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cathnz: tapering off Remeron / mirtazapine

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cathnz
23 hours ago, brassmonkey said:

Hi Cath-- I'm sorry to hear that the upgrades your classroom are causing problems.  Do you have windows you can open to air the place out?  The smell should dissipate in a couple of weeks, which will help.

 

There is so much involved in dealing with these drugs, it's quite easy to get over whelmed with it all.  Stressing about doing the "right thing" is pretty common.  To make it worse we can't really tell what the right thing is, all we can do is go by past experience and try to relate it to each person. But all the mods are here to help you make sense of it all and guide as best as we can. So you are not alone, we truly understand.

 

It's good to know that there was a dose where the problem became apparent.  That gives a target to work with.  The standard 10% Brassmonkey Slide has a half life of 9 months. Which means that if you start today at 30mgai in 9 months you will be at 15mgai and in 18 months you will be at 7.5mgai. It does take a long time, but it is so much better to go slow and have a smooth taper than to go fast and have a very bumpy ride. By taking our time your body will have time to adjust and heal as you decrease so the symptoms really will start to resolve and fade. Shocking the body with large abrupt changes is what causes many of the problems people face when tapering. By taking it slow and listening to your body by the time you get back to 15mgai things should be quite different than the first time.

 

The easiest way to do the Slide is to crush up your current pills and make up your own capsules with specific doses.  This will require a milligram scale and some empty gel caps.  You can get both on line for a quite reasonable price. We will determine the average weight of your pills and then set up some calculations to determine the weight of each new dose.  Then it is a matter of crushing the pills and weighing out the proper amount for each week.  It's pretty easy once you've done it a few times.

 

All the mods here are well versed in how to do it so there will always be someone on call.

 

Thank you @brassmonkey.

 

I'm feeling really overwhelmed and a little suicidal the last couple of days. The realisation that I'm going to need to taper when I'm already so depressed and anxious has got to me. I know I need to do it. But this is what I think I'll do - take a few weeks to work on my cognitive stuff (I start CBT this week). Also establish some good routines around yoga, breathing and mindfulness. I need a stronger base before doing this. I can take this time to get my head around it. I know I need off this crap, but I've managed 7 months, a few more weeks won't matter. Then I'll call on you to help me through with logistics. It still seems absolutely terrifying... this page is helpful in regards to advice, but terrifying in hearing what may lie ahead. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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cathnz
On 2/19/2020 at 8:58 AM, cathnz said:

 

Thank you @brassmonkey.

 

I'm feeling really overwhelmed and a little suicidal the last couple of days. The realisation that I'm going to need to taper when I'm already so depressed and anxious has got to me. I know I need to do it. But this is what I think I'll do - take a few weeks to work on my cognitive stuff (I start CBT this week). Also establish some good routines around yoga, breathing and mindfulness. I need a stronger base before doing this. I can take this time to get my head around it. I know I need off this crap, but I've managed 7 months, a few more weeks won't matter. Then I'll call on you to help me through with logistics. It still seems absolutely terrifying... this page is helpful in regards to advice, but terrifying in hearing what may lie ahead. 

 

@brassmonkey I have been so unwell this last week. I've felt so chemical and toxic. All my existing symptoms are so much worse. The only thing that has changed is the chemical smell in my workspace (but I haven't been in there for 3 days now) , and I had to start taking iron as my iron was low. The buzzing, restlessness, middle tightness, panic dread and doom have ramped up (its like the severe akathisia I had on the higher dose) . I really feel like I want this mirtazapine out of my system (even though I know it could still be withdrawl from paroxetine and short benzo use too). It's sooooo hard not to just want to CT the Mirtazapine, but I won't do that!!!!

Tapering off while I'm already in withdrawl from the other meds is a scary prospect. Is it possible to taper from another med while already in withdrawl without it definitely causing problems (as long as I do it slow)? 

My husband has said he will help me with the taper as long as I take every measure to build a strong foundation first (although without being able to take supplements I don't know how I will do this), and as long as my functional medicine Dr agrees (because he knows my physchiatrist won't support it). So can you please advise me (by way of a link if possible) as to which scales are the most accurate (and can measure to the smallest amount... is it possible to taper in 1% increments?). Also which capsules to purchase. And any equipment I'll need to grind tablets. Is it better to put in capsules instead of liquid? 

Thank you for your help. It's a travesty that there are next to no medical professionals that can assist with this. How can they deny so many people being this unwell. I thank God that people like you have lived through to tell rhee tale and hold hope to those of us that don't have it. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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brassmonkey

Hi Cath-- I'm sorry to ear that you're feeling so badly, this really is a rough business and many of the doctors don't make it any easier. I'm glad to see that your husband is on board with your taper, having his support and help is a wonderful thing. Be sure to thank him from time to time as it will be very hard on him watching you go through this.

 

Many of us use the Gemini-20 scales.  I don't have a link for availability in NZ but I now others have bought it there.  I would google Gemini-20 Amazon. The gel caps probably will come up on the same page.  You will need a bag of 1000 and get the size "00". They are big enough to be easy to work with and small enough to swallow easily. The easiest way to crush the tablets is between two large spoons then follow up with a spoon on a bit of waxed or parchment paper. I often used the square sticky notes.

 

We have a lot of information on coping tools and how to use them. Reading through the Symptoms and Self care forum is a good place to start. Decide what feels right for you and start practicing. https://www.survivingantidepressants.org/forum/8-symptoms-and-self-care/

 

Paxil has a reputation as being one of the hardest to taper off of, to CT it and replace it with another drug will work, but it can be rough for a while in the beginning. We have had fair success with people switching from paxil to prozac and with others like you who change to mirtazapine.  It just takes a while for things to stabilize from the change.  I hate to say it but seven months is just getting going, so it may take a while longer to get stable and be able to start tapering. And please don't even consider CTing the mirtazapine, that will only make thing much, much worse.

 

You've got your husband and the whole team here to help and a huge number of friendly members to cheer you on, so you've got this.


20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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cathnz
59 minutes ago, brassmonkey said:

Hi Cath-- I'm sorry to ear that you're feeling so badly, this really is a rough business and many of the doctors don't make it any easier. I'm glad to see that your husband is on board with your taper, having his support and help is a wonderful thing. Be sure to thank him from time to time as it will be very hard on him watching you go through this.

 

Many of us use the Gemini-20 scales.  I don't have a link for availability in NZ but I now others have bought it there.  I would google Gemini-20 Amazon. The gel caps probably will come up on the same page.  You will need a bag of 1000 and get the size "00". They are big enough to be easy to work with and small enough to swallow easily. The easiest way to crush the tablets is between two large spoons then follow up with a spoon on a bit of waxed or parchment paper. I often used the square sticky notes.

 

We have a lot of information on coping tools and how to use them. Reading through the Symptoms and Self care forum is a good place to start. Decide what feels right for you and start practicing. https://www.survivingantidepressants.org/forum/8-symptoms-and-self-care/

 

Paxil has a reputation as being one of the hardest to taper off of, to CT it and replace it with another drug will work, but it can be rough for a while in the beginning. We have had fair success with people switching from paxil to prozac and with others like you who change to mirtazapine.  It just takes a while for things to stabilize from the change.  I hate to say it but seven months is just getting going, so it may take a while longer to get stable and be able to start tapering. And please don't even consider CTing the mirtazapine, that will only make thing much, much worse.

 

You've got your husband and the whole team here to help and a huge number of friendly members to cheer you on, so you've got this.

Thank you @brassmonkey. My family and friends are all scared for me and are desperate for me to go back to the crisis team to switch meds. I'm fighting it tooth and nail, but am afraid I'll get desperate and crumble. But for now, I'm hanging in there (and driving them nuts because they think I'm not helping myself and they can see I'm slipping backwards) . My relationships with friends and family are all definitely suffering. My husband had said he'll help, but there is such strain on our marriage now.

Very very very worse case scenario, if it becomes too dangerous for me to hold on, and they need to take me to the hospital to keep me safe, I need a contingency plan of what they CAN and more importantly CANNOT do. Any advice here? If its dire, am I better to let them add something (but preferably not an antipsychotic because I already have akathisia), or add a benzo? Or switch the Mirtazapine to something else (and if so, what... paxil and Lexapro both pooped out on me and I had an adverse reaction to prozac. Genetic test said I won't metabolise zoloft), and do I insist they crosstaper and at what rate? Believe me when I say, I absolutely 100% don't want any of those options and I will be doing my absolute damndest to stay out of the crisis centre. But I also know I need to stay alive for my son and I am barely hanging in there. I need to at least give my husband instructions on what they can do in that case, and what they absolutely must not to. 

Like I said. I pray it doesn't come to that. But I don't want to make a bad situation even worse because I don't have a plan b and then the Dr's take over. THAT will only end badly. 

But for now, I will AAF. I just need a sensible and safe emergency contingency plan. Can you or any of the others help me with this? 

@brassmonkey  @Shep @Sassenach


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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brassmonkey

I'm sorry that your friends and family are pulling back and not being as helpful as you thought they would be.  Unfortunately ADWD is a very personal experience and it is very hard for them to realize just what you are going through. They just want what they think is best, without really knowing what is going on.  It's quite often helpful if they would visit the site and learn from us.  Once they see just what is involved many people can become very supportive.

 

Try not to dwell on worst case scenarios.  It's good to have a plan, but try not to overthink the possibilities.  We can't make recommendations on hypothetical situations, but I can say that unless there is a distinct adverse reaction, CT changes of drugs to try and improve a situation never goes well.  Adding a benzo can help in some cases, but there's the downside of having yet another drug to deal with once you're stable. Also if you go to or are taken to a hospital the Doctors are the ones in charge and it is very hard to tell them what you will or won't do. In many cases they have the law on their side and you have very little say in things.  We face this situation every once in a while and find that it is best to do what every in necessary to survive and then sort things out later.

 

The anxiety that we feel while tapering is different than regular anxiety.  Regular anxiety can actually be controlled to some extent, but because it is caused by chemicals ADWD anxiety can't.  Even though it is a very uncomfortable feeling however, it is not dangerous. It's just your nerves going haywire.  You mentioned AAF.  That is the best way to handle it.  It may not go away when you want it to, but it can successfully be ignored. Eventually things will change in your body and the anxiety will fade. I went through a number of waves of it during and after my taper.  All of them were very uncomfortable, but they ran their course and went away after a while.


20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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cathnz
3 hours ago, brassmonkey said:

I'm sorry that your friends and family are pulling back and not being as helpful as you thought they would be.  Unfortunately ADWD is a very personal experience and it is very hard for them to realize just what you are going through. They just want what they think is best, without really knowing what is going on.  It's quite often helpful if they would visit the site and learn from us.  Once they see just what is involved many people can become very supportive.

 

Try not to dwell on worst case scenarios.  It's good to have a plan, but try not to overthink the possibilities.  We can't make recommendations on hypothetical situations, but I can say that unless there is a distinct adverse reaction, CT changes of drugs to try and improve a situation never goes well.  Adding a benzo can help in some cases, but there's the downside of having yet another drug to deal with once you're stable. Also if you go to or are taken to a hospital the Doctors are the ones in charge and it is very hard to tell them what you will or won't do. In many cases they have the law on their side and you have very little say in things.  We face this situation every once in a while and find that it is best to do what every in necessary to survive and then sort things out later.

 

The anxiety that we feel while tapering is different than regular anxiety.  Regular anxiety can actually be controlled to some extent, but because it is caused by chemicals ADWD anxiety can't.  Even though it is a very uncomfortable feeling however, it is not dangerous. It's just your nerves going haywire.  You mentioned AAF.  That is the best way to handle it.  It may not go away when you want it to, but it can successfully be ignored. Eventually things will change in your body and the anxiety will fade. I went through a number of waves of it during and after my taper.  All of them were very uncomfortable, but they ran their course and went away after a while.

Thank you @brassmonkey.

Funnily enough, when I entered the crisis team care back in Aug 19, they got me to fill in a booklet where I had to fill in my preferred treatment in crisis, and things I absolutely didn't want to have. That goes on my record. That's quite impressive then isn't it if that's not standard practise! 

 

I'm still going to order the scales in preparation for the Mirtazapine microtaper. I still can't help but think there's mirtazapine in play here too, seeing as the issues I have became slightly less intense when they reduced the dose from 45mg to 30mg. But then again, that was also following a benzo taper, so I guess that just clouds the issue further. I'll order the scales anyway. 

 

Ahhhh, it's a mucky confusing business isn't it. 

 

I have a question about the Mirtazapine, and I'm not sure who the best person is to answer this. Perhaps you can point me in the right direction if you're not the one to answer this. 

Given that mirtazapine affects norepinephrine, I can't see how this medication is remotely helpful for me given that my system feels locked in fright/flight. I feel like stress hormones are pumping through me continuously, even when 'at rest' and undertaking restful activities. I'm always on high alert. I know getting myself out of this f/F is key, but how do I do that if the med is pumping norepinephrine through me??? I don't see how this is even possible. I'm genuinely curious why they'd give you a med that increases norepinephrine when you suffer from panic attacks?! How do I get around this?? 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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cathnz

@Altostrata  @GiaK

I have a question for you about the god awful Mirtazapine that I'm currently stuck on while I'm waiting to stabilise enough from my paxil wd. 

 

Given that mirtazapine affects norepinephrine, I can't see how this medication is remotely helpful for me given that my system feels locked in fright/flight and my limbic system is on utter distress. I feel like stress hormones are pumping through me continuously, even when 'at rest' and undertaking restful activities. I'm always on high alert, feeling like I'm living in a war zone. I know getting myself out of this f/F is key to limbic system healing, but how do I do that if the med is pumping norepinephrine through me??? I don't see how this is even possible. I'm genuinely curious why they'd give you a med that increases norepinephrine when you suffer from panic attacks?! How do I get around this?? I'm feeling a bit screwed really. I'm on 30mg, not stable enough to taper yet, so at this rate I'm going to have excess norepinephrine pumping through me for years, all the while my body rewiring to fear what's going on inside. How do I dig my way out of this? You can imagine the answer I got when I asked my pdoc 😔


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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brassmonkey

This is the first I have ever heard of a crisis team getting preplanning instructions.  I think it's a great idea.  It's a real eyeopener dealing with heath care on an international basis like we do here.  The systems are so different in each country, the American system is quite different from the UKs NHS and the NHS is different for England than it is for OZ then it is for New Zealand. Not to mention the Netherlands or Indonesia.

 

It really does sound like the mirtazapine is the major cause, but the benzo also is a contributing factor. It is a positive that the symptoms decreased along with the decrease in dosage.  That really helps point a direction to head in.  I hate to say you're one of the lucky ones, because I don't want to diminish what you're going through in the least, but you are only dealing with two drugs. Some of the new members we get, all I can do is a face palm and shake my head and sigh "what the H were the doctors thinking". Along those lines we get that quite frequently, a prescription for a drug that causes the exact symptoms that they are trying to treat. Makes no sense.

 

The microtaper should be a good thing. They tend to be less symptom producing and in the case of the Brassmonkey Slide Method can proceed at a fairly rapid pace.  We don't want to rush things, that can end up being very counterproductive, but we do want to get people off as quickly and comfortably as possible.


20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hamster
15 hours ago, cathnz said:

Given that mirtazapine affects norepinephrine, I can't see how this medication is remotely helpful for me given that my system feels locked in fright/flight. I feel like stress hormones are pumping through me continuously, even when 'at rest' and undertaking restful activities. I'm always on high alert. I know getting myself out of this f/F is key, but how do I do that if the med is pumping norepinephrine through me??? I don't see how this is even possible. I'm genuinely curious why they'd give you a med that increases norepinephrine when you suffer from panic attacks?! How do I get around this?? 

Cath,

 

as far as I know mirtazapine may act quite differently at high and at low doses. At low doses the calming  / sedating effect is dominant (antihistaminic ?) while at higher doses other neurotransmitters are affected too. It's approved for treating depression, OCD and anxiety. I can't tell what logic was behind your prescription. These meds are not well understood ... so in many cases I fear it's more or less trial and error. Some "errors" end up to be severe as a lot of stories here on SA show.

When you taper the mirt you should (in theory) go in the right direction in terms of "less activating" and "more sedating". 

 

Regards,

 

Hamster


Nov 2018: St. John's Wort 900 mg Extract / day Dec 2018: fast taper of St. John's Wort  (900 mg -> 0 in about 2 weeks)
Jan 2019: start of  citalopram (10 mg/d) and mirtazapine (30 mg/d) Feb 2019: citalopram increased to 20 mg/d, start of talk therapy
March 2019: 10 mg/d citalopram & 15 mg/d mirtazapine April 2019: 7 mg/d citalopram & 7.5 mg/d mirtazapine
May 2019: 5 mg/d citalopram & 5 mg/d mirtazapine June 2019: 5 mg/d citalopram & 3.75 mg/d mirtazapine

July 2019: 5 mg/d citalopram & 3.12 mg/d mirtazapine July 16th 2019: 5 mg/d citalopram & 2.5 mg/d mirtazapine

August 22nd 2019: 5 mg/d citalopram & 2.2 mg/d mirtazapine September 20th 2019: 5 mg/d citalopram & 2.0 mg/d mirtazapine -> BM slide (around 2%/week, some holds). Feb 2020: 3.4 mg/d citalopram & 1.5 mg/d mirtazapine

Supplements: linseed oil for omega3 (can't tolerate fishoil), magnesium

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Altostrata

Hi, Cath. I moved your post here.

 

What happened to diazepam? When did you stop taking it? How did you go off? How have your symptoms changed since you went off?

 

Do your symptoms follow any daily pattern?  Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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cathnz
7 hours ago, brassmonkey said:

This is the first I have ever heard of a crisis team getting preplanning instructions.  I think it's a great idea.  It's a real eyeopener dealing with heath care on an international basis like we do here.  The systems are so different in each country, the American system is quite different from the UKs NHS and the NHS is different for England than it is for OZ then it is for New Zealand. Not to mention the Netherlands or Indonesia.

 

It really does sound like the mirtazapine is the major cause, but the benzo also is a contributing factor. It is a positive that the symptoms decreased along with the decrease in dosage.  That really helps point a direction to head in.  I hate to say you're one of the lucky ones, because I don't want to diminish what you're going through in the least, but you are only dealing with two drugs. Some of the new members we get, all I can do is a face palm and shake my head and sigh "what the H were the doctors thinking". Along those lines we get that quite frequently, a prescription for a drug that causes the exact symptoms that they are trying to treat. Makes no sense.

 

The microtaper should be a good thing. They tend to be less symptom producing and in the case of the Brassmonkey Slide Method can proceed at a fairly rapid pace.  We don't want to rush things, that can end up being very counterproductive, but we do want to get people off as quickly and comfortably as possible.

It's only through my dogmatic sheer willpower that I'm not on more (and I'm only on the one BTW... mirtazapine ... the paroxetine and benzos were stopped 5-7 months ago). The physchiatrist wanted to add a mood stabiliser, an anti physchotic, or a beta blocker. As horrendous as I feel and desperately want relief, I just know in my heart it will make things worse. But it's soooo hard on the days where I feel I can go on no longer, and to push against what my friends, family, and Dr all want. My support worker told me I owe it to my family to get better (so I should address meds). But at least I have the crisis plan there, but I haven't filled it out yet because I didn't know what the best crisis plan was. Like what's the LEAST damaging option if it came to that?! 

I'm so flooded with adrenaline. I just need this **** out of my body. 

Is it normal to be scared of a life off drugs? For 17 years I've believed that they saved my life. I was non functioning off them. The prospect of falling deeper is scary. Its hard to change your whole mindset. I've always thought "it'll be ok, the meds keep holding me up through tough times". It's quite terrifying not having that safety net anymore. It's this a normal reaction? 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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cathnz
1 hour ago, Altostrata said:

 

What happened to diazepam? When did you stop taking it? How did you go off? How have your symptoms changed since you went off? 

 

 

Hi @Altostrata

 

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

 

So I haven't been on Diazapam since the end of Sept 19 as per my signature (above). I was prob on it about 6-7 weeks (intermittently in the first couple of weeks).

Symptoms no different now than before starting and stopping the Diazapam though.

Some symptoms became apparent when my paroxetine began to poop out (I was only on paroxetine then nothing else), but the worst of the symptoms I have now (which I suspect may still be akathisia) began in the week or so after the abrupt swap from paroxetine to Mirtazapine. The was no Diazapam in the picture at that stage. They added that later to 'cover the anxiety while they bumped the dose of mirtazapine up'. So how I'm feeling now was present BEFORE the Diazapam. But of course, getting put on that, then stopping would have just added fuel to the fire in my already unstabilised system. 

 

Re the daily record... I'm just in the process of recording that. I was going to post it when I had info from a few consecutive days (so it was all infront of you rather than having to check each day). Is that advisable? 

 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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cathnz
On 2/24/2020 at 2:18 PM, Altostrata said:

 

Do your symptoms follow any daily pattern?  Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 

Hi @Altostrata @brassmonkey @Shep @Sassenach

 

I've put down my notes from the last 3 days. I think I've gone into too much detail. I'll try and condense it down next time. 

 


Monday 24.2.20


5.30am - Woke to tremors and gnawing in my solar plexus, and buzzing in my chest, abdomen, genitals and legs. Feelings of dread. Dozed on and off until 6.45am

 

7am - Got up out of bed due to urgent diahorea.

 

8.30am - Glass of water. No food, too anxious. Went to work.

 

11am - Ate a banana. Glass of water. Anxiety high. Gnawing feeling in solar plexus, buzzing feeling in chest, genitals and legs. Legs feel tight and rigid. Tinnitus. Reacting adversely to loud sounds. Easily frightened.

 

1.30pm - Work finished for day. Went to appointment. Anxiety still high. Still have gnawing feeling in solar plexus (even worse now) , buzzing feeling in chest (even worse now) , genitals and legs. Muscles burning in neck and back, legs feel tight and rigid. Tinnitus and sensitive ears. Waves of panic and dread that this will never end. Trying to float and accept and deep breathe, but keep getting waves of overwhelm and panic.
Still can't eat.

 

5pm - Trying NAC for very first time (for obsessions) starting slow with one capsule.

 

6pm - Had dinner (first food today other than a banana earlier).
Still all same physical symptoms as rest of the day.  Anxiety still there but panic less. Managed to watch some TV.

 

8.30pm - 30mg Mirtazapine then bed. Asleep by 9.30pm.

____________________________________

 

Tuesday 25.2.20


4.30am - Woken up by sick son. Gnawing feeling in solar plexus. Feeling dread and doom. Dozed on and off until 7.30am.

Weirdly buzzing in chest and legs not AS strong as normal, and no terrible internal tremors upon waking this morning (first time this week) .

 

8am - Feeling a bit nauseous (not unusual for me in the am even pre WD). Forced myself to eat a small amount today though (oatmeal).

 

8.30am - Went to work. Symptoms same as earlier (buzzing, gnawing, muscle tightness etc) .

 

10.30am - Ate a capsicum for morning tea. Symptoms same as earlier (buzzing, gnawing, muscle tightness etc)... possibly at a slightly lower level?? Legs feel tight and rigid.

 

1.30pm - Realised I haven't drunk anything today. Drunk 2 glasses of water and  took a NAC capsule.

 

2.30pm- Ate sushi, a banana and apple.

 

3pm - Finished work. Exhausted and depressed. Legs tight and buzzing, genitals and chest buzzing (possibly lower than usual?) . Feel anxious but not massively overwhelming like yesterday.

 

4pm - Lay down and practise deep breathing. Muscles in back burning.

 

6pm - Beef salad for dinner. Still exhausted. Still have buzzing and gnawing. Anxiety present but not overwhelming .

 

8.30pm - 30mg Mirtazapine then bed.

 

10pm - Woke up. Frightened and internal tremors again. Chest and legs buzzing. Had been reading wd stories earlier... has this made anxiety higher?

___________________________________

 

Wednesday 26.2.20


4.30am - Woke to internal tremors and gnawing in my solar plexus. Diahorea. Feelings of dread. Dozed on and off until 6.30am.

 

8.30am - No food, too anxious. Went to work. Gnawing feeling in solar plexus, buzzing feeling in chest, genitals and legs (strong) . Legs feel tight and rigid. High level anxiety again.

 

10.30 - Took a NAC (with first glass of water for the day) .

 

11am - Ate a banana. Same symptoms at same level as earlier

 

1.00pm - Work finished for day. Went to appointment. Anxiety still high. Still have gnawing feeling in solar plexus , buzzing feeling in chest , genitals and legs. Muscles burning in neck and back, legs fell tight and rigid. Exhausted and depressed.
Still can't eat.

 

5pm - Anxiety and symptons high. Constant diahorea. Bereavement in extended family. No tears but feel an increase in anxiety.

 

6pm - Ate dinner (first time today other than banana). Diahorea afterwards (many times). Buzzing and gnawing high. High anxiety.

 

8.30pm - 30mg Mirtazapine then bed.

 

12am - still awake. Haven't been to sleep. Waves of panic washing over me and chest is buzzing and crawling more than ever. Desperate. Brief thought of using a benzo and I HATE benzos!!! But so desperate for relief. Had go and sit outside and midnight and try and ground myself. Thinking about bereavement in family. And also regretting role change at work that I made last week.

12.30ish finally drifted off to sleep. Woke at 5am. Chest crawling.

 

_________________________

 

I don't know how much more of this I can take. I'm getting worse not better. And I know that I had all these symptoms after they  did the med switch and started me at 15mg (so if it is an adverse reaction, I'll need to get to at least lower than 15mg to resolve). I HATE that I let them push the dose up when I knew in my heart stuff wasn't right. Anxiety makes you lose trust in your own judgement 😭

I feel like hell. I have never in my life felt as awful as I do on the Mirtazapine. The adrenaline surges are next level. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata
On 10/13/2019 at 8:40 PM, cathnz said:

....

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks, but experienced akathisia, so dose reduced to 15mg over next few weeks). Stayed at 15mg for 7 years until it 'pooped out'.

 

4th Aug 2019 - Reduced dose  of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

 

5th Aug 2019 - Switch to 15mg Mirtazapine. 

 

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5  once a day every few days or so). Also used 12.5mg Quetiapine for 3 nights for sleep.

 

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

 

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

 

6th Sept 2019 -  Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

 

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily. 

 

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

 

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization. 

 

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

Friday 4th October - Friday 11th October: 45mg Mirtazapine

 

Friday 11th October - present: 45mg Mirtazapine, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

 

* Everything done from 23rd August under care of outpatient crisis team management.

 

On 2/23/2020 at 7:00 PM, cathnz said:

 

Hi @Altostrata

 

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

 

So I haven't been on Diazapam since the end of Sept 19 as per my signature (above). I was prob on it about 6-7 weeks (intermittently in the first couple of weeks).

Symptoms no different now than before starting and stopping the Diazapam though.

Some symptoms became apparent when my paroxetine began to poop out (I was only on paroxetine then nothing else), but the worst of the symptoms I have now (which I suspect may still be akathisia) began in the week or so after the abrupt swap from paroxetine to Mirtazapine. The was no Diazapam in the picture at that stage. They added that later to 'cover the anxiety while they bumped the dose of mirtazapine up'. So how I'm feeling now was present BEFORE the Diazapam. But of course, getting put on that, then stopping would have just added fuel to the fire in my already unstabilised system. 

 

Re the daily record... I'm just in the process of recording that. I was going to post it when I had info from a few consecutive days (so it was all infront of you rather than having to check each day). Is that advisable? 

 

 

 

cath, I'm sorry we didn't see your drug history earlier.

 

What it looks like to me is that you got withdrawal syndrome from going off paroxetine August 4, which was the cause of your "crisis" on August 23.

 

You were using a benzodiazepine from August 5 to September 29, when you went off diazepam very quickly.

 

This caused WORST ANXIETY EVER afterward. (It's also possible you were taking too much mirtazepine, with adverse reaction masked by the diazepam.)

 

I believe what you have now is a combination of paroxetine and diazepam withdrawal syndrome. If mirtazapine is helping you sleep, at least it's serving some purpose. I'd like to bring in @Shep to confer on next steps.

 

PS Whoever told you to go off paroxetine and diazepam that fast is an idiot.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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cathnz
2 hours ago, Altostrata said:

 

 

cath, I'm sorry we didn't see your drug history earlier.

 

What it looks like to me is that you got withdrawal syndrome from going off paroxetine August 4, which was the cause of your "crisis" on August 23.

 

You were using a benzodiazepine from August 5 to September 29, when you went off diazepam very quickly.

 

This caused WORST ANXIETY EVER afterward. (It's also possible you were taking too much mirtazepine, with adverse reaction masked by the diazepam.)

 

I believe what you have now is a combination of paroxetine and diazepam withdrawal syndrome. If mirtazapine is helping you sleep, at least it's serving some purpose. I'd like to bring in @Shep to confer on next steps.

 

PS Whoever told you to go off paroxetine and diazepam that fast is an idiot.

Thanks @Altostrata.

 

When my paroxetine 'pooped out' mid June, the physchiatrist switched me straight to Mirtazapine. Despite my reservations, he said a straight switch from 15mg paroxetine to 15mg mirtazapine would be fine and not cause issues. I was naeve.

 

When things went from bad to worse, a second physchiatrist increased the dose of mirtazapine and added benzos, I got worse, so they increased mirtazapine more. I most definitely had these intense physical and emotional symptoms within the first 7-10 days of the paroxetine/mirtazapine switch before benzos were involved. But yep, that would have made it worse. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Shep
8 hours ago, Altostrata said:

I believe what you have now is a combination of paroxetine and diazepam withdrawal syndrome. If mirtazapine is helping you sleep, at least it's serving some purpose. I'd like to bring in @Shep to confer on next steps.

 

6 hours ago, cathnz said:

When things went from bad to worse, a second physchiatrist increased the dose of mirtazapine and added benzos, I got worse, so they increased mirtazapine more. I most definitely had these intense physical and emotional symptoms within the first 7-10 days of the paroxetine/mirtazapine switch before benzos were involved. But yep, that would have made it worse. 

 

Cath, thanks for your notes and how your clearly documenting your taper and symptoms. 

 

We generally don't recommend reinstating a benzo after you've been off for more than a month. And it's been 5 months since you were last on them. So the best path forward may be to cope as best you can and nurture your nervous system with as much self-care as possible. 

 

I noticed you just started taking NAC.

 

On 2/26/2020 at 3:54 PM, cathnz said:

5pm - Trying NAC for very first time (for obsessions) starting slow with one capsule.

 

Please see:

 

N-acetylcysteine (NAC)

 

Because NAC does effect GABA, this may be a way of helping with benzo withdrawal as Alto notes here,  but with so many other factors in your polypharmacy journey, it will be best to keep everything steady for awhile to see how you do on this. 

 

Please include the NAC dose you are taking in your daily notes and also place this in your signature (a direct link is here - Account Settings - Create or Update Your Signature).

 

Please take the NAC (and all supplements and drugs) at the same time(s) of the day and let us know how you're doing over the coming days. 

 


Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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cathnz
5 hours ago, Shep said:

 

 

Cath, thanks for your notes and how your clearly documenting your taper and symptoms. 

 

We generally don't recommend reinstating a benzo after you've been off for more than a month. And it's been 5 months since you were last on them. So the best path forward may be to cope as best you can and nurture your nervous system with as much self-care as possible. 

 

I noticed you just started taking NAC.

 

 

Please see:

 

N-acetylcysteine (NAC)

 

Because NAC does effect GABA, this may be a way of helping with benzo withdrawal as Alto notes here,  but with so many other factors in your polypharmacy journey, it will be best to keep everything steady for awhile to see how you do on this. 

 

Please include the NAC dose you are taking in your daily notes and also place this in your signature (a direct link is here - Account Settings - Create or Update Your Signature).

 

Please take the NAC (and all supplements and drugs) at the same time(s) of the day and let us know how you're doing over the coming days. 

 

Thank you @Shep.

Shep, honestly, will I heal? I thought I was just dealing with AD wd/or adverse reaction (seeing as this was a problem before touching benzos). Now I'm more despairing than ever thinking benzo wd is in the mix. Do people recover from such quick wd from a benzo (plus AD) without reinstatement? 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata

How are you feeling with the NAC?

 

The mirtazapine is helping you sleep, is that correct? You are currently taking 30mg? What happened the last time you reduced mirtazapine?


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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cathnz
7 hours ago, Altostrata said:

How are you feeling with the NAC?

 

The mirtazapine is helping you sleep, is that correct? You are currently taking 30mg? What happened the last time you reduced mirtazapine?

@Altostrata

I've stopped the NAC, to see if that was the cause of the diahorea I've been experiencing. It may or may not be related, so will stop and see. 

 

Is the Mirtazapine helping me sleep... I don't know. I thought it was. But I've begun feeling panicky when falling asleep again. And waking earlier than normal. So sleep quality os deteriorating. That said, I'm at least getting 5 hours... nowhere near my usual sleep, but far better than other people, so I'm grateful for that at least. 

 

My memory feels a bit shot, so recalling things is tricky, but at the time, when they dropped me from 45mg to 30mg of Mirtazapine it felt like a relief and that I had some improvement. But now I feel back at sqaure one again (having these panicky feelings frequently), so now I'm questioning if it was an improvement or if I'm actually now just as bad as then (on 45mg)... it feels like I've deteriorated I think. But because everything is so subjective, I doubt my own ability of accessing things. I just don't know any more 😢

I'm really sorry that my answers are vague. I'm very confused. 

 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Shep
20 hours ago, cathnz said:

Shep, honestly, will I heal? I thought I was just dealing with AD wd/or adverse reaction (seeing as this was a problem before touching benzos). Now I'm more despairing than ever thinking benzo wd is in the mix. Do people recover from such quick wd from a benzo (plus AD) without reinstatement? 

 

I came off 6 psychotropic drugs cold turkey or rapid taper (Seroquel, Halcion, Sonata, Klonopin, Viibryd, and dexedrine) after taking various cocktails for 30 years, and I'm healing nicely.  I hadn't found any of the withdrawal forums until the very end of the Seroquel rapid taper, and I definitely don't recommend coming off as quickly as I did because it was nothing short of a hellride, but I know from my experience and the cold turkey / rapid taper survivors I've made along the way - we can also heal. 

 

I'll write this again - we can also heal. 

 

You're going to be fine, but you need to do as much self-care as possible. And that means ignoring the thoughts that you aren't going to heal. 

 

This is a great post by River Wolf over on Benzo Buddies:

 

Benzo Lies That Have Been Busted

 

A lot of the thinking that you'll never heal is actually a symptom of withdrawal itself. And it's simply not true. 

 

13 hours ago, cathnz said:

I've stopped the NAC, to see if that was the cause of the diahorea I've been experiencing. It may or may not be related, so will stop and see. 

 

Let us know how you're feeling over the next few days without the NAC. To be honest, you may be better off not using this. We found from members' experiences that fish oil and magnesium are the two supplements that many members are able to tolerate and find helpful. Other supplements are a hit or a miss. So the simpler you make your withdrawal journey, the better. 

 

Since the NAC is a recent addition, did you have any GI issues prior to starting the NAC? Do you know of any food sensitivities or allergies that may be suspect? 


Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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Altostrata

I believe NAC is known for gut irritation.

 

17 hours ago, cathnz said:

Is the Mirtazapine helping me sleep... I don't know. I thought it was. But I've begun feeling panicky when falling asleep again.

 

Do you feel panicky before or after you take mirtazapine? If after, how long after? Still need to see those daily notes!

 

It makes sense that you felt better upon reducing mirtazapine, 45mg probably was too much for you. It's possible you could do with less than 30mg.

 

If it's helping you sleep, that's a good thing. I do not believe mirtazapine is causing your symptoms during the day, I think that's the underlying withdrawal syndrome.

 

In the meantime, many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Magnesium in particular can be soothing; you can put magnesium citrate in water and sip it throughout the day. You might try a little bit of one at a time to see how it affects you.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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cathnz
3 hours ago, Altostrata said:

I believe NAC is known for gut irritation.

 

 

Do you feel panicky before or after you take mirtazapine? If after, how long after? Still need to see those daily notes!

 

It makes sense that you felt better upon reducing mirtazapine, 45mg probably was too much for you. It's possible you could do with less than 30mg.

 

If it's helping you sleep, that's a good thing. I do not believe mirtazapine is causing your symptoms during the day, I think that's the underlying withdrawal syndrome.

 

In the meantime, many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Magnesium in particular can be soothing; you can put magnesium citrate in water and sip it throughout the day. You might try a little bit of one at a time to see how it affects you.

Thank you @Altostrata.

Daily notes given above (3 days worth). Should I post more? 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata

I need the answers to these questions

 

1 hour ago, cathnz said:

Do you feel panicky before or after you take mirtazapine? If after, how long after?

 

I need to see daily notes ongoing, at least 24 hours at a time. Thanks.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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cathnz
1 hour ago, Altostrata said:

I need the answers to these questions

 

 

I need to see daily notes ongoing, at least 24 hours at a time. Thanks.

@Altostrata there is no particular time that the panicky feelings come... it can be anytime at all. For example, some nights I feel panicky after after I've taken my mirtazapine, as I'm going to sleep. Then other days I'm absolutely fine after I've taken my mirtazapine at night, yet I'm panicky first thing in the morning, or during the middle of the day (for example, yesterday I was  reading during the early afternoon and started to doze off, but was abruptly startled awake in panic... but I was fine that evening after my tablet). So there is no set time whatsoever. It's most definitely worse as I'm transitioning from awake to asleep though, regardless of the time of day.

 

I'll continue to record daily notes. I am wondering if I should wait a couple of days though, as I'm heading out of town to a family members funeral tomorrow, so I anticipate that being out of routine and in stressful circumstances won't be fully indicative of my usual situation. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata

What I'm trying to find out is if the mirtazapine is causing a reaction shortly after you take it. This is what you wrote:

 

On 2/28/2020 at 5:21 PM, cathnz said:

But I've begun feeling panicky when falling asleep again.

 

How often does this happen? Can you tell if you're having a reaction to the mirtazapine or is this one of your random panicky feelings?

 

We can't tell you anything unless you carefully observe your symptoms and describe them to us.

 

If you're taking too much mirtazapine and it's causing a paradoxical reaction, first step would be to reduce it. The paradoxical reaction would occur approximately the same time each night after you take the mirtazapine.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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manymoretodays
Posted (edited)

Hi cathnz,

5 hours ago, cathnz said:

I'll continue to record daily notes. I am wondering if I should wait a couple of days though, as I'm heading out of town to a family members funeral tomorrow, so I anticipate that being out of routine and in stressful circumstances won't be fully indicative of my usual situation. 

 

I'd give them a good effort/try while out of town.  Why not?  You could just note, out of town, and usual environment/routine. 

 

Keep daily notes of drug schedule and symptoms

I copied over the sample note:

 

Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 
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

 

L, P, H, and G,

mmt

 

Edited by manymoretodays

Started with psycho meds circa 1988 I think 27 or 28 total.

AD's, antpsychotics, antiseizure mood stabilizers. Lithium, lamictal ,benzos, and stimulants. Some med. for narcolepsy once(Provigil,) Gabapentin........probably more.  Ask me?......I probably was on it.  Haphazard W/D's by Dr. recommend or uneducated self.

10/2014- off Lexapro--had been on highest dose 10 mg. then 5 mg. for a couple of years, went from 5 mg. to 3 mg. liquid and then CT in hospital(voluntary).  I got out of the hospital on a combination of low dose adderal salts x1/day and trileptal 150mg. x2/day.

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!

 

3/21/2016---I did some unwise updosing of trileptal/oxcarbazepine with some stressful stuff......doubled the above dose x2 during this last wave but began liquifying again and on approximately 68mg. starting today.  11/12//2016 24 mg. oxcarbazepine  12/9/2016 off oxcarbazepine/trileptal!!!! :) optimistic  2016 December 9- completely off all medications!!!!!

Omega3's,EPA +DHA= 1800 mg/day. Magnesium complex, orally, diluted in a liter of H2O(that I can shake up.....it usually dissolves more completely as the water gets down to room temperature) and/or Epsom salt baths prn.   Vit. C, D3, and E.  B12, melatonin tapered to 1mg., and bioidentical hormones sublingually.  Trace mineral drops.  L-lysine.  L-methylfolate=400 mcg plus daily spinach. Totally ready for a good long window to hit soon and getting better strings of full days and partial days along the way.  Definite improvement overall since I first arrived on the SA survivor ship.  Herb and alcohol free since 5/15/2016.  None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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cathnz

Hi @Altostrata @Shep @brassmonkey @Sassenach @manymoretodays

 

I'm sorry I haven't been posting my daily logs. In all honesty, I got very very overwhelmed trying to track my symptoms. I felt like all I was doing was focusing on them, so I tried to have a break and just tried to distract myself and just make my way through life as best I could, and hoped with distraction that everything I was experiencing would just fade into the background. It didn't. I'm worse. There may be a few reasons I'm worse... 

*The current covid situation has driven my stress levels up (I'm terrified of the isolation from our 4 weeks plus of lockdown... being in the company of others and working is the only thing that's got me through the last 8 months). But to be fair, everything was worse before this started, it just might have exacerbated it. 

*I had some blood tests done which came back with low B12, low folate, extremely low selenium, low vit E, low iron, extremely low mitochondrial function, and extremely high toxin levels (this particular test didn't show which toxins in particular, just that my general levels were 3 times that in the accepted range... off the charts high). I was very cautious about starting any supplements but decided to try to introduce a couple very slowly, at low doses, one by one. I began with the b12  (started low then slowly built up), then added coq 10 a few days later. All seemed ok (infact I had a few days feeling better mentally than I had for a while... physical symptoms didn't go though), but then after about 10 days I felt like my physical symptoms might have been getting worse, so I stopped both immediately. This did coincide with the stress of covid 19, so may have been a coincidence, but I didn't want to risk it. I'm now on no supplements (including the ones which are in my signature, which I haven't taken for months, but for some reason am unable to remove... is someone able to help me with that?). 

 

Anyway. I'm here to reinstate my dairy entries, and to see if once and for all I can figure out if my symptoms are withdrawl (8 months out from the med switch) or side effect from the Mirtazapine. I'm getting sicker and sicker and I'm now scared as hell. I hate that we're on lockdown and that my son has to witness me this way. I'm very scared I'll end up in the physch ward. 

I'll try to keep the emotion out of my daily symptom log, but what I will say, is that my days are filled with constant fear, dread, overwhelm and waves of panic and SI. 

 

The physical symptoms I've been experiencing since the med switch in Aug have been consistent. They began within the first week of changing from 15mg paroxetine to 15mg Mirtazapine. Constant electrical buzzing. At first, most noticeably in genitals and chest. Over the next month (Sept 19) became apparent in legs too. 

Now at its worst ever... head, teeth, ears (sensitive hearing also), chest, genitals, and legs. What began as just buzzing from Aug 19 to Feb 20, is now accompanied by a burning/itching/prickly/crawling feeling. This is all day long, every day. From the moment I wake, to the time I go to sleep, and if I wake during night it is there too. Sometimes it's more of s background 'noise', sometimes it's 'in my face screaming at me'. 

This is accompanied by emotional distress too... dread, terror, panic, overwhelm... although this comes in waves. Somedays more manageable than others. 

 

I'll begin with yesterday... 

 

Tuesday 24th March

 

*6am - Woke up. Buzzing/tingling/prickling/crawling as usual. 

 

*8am - Too nauseated to eat. Glass of water. Went to work. 

 

*9.30am - Brain buzzing had a really severe 'wave'. Like a jolt. Couldn't read properly, felt unsteady. Very frightening. 

 

*10.30am - Ate a small peice of banana bread for morning tea. Glass of water. 

 

*11. 45am - Aside from the usual buzzing tingling feeling, the burning and itching in legs really bad. Massive wave of overwhelm by it. Scared I will be driven to kill myself due to it. Wave of panic. 

 

*1pm - Too nauseated for lunch. Glass of water. 

 

1.20pm - Another wave of panic due to intensity of body prickling. 

 

3.30pm - Broke down in tears. Panic attack. Hyperventilating. Afraid of the huge increase in my symptoms. (Catastrophising about the thought of meds being a problem and that I'll end up getting sicker and sicker. Worried I'll end up in physch ward... and due to covid services are stretched... and no contact with family. Frightened of going mad). 

Feeling suicidal. Can't deal with these sensations anymore. Rang a friend. 

 

4pm - Slightly calmer than 30 minutes ago. Still overwhelmed by symptoms. Tried to distract myself until bed. 

 

5pm - Skin on face and neck red and burning. 

 

6.30pm - Ate small amount of dinner 

 

7pm - Continue to try and 'distract' from the burning /tingling /itching /crawling. Still some SI. 

 

8.30pm - 30mg Mitrazipine 

 

9pm - Bed to watch TV . Physical symptoms continue as previous.

 

Asleep by 11pm.

 

 

 

 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata

Does anything significant happen in the hour or so after you take mirtazapine?

 

On 10/19/2019 at 12:07 PM, cathnz said:

....

Akathisia - it was extreme at 45mg (couldn't sit still, felt like I wanted to jump out of my skin). Improved at 30mg, now its just a feeling like my insides are running with electricity... like my insides are buzzing (although now I've read more, I realise this may be anxiety and withdrawl induced effects). From what I can tell, there is no real pattern, it's with me mostly constantly, but if I'm able to go for walks or keep occupied I notice it less.

....

 

Are you still feeling this buzzing or electricity? Is it better or worse at any particular times of day?

 

One thing we haven't talked about -- you were taking diazepam for about 5 weeks August-September 30, 2019. After you went off diazepam:

 

Quote

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

 

How did your condition on October 3 compare to your condition in early August, when you switched from Paxil to mirtazapine?

 

I am wondering if you might have Paxil withdrawal syndrome AND benzo withdrawal, plus mirtazapine has been too activating for you at higher doses and may be activating now. I'll ask @Shep to consult.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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cathnz

Thsnks @Altostrata 

 

I've no doubt that the benzo will have made issues worse. But that said, I most definitely had this electrical buzzing BEFORE I took any benzos. The intensity of them is what led me to the benzos in the first place (I 'spun out' one night about the buzzing and the overwhelm and terror, locked myself in the bathroom and refused to touch the poison of meds ever again... that led me voluntarily to call the crisis team the next day as I was suicidal). Then they increased my Mirtazapine dose  (from the original 15mg to 30mg) and started the regular benzo (before then I might have had two or three tiny fractions of the smallest dose over the space of a week) . 

So the buzzing in torso, genitals and legs was most definitely there before benzos were started. 

It was 7 months later that the head and teeth buzzing began, and the skin crawling. 

 

 

Answers to your questions...

 

Does anything significant happen in the hour or so after you take mirtazapine?

Not consistently. Some nights I will  jolt awake as I'm falling asleep, but some nights I'm fine and go to sleep straight away (still with the usual buzzibg sensations, but at the same level they are all day... no better, no worse). I also experience the jolting awake if I try to nap in the day, so I think it's more to do with the act of falling asleep rather than being time related to Mirtazapine. I do tend to notice things more at night, but I think that's because I'm still and not distracted (I find the same thing of I try to lay down during the day... that I'm more aware of the intensity of sensations) . Because I take my Mirtazapine at night then MOST times, go straight to sleep, I may well sleep off any increased problems... hard to know. 

So in short... no consistent pattern of symptoms an hour after Mirtazapine. 

 

Are you still feeling this buzzing or electricity? Is it better or worse at any particular times of day?

Yes I'm still feeling it at the same intensity as I was back then.

I thought I had improved marginally when they dropped me back from 45mg to 30mg (not wonderful but an improvement). But in all honestly, when I think about it, I think the symptoms I'm experiencing now are just as bad (given they've progressively gotten worse and now buzzing in my head is present... that is new). I think the difference now is that I'm doing everything in my power to manage this myself this time because I know that spinning out and reaching out for help will see me in a worse mess. So I'm doing my best to manage. But the sensations are now becoming just as bad again I'd say (hindsight is tricky though).

 

I have had days where it has been more manageable if I can throw myself into distraction... its still there at the exact same level, but I manage it best I can. But some days (particularly when I'm tired or stressed) it's completely overwhelming at my distraction techniques are too difficult. On these days I fear that I can't go on. 

 

There is no time of day it is better or worse. If can keep active I can somewhat distract. But this isn't always possible. It's exhausting. 

 

How did your condition on October 3 compare to your condition in early August, when you switched from Paxil to mirtazapine?

I'm going to try and recall this as best as possible. My memory feels frazzled

I remember 2 major events...

One was early Aug, from memory, about 2 or 3 weeks after the switch (this was the time off the  event when I locked myself in bathroom terrified). I was suicidal, restless, buzzing and terrified.

The other event was the week in early October where they reduced the benzo 'to see how the 45mg looked without the benzo masking things. Again, I was suicidal, restless, buzzing and terrified. These two events (early Aug and early Oct) were very similar in nature.  I think perhaps the October event, was slightly worse in that it was harder to contain the restlessness. I felt like I constantly wanted to climb the walls. But that said. I'm beginning to feel like that again now, and I've made no dose changes since that event in Oct when they dropped me from 45mg to 30mg.

 

 

 

I'm sorry if I'm not concise enough. I'm trying very hard to recall facts well. 

I really really appreciate all of your thought and help with this. I look at my son, and keep thinking I HAVE to survive this for him. Honestly. I'm scared I won't. Because I've always thought of the medical community as my safety net, but not now I realise how messed up that is. Now I feel like I have nowhete to go. But I HAVE to not give up for him. I don't want this to be his reality when he's older... I need to show him a better way. But some days that fight seems too overwhelming. But I'm sincerely grateful for the work you do on here, and that I can tap into your expertise. Without you and the other mods I'd be up the creek without a paddle. So thank you 🙏

 

P. S I'm very mindful that the currency stress of Covid, and isolation and lack of routine are causing me stress that might be exacerbating things. I'm trying my best to implement different coping strategies to those I usually do (work and interaction). So I am trying to schedule daily gentle walks, gentle yoga, EFT (I have no idea if it will help but I'm desperate) and something very basic...drinking more water, as I often wonder if my low fluid intake makes matters worse. I'm trying to keep it simple. But still survive. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Shep
16 hours ago, cathnz said:

*8am - Too nauseated to eat. Glass of water. Went to work. 

 

16 hours ago, cathnz said:

*10.30am - Ate a small peice of banana bread for morning tea. Glass of water. 

 

16 hours ago, cathnz said:

*1pm - Too nauseated for lunch. Glass of water. 

 

16 hours ago, cathnz said:

3.30pm - Broke down in tears. Panic attack. Hyperventilating.

 

Cath, you need to eat. Low blood sugar from not eating can cause panic attacks and high anxiety. 

 

When did the nausea start? 


Drug free May 22, 2015 after 30 years of neuroleptics, benzos, z-drugs, so-called "anti"-depressants, and amphetamines 

 

My Success Story:  Shep's Success: "Leaving Plato's Cave"

 

And what is good, Phaedrus, and what is not good — need we ask anyone to tell us these things? ~ Zen and the Art of Motorcycle Maintenance


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

 

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Altostrata

You're doing a very good job of answering questions.

 

13 hours ago, cathnz said:

One was early Aug, from memory, about 2 or 3 weeks after the switch (this was the time off the  event when I locked myself in bathroom terrified). I was suicidal, restless, buzzing and terrified.

The other event was the week in early October where they reduced the benzo 'to see how the 45mg looked without the benzo masking things. Again, I was suicidal, restless, buzzing and terrified.

 

Well, this is Paxil withdrawal syndrome. The buzzing is the symptom called paresthesia. The benzo was masking the symptoms --- which is the benefit of taking them. Why did they take the benzo away entirely?

 

Going on and off drugs can make adverse reactions progressively worse -- this is called "kindling."

 

Are you feeling any benefit from the magnesium you're taking?


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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cathnz
7 hours ago, Shep said:

 

 

 

 

Cath, you need to eat. Low blood sugar from not eating can cause panic attacks and high anxiety. 

 

When did the nausea start? 

 

@Shep Nausea has always been one of my most common anxiety symptons. For decades. I lost 20kg in 6 months last year (starting even before med switch) due to loss of appetite /nausea because of anxiety. Its not new.

 

But yes, you're right I know. I'm my own worst enemy when it comes to food and water. I'll make a concerted effort now that I'm at home for unforeseen future.  

 

The diary entry I'm about to post from yesterday is the same, but going forward from today, I'll make it a focus to eat even if I don't feel like it. 

 

 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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cathnz
2 hours ago, Altostrata said:

You're doing a very good job of answering questions.

 

 

Well, this is Paxil withdrawal syndrome. The buzzing is the symptom called paresthesia. The benzo was masking the symptoms --- which is the benefit of taking them. Why did they take the benzo away entirely?

 

Going on and off drugs can make adverse reactions progressively worse -- this is called "kindling."

 

Are you feeling any benefit from the magnesium you're taking?

 

Hi @Altostrata,

 

You're doing a very good job of answering questions.

Thankyou. I'm trying very hard to be accurate. Its difficult sometimes to know what is fact and what is me being subjective. 

 

Why did they take the benzo away entirely?

They took me off the benzo completely because I had showed such resistance to going on them in the first place. I was scared to become reliant on them, so my physchiatrist promised me he'd only use them short term to get me 'over the hump'. He told me I could use them for 6 weeks before it would be an issue. Yes, I know now that was wrong, but at the time I trusted him. So they took me off so I wasn't left on them long term, as per my fear. I was stupid and naeve and like most here, wish I knew then what I know now. Ignorance was bliss back then though. 

 

Are you feeling any benefit from the magnesium you're taking?

I'm no longer taking Magnesium (I haven't taken for a few months). For some reason I am unable to edit my signature, so I haven't been able to take it off.

I stopped because a) I didn't notice any improvement and b) blood tests showed that my levels were in the slightly higher end of adequate range. Do you think I should try it again? Given my symptoms have got worse in the last month, perhaps it may now help? Is it something that can be specifically helpful for paraesthesia? Does it matter that my levels are high enough (although I dare say that the amount of stress I'm feeling now, I'm probably depleting my Magnesium levels!). 

 

I'm not taking any supplements at all at the moment. Even though I had low levels of b12, folate, iron, vit e, selenium (extremely low), and mitochondria, after my initial trial of starting things at low levels I got scared off at the first sign of feeling somewhat unwell. It was hard to know if the supplements were the actual cause though... I might have talked myself into it based on knowing others experiences? Or the worsening might have been nothing to do with the supps, and instead, was just my fear around covid isolation. But when things started getting worse (the intensity of the buzzing increasing, and the introduction of brain and teeth buzzing) I took no chances and stopped. I am concerned about my low levels though, as I have had extreme fatigue for about 2 years (so well before any of this started), and being fatigued is a major trigger of low mood and anxiety for me. But as you can see from my diary, I'm not eating or drinking enough, so I will make more of an effort going forward. 

Over the last month, I also tried 2 separate one off doses of fish oil. Both times, my symptoms seemed to get even worse within hours of the dose. This was very confusing, as I understand it to be helpful for most people. I may try again in the future, but just too scared to risk it right now. 

 

My toxin level came back EXTREMELY high too, and I must say, I do feel INCREDIBLY toxic. But I assume that there isn't something recommended for this? I do have some NAC here that was given to me for both my OCD and ruminating AND detox. I stopped after a few days because I thought it was causing diarrhoea. But in the month since, I've had days of terrible diahorea, so perhaps it wasn't that. Interestingly I had some IV myers cocktails several months ago (Dec 19), with  high magnesium and glutathione which I DIDN'T react to. And I understand NAC helps with glutathione, so perhaps it would be ok? Too scared to try now. But I definitely feel incredibly toxic (and kept saying this to my dr BEFORE we got those test results back). 

 

I'm sorry for the long message. I'm just trying to make sure I give you all the info I can to help you to help me. I hope it isn't too much to wade through. 

 

I am becoming increasingly scared. I have felt awful from the time of the med switch. But I thought I had a handle on what I was experiencing, and kept telling myself that with time, things can only n improve (as long as it wasn't BECAUSE of mirtazapine... I'm which case, the only cure will be to come off). But now that things are getting WORSE again, after 8 months, and I'm getting new and more scary symptoms (like head buzzing), I'm beginning to freak out that things will get even worse still. I know that this thinking is not helpful at all. And I'm trying my best to keep it in check. But thoughts of 'how much worse will this get' and catastrophising are creeping in. This is all so unpredictable. 

Does the fact that the sypmtoms have been present ALL DAY EVERYDAY since the switch, with no breaks, mean I have had zero windows yet? I don't understand how there have been no breaks in 8 months. It at times has got more intense then less intense, but never ever gone. Is this usual? 

 

Anyway, here is my dairy for yesterday... 

 

Wednesday 25th March

 

 

*5am - Woke up. Body buzzing with electricity as usual

 

*5.30am - Waves of nausea and slight panic

 

*7.30am - Diaorhea. Shaking.

 

*8am - Too anxious and nauseated to eat. Went to work for last day before Covid lockdown. 

 

*12.45pm - forced myself to eat. Had a capsicum and apple. Had a glass of water (first for the day). 

 

*4pm - Wave of increased brain buzzing and feels like it's on fire. 

 

*6.30pm - Dinner

 

*8pm - Trying to sit quietly and practise some mindfulness, but electrical buzzing in legs severely uncomfortable.

 

*8.45pm - Mirtazapine and bed. Legs buzzing intense. 

 

*Asleep by 10.30pm

 

 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata
1 hour ago, cathnz said:

My toxin level came back EXTREMELY high too, and I must say, I do feel INCREDIBLY toxic.

 

What toxin levels? How was this tested? Have you been exposed to high levels of toxins?

 

Generally, psychiatric drug withdrawal syndrome has nothing to do with toxins.

 

My guess is you are suffering from benzo withdrawal along with Paxil withdrawal. Taking a little bit of diazepam, perhaps 05.mg twice a day, may help. You can taper off by tiny amounts later.

 

Taking a little diazepam may enable you to reduce mirtazapine, but I do not think mirtazapine is causing your symptoms, though it is helping you sleep.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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cathnz
3 hours ago, Altostrata said:

 

What toxin levels? How was this tested? Have you been exposed to high levels of toxins?

 

Generally, psychiatric drug withdrawal syndrome has nothing to do with toxins.

 

My guess is you are suffering from benzo withdrawal along with Paxil withdrawal. Taking a little bit of diazepam, perhaps 05.mg twice a day, may help. You can taper off by tiny amounts later.

 

Taking a little diazepam may enable you to reduce mirtazapine, but I do not think mirtazapine is causing your symptoms, though it is helping you sleep.

 

@Altostrata 

What toxin levels? How was this tested? Have you been exposed to high levels of toxins?

I had extensive blood tests done about 2 months ago. Among other things, these showed toxin levels to be extremely elevated (but this particular test did not identify WHAT the toxins were). 

About 17 years ago I worked in a printing factory with chemicals. That's when I first became unwell. I've seemed to be extremely sensitive to chemicals since. I've only ever been able to tolerate low doses of meds (for example 15mg was the most I could ever tolerate of paroxetine... anything higher would cause symptoms similar to now, albiet to a lesser extent. This has only just dawned on me (having similar feelings on higher than 15mg paroxetine several years ago). 

 

Taking a little bit of diazepam, perhaps 05.mg twice a day, may help. You can taper off by tiny amounts later

Ok. Will need to work out the logistics of this as it's not an option I'd thought through. On 2/29 @Shep had advised me

"We generally don't recommend reinstating a benzo after you've been off for more than a month. And it's been 5 months since you were last on them. So the best path forward may be to cope as best you can and nurture your nervous system with as much self-care as possible. "

So this is an option I haven't got my head around, and one which I feel a bit scared about to be honest (introducing another med into my system) . I also don't know how I would even get any benzos... my physchiatrist will be hesitant to prescribe and given that our country is on lockdown they're only seeing extreme cases. I don't know if I'd get in.

But I'll give this some serious thought, so thank you for your advice. 

 

I'm not sure I can bring myself to taper Mirtazapine yet. I'm too scared to lose sleep. And destabilise my cns even more. I was hoping I could heal before I faced that, but also mindful of the fact that the Mirt might be the problem? But as you seem to think it's not, I'll bear that in mind. Infact I don't have the means to taper Mirt yet anyway. I don't have the equipment @brassmonkey told me to get (I need to order from overseas as I live in NZ). I wanted to wait until I was in a better place mentally and have done some more work with a physchologist. I'm also highly anxious at the moment due to covid, so questioned with myself if this was the best time to taper. What I did wonder though, was if infact infact it was better to get the ball rolling and start extremely slowly. A slowed down version of the brass monkey slide? I just don't know. If only we had a crystal ball aye. 


 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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Altostrata
16 hours ago, cathnz said:

I had extensive blood tests done about 2 months ago. Among other things, these showed toxin levels to be extremely elevated (but this particular test did not identify WHAT the toxins were). 

 

Who ordered the tests? If this was a naturopath's test for "toxins", you need more information. If you were exposed to actual toxins in the printing factory, these tests should be for specific toxins. If your toxin level was very high, I strongly recommend you speak to your medical doctor about this.

 

It could be you were sensitized by exposure to the chemicals. This is called Multiple Chemical Sensitivity, it heightens reactions to ordinary household chemicals as well.

 

17 hours ago, cathnz said:

"We generally don't recommend reinstating a benzo after you've been off for more than a month. And it's been 5 months since you were last on them. So the best path forward may be to cope as best you can and nurture your nervous system with as much self-care as possible. "

 

@Shep's advice is good. You are in a bind. Paroxetine is an extraordinarily difficult drug to come off and you are showing signs of activation.

 

Ordinarily, we might suggest reinstatement of a very small amount of fluoxetine to substitute for Paxil, but it's possible it will make the activation worse. You can hold on as best you can and allow your nervous system to settle down. You will have to be very patient and practice self-soothing.

 

On the other hand, a very small amount of diazepam might help resolve a combination of benzo and Paxil withdrawal. Do you have any diazepam left?

 

I have been told by a leading psychiatrist that psychiatrists perceive current events as an anxiety emergency and are being more lenient in prescribing anti-anxiety drugs for the time being.

 

If you need to decrease mirtazapine, you can use a liquid. This does not need a lot of equipment.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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