DD44: please help, currently on mirtazapine and gabapentin

[elbee]

21 hours ago, Altostrata said:

There are many ways the prescription can be written.

 

Alto presented many possible options here, DD44. It's up to you to decide what you think will work best for you.

[DD44]

I decided to just go with 7.49 

 

I should switch over on Jan 3

 

l keep everyone updated 

[DD44]

Will be switching tonight 

 

wanted to know if anyone had some encouraging words about flashbacks 

 

Iv done pretty good at blocking what happen to me in the summer (not sure if my Med assist that as i feel I just hardly ruminate -not like my former self) 

 

but now and then, I get a flashback. It feels like my memory of what took place is out of a horror movie that became my life.  It’s really scary and scaring. Want to know how to make peace with it and release it. I never knew a human could suffer so much... it breaks my heart honestly to think anyone should or could have to go through that Or anything similar ... I still have questions and doubts in my mind of what took place ... I thought I was dying ... its

just weighing on my heart a bit this morning... 

 

 

 

[elbee]

On 1/2/2020 at 8:00 AM, DD44 said:

wanted to know if anyone had some encouraging words about flashbacks . . . It’s really scary . . . Want to know how to make peace with it and release it.

 

Hi @DD44. I can't tell you what to do about this . . . I don't have all the answers and I don't think anyone does, but I have dealt with what you describe as part of my own WD / recovery process (memory flashbacks, emotional flashbacks, intense fear, horror, rumination, not my "self," indescribable pain, like I was dying, etc.).

 

I definitely believe the drugs and the withdrawal process have played a huge role in my experiencing these things that you describe. Some might say that what you are experiencing is completely a result of the standard withdrawal / taper process and that may very well be the case. These drugs are incredibly powerful and we still probably have very little idea about how truly profound and extensive the effects are of taking these drugs, nor about the effects of getting off of them. It is also true that the brain can heal in miraculous ways, and the slow taper seems to be the best way to get off these drugs, allowing the physical healing that needs to happen to take place. As you noted, even with the slow taper, this process can be incredibly scary. These drugs mess with our lived experience . . . our reality, and extricating them from our bodies (even slowly) is going to have very real effects on how we experience life . . . psychologically, emotionally, spiritually, etc. 

 

For me personally, I also believe that I experienced "wounding" in early life that affected me as grew into adulthood. And the psych drugs (supplemented with alcohol, caffeine and nicotine in my case) helped keep the inner distress that was stored from my childhood wounding "blocked" (both through stimulation/distraction and numbing processes) which is I why I took these substances in the first place. But over the years, this turned out to be a temporary "solution" because just as our brains can change to heal, our brains also change to adapt to having the drugs our system, and we build "tolerance." Unfortunately, this insidious process takes us to a place many of us find ourselves in now . . . still with whatever unhealed wounds we carry, but now also "addicted" to chemical substances and overwhelmed with a bunch of unhelpful adaptive behaviors.

 

This is another reason I think the slow taper off these drugs is SO important. As I withdrew from the drugs, that which was "blocked" (my original wounding) re-surfaced, and I needed to go slowly in the recovery process to allow that which needed to arise, to arise (and ultimately be healed and released). It is MY opinion that my recovery experience included both a process of physical transformation as I slowly tapered the drugs from my system, as well as a process of gradually learning to stop and "sit" with that from which I had been running my whole life. I needed to learn how to become "more comfortable with discomfort." AND, I needed to learn to engage in self-care in ways that I had never done before . . . in ways I didn't learn to do as a kid. Yes, some of this is very much about physical self-care, and as you continue to "tune-in" to your body, you will learn these skills. But for me, it has also involved emotional self-care . . . connecting to the most vulnerable parts of myself (some call this an inner child) and being a "loving parent" to that part of me that wasn't parented with enough unconditional love when I was young. This is how I have been "making peace" with my early wounds and more generally, "releasing" that which no longer serves me.

 

I of course did what I could do to minimize the negative effects of the psych drug withdrawal, and a large part of this was to go through the process SLOWLY. But, I also learned to connect with the parts of myself that were so scared . . . to put the face of a child on that fear (a younger version of me) and approach that part of me with a loving presence instead of the harsh critical tone that has driven me most of my life. This has not been fast. It has not been easy. But it has been transformative. And as my "inner world" has become more safe and nurturing, I'm more able to bring that sense of safety and connection to my "outer world," too. 

 

Hang in there and go gently 

[DD44]

@Altostrata @elbee @Shep

 

So I’m now at 3 Evenings of the 7.4 (that’s the closest they could make) and I don’t feel it’s going too well. The first two nights were soso and I though I was going to push through and my body would adjust (this is all related to getting rest- I have no other symptoms) but last night was a 0 night. This is something I cannot tolerate. I’m making a lot of money now, I have so many things going well in life. I still want to begin this process but I cannot tolerate 0 nights as I know that can send me somewhere very bad Very quickly. I’m not sure where to go from here. I don’t understand how it’s possible that my body is that sensitive to .1 of this med. might it be the compound? Should I try a liquid or should I try measuring my own at home? I don’t like how I feel like the grip of this thing is so tight. All I want to know is that I have to power to reduce - no matter how sow I need to go. But feeling like a .1 different gave me a 0 night where I canceled an appointment this morning - that just doesn’t work for me. At this point I would really like to believe it’s the compound and not the .1 change. If I’m to believe that .1 would throw me off this bad I feel just really trapped and lost on this journey. Sorry I’m just a little frustrated- please let me know what you think I can do. On thing I thought of was I mention that the 7.5s are very hard to break down - when I first began this Med in 2018 I was given 15mg which were easier to scratch a little off at a time. That’s what I did without measuring anything when I attempted to get off and of course by May of 2019 my life was a disaster. Anyhow I’m fairly certain I’m going back to my 7.5 this evening- I’m not willing to gamble 0 nights ....

[elbee]

17 minutes ago, DD44 said:

I’m making a lot of money now, I have so many things going well in life. I still want to begin this process but I cannot tolerate 0 nights as I know that can send me somewhere very bad Very quickly.

 

@DD44 Doing a med taper like this requires that you experience some discomfort and some not knowing. For most who find their way to this website, the taper will not be a pain free process. Most likely, your sleep will begin to normalize with more time. Experience on this website shows that this is almost always the case. Working with the anxiety and frustration that arise, and finding ways to do self-care and to self-sooth is part of the healing process. But no one can tell you with certainty how you will react to any part of the withdrawal process, or in this case, how long or to what extent your sleep will be disrupted. And yes, this is scary.

 

23 minutes ago, DD44 said:

I don’t understand how it’s possible that my body is that sensitive to .1 of this med

 

As hard as it may be to believe, this very much seems to be the case for many. 

 

18 minutes ago, DD44 said:

Anyhow I’m fairly certain I’m going back to my 7.5 this evening

 

If you feel things are going well for you in life as they are right now and that you are unable to go through withdrawal symptoms as they present themselves, then it may not be time for you to do this taper. Only you can make the call.

 

[DD44]

@elbee

i understand that some discomfort is part of the process - but going from full nights to 0 nights doesn’t seem like “some discomfort” I could completely handle waking multiple times, waking too early, etc - but 0 nights make my physical health and my mental health go down the gutter quick. What I’m saying is it doesn’t make sense to me that a .1 decrease would change things from full nights to 0 nights. 
I’m  just trying to figure out if it’s the compound itself? I’m willing to deal with discomfort, but multiple 0 nights makes me non functional. If the goal is to have a no harm or a low harm taper then the goal would be to get to a place where sure when I make a drop I feel some discomfort but not that my life runs the risk of falling apart. Sorry I’m just extremely frustrated. 

[elbee]

@DD44 I have struggled with sleep my whole life too, so I know the effects of not sleeping, and how scary and frustrating sleep deprivation can be. I have gone to "those scary places" many, many times. I have had to do a lot of work on sleep hygiene, sleep routines, evening routines, morning routines, etc. I have discovered that how authentically I live my life each day effects my sleep. I have had to do a lot of work on managing fears and anxiety when I haven't had enough sleep, and finding techniques to do that. Sleep for me, like it sounds like for you, has been a "measurement tool" for how "good or bad" I'm doing. If I'm not able to sleep, I'm doing "bad" and things are "bad" and I spiral from there. For me, my FEAR of not sleeping has played a huge roles in my not sleeping. If this is the case for you, then generally speaking, making any change that you are fearful of will effect your sleep. So yes, part of the issue seems to be that some of us have become incredibly sensitized to getting off these drugs. And part of your issue is probably your fear of not knowing what's involved as you would taper to get off of them. 

 

The good news is that by doing the slow taper, we not only give our brains a chance to physically heal, but we also give ourselves time to adjust to the various fears and discomfort that arise. Aside from generally known "sleep hygiene" tools, I developed a whole host of self-care tools that I can do when I can't sleep (gentle stretching, journaling, listening to quiet guided visualizations online, reading "light fiction" books, etc.). With time, these things began to work. In the process of developing them, they oftentimes didn't. And when they didn't, I needed to work with the fear and frustration that arose from them not working. I thought the drugs were a silver bullet, until I discovered that the "quick fixes" came with huge costs. So I had to stop looking for "sliver bullets" to ease my discomfort and turn instead to self-care.

 

Today, I am 100% drug free, and my sleep is generally pretty good, but I still work on it each day. I can't tell you what to do, or what will happen as you might go through the slow taper process. I can simply share my own experience. You have to make the call on this stuff, no one else can tell you what the best way forward is for you.

[DD44]

So o guess Iv decided to go back to my 7.5

 

i have a lot going on and I don’t feel comfortable just waiting things out. After last night I felt like total crap today and I don’t want to feel like this

 

im wondering if I could/should try liquid with this compounding pharmacy before I throw in the towel and figure out how I’ll do this at home with my own tapering tools which I really prefer not to have to mess with but I’m willing to do whatever I have to do 

 

the only thing I’m not willing to do is have multiple 0 nights in a week... I’m not sure where things will go from here but I’m really determined while wanting to maintain my life and happiness ...

 

[elbee]

12 hours ago, DD44 said:

I’m really determined while wanting to maintain my life and happiness

 

Yup, it seems this is the inner conflict you are struggling with.

[elbee]

@DD44 The taper is a slow, methodical process of healing and desensitization that we commit to. It takes time and patience, and some gentleness which is something that can feel foreign to many of us. If you're unable to stay with the shift / drop you did to 7.4, then yes, it makes sense to reinstate. You might stay at that does for a few weeks, then try again and see how it goes. I think the focus on self-care for you will be with your sleep, and finding things you can do to take care of yourself in that area. During the tapering process, self-care becomes the replacement for the drugs. When you do a drop and your sleep is affected, that is the opportunity to listen to your body, try some new things, and discover what works for you . . . what YOU need to be able to sleep. If it gets too difficult, the protocol is to reinstate to the previous dose (or up slightly but less than the previous dose) and hold . . . then try it again.

[DD44]

@elbee @Altostrata

its my suspicion that it’s a issue with the compound and not the dose reduction 

 

I say this because I personally feel as though that yes I may feel a change from 7.5 to 7.4 it doesn’t nor make sense that 7.5 would yield me full nights (When I switched back over two nights ago I went right back to full nights) and 7.4 would drop me down to 0 nights. That’s why I’m trying to say to myself this sounds more an issue with the compound itself and not a change in .1. Basically I’m saying you would think 7.4 would yield me something. Of course I could be wrong, but I’m just trying to use logic. 
 

my next step I thought would be to try the liquid from the compounding pharmacy and see if that works. 
 

feel free to share anyone what they think of all this 

 

 

[DD44]

And to add

7.5 puts me down for nearly 9 hours 

my hope would be a lower dose could help me shorten it up a little 

[elbee]

@DD44 Yes you could try a liquid from the compounding pharmacy, or you could make your own liquid, in which case you know it would be exactly what it is you are currently taking, just a does change:

 

 

[DD44]

ill be discussing getting liquid from the compounding pharmacy with my psych thursday. any tips or things to remember to talk about are welcome.

 

thanks guys.... hope this works out soon. 

[elbee]

Hi @DD44. How did the talk with your psych about the liquid go?

[DD44]

@elbee @Shep @Altostrata

 

i tried 7.5 liquid last night and it felt like almost a 0 night. I’m becoming really concerned, discouraged, worried...

 

the compounding pharmacy said they make some type of oil, this would be my last option with them before I would have to try making my own things at home. 
I really need some guidance here. I just want to feel like I’m in control and making some progress on starting w taper no matter how slow. ...

 

please advise - thanks 

[elbee]

 

 

On 1/6/2020 at 11:04 AM, elbee said:

Doing a med taper like this requires that you experience some discomfort and some not knowing. For most who find their way to this website, the taper will not be a pain free process. Most likely, your sleep will begin to normalize with more time. Experience on this website shows that this is almost always the case. Working with the anxiety and frustration that arise, and finding ways to do self-care and to self-sooth is part of the healing process. But no one can tell you with certainty how you will react to any part of the withdrawal process, or in this case, how long or to what extent your sleep will be disrupted. And yes, this is scary.

 

On 1/6/2020 at 11:50 AM, elbee said:

I have struggled with sleep my whole life too, so I know the effects of not sleeping, and how scary and frustrating sleep deprivation can be. I have gone to "those scary places" many, many times. I have had to do a lot of work on sleep hygiene, sleep routines, evening routines, morning routines, etc. I have discovered that how authentically I live my life each day effects my sleep. I have had to do a lot of work on managing fears and anxiety when I haven't had enough sleep, and finding techniques to do that. Sleep for me, like it sounds like for you, has been a "measurement tool" for how "good or bad" I'm doing. If I'm not able to sleep, I'm doing "bad" and things are "bad" and I spiral from there. For me, my FEAR of not sleeping has played a huge roles in my not sleeping. If this is the case for you, then generally speaking, making any change that you are fearful of will effect your sleep. So yes, part of the issue seems to be that some of us have become incredibly sensitized to getting off these drugs. And part of your issue is probably your fear of not knowing what's involved as you would taper to get off of them. 

 

41 minutes ago, DD44 said:

I just want to feel like I’m in control

 

Most likely, you will need to experience the fears and other discomfort associated with releasing some control in this tapering process. As I have described above in my own experience, this is what I had to do. As I also described in my experience, after each change I made that produced "unacceptable" consequences, those consequences would eventually subside and my life would "normalize." As long as NOT experiencing "0 nights" are a control requirement for you in your tapering process, then most likely it will arise as a barrier with any of the changes you would make in your process.

[DD44]

@elbee

 

i don’t know. As iv said before I’m willing to deal with some discomfort 

 

but 0 nights isn’t just “discomfort” 

 

it creates a very risky situation for me. 
 

my expectations were to experience some disruption in my ability to  Get rest but not a total absence.... I don’t know. I’m fine with disruption but it disappearing seems a little unusual. Again that’s why I keep trying different formulas because I don’t see how simply going from 7.5 pill to 7.5 liquid (same dose) would just make it disappear... 

I’m also most certain that if I decided to simply scratch a little bit off of my 7.5 pill- it would not result the same as what happen last night 

[elbee]

35 minutes ago, DD44 said:

I’m also most certain that if I decided to simply scratch a little bit off of my 7.5 pill- it would not result the same as what happen last night 

 

Then maybe start scratching and see how it goes? That's what I did. I got a mg scale and started scratching at my pills with a razor. I basically did that with incremental reductions over 3.5 years until I got to zero. That was my taper.

[DD44]

What did you use to scratch? My pills are rather hard so I am also considering using a pill grinder and then measuring and inserting into a capsule. All options worth a try. 
 

the scratch method I guess Gave me  bad memories since that’s what I did in fall 2018 (went from 15mg to 0mg by May 2019) and by May I was a total mess. The difference is I went to fasts obviously - Didn’t measure a thing, didn’t see the warning signs and wasnt informed.

 

im coming into it now with better awareness 

[elbee]

22 hours ago, DD44 said:

What did you use to scratch?

 

22 hours ago, elbee said:

I got a mg scale and started scratching at my pills with a razor.

 

[DD44]

@elbee so did you weight pills after scratch? How did you go about deciding how much to scratch off...

 

were you able to succeed in a minimal harm taper? 
 

no one else seems to be responding anymore while I’m at this difficult juncture... wish I could just get on the road 

[DD44]

I guess what I’m trying to figure out is 

if I decide to grind the pill down myself and then measure a new amount how do I calculate that measurement 

 

I know my pills weigh .80 of a milligram(I think) so if they weight .80 and they contain 7.5 mg of mirt, how would I calculate say taking .2 away ? 

[elbee]

@DD44, I used the word "scratch" figuratively. Yes, I did got off the drugs I had been on for 25 years very much using the protocol of this website, "cutting" 10% reductions from the current dose every 4-6 weeks (thought I pushed it at times). I also did some micro tapering along the way, but basically I did what this site suggested be done. For more details, you can read my introduction thread: https://www.survivingantidepressants.org/topic/11862-elbee-25-years-of-meds/

 

Like you, I didn't think it could work. I thought somehow I was more "broken" than others. It was incredibly uncomfortable at times, and I replaced the drugs by doing lots of "internal work" and learning and committing to self-care in ways that I never understood before. I'm almost a year completely off the drugs, and it while I know I'm still experience some effects from the withdrawal, it's clear to me now I've reached the others side. The process was not at all easy, but this protocol worked for me. 

 

 

 

[DD44]

I’m willing to go as slow as I need to let my brain recover and catch up. I refute to bring myself back to the hell I experienced in the summer. No one should ever have to suffer that way 

 

just tying to figure out my calculations ... hoping grinding a pill and measuring could work for me so then I could make a months worth And not worry until next month 

[elbee]

Yes, I "shaved" off enough of the pill to cut it to the dose I needed (using a scale something like this: https://www.amazon.com/Homgeek-Milligram-Calibration-Tweezers-Weighing/dp/B071GYVQF3)  then threw away what I didn't need. Or there would were times when the reductions got smaller, and I would cut a pill into several pieces, trim it, and get it to the weight I needed. 

[DD44]

@elbee

 

i guess I didn’t realize that a razor could be so precise 

 

my pills are so small are hard that if you try to cut them I feel like you can end up cutting too much or not enough .... that’s why I wondered if grinding and weighing might be better 

 

although grinding does pose the risk of not working out since compounding has seemed to be a issue for me 

[DD44]

I already have that exact scale 

need to know what to cut it with 

what type of razor I guess 

[elbee]

I just tried to keep it simple, used a weekly pill storage box, and on Sundays I would cut my pills and get them setup for the week. Yes, you could conceivably grind up the whole pill I suppose and pull out what you need. But at least to get started, I would just cut a little off the pill with a razor. It's really pretty easy. I just used a standard razor blade, bought a pack of a few of them. And you just nick off a little of the pill, and weight it. If you need to nick off more, you do that. If you went over, you set the pill aside and save it until you reach a lower taper.

 

You will need to know the difference between milligrams of pill weight (mgpw) and milligrams of active ingredient (mgai). The first is the measurement of how much the pill actually weighs when you set it on the scale. The second is how many milligrams of active ingredient are in the pill. Your remeron is 7.5 mgai. When you put the pill on the scale, you can determine how much the pill actually weights (mgpw). This can seem scary for some, but calculations are based on a simple ratio between mgai and mgpw.

Edited January 28, 2020 by elbee

[elbee]

https://www.uline.com/Product/Detail/H-595B/Utility-Knives-and-Cutters/Replacement-Blades-for-H-595-H-5838-or-H-1001

 

[DD44]

@elbee 

 

my guess is your mirt mig he have looked different than mine 

 

mine had a coating on it currently, which is why I wonder about “knicking” it as you say but it’s worth a try.

 

do you have the formula to know active ingredient? If my pill weights .80 of a milligram and is 7.5 how do I calculate active ingredient?

[DD44]

Also you said you had discomfort 

 

could you have gone slower to reduce that?

 

my discomfort all revolves around one thing ... 

unfortunately that thing is still very sensitive. My goal is for that to not be highly disrupted. Right now I’m down from 12a to almost 9a / 10a , I would welcome being more alert at say 7/8am, but anything beyond that to me would be a signal that I’m going too fast ... just thoughts 

[elbee]

I don't remember about the remeron having a coating, but my zoloft did. The coating probably doesn't have any active ingredient in it, so it just means at the beginning I might actually be cutting ever so slightly less than I would be if it had no coating. Not a problem reducing less, right?

 

Here is a link to a spreadsheet to help you calculate your taper . . .

 

https://www.survivingantidepressants.org/topic/9167-how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators/?tab=comments#comment-110736

 

There are other resources available on this site if you want to calculate on your own by hand.

 

Edited January 28, 2020 by elbee

[Altostrata]

DD, in what form was that 7.4mg? Was it a compounded capsule?

 

Were you already anxious about it when you went to bed? You seem to be a person who is very concerned about details. Would you say you're a perfectionist? Do you have a tendency to health anxiety?

 

You might do well to learn these techniques:

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

Health anxiety, hypochondria, and obsession with symptoms

 

 

[DD44]

No, I think I went to bed very optimistic 

 

admittedly either my Med or myself (talk therapy, making a lot more money, and getting my rest) Iv had almost no anxiety 

 

I do like details but I’m expectation was to go to 7.4 with no problem 

 

It was a capsule compounded from a pill

 

i did have tremendous health anxiety during the summer when my health was completely out of control for what seemed like no reason. You may remember my symptoms were pretty all over the place. I still to this day feel like I can’t be sure what the true cause was. Total lack of rest, rapid weight loss, all kinds of stuff, anyone would think something is very wrong. It’s kind of a mystery to me