between 2-3 weeks after cuts.  It's gotten a bit better but there has always been this delay.  Most times it would last 3-5 days and then I would slowly stabilize.  You may be experiencing that delayed reaction.  

[heatherjc]

Ok I am back, is anyone available for a chat? . Am 5 weeks off mirtazipine after 7 months tapering off 15mg. Sorry cant add signature on my phone so that is the short version, I feel terrible

[scallywag]

It's difficult for us to assist you or direct you to possibly useful information with so few details about your meds history and about your current symptoms.

 

Here are 2 posts that explain how to create a signature using a phone or tablet:
Post #8; Post #9
 

What are you experiencing that is terrible?

 

You can search the site for specific symptoms using a search engine such as google. If you want to search for insomnia, use these search terms:
site:survivingantidepressants.org insomnia

[heatherjc]

Just so full of anxiety and brain fog, not sure if its the lack of mirtazipine or the thought of the lack of mirtazipine if that makes sense? I have got myself into this mess before by spending my every waking moment online researching symptoms. Long story but also on 10mg paxil which no longer does anything but rather be stuck on it than go through withdrawal, that is what ended with me having the mirtazipine added in the first place.

[scallywag]

Yes your statement about possible causes makes sense.

 

I hope you'll understand and forgive my directness/bluntness: If you aren't well enough to create a signature, you may not be well enough to work with  online peer information sharing networks, such as this site.

[heatherjc]

Ok, but my options are, suffer like this on my own, or go to hospital and get totally over medicated which is the main cause of my anxiety. A lose lose situation

[ChessieCat]

"suffer like this on my own"

 

You don't have to do it on your own, we can offer support and suggestions here at SA

 

BUT we do need you to provide your drug history.

[heatherjc]

signature updated.

I have taken 50mg Promethazine tonight is that too much?

please i really need someone to chat to

[scallywag]

Please put all your medications in your signature, including the 50mg Promethazine + when you started taking it and as well as start dates and recent dose change dates for ALL OTHER MEDICATIONS you are currently taking.

edited to add: When a someone is taking multiple medications, we ask that that you post an interactions report. Follow the link below to get your report. Just select the text of the report, copy it and paste it in a post here.
Drugs-dot-com Drugs Interactions Checker.

[heatherjc]

the 50mg promethazine I have just taken tonight just this once to try to calm things down, not taken it for years and never regularly

[scallywag]

Thanks for clarifying that. Regardless of the fact that you have only taken one, you may want to look at the interactions. Because you are dealing with difficulties from discontinuing mirtazapine, you may be more susceptible to interaction effects between paroxetine and promethazine.

 

Two questions:

1. Are you taking any other medications - prescription, over-the-counter, or street drugs?
    
2. You've previously mentioned anxiety and brain fog. What other symptoms do you have, if any?

[ChessieCat]

Please provide additional details in your signature.  Having this information in your signature enables it to be easily seen without us having to read back through your posts.

 

Seroxat (Paxil) since 1996 various doses, stopped in 2007 for approx 10 months for pregnany then back on.

Currently 

Please add approximate start date  Paxil 10mg

Please add approximate start date  Mirtazipine 15mg just tapered off please add the dates and doses of your tapering and date of last dose

Please add approximate start date 7.5mg for 4 months then please add date 3.75 for 3 months, stopped on 1st October 2016

 

Having detailed drug information enables us to assess your situation and offer suggestions based on your individual situation.

 

Please remember to update it whenever you make a change.

 

Thank you.

[heatherjc]

Thank you for merging my posts & your help with signature, I think it is now correct, so please to you have any advice for me?

[heatherjc]

Anybody awake & want to chat? It is 1.30am currently here in UK am tapping away on my keyboard while the world sleeps lol

[heatherjc]

paroxetine  mirtazapine

Applies to: Paxil (paroxetine), mirtazapine

Using PARoxetine together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate promethazine  paroxetine

Applies to: promethazine, Paxil (paroxetine)

Using promethazine together with PARoxetine may increase some of the side effects of promethazine. This includes tremor (uncontrolled shaking), trouble walking, drooling, and restless muscle movements in your eyes, tongue, jaw, or neck. Talk with your doctor before using these medications together. You may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate promethazine  mirtazapine

Applies to: promethazine, mirtazapine

Using promethazine 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. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

[heatherjc]

Scallywag that is all the drugs I am taking, anxirty is major today also really tight  feeling around my head and finding it so hard to concetrate on anything, feeeling sleepy now but dare not fall asleep for fear of waking up in an even worse state.

 

when I first stopped the mirt approx 6 weeks ago I was feeling amazing. infact almost too good, so now thinking i have bipolar disorder too.

 

I have made a doctors appointment for tomorrow (not sure why really as I already know they cannot help me) but scared they will push bipolar meds on me

[heatherjc]

anyone out there?

[heatherjc]

ok its 3.20am here and i am going out of my mind, my family are asleep I cannot use the phone to call anyone as will wake my daughter and I dont belong to anyother message boards but I REALLY HAVE TO DO SOMETHING! or talk to someone, anyone? if i was admitted to hospital what would they do? offer me benzos? as is that is so there is no point in going but I just have to do something

[heatherjc]

Have I been off too long to re instate?  i think i need a hospital. shall i increase my paxil? i cannot cope someone help me i am so scard

[heatherjc]

scared the doctor will think i am bipolar as when I first stopped mirtazipine a few weeks ago I felt really high and felt amazing is that normal?

[heatherjc]

please someone reply to me? now scaredas feeling manic 

[ChessieCat]

Sometimes when people stop their drug they can get several weeks where they feel okay but then withdrawal symptoms show up.

 

A diagnosis cannot be made whilst someone is tapering or experiencing withdrawal symptoms because the drug/s have changed the brain.  From this post Ch4:

 

"Antidepressants can certainly make patients look manic or hypomanic. But the American APA DSM explicitly states that “manic like [or hypomanic –like] episodes that are clearly caused by somatic antidepressant treatment (e.g. medication) should not count toward a diagnosis of bipolar I or bipolar II disorder because these are drug induced states."

[ChessieCat]

"shall i increase my paxil?"

 

NO!!!

 

"Have I been off too long to re instate?"

 

From Post #10: 

 

"The best way to deal with withdrawal symptoms is to reinstate a very small dose of the drug you discontinued, mirtazapine in your case. It works for many people but not for all. The likelihood is higher in your situatoin because your last dose was only 3 weeks ago and you only just now started having symptoms. Please read this topic to understand the potential benefits and risks of reinstatement:  About reinstating and stabilizing to reduce withdrawal symptoms"

 

I'm asking the other mods what dose they suggest you could try.  It might be a dose as low as 0.5mg so please don't take any more than that.  It takes 4 days for the drug to get to a steady state in the blood and a few more days for it to register in the brain.  Please keep a daily diary of symptoms (what improves, what worsens, what stays the same).  This will help us to know if reinstatement is working.  Keep Notes on Paper.  Also Keep it Simple, Slow and Stable

[heatherjc]

thank you for the replies, so would you say that its definatly withdrawal or have i brought this on myself because i have been worrying about withdrawal? I was doing all the right things to keep myself well so I could do without drugs,  but maybe i do need them for life after all, the paxil does nothing but too scared to taper further with that. I have had to call in sick to work today I cannot believe I am back here again 

[ChessieCat]

I suggest your read through the links Scallyway gave you in Post #10.

 

Also check this:  Dr Joseph Glenmullen's WD Symptoms Checklist

[heatherjc]

Yes I pretty much hhave all of those symptoms but could mean anything, if it is withdrawal can I expect months of this like is expected with paxil?

 

Is there any ladies here that can throw any light on any connection between anxiety and hormones? Always always worse that time of the month, this month its late, I am almost 45 how do you know when you have started the menopause?