seekingadvise: Trying to withdraw Zoloft, Valium, Gabapentin (Mirtazapine last)

[seekingadvise]

I have been in chronic pain for five years -- on and off various medication for five years (which never decreased my pain and did a number on my CNS). I can't tell what is a pain symptom, side effect or withdrawal at this point. You can see some history in my signature.

 

My plan was to withdraw from Valium first, then Gabapentin, then Zoloft, but I've been tapering slowly off Gabapentin and Valium at the same time. I also made a jump from 25mgs of Zoloft to 12.5mg of Zoloft 8/10/17. I was only taking 25mg of Zoloft since 6/16/17, Then before that, 10mg Paxil from 2/16/ - 6/14/17, which I halved, stopped and switched to Zoloft. My quick withdrawals from ADs may be causing some side effects.

 

Now I'm thinking since I stared Mirtazapine 7.5mg at night (which finally is enabling me to sleep), I should wean the Zoloft first (before the Valium). I would like to micro taper all three together.

 

Comments please?

 

Thanks,

 

 

Medication Tapering Schedule.pdf

[baroquep]

Hi Seekingadvise,

 

Welcome to Surviving Antidepressants.  I am glad that you found the site and hope that you find the information helpful.  I would recommend that you have a look around and have attached a few links to topics that I think will be of particular interest to you.  If you have additional questions, or need clarification on any topic, please feel free to post questions in your intro and connect with other members.

 

SurvivingAntidepressants.org provides volunteer peer support for antidepressant withdrawal, while tapering and after you've quit.  

 

This site offers information to empower you to talk with your doctor.  For medical advice, consult a knowledgeable medical caregiver.

 

While some people may be able to quickly stop taking psychiatric medications without serious discontinuation symptoms, others cannot.  Slowing the taper usually makes quitting more tolerable, reducing the severity of withdrawal symptoms.  Gradual weaning can take many months and much patience.  

 

If you are currently tapering or thinking of going off a drug, visit our Tapering forum for further information.  Gradually tapering off the medication is the only known way to reduce the risk of prolonged withdrawal syndrome.  Do not risk suddenly stopping any psychiatric medication.

 

Pertinent discussions

- Rules and guidelines

- Before you begin tapering - what you need to know

- Intro to antidepressant withdrawal syndrome

- Tapering multiple psych drugs? Taper the antidepressant first

- Important topics in the Tapering forum and FAQ

 

Edited September 1, 2017 by ChessieCat
Added Before you begin taperin

[ChessieCat]

Hi seekingadvise and welcome from me too.  Here are some more links which you might find useful/helpful:

 

taper-more-than-one-drug-at-a-time

 

Why taper by 10% of my dosage?

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Skipping Days vs Every Day Dosing Graph

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Keep Notes on Paper

[Altostrata]

Welcome, seeking.

On 8/31/2017 at 5:14 AM, seekingadvise said:

I have been in chronic pain for five years -- on and off various medication for five years (which never decreased my pain and did a number on my CNS). I can't tell what is a pain symptom, side effect or withdrawal at this point. You can see some history in my signature.

 

My plan was to withdraw from Valium first, then Gabapentin, then Zoloft, but I've been tapering slowly off Gabapentin and Valium at the same time. I also made a jump from 25mgs of Zoloft to 12.5mg of Zoloft 8/10/17. I was only taking 25mg of Zoloft since 6/16/17, Then before that, 10mg Paxil from 2/16/ - 6/14/17, which I halved, stopped and switched to Zoloft. My quick withdrawals from ADs may be causing some side effects.

 

Now I'm thinking since I stared Mirtazapine 7.5mg at night (which finally is enabling me to sleep), I should wean the Zoloft first (before the Valium). I would like to micro taper all three together.

 

Comments please?

 

Thanks,

 

 

Medication Tapering Schedule.pdf

 

Please read Taking multiple psych drugs? Which drug to taper first?

 

Generally, we do not recommend tapering more than one drug at a time. Tapering multiple drugs at one time is for people who are very experienced at tapering, know their symptom pattern, and know what to do if bad withdrawal symptoms arise.

 

Also, going off Zoloft first is preferable, as the gabapentin and Valium may cushion any withdrawal symptoms, such as sleeplessness, muscle tension, and pain, from Zoloft. Conversely, Zoloft does not ameliorate withdrawal symptoms from gabapentin or Valium.

 

Tapering Valium and gabapentin at once while still suffering from drug switches (Paxil to Zoloft) and making the occasional change in Zoloft is a high-risk strategy. Your nervous system is probably already sensitized from going off Paxil.

 

Do you have symptoms dating from the switch from Paxil to Zoloft? What are they? Did taking Zoloft reduce those symptoms? If sleeplessness is one of them, reducing any of your drugs may make it worse, even though mirtazapine is currently effective.

 

Why do you want to go off Valium, gabapentin, and Zoloft? When did you start mirtazapine?

 

Please put all your drugs in the Drug Interactions Checker and copy and paste the results in this topic.

[seekingadvise]

My pain doctor discharged me from his practice and my PCP will not prescribe Valium. My physiatrist is prescribing it as a favor (and I have some extra valium pills). This my reasoning for doing valium first.

 

Now, I believe Zoloft should be the first to taper. I think I am experiencing withdrawal symptoms both from stopping oxycofone July 23 and switching and lowering the dose of Zoloft. At 3-4:00pm, I am very irritable, go from one thing to another, mom-focused and in crazy pain until my dinner meds.

 

Would you believe I saw my neurologist yesterday, and he said my Zoloft and Gabapentin is so low, I can just stop them? Crazy! The doctors know nothing about withdrawal symptoms! Plus I banged my head very badly in March, began to get headaches in about June. I think that's about the time I switched to Zoloft. Anyway, I'll be getting a a brain MRI. I still have a bump. On my head and don't know what the headaches are from

 

even though I am likely expecting withdrawal, I want to hold and do not want to updose. I'm strong using meditation and mind body tool to calm down.

 

thanks for responding. Who administers and approves posts, please?

 

thanks

 

 

[seekingadvise]

I started mirtapine about when I halved the Zoloft from 25mg to 12.5mg. It was 8/15/17

 

its all in my attached PDF 

Medication Tapering Schedule.pdf

[seekingadvise]

Can someone please tell me where I can find that 10% Dosing Tapering Spreadsheet? Thanks.

[baroquep]

Here you go,

 

Tapering Calculator - Online
Tapering Calculator - Download

[seekingadvise]

Thank you. Can you please tell me wher I am supposed to make posts with questions? In my info stream or another topic? I'm having a terrible time with 7.5mg of Mirtazine. I'm sleeping great, but waking up with headaches, extreme agitation and my body aches are worse. I started the drug August 15. Been on it s little less and three weeks.

 

I sldo cant find the online tapering calendar. In the other one, the download one... they give calculation broken into 36 months. What if you just want to cut by 10% monthly and then end? I'm on 7mg Valium a day. Surely it won't take 36 months, but that's the break up in the spread sheet

 

thanks. 

[seekingadvise]

NEED HELP WITH 7.5mg MIRTAZAPINE 

 

 I just started taking this August 15. I am now experiencing extreme headaches in the morning and swelling of feet and legs. Can I reduce by 1/4 for four days,  then another 1/4 for four days then another 1/4 for four days and then stop? I will hold all the meds for a month.

[baroquep]

Hi Seekingadvise, you are posting exactly where you should.  

 

As you have been taking Mirtazapine for less than a month, a faster taper may be tolerable, such as a 25% reduction per week.   You might even be able to make more frequent dosage reductions to discontinue in a week.  Slow down and make smaller decreases if you get any withdrawal symptoms.  

 

Your idea to reduce by 25% and hold for four days between decreases is a good one.  See how you are feeling after the first decrease and then report back and let us know how you are doing.

 

Please do not make any changes to your other medications at this time and just concentrate on getting the Mirtazapine out of your system.

 

[seekingadvise]

Thanks so much. I am also waking up with extreme dizziness, more pain and extreme agitation. I be been with my husband for 13 years and in all the years I have been with him I NEVER was agitated by our differences. Now the some of the things he is doing is annoying the Hell at of me, I'm screaming at him about it and then I hate myself for it afterwards. He's imperfect, as I am...has his quirks, just as I do. These meds make you crazy! I loved Mirtazapine because it gives me a wonderful sleep and I have no idea what I am going to do for my insomnia now. 

 

ANY IDEAS FOR INSOMNIA? Benzo buddies does not recommend melatonin while on benzos (I'm on 7.5 Valium a day). What am I to do?

 

Thanks.

[baroquep]

Agitation and anger are to be expected.  I've had to deal with it many times over the course of the last year, agitation is a very common symptom. It would get so bad, that even the slightest noise would bother me and I had to embrace that this was part of withdrawal and try to find methods of keeping the agitation under control so that I wouldn't blow up.  Oftentimes, when I feel it building up at work, I'll put on headphones with calming music or try and distract myself by going for a break or calm myself by guiding and calming my thoughts.  

 

Your insomnia is likely caused by the difficulties you are having with Mirtazapine (among other medications) and the only thing I can recommend is to have a look at the links below and see if there are any non-drug techniques you can incorporate into your daily routine to cope with the insomnia.  From my experience, it does resolve over time but can take quite a bit of time.  

 

Sleep problems - that awful withdrawal insomnia

Guided Meditations, Calming Videos, Sleep Hypnosis

Non-drug techniques to cope with emotional symptoms

[seekingadvise]

IS THERE A SPREADSHEET NOT BROKEN DOWN IN 36 MONTHS? 

 

I'd like to find one that I am able to change the dosage, the number days we will reduce by and the % of reduction -- but I don't want it set up for 36 months. Thanks

[baroquep]

Hi again, we ask that members not use all caps in their threads (as it denotes yelling) and would ask that you post your questions in a regular font.  This practise can get you banned from the site.  

 

I did provide you with an online calculator above that you can download onto your desktop and make the necessary edits relevant to your own situation as required.

 

Tapering Calculator - Online

 

You can download (see instructions in red to the right of the spreadsheet) and make the changes relevant to your situation at the top left (in yellow/green).  

 

I'm not sure that you understand that it can take multiple years to withdrawal safely from psychiatric drugs and am going to re-attach links that will help explain the recommendations made by Surviving Antidepressants and why these recommendations are so important.

 

Obviously these recommendations don't apply to Mirtazapine as you are having a reaction, were on the drug for less than a month and can discontinue it much more quickly, but these recommendations do apply to the other medications you are taking.  I recommend that you familiarize yourself with the protocols.  

 

Before you begin tapering - what you need to know

taper-more-than-one-drug-at-a-time

Why taper by 10% of my dosage?

 

Edited September 4, 2017 by baroquep

[seekingadvise]

My apologies for the all caps. I didn't realize. 

 

Thank you for the downloadable spreadsheet. I was able to see and download that one, but I didn't see the online one. If they are the same, I have it.

 

Thank you very much...and thank you for including it again.

[seekingadvise]

A very big thank you to all who have replied to my posts.

 

Can you please let me know if you think I am in danger from the large decreases in my medications? I am do glad I am here. Now i can do it right!

 

2/16 - 5/30/17     10mg Paxil   (went directly to half dose 5/31 then stopped)

5/31 - 6/14/17     5mg Paxil    (then stopped and switched to Zoloft 6/15, which I hate)

6/15 - 8/10/17    25mg Zoloft  (went directly to current dose of 12.5mg and holding

8/11/17 —current 12. 15 Zoloft

8/15/17 7.5mg Mirtazapine for sleep (want to wean down correctly due to headaches, dizziness, extreme agitation)

 

Thank you.

 

 

 

[seekingadvise]

Need help with calculations please. Thank you Baroquep.

 

Thank you so much for your help and for all your posts. I'm a little confused about how to decrease the 7.5mg Mirazipine. I mentioned a 25% decrease with a hold every four days. The first 25% cut was fine. The dosage went from 7.5mg down to 5.6mg. How do I figure out how to do down from there? If I use the 25% cut on the spreadsheet, it has me stopping by 11/14/17. The original weight of the 7.5mg is .075 and the weight went down to .056 on my Gemini-20 scale.

 

The question is do I reduce according to the spreadsheet? Or am I taking 1/4 of the pill down and holding for four days? Then I can be done in 16 days. If I go by the calendar, I'll be off 11/18/17.

 

Can someone please help me here?

 

Thanks so much.

 

------

Hi Seekingadvise, you are posting exactly where you should.  

 

As you have been taking Mirtazapine for less than a month, a faster taper may be tolerable, such as a 25% reduction per week.   You might even be able to make more frequent dosage reductions to discontinue in a week.  Slow down and make smaller decreases if you get any withdrawal symptoms.  

 

Your idea to reduce by 25% and hold for four days between decreases is a good one.  See how you are feeling after the first decrease and then report back and let us know how you are doing.

 

Please do not make any changes to your other medications at this time and just concentrate on getting the Mirtazapine out of your system.

[baroquep]

I understand that the brain fog can get pretty bad when we are on numerous drugs, but you have to be cognizant of what you are attempting to do and take the time to read the posts carefully and understand the steps you need to take.  These drugs are very strong and can cause a multitude of problems if not withdrawn carefully.  Does your doctor know that you are attempting to come off of Mirtazapine?  or any of the other drugs you are currently taking?

 

As I mentioned in a previous post, the tapering chart will not apply to the Mirtazapine as you felt that you had a bad reaction to it and were only taking it for two weeks. 

 

On 2017-09-04 at 11:40 AM, baroquep said:

Obviously these recommendations don't apply to Mirtazapine as you are having a reaction, were on the drug for less than a month and can discontinue it much more quickly, but these recommendations do apply to the other medications you are taking.  I recommend that you familiarize yourself with the protocols.  

 

You previously asked me if it was a good idea to reduce by 25% every four days and I responded:

 

As you have been taking Mirtazapine for less than a month, a faster taper may be tolerable, such as a 25% reduction per week.   You might even be able to make more frequent dosage reductions to discontinue in a week.  Slow down and make smaller decreases if you get any withdrawal symptoms.  

 

If you are planning on reducing 25% of the Mirtazapine in the next couple of days, please come back and post and let us know how you are doing.

 

 

[seekingadvise]

Thank you so much for replying. Yes, I'm very confused, unfocused and dizzy. I do not know if it is the meds or my neuro condition. My physiatrist (who has followed my care very closely since 2012) agrees with me that it might be best to stops all meds so I can see what is a symptom and what is a side effect. (I suffer from multiple complex neurological and muscular skeletal conditions). 

 

I don't have a PM doctor because he discharged me (he thinks I should get a spinal chord stimulator from a specific doctor who specializes in one of my conditions)...but I have sacral cysts and a SCS makes symptoms them worse (all the newsgroups who have experience with this said). I saw a Pyschopharmacologist once to get Valium because my PCP wouldn't prescribe it and neither does the Pyschopharmacologist...he sees me as a chronic pain patient (not depressed or with true anxiety issues), so he said he cannot help me. He did me a favor and prescribed sixty 5mg Valium pills. I told him I could not sleep, so he prescribed the mirtazapine. Now, my PCP is prescribing Zoloft, Gabapentin and Mirtazipine. I've been all over the place with PM doctors who put me on and off multiple drugs...and some switching around was my doing because of side effects.

 

My physiatrist, who usually doesn't do meds, said he will do me a favor and prescribe the Valium as he thought that would be the first to wean.

 

At this point, my headaches, dizziness and confusion might not be the meds at all. My am Cortisol was extremely low and last week I was tested for Addisin's disease (which my physiatrist does not think I have). My headaches and dizziness occur in the morning and whenever I lie on my back -- I'm discovering thing daily. I'm not sure what's causing it, but for the first time in months, at least I am sleeping with mirtazapine. 25% down last night, with 5mg of Valium and 50mg of Gabapentin I was able to sleep.

 

To add to the complexity of this, I banged my head very badly before the 3/30/17 surgery and the headaches and dizzyness can be from the head bang (I will be getting a brain and cervical spine MRI in two weeks). The headaches began in June when I switched from Paxil to Zoloft, so I thought it was the 25mg Zoloft and just halved it to 12.5...but the dizzyness, body aches, lack of focus and headaches can be side effects, low cortisol, the bang or from the spinal cysts -- which is why my physiatrist and I thought it best I go off all drugs to see what is what. Nothing I've taken has helped with pain...but Valium has been the only thing that calmed my nervous system down...but I need to wean down because no one in my area will dispense it...I can't travel, I'm basically housebound with my condition.

 

So, in sum, I really don't know what to do...maybe I should wean off Zoloft and Valium first? Benzobuddies.com say wean the benzos first, your group says the ADs should go first.  I'm at a loss at what to do and am barely able to function. I was so healthy five years ago. Got certified as a yoga teacher at 58 years old. You can read my About Me section which I just edited today.

 

Thanks so much for your replies, your wealth of information, your kindness, your patience and your criticism (of my all capitals).

[baroquep]

If you are getting side effects/adverse reaction from the Mirtazapine and no clear benefit, and because you've haven't been on it very long, I would consider getting off of it sooner, rather than later.  The central nervous system adapts to the presence of an anti-depressant (among other drugs) after a period of a month.  I think it would be a good idea to try to minimize your drug burden while the opportunity still exists.

 

According to the journal literature on antidepressant withdrawal syndrome, anyone who has been taking a drug for a month or more is at risk.   

Edited September 6, 2017 by baroquep

[seekingadvise]

Thank you. Will do.

[seekingadvise]

Thank you so much for replying. My physiatrist, who has followed my care is the one most familiar with my case. I will see him on Sept 21 and discuss all my medications and I will discuss my medications with the Pyschopharmacologist I saw once who prescribe the Mirtazpine (I am not under his care).... as he felt I was a chronic pain patient and did not need psych help. He just prescribed the Mirtazapine for sleep and my my PCP renewed it.

 

So far I am weaning the Mirtazapine like this:

3/4pill for four night

1/2 pill the next four nights (tonight is the last night for this dose)

1/4 pill the next four nights (this is will a challenge)... I will see how sleep is after that. I am still taking 5mg Valium at night and 36mg of Gabapentin at night. I am at 72mg Gabapentin a day. My neurologist said I can just stop the 100mg, but I am not going to do that. I'm weaning down, but not at the 10% per month rate.

 

my largest concern is when I switched from 10mg of Paxil to 25mg of Zoloft...took that for two months and just halved it...so now I'm at 12.5mg of Zoloft a day. I am quieted by and agitated. Today my face feels somewhat tingly and I've been having headaches on and off (getting a brain MRI Thursday)... I did suffer a major bang on it a few months back. The headaches are hitting me now on the same spot I had the bump, but it's expanding.

 

comments? Thanks so much for your help.

 

[seekingadvise]

Need Help here:

 

i was put on 7.5mg Mirtazpine and then after two weeks, did a quick wean by cutting the pill in 1/4... taking 3/4 for four days, 1/2 pill four days, 1/4 pill four days then stop. (I weaned because of extreme headaches and dizzyness in am) I didn't take it last night and was able to sleep with my 5mg of Valium and 36mg Gabapentin.

 

My concern is my memory. Ever since Mirtazapine, my focus on things has been about two seconds. I go aroun the house like a crazy person not remembering what I just did. What is happening to my brain?

 

Thanks.

[ChessieCat]

Have you made any changes to other drug doses during this time?

[seekingadvise]

i did make this change to Gabapentin:

 

8/29 - 9/9 Went back to capsules, weighing w Gemini-20 mg scale (45mg am, 45mg pm) = 90mg

9/10 - 9/24 36mg am/pm     72mg Total

 

My neurologist said I could just stop my 100mg capsules....but I'm a bit wiser than that. I'm weaning. It's giving me severe gastrointestinal problems I lost about 15 lbs this year. 4'11" and 100 lbs. probably about what I should be, but I look very thin compared to what I was. I used to average 115-118 lbs. having an endoscopy this Tuesday. The anti-inflammatories after my March surgery also killed my stomach.

 

There was a switch from 10mg Paxil to 25mg of Zoloft in mid-June. I stopped Oxycodone the end of July...so I think my mind has been yo-yo since. Please look at updated signature.

 

I went on Mirtazpine 8/15 - 9/3/17, then starting weaning and stopped.

 

Just those changes. Feedback please. Thanks.

[ChessieCat]

Making more than 1 change at a time makes it difficult to work out what the issues are being caused by.

[seekingadvise]

Do you think I can wean Zoloft and Gabapentin at the same time? I've only been on Zoloft since mid June and ADs (Paxil) since February.

[ChessieCat]

Tapering 2 drugs at once is not recommended because if you have issues then you won't know what is causing what.  The fact that you have only been on Zoloft and Paxil for a short time doesn't take into account that you have previously been on other psychiatric drug/s in the past.  The effect on your CNS is cumulative.

 

Even making a reduction on one drug, holding and then reducing the other would not be a good idea because withdrawal symptoms can be delayed so if you reduced drug A and then drug B and then had issues you wouldn't know it if was delayed withdrawal from drug A or caused by reducing drug B.  If things got really bad you would probably then increase A, B or both and then have to stabilise and then try again.  In my opinion it would be better to do it the safer way from the beginning than risk things going pear shaped and end up suffering and it taking longer anyway.  There are a couple of members here who if they had reduced their drug the recommended way which was suggested when they joined SA would probably be drug free by now.  Instead they are still on a drug or two and not doing as well as they might have been if they had used the harm reduction method of tapering in the first place.

 

Taking multiple psych drugs? Which drug to taper first?
If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug).

[seekingadvise]

Thanks so much for your feedback. I will talk to my pain doctor...he may want me to wean the Valium first. I'd rather wean Gabapentin, then Zoloft, then Valium....but that leaves me on a benzo for a very long time.

[seekingadvise]

Natural remedies for stomach inflammation needed -- help please.

 

the medication I am taking:

36mg Gabapentin 2x day

2mg Valium am and 7mg Valium pm

 

are killing my stomach. I believe I now have what is called "benzo belly" and the Gabapentin never agreed with me and caused acid reflux. My stomach is sooooo bloated.

 

i also take 12.5mg Zoloft.

 

can anyone lead me to where I can find some natural remedies? I do not want to add Nexium to my regiment of meds.

 

thanks.

[ChessieCat]

Here are a couple of discussions:

 

digestive-problems-nausea-diarrhea-bloating-gerd

 

probiotics-and-gut-health

 

dgl-deglycyrrhizinated-licorice

 

Please see the warning here:

 

licorice-root

 

[seekingadvise]

Thanks so much. I'm taking DGL Licorice.... so is it good or bad?

 

I'm also taking allergy shots once a month. Do you know how that affects withdrawal?

[seekingadvise]

I made a big mistake and I need help.

 

i was on 100mg of Gabapentin for almost four months (until mid August) and I messed up my calculations on the scale! Oy! I'm having terrible burning everywhere in my body (and very achy).

 

4/27 - 8/18: 100mg 

8/19 - 9/5: 90mg 

 

then because I screwed using my scale, I jumped and didn't even realize it:

 

9/9 - 9/22: 56mg

9/23 - 9/26: 34 mg ......then I realized what I did

 

My mind is a fog. I go in rooms and forget why I went there. I stand in front of a microwave, then hesitate in how I'm supposed to use it. I'm so afraid I permanently damaged my mind. Did I? Will I heal?

 

So I went up to total of 70mg yesterday (35mg am and pm) and took 35mg this morning and I am so sick. I could hardly eat at all today. My gastroenterologist tells me to stop the Gabapentin first before the Valium and AD because it causing mild gastritis. I can't go all the way up again because my stomach won't take it. Gabapentin always gave me acid reflux. I had an endoscopy two weeks ago because it was so bad.

 

So I decided to to back to 52mg and just hold there and suffer it out. Please experienced people, help me here.

[seekingadvise]

My homeopathic doctor just gave me "Glutagenics" from Metagenics. 

 

Per serving, it contains:
 3.5g L-Glutamine per serving
500mg DGL Licorice
50mg Aloe

 

She wants me to take two servings a day because she says Glutamine is crucial to heal my gut. How will this affect my brain and withdrawal symptoms? I'm withdrawing from Gabapentin, Valium and Zoloft (not all at same time)....just Gabapentin right now.

 

I've read Glutamine is not good during withdrawal. Am I correct? Please help.

[seekingadvise]

Can someone familiar with this topic of L-Gluatme kindly share what you know. Thanks.