Peculiar

[Peculiar]

Thank you for accepting me to your forum.I am about to start a taper off mirtazapine . I have been taking it for 7 weeks. I had previously been tapering Prozac every other day 40mgs for one week then reducing to 20mgs every other day for two weeks. Then I started Mirtazapine 15mgs for two weeks then upped it to 30mgs a day.  I dropped the Prozac completely 2 weeks into the Mirtazipine (on my drs instruction) so needless to say I am in a bit of a state! I need to get off the Mirt and then am thinking about taking Prozac again and commencing a slow steady taper. I am not sure what to say to my Doctor? 

[MollyN]

Hi Peculiar! 

 

Welcome to Surviving Antidepressants (SA)! Sorry to hear you're feeling off. Sounds like it was a very fast taper off prozac - can you tell us more about the timing of that? How long you took it for, when you started tapering? When did you finish taking it?

 

At SA we recommend a taper of 10% drop of your last dose, and definitely,  alternate day tapers are to be avoided - that's really hard on our brains (my doctor recommended the same strategy). We want to take it slow and steady as we can to allow time for our brains to adjust to the changes the drugs have created in our brains.

 

Was the mirtazapine prescribed to deal with the symptoms you were getting from the fast taper of prozac?

 

I'm just learning about the different drugs, so we'll wait for one of the other moderators or knowledgeable members to recommend how to go from here, but in the meantime you could read the links below and also if you could provide your drug history for a signature - that appears below every post you make around the site, so other members know  a little about your experience at a glance, that would be really helpful.

 

Here's how to do it:

 

Summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

 

Here are some discussions that you might find really helpful:

 

Why taper by 10% of my dosage

 

What is withdrawal syndrome

 

The windows and waves pattern of stabilisation

 

Tips for tapering prozac

 

Tips for tapering remeron (mirtazapine)

 

Here is a discussion about talking to your doctor about tapering and withdrawal

 

Depending a lot on the info you give about when you last took prozac and the dose, reinstatement may be an option, but someone will chat about that soon, in the meantime, you could read this discussion:

 

About reinstating and stabilising to reduce withdrawal symptoms

 

This is a great discussion of non-drug techniques to cope with emotional symptoms.

 

You can use this thread as a journal to ask any questions you may have and people will come and support and help you here. Feel free to read other people's experiences as well, it really helps to understand what's happening.

 

See you soon xxxmollyn

 

Edited November 6, 2017 by MollyN

[Peculiar]

15 hours ago, MollyN said:

Sounds like it was a very fast taper off prozac - can you tell us more about the timing of that? How long you took it for, when you started tapering? When did you finish taking it?

15 hours ago, MollyN said:

Was the mirtazapine prescribed to deal with the symptoms you were getting from the fast taper of prozac?

 

I had been on Prozac for about 21 years with short breaks throughout the years, (pregnancies and trying other ADs).  The Prozac was not working as it once had. After as chat with my husband in mid  August of this year,  I decided to come off it. I got down to 20 mgs every other day over a 4 week period). I was doing ok but I felt the waves were becoming more frequent and the windows had lessened. So I make an appointment with my Doctor. He asked me if I was sleeping ok? (a family member had recently been very ill) . I told him my sleep was not great and I was feeling lifeless and just going through the motions. Withdrawal from Prozac was not even mentioned? At the time I thought my depression was just coming back! He prescribed me Mirtazapine 30 mgs and said that I was to come off the Prozac asap as these would get into my system and should lift my mood. I had a crossover for only one week , before I stopped Prozac completely.

 The first time I took Mirtazapine  alarm bells should have rung! Within half an hour I was laying on the kitchen floor feeling dizzy and so weak. I had been there for about 20 mins when I mustered up the strength to get upstairs to bed! Where I slept for 6 hours straight!  And after being up for  just 2 hours I then slept another 8 hours! The Dr said it was just too high a dose so told me to take 15mgs daily for 2 weeks and then up it to 30mgs daily.

Thank you for reading and for welcoming me! 

Edited November 7, 2017 by Peculiar
Wrong dose

[Peculiar]

21 hours ago, MollyN said:

 

I have just spoken to my Dr. He says I should just stop the Mirtazapine no taper? Nervous about this. I have only been on it six weeks though. He said I should go back on Prozac 20mgs for a month or two and then look at trying something else or tapering off again.. I thought about asking him about the slow 10% taper but he thinks 4 weeks to get off Prozac IS  a slow and gentle taper! Any thoughts? Thanks xx

[Altostrata]

Welcome, Peculiar.

 

Many doctors do not taper as slow as we do, they think it's unnecessary. If you've had problems with drug changes before, you might be hesitant to go off as fast as many suggest.

 

Rather than ask your doctor how to go off, if I were you, I would present your doctor with your preferred schedule. There is no reason for a doctor to rush a patient off a drug if the patient doesn't want to do that.

 

If you have difficulty communicating with this doctor, you might want to work with another who is more considerate. Any doctor can prescribe these drugs.

 

See

Why taper by 10% of my dosage?

Tips for tapering off Remeron (mirtazapine)

Did you have any problems going off Prozac? How did you go off? Why are you taking mirtazapine? Why do you want to go off?

Are you taking any other drugs?

[Peculiar]

Hi Altostrata,

 

Thank you  for the links and your advice about speaking with my Dr. 

 

Coming off Prozac was actually ok. I had been on it for something like four years this time. I reduced my dose quickly from 40mgs daily down to 20mgs daily for about two weeks then from 20mgs daily to 20mgs e/o day. Then I took two a week for about another two weeks. The reason I came off Prozac was it had mostly stopped working . I had used it on and off over the last 20 years. I think the reason I went on the MIrtazapine was because I was desperately trying to reinstate some feelings of appreciation and happiness back into my life. I have a loving and supportive husband and 3 great boys. A nice home, a job , and yet I feel so unappreciative of it all.

About four weeks into my Prozac taper I went to see my Dr  about how "flat" I was feeling and he suggested I try Mirtazapine. He thought I would do well on it due to my poor sleeping and the stress I had recently been under with my sons health.  So I went away with the plan to start on the Mirtazapine  while at the same time continuing to taper the Prozac.. I was only taking Prozac 20mgs one or two tablets a week by this time and jumped off around two weeks later.,..  .Once I had been taking Mirtazapine 15mgs daily for four weeks I went up to 30mgs daily where I stayed until just a few days ago when I went ct. I did experience side effects on it, vivid dreams, whooshy head and I also ate a lot while taking it and have put on 10lbs!  Over the six week period I had not noticed any improvement in my mood. It did improve my sleep problems though.

 I found SA and realised that I wanted to live my life without these horrible meds!.  My Dr said that was ok to go ct on the Mirtazapine and to reinstate  Prozac 20mgs daily. (I am doing ok sx wise except for a queasy stomach and some lightheadedness( not sure if these are withdrawal symptoms as I had similar symptoms while taking Mirtazapine!

 So all in all I was on Mirtazapine for 6 weeks and been off it ct for four days. I plan to try a slow taper off the Prozac in a couple of months and will make an appointment with my Doctor and sit down and show him my preferred schedule which will be the 10% of my dosage! 

.

I also take Sulfasalazine for Auto Immune Arthritis.  I have only been on this for a few weeks. Was on Methotexate prior to that again for Arthritis. I switched to Sulfasa as the Mtx made me nauseated and tired.   I also take folic Acid 5mgs once a week.  

 

I hope this makes some sense! 

 

 

[Peculiar]

Also on a different note, I have just realised that just two months of coming off Sertraline ct (back in Nov 13)  my mysterious inflammatory disease kicked in. It happened almost overnight!  I couldn't walk properly.All my joints were swollen. After loads of tests.. and 2 months off work. I was put on a high dose of steroids which took months to taper off. After that came the dreaded Methotrexate. I could cry thinking of what my poor body and brain has been through! 😣😤

[Peculiar]

I have been in to my signature and edited it somewhat in the hope it is now making more sense!

 

Well I woke up at this morning at 7am feeling sick and anxious. My bowels are not happy either! I am feeling hot and cold.  Nothing major just jittery! Last night was not too good. I got off to sleep  around 1am  but woke around 3am where my thoughts kept me awake till around 4am when I finally managed to drop off again.  I have been trying to get up to speed on reinstating Prozac and tapering off Mirtazapine and I have become really anxious. My body feels out of whack! Am I  experiencing WD from the Mirtazapine? I was really hopeful that as I had only been on it 6 weeks that my brain had not got used to it. I may have underestimated that!  Im in a dilemma!  I have reinstated the Prozac at 20mgs daily from 5th November( concerned this might be too high, although I was taking 40mgs daily for a long time). But I have not reinstated the Mirtazapine, not even a tiny dose! Am I taking too big of a chance here by not reinstating it? Have I got it wrong by reinstating Prozac? Help!!

[Peculiar]

 I think I might  Reinstate Mirtazapine . I have followed the instructions on making an oral solution, I have dissolved a 15 mg tablet in 15mls of water. Question is how much should I take?  3mls? as I was on 30mgs up until ct on 4th November. Does this sound sensible? 

 

Now what do I do?!!

Interactions between your selected drugs

Major

fluoxetine  mirtazapine

Applies to: Prozac (fluoxetine), mirtazapine

Using FLUoxetine 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.

[Peculiar]

Is anyone about to give me some advice please? 

Mirtazapine..What would be a good dose to reinstate? I was taking 30mgs dailyfor a total of two and a half weeks. I went ct on 4th November. 

2

Prozac.. I have reinstated at 20mgs daily. I think this is a bit too high . My dose was 40mgs daily up until Aug 2017. Coming off prozac has never given me any physical symptoms! My mood always plummets though.

 

I am experiencing physical withdrawal symptoms from the Mirtazapine.  Insomnia, loose BM, sweating, dizziness.  

I have been too unwell to go to work this week. 

Thanks x

 

 

 

 

[AliG]

Hi P. As there is a major interaction between these two drugs, I would be inclined to leave off reinstating the Mirtazapine and concentrate on tapering the Prozac for now. I can't quite understand why you reinstated at such a large dose of Prozac. We would have advised a much lower dose to reinstate. 

 

I've also been on the Mirtazapine and I understand how it can mess with the sleep cycle as well as weight gain and a general feeling of being out of it, so I would probably just leave it for now. It's obviously not ideal and you will most likely be suffering withdrawal symptoms but now that you're off, I would think about staying off. It's a nasty drug and I would be hesitant about re- introducing it.

 

What are your thoughts?

Ali

 

[Peculiar]

26 minutes ago, AliG said:

Hi P. As there is a major interaction between these two drugs, I would be inclined to leave off reinstating the Mirtazapine and concentrate on tapering the Prozac for now. I can't quite understand why you reinstated at such a large dose of Prozac. We would have advised a much lower dose to reinstate. 

 

I've also been on the Mirtazapine and I understand how it can mess with the sleep cycle as well as weight gain and a general feeling of being out of it, so I would probably just leave it for now. It's obviously not ideal and you will most likely be suffering withdrawal symptoms but now that you're off, I would think about staying off. It's a nasty drug and I would be hesitant about re- introducing it.

 

What are your thoughts?

Ali

 

 

Hi Ali, thank you for your reply.  I had been on Prozac for 4 years up until and including the taper until mid Sept. I had been doing a fast taper 40mgs down to zero over a period of 2 months. Why did I reinstate at 20mgs you ask? I will try to explain:

 

I was on 40mgs daily and I think I had become tolerant/ pooped out so I began the taper. By the time I had got down to 20mgs every other day I was feeling more melancholy generally and had no interest in pretty much anything. I had no idea it could be the fast taper that was increasing my depressed state.! At this point I wish to dear God I'd have found this site!

Then it got complicated once the Mirtazapine was thrown into the mix! It was prescrbed around 3 weeks into my Prozac taper to lift my mood and help me sleep better. (If only I'd never taken it)  I was only taking it for 6 weeks. That was enough! I just stopped it which in hindsight was plain stupid! In

 a panic I took a prozac thinking it might minimise the side effects of going cold turkey ! Next day (6thNov ), my Dr advised I should continue on Prozac 20mgs daily and then try to taper in a month or two. This sort of made sense as it was about half of what I had been taking and I thought I needed this high dose to balance out the drastic mirtazapine cold turkey disaster! 

Oh hope I am making sense?  And I had a feeling of comfort that I could now make a slow steady plan to taper off of Prozac once and for all! 

 

This morning I woke feeling awful after a bad nights sleep. I had night sweats and and am so jittery. I need to feel better as I have work tomorrow and my family are worried about me so I took 2mls of mirtazapine. I plan to stay at this dose and will just have to see how it goes next few days! I know it's not ideal but Its worth a try!  I am sorry to hear you too had bad reaction to the mirtazapine. How are you doing now? Are you off it completely? 

Once again than you for taking time out to reply Ali. Means a lot xx

 

 

 

[AliG]

On 11/9/2017 at 3:17 AM, Peculiar said:

Was on Methotexate prior to that again for Arthritis

 

Oh my, are you still on it? It's a chemotherapy agent. Why were you put on this? Can you please add in all your drugs?

 

Did you take 2 mls mirtazapine in the am?

On 11/9/2017 at 3:17 AM, Peculiar said:

I also take Sulfasalazine for Auto Immune Arthritis.  I have only been on this for a few weeks. Was on Methotexate prior to that again for Arthritis. I switched to Sulfasa as the Mtx made me nauseated and tired.   I also take folic Acid 5mgs once a week.

 

Can you please add these to your signature? Thanks in advance. 

 

P. It will be ok. We will get there. We just have to have all the information up front and then we can slowly and rationally deal with it.

[Peculiar]

3 hours ago, AliG said:

 

Oh my, are you still on it? It's a chemotherapy agent. Why were you put on this? Can you please add in all your drugs?

No not anymore. I was switched to Sulfasalazine at the start of October 2017. These drugs are called DMARDs... (Disease Modifying Anti Rheumatic Drugs) After writing this here I will go and add everything in my drug history to  my signature. I was put on Mtx in the aim to get my autoimmune Arthritis into remission. 

 

3 hours ago, AliG said:

 

Did you take 2 mls mirtazapine in the am?

Yes, I took 2 mls this morning. 

 

P. It will be ok. We will get there. We just have to have all the information up front and then we can slowly and rationally deal with it.

 

Thanks you for your help AliG 

 

[Peculiar]

I have started taking Fish Oil today 10th Nov.  I am Starting Magnesium tablets tomorrow 11/Nov. In the last couple of hours my tummy seems much happier, queasyness has eased , feels more settled. Still feeling a bit disorientated. Managed a bit of tidying up and cooked dinner. 

Edited November 10, 2017 by Peculiar
spelling!

[Peculiar]

Well I am feeling stable again and its been one week since I reinstated the Mirtazapine (2ml) and 15 days since I reinstated the Prozac (20mgs). I have also started taking Fish Oil 3 CAPSULES daily plus Magnesium tablets. I don't know for sure but I think the fish oil is making me feel a bit nauseous? Any one else had any experience of this happening? I am doing gentle stretching exercises daily for 15 mins. I am finding hard to get motivated  but once I get started I do enjoy them. I also notice a little improvement in my mood immediately after exercising too! I have cut out alcohol completely since 3rd November. I do get cravings every few days as I did drink around 4 units, 3 times a week. I am going to start tapering the Mirtazapine on 8th December which will be 4 weeks since reinstatement. I am going to try 1.5 mls for 4 weeks and if all ok I will go down to 1ml in 8 weeks. After that i'm not sure what dose to go down to.  Today I am in a wave, but I have had a few windows this week. They did'nt last long but I definitely had some which felt good. 

 

P x

[Peculiar]

Hi ,

 

Well its been a little over 4 months since I last posted. I am now completely off The Mirtazapine. I have been taking 9mgs Prozac since the 4th March 2018 and I am in all sorts of trouble. My mood is very low. I have no interest in anything. I sleep walk through my days. Feeling numb and alone. I struggle to go to work and when I get home I just want to hide out in my bedroom. I  have started drinking again even though the come down from it is horrible. I seem to need the fix from the alcohol. But of course when the alcohol leaves my brain I feel even worse plus guilty for drinking again! I was wondering about the Prozac taper. Is it worth continuing with a slow taper when I have pooped out on it?  Would I do better just to come off it cold turkey as It doesn't  seem to be doing anything? 

Thanks x

[Altostrata]

You probably know we advise against drinking alcohol while experiencing any kind of adverse symptoms from a psychiatric drug.

 

What symptoms do you attribute to drinking and which to a drug? How did you feel when you were completely off mirtazapine? Were you drinking then?

[Peculiar]

Hi, yes I know not to drink Altostrata,  I have a long history with alcohol.  It is my crutch, my means of escape . It can transform my mood within minutes of taking it. When I drink it's a little bit of a release from the sadness and hopelessness I feel. But after consuming it there is the headache. The feeling of poisoning both my body and already  damaged (from prozac/mirtazapine/sertralaine)  brain. The self loathing is particularly unpleasant.  So I stay away from it for a few days then comes the inevitable  craving  and back I go to seek some relief in a bottle of wine. I am usually careful not to drink more than 350 mls (about 2 glasses) in one session as any more and  the alcohol irritates my stomach and urinary tract. But just lately I am seem  unable to limit my intake and can even drink a whole bottle of wine  (750 mls) in one session.  When I do this my  physical symptoms are : headache, irritable stomach and bladder. Mentally I feel guilt, self loathing, sadness. 

 

Now with the prozac taper.  I am so pleased to be doing  well physically. But I am worried about my brain. I do not like being around people. I am quiet and withdrawn even with my own family. I feel like an alien. I cannot relate to my fellow humans. I feel despair. I can get it how some people want out! Then i will get a window and just for a few hours I have hope and I start thinking about spring and my garden and new beginnings. And in those moments I know there is hope for me.

 

I felt ok when I got completely off the mirtazapine. I went down to 0.5ml and then after a  week just stopped  taking it. At that time I did not regularly drink alcohol (maybe a glass or two a week). Now its about 2 bottles a week! I want to continue my prozac taper as recommended here but I am losing hope that I will be able to recover and have a life.

 

[brassmonkey]

Hi Peculiar-- Mixing alcohol with the two drug that you're taking is not doing you any favors.  In fact it is setting up a self perpetuating spiral that will just make things a lot worse and could cause some bad damage to your body.  Prozac is well known for causing alcohol cravings and the more you drink the more you will want to drink.  Sulfasazaline on the other hand reacts badly to alcohol and causes most of the symptoms that you are experiencing.  It also reacts with the alcohol to cause liver and kidney damage among other things.  I would suggest doing everything possible to eliminate alcohol altogether.  It will probably cause an uptick in your symptoms for a while as your body works through the changes, but it will be so worth it once you're stable again.

 

Brassmonkey

[HopefulOne1]

Hi Peculiar,

 

Sorry to hear that you’re another person that had Mirtazapine recommended because you were instructed to taper way to fast (poor doctor’s advise), but it’s good to see that you were able to stop taking it.

 

Although you may have felt that needing to reinstate Prozac was a set back I’d continue to taper slowly since you were on it for a long time. You might feel that it’s no longer working, but although I’m still learning about all this, I’m pretty sure that your body will notice large cuts and especially if you quit ct. If you’re feeling confident then maybe you could try to reduce by more than 10% and see how it goes but listen to your body and be prepared to reinstate and then continue tapering .

 

I’m in a similar situation and was put on Mirt to help get off Lexapro because I was having severe insomnia. I could fall asleep but couldn’t stay asleep and now I know this was a wd effect from tapering off Lexapro too fast but my doctor seemed to insist that it was “anxiety” coming back even though I never in my life had issues with sleep. 

 

I reached a similar crossroad but instead I decided not to go back on Lexapro and chose Mirt instead. I already decided that Lexapro wasn’t helping anymore and after suffering through bad wd I never wanted to touch that pill again. ..but I traded one evil pill for another and now have to taper Mirt. I’m going to do it slowly this time though and I suggest you do the same. I might try doing more than a 10% cut but I will definitely not cut things in half again.

 

You’re definitely not alone so continue to post your decision and progress. 

[Peculiar]

Hi, wanted to update my progress so here goes:

 

I am down to 1mg of Prozac daily. It has been tough on my mental health but I am determined to get off this drug! I have been experiencing alot and I mean ALOT of emotions! It's like the flood gates have opened and I can feel joy and sorrow once more. 

My autoimmune disease has been active and I have been through a really rough time of it these past 6 months as my medication has not been working. I have now switched back to Methotrexate from the sulphasalazine. I'm also taking prednisolone to keep the inflammation under control. 

I also take omega 3 and 6, VitD,

Folate, Iodine, Turmeric supplements. 

Hope you are all ok out there.

 

☺♥️