Alix8082: mirtazapine / Remeron - small dose, long time

[Alix8082]

Hi - I’m new here, and hoping I can get some perspective, advice, encouragement. I’ve been on 7.5mg of Mirtazapine for 7.5 years. I was also on it for about 6 months in 2005. I remember the withdrawal as being horrendous then, but I still had active PTSD so it’s confusing. I was put back on it in 2011 for a recurrence of the PTSD (brought on by various life crises), primarily to help me sleep! I refused to updose when they insisted I should, so it’s been the one drug, same dose, for 7.5 years. I tried a few times over these years to taper, but the withdrawal was bad, and I was in a demanding job. Think I was going too fast. This time I have gone super slow - over 9 months to get to 3.5mg. I was going pretty well, with some manageable symptoms, but hit a tsunami 4 weeks ago. Got a virus, but the nausea, headaches, skin shocks, muscle tension / spasm, gut issues, lack of appetite, weakness etc etc has continued. I’m thinking I have to stick at 3.5 for a few months. I am getting better, but I’m scared to drop again. Most medical practitioners tell me my dose is ‘nothing’ and I could just jump off now. I know better, and have a GP who’s a personal friend who is prescribing the compounded scripts and being supportive. She feels I could get to 1mg and jump though. 

Any thoughts or experiences with this nasty little drug? 

 

[Sassenach]

Hello  Alix and welcome to SA.

 

I apologise for the delay in replying.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

I am sorry you are having such a rough time but you are now in the right place.

 

You have been unlucky to get caught by W/D as you have pretty much doing it right,

if a little too fast.

On 9/4/2019 at 3:58 AM, Alix8082 said:

I refused to updose when they insisted I should,

Congrats on that, definitely right decision.

 

On 9/4/2019 at 3:58 AM, Alix8082 said:

so it’s been the one drug, same dose, for 7.5 years

This is definitely in your favour.

 

On 9/4/2019 at 3:58 AM, Alix8082 said:

Got a virus,

Has it cleared up completely?

Were you given or did you take any meds to help?

Have you taken any other meds or supplements in the last two years, if you have please add to your drug signature?

On 9/4/2019 at 3:58 AM, Alix8082 said:

This time I have gone super slow - over 9 months to get to 3.5mg.

 

At SA we recommend a maximum taper speed of 10% of current dose.

If you taper at 10% of starting dose the percentage of each drop actually increases.

why-taper-by-10-of-my-dosage/

If you were using a straight percentage of starting dose this could explain why W/D caught up with you.

The virus will also have had an effect as indeed will any change, physical or emotional.

On 9/4/2019 at 3:58 AM, Alix8082 said:

I’m thinking I have to stick at 3.5 for a few months.

This is correct. Your CNS ( central nervous system ) needs to stabilise on the dosage, unfortunately there is no way of knowing how long that could take.

 

On 9/4/2019 at 3:58 AM, Alix8082 said:

I am getting better, but I’m scared to drop again

Exactly the right attitude as is your comment about symptoms being bearable.

Stabilisation means different things to different people, but the above is what most of us view as stabilising.

I am glad you have a GP as a friend and she is doing better for you than most doctors.

On 9/4/2019 at 3:58 AM, Alix8082 said:

She feels I could get to 1mg and jump though. 

Unfortunately she could not be more wrong here.

The 10% of current dose is very important here .

As an example.

If your penultimate drop was .2mgs, by dropping 1mg to finish you would be increasing your taper rate by 5X.

I know it may sound complicared but really is just common sense.

On 9/4/2019 at 3:58 AM, Alix8082 said:

nasty little drug?

They are all nasty🤣 but we can and do beat them.

I am really sorry you have ended up in W/D because you were so close to getting it right.

However your attitude and experience will help you cope better than most.

Below are links that may be of help to understand what is happening.

the-windows-and-waves-pattern-of-stabilization/

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

acceptance/

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

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

 

Again welcome.

 

Sassenach

 

Edited September 7, 2019 by Sassenach
missed word

[Gridley]

On 9/3/2019 at 9:58 PM, Alix8082 said:

She feels I could get to 1mg and jump though. 

We recommend going lower than 1mg to jump, at least to 0.1mg or lower if possible.  The thinking several years ago was that 1mg was a good target for jumping off.  Sadly, that has been proven wrong on many occasions.  

 

[Alix8082]

 

Thanks for your help. I haven’t taken anything else whilst on the mirtazapine, apart from drinking a moderate mount of alcohol, the occasional painkiller etc. interestingly though, I took a panadrine forte the night before I crashed in a sick heap a month ago. My husband reminded me it stops the cough reflex, and would help me sleep. I was bothered by a tickly cough and felt I was coming down with something. I vomited and retched the whole next day and ended up on a drip in hospital with severe dehydration. I have taken this drug very occasionally before, without any ill effects. I haven’t drunk alcohol or coffee since and am very particular about what I eat, flexitarian but no red meat or dairy. Lots of other specific nutrients to make up for that, and I take fish oil and magnesium. I am on 3.5 now, but may ask for the next drop to be compounded down by only .25 of a mg. 3.25 mg?  My virus is lingering in terms of the cough and fatigue, but I’m much better. I think the grief of our darling old dog dying a week before I got ill didn’t help, but I’ve accepted that now. I’m 63, but in (otherwise) really good shape. I practice daily yoga, walk, work out etc etc. Thanks again!

 

Edited September 8, 2019 by ChessieCat
removed quote

[Adrian65]

Alix

 

I was on Mirtazapine for 2+ years. Started out at 15 mg, dropped to 7.5 mg with no significant side effects but then tried to drop to zero, which turned out very unpleasant. It was at this point that I found SA and tapering. Going back on Mirtazapine I managed to stabilise at 5 mg and then over 6/7 months steadily reduced the dose down to 1 mg. After a month at 1 mg I was not sure what to do and so jumped off. First couple of weeks was ok but then my sleep began to get squeezed, long time to get to sleep and early awakenings. Couldn’t cope with the insomnia and went back onto 1 mg for a further month. Stabilised very quickly and was pretty surprised how much 1 mg could impact my well-being. After another month at 1 mg I jumped off again and this time was ok. Still have 2-3 day bouts of insomnia and cns isn’t always great but I am now 12months off Mirtazapine. 

 

In retrospect I wish I had gone down further from 1 mg and tapered for longer. At the time I was really wanting to come off but taking a longer perspective a few more months of a very low dose would have been very little time in the grand scheme. 

 

Best set of luck with your taper. 

[Sassenach]

Hi Alix

 

Really sorry about your dog, I lost mine in April at 16 years.

As you can see he loved his ball.

 

It is really important not to restart your taper too soon.

Listen to your body and you will know when the time is right.

It is better to wait one month longer than rush and have to reinstate again.

 

The link below includes taper calculators as well as tapering advise.

the-brassmonkey-slide-method-of-micro-tapering/

 

Good luck, you know where we are if you need us.

 

Sassenach

Edited September 8, 2019 by Sassenach
omitted link

[Alix8082]

Thanks again guys. It’s great to have this site to feel supported. Yes Adrian, I will definitely take it very sloooooow on the remaining tiny doses. I’ll probably quarter the last mg, then go to alternate nights etc. I’ve been diagnosed with a hiatal hernia and that is probably the culprit for the cough. My anxiety has caused my abs to contract so badly over the years, this has caused the hernia. I’m using massage, meditation etc to try to relax this. The hernia, of course, is way worse since starting the taper. Muscle tension and spasm are bad problems for me. I’ll stay on 3.5 then go to 3.25 in a couple of months I think. Cheers. 

[Alix8082]

Thanks for condolences re my boy Sassenach. It’s so traumatic to be with them when they’re put down, to see their lifeless bodies, then the empty space they leave behind... but that’s what we sign up for when we get a pet, sadly. I’ve gone through this  with 4 dogs now. It doesn’t get easier. It makes me averse to getting another, but... we’ll see.

[Gridley]

4 minutes ago, Alix8082 said:

hen go to alternate nights etc.

Alix, we strongly advise against alternate day/skipping dose tapering.  It causes the amount of the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse. It's like playing ping pong with your brain.  It's a terrible idea much beloved by psychiatrists.

 

Just get down as far below 1mg as you can (again, below 0.1 if possible) then jump when you can't manage to reduce further.  These tiny doses are a pain to work with but it will be well worth it.

 

Sorry about your sweet dog.  We lost a 15-year old Yorkie back in May.

[Alix8082]

Topic title:  Is it possible my (slow) withdrawal is making me so sick?

 

Thought I’d start a new topic as this is super concerning to me. I am entering into the 6th week of a ‘virus’. I have: one session of coughing my guts up for about 30-40 minutes per day, but have had several days when I didn’t cough at all, mild headache / nechache most days, nausea off and on, lack of appetite, terrible fatigue, muscle aches, muscle spasms, knots in my stomach, mild weight loss. My blood tests are fine and my lungs sound clear. I do have a hiatal hernia - told it was ‘small’ several years ago. Could this get worse with all the spasm in my gut? I’m thinking yes, but.... right now I feel like I’m dying. I’m down to 3.5 mg from 7.5 years on 7.5 mg of  Mirtazapine.  I’ve been tapering since the beginning of December last year. I’ve now been on 3.5 for 6 weeks and will stick at that until I’m better. I’ve thought I was getting better quite a few times, but then, like tonight, I feel like I might not see the sun come up. I’ve just had an enormous coughing fit. No blood, clear mucous... my doctor says the withdrawal could well be making me this ill. What do you guys think?  Thanks in advance.

 

Edited September 16, 2019 by ChessieCat
added topic title before moving to intro

[Santino]

HI Alix

In fact the Mirtazapine is a giant antihistaminic in itself. It might be that you have taken it for quite a long time and now that you are going into lower doses you might be more allergic than before. During my WD i used to have a lot of nose (flu) symptoms, Not being able to smell for weeks and months in a row, at the point i got very worried from that. Now for your situation it might be that your body is reacting to the lack of Mirt in your system. As the receptors get liberated you are know prone to allergies.

Check your food and try to find a diet with low histamine foods. Try that and than check the cough... will you have some improvements or it will be the same..??!!! If you have improvements than this might be related and you should follow that diet for some time.

All the best
Santino

[Alix8082]

Hey thanks! I just found out I have pneumonia. Probably had it for 4-5 weeks and my poor old body tried to fight it. The cough has been horrendous. Then chest pain. I think part of the problem is the withdrawal and I’ll definitely look at low histamine foods. I’ve had zero appetite since I got sick. I’m on 2 different antibiotics now. Aaarrgh!