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cathnz: tapering off Remeron / mirtazapine

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cathnz

@Altostrata as per above message, I'm not taking any other meds, drugs, or supplements of any kind and haven't for many many months. I have made no changes to meds in 8 months and no changes to supplements in about 3 months.

 

I will do the symptom diary, although it will look exactly as per the ones I've done above in the past - my routine hasn't changed and nor has the occurance of the symptoms... they're now just more intense. There is no time of day that is consistently better or worse. But I will restart symptom logging again. 


 

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
23 hours ago, cathnz said:

Which brings me back to the question... could this actually be caused by the 'new' med Mirtazapine (it began happening within 3 weeks after the switch). Seeing as things are getting worse, not better, with time, could this be the Mirtazapine building up and making me sicker? If so, how on earth will I face a taper when I'm already so unstable?? My depression and anxiety is the most severe its been in 17 years - its on par with how bad I was before I was ever put on meds (the severity of which lead me to meds in the first place). If it IS the Mirtazapine causing the akathisia, if I continuing holding to let my cns settle more before tapering, can staying on the offending med increase the chances of this being permanent? 

 

What is the "new" mirtazapine? Did you switch brands?

 

Looking back over your topic, you seemed to say the symptoms got worse after you took mirtazapine. Is this so, or is there no difference after you take mirtazpine?

 

From your signature:

Quote

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

 

It could be 30mg mirtazapine has become too much for you as well. Have you tried a 10% decrease since October?

 


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:

 

What is the "new" mirtazapine? Did you switch brands?

 

Looking back over your topic, you seemed to say the symptoms got worse after you took mirtazapine. Is this so, or is there no difference after you take mirtazpine?

 

From your signature:

 

It could be 30mg mirtazapine has become too much for you as well. Have you tried a 10% decrease since October?

 

@Altostratathank you. Sorry, my term 'new' Mirtazapine was misleading. It's been the same Mirtazapine (and brand) the entire time since the switch. I just meant 'new' in the context of the med they changed me to after the Paxil pooped out. So I've been on Mirtazapine for 10 months and on this current dose for 8 months.

 

I haven't tried reducing since October. I thought my system was too destabilised from the Paxil switch and then the abrupt sessation of the benzo in Oct. So I got too scared to try incase I destabilised further. I've kept waiting and waiting to stabilise, but it hasn't happened. And people's horror stories of even microtapers destabilising them scared me from trying. 

 

But it's getting to the point where I'm concerned of I don't take action, things might progressively get worse and irrepairable. I have thought about starting to reduce at a rate of 1% each week or two to try to avoid issues, but given that I experienced akathisia even on the 15mg they started me on (I just didn't know it at the time), it's going to be a long road down to get relief below 15mg if I'm doing it in 1% increments. On the flip side, maybe starting at 10% then slowing the rate down as I go lower might be the better option. I feel like a startled deer in the headlights not knowing what to do without worsening my depression and akathisia.

 

The akathisia I'm experiencing now is probably on par again with when it was bad on the 45mg back in Oct... the only difference being now is that I'm pulling every resource I can not to panic so that further meds don't get thrown at me. 


 

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 would try a 10% reduction of mirtazapine. If the symptoms reduce, you're having an adverse reaction to mirtazapine, though it may be helping you sleep.

 

Please let us know how you're doing.


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
4 hours ago, Altostrata said:

I would try a 10% reduction of mirtazapine. If the symptoms reduce, you're having an adverse reaction to mirtazapine, though it may be helping you sleep.

 

Please let us know how you're doing.

Thanks @Altostrata.

 

Re the reducing by 10%... does it matter if I make a liquid or use scales and dry cut? And once I've made the cut, if things start going south, how long should I ride it out  to see if things settle? Is it better to reinstate at the first sign of trouble, or wait? If I had to reinstate, would it be the full 10% or just a smaller amount. I know these are all 'what ifs'... I just want to be prepared while I'm in my rig mind, and give my plan to my husband. I don't want to make any stupid knee jerk decisions that I'll regret later. 

 

One more thing, in your experience, can a brain that feels on fire be an adverse reaction too, or does that sound like wd. That started later in the peice... maybe back in January. I wondered if that was some sort of protracted issue with coming off the benzo quickly in Oct. 

 

 


 

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 6/3/2020 at 1:49 PM, cathnz said:

Thanks @Altostrata.

 

Re the reducing by 10%... does it matter if I make a liquid or use scales and dry cut? And once I've made the cut, if things start going south, how long should I ride it out  to see if things settle? Is it better to reinstate at the first sign of trouble, or wait? If I had to reinstate, would it be the full 10% or just a smaller amount. I know these are all 'what ifs'... I just want to be prepared while I'm in my rig mind, and give my plan to my husband. I don't want to make any stupid knee jerk decisions that I'll regret later. 

 

One more thing, in your experience, can a brain that feels on fire be an adverse reaction too, or does that sound like wd. That started later in the peice... maybe back in January. I wondered if that was some sort of protracted issue with coming off the benzo quickly in Oct. 

 

 

@Shep @brassmonkey... I'm not sure if @Altostratasaw my message above. Are you guys able to shed some light please? 


 

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

Have you read this Tips for tapering off Remeron (mirtazapine)

 

After you make a reduction, you observe for a while. What you do next depends on the symptoms, if any, you get. Please let us know how you're doing.

 

On 6/2/2020 at 6:49 PM, cathnz said:

One more thing, in your experience, can a brain that feels on fire be an adverse reaction too, or does that sound like wd. That started later in the peice... maybe back in January.

 

Did anything happen in December, skipped doses or antibiotics or a glass of wine to celebrate?


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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Mimi79

Hi @cathnz ,

I don’t know if you’re still coming on SA, but I just wanted to know how is going your taper?

I would like to start my remeron taper and I want to have some insight from people who are in the process.

 

Thank you and hope you are doing well...

 

Mimi79


Oct 2007 - aug 2008: Mirtazapine (for insomnia). Tapered from march until august 2008.

Sept 2008 - Anxiety relapse, so been put on 20mg Celexa - tapered from feb 2009 until august 2010. Dec 2009-Sept 2010: Celexa, Cymbalta. Quit C/T both.

Sept 2010 - Jan 2015: Paxil 20mg.  Jan 2015 - Paxil Poop-out so tapered very fast (over 3 weeks) then switched to 30mg mirtazapine.  Suffered very bad w/d symptoms for

                    3  months. March 2015 - Mirt didn't work so switched to 100mg Pristiq.

April 2015 to oct 2018 : Mirtazapine 30mg + Pristiq 50mg. March 2018 to Dec 2018: Tapered Pristiq (by switching to effexor) and updosed Mirtazapine to 45mg.

June 2019: Adverse reaction to short use of Zopiclone (1 week use). GP put me on Zoloft 50mg. Adverse reaction to Zoloft so stopped it after 10 days.

June 2019-aug 2019: Fast taper of Mirtazapine, sept 2019 hit bad W/D symptoms, so updosed to 45mg. GP put me on 10mg Lexapro, C/T after 4 weeks.

Dec 2019-Jan 2020: Tapered Mirtazapine (45mg down to 37.5mg), but end of january, hit a wall of symptoms, so updose again to 45mg Mirtazapine.

Feb 2020: GP added 50mg SeroquelXR and upped Mirtazapine to 52.5mg. Stopped SeroquelXR after 2 weeks.

21 Feb 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

Seroquel 25mg on and off to help sleep, since may 2019. Ativan 0,5mg PRN, since oct 2019.  Early march '20, stopped both seroquel and ativan.

Supplements: Magnesium Glycinate, Omega-3, B complex vit., D vit. 1000UI. Melatonin, probiotic.

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cathnz
4 hours ago, Mimi79 said:

Hi @cathnz ,

I don’t know if you’re still coming on SA, but I just wanted to know how is going your taper?

I would like to start my remeron taper and I want to have some insight from people who are in the process.

 

Thank you and hope you are doing well...

 

Mimi79

 Hi @Mimi79,

 

Thanks for the message. No I haven't started my taper yet. I was still destabilised from stopping Paxil, and since then my mother has been diagnosed with Alzheimer's and I'm crippled with grief. I didn't think it wise to push a taper with all that. 

 

It scares me that I'll still be on this crap, and scared I'll hit tolerance and be forced off uncomfortably, but I just don't know what to do. Sitting tight seems the lesser of the 2 evils right now. Dealing with this grief is pretty emense. 

 

@Altostrata  @brassmonkey @Shep do you think I'm doing the right thing? 


 

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.

 

Untitled document.docx

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Mimi79

Oh dear Cathnz,

I’m so sorry for your mother. Life can bring us big challenges along the way, even if we are stuck with this WD thing...

 

I think you are doing the good thing, especially if you are stabilizing now. Did your symptoms have improved a lot since last spring? 
 

It’s not an easy ride and we are clueless of what we have to do. The biggest challenge of all our life.


Take care!

 

Mimi79

 

 

 


Oct 2007 - aug 2008: Mirtazapine (for insomnia). Tapered from march until august 2008.

Sept 2008 - Anxiety relapse, so been put on 20mg Celexa - tapered from feb 2009 until august 2010. Dec 2009-Sept 2010: Celexa, Cymbalta. Quit C/T both.

Sept 2010 - Jan 2015: Paxil 20mg.  Jan 2015 - Paxil Poop-out so tapered very fast (over 3 weeks) then switched to 30mg mirtazapine.  Suffered very bad w/d symptoms for

                    3  months. March 2015 - Mirt didn't work so switched to 100mg Pristiq.

April 2015 to oct 2018 : Mirtazapine 30mg + Pristiq 50mg. March 2018 to Dec 2018: Tapered Pristiq (by switching to effexor) and updosed Mirtazapine to 45mg.

June 2019: Adverse reaction to short use of Zopiclone (1 week use). GP put me on Zoloft 50mg. Adverse reaction to Zoloft so stopped it after 10 days.

June 2019-aug 2019: Fast taper of Mirtazapine, sept 2019 hit bad W/D symptoms, so updosed to 45mg. GP put me on 10mg Lexapro, C/T after 4 weeks.

Dec 2019-Jan 2020: Tapered Mirtazapine (45mg down to 37.5mg), but end of january, hit a wall of symptoms, so updose again to 45mg Mirtazapine.

Feb 2020: GP added 50mg SeroquelXR and upped Mirtazapine to 52.5mg. Stopped SeroquelXR after 2 weeks.

21 Feb 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

Seroquel 25mg on and off to help sleep, since may 2019. Ativan 0,5mg PRN, since oct 2019.  Early march '20, stopped both seroquel and ativan.

Supplements: Magnesium Glycinate, Omega-3, B complex vit., D vit. 1000UI. Melatonin, probiotic.

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cathnz
9 hours ago, Mimi79 said:

Oh dear Cathnz,

I’m so sorry for your mother. Life can bring us big challenges along the way, even if we are stuck with this WD thing...

 

I think you are doing the good thing, especially if you are stabilizing now. Did your symptoms have improved a lot since last spring? 
 

It’s not an easy ride and we are clueless of what we have to do. The biggest challenge of all our life.


Take care!

 

Mimi79

 

 

 

Thank you @Mimi79.

 

Have things improved? I'm not sure. Some days I think maybe. Other days maybe not. I don't think things have gone, I think perhaps I'm just getting used to them and they're my new normal. I'm not sure. 

 

I am however very scared of things getting worse if I don't get off. This beast I might have become accustomed to, but any worse, I'm not sure I could handle. 

 

Thank you for your message. Wishing healing for you x


 

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.

 

Untitled document.docx

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