BfromNJ: mirtazapine taper

[BfromNJ]

Hello Im new here.  Thank you for taking time to read this if you are.  :)  I have been on Mirt for only 12 days at 15 mg. Im looking to come off due to side effects, its just not suited for me.  

 

I was going to do 11.25 for 4 days,  7.5 for 4 days, 3.75 for 4 days, then off.  

 

Is that too quickly?  I thought not since I have only been on it for 12 days at 15 mg.  

 

I appreciate everyones input and advice!   :)

[BfromNJ]

Hello again all..  I know there are a lot of posts here, but I was hoping for some advice and input here on my post.   I was going to do the 15 down to 11.25, but its too hard to cut the tablets this way and they just come apart.   so last night I went down to 7.5, which I will stay at for about a week I guess?   I was going to ask my doctor if I can get the 7.5 mg tablets, if they are available since when I want to half that it will be easier.  

[BfromNJ]

Im a bit confused and its probably because a lot of the people here at on a liquid form of medication, such as mirtazapine and thus its easy to do a taper rate of 10%.   But I am in the us and we cannot get the liquid form.  So I don't know how I am supposed to do 10%, they are hard enough to break with a pill cutter at a 1/4 for each pill.   So would 25% be sufficient, beings I was only on the med for about 13 days thus far?

[Shep]

Hi, BfromNJ.

 

You may be okay doing a rapid taper at 25%.  It's possible you went through a series of drugs so quickly, you may not be that dependent on any of them. Please see the thread on reducing mirtazapine: 

 

Tips for tapering off Remeron (mirtazapine)

 

Why taper by 10% of my dosage?

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

 King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

How are you feeling now?  Are you able to sleep on the reduced mirtazapine? If you do find yourself struggling with symptoms, you may want to reduce at the 10% rate. 

 

Please use this thread to document your taper and to ask questions. 

[BfromNJ]

Thank you for the reply.  I know i should have gone 11.25, then down to 7.5,  but i could not cut them right this way.  So i ended up doing 15, down to 7.5.  Still there for now.  Then best i can do is down to 3.75.  Unless dr will prescribe the 7.5 mg tabs which would be easier to go even smaller.  

[BfromNJ]

And yes i do magnesium now.  I will also be adding fish oil soon.  Also eating alot of nuts and veggies.  

[ChessieCat]

You might find it helpful to write a script and rehearse what you are going to say.  Be calm, gentle but assertive.  You are the customer, it is your body.  Use words like I'd like to try this, or I'd prefer to do it this way.  If a suggestion is made that you don't want to follow, say I'd like to think about it before making a decision.

 

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

What should I expect from my doctor about withdrawal symptoms?

[Shep]

8 hours ago, BfromNJ said:

Thank you for the reply.  I know i should have gone 11.25, then down to 7.5,  but i could not cut them right this way.  So i ended up doing 15, down to 7.5.  Still there for now.  Then best i can do is down to 3.75.  Unless dr will prescribe the 7.5 mg tabs which would be easier to go even smaller.  

 

Here are other ways to get to these lower doses:

 

• Using a digital scale to measure doses
• Making a liquid from a tablet or capsules

How many hours are you sleeping at night? What symptoms are you having? 

[BfromNJ]

Right now im getting about 5 hours I would say. Much better than none I would say.  I have been taking melatonin an hour before bed and magnesium at dinner time.  

 

I have tapered to 5.625 and my next step is 3.75, then 1.875.  Unfortunately that is probably the lowest I can go, since I cannot get a liquid form here in the US. I cant even get my doctor to return a call to me, let alone have him give me a script to a compounding pharmacy.  And converting a pill to liquid seems like a daunting task and I would be afraid to do it wrong.  I actually saw someone on another website giving advise on this incorrectly.  Their conversion from mg to ml was very wrong.  here everyone seems to know what they are talking about.  :) , but I still am hopeful I will be okay the way I am going, since it wasn't that long I was on to begin with.  The pharmacist was talking about the skipping days kind of taper.  What do you think about that?  that doesn't seem to make sense to me. 

[Shep]

17 hours ago, BfromNJ said:

The pharmacist was talking about the skipping days kind of taper.  What do you think about that?  that doesn't seem to make sense to me. 

 

You're right - it doesn't make a lot of sense.

 

Please see Alto's post explaining why this isn't a good idea:

 

On 5/4/2011 at 5:57 PM, Altostrata said:

How about taking my medication every other day to reduce my dosage?
 

DO NOT TAKE YOUR MEDICATION EVERY OTHER DAY TO TAPER.

 

(See this comparison graph:  Skipping Days vs Every Day Dosing Graph)

If your medication is not designed to take every other day (very few are), don't try to taper by alternating doses. The half-lives of almost all psychiatric drugs are too short for this to make sense. It causes the amount of the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse.

Your brain likes stability, to be treated gently. The object is to gradually accommodate it to lower and lower dosages. Don't throw it off a cliff every day. Move it slowly down a ramp by gradually decreasing dosage by an amount it may hardly notice. A 10% reduction in dosage may be appropriate. Stay at that dosage for 3-4 weeks, then decrease again -- by 10% of your last dosage. Your decreases will be progressively smaller the lower you go in dosage.

Some people can quit cold turkey and not notice. Some people can alternate dosages and not notice. If you are having withdrawal symptoms, you are not among those people.

We don't know why some doctors, pharmacists, and alternative practitioners recommend tapering by alternating dosages. It's terrible advice. Don't do it.

 

17 hours ago, BfromNJ said:

Right now im getting about 5 hours I would say. Much better than none I would say.  I have been taking melatonin an hour before bed and magnesium at dinner time.  

 

How much melatonin are you taking?

 

When did you start taking it? 

 

Taking too much melatonin can cause a paradoxical reaction, especially when taking with another drug that is sedating. For more on melatonin, please see:

 

Melatonin for Sleep

 

17 hours ago, BfromNJ said:

I have tapered to 5.625 and my next step is 3.75, then 1.875.

 

I know you are doing a rapid taper because it's not clear if you're dependent on this drug or not, but please don't push yourself to go too fast. 

 

You don't seem to be a fan of doing a liquid taper, but what about using a scale so you can slow this down a bit? 

 

• Using a digital scale to measure doses
• Using a Scale video (6.5 minutes)

 

 

[BfromNJ]

Shep thank you for your responses.  You all are so helpful .  I am taking 3 mg of melatonin for about 5 days now?   What I actually find most helpful for getting to sleep is the magnesium I take at dinner. It relaxes me. the problem is staying asleep at this point.    Do you all recommend something else for sleep?  The magnesium I take is citrate at 250 mg. 

 

As far as the taper, I wasn't sure to be honest if my taper was too rapid,, I have not much past experience with tapering, although I can see now in hindsight I should have.    I just thought that since I was only taking it for two weeks when I decided to start tapering, that my schedule was okay.  but is that not so?   I guess I thought I was just prolonging getting off of something that I was only on for such a short time.  But I see what you are saying.  Maybe I should slow it down.  The weirdest thing right now that is happening to me is that I have this really odd sensation in my head and this "zinging"  tinny kind of noise.  Now I do have tinnitus, but I was having trouble with it before this med.  but this is a whole differnet kind of noise and/or sensation.  Would this maybe be what they call "brain zaps"?  if so, could they be happening all day long?  its not painful, just really scary and I thought brain zaps were painful.     I am also feeling very foggy, like in a fishbowl looking out, if that makes sense.  it sucks.  Maybe its all just anxiety playing tricks on me. 

[BfromNJ]

I just read the info on the melatonin.  very interesting.  maybe I will try only 1 mg instead.  

[BfromNJ]

1 hour ago, Shep said:

 

You're right - it doesn't make a lot of sense.

 

Please see Alto's post explaining why this isn't a good idea:

 

 

 

How much melatonin are you taking?

 

When did you start taking it? 

 

Taking too much melatonin can cause a paradoxical reaction, especially when taking with another drug that is sedating. For more on melatonin, please see:

 

Melatonin for Sleep

 

 

I know you are doing a rapid taper because it's not clear if you're dependent on this drug or not, but please don't push yourself to go too fast. 

 

You don't seem to be a fan of doing a liquid taper, but what about using a scale so you can slow this down a bit? 

 

• Using a digital scale to measure doses
• Using a Scale video (6.5 minutes)

 

 

Shep as far as the scale method, the information states its for capsules. But I don't have capsules, I have tablets.  Would I still be able to use the scale method?

[Shep]

2 minutes ago, BfromNJ said:

Shep as far as the scale method, the information states its for capsules. But I don't have capsules, I have tablets.  Would I still be able to use the scale method?

 

Yes, you can use the scale method with tablets. You crush the tablets and then weigh the powder. Please see the video I posted. The lady in the video used a mortar and pestle to crush her tablets, but some people are able to crush the tablets with a spoon. Whatever method you find works the best. 

 

If you decide to use a scale, please let us know and we'll walk you through the process step by step. 

[Shep]

38 minutes ago, BfromNJ said:

I just read the info on the melatonin.  very interesting.  maybe I will try only 1 mg instead.  

 

This sounds like a good idea. Please let us know how you do with the reduced amount. 

[BfromNJ]

Just now, Shep said:

 

Yes, you can use the scale method with tablets. You crush the tablets and then weigh the powder. Please see the video I posted. The lady in the video used a mortar and pestle to crush her tablets, but some people are able to crush the tablets with a spoon. Whatever method you find works the best. 

 

If you decide to use a scale, please let us know and we'll walk you through the process step by step. 

I am looking at getting a scale.  My question is, when you get down to measuring powder that you have from crushing pills, what do I do?  put it in a capsule or in water or something?    forgive the questions, I am a newbie.

[Shep]

Please read the thread on using a scale. It answers your questions. Yes, you will need to order capsules. 

 

On 1/1/2012 at 3:38 PM, Altostrata said:

Nice big gelatin capsules (sizes 00 or 0) will help you deal with the powder.  Comparison picture with measurements  The capsule size doesn't have to be the same as your initial capsule of medication.

[Shep]

You may also want to get a micro-spoon or lab spatula to move the powder into the capsules (the lady in that scale video is using one). Some people use mini funnels (JanCarol pictured them here). 

 

The Gemini-20 Scale is very popular, if you're not sure what kind of scale to get. 

 

Gemini 20 Scale

 

You can get these off eBay or Amazon. 

Edited February 12, 2019 by Shep
fixed typo

[BfromNJ]

how about this one? they don't have the Gemini one on amazon. and ebay will take too long to get.  

 

https://www.amazon.com/gp/product/B00ESHDGOI/ref=ox_sc_act_title_2?smid=A1OXMGBNNDVO3Y&psc=1

[Gridley]

Here is is on Amazon.  I've been using it for over 2 years and recommend it.  

 

 

American Weigh Scales GEMINI-20 Portable MilliGram Scale, 20 by 0.001 G

 

 

 

 

[BfromNJ]

Shep I see you did a rapid taper. How did you fare with it?  I am so conflicted because I feel like I am just prolonging my agony, but I don't want to mess myself up, since it would seem that my nervous system is already a mess from other stuff I was on and also the anxiety, lack of sleep, hormonal changes, etc etc etc.   this is just a bad day for me. 

[Shep]

18 hours ago, BfromNJ said:

Shep I see you did a rapid taper. How did you fare with it?  I am so conflicted because I feel like I am just prolonging my agony, but I don't want to mess myself up, since it would seem that my nervous system is already a mess from other stuff I was on and also the anxiety, lack of sleep, hormonal changes, etc etc etc.   this is just a bad day for me. 

 

I don't recommend the rapid taper. You can tell why in the first few posts of my benzo thread: 

 

Shep's Journey

 

It takes years to recover from that. The slow and careful taper approach is best. 

[Karl]

Hi B, it seems you’ve had a similar experience to me with various meds being thrown in and adverse reactions to all of them. I don’t feel myself at all on Mairtazapine, been on them six weeks and really want to come off. I was on 15mg for 4 weeks, 30mg for the last 9 days, and went down to 15mg last night and another 7.5mg a few hours later, so initial taper is starting at 22.5mg, which is a bit above the 10 % recommendation, but I’m going to see how that goes. I also have a strange ear zinging, which started when I was on Prozac for a couple of weeks,, thought it was tinnitus but think the meds aren’t helping. All the best with your taper, let’s see how we go along from here. 😁

[BfromNJ]

2 hours ago, Karl said:

Hi B, it seems you’ve had a similar experience to me with various meds being thrown in and adverse reactions to all of them. I don’t feel myself at all on Mairtazapine, been on them six weeks and really want to come off. I was on 15mg for 4 weeks, 30mg for the last 9 days, and went down to 15mg last night and another 7.5mg a few hours later, so initial taper is starting at 22.5mg, which is a bit above the 10 % recommendation, but I’m going to see how that goes. I also have a strange ear zinging, which started when I was on Prozac for a couple of weeks,, thought it was tinnitus but think the meds aren’t helping. All the best with your taper, let’s see how we go along from here. 😁

Im having a really tough time now.   Not sleeping,  anxiety is through the roof, im beside myself.  I dropped to 3.75 two nights ago.  I hear you with the ear zinging.   I woke up on January 5 with really bad ringing.  Ive had iltinnitus but never that i noticed and not this bad.  I actually forgot it was there.  Not sure where this came from but its been pretty much what has kept me in a persistent state of anxiety.  But now its different on mirt.  Its like an electrical current.  I feel like im going mad.  Hearing also very sensitive.  Cant stand quiet but noise is bothersome.   No quality of life here.  I am tired of it all.   

[Karl]

7 minutes ago, BfromNJ said:

Im having a really tough time now.   Not sleeping,  anxiety is through the roof, im beside myself.  I dropped to 3.75 two nights ago.  I hear you with the ear zinging.   I woke up on January 5 with really bad ringing.  Ive had iltinnitus but never that i noticed and not this bad.  I actually forgot it was there.  Not sure where this came from but its been pretty much what has kept me in a persistent state of anxiety.  But now its different on mirt.  Its like an electrical current.  I feel like im going mad.  Hearing also very sensitive.  Cant stand quiet but noise is bothersome.   No quality of life here.  I am tired of it all.   

Please don’t lose hope, I was like that a month ago, still get huge ups and downs in anxiety but you will get through this and things will even out. There are lots of vids on you tube with tinnitus masking noises on, I use these at night to go to sleep. There’s a great guy in the UK called Julian Cowan Hill, I find his you tube Chanel very reassuring. I’m currently trying cranio sacral therapy, I’ll let you know how I get on with that. I hear you completely on the zinging tinnitus, hard to ignore it, I try to make sure I’m not in complete silence, and am hopeful that it will resolve at some point when off the meds. It’s a stress response, the tinnitus, and that’s the vicious  circle, hard to break as stress causes stress. So I am trying to reduce stress in all areas, all takes effort, and when we feel awful the effort seems too much.  Please take a look at Julian’s Chanel, I hope you find it as reassuring as I have. There is also TRT (tinnitus retraining therapy) and other treatments, all quite expensive here in the UK unfortunately, but it shows there is hope. There’s also Liam Stops Tinnitus, try googling it, I haven’t had a good look at it yet but it might be something to research. Let me know how you get on, you’re not alone. Karl 

[BfromNJ]

Thanks for your kind words.  It seems like this new level of buzzing has started since lowering/tapering/being on the mirtazapine.  I am second guessing everything im doing.  Should i just stop it at this point,  stay on it.  Blah blah blah.  I have ocd and this is my vicious cycle.  In addition to a piece of crap psych nurse who wont return phone calls.  So im on my own.  

[Carmie]

Hi BfromNJ, 

 

How are you doing?💚

[BfromNJ]

Not good.  I ended up inpatient,  complete meltdown.   Too fast off the mirt I guess.  Now I'm on other meds I'm wishing to get off of.  I just hate them.  I'm working with point of return.  

[BfromNJ]

Topic title:  Point of Return

 

I recently joined this online group.  Has anyone else worked with them to help with taper?  They seem like I wonderful bunch of people.   

 

Edited March 20, 2019 by ChessieCat
added topic title

[BfromNJ]

Topic title:  Point of Return

 

Has anyone else joined this for their taper and withdrawal help?  Them seem like very caring individuals.  And the taper recommendations seem very similar to here.  Also, supplements are recommended.  Unfortunately I may be having increased anxiety from their omega 3 supplement, but we will see.   They are very proactive in answering any questions and drew up an assessment plan for me to start tapering off on my first med, luvox 25 mg.  I will meet with my doctor next week to hopefully get my prescription for the compounding. 

 

Edited March 20, 2019 by ChessieCat
added topic title

[ChessieCat]

On 11/11/2014 at 5:04 PM, LexAnger said:

 

I'm now only taking fish oil as most supplements I tried (from point of return, roadback) are messing thing up more.

 

 

no-recommendations-for-commercial-programs-to-assist-withdrawal

 

truehope-the-road-back-labelmesane

 

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Only make one change at a time and try a small dose to see how it affects you.  Keep it Simple, Slow and Stable

 

I suggest that you research all supplements before trying them.  Use google and add survivingantidepressants.org to your search term to see if other members have posted about the supplement and their experience using it.

[BfromNJ]

I think maybe you are right.  I am going to stop them and see.  Because I started yesterday and have felt terrible.   Increased anxiety, worse tinnitus, etc.  

[BfromNJ]

So here I am again wanting of these meds.  So, currently I plan to taper off of luvox first. I'm only on 25 mg.  I am also on gabapentin 25 (see quote below) 600 mg and seroquel 25 mg for sleep.  So one at a time right?  I see my doctor next week and will ask for script to compound to liquid.  

 

28 minutes ago, BfromNJ said:

Sorry typo not 25 600 of gabapentin.   It's just 600.  

 

Edited March 20, 2019 by ChessieCat
correction

[ChessieCat]

I've moved your new topic to your Intro topic.  This keeps your history in one place.

 

I've asked the other mods for their assistance.

[Altostrata]

Hello, Bfrom.

 

When you go into the hospital for psychiatric reasons, you can count on coming out on a boatload of drugs.

 

It's unfortunate that you were tapering off mirtazapine for sleep and now you're on 3 drugs because of mirtazapine withdrawal.

 

Why are you taking Luvox? What is the gabapentin supposed to do for you? You had an adverse reaction to it before, correct?

 

Yes, Luvox would go first, as you want to maintain sleep with the other drugs (if they help sleep). Since you've been on it for more than a month, you are at risk for withdrawal symptoms. As it's been only 35 days, you might try a 25% reduction to start, but you'll have to put it up right away if you get withdrawal symptoms.

 

Read Tips for tapering off Luvox (fluvoxamine)

 

Please think carefully: Going off psychiatric drugs means you may need to carefully taper, possibly cope with withdrawal symptoms, and use non-drug techniques to deal with your life problems. Is this something you want to do? Do you want to unpatient yourself?

[BfromNJ]

The luvox is for OCD type tendencies.  And yes I am wanting to be off meds.   I have a hormonal issue to deal with  and had I done it first, I may not even be in this situation.   But I cannot go back.  Yes, I knew what I was in for going impatient and I regret it now but I can't take it back.  And yes I was on gaba before.  I had an intrusive suicidal thought on it and it made me too mellow but helps anxiety I suppose.  I just wanted to feel safe at the time and the tinnitus was driving me insane.