Laurenjade08: mirtazapine withdrawal?

[Laurenjade08]

Hello

 

This is my first time on any proper medication.

I was placed onto this medication due to failed attempts on SSRIs, and due to constant stomach pain with no relief.

Anyway, I was placed on 15mg of mirt 9 1/2 weeks ago, I tried upping to 22.5mg 2 weeks ago, and dropped back down to 15mg 5 nights ago now.

 

For the last two days I have been suffering with very bad nausea, day 4 I had a bout of diarreah but today still constant nausea. Does anyone know if this is likely to be nausea due to dropping dose? I’ve only been on a short time and would like to come off... what do you suggest? Do I wait to stabilise and drop 10% a month? 

[ChessieCat]

Hi Laurenjade and welcome to SA,

 

Thank you for creating your drug signature.

 

You mention that you have been on other SSRIs.  Please add this information to your drug signature.  We need it nice and simple so we can see the basic information at a glance.

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

as an example:

Drug name:  date, dose; date, dose; date, dose;

 

 

Once we have the additional information we will be better able to offer suggestions.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[ChessieCat]

The effect of psychiatric drugs is cumulative.  What you have previously taken can affect what happens now.

[ChessieCat]

17 hours ago, Laurenjade08 said:

For the last two days I have been suffering with very bad nausea, day 4 I had a bout of diarreah but today still constant nausea. Does anyone know if this is likely to be nausea due to dropping dose?

 

If the nausea and diarrhea started after the reduction it is highly likely to be as a result of the reduction.  I had an upset stomach after reducing my drug too quickly.  See numbers 35 and 37 on the Glenmullen withdrawal symptom list.

 

Unfortunately it only takes about 1 month for the brain to adapt to getting the drug.  However, you may be able to taper faster than SA's recommended 10%, which is a harm reduction method which generally suits most people, however there are some who have been on a drug a long time who can go faster than 10% and some that have to go slower than 10%.  But nobody knows who fits into which category.  However, the effect of going on and off psychiatric drugs is cumulative and might make it harder to taper faster.
 

You will need to listen to your body and if you start to get withdrawal symptoms which are more than mild you will need to reduce by less/go slower.  Please read Post #1 of this topic much of which is relevant to updosing if your withdrawal symptoms are unbearable.  About reinstating and stabilizing to reduce withdrawal symptoms

 

Please note that if you need to updose you only take a tiny bit more and you should not make another reduction until you have stabilised.  More information in my next post.

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

You might find this topic interesting.  Many members find that the lower their dose gets the slower they need to go, by reducing less and/or holding longer.  Why taper paper: dose-occupancy curves

[Laurenjade08]

Thank you

[Carmie]

Hi Lauren, 

 

I wanted to welcome you to SA as well. How have you been doing? How is your nausea now?

 

Sending hugs🤗

[Laurenjade08]

Hi Carmie

 

It got worse, and my anxiety skyrocketed so I had to reinstate to 22.5mg 2 nights ago. 
Looks like I'm hooked. 
I'm going to wait until I feel fully better and do a much slower, lower taper. 
Wish I hadn't been talked into starting this drug due to stomach pain, I should have requested that the doctor put me forward for an endoscopy, never mind. 
I will be free one day.

[Carmie]

Hi Lauren, 

 

I’m sorry your nausea got worse. How are you feeling since you went back up to 22.5mg?

 

You will get off these meds one day, we all will, it’s just a really slow journey. You’ve been on different meds in the past too which can sensitise your system. My body is sensitised as I was put on and off a ton of meds. Like you, it started with chronic pain. 

 

How long have you had the stomach pain? I’m really sorry they put you on psych meds for it. 

 

Take care, sending hugs🤗

[Laurenjade08]

I’ve felt anxiety through the roof, today some really really bad intrusive thoughts. I’ve had my dad over today to try and calm me down.. 

ive had the stomach pain since September 2018.. I wish I’d never listened to the doctors and not tried anything like this for it.. oh how I wish!

I just want to start feeling ok again, so I can get back to work and do normal everyday things like everyone else.

thank you for your message x

[Altostrata]

Welcome, Lauren.

 

How are you feeling now, on 22.5mg mirtazapine? How are you taking it, are you cutting up a tablet?

 

What time of day do you take it? You'll have to be careful to take it the same time each day.

 

Yes, insist on examination by an gastroenterologist and have the endoscopy! Why did your doctor think you needed an antidepressant before testing for all possible medical conditions?? That is not a good doctor.

[Laurenjade08]

Hi, thanks for your message.

I am feeling pretty down, still slightly nauseous, hoping it might improve over the next few days. I’ve told my work I’m not going to be in next week, so at least I don’t have that to stress over now.

 

I take a 15mg and split a 15mg tablet in half yes, although I know I’m not getting exact measurements, so I brought a pill cutter from our local pharmacy to help. 

 

I think they just assumed it was anxiety related, as I’ve had GAD diagnosis since 9 years of age, they are quick to label any of my problems with anxiety.. I just trusted what they said. Now when I think about it, it’s completely stupid, I still have the pain and now I’m on an antidepressant that’s messing about with my anxiety which I have dealt with fine all by myself all these years, and never needed medication for! 

 

Looks like I need to settle for a while and start a low, slow taper.. honestly on reflection now I could literally kick myself that I let him talk me into me thinking it was all in my head, probably because the procedure at hospital costs thousands and a packet of mirtazapine costs £1.99. 😔

[Altostrata]

Sadly, true. You need to make them take your stomach pain seriously. They often brush off women's health complaints.

 

For tips about how to talk to doctors about any medical condition, see How do you talk to your doctor about tapering and withdrawal? 

 

Over the last 4 days, have you been feeling better on 22.5mg mirtazapine? Have the symptoms lessened?

 

What time of day do you take it?

[Laurenjade08]

I will, thank you very much.

 

I had a bad melt down this morning, and again this afternoon, suicidal thoughts.. I had my dad around making sure I was ok. The diarreah was intense for a day and the nausea was intense for 2 days after the drop, it’s levelled out but felt much the same since dropping and going back up to 22.5... just waiting and praying it goes away and my anxiety gets better again, it’s exhausting feeling bad all day everyday isn’t it. 

[Altostrata]

It may take a while for your nervous system to settle down. See The Windows and Waves Pattern of Stabilization

 

Does mirtazapine help you sleep?

[Laurenjade08]

Thank you that’s what I needed to hear.. I wonder how long, my husband said I should listen to my doctor and go up to 30 as soon as I am ready.. I’m not sure, I don’t want to go higher in fear that it will be even harder to get off in the future, but then again maybe 30 could help me..

my dad however has said keep at this dose for a month and see if it settles down again, then to plan a taper.

 

The mirtazapine does help me to sleep yes, about 1 1/2 hours after I take it I have no choice but to go to bed, I can’t stay awake any longer, but that wasn’t the reason I was put on and had no trouble in sleeping before I started taking it.

[Carmie]

Hi Lauren, 

 

How are you doing?💚

[Laurenjade08]

Hi Carmie,

 

Pretty rubbish, a lot better than I was dropping my dose down, doing things around the house, but the thought of going to week next week sets my anxiety off badly and it seems to be worst waking until 10am and then 5.30pm until I take my next dose my anxiety is pretty intense!

 

I didn’t have this anxiety issue before this medication which makes me depressed when I think about how I am stuck on it!

 

How are you? 

[Carmie]

Hi again Lauren, 

 

Yes, theses meds certainly cause us a lot of distress. I thought for ages there was something terribly wrong with me, until I found out it was the medications and withdrawals from them. 

 

I know you’re feeling horrible. This journey is definitely a rollercoaster ride, up down, up down🎢🎢🎢. We never know how we will be from one day to the next, or some days, one minute to the next. It’s the windows and waves pattern. It shows our brains are healing though. There’s no escaping waves while healing from these meds. 

 

We can’t change the past or what has happened to us. It will only add stress to our lives if we keep looking backwards, and that stress will ramp up our symptoms even more. Any kind of stress, whether mental, physical or emotional can ramp up our symptoms. Even happy stress can ramp up symptoms, like big exciting events. We need to try and be as calm as we can, it’s not easy at times.

 

I’ve found that one of the things that really helps me cope is distracting myself. I have a million distractions, arts and crafts, creative projects, listening to music, watching Netflix and DVDs, playing word games, reading when my brain lets me, going out in nature, going to concerts. No matter how awful I’m feeling I always do something to distract myself. I went to a concert on Saturday night. Having concerts to look forward to always brighten my day. I hope you can find distractions too. 

 

Take care💚

[Laurenjade08]

Sounds like you’ve got things really well under control. I’m just struggling at the moment, maybe I should force myself back to work next week to see if it is a good distraction.

 

I am just wondering how long I should give it before i try to slowly taper off again.. I’ve been on around 12 weeks now, everyone I’ve spoken to has said try to see if you stabilise on this 22.5mg for 4 weeks and start slowly again.

I feel now just like I did before i tried to drop to 15, flat mood and anxiety in the morning and from 5.30 until my next dose. 

 

[Carmie]

Hi again Lauren, 

 

With the amount of changes you’ve made it can take more than a month for you to stabilise. You’ve gone down and up, and down and up. Your poor brain is trying hard to find some homeostasis. Last year it took me about three months to stabilise because I changed from water titrating my tablet to water titrating a compounded capsules. I went through waves all that time pretty much. I didn’t know about crossovers then. I went back to my original tablet once I learnt compounding formulas aren’t always that accurate. This time I did a crossover and it went fine.

 

My point being though, if we rock the boat and make big changes, like you did, going up and down, it can take a while to stabilise. We have to learn to try and be as calm as we can, even though it’s not always easy. After every taper I’ve done, no matter how long or severe it’s been I’ve always stabilised. You will stabilise again too, and then you can taper slowly. 

 

We will all eventually heal. We can do this! 💚

 

 

[Laurenjade08]

I feel my only complaint now is the anxiety in the morning and last thing at night.

I just can’t work out if this is likely to be part of stabilising, or if it is just how I almost on this dose, and it’s the medication causing it.. does that make sense?

[Carmie]

If you think it might be the actual medication causing the anxiety or any other other symptoms Lauren, it might be a good idea to do a daily log. 

 

Chessiecat will send you an example of how to do it. I’m not computer savvy, I don’t know how to copy and paste or share links. 

Keep a log for three days and then put it on here. 

 

The weather is so warm here at the moment in Aussie Land. You’re probably freezing over where you are. It’s almost bedtime for me. 😴😴

 

By the way, morning anxiety can be caused by a cortisol spike, it’s very common in withdrawals for people to wake up in fear and panic. There’s a thread in Symptoms and Selfcare on that too. I’ll ask ChessieCat to send the link to you too. She started a tag team with me.😄 

 

Take care💚

[ChessieCat]

Example:

 

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

[Laurenjade08]

I don’t mean to be funny or rude, but what will this do? Will it help me to work out of it is the medication with certain times things happen?

Thank you, I’ll have a look in the self care section, and yes it’s pretty darn chilly around here! I hope you’re enjoying the warmth! X

[ChessieCat]

23 minutes ago, Laurenjade08 said:

 

I don’t mean to be funny or rude, but what will this do? Will it help me to work out of it is the medication with certain times things happen?

 

 

6 hours ago, Carmie said:

 

Chessiecat will send you an example of how to do it. I’m not computer savvy, I don’t know how to copy and paste or share links. 

Keep a log for three days and then put it on here. 

 

 

This allows the mods to assess your situation and see if there is a pattern to your symptoms and possibly offer suggestions.

 

Edited March 11, 2019 by ChessieCat

[ChessieCat]

6 hours ago, Carmie said:

By the way, morning anxiety can be caused by a cortisol spike, it’s very common in withdrawals for people to wake up in fear and panic. There’s a thread in Symptoms and Selfcare on that too. I’ll ask ChessieCat to send the link to you too.

 

waking-with-panic-or-anxiety-managing-the-morning-cortisol-spike

[Carmie]

Hi Lauren, 

 

How are you doing?💚

[Laurenjade08]

Feeling better, not waking up with the awful dread I was getting, just anxiety as usual but I’ve been using some CBD, I think that is helping.

im getting ready to start my taper again in a few weeks, I will be doing what’s advised on here.. can’t wait to come off but happy I’m stable at the moment.

how are you? X

[Laurenjade08]

Starting my taper tonight, shaved down my tablets..

first drop from 22.5mg to 20.3mg... here we go.

[Carmie]

Wishing you all the best with your taper Lauren, 

 

I missed your message to me. I’m not doing too badly thank you, going through windows and waves like everyone else here. Happy to get windows though, and I’m distracting myself through the waves. I’ve been watching a million period dramas, doing diamond paintings, listening to to audio talks etc. Today is day twenty of my taper from 7.5mg to 7.25mg. 

 

Take care, sending hugs🤗

[Laurenjade08]

Thank you for your message, only just seen this. I’ve been ok up to this afternoon and this evening I’ve been feeling rather sick.. I hope it goes away soon.

I keep wondering if cutting and using a scale is good enough. How are you cutting down your dose? 

L x

[Carmie]

10 hours ago, Laurenjade08 said:

Thank you for your message, only just seen this. I’ve been ok up to this afternoon and this evening I’ve been feeling rather sick.. I hope it goes away soon.

I keep wondering if cutting and using a scale is good enough. How are you cutting down your dose? 

L x

 

Hi Lauren, 

 

I’m actually water titrating my tablet. I just crush it with a mortar and pestle and add water. 

 

I hope you feel a bit better soon💚

[Santino]

Hi Lauren

I agree with Carmie.... the best way for you is to titrate the tablets in water. For me i was warming up the water put the tablet inside, melt it down and mix with my finger or a spoon and than take the needed dose with a syringe. The rest of the juice i would put in the fridge and use for other 3 days... after that i would do a new mixture. 

I believe you can try that thing. It is easy to do... 

All the best

Santino

[Laurenjade08]

Hi,

did you have the tablets that disperse in water? Mine are the standard tablets.

thanks