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HopefulOne1: Lexapro to Mirtazapine - next steps?


HopefulOne1

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Hello All!

 

I’m very glad to have found this forum and in a matter of a couple months I’ve learned so much! I’m still trying to figure things out and how to proceed next but I’m sure the support/feedback at this site will help me with the decisions I’m facing.

 

My history outline is in my signature but I’ll provide a recap; I recently came off Lexapro 20mg and it has only been 3 weeks (13MAR18) but I tapered way too fast and was done within about 1 1/2 months. My first big drop was from 20mg to 10mg and after about 5-6 days I was hit with major wd (insomnia, night sweats, nausea - lost 10-15 pnds in 3 wks, etc). I somehow managed through it and after being 3 wks in I just stayed the course and didn’t want to go back to taking more Lexapro after already going through all that. I stayed at 10mg for about 2 weeks and my doctor suggested starting Mirtazaline 7.5mg to help with coming off the 10mg Lexaoro since all that remained at that point was bad insomnia. I could fall asleep fine but couldn’t stay asleep and kept waking up at 1-3am without being able to go back to sleep. I have a full time job and a family so I reluctantly accepted knowing that I’m probably just trading one evil pill for another. I started taking Mirtazapine while still taking Lexapro 10mg for one week, then Lexapro 5mg for the next week and then zero the following week. After cutting again from 10mg to 5mg my insomnia came back but only very minor other wd so my doctor suggested increasing the Mirtazapine to 15mg, which has worked so far and that’s where I’m at now. I’ve been on Mirt 15mg for just 2 wks now and off Lexapro for 3 wks. The other minor wd that I’m experiencing is an increase in anxiety and worrying a lot about insignificant things that I have limited to no control over but I keep telling myself it’s because I came off the Lexaoro WAY too fast. Oh, I also think I accidentally experienced withdrawal from Xanax during the initial cut from 20mg-10mg Lexapro and some of the extreme symptoms could have been from that. I was so tired and was able to hide in my office or work from home so I didn’t take my daily (Mon-Fri) Xanax. I was somehow making it through each day on maybe 2-3 hrs sleep. Since I managed through that I stayed the course there as well and stuck with a dose of 0.25mg and only take it maybe 1-2 times/wk now.

 

So that’s my story! Unfortunately by time I was hit with wd and started to look things up myself I had already suffered through the worse (I hope).

 

Although Lexapro and Mirtazapine are in different drug categories I’m thinking it must have helped me overcome most effects but now I’m going to have to taper off this and I plan to do it at a very slow rate. Hopefully the worst is done from a Lexapro wd standpoint. I’ll take a look around and I believe the best place for my questions will be a forum on this site that’s dedicated to Mirtazapine tapering? 

 

God bless everyone that’s dealing with similar issues because this has been a nightmare that could easily have been preventable if doctors would educate themselves about these issues.

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • ChessieCat changed the title to HopefulOne1: Lexapro to Mirtazapine - next steps?
  • Moderator Emeritus

Hi HopefulOne and welcome to SA,

 

Thank you for completing your drug signature.  Please remember to update it whenever you make a change.

 

Q:  Are you still taking Xanax?  If yes, please add that info to your drug sig.  If no, please state that you are no longer taking it.  Thank you.

 

The mods like the drug sig to be nice and simple so we can glance at it quickly.  Many of us experience cog fog and the additional information makes is difficult for us to see the information we need.

  • Please delete what I have struck out.
  • Please move Mirtazapine to the top because that is your current drug.
  • Please provide dates and doses for Prozac, Zoloft, Wellbutrin.

 

Thank you.

 

- Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18), to treat extreme insomnia caused by tapering from Lexapro way too fast.

- Lexapro 20mg for ~10 yrs; just quit by tapering too fast per bad dr advise within 1.5 months starting 29JAN18

- Xanax 0.5mg once/day (Mon-Fri) for ~10 yrs; cut back to 1-2 times/week during Lexapro tapering (bad mistake)

- Tried others prior to Lexapro and transitioned each time without noticing any effects; Prozac, Zoloft & Wellbutrin.

 

 

 

I'm going to give you lots of links to check out.  Please don't feel overwhelmed, just work your way through them one at a time as you feel able.

 

SA recommends tapering by no more than 10% of the previous dose followed by a hold at that dose for about 4 weeks to allow the brain to adapt to not getting as much of the drug.  This is because psychiatric drugs create a physiological dependence, not physical like caffeine or nicotine.

 

Patience is needed to get off these drugs.  We suggest throwing out the calendar and listening to your body and your symptoms.  If after 4 weeks you don't feel stable, are unwell or life circumstances are a bit more stressful than usual (for example the Christmas period, winter time, or job change) it is better to stay at that dose for a bit longer until things settle down.

 

Why taper by 10% of my dosage?

 

Tips for tapering off Remeron (mirtazapine)

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Windows and Waves Pattern of Stabilization

 

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


What should I expect from my doctor about withdrawal symptoms?

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

Keep it Simple, Slow and Stable


Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

Tapering Calculator - Online

 

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.  It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  

 

Even with a careful and slow taper you will most likely experience times of discomfort.  It is best to learn and use Non-drug techniques to cope

 

There are many existing topics and discussions on this site.  You can use the site search function on the main page of the site at the top right, or use a search engine and include survivingantidepressants.org in your search string.

 

As I said, lots of information, but I really want you to have what you need so you can have a successful taper.

 

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

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hi ChessieCat, thank you for your response and the resource links!

 

I definitely plan to do a lot of research before trying to taper Mirtazapine and the worst symptom I fear most is insomnia, which seems to be one of the primary wd effects when trying to taper this medication. I never had any issues with sleep before or while taking Lexapro but I see this is a common wd effect when coming off SSRIs. I wish I would have resisted taking Mirtazapine to alleviate the severe insomnia when coming off Lexapro but I was desparate for relief and I guess the Mirt probably helped alleviate other symptoms as well.

 

I just have to accept where I’m at, stabilize, and then properly plan my next steps to taper Mirt. Part of my planning will be to search for a doctor that’s either experienced with tapering slowly or one that will at least work with me. My current doctor seemed to get irritated by the fact that I suggested using liquid to taper at a much slower rate, as if I was questioning his “expertise”. He appeared to lecture me that Mirt was a non-narcotic and even told me that he thinks it’s perfectly fine for someone to be on a low dose if it helps with sleeping. After doing my own research during/after my Lexapro wd I questioned some things as a test and he failed miserably. Too bad because I’ve been seeing him for at least 10 yrs, but he’s proven himself to be a pill pusher and not someone that’s interested in really helping to improve my mental health.

 

I modified my signature as per your suggestions. Just let me know if I should make any other changes.

 

Sorry for the long posts but it helps to get things off my chest so to speak. 

 

Thanks again!

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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I have some questions:

 

1) Even though Mirtazapine is a NaSSA and not an SSRI, is there an equivalency table that would help show how Mirt compares to Lexapro? I’m curious to know how 15mg Mirt compares to 10 or 20mg Lexapro.

 

2)  Even though Mirt is an NaSSA, is the way it works similar enough to an SSRI that it helped alleviate Lexapro wd symptoms? I’m trying to determine if the worst is in the past or if more Lexapro wd could be coming since its only been 3 wks since my last Lexapro pill and I dropped doses extremely fast by cutting them in half and only staying at the dropped dose for about 1 week. Luckily I feel like the Mirt has stabilized me somewhat but who knows what’s coming next and when.

 

I’m also trying to determine if I could consider my Mirt use to be “short term” and maybe my body will not have gotten as addicted to it? I suspect that Mirt has helped by “replacing” Lexapro and therefore I need to be very careful and treat tapering as if I’ve been on it for years. I’ve also read a lot of horror stories about people trying to come off Mirt but most were using 6 months or longer, which is why I’m wondering about this.

 

3) Knowing that I’ve been on 15mg Mirt for two weeks (plus 2-3 wks @ 7.5mg prior) and off Lexapro for 3 wks, how long should I wait until I even attempt to lower my Mirt dose? I’m thinking I should at least wait for a full month at 15mg.

 

4) Are there links or resources that talk about waking in the early morning with anxiety due to a cortisol spike? The link on the page that deals with methods for coping with wd isn’t working. I think this is what was happening to me whenever I dropped Lexapro doses, which was the reason why I accepted starting Mirt. I could fall asleep no problem but couldn’t stay asleep and kept waking up anywhere between 1-4am and couldn’t fall back asleep. I’d wake with sometimes an intense anxiety feeling for no reason. I never in my life had any issues with sleep and if anything I’ve had the opposite and could sleep too much. I used to take Lexapro every morning between 5-6am.

 

Thanks!

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • Administrator

Hello, HopefulOne.

 

Milligram for milligram, Lexapro is a very strong SSRI, several times stronger than its sibling Celexa. Mirtazapine is a milder drug. It would be hard to find an equivalency. What's important is how you feel.

 

As they're both "antidepressants," theoretically mirtazapine might compensate for some Lexapro withdrawal symptoms. Getting some sleep is very important, too.

 

You could consider mirtazapine to be temporary, but most likely you will be on it for some months and you will need to taper it.

 

Do not lower your dose as long as you are having some withdrawal symptoms.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator

HI HopefulOne

Altostrata s suggesting the best course for you. From my experience it is important to keep steady on your Mirtazapine dose for now until most of the WD symptoms from lexapro abate. Later you can continue with a slow and managed taper of Mirtazapine which is the best way there is to go off these drugs.

You have done remarkably well. I was working full time and apart from that i started a new business and had a baby... all during my WD from benzos and Mirtazapine. Here I  am.... not yet out of the woods but living an almost normal life... You can read my topic for more info my friend.

All the best

Santino

 

2015 -  2016 Xanax only rescue doses of 0.125 mg 1-2 times per month
 March 2016 0.125Mg * 2 Xanax for 10 days.

20 March 2016 0.25 Mg * 2 Xanax for one week. 1 April 2016 Tranxene 5 mg and Fevarin but bad reaction for 5 days.4 April 2016 25 Mg Amitryptiline + 6 MG bromazepam at night

Started tapering Bromazepam 6 days later reached up to 3 MG in 10 days and withdrawal. Pdoc asked to go 6 MG again.

10 of May started Remeron 15 MG and started tapering Bromazepam again.

SINCE 09/06/2016 BENZO FREE - Started Tapering Remeron 04/07/2016

 

04/Jul/16 12.8 Mg, 11/Aug/16 12 Mg, 20/Aug/16 11Mg, 3/Sept/16 10Mg, 11/Sept/16 9 Mg, 30/Sept/16 8.1 Mg, 14/Oct/16 7.25 Mg, 17/Nov/16 6.7, 23/Nov/16 6.5, 2/Dec/16 6.25, 9/Dec/16 6Mg, 25/Dec/16 5.7Mg, 4/Jan/17 5.4Mg, 20/Jan/17 5.2Mg, 07/Feb/17 5 Mg, 15/Feb/17 4.8Mg, 27/Feb/17 4.5Mg, 15/Mar/17 4.2Mg, 23/Mar/17 4Mg, 1/Apr/17 3.7Mg, 14/Apr/17 3.4Mg, 27/Apr/17 3.1Mg, 06/May/17 2.8Mg, 22/May/17 2.6Mg, 31/May/17 2.3Mg 09/Jun/17 2Mg, 20/Jun/17 1.7Mg, 29/Jun/17 1.4Mg, 11/Jul/17 1.2Mg, 20/Jul/17 1Mg, 31/Jul/17 0.8Mg, 11/Aug/17 0.6Mg, 23/Aug/17 0.5Mg, 05/Sept/17 0.4Mg, 13/Sept/17 0.3Mg. 22/Sept/17 0.2Mg, 03/Oct/17 0.15Mg, 10/Oct/17 0.1Mg, 23/Oct/17 0.05Mg, 22/Nov/17 0.025Mg, 06/DECEMBER/2017 MIRT FREEE.

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Thanks for the feedback, Alto and Santino! It definitely helps coming from people who have already been in similar circumstances. 

 

I guess since for the last ~1-2 weeks my only major concern has been waking up WAY too early, so I’m probably over confident and still naive about what can happen, really fast, especially if Mirt is helping to mask a lot of Lexapro wd. If I knew waking up too early was the only thing left then I’d go for it, but it sounds like that’s a big unknown. 

 

I actually cut Mirt down to 11.25mg last night and I woke up at about 3:45am so I’m going to stay put at 15mg and quit messing around for a while. 

 

From your experiences or from what either of you’ve read, is Mirt any harder to quit than an SSRI like Lexapro? Since I was pretty much done with Lexapro I didn’t spend much time researching Lexapro wd, but I started reading a lot about Mirt (so I could taper the right way) and there are tons of horror stories. I’m sure it’s the same for Lexapro?

 

I’m pretty confident that if I had tapered properly then I would have come off Lexapro OK, so if I apply the same mindset to Mirt then even if I’m on it for another 6 months or more I’ll be fine. I hope I’m not being naive but I’ve seen people say that Lexapro is very powerful stuff. So if I could come off that the “wrong” way then I could certainly come off Mirt doing it the right way. ...hopefully? :)

 

Thanks again for your feedback!

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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I had another night where I woke up just before 4am, so the 15mg Mirt no longer appears to be working. I’m going to try other methods to remain asleep or to fall back asleep, but since I was put on Mirt to help me sleep and I’ve only been on 15mg for 16 days now, should I immediately try to lower the dose? Like others, I’m worried about getting too hooked on this, especially if it’s not helping do what it’s supposed to be doing - keep me asleep. That’s why I was put on it in the first place. 

 

Is the fact that 15mg Mirt isn’t working any longer evidence that some bad Lex w/d is still lurking inside me? 

 

If I drop to 11.25mg (1/2 plus 1/4 pill) is that a definite mistake? After 2 wks at 15mg should I expect to get hit hard by a drop like this? I know it’s more than 10% but I’m wondering if that’s still the recommendation after only 16 days? 

 

I see how Santino’s 50 day use at 15mg turned into more than a year of tapering, plus a lot of w/d after each drop ..and he appeared to push the limit, so I keep arguing with myself to just do it. ..but then I think about how terrible w/d was about 4-5 wks ago and I have second thoughts. 

 

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • Moderator Emeritus

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  After 2 weeks at 15mg, your brain has already made adaptations to the new dose.

 

On 4/5/2018 at 12:46 PM, Altostrata said:

 

You could consider mirtazapine to be temporary, but most likely you will be on it for some months and you will need to taper it.

 

Do not lower your dose as long as you are having some withdrawal symptoms.

 

 

Psychiatric drug use has a cumulative effect.  Once you experience withdrawal symptoms your CNS isn't as stable as it was.

 

Sleep problems - that awful withdrawal insomnia

 

waking-with-panic-or-anxiety-managing-cortisol-spikes

 

Acceptance


Acceptance and Mindfulness

 

Non-drug techniques to cope

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Agreed. I’m not going to mess around because I have to work and take care of other responsibilities and I barely managed when dealing with Lex w/d. Now that things have subsided for the most part, except for poor sleep and mild anxiety, I’ll wait until all w/d has disappeared and stayed away for a couple months. When I get back to trying to taper I’ll go as slow as possible and maybe I’ll be lucky and barely notice any w/d. It’s frustrating to be in this situation but I was on Lex for ~10 yrs so who cares, just need to stay positive and go slow.

 

Thanks again for listening and giving feedback. It definitely helps to reinforce the best approach when we’re internally struggling with these decisions. 

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • Moderator Emeritus
4 hours ago, HopefulOne1 said:

I’ll wait until all w/d has disappeared

 

Sometimes it doesn't go away completely.  See Withdrawal Normal Description

 

4 hours ago, HopefulOne1 said:

It’s frustrating to be in this situation but I was on Lex for ~10 yrs so who cares, just need to stay positive and go slow.

 

I've been taking an AD for 25 years.  I was taking 100mg Pristiq when I found SA at the end of October 2015.  I had tried to reduce to 50mg and experienced severe cog fog for 3 weeks and researched online.  I've been following SA's tapering guidelines and I am now down to 10mg.  A week ago I thought I'd make my reduction 1 week early and took 10mg.  About 1/2 hour later I went and took the additional 1mg, because I realised in the scheme of things it wasn't going to reduce the overall time by much and it wasn't worth the risk.

 

You might find that you are able to reduce by 10% once you have stabilised.  However there are other ways to reduce.  You might consider Brass Monkey Slide

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thanks for the feedback and links, ChessieCat! 

 

I agree that w/d symptoms may never go away but I guess what I meant was that after I think I’m “stable” then I’ll consider tapering Mirt. Although I was struggling with myself about whether or not I should start reducing ASAP because I’ve only been on 15mg Mirt for 2 wks, I decided it wasn’t worth the risk. Since I’m not experiencing adverse reactions to Mirt, I’ll wait until I’m pretty sure Lex w/d isn’t lurking any longer.  

 

After reading some of the horrible experiences people have had with tapering  Lex, even when trying to do it slowly, I’m beginning to think I’m either very lucky or Mirt has done a very good job at “replacing” Lex (or both), so I better not mess around with tapering yet. 

 

I admit I’m not 100% sure how to gauge feeling “stable” but I’m thinking as long as things don’t get any worse for an extended period of time (maybe 2 months??) then I’ll consider tapering Mirt again.

 

These are the side effects that I’m experiencing;

- waking early on some nights (still trying to figure out if I’m doing anything different on my early wake days)

- brain fog & weird feeling in my head. Not quite dizzy or light headed ..just strange. This comes and goes throughout the day.

- the last few days I think I felt some anxious stomach feelings in the late afternoon / early evening, which goes away after a couple hours. Doesn’t prevent me from doing anything and I can still eat so not too bothersome.

- tired earlier than normal and/or tired during the day, but this could be the Mirt. I’ve had issues with fatigue for a very long time, which is why I was also prescribed Provigil (modifinil) so this isn’t a reliable indicator. I’m no longer taking provigil. 

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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Has anyone tried phosphorylated serine (Seriphos brand name) to try to correct cortisol spikes from AD w/d, which either keep you from falling asleep or waking too early? I’ve read a bunch of Amazon reviews and it appears to help a lot of people that have issues with waking too early. 

 

https://www.juliarosscures.com/identifying-and-correcting-elevated-cortisol-levels/

 

Seriphos_Data_Sheet.pdf

 

 

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • Moderator

Please do a site search on Seriphos.  There has been a lot of discussion about it.  We do not recommend it as it does not mix well with ADs, antihistamines and benzos.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Thanks brassmonkey! I’m doing searches but haven’t found anything about Seriphos not mixing well with antihistamines. I’ll continue looking.

 

It’s crazy that Mirt is supposed to be a very strong sedative but has already stopped helping me sleep through the night. Knocks me out most nights but up at 3am like clockwork. I’d rather not add anymore variables but lack of sleep has me searching for backup plans I guess.

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

Link to comment

Hello, 

 

If I start to taper Mirtazapine next week, does anyone think this is too soon? My sleep is still messed up and I keep waking at 2-3am but I’m not sure this is a good indicator to use when it comes to trying to determine if I’m “stable”. Tons of people seem to have this issue throughout tapering and sometimes long after. I feel a lot of cog fog but that too can be attributed to poor sleep so maybe not the best indicator either. I have some anxiety but I’ve always been an anxious person and it’s not preventing me from doing things, so that’s a hard one to read too. Negative thoughts aren’t like they were either, but again, I’m an anxious person so I tend to worry and over think things.

 

As as you can see I’m starting to debate this with myself again so any advice from folks that have already walked this road would be helpful. If someone feels I should delay tapering, I’m definitely listening. If there are other questions I need to ask myself, let me know. I’m trying to listen to my body but I’m starting to think this is how Mirt and the lack of good sleep makes me feel (tired, sluggish, etc).

 

On another note, I met with my doc today and he has no issue with me trying to taper Mirt. I had to talk him into extending my 15mg script cuz he wanted to immediately cut it in half (7.5mg), like he did with Lex, but I’m pretty sure now that he’ll let me do this my way. I’ll revisit this again at my next monthly appt and just tell him I’m not as far along as planned. If I decide to delay tapering, that should be OK too. He prescribed me trazodone to help with sleep but I’m going to resist and continue to explore other things and ultimately hope it gets better. He actually told me it’s non-addictive (I know this isn’t true). I also made an appt with another doc to see if I find someone better but at least my current doc is letting me tell him what I want to do. I also made a separate appt with a psychiatrist to see if there’s some insight into my mild anxiety and see if I can learn more non-drug techniques that could help as I taper and hopefully get off Mirt. I’m thinking the sleep issue could have an underlying anxiety component because I was able to sleep just fine last weekend but once Monday 2am rolled around I was awake again..Tues too. Still too soon to know if this is a trend tho.

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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Just an update;

 

sleep is still not like it was but for the last 4 nights I’ve been able to fall back asleep after waking in the wee hours of the morning. I seem to wake up a lot though.

 

Started using a sleep mask 4 nights ago so I think it’s helping. Hope it’s not coincidence cuz my room is always very dark. 

 

Started taking Seriphos in the evening btwn 8-9pm last Friday. Not sure I can contribute falling back to sleep to that but at the same time I’m afraid to mess with my current routine and won’t try to stop taking it for now. 

 

Tried melatonin with l-theonin on Thursday night but didn’t notice any better sleep (still woke up a bunch of times). No worse either. I’ll keep it as something to rotate into the mix later because I’ve read a lot about people needing to rotate different things every 2-3 days to keep to,earn everything from building.

 

Started keeping a calendar on Saturday to note my mood, what I ate for dinner, my quality of sleep, etc, to see if I find any patterns. 

 

Still havent resorted to using trazodone, which my doc prescribed this week for sleep, which is great. 

 

Despite better sleep, still feeling tired, more so in the early evening. Resist napping so my sleep doesn’t get more messed up. Also still feel cog fog or whatever it’s called.

 

Now that my sleep appears to have gotten better, if it continues into next week, I’m thinking about doing my first taper from 15 mg Mirt, starting Wed night. 

 

 

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • 3 weeks later...

Update -

 

Sleep (waking at 3-4am) has been an ongoing issue, at least Mon-Fri. I’ve been able to sleep better on the weekend so there must be some underlying anxiety related to my job that the Lexapro helped eliminate or it’s due to w/d.

 

Regardless, I’m tired 24/7 whether or not I get decent sleep and never adapted to being on Mirtazapine so I started to taper on 30 APR. I don’t want to switch to another AD. I started out with a 20% taper and I haven’t had any major issues; 14mg for 2 days, 13mg for 2 days, 12mg for 2 days, and then held at 12mg for 10 days. My sleep didn’t get any worse and I don’t think I experienced any other issues (maybe slight butterflies in my stomach some days). 

 

I dropped to 11mg last night and plan to take the same approach to drop to 9.6mg by Thurs as long as I don’t experience any additional issues. 

 

I can’t stand being tired 24/7 even when I do get decent sleep so I decided to push myself a little, at least until I get to lower doses (<7.5mg). I still think I’m taking a “controlled” approach but I do understand what could happen. I’m hopeful that 20% reductions will still give me some advance notice to slow down or hold before all hell breaks loose. 

 

I started to try to work in a rotation of sleep aids but this is the first week regarding this experiment so it’s too soon to see any pattern good or bad. I don’t want to rely on one thing for long periods to prevent tolerance. I took a non-antihistamine sleep aid (Unisom?) to sleep Sun night but still woke up early and had trouble falling back to sleep. I took 3mg melatonin and 200mg l-theonin on Mon night and I was able to fall back to sleep after waking up at 3-4am. However, it was broken sleep after that point until my alarm got me up at 5:30am. I plan to take melatonin/l-theonin again tonight and Wed night, followed by Unisom again on Thursday. Fri and Sat I won’t take anything because I’m seeing that I tend to sleep better on the weekend. 

 

 

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

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  • 3 months later...

Update -

 

My hat goes out to everyone that was able to taper and eventually quit these psychoactive drugs because I had to raise the white flag and declare defeat, at least for now. I managed to get down to 6mg Mirt and held for about 6 weeks but the morning anxiety and insomnia were too much and I was having difficulty functioning at my job and felt like I was having a mental breakdown. I was dealing with a lot of negative thoughts and worrying about anything and everything ....things that I knew were irrational but I couldn’t get them out of my mind. 

 

My new doctor convinced me to quit Mirt CT and immediately start Zyprexa (5mg), despite my better judgement, which was 1 month ago, and my sleep has stabilized somewhat and fortunately I didn’t experience significant withdrawal from stopping Mirt. I was so worried but luckily my allergies seemed to get real bad for about 1-2 wks but that’s it. Mirt made me very tired all day, yet didn’t help me sleep and the morning anxiety wouldn’t go away so I felt a sense of urgency to stop ASAP because there was no benefit or improvement. Plus I admit all the horror stories about quitting Mirt got to me.

 

However, I know I just traded one evil pill for another, yet again. I’m just hoping to find something that will help me stabilize so I can do a proper slow taper and I don’t want an SSRI because of the side effects (for me it was excessive sweating and excessive sleep). I have an appt with my doctor on Sat to switch again to something else because Zyprexa is also causing excessive daytime sleepiness and I have an extreme thirst and dry mouth that is very uncomfortable. It’s not a minor cotton mouth type feeling and its driving me crazy. Anyone else have extreme thirst with zyprexa? I’m also having to pee a lot and I can’t tell if this is because anxiety is still there, I’m drinking more, or maybe it’s the Zyprexa (or a combination of all).

 

I know by switching again I’m at risk for more withdrawal, probably poor sleep again, and possibly other side effects but I need to find something that I’m comfortable on in order to stabilize for a long duration (maybe 6 months to 1 year?) before I try to taper again. I’m hoping that the transition to another med will help offset some Zyprexa withdrawal but I realize it depends on the type of drug, so we’ll see. I haven’t been scared of really anything for as long as I can remember but all this has me very worried and I feel stuck in a terrible situation.

 

Again, congrats to everyone that have managed to get through something like this! For now I’m admitting defeat but hopefully once I find something to stabilize on I’ll be in a better place to properly taper. If I knew back in Feb what I was getting into I would have done it properly from the start and probably wouldn’t even be in this situation. Can’t go back in time tho :( 

 

Good luck to everyone dealing with the same terrible situation!

HopefulOne1

History:

Zyprexa 5mg (21JUL18) ☹️

Mirtazapine 7.5mg (19FEB18), raised to 15mg (20MAR18)

==> taper started; 14mg (23APR18)....9.5 mg (12MAY18)...7.5 mg (02JUN18)...6 mg (23JUN18)....stopped CT (21JUL18)

- Xanax 0.5mg 4-5 days/wk for ~10 yrs; reduced to 2-3 days/wk (19JAN18)

- Lexapro 20mg for ~10 yrs; ~6wk fast taper, last pill 13MAR18

- Provigil 200mg for ~10yrs; quit ct AUG 2017

- ~10 yrs of Prozac, Zoloft & Wellbutrin (not at same time) prior to Lexapro but don’t remember lengths of time or doses.

- Supplements: morning - kelp (iodine), VitD / evening - fish oil, mag gly, fiber 

Link to comment
  • 4 months later...
  • Mentor

hi HopefulOne

just wondering how you are doing

 

hope all is well with you!
 

  • pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total)
  •  Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years
  • started lexapro 2002, dose varied from 20mgs to 40mgs. I tried to get off it several times. WD symptoms were mistaken for "relapse". 
  •  2013 too fast taper down to 5mg but WD forced me back to 20mgs
  •  June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". Crashed in Sept, reinstated at 0.3mgs in Oct. 2106
  • Tapered off to zero by  Oct. 2017 Doing very well
  • Nov. 2018 feel 95% healed, current age 63 
  • Jan. 2020 feel 100% healed, peaceful and content 
  • Aug  2022 ❤️ loving life ❤️ 
 
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