JMBR: Remeron

[JMBR]

Taking between 5-10mg Remeron for sleep for 2.5 months.  How should I taper?  I have severe, chronic insomnia but Remeron is not working.  Is replacing the dose with Trazadone an option or do I need to taper off Remeron first?

 

[ChessieCat]

Hi JMBR and welcome to SA,

 

Q:  Have you or are you currently taking any other psychiatric drugs?

 

Please create your drug signature using the following format:

 

A request: Would you 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.

 

After being on Remeron for two and a half month your brain will most likely have already become physiologically (not physically) reliant on the drug.  SA generally recommends tapering by no more than 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  However, if you are not currently taking another psychiatric drug, or haven't taken one in the recent past, you may be able to taper more quickly.  You will need to listen to your body and if withdrawal symptoms arise then slow down.

 

It's important to note that many members find that the lower their dose gets the slower they need to go.

 

Sleep problems - that awful withdrawal insomnia

 

Why taper by 10% of my dosage?

 

Tips for tapering off Remeron (mirtazapine)

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Keep it Simple, Slow and Stable

 

Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

 

The are useful in understanding why tapering is recommended:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Intro topic where you can ask questions and journal your progress.  We encourage members to visit other members' topics so you can support each other.

[JMBR]

Thank you Chessie Cat for your prompt and detailed response.  I have been taking 1-3mg Lunesta with the Remeron but I do not plan to taper off the Lunesta yet.  I need to protect whatever sleep I can get at this point.  I do not and have not taken other psychiatric meds in the past.  I thought about replacing the Remeron with Trazadone as the doc gave me a script but after reading so many of these posts, I think I'd just be trading one problem for another.  Doc just told me to quit taking the Remeron as it only hits the histamines at such a low dose so there is no withdrawal issue.  Ironic how they tell you this but yet tons of stories online paint a very different picture.  Live and learn.  

Any advice is appreciated.  Thank you!

[JMBR]

I would like any advice on reinstating Remeron after 6 weeks.  

 

History - I was put on Remeron for sudden onset insomnia and anxiety brought on by a reaction to a antibiotic.  I have not previous history of taking any meds or any history of anxiety.

 

I took between 5-7.5 (I took 5 most of the time) for 3 months and began to taper off as it was not helping with my sleep. 

I tapered down from 7.5 starting in Feb 18 and dropped off completely the end of June (so over a period of 5 months).

 

The taper looked something like this:  (doc told me to just drop in half for 2 weeks and then come off)

5 to 3.75 over Feb and March

3.75 to 0 April to end of June

 

This drug never agreed with me and I never felt well on it so it is hard to say what, if any dose, I ever "stabilized" at.  

 

I have now been off 6 weeks and have panic attacks (which are new), heightened anxiety, agitation, anger, sweats, problems sleeping, general feeling of illness, loss of appetite, crying jags... I do have periods where I feel OK but I am homebound for the most part since the symptoms are so debilitating.

 

I was put on a low dose .375 Klonopin in Feb. and I've had to increase this to deal with these symptoms.  I want to titrate off the Klonopin but obviously cannot with this going on.

 

I would appreciate any and all advice!

 

Thank you!!!!!!

[ChessieCat]

Your signature says Valium PRN.  How often do you take this?  When and what doses of Valium have you taken over the last 2 months?

 

What is your current symptom pattern, ie at what times do your symptoms worsen compared to when you take your drugs?

 

I've asked the other mods for their thoughts on you.

 

Edited July 31, 2018 by ChessieCat

[JMBR]

I have not taken Valium for several months although I do have it.  I have had to take .125 of Klonopin a few times over the last 6 weeks when my anxiety got so bad that I had extreme panic attacks - or at least that's what I assume they are.

 

I take Klonopin at night only, aside from the few times I mentioned above.

 

I have very high anxiety in the mornings.  I am almost always much calmer and feel better in the evenings.  I have days where I cry on and off and feel deep despair/depression (no history of depressions), then days where my anxiety is extreme with agitation (can't sit still, pace).  The newest one is I've had some anger issues which is completely out of character for me. The anger isn't directed at people - just throwing pillows, shoes, yelling,  etc... then days where I feel like crap physically - so ill I can't even articulate.  Symptoms seem to be on and off during the day but always in the same thread - anger, depression, etc.

 

I should mention that the antibiotic I took is known for creating some CNS issues so I don't know if this is withdrawal or not.  I do know that I got much worse when I went off the Remeron.  

 

Thank you ChessieCat.  I am in a crisis here.  My doc just wants to give me more meds.  I don't know what to do.

[Altostrata]

Welcome, JMBR.

 

What time of day do you take Klonopin? You've been taking .375mg Klonopin every night since February?

 

Do you also take Lunesta nightly?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

 

[JMBR]

Altostrata,

 

I am currently prescribed 1.5 mg Klonopin nightly.  That was way too much form me so I was taking .375 nightly from Feb until about a month ago when I went off the Remeron. I had to increase the dose and I now take .5 and on a really rough day .75. 

 

I do not take anything else except some vitamins (magnesium, b complex, multi)

 

My apologies but I did not know how to edit my tag.  I was on Lunesta and Valium prn back in February.  I was sleeping about an hour tops per night for nearly 2 months so they tried Remeron, Trazadone, Lunesta..... Unfortunately, the only thing that worked was the Klonopin.  They told me to stay on the Remeron even though it was not helping my sleep because it was an appetite stimulant and I'd lost so much weight.  They said it was non-addictive and given to children!  I wish I would've never stepped foot in a psychiatrist office.  I am having a hard time knowing if this is withdrawal.  Doc says it is not because my dose wasn't even at the minimum therapeutic level of 7.5mg and Remeron does not have withdrawals.  I'm so confused.  

 

Thanks for any advice you may have.  

[Altostrata]

It looks to me that you are getting rebound anxiety in the morning from the Klonopin. Please start a topic for yourself here to discuss how to deal with your benzo intake.

 

We will need your daily symptom pattern. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

[JMBR]

Just to be clear - you believe my issues are from the Klonopin and not the Remeron withdrawal?  

 

 

[JMBR]

Groundhog Day

 

Hello fellow warriors.  I have been gone from this forum for some time. in Oct. 2017, I had an adverse reaction to an antibiotic that left with me with many symptoms similar to benzo w/d and severe insomnia.  I was eventually put on Klonopin which settled things down for a bit but then things got worse.  Prior to this, I was in perfect health, high functioning and had no history of anxiety/depression or drug use - prescribed or recreational.  

After 8 months on, I completed a 20 week taper off .75 Klonopin Feb 2, 2019.  I was unstable when I started to taper and the taper was like an entry to hell.  Fast forward to 3.5 months off and the suffering continues.  My symptoms are as follows in order of severity...

 

Internal restlessness/need to move/pacing/Akathisia

Severe insomnia for 20 months now - last 3 months sleeping 2-3 per night on average with too many sleepless nights 

Anxiety - toxic in the mornings

Panic, chest pressure, racing heart

Depression

Crawling muscles

Night sweats

Hot, burning skin especially upon awakening

Racing mind/intrusive thoughts, looping songs

Go to bed dreading the next day, 

Those are just the bad ones....

 

I have days where I can run an errand or 2, days when I can hike, but mostly days where I am homebound.  I am unable to schedule appointments, work or function as a normal, responsible adult in many ways.  My husband is picking up the slack.  

 

I was taking 20 mg of hydroxyzine during my taper.  I took this to try and stabilize rather than updose the benzo.  6 weeks after I jumped, my sleep got worse and I upped the hydroxyzine to try and deal with the insomnia and return of the anxiety that had all but left during the taper.  I take between 25-100 mg per day.  I have gotten worse and I wonder if it could be this increase.  By worse, I mean pleading with my husband to take me in-patient because I have days that I have hours where I cannot stop sobbing, pacing, and feeling like I'm in a room with a tiger.  I've had nights where I have paced all night.  My doctor is clueless and says it is underlying and wants me to take Trazodone.  I know I have some PTSD from all this but I'm not sure I buy his theory as I have days with no anxiety and no pacing and these can be days where I've had zero sleep and am VERY frightened to face the day so why no anxiety all of a sudden.  

 

Sorry for the long post....

 

I'm looking for any suggestions, comments, experiences that may help me.  I think I'd like to try to reduce the hydroxyzine.  Any advice on this and how to taper?

 

TIA!!!!!!

 

 

Edited May 27, 2019 by ChessieCat
added topic title

[Shep]

On 7/31/2018 at 9:44 PM, JMBR said:

I do not take anything else except some vitamins (magnesium, b complex, multi)

 

Jmbr, are you still taking these vitamins?

 

Please note that B complex and multivitamins can be stimulating, so they can make insomnia worse. Please see:

 

Multivitamin tips

 

Vitamin B3 (niacin, niacinamide)
 
Vitamin B8 (inositol)

Vitamin B12: essential for mood, nervous system

 

How is your diet? Are you able to get key vitamins and nutrients in your diet? 

 

12 hours ago, JMBR said:

After 8 months on, I completed a 20 week taper off .75 Klonopin Feb 2, 2019.  I was unstable when I started to taper and the taper was like an entry to hell.  Fast forward to 3.5 months off and the suffering continues.

 

Unfortunately, 3.5 months off is still early on for psychiatric drug withdrawal.  This thread is an AD withdrawal, but there's a lot of overlap with benzo withdrawal regarding the timeframe for recovery:

 

Are We There Yet? How Long is Withdrawal Going to Take?

 

12 hours ago, JMBR said:

I take between 25-100 mg per day.  I have gotten worse and I wonder if it could be this increase.

 

It could be the increase in hydroxyzine that is causing the problems, or at least, making your benzo withdrawal symptoms much worse by creating a paradoxical reaction. The more you dampen down the nervous system, the more it fights to stay alert, creating this paradoxical reaction.

 

I would pick a dose and stay on it consistently. Bouncing around doses is very traumatic to the nervous system, which is seeking stability. The more stable you can be with the dose, the less trauma to the nervous system.

 

12 hours ago, JMBR said:

My doctor is clueless and says it is underlying and wants me to take Trazodone.  I know I have some PTSD from all this but I'm not sure I buy his theory as I have days with no anxiety and no pacing and these can be days where I've had zero sleep and am VERY frightened to face the day so why no anxiety all of a sudden.  

 

Most doctors are clueless and want to cite an underlying condition. From what you've posted, it's clear you suffered an adverse reaction from an antibiotic and then were subjected to numerous chemical assaults to try and fix the first chemical assault. 

 

The days with no anxiety and no pacing followed by days of agitation ties in very well with the "windows and waves" phenomenon of psychiatric drug withdrawal. So I would not add in Trazodone. From what you've described with the hydroxyzine, adding in another sedating drug is likely to create even more paradoxical reactions. 

 

The Windows and Waves Pattern of Stabilization

 

Please let us know what dose of hydroxyzine you are comfortable taking consistently. 25 - 100 mg is a wide range. Is there a dose you were at the most consistently during this time?

 

Also, please take a look at the threads for sleep and non-drug coping, as they provide helpful tips. 

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

Non-drug techniques to cope with emotional symptoms

[JMBR]

I typed a question earlier but after reviewing others posts, I realize I did not provide nearly enough information.

 

I had an adverse reaction to an antibiotic 2 years ago at the age of 50.  I had no previous history of mental illness and had never been on meds.  The reaction brought on panic attacks, anxiety and severe insomnia.  I was polydrugged over 5 months and eventually ended up on Klonopin .75 and Remeron 5.0.  I was still unable to sleep.  I tapered off Remeron and was done in June of 2018.  I then completed a 5 month taper off the Klonopin and was off in Feb. 19.  I was never stable on any of these meds and have been off work and most homebound since  In March of 2019, my sleep which had improved, went to 1-2 hours per night and I developed Akathisia.  My anxiety went through the roof and I became despondent.   If it weren't for my husband refusing to admit me, I should have been hospitalized.  I was a complete mess.  My sleep doc/psy tried a number of meds.  I didn't last more than a few days on any of them (Effexor, Trazodone, Seroquel and Elavil) - they all made me worse.   I started Gabapentin at 300 mg per night the third week of September and then 15 mg Remeron the last week of September.  I settled down and began to sleep.  I then developed stinging, burning type pain in my ankles and forearms along with widespread muscle pain.  I had some joint pain when on Remeron in 2018 so I assume it was the culprit.  I cut down to 11.25 mg two weeks ago but the pain has not gotten any better.  This is not a tolerable side effect.  It is a "bring me to tears" type pain.  It rivals the 12 hour pacing, skin burning, terror etc that I experienced after coming off Klonopin.  

 

I do not know what to do at this point.  I feel I must come off the Remeron but I cannot go back to the Akathisia.  My doc is no help except to keep offering more drugs.  I need to get off this merry-go-round.  Any advise is appreciated.  I am truly at the end of my rope!  

 

[JMBR]

I would like some advice on which drug to taper and at what rate to start.

[Sassenach]

Hello JMBR    and welcome to SA.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

I am sorry you are having such a rough time but you are now in the right place.

 

The site is currently extremely busy so please ensure you answer any requests from staff fully.

 

Thank you for completing your drug signature however you have omitted your recent Remeron and Gabapentin doses and taper.

Please add these as they are essential to enable us to help you.

You appear to be experiencing withdrawal symptoms from so many drug and dose changes since March 2019.

Your drop from 15mgs of Remeron to 11.25 is much faster than this site advocates.

However there is a possibility of an adverse reaction so I will refer to our senior mod, @Altostrata for her input.

Please see the following links to help you understand your situation.

the-windows-and-waves-pattern-of-stabilization/

why-taper-by-10-of-my-dosage/

dr-joseph-glenmullens-withdrawal-symptom-checklist/

As you are having sleep issues you should note that B vitamins can be activating in W/D.

In the meantime DO NOT MAKE ANY CHANGE TO YOUR CURRENT MEDS please.

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

 

Again welcome.

 

Sassenach

 

 

 

 

 

 

 

 

 

[JMBR]

Mod note:  Merged Introductions, added new to the old one. Additional Benzo topic is here:  Klonopin rebound anxiety

 

Thank you Sassenach.

 

I will update my signature.  

 

I am no longer taking supplements except a whole food supplement which has not bothered me so far.

 

I was only on the Remeron for 3 weeks when I cut to 11.25.  I held there for 2 weeks and then cut to 7.5.  My thought was to get off but I couldn't handle the dose reductions so I went from 7.5 back up to 11.25 after 2 weeks.  I am now holding at 11.25 Remeron and 300 mg Gabapentin until I hear from the forum.  I am done listening to my sleep doctor.  I am just getting worse!

 

I will wait to hear from Altostrata.

Edited November 13, 2019 by manymoretodays
merged with main introduction

[Shep]

 

On 11/10/2019 at 8:04 PM, JMBR said:

I started Gabapentin at 300 mg per night the third week of September and then 15 mg Remeron the last week of September.

 

Please add the start dates and the starting doses for these drugs in your signature. A direct link to your signature is here:

 

Account Settings - Create or Update Your Signature

 

Questions:

• What time(s) of the day are you taking these drugs?
• How many hours are you sleeping?
• How did you feel on gabapentin prior to starting Remeron? Did the gapatentin help with sleep or with pain? 

 

 

[JMBR]

I take the Remeron and Gabapentin at 9 pm.  I don't take anything during the day.

 

I am now sleeping between 5-6 hours per night.  

 

Before the Remeron, the Gabapenin seemed to be starting to help me sleep a bit and it calmed down the severe anxiety/panic akathisia a bit.  I started on the Remeron because I wasn't sleeping much and the anxiety was still so bad that I was unable to function.  I did not have pain when I started the Gaba.  I had not been sleeping for 6 months so I don't know if the adrenaline was masking the pain or not.  The pain started about 3 weeks into being on Remeron and it is not constant, it comes and goes.

 

Thank you Shep

 

 

[JMBR]

I desperately need to get off these drugs safely!

 

Any advice is very much appreciated!

 

 

[Shep]

Thanks for the helpful information, Jmbr.

 

It's possible you may be getting a paradoxical reaction from taking all your drugs at one time. The more you dampen down the nervous system with sedating drugs, the more it fights to stay alert. Thus, the paradoxical reaction.

 

Also, since you're still dealing with benzo withdrawal, your nervous system is already hypersensitive, leading it have more paradoxical reactions.

 

You also may be dealing with interdose withdrawal and by spacing out the drugs, you could prevent some of the symptoms during the day. Gabapentin has a half life of 5 - 7 hours and Remeron, a half-life of 20 - 40 hours, so it's likely going to be the gabapentin that needs to be spaced out. 

 

Please start a drug and symptoms journal in the format quoted below. After you complete a couple of days, we can go through it together and see if there may be a way of spacing out your drugs so you feel better. We recommend doing this gradually at just an hour a day. 

 

Please also list:

• any supplements you are taking
• the hours you sleep at night

 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

[JMBR]

Thank you Shep.  I will do this.  By paradoxical reaction - are you referring to the pain or the sleep?  My sleep has been better although it is very restless.  The pain is my biggest concern now.  I think it could be the Remeron.  I have seen it listed as a side effect.  Is it possible to come off this drug in a safe manner?

[Altostrata]

On 11/10/2019 at 5:04 PM, JMBR said:

I started Gabapentin at 300 mg per night the third week of September and then 15 mg Remeron the last week of September.  I settled down and began to sleep.  I then developed stinging, burning type pain in my ankles and forearms along with widespread muscle pain.  I had some joint pain when on Remeron in 2018 so I assume it was the culprit.  I cut down to 11.25 mg two weeks ago but the pain has not gotten any better.  This is not a tolerable side effect.  It is a "bring me to tears" type pain.  It rivals the 12 hour pacing, skin burning, terror etc that I experienced after coming off Klonopin.  

 

Hello, JM. I might take the gabapentin separately, as @Shep suggested, to see if the combination can be more effective for sleep.

 

Once your sleep stabilizes, you might then gradually reduce the Remeron to reduce the adverse effects. My guess is your earlier attempts to taper Remeron to a tolerable dosage might have been too fast. You might use a liquid to very gradually get to perhaps 5mg.

[JMBR]

Thank you Altostrata.  My sleep has actually been pretty tolerable now for about 6 weeks.  I average 6 hours or so with some stinkers in there.  If I had to guess, the Gaba is likely helping more with sleep.  I had taken Remeron in the past (before and with Klonopin) and it never really helped me sleep.  I have taken 200 mg Gaba during the day and it makes me very tired so perhaps it helps at night.  I think my sleep has improved mostly because I calmed down a bit.  The akathisia was utter torment and I paced for hours on end and could not calm down.  It was horrible and I am terrified of it coming back!

 

About 3 weeks after I started Gaba, I noticed a weird hot, numb type feeling above my knees and I also would feel pretty unwell.  These 2 things often happened late in the day.  At that time, I was taking 100-200mg Gaba at bedtime and then 100 mg early morning.  I wondered if the later afternoon issues were dose issues.  I have been so ill for so long that it is very hard to tease out what is what.  I just know I need to get off meds and heal.  I think I tapered the Klonopin too quickly.  I did not listen to my body as I was convinced I needed off.  

 

If I think the meds are contributing to my symptoms, at what point do I know to taper?  I will post my symptoms so you and Shep can help guide me.  I SO appreciate your help.  I just want my life back.  I feel like these drugs have ruined me!

[JMBR]

6 pm pain in wrists ankles/ took shower/ eased a bit

7-8 watched TV - distraction helped a bit

8-9 tried to relax - mind just wants to ruminate

9:30 Toom 250 mg Gaba, 11.25 Remeron - lights out

10:30ish asleep

11:30 awake with crawling out of my skin anxiety (this happens almost nightly at about the same time - meds??

12:30 back to sleep

5 am up - low mood/low anxiety

5-6:30 laid in bed ruminating

6:30 got up, tea

7 - feel wiped out, feel ill, internally shakey

8 feeling anxious how to get through another day - did some chores

9 knees feel swollen, legs feel weak eat and take 1 Standard Process Cataplex b

10-1130 gentle hike 4 miles feel very depressed - legs feel weird

noon - lunch take 1 Cataplex b

1 - fatigue, deep groin pain, ankles sting

2 - tea, try to sit and chill, legs feel numb and leaden, feel shakey/weal inside

4 - acupuncuture - feeling ok, able to chat and focus

530 dinner, 1 Cataplex B, feel better

6-8 movie - able to focus, feel shakey side but better 

9 ankles and wrist facia hurt, groin hurts again

9:30 11.25 Remeron 250 mg Gaba 

10:30 wake up, crawling out of skin, feel like I need to get out of bed but stay in bed and fall back asleep

12:00 am wake from dream, feel like sleep paralysis

5 am awake - sleep app shows I slept but feel like it was restless

5-7 lay ib bed afraid to face the day, check emails

7 - tea, feel fatigued and weak 

8:30 going out to hike - distract

 

 

 

[Altostrata]

Identifying adverse drug effects is exactly why we ask for daily drug and symptom notes.

 

2 hours ago, JMBR said:

11:30 awake with crawling out of my skin anxiety (this happens almost nightly at about the same time - meds??

 

Mirtazapine peak plasma is about 2 hours. My guess is this is what's causing that reaction. I agree, keep the gabapentin where it is.

 

I fear you are allergic to mirtazapine. If I were you, I'd go off very gradually, using the liquid, reducing by 0.1mg every 3 days. This is a reduction of <1% per step. As you reduce the dose, the adverse symptoms should reduce. You can stop reducing when the symptoms go away. Please let us know how you're doing.

[JMBR]

Thank you Altostrata.  I have seen online that it is ok to make your own solution with water.  Would you agree?  I did this when I tapered off this med in 2018.  Looking back, I think some of the symptoms I had then were the Mirtazapine but I was so very sick that I didn't realize it.  I knew nothing about psy meds at that time.  I had some of the same pain.  Unfortunately, this is the only med that calmed the akathisia so I pray I can taper it and not need to go on something else.  I will go slow as you advise.

 

Frankly, I am terrified of these drugs at this point but I learned the hard way not to go faster than I'm advised by people who know.  My CNS is a mess.

 

Again, thank you.  I'll do the reduction and report back.  Please let me know about the water solution.  

[Altostrata]

See Tips for tapering off Remeron (mirtazapine)

[JMBR]

Shep and/or Altostrata,

 

I have been holding on my doses - trying to stabilize.  I tapered the Klonopin last year and did not listen to my body and I believe that is at play here.  I could not stabilize on the Klonopin and stubbornly refuse to updose.  I had also done a "too fast" Remeron taper.  Needless to say - lesson learned.

 

I am still having a VERY hard time.  Symptoms are deep depression that can come and go within an hour (usually worse in the morning), nerve pain that moves, feeling profoundly unwell and lousy sleep  - although nothing compared to what it was.  I am getting 4-6 hours of interrupted sleep most nights.

 

I feel like my CNS is the problem and I'm afraid maybe dosing the Gaba only at night might be aggravating things.  I am unable to find much online regarding this.  My goal is to stabilize and taper SLOWLY so I can be off drugs safely this time.  As I mentioned before, I developed akathisia and severe insomnia after my Klonopin taper.  This nearly drove me off the edge and it how I ended up on more meds. I feel like taping in my current health is not possible.  I need to be in a better starting place if possible.  

 

Any advice on the Gaba and splitting doess or any advice in general is appreciated.

 

Thank you!!!!!!

[Shep]

13 hours ago, JMBR said:

Any advice on the Gaba and splitting doess or any advice in general is appreciated.

 

On 11/15/2019 at 2:52 PM, JMBR said:

If I had to guess, the Gaba is likely helping more with sleep.  I had taken Remeron in the past (before and with Klonopin) and it never really helped me sleep.  I have taken 200 mg Gaba during the day and it makes me very tired so perhaps it helps at night.

 

To address your question about splitting out the Gabapentin, I wanted to go back to an earlier post. You mentioned having taken Gabapentin during the day but it made you tired.

 

Do you not feel that Gabapentin is helping with sleep anymore? 

 

13 hours ago, JMBR said:

I am still having a VERY hard time.  Symptoms are deep depression that can come and go within an hour (usually worse in the morning), nerve pain that moves, feeling profoundly unwell and lousy sleep  - although nothing compared to what it was.  I am getting 4-6 hours of interrupted sleep most nights.

 

 

It looks like you're seeing improvements. Improved sleep - even going from worse sleep to lousy sleep - is still an improvement. It's possible that moving the Gabapentin away from the nighttime dose could make your sleep worse. 

 

When was your last reduction? How much of each drug are you taking now? 

Edited November 28, 2019 by Shep
fixed typo

[JMBR]

I do think the Gaba is helping with sleep.  The last reduction I made was from 300 mg of Gaba to 250 and that was 2.5 weeks ago.

 

Before the Remeron and Gaba, I had akathisia, morning terror, extreme anxiety, panic attacks, agitation, felt like I couldn't breathe for hours...among other things.  I feel very defeated that I went back on any med but I could not function.

 

I have lots of muscle. bone and joint pain now which is why I keep wondering if it's benzo w/d or these drug.  I want to get stable and come of these slowly.

 

Thanks for responding Shep.  Happy Thanksgiving!

I am TAKING11.25 REMERON AND 250 GABA ALL AT 930 PM

 

[Shep]

On 11/28/2019 at 10:20 AM, JMBR said:

I do think the Gaba is helping with sleep.  The last reduction I made was from 300 mg of Gaba to 250 and that was 2.5 weeks ago.

 

That was more than a 16% reduction. Do you feel that updosing might help? You don't have to go all the way back up, but maybe to 275 mg? 

[JMBR]

I guess I could but I had the pain before the reduction so I don't know what is going on.  The pain started about 3 weeks after I started the Remeron and about 5 after the Gaba.  I have no idea if it is one of the meds or Benzo w/d??  I did not have the pain before - just some mild aches in my joints.  I started sleeping and I started to feel VERY unwell with lots of pain.   I can't seem to win for losing.  I am feeling so very hopeless

[JMBR]

I'm assuming replacing the Remeron with Trazodone or Elavil is a bad idea too.

 

I feel panicked that I am on something causing me to be so sick and now I can't get off.

 

Please advise.

 

[JMBR]

I don't know if this helps at all but  the symptoms over the last few weeks are .... I wake up fairly calm, I get out of bed when anxiety starts to creep in and the pain starts within the hour and I feel profoundly unwell.  It usually backs way off with an hour or so and then I don't feel right in my head - like I'm going to have a breakdown or something and all of what has happened seems surreal and I cab't wrap my mind around it.  I tend to get calmer as the day goes on.  I did try taking 1.50 Gaba last night and 100 this morning and nothing changed.

 

I just want to try and get stable and functioning so I can slowly titrate.

 

I know this site is busy and you all are volunteers.  I just want to thank you again.  I hope I can pay it forward if I can get through this!

 

[Altostrata]

Thanks, JM. We need at least 24 hours of drug and symptom notes at a time.

 

On 11/15/2019 at 5:42 AM, Shep said:

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

This is at least the third request.

[JMBR]

My apologies Altostrata.  I did do one above.  I can add more days.  I basically feel much the same as that post but the waking with the crawling out of my skin has not happened in a few nights.