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Emily123

Emily123: Mirtazapine insomnia

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Emily123

Hello I started 7.5 Mirtazapine to stimulate my appetite in late October 2016. It also helped me with Ativan withdrawals and my insomnia. I had my gallbladder out in November and appetite returned but decided to keep taking the Mirtazapine because it helped me sleep.

I decided in March that it was making me too tired during the day and I didn't want it anymore. About 2-3 weeks after quitting in mid April insomnia got real bad and nothing that I took would help me sleep. Then the withdrawals got real bad, horrible waves of cortisol surges; I've never felt anything like this before. I couldn't handle it so I started back on the pills at 3.75 mg. Finally stabilized but still had insomnia. Took same dose every night for about 5 weeks but still couldn't sleep. Started 7.5 mg on Monday May 15 slept good one night then few hours so went to doctor and he put me on 15 mg Thursday night and slept good one night. Last night didn't sleep at all and don't know what to do.

 

I'm wondering if the anxiety from worrying about getting to sleep is keeping me awake since I haven't really slept well in weeks. I've had so many nights with just a few hours sleep so bedtime is not a relaxing time for me. Or maybe the pills aren't working for me anymore.

I would like to stay on these for at least a year before going off of them so I can heal myself because I realize how sensitive my system is, that is if I can start sleeping again.

 

I would just wonder if anyone thinks I have a chance at sleeping again soon. I can't do this much longer as ive already missed too much work.

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AliG

Hi Emily. Welcome to SA. I'm sorry you have been on the drug merry go round and are experiencing sleep issues.

 

I wouldn't think about staying on the Remeron for that length of time. You could perhaps eventually taper off very slowly after a long hold to reestablish homeostasis.  Holding would give your CNS time to adjust to all the recent changes and perhaps get back to a normal sleeping cycle.

 

Have you tried Melatonin? I found it to be helpful in normalizing my sleep cycle.

 

Melatonin for sleep

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flatrock

Hi Emily. I feel for you. I found Remeron to be a constant battle while I was on it. I never knew how my nights were going to go. Tossing turning crazies made me crazy! And my restless legs became a thrashing around. Awful. I do remember a few weeks into it, feeling well during the day a few times... and that inspired me to keep trying since my dr wanted me on it. And every now and then I'd have a good night's sleep.

 

I ended up getting a tremor after about 3 months on it. Neurologist thinks it's from a forced crash that was a rapid withdrawal from Klonopin (chlonazepam) that happened at the same time I started the Remeron, but I'm telling you about it here because a tremor is one of the side effects possible from Remeron. And so, as if I wasn't already crazy enough with all the meds my new dr shook up with me, he wanted me to rush to get off of Remeron (because of the tremor). Anyway, I was at 30 mg, went down to 15, then about a week later to 7.5 then a week later I had to come off of it. Blech.

 

Good luck! I hope you keep updating!

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Emily123

Thank you for your help. I will try to keep updating. Sleep is what I'm looking for right now but I am having trouble getting there, If I can fall asleep I usually stay there for a few hours sometimes four, a few times I have slept six or seven but that is with frequent wake-ups and usually right after an up-dose.   I can't figure our how much I should be taking right now. 7.5 or 15 mg and go down from there. I want to get this right but am unsure. My anxiety is bad in evenings because I'm so worried about getting asleep and that makes it worse.

I have always had anxiety and insomnia but it got real bad during the summer w last summer and I guess these pills have caused more problems than help. I just want to sleep but I can't. I haven't been to work in over a month because of this and am worried about losing my job and that causes a lot of anxiety too.

 

I am worried that since I had a terrible time on the Ativan and went directly to Remeron that I am going to have to take it slow. So do you agree that I should stay on 15 mg and see if my sleep comes back? Then  I will taper off but probably slow  because those withdrawals were horrible.

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flatrock

Hey Emily!

Well first of all, are the people where you work, or your boss, are they understanding? Keeping yourself fed and a roof over your head is pretty important!

 

I don't have any professional advice, that's for sure. Did your dr think he was replacing the Ativan with the Remeron? I think that's how my new dr was approaching it too.

 

How did you taper off of the Remeron in March 2017? You wrote that you had horrible withdrawals. I hear ya. My having the tremor removed the question about tapering off -- the dr wanted me to quit the Remeron as soon as possible, and I rushed it and just sucked it up. It was a terrible time, so many withdrawals plus I had just moved plus I was helping out my daughter with her 3 month old twins.

 

Here are some things I wrote here when I first joined:

 

"The dr was worried about my tremor, and I think that is the main reason he wanted me off of the Remeron quickly. I was the one who said No, I'm NOT going to go directly back down to 15 mgs. But because I was on the Remeron for a relatively short period of time, the taper I did seemed okay - except that right now I ain't feelin' so great:

- First week at 15 mg

- about 5 weeks at 30 mg - this is when my tremors became really obvious

- about 2 weeks at 22.5 mgs

- about 2 weeks at 15 mg

- about 4-5 weeks at 7.5 mg (finally got first appt with psychiatrist at about 2 weeks at this level) - and then quit."

 

A week or two later I wrote:

"High anxiety during the night and all day today. As I wrote on some other thread, I'm one big ball of anxiety!  I can tell my body wants me to increase the chlon. Also I can tell that I recently quit the Remeron. So it just is what it is. But that doesn't make it easy! I journaled, I meditated today, I wrote down my gratitudes, I had my quiet contemplative morning time, I practice mindfulness as much as possible. But it is challenging to sit there and notice one's anxiety and to just be with it, to just sit there with it. The urge is to do something for it, to take medicine, to take a drink, something, anything. Especially after a bad restless night - I just sat there thinking, well, that stunk, that was rough, what the heck? And then I just sat there with the after-feelings, the anxiety, the shakiness, the miserableness. Part of me felt like a big baby, that I was just being oversensitive and I should just grow up and get on with my life."

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Emily123

Thank you so much for getting back to me. I really appreciate it. I have been off work for 5 weeks now and I have disability where I work and my counselor has been taking care of that for me. She knows and understands that I am unable to work since my job is very strenuous. I cannot do my job without sleep and with this anxiety and depression that all this has caused me with these withdrawals.

 

The Ativan put me in the hospital for a week. I was having panic attacks that started with an adverse reaction to Lexapro. I was sick from having a bad gallbladder that was only functioning at 11% and nobody could figure out what was wrong with me for over a year. So I was in the hospital (late October) because I lost 20 pounds from no appetite, bad nausea, and I couldn't get off of Ativan that I was only on for 5 weeks; bad withdrawals.

They put me on Remeron 15mg, Cymbalta 60 mg, and Klonopin while I was in the hospital and sent me home with the Remeron, Cymbalta, and 10 Klonopin (I still have 7). After 2 days I quit the Cymbalta. It was just too much. My head couldn't take all that medication.

 

I continued the Remeron for 4 1/2 months taking 7.5 mg for about a month then 3.75 around 2 months and the rest small pieces which I never measured they just got smaller each week. During the next 2-3 weeks I would get headaches a lot and during all this time of withdrawal I would be irritable that I thought was from the pill itself and that was why I was so anxious to get off of it. At around the third week off of it is when the horrible withdrawals and insomnia started. So I went back on the Remeron around the second week of April about 1/4 of the pill. I did some research and found this website  and then I bought a scale and started cutting and weighing on April 24, 2017 at .41 gm. then May 15 I decided to go up to .8 gm (which was about half of 15 mg pill) because the sleep was still so bad but most of the waves were gone. Went to doctor because I still wasn't sleeping on Thursday May 18. But I didn't sleep last night so I really need some help from people who understand what I am going through. Which isn't my doctor. He seems concerned and he knows I am sensitive he just doesn't see things the way I do.

 

I'm still debating with myself whether to take a half or whole tablet tonight. My anxiety is so bad at night that the pill isn't helping me. I have some Klonopin and Lunesta but do not want to use them and am strong enough not to. But I have found out that l-theanine helps with anxiety and my doctor is pushing the Vistaril on me but I don't want to take it. I also usually take fish oil, vitamin c and magnesium every day.

 

I really don't have anybody else to talk with that knows anything about what I'm going through, I have been doing this on my own. I thank you all for your help.

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flatrock

If you're still awake and reading...

I'd say that you should consider taking whatever amount has been most constant this week, without considering the sleep factor. Because keeping your central nervous system steady is so important, you don't want to be going up and down. I also suggest that you try tons of other things to add at night to help you sleep. I used Calms Forte, Midnite, Tylenol PM, oh I tried all kinds of things and they do help quite a bit. I should be more cautious in suggesting things like this... but you seem open to ideas. 

I have a Brookstone clock that has all kinds of soothing sounds. The best part is that it has sleep coaching. It is the best I've ever heard. There are 8 coachings to choose from, and under the narration you can hear the sounds or music. Once the narration is over, the sound keeps going all night. Highly recommend! I bought two, I love it so much.

Gotta get to bed, good luck tonight!

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Shep

Hi, Emily.

 

Welcome to SA from me, too. 

 

 

 

The Ativan put me in the hospital for a week. I was having panic attacks that started with an adverse reaction to Lexapro. I was sick from having a bad gallbladder that was only functioning at 11% and nobody could figure out what was wrong with me for over a year. So I was in the hospital (late October) because I lost 20 pounds from no appetite, bad nausea, and I couldn't get off of Ativan that I was only on for 5 weeks; bad withdrawals.

They put me on Remeron 15mg, Cymbalta 60 mg, and Klonopin while I was in the hospital and sent me home with the Remeron, Cymbalta, and 10 Klonopin (I still have 7). After 2 days I quit the Cymbalta. It was just too much. My head couldn't take all that medication.

 

 

You certainly have been down the polydrugging merry-go-round. I'm sorry you had to go through this.

 

How long were you on the various drugs that I highlighted in the above post? 

 

Below is some information about tapering off of Remeron:

 

Tips for tapering off Remeron (mirtazapine)

 

Why taper by 10% of my dosage?

 

And some information about what to expect in withdrawal: 

 

What is withdrawal syndrome? 

 
The Windows and Waves Pattern of Stabilization

 

How Psychiatric Drugs Remodel Your Brain


 

Questions:

 

  • Were you on any psychiatric drugs prior to your recent experience? If so, please list them in your signature. The dates, doses, names of the drugs, etc. 
  • Other than l-theanine, are you taking any supplements? If so, please list them. 

Due to all of the recent changes, your nervous system is letting you know it needs to stabilize. Please hold and give your nervous system time to stabilize before making any more changes.

 

You are wise not to use the Klonopin and Lunesta, as they can cause very bad withdrawal and can cause dependency in as little as 2 weeks.  If you have any questions about your Ativan withdrawal or symptoms, please feel free to start a thread in the benzo area of the forum, which you can find here:

 

Members-only benzo forum

 

You may also want to have a read of some of the non-drug techniques for insomnia, as that is a very common symptom during withdrawal. 

 

Tips to Help Sleep

 

This is your thread to keep up with your symptoms and to ask plenty of questions. Please keep updating. 

 

 

 

 

 

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Emily123

flatrock, last night I went back to 7.5 mg Remeron and slept good. Felt pretty good today. I hope to stay on this dose for awhile until I'm able to start tapering.

 

Shep, I took Lexapro only once and went to the er with adverse reactions. Started the Ativan right after that for five weeks. Went to hospital to get off Ativan. They put me on Remeron 30 mg, Klonopin, and Cymbalta 60 mg. Stayed on them for about 10 days. Continued on the Remeron 15 mg a few days then went to 7.5mg till March by tapering down.

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Shep

Hi, Emily.

 

Thanks for the additional information. I'm glad you are sleeping at 7.5 mg. I would hold for a few weeks and give your nervous system time to settle down. 

 

It's possible your previous history of psych drugs may have caused some limbic kindling, even though it was a number of years ago. So I would be as gentle with your nervous system as possible. 

 

Please have a read of the Tips to Help Sleep and see what you think. You may also find some helpful information in the non-drug coping section. Many people struggling with insomnia find the mindfulness links to be especially helpful. 

 

Please keep updating. 

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Santino

HI Emily

Your case is similar to mine and i am telling you that if you accept the situation for what it is and enforce discipline in your actions you will soon stabilize. Shep is giving you a very good advice regarding hodling at 7.5 for a while until your sleep cycle is stable. Than you can start tapering by using the 10% rule again. Now you know that your nervous system is sensitive to such meds so you need to to be careful.

Apart from the Remeron if you still have problems at 7.5 you can use magnesium and vit C at night and normally bananas or cherries before sleep. Magnesium is a muscle relaxant and than bananas and cherries have a lot of melatonin which is natural hormone for sleep.

 

I also sent you a personal message so have a read and let me know. 

All the best my friend... and just try to keep calmness. It is all manageable... 

Santino

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Emily123

Well I took 7.5 mg again last night and no sleep. I'm going to stay on this dose and see what I can find to help with sleep. Thanks I'm going to use those links now.

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Santino

HI Emily

Try improving your sleep hygiene as well. It is very important.
How is your lighting at the room you sleep?
Are you making yourself tired enough before sleep?
Are you exposing yourself to light in case you wake up in the middle of the night to go to the toilet? 
What is your strategy in case after 2 hours tossing and turning in the bed you can not sleep?

Write to me in private so maybe we can help you more on these....

Santino

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Emily123

I don't know why it is that I either sleep very well or very bad no in-between.I try to keep it dark but if I cant sleep then I will try to read, but I probably do stay in bed to long if I cant sleep.

 

Shep, you mentioned limbic kindling. I have an appointment with my therapist tomorrow and she brought up EDMR last time I was there. I'm gonna tell her I wanna do it. It has to do with the Limbic System. Hopefully it will work.

 

Thanks everyone for all your help. Today was a bad day a lot of anxiety. Hope tomorrow is good for you all.

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Emily123

I had two hours sleep last night or I should say this morning from 6-8 am, at least I got some. I took some melatonin, l-theanine and magnesium then finally dozed off.

I am wondering if I would sleep better on a full stomach. Lately I haven't been eating before bed, thinking it will disrupt my sleep. Trying to be careful in everything I do.

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flatrock

Emily, I really feel for you. When I was on Remeron, it was the same thing. Never knew if I'd sleep well or not at all. Sorry you had a high anxiety day. Me too, yesterday and today. It's very very hard.

Sending you ((( hugs )))

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mammaP

Hi Emily, I also have problems sleeping so understand how you are feeling. I have stopped wottying about not sleeping, and just rest in bed. I try and think about positive things and not focus on the fact that I am awake. I get by and don't think about it, any sleep is a bonus but I don't expect it. I used to get anxious and even scared of going to bed because I would lie awake but now I love my bed, even if I don't sleep it is warm and comfy, and gives me a hug  :wub: .

I hope you stabilise and start sleeping better soon.

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Gridley

That is a great way to look at it, mammaP.  I love my bed too, and when I can't sleep I lie cradled in it and say to myself, "I am safe."

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Emily123

Wow, there is so much wonderful support here. I really appreciate it; it helps so much. I have to be back to work in a week, next Tuesday so I feel pressured that I have to be sleeping good by then. If I'm not well enough by then I'm going to try and get a personal leave. If not then I'm going to go ahead and quit. I don't need to be worrying about that when I'm trying to heal. I've been feeling warm tonight to and have a 94 f temp don't know why that's there either.

 

I'm gonna take your advice and get cozy in my bed tonight. No worries.

 

Thank you all so much. I feel the love here.

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Emily123

Sorry that's a 99.4 f temperature.

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flatrock

mammP and Gridley, I just love your attitude about sleep! I need some lessons I think. I get scared of sleep, and have a history of night time abuse from my ex, so, yeah, sleep is a work in progress for me.

Emily123, oh those low grade fevers are the worse - they make me cry for some reason too. I'm so sorry! You must feel fed up. sending ((( hugs )))

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Emily123

MammaP that's exactly how I got. I was really afraid of going to bed, dreading it. Now not so bad but stilly anxious over it.

 

That is such a great idea to think of any sleep as a bonus and not to expect it. Thank you so much for the support.

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Santino

Emily now for the sleep my friend... i suffered myself during tapering that problem so what i would advice is as below.

1. Try not to scare yourself before sleep with thinking that you will not be able to sleep properly. Lower level of your lighting in the living room half an hour before sleep so the body makes itself ready.
2. Take magnesium and vit C before sleep and also eat one banana or a pot of cherries half an hour before sleep... (they are full of natural melatonin).
3. In case you wake up early with anxiety or you can not sleep for more than 1-2 hours wake up and take a mix of Linden and Chamomile tea. After that lay down in bed and with earphones listen any meditation video from youtube. For me the one that works perfectly is this one... 

4. If you wake up at night to go to the toilet... make sure you do not turn any light on... and try to keep your eyes closed. If light enters into the retina of the eyes... the melatonin depletes quite fast and your body is signaled for waking up and starting the new day.
5. If you wake up in the middle of the night being anxious... do not worry, it is just the cortisol that is playing tricks on you. Vit C before sleep is a natural regulator of Cortisol so with time it will regulate by itself.

Normally for me these points work like a charm regarding the sleep. I have negative thoughts as a result of WD but normally i am able to shrug them off time after time. Have a nice day my friend and do not worry.

All the best

Santino

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Emily123

I finally slept last night. Maybe 7 hours. I'm not sure what time I fell asleep since I can't see it anymore.  I've been on 7.5 mg Mirtazapine now for 4 nights. Today is bad real bad. Had to lay down and do some breathing. Looking around to see what has helped others like this. I thought I was done with this, didn't ever want to go back here.

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flatrock

Hi. I find lying flat on the floor or a bed is helpful too, so you did a smart thing by lying down.

Emily I'm so sorry you're having a bad day. 

I discovered this AMAZING audio instruction for yoga nidra. She says it's for sleep, but I've done it many times just for relaxation: https://www.doyogawithme.com/content/yoga-nidra-sleep

 

And remember, you don't have to feel happy to survive. You just have to get through it and believe that you'll end up back at your old self. You will!

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Emily123

I'll listen to that audio tonight before bedtime. Thanks flatrock.

 

It got a little scary today, There was one of those cortisol surges that I thought had stopped. It probably was because my dose changes are catching up with me. I did Mirtzapine 5 weeks @ 3.75 then 3 nights @ 7.5 then 2 nights @ 15 and back down to 7.5 for 4 nights now. I had finally stabilized at 3.75 but was unable to sleep and went up to 7.5 on my own. Then went to doctor and he told me to go up to 15 because It was my anxiety and that it takes six months to one year for me to get my neurotransmitters back to normal since they were imbalanced. He was the person who put me on Ativan with no instruction or how addicting they are.

 

At least I got a lot of sleep last night. I know it can happen.

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flatrock

Hey Emily, ya know when I read over your most recent post here... You sure have had a lot of changes on the Remeron. Whew. Do you feel like you can hang in there at 7.5 to stabilize?

 

I hope you like that audio... I can't imagine anybody not liking it!

 

That's awesome that you got some good sleep last night!

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Emily123

yea waiting to stabilize here, I hope soon as I need to be back to work Tuesday. I slept ok last night so maybe I'll be better soon. Sure hope so. I wish I never messed with the Remeron, I didn't know. Now I do. I realize what's going on. Bad Stuff.

 

I'm a highly sensitive person, always have been. I wonder if that had anything to do with why it affects me so much. That's probably why I go on these medicines so easily. Are there many people here that have always been sensitive?It seems that when I come on here and post that it relaxes me some.

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flatrock

Yes, HSP! Being an HSP is hard work, but it also allows us to see the extra beauty all around us. Don't know if I'd wish it away or not, I guess not.

 

That's cool that it relaxes you to log on. I log on usually when I'm over-thinking or frazzled. And yeah, it does help.

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Emily123

I'm going to make my first drop tonight. I'm going to 6.9 mg. Being on Mirtazapine in this hot humid weather is making me sick and I'm always tired. I really need to get off of it. Gonna take it slow for this first cut. I can still remember how bad withdrawals were. But hopefully It won't go so bad and I can go a full 10% on my next one.

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Starboy17

Hi Emily123,

 

I've found that on the lower doses of  mirtazapine that it takes me a little longer to stabilise 4-7weeks, I'm currently at 2.8mg for a month, I was hoping to taper another 5% but knowing what the full withdrawals effects are I wont dare take my chances, plus it pure misery.  I read somewhere that ppl need to ride the withdrawals out, obviously in the most comfortable way possible

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Emily123

I will probably go real slow then when I get under 4mg. I'm hoping to get low enough so I won't be so tired. And it seems that I can't tolerate the heat like I use to before these pills. I've been feeling sick at work when it's so hot.

 

I see that you took Lexapro and went to the ER. Something similar happened to me, when I took only one. I had what they called an adverse reaction to it, that was when my panic attacks started and I got hooked on the Ativan after just a few weeks on them.

 

 

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Starboy17

yeah my adverse reaction to Lexapro was one of the scariest moments of my life, never experienced anything like that! I'm noticing on the lower doses from 3mg that i'm not so groggy in the morning, also the clarity in my vision has greatly improved, that mirtazapine haze sucks bad.  Most Drs in Australia rarely prescribe benzo's and when they do its only for the short term. I was given 2mg of Valium but I was careful not to take them for more than a week, I grew up in a neighbourhood surrounded by drug addicts and family members who are addicts.  

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Emily123

Well I started to feel the withdrawals about 5 days after I cut, only lasted a few days. It wasn't too bad. But at the 2 week point I got the insomnia back. Three nights I haven't slept. I'm still practicing good sleep hygiene. Hope it goes away here real soon.

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Santino

HI Emily

You are doing quite OK with your cuts i think my friend. AT the lower levels of the drug the fatigue increases especially at the levels you are now. When i reached 1.8Mg the fatigue started to go lower and at 1MG it became almost became in-existent. Currently i am taking 0.8g and very soon in a matter of days i will do another drop.

I hope things will be OK with you my friend. All the best

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flatrock
6 hours ago, Emily123 said:

Well I started to feel the withdrawals about 5 days after I cut, only lasted a few days. It wasn't too bad. But at the 2 week point I got the insomnia back. Three nights I haven't slept. I'm still practicing good sleep hygiene. Hope it goes away here real soon.

Hi Emily. So sorry you're going through this. My experience with Remeron was awful. Sometimes it helped me sleep, sometimes complete insomnia. I was forced off of it in a quick withdrawal because I developed a tremor and my dr thought it probably was from the Remeron. In retrospect the tremor was from a forced dramatic drop in the amount of chlonazepam I was "allowed" to have. It was a crazy few months full of changed meds, withdrawals, insomnia - blechhh!  Medications can cause such a mess. How was your experience with Lunesta in the past? While it is not recommended here at SA, if I were in your position, I'd probably take a Lunesta now and then just to get a good night's sleep. It's so hard to go without sleep!

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