success ☼ Squiggle

[Squiggle]

 

Link to Success Story:  squiggle-success-at-4th-attempt

 

Hello,

 

As you can see from my signature line, I have had a bit of a time of it over the last couple of years. At the end of 2009, I had a nervous breakdown precipitated by an unusual and unexpected reaction to a breathing technique that I tried. Lots of horrible drugs followed. After I came off diazepam over two days after a two week period (I knew no better then) I had terrible pain which was diagnosed as acid reflux and treated accordingly with drugs, which did no good. The psychiatrist thought that citalopram might be causing the problem so switched me to mirtazapine, which did nothing for the pain, though seemed to help me to sleep better. To cut a long story short, after months of daily pain (except at night, when I took temazepam) I stumbled across the Ashton manual and with its help and that of the sadly defunct forum Benzo Island, did a successful diazepam taper, coming off in January 2011. The pains incidentally vanished shortly after I crossed to diazepam.

 

I decided not to rush tapering the Mirtazapine but to give myself time to recover from the benzo taper. I began mirtazapine taper in July 2011. I used the liquid to bridge the doses between convenient pill cuts, which is why the pattern is not always absolutely consistent. The taper went pretty well. I had some wobbly times but whether these were w/d or my own anxiety, it is hard to say. I was back at work (worked all through diazepam taper), back with old and new hobbies and generally coping, though sometimes it took some effort.

 

I finally came off a couple of weeks ago, from 2.5mg, where I had been for three weeks. I had a couple of slightly edgy days but thought not much of this. When I had quit diazepam, I had had a difficult, though not terrible, fortnight and from then on, it was pretty much OK. Days three and four off mirt were great. I felt really good and so pleased to be drug free. Then it began to go wrong. My sleep began to fracture and my anxiety levels to rise. It culminated on the ninth night with a night so bad, just like my early nervous breakdown, that I begged for a mirtazapine (my husband looks after these things) and on taking 7.5mg calmed immediately (placebo?). Since then, I have settled again. W/d or old problem?

 

So, one failed attempt and trying to see it as a learning experience. I have just taken on a very responsible part time job and have some big family events coming up in the near future so I can't afford to be flaky at present. I will not attempt to come off completely again until I have clear time to be a basket case, should that happen. I can of course start reducing again as soon as I feel I have my breath back but how to do it,is the question. The liquid is a pest as it only lasts six weeks once open. Cutting tablets would in some ways be a better option but would be more inaccurate. Also, the CITA website recommends a stepped reduction for this drug, something that is supported by some people on the patientUK site, from personal experience, so I don't know whether to give that a go. Probably hold cuts longer too.

 

Any comments and advice on this story and where to go from here would be very welcome.

 

Squiggle

 

Edited March 18, 2022 by ChessieCat
added success story link

[Altostrata]

Hello, Squiggle. Welcome to our community.

 

That the small amount of mirtazapine quelled your symptoms indicates they were from withdrawal. As you were tapering, your nervous system was adapting to the lower amount of mirtazapine. When you went down to zero, your nervous system was not quite adjusted to that level yet. 7.5mg was enough to satisfy it.

 

We advocate gradual tapering by a 10% reduction on the last dose, less if withdrawal symptoms ensue.

 

Pulverizing the tablets and weighing out tiny doses with a digital scale may be the tapering technique most suited.

[Squiggle]

Thanks Altostrata. On looking back, I think that I did rush the last 7.5 mg a bit. I had a schedule in mind and was keen to stick to it and perhaps was not as attentive as I should have been to how I was feeling. The experience has scared me now and I need to work on letting that go. Strangely, as I was getting to the end of my benzo taper, I was terrified of what might happen and in the event, not much did. Nearing the end of the mirt taper, I felt pretty positive - and then crashed.

 

I think I will investigate the pulverising and weighing. The problem I found with the liquid is that its short shelf life means that you feel pushed on a bit and constrained to a schedule.

[Squiggle]

Well, I'm tapering again. I bought a microbalance, mortar and pestle and gelatine capsules. However, for this first chop from 7.5 mg, I have just shaved the tablets and kept the shavings for later use with the capsules for smaller doses. I'll hold this dose for at least three weeks and if all is well then, go down 10% again but if there is any wobbliness, will hold for longer.

 

Good to be tapering again.

[annej]

Hi Squiggles,

 

Remeron can be an extremely difficult drug to taper from as you have already gleaned. I found the withdrawal from Remeron to be in some ways worse than getting off of benzos, specifically complete inability to sleep (insomnia to its extreme) and inducement of a state that can best be described as terror. Some have found that what worked for them was to go off over a period of 1 year or more and some have made the concession that they could only find quality of life by staying on 2 mg or more. Congrats on getting off the benzo. I would revel in that accomplishment and NOT rush your taper. Be "symptom-led, not calendar led". All the best to you, Annej

[Squiggle]

Hello Annej,

 

I hope to be able to get off completely but I am not intending any rush. The horribleness of my failed first attempt cured me of that. I feel so well now, the last thing I want to do is to compromise that.

[annej]

Hello Annej,

 

I hope to be able to get off completely but I am not intending any rush. The horribleness of my failed first attempt cured me of that. I feel so well now, the last thing I want to do is to compromise that.

 

I am so glad that you feel better now. Hugs, Annej

[Squiggle]

Thank you. Very colourful dreams over the last few days - not horrible, as I know can sometimes happen but just colourful and memorable on waking. This may or may not be drug-related but I know from past experience with the benzos, that if it is, it is a good sign. Also felt rather "wired" over the weekend but suddenly calmer from mid-afternoon on Sunday. Again, this may or may not be down to the mirt. I am keeping a note of these things in my diary so that I can see how they ebb and flow and how that may relate to a similar point in each cut. One thing I know for sure is that the feeling was not down to my previous anxiety: I took part in an activity on Saturday, singing in a concert, that usually has me all wound up but I was cooler than I have ever been, which was great.

[annej]

Thank you. Very colourful dreams over the last few days - not horrible, as I know can sometimes happen but just colourful and memorable on waking. This may or may not be drug-related but I know from past experience with the benzos, that if it is, it is a good sign. Also felt rather "wired" over the weekend but suddenly calmer from mid-afternoon on Sunday. Again, this may or may not be down to the mirt. I am keeping a note of these things in my diary so that I can see how they ebb and flow and how that may relate to a similar point in each cut. One thing I know for sure is that the feeling was not down to my previous anxiety: I took part in an activity on Saturday, singing in a concert, that usually has me all wound up but I was cooler than I have ever been, which was great.

 

Hi Squiggle,

 

The vivid dreaming may well in fact be an indicator of lowering the Remeron, however since they are "colorful" and not horrific, I would not be concerned.

 

Keeping a daily journal is helpful for me as well.

 

Hooray for you for feeling better!

 

Hugs, Annej

[Squiggle]

Well, I have made a new cut. I held onto the last one longer than was strictly necessary. I wasn't suffering any ill-effects but there was quite a lot going on in other areas of my life so I decided to hold the drug steady until those things had calmed a bit. I felt ready to cut again last Thursday so went ahead, now down to 6.1 mg. Feeling OK at present, just a little bit tense but nothing significant.

[Altostrata]

You've got the hang of it, Squiggle. Hope this cut goes well.

[Squiggle]

Thanks Altostrata. Not doing too well at present - sleep is a bit fragmentary and I am feeling quite anxious. Interestingly, when I made the last cut, I felt anxious enough to note it in my diary about the 6-7 day point and this is about the same point following the latest cut. Maybe significant, maybe not. Either way, I know that I just have to ride it out as I have done so many times before. It does get so so exhausting though.

 

This taper is different to the benzo one where we tended to adhere to a fairly strict timetable for cutting. I suppose there was always the danger there of tolerance withdrawal if you stayed at a dose too long.

[Skyler]

This taper is different to the benzo one where we tended to adhere to a fairly strict timetable for cutting. I suppose there was always the danger there of tolerance withdrawal if you stayed at a dose too long.

 

Hi Squiggle.. the benzo protocol was obsessed with tolerance withdrawal for a reason many of us here cannot figure. That hurt a lot of people because it had them tapering at a rate that was too fast. I'm still coming off the tail end of a long benzo taper. No probs holding as per the suggestion here.. no tol. withdrawal. You might want to read about this here.

[tezza]

Hi Squiggle,

 

It sounds like you are doing fairly well with your Remeron taper. I'm happy for you and it gives me hope because someday I'll be doing a taper from it also. I hope you continue to do well.

[Squiggle]

Almost two weeks into this cut and I am now feeling well. My sleep has settled down again after a few nights of fitfulness. The edginess that was present until about last Sunday seems to have faded. I have been very busy and active this week and the sun has been shining (quite rare here this year) and I am sure that these things have helped. Just at the moment, things are fine.

 

Best wishes to all here.

[Altostrata]

Great news, thanks for checking in.

[Squiggle]

Two weeks into latest cut (5.5 mg) and again I am feeling fine. There were as before some edgy bits in the first couple of weeks but nothing too significant. Sleep has mercifully been unaffected. I have kept very busy and active, physically as well as mentally and these things help, so I find.

 

I am aware that there are a lot of people on here having a much harder time of it than I and it can feel odd to come here and post these upbeat messages. When I was struggling with benzo withdrawal (and I did) it was useful to me to know that there were others who were also struggling but equally, it helped me to learn that some were doing OK, and that it was possible for that to happen. So, I hope my telling the list that I am doing OK is helpful to someone out there.

[tezza]

Hi Squiggle,

 

Indeed, it is very nice to know that you're feeling well. I'm currently on 7.5 of Remeron after a failed attempt to switch from it to a different med. I went back on 7.5 at the end of July and will hold here for a while. Thanks for letting us know how it's going. It is encouraging!

 

Love,

 

Tezza

[Skyler]

I am aware that there are a lot of people on here having a much harder time of it than I and it can feel odd to come here and post these upbeat messages. When I was struggling with benzo withdrawal (and I did) it was useful to me to know that there were others who were also struggling but equally, it helped me to learn that some were doing OK, and that it was possible for that to happen. So, I hope my telling the list that I am doing OK is helpful to someone out there.

 

You came off diazepam pretty fast. Ashton's time frame can be pretty rigorous for a lot of folks. Glad to know the mirtazapine taper is going better. Awrighttt

[Squiggle]

5 mg now and things continue fine. I will be holding at this dose rather longer than usual as I am about to go on holiday and do not want to be bothered with cutting and any possible ill-effects whilst away.

[Altostrata]

Good idea. May the good news continue!

[Squiggle]

Good holiday and down to 4.4 since returning (I was actually on 4.9 before - my husband does the cutting as he has a steadier hand and is more precise than I over the decimal places). All continues quiet on the symptom front. I get occasional worries about what will happen when I finally stop taking it but remind myself that that is still a way ahead and is not important: the goal is instead to manage the process as a slow and steady one. Who knows what will happen at 0 but my way of getting there this time is different from last time so last time's experience is no predictor of what will happen this go.

[Squiggle]

It's ages since I have been on the forum so I thought I would drop by to update progress and wish everyone a Merry Christmas - or at least as merry as it can be when you are stuck tapering.

 

I have been getting on with the taper since I last posted.  I have stuck to a very slow cut rate at, where there were no contraindications, three week periods.  At times, especially earlier in the taper, I have held for longer when that felt right, though it has not been necessary for some time.  As a result, I am delighted to now be at 0.6 mg per day.  What's even better is that I feel fine and am getting on with my life as though this issue did not exist.  I guess that I could probably try dropping straight off from this level but so long as it is physically possible to cut further, I am going to do that, so as to give my body and brain the tiniest final hurdle.

 

So for me, the jewellry scale approach and the 10% every three or more weeks has worked brilliantly.  If you are still at higher doses and despair of ever getting to the end, take heart - it really does work and you will get there.  I wish you all the very best.

[mammaP]

You are doing great Squiggle and I think you are very wise to continue tapering

even at such a low dose. It's great to see your taper going so well, thank you for 

updating us. 

[Altostrata]

Happy holidays to you, Squiggle. Eventually, you'll be adding a success story to this site, a gift for us all.

[Rhiannon]

Yay! Congratulations, and thanks for stopping by! 

 

(I'm finding the same thing, at the lower doses, although I'm not as far along as you are--I don't mind so much that I'm not finished with the taper, because I'm enjoying my life and feeling so much better, and I know I'll get there eventually.)

[Squiggle]

Well, pretty much two years to the day of my last attempt, I stopped taking Mirtazapine last Friday, 21/03.  I had gone down to 0.1 mg (being a third of one per cent of my starting dose of 30 mg) and was feeling fine, if a little cautious.  I had had no withdrawal effects from my reductions for a long time so surely there would be little or no effects on final withdrawal - no?  It seems I was wrong and five days in, I'm not feeling so good.  I am not sleeping well, always a big hurdle with me.  Since giving up, I am sleeping fitfully until the early hours, maybe 4.30, when I get very hot and panicky.  I have learnt so many techniques in the last two or more years of mindfullness, calming, meditation etc and I am using them like crazy but still it is hard.  It's really difficult to hang onto the thought that this is just withdrawal, i.e. a phsyical effect and not me creating it "in my head".  When you come down so low, over so long a period, it doesn't seem logical that these things will still happen.  It's so long now since I withdrew from benzos that I can't exactly remember the experience but I do recall that I didn't sleep well for about a fortnight and then it all settled down.  I do get a craving for that tiny crumb of mirtazapine in those early hours, so that must be saying something.  Anyway, day 5 now - last time I only managed a week but I really hope I can hold on this time.  Very disappointing.

[Rhiannon]

Oh Squiggle, please hold on. I know it's scary after what you went through with the benzo withdrawal, but that was much too fast, a different situation.

 

This time you have tapered slowly and you've been stable throughout the process. It's just that you're finally at zero, so the withdrawal is more intense. I feel confident that you will get through it and it will pass.

 

I have only gone to zero with one of my meds so far, the Neurontin, and I remember being surprised at how much difference there was between "a very small amount" and "none at all." The recovery process took quite a bit longer than the usual post-cut recovery had been taking. I would say it was almost three months before I felt really stable and good. But it passed, it did! and I was fine and so relieved to finally be off the stuff.

 

Hang in there. You're going to be fine. Congratulations on your skillful and successful taper!

[Altostrata]

Sometimes people take a tad of the drug here and there to get over the final hump.

[Squiggle]

After another two not very good nights, including one where I hardly slept at all (though this wasn't actually a big problem because I found I was very calm about it and didn't much mind), last night I was out like a light and slept for eight hours.  So I feel rather better today.  I felt rather knocked off balance by the reaction to 0 but feel that I have now been able to regroup somewhat and use the skills in mindfulness etc that I have learnt in the last two years.  I realise that it may be up and down for a while now but hope I'll be able to ride this out.  I guess that it is a bit like the brain has suddenly lost its comfort blanket and is having a little tantrum - the 0.1 mg wasn't actually doing anything more than that.

 

So for today, it's OK!

[Altostrata]

Sounds like you're doing okay. Don't forget, you can take a tiny crumb here and there.

[Squiggle]

Choppy ride continues.  On Saturday I felt rather better and on Saturday night, had a wonderful night's sleep and on Sunday felt really good - a real window.  When I was tapering, I used to feel some mild effects from about days 5-9 and Sunday would have been day 10 after total withdrawal.  I tried to remind myself that the process was not necessarily over and things could go downhill again but when you feel good, it's hard to imagine that you will feel awful again, even though it has happened before. And when I feel awful, it's hard to imagine feeling good again! Late Sunday evening I had a lot of trouble with hayfever beginining and had a not too good night and last night, all my old chums were back in the early hours.  Today, I feel ropey again - sick, tired, scared.  I think that I am actually sleeping enough in the early part of the night to keep me going but it's later on the problems start - I suppose disturbed sleep is a classic withdrawal symptom.  I am coping in that I am doing all my usual stuff so I am doing OK but it's hard.  What's hardest is that two weeks ago, I felt great - and then I have to go through all this again.  I try to keep reminding myself that it is only withdrawal and that it will pass - it's so easy to start thinking that physical feelings of fear really mean fear.  I can see why some people just end up staying on the stuff as this experience is just too hard to deal with.  Never mind - 12 days in and hanging on.  Thanks for the advice Altostrata but I'd like to try to avoid it unless absolutely in extremis.

[Petunia]

Hi Squiggle, I just read through your thread and want to say I think you have done extremely well and congratulations on getting off Mirtazapine this time.

 

Hang in there, even when people taper properly, over a long time, there can still be an ongoing period of recovery which lasts for a while as the nervous system continues to readjust and regain its previous state.  Perhaps reading through the topic on windows and waves again might help:

 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

 

Let us know how you are doing.

 

Petu.

[Rhiannon]

Sounds very normal, Squiggle, and I don't hear anything concerning. Just hang in there and walk through this the way you already know how to do.

 

In no time at all you will be looking back on all of this, finished with your taper, off mirtazapine forever, clicking your heels and dancing your way into the future!

[Squiggle]

Sorry to disappoint but last night I caved in and took 0.1 mg.  I just could not take it any more.  The withdrawal is so alike my original nervous breakdown that I cannot hang in any more at present - the cost feels just too high at this point.  So I will retrench to this ridiculously low dose, which cannot possibly be doing anything but keeping withdrawal at bay, get my strength back and my weight back up and consider how to make a fourth attempt.  Benzo withdrawal was never this bad.  Apologies for letting the side down.

[Altostrata]

Not disappointed at all!!! Many a brave person has taken a tiny crumb here and there to get over the hump.