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Distraut: asking how can I help my son, akrontes?

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Distraut

I have a digital scale.  A 7.5 mg tablet weighs approx. 23-25.  If I reduce the tablet by .01 daily .. 25, 24, 23 etc. could this be a possibility to taper off?

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Altostrata

Akrontes will need to decide himself if he truly wants to stop taking the drug.

 

As I've said before, it's very well known that mirtazapine causes weight gain. It sounds like Akrontes is very sensitive to its effects. If he takes the smaller dose in the evening, it sounds like it causes sugar cravings as it takes effect during the night.

 

Yes, if you reduce a tablet that weighs 23-25mg by 0.01mg per day, that would be a very gradual reduction of approximately 0.30mg per month. We recommend a 10% reduction per month. 10% of 25mg by weight is 2.5mg, or 0.08mg per day for 30 days.

 

A very gradual decrease is preferable to a sudden decrease. He might tolerate a decrease of 0.10mg per day, even though over the month it amounts to a greater than 10% reduction, because the daily reduction is so small.

 

If any withdrawal symptoms occur, stop reducing and maintain the dosage at a constant level for a while to allow the system to accommodate.

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Distraut

Just an update about Akrontes's current situation. 

 

As mentioned in his history, he has been on different SSRI's since 2008 when he was 20 years old and on two occasions in the past has quit cold turkey but had to go back on medication some two - three months down the line.  We did not know anything about withdrawal at the time.  During this period he developed OCD which he did not have before psychotropic medication as far as I can remember.  I am not sure whether he naturally suffers from OCD or whether this is a symptom deriving from previous cold turkey withdrawals which will eventually pass when he is eventually medication free.  I do not recall him suffering from it in childhood although he was always tended towards anxiety.   I cannot find much information on the site about others experiencing OCD in the way he is and would be grateful if anyone who recognizes this condition would post a comment.

 

To update, he quit Sertraline cold turkey at the beginning of May 2016 after being on it for 3 and a half years.  Luckily he did not experience any physical symptoms, but he gradually got worse as the months passed. At the beginning he could go out and take on some casual work but as the months progressed he became more and more anxious. So I read up and found this site which has informed us about withdrawal.

 

In mid-October, whilst trying some therapy at home by himself for his OCD, he managed to tip himself over the edge with a new obsession which haunts him till today and which was worsened by an intensive course of CBT with a therapist in November 2016 following his 4 day hospitalization.  He thinks he has hurt people and is destined for hell.  This obsession is driving him crazy during his waking hours. 

 

At the end of October, beginning November I even took him from London to Vermont to the Inner Fire Centre but because of his extreme anxiety and a bad start to his stay we returned to London within three days.

 

After being drug free for 7 months, in a state of high anxiety (although he did have two or three short "windows")  he checked himself into hospital for 4 days on 13 November 2016 where he was prescribed Mirtazapine 15 mg as he did not want to take any more SSRI's and was told it was an easier, "gentler" drug to taper, but after reading reports of this medication he reduced to 7.5 mg after two weeks.  During this period his taste for sugar soared through the roof and he gained many pounds in weight.  Since it is less than two months that he has been taking this medication, from 24 December we have been shaving off a tiny bit each day until now he is taking about 4 mg. and we intend to stop here for the time being.  It has done nothing to relieve his OCD symptoms.  Now he is also depressed, gets headaches, aching limbs.

 

He is not doing well.  He spends most of his time in a darkened room.  He does not want to socialize and came downstairs for a short time over the Christmas period to see his family members but did not want to eat with us.  His night and day seem reversed. He does not eat during daytime, only during the night.  He has moved his bed to be near an open window.  He does not want to see his friends and rarely leaves the house.  He does not want to see any doctors.  He is tearful and feels he has no hope and will never recover. 

 

I am at an absolute loss what to do for the best for him now.  I hate to see him suffering in this way and would welcome some advice from others posting here.

 

Thank you so much

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Buccaneers47

Hi there.

I am a sufferer of OCD and it sounds like he suffers from 'Pure O' OCD.

If I were you I would look into ERP therapy. It's slow, but from studies it is the top of the line treatment for OCD.

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Distraut

Thank you so much Buccaneers47

 

The therapist who gave him an intensive course of ERP recently said she could not treat him unless he was medicated because he was too unstable.  She suggested an SSRI plus an anti-psychotic!

 

Her treatment was so radical for him that the action she suggested he took has become his major obsession now.

 

This has left us in a terrible quandary.  What do we do?

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Distraut

I would be most grateful for any advice about what to do now with tapering the medication.

 

Also, any further information about withdrawal-induced OCD would be most welcome.

 

Thanks in advance

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Buccaneers47

I'm very sorry that I don't have any advice about medication. I am in my own struggle right now with meds unfortunately.

 

can I suggest a book and website that may help him?

Dr Claire Weekes has an incredible book for anxiety and Panicend.com has a great website on panic attacks. They may help him get to a place that could help him start ERP. I highly recommend that he stay off of medication if he can because the meds have put me into a FAR bigger hole than I had before!!!

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Altostrata

It sounds like he may be eating at night because the mirtazapine stimulates his appetite.

 

As he doesn't participate here, it's difficult for us to find out exactly what's going on.
 

 

Her treatment was so radical for him that the action she suggested he took has become his major obsession now.

 

 

Could you please clarify? What was the treatment and what is his obsession?

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Distraut

As part of his exposure therapy she asked him to write nasty accusations about his friends on bits of paper and distribute them around town.  He is now terrified he has put them in danger and that he will go to hell

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KarenB

:blink: That therapist has issues. 

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nz11

As part of his exposure therapy she asked him to write nasty accusations about his friends on bits of paper and distribute them around town.  He is now terrified he has put them in danger and that he will go to hell

!!??!!

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Distraut

It is driving him crazy 24/7

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AliG

This is why sometimes therapy can be questionable. In the hands of someone either, inexperienced or lacking in knowledge and /or empathy it can be a destabilizing influence that can either traumatize or re- traumatize a person experiencing pain particularly during withdrawal.

 

My advice would be to try and find a new therapist. I'm sorry you have had to deal with this and I hope you can find someone knowledgeable who can guide him in the right direction.

 

I'm not sure if you have read this : It may help.

 

http://survivingantidepressants.org/index.php?/topic/3882-ocd-obsessive-thoughts-compulsive-behaviors/

 

Ali

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Distraut

Yes indeed.  I wish he had never seen this person - or gone to hospital and started taking Mirtazapine!  He had been 6 months AD free at that point and although not doing well, was having an occasional window

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AliG

Distraught. I would hold on the 4 mg for now but I will check in and see what the other Mods think regarding tapering.

 

In the meantime could you please update his signature to reflect this change ?

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Distraut

Today he is really in a bad place, screaming and terrified.  I do not know what to do.  I do not want to call the medical services and have him clobbered with who knows what.

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Distraut

I hope at some point he may wish to post on this thread himself.

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AliG

I was going to say that. If he could post himself it would be preferable.

 

I have two sons also and I can imagine how upsetting this must be for you. It's a helpless feeling, I know.

 

Can you keep him safe ? If you can that's all that matters for now. I hope you don't have to call anyone as it always seems to go downhill from there.

 

Has he calmed down for now ?

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Distraut

He calms down then flairs up again.  I am trying to persuade him to post himself.  He feels there is no point going on as he will never be a "normal" person

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akrontes

I am really in a terrible state right now and not am able to attribute it to the withdrawal. Unfortunately I haven't been good for a long time now especially since my first cold turkey more than 7 years ago, then for some reason I decided to do it 3 more times! I for so long completely by passed basic human functioning, and have gone too such an extreme trying to reason with all the absurdities in my head. I am so convinced that I have done wrong. If I were not so convinced of the reality of these fears, it would make the withdrawal so much more hopeful. I have managed to mess up everything in these last months, and have been trying to balance and combat all these differing opinions. At moments I regret not being more convinced in the withdrawal, and others I am raging against my Mother and thinking she is psycho for making me do this. For the past three months I have been living as if it is all finished such is the effect of this obsession,which then has caused things to worsen, and have been constantly suicidal, not just because I can't cope but because I deserve to die. What makes this worse is I am destroying my family for this irrational fear of having caused harm to many people, and am terrified that I am also damning them. This is my problem not being able to relate all this thinking to the symptoms and the last 7 years has just taken me so far away from normality.

Edited by ChessieCat
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AliG

Akrontes. Welcome. It's nice to have you here.  You are not alone. If you read around here we have all gone through this to varying degrees.

Of course the situations vary as well as the medications themselves but we do understand. This is not an easy time but you will come through this. We do heal. It just takes some time.

 

It does sound like it is withdrawal as you have had so many changes in a relatively short space of time. This can be destabilizing to your CNS ( central nervous system).

 

How are you feeling now ? What are your main symptoms ?

 

I'm so glad you decided to post. We are a helpful bunch and I'm sure you will like us as you get to know us.

 

We want to support you through this in the easiest way possible for you.

 

These links might help you to understand what is happening and why it seems so hard right now :

 

Healing from antidepressants. Patterns of recovery/

 

Brain Remodelling

 

What is withdrawal syndrome?

 

http://survivingantidepressants.org/index.php?/topic/10914-what-is-happening-in-your-brain/

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Neuro emotions

 

Please have a read and come back with any questions or concerns you may have . I'm glad you posted. Let's try and keep the channels of communication open. We are here to help. I hope you stay in touch. 

 

Ali

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nz11

I am really in a terrible state right now and not am able to attribute it to the withdrawal. Unfortunately I haven't been good for a long time now especially since my first cold turkey more than 7 years ago, then for some reason I decided to do it 3 more times! I for so long completely by passed basic human functioning, and have gone too such an extreme trying to reason with all the absurdities in my head. I am so convinced that I have done wrong. If I were not so convinced of the reality of these fears, it would make the withdrawal so much more hopeful. I have managed to mess up everything in these last months, and have been trying to balance and combat all these differing opinions. At moments I regret not being more convinced in the withdrawal, and others I am raging against my Mother and thinking she is psycho for making me do this. For the past three months I have been living as if it is all finished such is the effect of this obsession,which then has caused things to worsen, and have been constantly suicidal, not just because I can't cope but because I deserve to die. What makes this worse is I am destroying my family for this irrational fear of having caused harm to many people, and am terrified that I am also damning them. This is my problem not being able to relate all this thinking to the symptoms and the last 7 years has just taken me so far away from normality.

As i read this one word came to mind ....'neuro-emotions'.

 

I could have written this myself.

I also was convinced i was going to hell and i deserved to die too.

 

Akrontes i know you dont think this is wdl but it is. Your brain is BS-ing it is lying to you.

To overcome this i spent a lot of time speaking back to these thoughts telling them out loud 'thats not true'. It was a battle. It is very scary when our brain turns against us like this.

 

Please check out that link from AliG about neuro-emotions.

 

We are all telling you that this is the wdl, its not you. You must believe us. As AliG says we have been there. It will recede in time.

Edited by ChessieCat
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Distraut

PLEASE can someone give me some advice about medication? 

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Distraut

Can he ever recover from this "neuro-emotion" whilst still on medication (which isn't doing any good!)

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Distraut

Thank you nz11 for your confirmation that this obsession is withdrawal.  Unfortunately Akrontes finds it very hard to believe in his present state of mind.

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Altostrata

We've discussed the possible adverse effects of mirtazapine. Has Akrontes's symptom pattern changed at all since he's reduced it?

 

It may be difficult because he feels so disoriented and confused from adverse drug reactions, but he must put his mind towards healing. Nobody can impose this on him.

 

He seems to believe his symptoms are because there's something wrong with his brain. Many people come here believing that. But there's a big difference between experiencing adverse drug effects and being intrinsically flawed, and he needs to find that difference to unpatient himself.

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Distraut

Thank you Alto

 

From my external point of view, since he has reduced his dose he has become less numbed and shows more empathy.  His appetite has reduced somewhat, although he still gets a craving for sugar during the night.  His sleeping pattern is all over the place and day often becomes night.  He is also more raw and emotional.  His obsession is his major torment. I don't know whether this has got worse during reduction.

 

I hope he might add his comment here too.

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AliG

How are you doing , Akrontes ?

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akrontes

Not good. I don't feel like I can explain anything in words anymore. I am a complete joke. I am completely tormented from my obsession. I don't believe that this is all entirely down to withdrawal. I don't understand what everyone else understands. I am a little kid and have not grown up. I am not coping now, and am torn between going to the doctor or not - or even the crisis team. I am terrified of the medicine but on the other hand I don't see myself improving. This obsession has been a death sentence and is so complicated. The problem is it is my Mother has been doing all the research and active on this site, and I have not been doing anything.

 

I am sorry to seem so horrible and abrupt, I didn't want to write anything but my Mother asked me to, because all I can come up with is this rubbish.

 

Thank you all for your help

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AliG

Akrontes. I'm so glad you replied. I think perhaps what you don't quite understand yet is that most of us here, have been exactly where you are right now.

 

This is what these drugs can do. It is complicated without a doubt but the really hard thing is to know that your thinking is off when you are right in the grips of withdrawal. It's not you, it's your brain reacting.

 

Your Mum is worried about you and is trying to help.

 

Have your symptoms changed since your dose reduction ?

 

You have to understand that this is " the drugs talking ". Have you checked out the links yet ? Please have a read in order to understand more about what is going on and why you are experiencing the symptoms that you are.

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akrontes

When I was on higher dose I was a little bit/ quite a lot quieter. Not constantly wailing. I was so freaked out about, I think alot was to to do with my obsessing, my brain and reality. It is hard to explain, also because I already feel completely removed from reality. The problem is I have been thinking strange for a long time now, not just since my withdrawal, and my over thinking, trying to understand everything has really messed me up. Especially with this obsession which has really pushed the boundaries for me, my head is basically trying to work out what could be happening to these 20 people, as I fear I could have harmed, them somehow. My over thinking has not helped me in all these years and brought me to this mess where I am now. I wish I could have taken a step back and recognised earlier what all these disturbances where, as I instead got so involve in them and have become so engrained in my psyche. Thanks

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AliG

I Just lost a post. I will start again.

 

You have been on a cocktail of drugs therefore your brain isn't working properly. It's trying to make sense of the changes.

 

We understand that.

 

Most of us have already been through this. Please let us know how we can help. We have many resources. If you can continue to stay in touch , then we can help .

Ali 

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nz11

 The problem is it is my Mother has been doing all the research and active on this site, and I have not been doing anything.

 

Well no problem now is the time to get informed read the links better now than never.

If you havent read anything to date then do you think there is a possibility you may be coming to conclusions that are based on incomplete or even incorrect information ....

It might be helpful to consider believing and reading what AliG and others are telling you....right.

 

Especially with this obsession which has really pushed the boundaries for me, my head is basically trying to work out what could be happening to these 20 people, as I fear I could have harmed, them somehow

Well did you put your name to it. If not then it could have come from anyone. right?

If you did or didnt put your name to it you could always write and say sorry and explain you are going through drug withdrawal thanks to your doctor  and doing uncharacteristic things...like following through on your therapists (ph xxxxxxx) nutcase ideas.

Besides didnt the therapist put you up to this so then what do they have to say about this psychological distressing outcome.

 

Hey well done on stepping up to post again.

nz11

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AliG

How are you feeling now Akrontes ? 

 

This obsession was put in your head by a warped therapist. It would be best if you moved on from that. It's easy to get " stuck " on something in withdrawal but if you put your mind to it , you can definitely move on. Read the links .... learn ...... and educate yourself. 

 

We are here for you with any questions that you may have. Please come back with those concerns.

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Distraut

Please can someone tell me whether waves and windows can occur when you are still on some medication or whether this only starts when you are completely medication free?

 

Thank you

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scallywag

Waves of symptoms and windows of less intense or no symptoms can occur when tapering, i.e. still on the medication.

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