evertonfan: mirtazapine / Remeron discontinuation

[Katy398]

Hi Evertonfan,

I glad to hear your sleep has improved. I wish you luck with your Psychiatrist in Melbourne. I too tried a Melbourne hunt and I have resorted to seeing a prescription drug ‘abuse’ councillor. Due to the withdrawal I qualify for free counselling, he’s not come across antidepressant withdrawal but has experience with addictions to benzodiazepines and opioids.  I’ve only just started seeing him so fingers crossed. I wish you luck. This really is a living nightmare.

 I’m guessing from your user name you or your family are from Liverpool. Are you going back for a Northern hemisphere Christmas. I’m from uk and my withdrawal has made me terribly homesick. 

Take care, hang on in there 

Kx

[evertonfan]

Hi Katy, 

 

Yes, I am indeed from Liverpool and I do support Everton - which is a big challenge at the moment. My last psychiatrist is very experienced and a senior psychiatrist in a private practice attached to a private hospital in the eastern suburbs of Melbourne. However, when I say experienced I mean he has spent a long time doling out drugs. He is very much committed to the chemical imbalance theory of depression. He had me on the maximum dose of Lexapro and twice the maximum does of Mirtazapine at the same time. I kept pushing back and got off the Lexapro very easily. It was causing my stomach to be upset and I got off it in a month. This led me to think I could reduce the Mirtazapine as easily. Little did I know!

 

It is amazing that a prescription drug 'abuse' counselor doesn't know about AD withdrawal. I hope he is providing you with some psychological assistance. I went to a psychologist but he has met me when I have been really low and he wants me to be with a psychiatrist as well. He indicated he would like to work with the psychiatrist to help me develop strategies to ward off depression which in my case comes from nowhere.

 

But it seems I am on a mission impossible if I want to find a psychiatrist who focuses mainly on psychological techniques. There just doesn't seem to be any in Melbourne. I did find a psychiatrist attached to Mitcham Hospital who claims in his blurb that he uses CBT. I rang up and he isn't taking any patients until the middle of next month. I may give him a try. I am reluctant to go back to the other psychiatrist at the Delmont as the last time he prescribed anything he wanted me to take 2 mg of Clonazepam to reduce the aching associated with the withdrawal. My trust in him has been destroyed by the side effects of the drugs I have taken under his 'care'.

 

From your signature I am surmising that you are off the anti-depressants now. If I am anything to go by, there is every chance you will recover but it takes time. I just hung in there and tried to keep occupied. In this situation the only person who seemed capable of helping me was me. It was so hard because I was on such a huge dose of Mirtazapine - one which the people on this site had not come across too often if ever - and I was so worried that it would take for ever to get better.

 

Anyway, best of luck,

 

Ivan.

 

PS I would like to know more about your experience with the counselor. Maybe this could be an option for me. 

 

 

[Shebon]

Everton:

 

 

Just checking in with you.... how are you doing now?  I know you have been through the "school of Hard AD Rocks and Benzos."  

 

Last post, I was glad to hear your sleep is much better.  Life is much easier when we can sleep.

 

Best regards,

Shebon

[evertonfan]

Hi Shebon,

 

Thanks you for contacting me. I am fine. My sleep has continued to improve and I am on what my GP calls a homeopathic dose of Amitriptyline of just 5 mg. I take it to assist with sleep. I looked at an antidepressant drug equivalency table to find out how much I am taking in comparison to the doses I was on. It would take me over a hundred days to take one day's dose of the antidepressants I was on in late 2018.

 

I am in contact with the GP once a month to keep in touch. At the moment that's by phone. I did go and see the psychologist but when the restrictions started I decided on the advice of the doctor to stop seeing him. Maybe I will go back when things ease up. He was willing to talk on the phone. He is a lovely guy and we have soccer in common so we talked about that a lot. His son is an A League referee and he is a member of Melbourne Victory. Now that I am so well I just didn't think it was essential any more.

 

The psychiatrist has agreed to be a fallback if I ever get sick again. I haven't seen him since December. He is going to talk to me by phone on Monday just to learn about how I am going.

 

I still find it incredible that I am virtually on no psychiatric drugs. I was on a huge cocktail of them when I came out of depression almost two years ago and I would never imagined then that I would no longer be taking any and that I would survive the trauma of two withdrawals to get to this stage.

 

Having the GP there is what really counts for me. He is open-minded about drugs and is prepared to use them. But like me I believe he sees them as a necessary evil. We both know that I am taking a risk staying off them. But they do have such awful side effects and I seem to experience them more than most.

 

I have stayed off the site because I don't want to see myself as a victim and constantly talk about antidepressants. The people who administer this site are doing a great job and they get joy out of helping people get through what can be really hard times. But I want to define myself by what I do in the real world rather than online. So I am heavily involved with the University of the Third Age as a leader and a class member. And since the outbreak of the virus I have been supporting Zoom classes. I also have been volunteering at the local library helping people improve their English.

 

I hope things are improving for you. Did you eventually get off the Remeron (Mirtazapine down her in Australia) or are you still gradually tapering? I would never recommend coming off the drug so quickly as I did but no matter what the psychiatrist tried the withdrawal symptoms would not go away. So I had to endure a nasty period of what he liked to call discontinuation.

 

Tomorrow is my 70th birthday. Thanks to the restrictions we decided not to try to organise a party - which thanks to Australia's success in dealing with the virus we could have considered. So I will just spend the day as I usually do and be immensely grateful that I am still here and in relatively good health.

 

I wish you all the best not only in dealing with the drugs but with everything else which is going on in the United States just now.

 

All the best,

 

Ivan.

 

 

 

 

[Shebon]

Hi Everton:

 

You are doing so well and I wish you continued years of "psych drug" freedom.   And a big Happy Birthday to you too!!  I hope you get to enjoy your day with love and smiles.  Even if distance is still the issue.  

 

I am astounded that a doc prescribed a high dose of Lexapro with 90 mgs. of mirt.  They just have no idea when the boundary is crossed for the patient and how the patient will fare present and future.  I hope you are feeling blessed you made it out!   My adventure started with benzos too and I now realize how sensitive the body can be to those kinds of drugs.  

 

My taper is going along nicely … next week I will reduce to 2.11 mg. mirt.  My biggest issue is with fatigue as I notice how my energy feels zapped by the taper.  Too bad too, because I would like some of the 10+ lbs to come off with the taper.  Various symptoms come and go but I hope sleep and energy will improve after I'm done.  I am taking a slow taper for sure....Mid-July to 1.87 mg. mirt, then will do the same protocol until I get to half of 1.87.  Then creep slowly off.

 

Here's to you Everton -- well done for your posting and may good things continue to happen for you.

 

Stay well, well

Shebon

[Altostrata]

Good to hear, Everton. Over what span of time did your sleep improve? When did you feel it turned the corner?

 

Please do check back in with us from time to time.

[evertonfan]

Hello Altostrata.

 

Thanks for taking the time to ask how I am going. Well it is now many months since I recovered from the "discontinuation" from Mirtazapine. During the withdrawal I had to resort to sleeping tablets to get any sleep. At first I took Mogadon (for one night). That night I discovered that it had been the culprit for the terrible diarrhoea I had during early 2018 when I was deeply depressed and on a huge cocktail of psychiatric drugs. Then I took Imovane but at very low doses. The psychiatrist recommended I try a low dose of Amitriptyline (20mgs). This enabled me to remove the Imovane to the point when I took it only when I could not get to sleep. The last dose was of a quarter of a tablet in mid-December last year. I stayed on 20mgs of Amitriptyline for a short period and then reduced it to 10mg and then 5mg. Last night I reduced it to 2.5mg and slept extremely well. So I may stay on that dose for a few days and then stop it altogether.

 

I saw the psychiatrist in December and he said that a low dose of 10mgs of Amitriptyline may or may not help ward off depression. However, my GP calls the dose "homeopathic" and is comfortable with me ending the psychiatric drugs totally. 

 

My doctor has maintained the view consistently that if one is well without the drugs, it is best to get on with life and enjoy it while one can. So the plan now is to have the psychiatrist as a fallback in case I get ill again. I will see him once every six months from now on unless things go wrong.

 

So that's where it stands. I do not have strong views one way or another about the efficacy of anti-depressants. All I can say is that they gave me lots of unpleasant side-effects and were not particularly successful in addressing my bouts of depression. However, it is true I am aghast at just how much my psychiatrist had me on. Moreover, I am delighted that I am no longer taking them. Indeed, I believe that it was a good thing that I had the reaction I had to stopping Mirtazapine for a couple of days. If I had stayed on such a massive dose, I could have found myself with another illness and been taken off Mirtazapine at the same time leading to two serious illnesses at the same time.

 

My experience of withdrawal from anti-depressants is so inconsistent that it would be impossible to draw any conclusions from what I have gone through. I got off 30mgs of Mirtazapine some years ago in a short time with little bother. I withdrew from Lexapro (45mgs) at the end of 2018 whilst on 90 mgs of Mirtazapine with no symptoms except an end to the flatulence I experienced all day every day whilst on it.

 

Your approach is the approach the psychiatrist calls the "textbook" way of dealing with getting off these drugs and your experience of dealing with many people would back that view up. My reaction to two nights without Mirtazapine was according to the psychiatrist most unusual. It could be attributed - I guess - to the massive amount that i was on, however. I was in a good position to deal with the sudden cessation of this drug over eight days, because I had gone through something similar with benzodiazepines and was convinced if I hung in there I would get better. But I wouldn't dream of advocating anyone else to do it this way unless they really have to.

 

Thanks for all the work you put in on here. And all the best,

 

Everton.

 

PS Shebon, I hope the gradual taper will come to an end soon and that your health is restored to the best it can be.

 

 

[evertonfan]

Recovery from Mirtazapine Withdrawal

Hi. I was on here a lot a year ago when I was going through a very diffiult withdrawal from a dose of 90 mg of Mirtazapine a day. I was having a lot of trouble getting to sleep and was not informed by the psychiatrist who was treating me that this could be a side effect of such a high dose. Moreover, he did not tell me anything about what he later called "discontinuation" from antidepressants. I had had no trouble getting off antidepressants before. So I decided for a couple of nights not to take the prescribed dose. The consequence was a terribele aching throughout the body which - no matter what dose the psychiatrist tried to put me back on - persisted. Indeed, my sleep collapsed and I had to take Imovane for a number of months in order to get any sleep. The psychiatrist tried all sorts of drugs but in the end I just had to accept that i was going to have to endure what was a shocking experience which lasted over three months. Fortunately, I believed throughout the ordeal that I would get better if I hung in there  - which I did. One antidepressant did appear to help my sleep at  a very low dose - Amitryptiline. I am still taking 2.5 mg each day. But as that is such a low dose (it would take me over six months of taking it to equal one night's dose of 90mg of Mirtazapine I was taking), I am considering dropping it altogether. Indeed, my GP calls the dose homeopathic which I interpret to mean it works because I believe it's working.

 

Now one year later my sleep is really good and in spite of the extremely severe lockdown we are going through here in Melbourne, I am coping ok.

 

I would love to have been able to follow the textbook last year and got off the Mirtazapine in a more orderly fashion by gradually reducing the dose and not have to experience the withdrawal I went though. But, sadly, in my case that was not to be. I have had a really nasty experience of successfully getting off Ativan. So I think that helped me get through the withdrawal last year.

 

What I can say is that even though I have been told by psychiatrists and by my GP that sometimes antidepressants can be a life saver, I am so pleased I am not on them except for the miniscule dose I now take. If I had not gone through the agony last year, the spectre of a dreadful experience getting off them would have been hanging over my head and I would still be struggling to get to sleep each night. Now I sleep normally and my life is so much better as a result.

 

My big fear though is that depression could descend on me from nowhere - as it has done before. So I have still have a relationship with the psychiatrist who has promised he will get me into a private hospital if anything goes wrong. I don't want to enter the public system again because of the 56 ECT treatments I was given with no discernible improvement in my mental well being but which stripped me of years of my memory.

 

I would like to thank the people on this site who dedicate their time to supporting others through depression and withdrawal. Having somewhere like this to come to certainly helped me get through a very difficult time.

 

All the best,

 

Everton. 

 

Edited September 27, 2020 by ChessieCat
added topic title

[Erell]

Hello Evertonfan, 

 

And thank you for letting us know that you're feeling better.

 

5 hours ago, evertonfan said:

One antidepressant did appear to help my sleep at  a very low dose - Amitryptiline. I am still taking 2.5 mg each day. But as that is such a low dose (it would take me over six months of taking it to equal one night's dose of 90mg of Mirtazapine I was taking), I am considering dropping it altogether.

 

2.5mg Amitryptiline sounds like a high dose before jumping to 0. Now that you're feeling so much better, it would be a pity to struggle while a slow taper might be gentler.

 

See : 

 

when-to-end-the-taper-and-jump-to-zero/

 

tips-for-tapering-off-amitriptyline/

 

Take care ☀️

 

[ChessieCat]

1 hour ago, Erell said:

it would be a pity to struggle while a slow taper might be gentler.

 

I agree.  Why risk causing issues when there is a better way.  Especially when it involves sleep.

 

Especially since you state the following:

 

6 hours ago, evertonfan said:

I would love to have been able to follow the textbook last year and got off the Mirtazapine in a more orderly fashion by gradually reducing the dose and not have to experience the withdrawal I went though.

 

6 hours ago, evertonfan said:

I have had a really nasty experience of successfully getting off Ativan.

 

6 hours ago, evertonfan said:

My big fear though is that depression could descend on me from nowhere

 

Edited September 27, 2020 by ChessieCat

[ChessieCat]

6 hours ago, evertonfan said:

Amitryptiline. I am still taking 2.5 mg each day. But as that is such a low dose (it would take me over six months of taking it to equal one night's dose of 90mg of Mirtazapine I was taking), I am considering dropping it altogether. Indeed, my GP calls the dose homeopathic which I interpret to mean it works because I believe it's working.

 

Lowest effective dose.  Our brains become physiological dependent on the drug and the process has to be reversed.

 

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.

 

[evertonfan]

Thanks very much for taking the time to reply ChessieCat and Erell.

 

 

I took a slightly smaller dose last night and slept really well - which is the case most nights now. My GP is quite happy for me to continue indefinitely on 2.5mg as it is such a miniscule amount of the drug. Cutting up a 10mg tablet leads to fragments falling off and bits becoming powder. So whatever I decide to do from now is going to be approximate. One advantage of continuing on this low dose is that it will mean that the psychiatrist is reassured that I am taking something. He fears that if I am no longer taking antidepressants, I am at much greater risk of getting depressed again. But given the side effects and withdrawals I have experienced he is willing to go along with the GP's recommendation that I enjoy life without them for as long as I can.

 

I have had terrible side effects from psychiatric drugs some of which have been inexplicable so if I can avoid taking them at any significant amount again I will be delighted.

 

So for the time being I will take your advice and try to gradually reduce the amount of Amitriptyline as best I can. 

 

Thanks very much again.

 

Everton.

[ChessieCat]

13 minutes ago, evertonfan said:

Cutting up a 10mg tablet leads to fragments falling off and bits becoming powder. So whatever I decide to do from now is going to be approximate.

 

It's very important to take as consistent a dose as possible.  And the lower the dose the more chance there is of any inconsistency causing issues.

 

It might be better if you purchase a scale and weigh your tablets or use liquid.  See Post #1 of the tips topic for other ways of getting your dose.

 

tips-for-tapering-off-amitriptyline

 

using-a-digital-scale-to-measure-doses

[evertonfan]

Thanks very much for this advice. I will check back in soon and let you know how I am going. Best wishes, Everton.

[evertonfan]

It is now a new year. Hopefully, it will be a better one for everyone on here and everywhere else. Here is an update: I struggled with sleep for most of the eleven nights I went without taking Amitriptyline. And i wasn't doin too brilliantly on 2.5mg either. So I decided after consulting with my GP to move up to 5mg indefinitely. This has worked well. I was getting to sleep easily without the drug. The problem was that I woke up in the middle of the night and couldn't get back to sleep. Consequently, I was constantly tired during the daytime. Given that the dose I am now on is tiny in comparison to what i was on in late 2018 when I was on 45mg of Lexapro and 90mg Mirtazapine, I feel that to be this well after getting off such a massive dose of antidepressants is really good. And given the dreadful experience I had for three months after stopping Mirtazapine, I am just so glad that I am no longer at risk bomb of catastrophic withdrawal symptoms like I was while I was on such a high dose.

 

Thanks again to everyone on this site who gave me encouragement and I wish you well.

 

Ivan.

[evertonfan]

I listened to Alto Strata's interview on Mad in America yesterday. It was interesting and informative. I really appreciated the advice to be firm and polite when dealing with psychiatrists. The man I meet rarely now - thank goodness - does try to appear to be an oracle. But at least he admits that he is more of an artist than a scientist. He does exactly what Alto Strata says: if there is a difficulty such as the one I was experiencing coming off Mirtazapine, he just throws more drugs at the problem and hopes that he finds an answer. It strikes me that psychiatrists are interested in an outcome i.e. to get people well and keep them well. They are not interested or apparently concerned about what all these drugs may do to their patients down the track. I have consistently and persistently and politely challenged the psychiatrist's advice which is what Alto Strata recommends in her interview. To his credit he has accepted that I am an informed and engaged client. Not all psychiatrists are like this, however.

[evertonfan]

Now could I ask for advice? Even though 5mg of Amitripyline is a very low dose, I am wondering if it may be a good idea to get off it even if it is ever so slowly. My GP says as far as he can see such a small dose is unlikely to have any deleterious effects and he's happy for me to continue with it especially as I am now sleeping normally. I would appreciate some thoughts. All the best. Ivan.