Maca44: mirtazapine withdraw not going well

[Maca44]

I think in the back of my mind I remember how coming off Citalopram was for me about 10 years ago, I just went CT and apart from Head Zaps which lasted ages, I found it was very easy with no real problems. I guess things change over time and at the start reducing the Mirt was pretty bad but I feel OK on 7.5mg now the headaches have gone but I do have an increase in Anxiety. The positives are no more morning hangover but that is replaced by  a very active mind first thing so I have to force myself to do something or else that will become anxiety if I let it get a grip. For me, im finding the Mirt more problematic coming off than I did with the Cit but maybe thats because im older and just struggle more with any med changes. Your withdraw from Cit sounds horrendous I really feel for you it must be a real struggle so thanks you for giving me your opinion/story I just hope in a years time you don't have to reply to my posts saying "I told you so, you went to fast".

[AlanC]

15 minutes ago, Maca44 said:

I just hope in a years time you don't have to reply to my posts saying "I told you so, you went to fast".

 

I would never do that 😉 and I really do hope the situation will never arise.

 

[Maca44]

12 minutes ago, AlanC said:

 

I would never do that 😉 and I really do hope the situation will never arise.

 

Yes but you will think it 😉

 

When I dropped from 30mg to 15mg the headaches were really bad they were above my right eye and were connected to my long distance sight so if I didn't look to the distance it went but driving for a living and not looking ahead is not a good combination. Anger has increased but generally I'm fairly stable on 7.5mg, for now anyway. 

[ChessieCat]

7 hours ago, Maca44 said:

3 months is a long time to pass and then get hit with withdraws, surely it can't be a physical withdraw after that amount of time can it ?.

 

I cold turkeyed citalopram SSRI and felt great for a few months (the best I had felt in a very long time) and then got hit with very bad withdrawal symptoms.  My counsellor did not recognise withdrawal symptoms and prescribed Pristiq, which is an SNRI and it did reduce the withdrawal symptoms.

[Cabinhope]

I tapered Mirtazapine over 2 years + with liquid.  It seemed like an innocuous drug, but it’s not or it wasn’t for me.  I had been on 7.5 for like 4 years.  It’s not joke.  It especially made hormone shifts during the month far worse.    

If you need help understanding how to do liquid most of us to could help you with that.

[Maca44]

Well still on 7.5mg of Mirt and was feeling stable but depression is setting in with raised anxiety so not so good. Not even thinking about any further reductions at this point and I'm worried that the depression with get bad as it did 3 years ago so this worry isn't helping. Spend all bank holiday just sitting with an empty mind, I found it so hard just to do anything and what I did do was such an effort. To be honest im scared that I am going to feel like I did 3 years ago it was such a dark time. 

[sunnysideup69]

On 5/10/2019 at 10:30 AM, Maca44 said:

 

 I find the more I engage with people the more I forget feeling bad. 

 

Could not agree more with this, by the way.....am practically forcing myself to do this on my wavey days (which is kind of every day at the moment.) Thank you for the reminder and hope you're doing better today,

Ruth.

[Maca44]

On 5/29/2019 at 8:30 AM, Ruthmcg said:

 

Could not agree more with this, by the way.....am practically forcing myself to do this on my wavey days (which is kind of every day at the moment.) Thank you for the reminder and hope you're doing better today,

Ruth.

Yes same here, not good at the moment finding it so hard to face work but each time I do I'm glad I went as I do feel better after. Sleep is bad finding myself waking often stressed.

Edited December 21, 2019 by Shep
updated new member name in text box

[sunnysideup69]

12 minutes ago, Maca44 said:

Yes same here, not good at the moment finding it so hard to face work but each time I do I'm glad I went as I do feel better after. Sleep is bad finding myself waking often stressed.

 

Sending strength and support your way.

[Maca44]

Same to you.

Beginning to see why a very slow reduction has been suggested to me so many times, but i have basically ignored the advice thinking I was doing OK. Can't say I wasn't politely warned I was going too quick and now paying the price. 

[ChessieCat]

You might want to consider updosing by a tiny amount.

 

Much of the information in this topic also relates to updosing.  See Post #1:  About reinstating and stabilizing to reduce withdrawal symptoms

 

[Maca44]

1 minute ago, ChessieCat said:

You might want to consider updosing by a tiny amount.

 

Much of the information in this topic also relates to updosing.  See Post #1:  About reinstating and stabilizing to reduce withdrawal symptoms

 

Thank you

[ChessieCat]

I've asked the other mods for their thoughts on what dose you could increase by.

 

Please be aware that taking too much can make things worse.  It's better to start with a small amount and increase if needed.

[Maca44]

5 minutes ago, ChessieCat said:

I've asked the other mods for their thoughts on what dose you could increase by.

 

Please be aware that taking too much can make things worse.  It's better to start with a small amount and increase if needed.

I was thinking going upto 15mg I have been at 7.5mg for sometime.

[Maca44]

I regret even trying to come off but I was just sick of the weight gain. Little did I know that the drug was in fact working better than I thought it was so I feel I am heading back to square one like I was before I started Mirt 

[ChessieCat]

19 minutes ago, Maca44 said:

I was thinking going upto 15mg I have been at 7.5mg for sometime.

 

No, that would probably be too much.  SA thinks in terms of lowest effective dose, not therapeutic dose which is an arbitrary term used by the pharmaceutical companies.

 

The idea of updosing isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

You might find that 1mg or 2mg might be enough.

[ChessieCat]

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.

 

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.  

 

[Maca44]

Is it too late to just go back on the drug and come off another time.

[ChessieCat]

Please read this IMPORTANT information which is from Post #1 of the reinstatement topic:

 

On 10/9/2012 at 10:17 AM, Altostrata said:

• When reinstating, start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find some relief from antidepressant withdrawal symptoms by reinstating as little as 0.5mg-5mg. Do not start at a high dose, your nervous system has been sensitized by withdrawal and you may make it worse -- see a fuller explanation below. 

 

Additional reasons to reinstate only a partial dose
Reinstating at a low dose reduces the risk of severe adverse reactions in case reinstatement does not work.

• Experiencing withdrawal may have sensitized you to drugs and a larger dose will cause an adverse reaction.
• These drugs are vastly more powerful than they need to be; often reinstatement at half dosage AT MOST is sufficient and many people do well with a lot less. You want to be taking only the lowest EFFECTIVE dose.
• Your receptors may have adjusted somewhat (upregulated) during the time you were tapering or had withdrawal symptoms.
• If you can stabilize on a lower dose, you have less to taper when you finally do go off.
• If you had adverse reactions while you were taking the drug, a low dose may not trigger the adverse reactions but still reduce withdrawal symptoms. Adverse reactions tend to be dosage-related: The higher the dose, the worse the reaction.
• You can always adjust the dosage upward if you find you need to.

 

How long should you give reinstatement?

• It takes at least 4 days for your body to fully register the addition of a neuroactive drug. Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. If you have an immediate bad reaction, reduce or stop taking the drug.
• After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
• Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Think in terms of months, not days.
• Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on. Do not attempt to taper again until you feel symptom-free, or at least until your withdrawal symptoms are mild and tolerable.
• The dose needed for effective reinstatement varies according to the individual.

 

[ChessieCat]

Drawing your attention to the quote posted in the previous post.

 

This is why we suggest a small updose:

 

On 10/9/2012 at 10:17 AM, Altostrata said:

Experiencing withdrawal may have sensitized you to drugs and a larger dose will cause an adverse reaction.

 

[ChessieCat]

We have had SA members panic and updose/reinstate too high a dose and made things much worse.

[Maca44]

8 minutes ago, ChessieCat said:

We have had SA members panic and updose/reinstate too high a dose and made things much worse.

Yes, I'm panicking so need to calm down. I did exactly this when I went from 30mg to 15mg, panicked and tried to go straight back to 30mg. I should have listened and learnt but I am sure you understand that when in panic mode thoughts are not always rational. Thank you once again for taking the time to help, believe me it is very much appreciated.

[ChessieCat]

You are very welcome.  The mods understand, from our own and others experiences.

 

It sounds like you are starting to understand things much better now.  You might need to read through the information we have provided again, even jotting down some notes, and of course asking questions if you need to.

 

It's also important to understand that it takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  You will need to be patient during the first week and not panic and increase the dose again too quickly.

 

It's a good idea to take daily symptom notes, writing down what things improve/worsen.  Providing these notes can help the mods to try and work out if you need to increase your dose or not.

 

Just remember that there is no magic bullet, it is going to take patience and time.

 

You might find these helpful.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[Altostrata]

You might want to increase by 1mg, maca. Adding 1mg in liquid form can do this.

[Maca44]

What I did last night was cut my 1/2 of 15mg in half again, it was abit hit and miss but it is about a 3mg increase so about 12.5mg. I will ask for 15 and 7.5mg tabs next time so I can halve each of those.

[sunnysideup69]

On 5/30/2019 at 10:19 AM, Maca44 said:

Same to you.

Beginning to see why a very slow reduction has been suggested to me so many times, but i have basically ignored the advice thinking I was doing OK. Can't say I wasn't politely warned I was going too quick and now paying the price. 

 

Hey.....sometimes we just have to learn by experience  Speaking as one who panic updosed last summer.....

Slow and steady. Hoping things settle for you soon.

[Maca44]

On 5/31/2019 at 6:17 AM, Ruthmcg said:

 

Hey.....sometimes we just have to learn by experience  Speaking as one who panic updosed last summer.....

Slow and steady. Hoping things settle for you soon.

Rrrr not just me then.

 

Last couple of days I have settled abit. The sad thing is that I dread weekends because I feel ok at work, its busy delivery driving so I don't have time to think about myself and kind of like the stress of work because its stressy then it ends and I feel calm after. 

Edited December 21, 2019 by Shep
updated new member name in text box

[sunnysideup69]

2 hours ago, Maca44 said:

 

The sad thing is that I dread weekends because I feel ok at work, its busy delivery driving so I don't have time to think about myself and kind of like the stress of work because its stressy then it ends and I feel calm after. 

 

Yep, totally get this...but it will change. You'll begin to feel better and actually enjoy your weekends again.

[Maca44]

Kind of abit calmer the last few days but still finding it hard to do anything so spend much time sitting in summer room doing nothing but my mind is fairly quiet. Weather has warmed up but Im not keen on hot weather I prefer the warm but not hot Spring days. Hope that the updose works out so will give it a week.

[Altostrata]

How much are you taking now, about 12.5mg? It sounds like you're doing better.

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

[Maca44]

31 minutes ago, Altostrata said:

How much are you taking now, about 12.5mg? It sounds like you're doing better.

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

Yes about 12.5mg

 

8pm every night 12.5mg Mirt no physical symptoms and anxiety down to 5/10.

[Altostrata]

We'll need to see how you're doing over the next week to make sure 12.5mg isn't too much.

[Maca44]

Yes early days isn't it.

[ChessieCat]

 

It would be a good idea to do your research to find way/s to get your dose as accurate and consistent as possible.

 

 

4 hours ago, Altostrata said:

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

An 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

[Maca44]

10am. Got up after restless night

10.30am. Didnt want breakfast.

11am. Showered and have anxiety.

12pm. Could not face lunch.

2pm. Went for drive which reduced anxiety.

3.30pm. Sat in summer room rest of afternoon.

6pm. Had dinner.

8pm. Took Mirt 12.5mg and went to bed awaiting/wanting sleep so I don't have to think.

[Altostrata]

How did you sleep Saturday night?