Laurenjade08: mirtazapine withdrawal?

[Laurenjade08]

Hi all

 

having a really bad time again, woke up yesterday morning being violently sick, haven’t eaten a thing and feel on the verge of being sick every second at the moment. I only dropped 10%, do i reinstate again, change to a liquid and go even slower? 😭

[Carmie]

Hi Lauren, 

 

How are you feeling now? I can’t taper by 10% myself. I’m tapering just under 4% now, but I still go through weeks of lots of waves. 

 

If you decide to eventually go to liquid you will need to do a crossover, otherwise your withdrawals will ramp up even more. This is what a crossover looks like:

 

3/4 of the old formula.                          1/4 of the liquid. 

 

1/2 of the old formula.                           1/2 of the liquid. 

 

1/4 of the old formula.                           3/4 of the liquid. 

 

Then all liquid. 

 

You do each stage for about 3 to 7 days, or longer if you like.

 

Please let us know how you’re doing, sending hugs🤗

[Laurenjade08]

Better again now, that was a rough ride again! I will be doing less next time! 

I will take your advice on the liquid change over for sure, I am waiting for the doctors to get back to me next week, as to whether or not they’re giving me the ready made liquid.

thank you all for all your help ❤️

Lauren x

[Carmie]

On 4/22/2019 at 2:21 AM, Laurenjade08 said:

Better again now, that was a rough ride again! I will be doing less next time! 

I will take your advice on the liquid change over for sure, I am waiting for the doctors to get back to me next week, as to whether or not they’re giving me the ready made liquid.

thank you all for all your help ❤️

Lauren x

 

Glad you’re feeling better now Lauren, 

 

I’m glad you’ll be doing a crossover when you go to liquid. Last year, before I knew about crossovers, I changed formulations and went through three months of waves. Then, when I went back to my old formulation I did a crossover, and it went really well. Yay! 

I went from water titrating my tablet to water titrating a compounded formula. Brassmonkey told me though that compounded capsules aren’t always that accurate, so that’s why I went back to my tablet. Crossovers really are the go when changing any kind of formulation. 

 

Please keep us updated as to how you’re doing.💚

Edited April 23, 2019 by Carmie
Typo. Brain fog.

[Laurenjade08]

So I was thinking of starting my cross over tonight..

but I only have 13 days worth of normal tablets left.

 

would it be ok to do;

 

15mg tablet and 5.3mg water/maple syrup  solution (4 days)

12.8mg tablet and 7.5mg water/maple syrup solution (4 days)

7.5mg tablet and 12.8mg water/maple syrup solution (4 days)

All new 20.3mg water/maple syrup solution 

 

[Laurenjade08]

Hi Carmie,

 

ive been speaking on a Facebook page and they have told me I should have changed straight over to liquid rather than doing part liquid and part tablet 😕 this had concerned me! 

I’ve been ok, some nausea and higher anxiety but tolerable thankfully.

 

hope you’re doing well ❤️

[Gridley]

30 minutes ago, Laurenjade08 said:

they have told me I should have changed straight over to liquid rather than doing part liquid and part tablet 😕 this had concerned me! 

 

That is bad advice from the Facebook page.  You should do the crossover.  The closer you can get to the proportions of 3/4 tablet 1/4 liquid, then 1/2 1/2, then 1/4  3/4, then all liquid the better.  The formulation in your earlier post isn't bad if you need to do it that way due to number of pills remaining.

[Carmie]

Hi Laurenjade, 

 

How are you doing? Did you do a crossover to the liquid? 

 

Sending hugs🤗

[Laurenjade08]

Hi Carmie,

 

I did do the crossover, I haven’t done huge reductions but i am now on 19.5mg, reducing 2% every 2 weeks all being well.

Its going ok ish so far, some anxiety, anger outbursts, short lived head pains and air hunger a few times, but other than that getting on with normal day to day life ok!

 

How are you doing?

 

Sending love! 

[Carmie]

On 6/15/2019 at 10:34 PM, Laurenjade08 said:

Hi Carmie,

 

I did do the crossover, I haven’t done huge reductions but i am now on 19.5mg, reducing 2% every 2 weeks all being well.

Its going ok ish so far, some anxiety, anger outbursts, short lived head pains and air hunger a few times, but other than that getting on with normal day to day life ok!

 

How are you doing?

 

Sending love! 

 

Hi Lauren, 

 

Glad you managed to do the crossover, that was very wise. 

 

Yes, it’s good to go slow. I’m going slower than you are actually. My body is so sensitised due to all the meds the doctors put me on and off that I’m tapering by about 4% or so every six or seven weeks. I’m just listening to my body. I still go through windows and waves, there’s no escaping those.

 

I’m glad your symptoms haven’t been too bad, that’s really good news.

 

Could you please update your signature too. Thanks. 

 

Wishing you all all the best with your continued tapering 💚

 

[Laurenjade08]

Difference between manufacturers.. side effects?

 

Hi everyone,

it’s been a while, but I’m back. 
I’ve been slowly tapering my meds for 15 months now, it’s been eventful to say the least.

Anyway, the point of my post was the fact I am still getting side effects 24 days into a change in mirtazapine manufacturer. 
Has anyone else found difference between manufacturer of generic mirtazapine? I’m struggling.

 

thanks! 

 

Edited June 20, 2020 by ChessieCat
added topic title

[ChessieCat]

8 hours ago, Laurenjade08 said:

Anyway, the point of my post was the fact I am still getting side effects 24 days into a change in mirtazapine manufacturer. 

 

Q1:  What was the reason for the different manufacturer?

 

Q2:  Did you make a reduction at the same time?

 

Q3:  Did you swap directly from one brand to the other?

 

Q4:  Was there any other thing that happened or you took/stopped taking at around the same time?

 

Q5:  Have you missed taking a dose?

 

Q6:  How has the Covid situation affected you?  Some members have reported unexpected waves/worsening of waves in the last few months.

 

Q7:  Do you have any of the previous brand left?

 

Q8:  If no, are you able to get some of the previous brand?

 

Whenever possible we suggest that if there is a change in drug form (eg tablet to liquid, brand to generic, etc) that a cross over from one to the other is done, without making a reduction.  This is more gentle on the nervous system.

 

Depending on your answers to Q2, Q4, Q5 and Q6, then it could possibly be the change in manufacturer.  Other members have reported issues.  See:

 

change-in-drug-manufacturer-or-generic-substituted-for-brand-name-drug

 

If you have, or can get, the original you could go back to taking it.  If you have a small supply but can't get more of the original for the long term you could go back to the original and then do a cross over.  Sometimes doctors have samples from the drug supplier.  The instructions for doing this are in Post #1 of the linked topic.

 

[marie123]

Yes, a difference in the manufacturer in Mirt or any of the others I tapered mattered. I would get quite sick. I told my doctor about it and he told me that each company puts different fillers in the med so they feel different. He prescribed the Mirt in the manufacturer I wanted and specified it. I think my manufacturer is Aurobindo. He wrote the script "Aurobindo only". If you get it from a local pharmacy you should call around and ask if they carry the brand. I get it from a mail away pharmacy that handles a lot of different manufacturers. Marie.

[Laurenjade08]

Hi thanks both for your messages! 
chessie cat.. in response to your questions;

1) they changed me over because they couldn’t get any more of my old brand, and now I’ve been told they might not be able to get any more dispersible tablets as there is a national shortage of one of the ingredients in them (only found this out yesterday) 

2) I didn’t make any reductions, knowing that these can create withdrawal symptoms alone and didn’t want to cause a double whammy effect!

3) I did swap directly over because I only found out about 4 days before collecting my next prescription before my old brand ran out, that they could no longer source this brand! Very helpful pharmacist.. 
4) nothing out of the ordinary! 

5) I’ve not missed a single dose since starting this med! 
6) the Covid situation hasn’t effected me as much as I thought it would.. I’m still working as normal so not much has changed other than the additional slight stress of having to teach my two small children and keep them entertained to keep them from causing havoc! 
7) None of the previous brand left unfortunately.. here in the UK you are only allowed 28 tabs at a time and only allowed to order the next set about 1 week before you need the next ones!

8 ) I’ve tried my absolute upmost to try to source some of my old brand, to no avail. I think this is due to the old brand being made in india, and with a global pandemic going on perhaps they have just stopped supplying here. I’ve rang about 10 different pharmacy's. I found my next box at a pharmacy about 15 mins drive away from me, they told me they have 90 currently in stock of this new brand. I asked my doc to prescribe the 90 tabs and they said no, only 28 at a time.

i also asked them to put my old brand aurobindo on the script, they also told me this is impossible when I have been told by an online pharmaceutical company this definitely is. 

thank you for getting back to me! 
 

marie, thank you.. like I said above, nightmare! I tried to use an online company for my prescription that told me if the name of the manufacturer is written on the prescription then they are allowed to try and source it that way, otherwise they just have to sent whatever they have in stock. My doctor told me he cannot do this, as the prescription is electrionic now he said it simply doesn’t come up as an option when you type it in.  Have you had to change brand for good before? If so, did it take long to stabilise? 

 

 

I have felt very slightly better the last few days thankfully, as I’ve ran out of options and people to turn to for help, I feel now I’ve got no choice but to wait it out without making any reductions until things get better.. hopefully they will get better? I don’t know. 
thank you both!

Lauren

[marie123]

Lauren, I take the mirtazapine Aurobindo too. Yes it is from India. I see you are from UK. Here is the US it is possible to request a certain brand. So far I have not had any problems getting the Aurobindo.  Can your doctor call the pharmacy himself to ask for a certain brand? That may help. No, I have never changed brands that I am aware of, but I know that people do it. It just takes a while to get used to it. Can you see another doctor in the practice or somewhere else? Marie.

[Laurenjade08]

Hi Marie

No they can't he is saying it is impossible to do this, to be honest I think they just want shut of me completely. I am considering changing GP and they have been very unwilling to help me in any way since starting this medication, but I'm not sure what the process of this is due to covid shutting most practices and them doing telephone consultations.
It's taking an awfully long time, I believe it's been 30 days now since changing over, I just wonder if this is the new me and if I should get on with my taper now. It seems so ridiculous after only taking it for 3 months, but I do of course try not to dwell, it's only when feeling bad that I tend to fall into this dark pit and struggle to get out! 
Lauren x 

[marie123]

I would not continue to taper until I felt improved enough. Sometimes feeling stable takes a few months. I know it's hard to be patient, but when you feel better you will find it much easier to taper.  Marie.

[Laurenjade08]

And after all that.. been to collect my next prescription and I’m back on aurobindo! I bet they will change it back to accord next time.. I wonder if I’ll ever be able to continue this taper! 
I will see how things go and decide what to do next. Thank you for your support! Means a lot to me. 

[Laurenjade08]

Hi again everyone 

 

I am having a really, really bad time. 
I cut from 10.8 very slowly over about 5 weeks down to 10mg and all hell broke loose. Mainly very very bad Anxiety, stomach cramps, unable to eat properly, headache. 
I reinstated up to 10.4mg on the evening of 26th July, still no better after a week so I’ve upped to 12mg 2 nights ago now.

I am seriously considering going back up to 22.5. I was angry and raging all the time, but I was still living my life, at the moment I’m just sat on the sofa wondering when the hell will end. 
Any advice? 
It has taken me a total of 15 months to get from 22.5 to 10mg, I can’t believe I am suffering so badly when still on the drug and tapering so very slowly.

 

Please help! Do I reinstate back to 22.5 and drop again in a year or so? All the reinstatement pages are talking about people who have stopped cold turkey which isn’t what I have done. 

[ChessieCat]

6 minutes ago, Laurenjade08 said:

reinstated up to 10.4mg on the evening of 26th July, still no better after a week so I’ve upped to 12mg 2 nights ago now.

I am seriously considering going back up to 22.5.

 

I strongly advise again going back up to 22.5mg at this time.  It takes about 4 days for a dose change to get to full strength in the blood and a bit longer for it to register in the brain.

 

You've only been on 12mg for 2 nights.  I suggest giving it one week in total and then reassess.

 

Even then if you feel that you need to updose, it is better to go up by small amounts at a time and waiting at least 1 week.  Taking too much might make things much worse.

 

Please read Post #1 of this topic, much of the information applies to updosing as well as reinstatement.

 

About reinstating and stabilizing to reduce withdrawal symptoms

[Laurenjade08]

I’ve read and read the pages hoping it would help. I know you’re right but my body just wants to be free from the misery that’s all. I’ll give it more time, thank you @ChessieCat

[Ripley]

Hi Laurenjade08

 

Just reading your story, I hope you were able to get the endoscopy or proper attention for the original stomach pain that your doctor (erroneously) prescribed MIrtazapine for in the first place? Just to rule out anything else apart from WD as you mention stomach cramps and nausea again...

 

I'm sorry to read you're suffering again and I totally understand the impulse to heavily updose to try to improve things as I did this myself when I had terrible insomnia. Although, knowing what I know now, I wish I could have been more conservative in my increase. So do try to take ChessieCat's advice on this if you can  - you will be free of it so much sooner! 

 

I hope things settle down for you very soon and you feel better!

 

Best wishes

Ripley

[Laurenjade08]

Hi Ripley,

 

Did reinstating to 7.5mg help you? Is that the most you ever took? 
 

thanks for your reply too.

 

Lauren

[Ripley]

Hi there

 

Yes it did help. About a week after the updose (from 1.5mg) my sleep started to become deeper and gradually longer (it took 2 months for stability). However, this may have happened at a much lower dose if I had known. Ultimately, I'm just grateful it worked though.

7.5mg is the highest I've been on apart from a few days higher.

 

Ripley

[Laurenjade08]

Hi again Ripley,

 

I listen to what I’ve been told and give it another week at this dose then. At least it worked for you a second time around, that’s my biggest fear.. keep increasing, even getting to my old max dose and never finding stability and wishing I hadn’t increased.

 

How are you finding the slow taper this time around? 
 

Lauren 

[Ripley]

Try not to worry about that, it's a circle of anxiety. I think stability is less about chasing it and more about waiting for it to come to us! Less is more.

 

ChessieCat advises to stay at 12mg now for a good week and then reassess. Hopefully things will have settled down in that time. If not, a moderator here will be able to advise the best next step or updose.

 

So far, the slow taper is going well

 

Wishing you well.

 

R

[Laurenjade08]

57 minutes ago, Ripley said:

Try not to worry about that, it's a circle of anxiety. I think stability is less about chasing it and more about waiting for it to come to us! Less is more.

 

ChessieCat advises to stay at 12mg now for a good week and then reassess. Hopefully things will have settled down in that time. If not, a moderator here will be able to advise the best next step or updose.

 

So far, the slow taper is going well

 

Wishing you well.

 

R

Thank you again for your kindness. This drug is so strong and cruel. I hope you have an uneventful taper.

Lauren

[Ripley]

Hi Lauren

 

How are you doing? I hope things have improved for you.

 

Ripley

[Laurenjade08]

Hi again Ripley,

No unfortunately they’re not. The doctors told me I need to increase back to my original 22.5mg and I couldn’t see a way out, so that’s what I did 4 nights ago. Still waiting for some relief.

Hope you are getting on ok! 
Lauren 

[Ripley]

Hi Lauren

 

I'm sorry things didn't settle down for you, especially as your taper seems to have been nice and slow. I hope you get relief very soon.

 

My sleep continues to be very fragile and I had an increase in symptoms just from increasing my (low) fish oil dose recently.

 

Best wishes

Ripley

[Laurenjade08]

Thank you - this afternoon I’ve felt very low in mood by very slightly better nausea and anxiety wise. 

I decided I’m going to wait a while and start my taper again, but firstly start my running again and introduce supplements first.

I hope you get some much needed good sleep soon.

Lauren

[ChessieCat]

2 hours ago, Laurenjade08 said:

I decided I’m going to wait a while and start my taper again,

 

Good idea.

 

2 hours ago, Laurenjade08 said:

but firstly start my running again and introduce supplements first.

 

Start slowly and build up.  At this time you may not be able to do what you have done before.  Some members find that over exerting themselves can worsen symptoms.

 

With supplements, it is suggested that you do not take anything in a complex.  Also start with a low dose and increase gradually.  Only make one change at a time.

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

There are existing topics about exercise and supplements.  I like to use search engine and add site: survivingantidepressants.org to my search term.  I suggest that you research things before trying them.

 

 

[juneight]

Hi my dear friend Lauren. How are you doing with your new program? I think you are ok. If you ask me, i get used to live with this anxiety. Until the things settle, i ll cut it 0.15/monthly, then it may 0.3/monthly. x

[Laurenjade08]

Hi,

things have settled very slightly but still left with nausea and bad anxiety, and new symptom of dizziness today. It’s a nightmare.

Your taper schedule sounds very sensible, as long as it’s working for you that’s great! 
lauren 

[Laurenjade08]

Hi everyone 

 

I know it’s been a while - I will need to update my signature 

 

after updosing to 12mg, I kept updosing further and further because I was in a rush to get back to work and feel better, but it’s just not worked in the way I’d hoped.

im now at a high dose, 30mg

i tried 37.4mg for 4 weeks, and came back down 2 weeks ago to 30mg, as I started to experience suicidal ideation and lots of other nasty symptoms.

 

since coming back down, as of 5 days ago I’ve been hit again with horrible symptoms - extreme nausea, fatigue, dry mouth, stomach pain, adrenaline rushes, awful anxiety with no relief. Last night I hardly slept at all. It’s at the point where I can hardly look after myself currently.
 

I feel like I had no choice but to make that 20% reduction after trying the higher dose for 4 weeks, as it was causing me to have panic attacks, as well as a whole host of other symptoms.

 

Though my tapering process, I am definitely aware that the larger the cut I make, the longer it takes to kick in but the worse the symptoms also are. At the moment, I’m either in bed or on the sofa, I don’t feel like I want to cry but the nausea is that intense I can hardly eat and I am losing weight rapidly. 
 

Part of me is thinking I should ask the docs for a benzo, but I know all this chopping and changing has already destabilised my CNS. What do you think?
 

I guess what I’m hoping for is some words of encouragement, that this isn’t going to last forever and it might get better soon.

 

When I tried a 10% cut previously I was hit with these awful symptoms for 5 days, bed bound again.. I’m a mum of two little ones, I work and I just can’t take any time off currently, so that additional pressure is taking it’s toll. 
 

any advice/support would be much appreciated right now. Thank you.

[Laurenjade08]

Any advice on this 20% reduction?

 

I didn’t have a choice but to make it, because adding the extra 7.5mg caused suicidal ideation, but I’m now 2 weeks into the cut, after only making the increase for a total of 4 weeks, and suffering with terrible nausea, very bad sensitivity all over my body and anxiety through the roof, with adrenaline rushes to top it off.

 

Thanks