Mike1972: tapering mirtazapine and gabapentin

[Mike1972]

Hi everyone,

 

Hey, first off -- found you guys after being referred by some fantastic individuals who are part of several Mirtazipine Withdrawal support groups on Facebook.

Thanks so much for this site!

As such -- AltoStrata, I've read a ton of your stuff already, in particular the posts about Windows/Waves, Mirtazipine tapering tips and, more crucially, the post about AD reinstatement (in the event of CT WD.)

 

Like everyone here, I have a somewhat unique story, with a bit of a twist....perhaps you guys will find it intriguing, at least. 

 

Anyway -- my experience with AD's is actually fairly short, relatively (only the last year).

After a successful cervical disc replacement surgery in July of 2018, I was told by several medical doctors that B vitamins were excellent for nerve regrowth/regeneration.

Since I'd had badly pinched nerves prior to the surgery, I took them up on this advice and began to take a chewable B-complex vitamin every day....which turned out to be extraordinarily high potency.

Within two weeks, I was developing strong painful tingling/stinging in my hands.....and after about five or six weeks, I had developed full-blown head-to-toe neuropathy --- all as a result of what turned out to be an overdose of Vitamin B6. (If you want an interesting read, look up "Vitamin B6 Toxicity"...)

 

I DC'd the vitamins immediately, once it was determined what the issue was, but that was just the beginning of a long ride.

Shortly after the vitamins were discontinued, the nerve pain symptoms actually got far worse, and I developed runaway panic attacks, as well as various autonomic nerve issues (tachycardia, insomnia) and bizarre nerve-related other issues (couldn't sense temperature properly, lost ability to sense where arms/legs are in space (proprioception), couldn't swallow properly, the list goes on....)

 

In any event, Starting last November of 2018, I was Rx'd a menagerie of medications by several doctors  (and these were all being taken concurrently!) to help with the burning nerve pain and also psychological trauma / insomnia issues.

 

In order: 

* Gabapentin (initially 400 mg / day, eventually peaked at 1200mg / day)

* Lexapro (10 mg / day)

* Clonazepam (1 mg / night)

* Mirtazipine (15 mg / night)

 

The next three months were hellish. I ran out of adjectives to describe the pain that coursed through seemingly every cell in my body.

But luckily....with time came healing. By Feburary I was well enough to return to work. I still can't quite believe what my body went through and was able to recover from.

 

With the nerve damage healing largely behind me, over the course of the next 7 months I slowly (and successfully) tapered off of three of the four medications, with little or no withdrawal (apart from perhaps a day or so of noticing I felt perhaps a bit "tense" after the last dose of each medication.)

In order of tapering:

* Tapered off from Clonazepam (last dose March 4, 2019)

* Tapered off from Lexapro (last dose July 8, 2019)

* Tapered off from Gabapentin (last dose September 24, 2019)

 

*** So here's where it all gets interesting (and relevant to this forum) --- ***

My plan was to follow a similar careful taper off from Mirtazipine....but fate intervened and a poor decision was made.

Ideally, I would have waited until after the upcoming holidays/New Year to do the taper from Mirtazipine....but after two late nights of being out to dinner with friends, I forgot to take my 15mg Mirtazipine two nights in a row. Once I realized what I'd done (two days later), I took a quick assessment of how I felt -- which was of course totally fine -- and I made the ill-informed decision to simply DC the Mirtazipine.

 

Now, I should mention that my Psychiatrist had told me that it was perfectly fine to simply DC Mirtazipine as well as Gabapentin (no surprise to this community, I am sure), but I had still insisted on doing a taper for everything. Why I didn't follow through and do a taper with Mirtazipine, I'll never be able to fully qualify....but it was surely a combination of eagerness to be done with this "one last simple med" and also the Psychiatrist's solid assertion that there was no need to taper with Mirtazipine.

 

AND OF COURSE -

- 11 days after DC'ing the Mirtazipine, I went into bad withdrawal.

Headaches, Gastric Upset, Insomnia, highly elevated heart rate, feeling of being totally "amped" as if I'd drank 3 pots of coffee, Panicked breathing ("air hunger"), all sorts of the stuff everyone here knows all too well.

- 7 days after that (a total of 18 days since DC'ing the Mirtazipine), I reinstated at 25% of my original 15mg dose, or 3.75mg.

 

A week later I felt quite a bit better. For several days I almost felt totally "normal" -- and sleep improved, heart rate went back down, things were on a solid track.

This continued for perhaps four or five days --- but then after a particularly stressful couple of days, it all seems to have reverted significantly backwards into five or six days now of feeling terrible and getting worse and worse sleep each night.

 

So here I am.

It's now been 20 days since I reinstated at 3.75mg (25% of original dose).....

.......and I'm wondering what the most logical (and intelligent) thing to do is now.

Ride this out?

Consider an up-dose at some point?

 

Thanks so much for your advice (and any criticism you wish to levy at me).

I am here to learn and hopefully one day to be part of helping here as well.

 

 

 

 

 

 

[Gridley]

Welcome to SA, Mike1972.  I'm sorry you're having to deal with these difficult symptoms.  

 

We recommend reinstating at a low dose, since your system has made some adjustments to the reduced dosage.  3.75mg might be right or it might be a little high.  The fact that you had around 11-12 good days is encouraging.  I wouldn't updose.  

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

How are your symptoms now compared to after you CT'd the Mirt?  

 

How do you feel after taking the 3.75mg?  Worse or better?

 

 

Edited November 24, 2019 by Gridley

[Mike1972]

Hi Gridley,

Thanks for your reply, and for your analysis that I probably should not updose.

 

To your questions:

1) My symptoms are overall better *now* than they were when I was in the peak of WD (which was around day 18 after I had CT'd....)

After I reinstated, I still felt positively awful for another two days.

But by the third day I was able to go back to work, and I felt my head clearing.

And one week after reinstating I finally realized that I felt pretty darn good. 

 

But then.....after I "felt good" for maybe four or five days....it all came crashing back down. 

Sleep fell apart again, my heart rate soared again, I had the dreaded return of the "air hunger" feeling of partially suffocating, headaches returned, stomach upset, physical feeling of anxiety, etc.

 

2) My apologies, but I'm not sure I totally understand your question, when you say "How do you feel after you take the 3.75mg?" -- 

(as in, do you mean how do I feel in general now that I've reinstated at 3.75mg?

Or....do you mean, how do I feel each day shortly after I've taken that day's dose of 3.75mg?)

I will attempt to answer both:

- In general I feel quite a bit better than I did when I was in the middle of peak WD symptoms. But that doesn't imply I feel great or even remotely good.

- Each day, after I take the 3.75mg dose, I go straight to bed (hoping it will help me sleep.) I don't notice any change in my overall symptoms or mood/anxiety after I take the 3.75mg.

 

You mention that it's encouraging that I had 11-12 "good days," and I'm curious how you're counting those --- are you referring to the 11 days that I felt good immediately following CT, before WD symptoms hit me?

Or....are you adding up days that I felt good after reinstating? By my measure, I would say that I've had maybe four or five of those. (In the 21 days since reinstating.) 

Still, I must readily acknowledge that I am subjectively better than I was prior to reinstating.

 

Among the many distressing symptoms of the initial WD was what I can only describe as "runaway thought loops" playing over and over in my mind. I had snippets of a couple songs from The Talking Heads that I positively COULD NOT get out of my head for about a week or more. That, thankfully, has gone away.

 

What I am left with at present is a collection of exhausting and deflating symptoms that include fragmented, terrible sleep/insomnia, frequent/regular "panicked breathing" or "air hunger," elevated heart rate, frequent stomach upset, frequent headache, frequent difficulty thinking clearly, waves of heavy/"icky" sadness that wash through me, random waves of resignation (that very little is worth putting energy into.), etc....though they do indeed come and go in waves. Some of these waves seem to last many, many days however....

 

I realize that the feelings that course through me are the result of a suddenly-miscalibrated CNS and its associated neuro-receptors/neurochemicals, so I'm able (thus far) to maintain a logical "keep marching and get through this!" attitude, but it is indeed overall exhausting (and the lack of sleep in particular makes everything feel worse/makes it harder to keep marching through all of this.)

 

Doing my best to eat right, avoid stimulants 100% (no coffee or alcohol), attempt sleep at a prudent, reasonable hour each evening, exercise regularly (doing a good 25 minutes of bike riding every day, minimum), have been working to locate and try to incorporate healing/supporting supplements/herbs into my daily routine, getting as many hugs from my girlfriend as possible, and I've been telling as much of my group of friends (and work-mates) exactly what I'm going through, working to maintain openness (and vulnerability) with the people around me that I feel I need to lean on for support and understanding. 

 

Wondering what else you might suggest that I might perhaps do (or expect, or proactively consider).

If I could at least find a way to sleep semi-decently/regularly, I think I could make my way through the rest of this awful forest somehow.

 

Thank you again so much.

 

 

 

 

 

[Gridley]

28 minutes ago, Mike1972 said:

To your questions:

 

Mike,

 

Yes, sleep is the thing and is perhaps the most common WDissue.

 

It's bedtime for me (very early, yes)  but I will answer your questions tomorrow.  Thanks for responding so compietely, which is very helpful.  I'm happy to help you through this to the best of my ability.  I have an appointment in the a.m. so it is likely it will be the afternoon before I get back to the computer.

 

Gridley

[Mike1972]

Ok Gridley, thank you so much!

Best / most appreciative regards. 

[Mike1972]

@Gridley, just checking back in with you (it's been about five days.) 

Hoping to get some more insight/guidance.

Thanks, Mike1972

[Altostrata]

Hello, Mike.

 

How are you measuring your 3.75mg mirtazapine dose? Are you taking it on a consistent schedule? Did you drink any alcohol in the last week or so?

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

[Mike1972]

Hi Altostrata,

Thanks so much for your reply....and for this website!

 

To your questions:

 

1) I'm still "pill cutting" to create my 3.75mg dose, haven't transitioned to creating a liquid titration of Mirtazipine yet.

(Though I have acquired all the equipment I need to do so.)

 

I know that the day-to-day dosage accuracy isn't the absolute greatest.

While I have as accurate a pill-cutter as I've been able to find (the EquaDose), that's still cutting a 15mg Mirtazipine tablet in four pieces....which by best reckoning (looking at the variance I see from one size piece to another) still means I'm varying as much as +/- an entire milligram or so from one day's dose to another. (One day might be 3.25...the next day's 4.25....maybe some days are closer to 3.75.....)

 

**I had been getting some advice that it's potentially advisable to wait until you're somewhat "stabilized" on a reinstatement dose before transitioning to a liquid titration, so I'd been holding off doing so for that reason. (Have heard that a person's CNS can respond differently to the liquid version (even made from the very same pill) when making that transition....I'm guessing this is because the finely-ground tablet particles in solution are absorbed faster than when a whole tablet dissolves slowly in the stomach?) Is this good advice to follow?

 

2) I haven't had any alcohol in the last week. (To that matter, I haven't had any alcohol since I first experienced withdrawal, which was over a month ago....and I was not a very regular or heavy drinker before that.)

I've also avoided all caffeine. (This was tough....I had previously been a three-to-five-cups-of-coffee-a-day person....and I stopped that cold-turkey as well, as soon as my Mirtazipine withdrawals kicked in....so I'm sure I endured a good several days of rough caffeine withdrawals on top of the Mirt withdrawals.....)

 

Thanks again Altostrata. 
(*I will work right away on creating my drug/withdrawal history in my signature now.)

[Mike1972]

Altostrata, I noticed I missed one of your questions in my previous reply to you:

 

I'm taking the 3.75mg dose every night before bed, as consistent a schedule as I can.

Trying to turn in around 10/10:30 each evening.

 

Full disclosure:  At the same time before bed that I take the Mirtazipine each evening: 

I am also taking 6mg of Melatonin (a timed-release version of it) as well as one 450mg capsule of Valerian root.

 

* I have been taking the Melatonin ever since my "rebound insomnia" hit (about a month ago now.)

* The Valerian root I added about one week ago....and this seemed to create a "tipping point" at which I started to get fuller nights of sleep.

 

[Mike1972]

Hi @gridley and @altostrata ,

 

First off --- I can't imagine the hours and effort that you all put in to help everyone on this website.

So I can't help but feel that I should apologize for asking for some attention....but it's been four days since the last response, and soooo....I'm going to sheepishly ask for some attention.

There! Haha, I did it. :)

 

In all seriousness --

Sincerely hoping that you might have some responses/thoughts with respect to the questions you asked me on Friday last week (and that I answered to the best of my ability in the previous two posts.)

 

Also wanted to give you an update - 

I feel like I may be moving a lot closer to "stabilizing" in this last week. 

The following list of improvements has me pretty happy about things, but I've experienced a number of windows/waves already in the last 5-6 weeks....so I won't be surprised or caught completely off guard if another wave does indeed hit.

 

Improvements: (for the last 4-5 days)
* Panicked "Air Hunger" type breathing is almost nonexistent

* Stomach pains / feeling of Nausea are resolved

* Appetite is normalized

* Brain Fog is gone

* Mood swings / sense of anxiety largely balanced out, though I feel frequently a bit jittery (like I had coffee on an empty stomach)

* Sleep is adequate (happens reliably, although with numerous wakings overnight that I *am* still able to go back to sleep from.) 

(currently taking the 450 capsule of Valerian root and 6mg of melatonin)

 

New, not-so-great thing:

* I am realizing that I've gotten frequently seriously irritable in the last week or so.

Small things can really set me off lately. (no worries, there's no violence or rage, but I do get perturbed and don't hold my tongue.....)

Have been told that this is not uncommon with Mirtazipine withdrawal....I'm hoping that's the case. I've said some uncharacteristically stern/impatient/harsh things to people in the last couple days. :(

 

My current thoughts:

If this perceived "stability" does indeed prove out to hold and be reliable going forward --- then  I had been planning to "hold" on this 3.75mg (pill-cutting) dose until *at minimum* sometime in January before attempting to do a proper taper.

 

Somewhere along the line it seems I should transition to home-made liquid titration (at the same dose), but again, not sure how I would perceive a wise juncture to do that.

 

Would you see that as a wise timeline? Or is that too soon to think about tapering (January), given the recent destabilization (via CT / reinstatement)?

How long is a good idea to wait after stabilizing, to begin to consider tapering?

 

Thanks you again so much for your time and compassion!!! 

Truly hope for some further guidance/advice.

Mike 

 

 

 

 

[Mike1972]

So it's been a good while since I last posted in here, and wanted to share some great news (brief!) and some not-so-great news (lengthy...)

I think I really need some help making sense of what seems to be happening to me.

 

First - the great:

I stabilized wonderfully on the 3.75mg of Mirtazipine!

Immense gratitude to all of you here for the guidance, and of course for Alto's immense experience and scientific understanding of this all!

I ended up holding at 3.75 for another four months after stabilizing, and then resuming tapering.

 

I fear, however, that emboldened by success with stabilizing, and equal success with the next few drops,  I may have made some subsequent drops that were too great in size, however....and then made a really dumb move, when not thinking as clearly as I should have.....

SO:

 

Second -- the not-so-great:

When I finally reached 3.00mg with the Mirtazipine, I decided to make my next drops in 0.50mg increments (as I'd handled the last couple of drops with little issue.) And so I dropped to 2.50mg. And I held there for a good month or so. And it was just fine, no issues apart from 2 nights of slight sleeplessness, no biggie. And so I dropped from 2.0 mg to 1.5mg......and then about 20 days later I made another drop to 1.0mg. 

I know these are small drops, mg-wise, but are progressively-larger giant drops from a %-age standpoint. Still, I though I could ride them out smoothly as I'd been doing so well. But in hindsight that was in total a 50% drop over the course of only 20 days.

 

Shortly after reaching 2.0mg, I started to get a pain in the back of my neck. I'd had neck surgery two years ago, so I figured I'd simply overworked it. Along with this neck pain came some nerve pain in my left pointer and middle fingers. I went to physical therapy and began exercising the neck muscles, and also began to take Sodium Naproxen (NSAID) 440mg. The neck pain (and nerve pain) refused to go away, however. So my Doctor suggested that I try Gabapentin again to "calm the nerves down" and see if that didn't remedy things. 

 

And so (having had such an easy time with Gabapentin tapering before last year, and forgetting completely that I was mid-taper on Mirtazipine, having just made some big drops %-age wise.....) ---

(you know where this is going....) -- I WENT BACK ON GABAPENTIN. 

 

The pain management doctor had me titrate up from 100mg/day to 600mg/day over the course of about a week. Along the way I noted that I was feeling muscle tension throughout a lot of my body, but it didn't seem that alarming a detail. BUT -- three days after I reached the 600mg/day mark, I suddenly felt a warm, electrical tingle sweep over my entire body, along with the sensation of tiny prickles and muscle twitches. It didn't let me sleep that night. 

 

I called the Dr. the next morning and described what I had felt/was feeling, and he agreed that it was a good idea to back off the dose (down to 400mg/day) immediately and see if that reduced (or eliminated) the weird buzzy warm tingle/twitching. And it did. That night, I slept great, not a single twitch or feeling of warmth or electrical tingle. 

 

So the next day, the Dr. decided to taper me back off from the Gabapentin right away. Having "not been on it for that long," he still advocated dropping by 100mg every third day, thus it would take me 12 days to taper back off. Really thought that could be the end of the problem. But, as with all things neuro-drug-related, its rarely that simple, is it.....

 

Long/short --- I'm still 3 days away from completing the taper (Sunday night, it is currently Friday night) and in the meantime symptoms have picked up and gone crazy. 

I now have profound (and increasing) muscle tension, muscle pain/stiffness, muscle weakness, a sense of "burning" in the muscles (the biceps in particular) and twitching throughout my body, and muscle jerks throughout the body (most noticeable when attempting to relax or sleep).

 

Have I kindled in some hyper-charged fashion? Or worse? How much trouble have I likely cooked up for myself here?

I'm feeling like I might need to go an ER at some point, these symptoms have me alarmed that I may have some sort of rapid Guillain-Barre type affliction. (In fact, I did go to an ER earlier today, and they didn't take it very seriously....they simply sent me home with a pamphlet on how to deal with muscle cramps. I am beyond frustrated and this his only added anxiety and despair to the equation here.

 

Hoping someone might be able to make sense of some of this. 

Thank you all so much for your tireless gift of kindness and knowledge to this community.

 

Mike1972

 

 

 

 

 

 

 

[Mike1972]

Its just occurred to me - I’ve begun to wonder if my thread/story here has violated any Surviving AD policies....? I am quite honestly beginning to get very worried that my situation has become too unique (or “off topic”?) to be given counsel by the community here.
 

Really hope that is not the case. 

 

The counsel of @Gridley and @Altostrata was immensely appreciated in the past, I hope I am still in your good graces and have not somehow created a story here (with my latest symptoms and Gabapentin resumption) that is beyond counsel. 
 

My very humblest hope for continued acceptance by this community. 

[composter]

Hi Mike, every person’s situation on SA is quite unique, but I don’t think yours is beyond the realms of SA guidance. I think we might be able to help. I’m going to notify the other mods that you need help so that someone who has more experience with gabapentin can respond. 
 

In the meantime, it may help to see more of a timeline laid out for your dosage changes. 
 

How long have you been on the 1.0 mg Mirtazipine? You may be correct in thinking that most of the issues you felt had to do with a too-fast taper. But what’s past is past. 
 

What were the dates of starting and changing the Gabapentin? 
 

It looks like your issue right now could be a mix of a Mirtazipine fast taper and possible adverse reaction to the Gabapentin. Thanks for updating your signature. 

Edited August 9, 2020 by composter

[Mike1972]

@composter, thank you so much for the compassionate reply. 

 

I couldn’t fit all the details of my tapering (and resuming) of the Mirtazipine and Gabapentin in my signature, so here’s the full taper schedule for Mirtazipine and the resumption/taper schedule for Gabapentin.

 

Mirtazipine Taper:

October 16, 2019 - CT (from 15mg)

November 2, 2019 -  Reinstatement @ 3:75mg. Stabilized after 3 weeks.

Jan. 24 - 1st drop to 3.00mg

Feb. 10 - 2nd drop to 2.50mg

Feb. 28 - 3rd drop to 2.00mg

May 24 - 4th drop to 1.50mg

June 10 - 5th drop to 1.00mg

(continuing to hold at 1.00mg)

 

Gabepentin Resumption / Subsequent Taper:

July 16: Resume at 100mg/day

July 17: Raise to 200mg/day

July 18: Raise to 300mg/day

July 22: Raise to 600 mg/day

July 28: **reaction** (?) - Intense, Warm/buzzy electrical tingle spreads over entire body when I lie down to sleep. Behaves like RLS (if I move, it stops....but then it starts right back up again)

July 28: Drop to 400 mg/day (result: no more buzzy tingle reaction.)

August 1: Drop to 300mg/day

August 4: Drop to 200mg/day

August 7: Drop to 100mg/day

August 9: projected last day of Gabapentin

 

Thank you again for any thoughts. I’m quite honestly terrified that between the weakness/fatigue and widespread muscle pain/twitches, I’ve perhaps caused myself something more like an autoimmune nerve issue. Hoping desperately that my condition is instead traceable to a possible compounded withdrawal situation, something that there is hope to recover from.

 

With great gratitude, 

Mike1972

 

[ChessieCat]

Hi Mike,

 

It might be helpful if you could provide us with daily symptoms notes.  Doing this might help the mods to work out what is going on and what the way forward might be.  We will need at least 3 consecutive days.

 

This is what is required.  There is an example in the post:

 

 

[Mike1972]

@ChessieCat, ok! I will put that together for you.
 

Luckily, I *have* kept an extensive logbook of dates/times for dosages and symptoms (and also sleep quality/lack thereof).

 

I will do my best to make a written account for you that is complete and usefully-detailed (but also without turning it into a novel.)

 

Thank you again so much for your counsel. I wish I had an emoji to use here for deep deep gratitude.
 

Mike1972

[Mike1972]

Hi @ChessieCat and @composter, 

 

Here's my best effort at daily symptoms / medications / timelines. 

It is lengthy, but I am going to assume this is what you prefer, to give you as complete a timeline as possible with as many details as I have been recording in my logbook.

 

1) Mirtazipine Taper:

October 16, 2019: CT (from 15mg)

 

October 25: Powerful withdrawal symptoms hit. Sleep terrible, panic, short of breath, agitation, brain fog, "feeling that brain is sick," sense of doom, stomach problems, exhaustion/fatigue

 

November 2: Reinstatement @ 3:75mg. 

3 weeks later I stabilized. 
*Definition of "stabilized": I honestly felt pretty good again. As the weeks passed after this, this improved further and I felt 100% "myself" and without any clear sense of anxiety or symptom.

I was going for Mountain Bike rides, camping, happily eating and recreating, sleeping good, etc......

 

***** NOTE: Began taking 3mg of Melatonin and 450mg of Valerian Root each evening at bedtime (between 10 and 11pm) to overcome insomnia. (Still taking this every night.) *****

 

January 10: Transitioned from pill-cutting to liquid titration of Mirtazipine. No dosage change (still at 3.75mg).

 

Jan. 24 - 1st drop to 3.00mg Mirtazipine

Feb. 5  - two nights of insomnia. This passes, however.

 

Feb. 10 - 2nd drop to 2.50mg Mirtazipine

Feb. 22 - a couple nights of insomnia, which passes. Sleep (and all measures of life) resume a healthy sense of normality.

 

Feb. 28 - 3rd drop to 2.00mg Mirtazipine. No obvious withdrawal symptoms with this drop.

 

May 24 - 4th drop to 1.50mg Mirtazipine

May 25, 26 - Terrible Sleep, Restless, Racing Mind, Stressful Dreams. Two nights of awful sleep and heightened sense of anxiety.

May 27 - Sleep returns to normal, though I may be still anxious & stressed overall.

May 29 - Muscle tension pain begins in back of neck.

Call Doctor and schedule physical therapy for what is assumed to be just normal muscle tension due to long days sitting at computer.

(*** Begin Physical therapy visits/exercises three times a week, going forward.)

 

June 10 - 5th drop to 1.00mg Mirtazipine. No obvious withdrawal symptoms with this drop.

June 11th through now (August 9) - (continuing to hold at 1.00mg Mirtazipine)

 

------------------------------------------------------------------------------------

 

2) Gabepentin Resumption / Subsequent Taper:

*** Gabapentin re-started at advice of Doctor who felt it might calm down recently-irritated nerves in my neck (where I was getting persistent muscle soreness and some nerve pain.) ***

 

July 16: Begin at 100mg/day -

10pm - 100mg Gabapentin

10pm - 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Great night of sleep.

 

July 17: Raise to 200mg/day:

2pm - 100mg Gabapentin

10pm - 100mg Gabapentin

10pm - 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Great sleep.

 

July 18: Raise to 300mg/day: 100mg taken at 10am, 100mg taken at 4pm, 100mg taken at 10pm.

10pm - 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Wake up in middle of night to find what appears to be "puffy eyes," looks like some kind of allergic reaction.

 

July 19: Skip one dose of Gabapentin, out of concern for puffy eyes. (so only 200mg/day today.)

2pm - 100mg Gabapentin

10pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Great night of sleep.

 

July 20:  Resume 300mg/day schedule

11am 100mg Gabapentin

Soreness: left chest/arm/shoulder, hands, tight/soreness in left knee/calve

4pm 100 mg Gabapentin

10 pm 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

vernight: awoke 4am, again "eyes appear slightly puffy".

 

July 21: 

Awoke to find left upper calve/knee sore/cramp-ish

11am 100mg Gabapentin

5pm 100mg Gabapentin

11:15pm 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Choppy sleep, many wake-ups/anxious.

 

July 22: Raise to 400mg/day:

10am - 200mg Gabapentin

12noon - 440mg Naproxen (***resumed --- had been taking on/off for last two months for neck pain.)

Mid-day: Noted that my breathing was becoming anxious, though my pulse seemed normal. 

5pm: Went to physical therapy. For some reason today, gentle exercises irritate nerves in arms, very strange. Nerves seem hyper-irritable now.

6:30pm - 200mg Gabapentin

9pm: left arm and hand "locks up" with stiff muscle spasm. Right wrist also begins to feel "stiff."

10pm - 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Terrible night of sleep due to arm muscle spasm/soreness/pain.

 

July 23:

10am 200mg Gabapentin,

1pm Naproxen 440mg,

6:30pm Gabapentin 200mg

Evening: Becoming aware of body aches! Fingers, Palms, Toes?

10pm - 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Somehow had good sleep.

 

July 24: **** Raise to 600mg/day****

Awake to body soreness in joints, fingers, toes. 

10am 200mg Gabapentin'

4pm 200mg Gabapentin

9:15 440mg Naproxen

12 midnite 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Deep painful Aches!!! Fingers, palms, joints

Overnight: terrible sleep, (Sense of "body soreness"....back, legs, arms.....)

 

July 25: 

10am 200mg Gabapentin

11:20am 440mg Naproxen

4pm 200mg Gabapentin

Muscle Knots appearing in back of lower thigh on left leg - rolled them out with foam roller (I never get muscle knots....)

11:15pm 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Noting Left leg/ankle weakness. (Calve/ankle/back of thigh)

Overnight: Choppy, poor sleep.

 

July 26: 

10:30am 200mg Gabapentin

Sense of left/leg/ankle weakness? Unsteady?

3pm 440mg Naproxen

5pm 200mg Gabapentin

11pm 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Choppy, but adequate sleep

 

July 27: 

9:45am 200mg Gabapentin / 440mg Naproxen

4:45pm 200mg Gabapentin

Perceived left leg ankle/calve weakness - stronger?

11:15pm 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Broken, worried sleep. Right Forearm stiff with muscle tension.

 

******* July 28:

Awoke to legs feeling "wobbly" and fatigued.

10:45am 200mg Gabapentin / 440mg Naproxen

5:15pm 200mg Gabapentin

Fore-arms (both sides) are now sore and tense feeling.

Left foot feels strange on bottom, like muscles that contact the ground have gone weak.

10:40 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

11pm - AT BEDTIME - *** REACTION? (?) - Intense, Warm/buzzy electrical tingle spreads over entire body when I lie down to sleep. Behaves like RLS (if I move, it stops....but then it starts right back up again)

Overnight: Warm buzzy tingle continues. Light muscle twitches over entire body. Lasted almost all night.

 

July 29:  - DROP: to 400mg/day

9am: Call Pain Management Doctor, ask to lower Gabapentin in light of possible reaction. Agree to drop to 400mg/day

12:30pm 200mg Gabapentin / 440mg Naproxen

Ears Warm. Skin feels hot and sensitive on face.

11:30pm 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Good night of sleep! There was no more buzzy tingle reaction.

 

July 30: 

Awoke to stiff hands, tight calves

10:30am 200mg Gabapentin / 440mg Naproxen

10:30pm 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Halfway-acceptable sleep that night.

 

July 31: 

9 am - talk to Pain Management Doctor, agree to taper me back off from Gabapentin 

10:00am - 200mg Gabapentin

Went for walk - left leg feels "wiped out/fatigued" and cramped

10:30pm - 200mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

*** Decide to stop Naproxen *** (suspicious of all these meds now....)

Overnight: Broken sleep. Anxious breathing upon awakening. Had to use nose-breathing techniques to calm down.

 

August 1: DROP: to 300mg/day

Awoke to find stiff/cramped calves and biceps.

Hands feel clumsy and weak, they appear to have an odd sense of movement to them.

10am - 100mg Gabapentin

2pm - Tried my stationary bike and rowing machine - followed by a small nap.

4pm - 100mg Gabapentin

11pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Top-quality night of sleep! Over 2 hours of deep sleep. But awoke feeling incredibly fatigued.

 

August 2:

Went for a morning walk of a couple miles.

Increasing sense of stiffness in limbs.

Stiff legs, weak calves, stiff forearms, stiff wrists, major fatigue setting in.

10am - 100mg Gabapentin

4:15pm  - 100mg Gabapentin

Left hand getting clumsy/weak (wrist/pinky finger in particular...left leg weakness (lower ankle/calve area);

muscle cramps and tightness in both legs.

10:30pm 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: FIrst half of night ok sleep....then absolutely terrible sleep. Light sense of "body tingling" from 4am onward. 

 

August 3:

Better sense of appetite upon awakening

Weird sense after awakening that "muscles on top of head were drawn tight"

10am - 100mg Gabapentin

4pm - 100mg Gabapentin

6pm - 200mg Magnesium (Beginning to take this, onward, in hopes of it helping muscles)

10:30pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Left hand/left ankle/ left wrist feel clumsy....strange and icky feeling of weakness and position sense

Overnight: comfortable but broken sleep

 

August 4: DROP: to 200mg/day

Awoke to find left wrist/hand feel "tired" and weak.

Biceps burning slightly. Left ankle feels tired as well.

10:30am - 100mg Gabapentin

3:30pm - 200mg Magnesium

10:45pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Similar weird feelings (as previous day) of clumsiness and weakness in left hand/ankle/wrist.....and now with random muscle twitches.

Overnight: Slept ok until 4am - then right upper leg twitched strongly in thigh for the rest of the night aggressively.

 

August 5:

Awake to find MUCH weakness and stiffness in limbs.

Both biceps burn. Hand weakness/clumsiness increasing.

10am - 100mg Gabapentin

2pm - 200mg Magnesium

Walking is clearly becoming affected. Wobbly and stiff/weak muscle tone.

Widespread "ache" ins arms and inside joints.

Nerve pain in arms felt late in the evening before bed.  

11pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight - Great sleep.....somehow! My girlfriend massaged my sore/twitching arm and leg muscles before bed.

 

August 6:

11:30am - 100mg Gabapentin

4pm - 200mg Magnesium

10:30pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Ruinously bad sleep. Bad muscle twitches throughout arms and legs kept me awake all night long.

 

August 7: DROP: to 100mg/day

8 am - Visited Emergency Room (at request of Primary Doctor, who is aware of my symptoms and wants to get things looked at ASAP)

Extreme sense of Fatigue in entire body/arms/legs, weakness, twitches everywhere!!! Right Tricep twitches all day long.

9pm - 1 hour nap (somehow, out of sheer exhaustion)

10pm - 100mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Somehow slept a bit. Twitching a bit less pronounced.

 

August 8: Decided to split the 100mg Gabapentin dose into two separate 50mg doses (water titration.)

10:40am - 50mg Gabapentin

Weak legs/arms; cramping left calve/forearm. Right wrist and forearm/bicep also continue to be stiff/tight.

3pm - 200mg Magnesium

4pm - Forced myself to do a 30-minute bike ride. Muscles begin to twitch strongly again after bike ride.

11:20pm - 50mg Gabapentin, 1mg Mirtazipine, 450mg Valerian Root, and 3mg Melatonin

Overnight: Twitching less pronounced then night before, slept a bit more regular set of hours. 

 

August 9: (Projected last day of Gabapentin taper)

10:40am - 50mg Gabapentin

Biceps tight/light sense of burning in them. Both forearms tight. Hands tight/stiff. Left calve/thigh/ankle stiff and painful.

Light sense of occasional tingling. Twitching and weakness prompted further by using arms/legs.

 

------------------------------------------------------------------------------------

 

This is up-to-date for me here today (as of August 9, 2020 at 2pm Pacific Time (US).)

 

Hoping that my symptoms possibly fit some sort of drug-reaction or kindling-type assessment.......this is all frightening the heck out of me.

Is it possible to "feel fine" with another taper (the Mirtazipine) but, in fact, be still fairly unstable.....and while still getting decent sleep, to be in fact in a state of high anxious / nervous condition....such that the addition of something like Gabapentin abruptly could cause this kind of neuromuscular disturbance.....?

 

Due Care:

I will add, to alleviate concerns, that I am also currently aggressively pursuing neurological assessment of my symptoms as well ----- through both my previous Neck surgeon (he ordered an X-ray, CT scan, and MRI, and they all came back showing everything looking great/normal) --- and also a Neurologist (he has done several electrical nerve-conduction tests, as well as recently had me go for substantial blood work. Results of testing are still pending.)

 

Thank you all again so much for your kind counsel and empathy.

(Tagging @Gridley and @Altostrata because you kindly weighed in previously during my initial Mirtazipine CT issues.)

 

Mike1972

 

[Altostrata]

As you decreased gabapentin, did you feel any change in your symptom pattern?

 

Has your sleep pattern been effected since you started tapering mirtazapine in April?

 

We would like to see your current daily symptom pattern. Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. 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.

 

[Mike1972]

Hello @Altostrata,

 

To your Gabapentin question:

As the Gabapentin has dropped, I have definitely noticed an improvement in SOME of the symptoms: for one, the “hot, full body electrical tingling” that occurred shortly after I reached maximum dosage of 600mg/day has not returned, nor has the weird hot/flushed sensation on my head and ears, and that has been gone as well. The overall amount and intensity of twitching seems to be possibly finally diminishing a bit too.
 

But, conversely, many other symptoms have continued to unravel/expand, throughout the entirety of this Gabapentin adventure, regardless of dose. The (increased limb stiffness/muscle pain/muscle cramping) carries on unabated for instance.

 

And certainly as I’ve titrated down, each successive drop brings a fresh spike of anxiety and near-panic in the evenings when I try I sleep.) I assumed this would be par for the course, regardless of how “short a time” I was on Gabapentin.

 

To your Mirtazipine question:

I have indeed noticed differences/disturbances in my sleep patterns since resuming the taper of Mirtazipine in April, but they have seemingly all been short-lived and have resolved fairly quickly after they spike. (Either a week or so after a drop, or two or three days after a drop.)
 

What has unfortunately been **increasing steadily,** however, has been a general and consistent increase/sense of heightened anxiety (sub-panic levels however.) I have been aware of this, and would probably have paid more attention to it as a possible WD symptom, but I ended up chalking it up to being “simple COVID and work-from-home stress/anxiety”....and so I soldiered on with the tapering.

I will work to update this thread with 24-hour daily symptom/activity/medication accounts as you’ve directed. The log I provided you thus far was the best of my recorded information thus far, but I will definitely expand and refine my logging to fit the template you’ve indicated.

Thank you again so much for your thoughts and experienced assessment/analysis/guidance Altostrata.

 

Mike1972

[Mike1972]

@Altostrata, beginning the 24-hour daily symptom/activity log as you requested.

 

August 9

8:30 am woke up. No anxiety but very fatigued. 

8:30-10am lie in bed exhausted.

10 am - got up. Arms/legs/hands stiff.

10:10 am - Ate breakfast

10:30 am - 50mg Gabapentin

3:15 200mg Magnesium / banana and coconut water for potassium

3:45pm despite pain and stiffness in muscles, went for 30 minute brisk bike ride. While on the bike ride I realized I was having pretty high levels of anxiety and panic breathing / air hunger. 

4:20 Leg muscles “burn” (hamstrings) with light tingling for 15 minutes. Biceps start twitching noticeably as well for a couple minutes.

5:00 Tried some light exercises again for legs and arms (5 minutes only)

5:30 showered. This makes me quite anxious, air hunger while showering. Amount of fatigue the shower generates is huge. Arms feel heavy and biceps burn. Legs feel wobbly. Right wrist cramped up while washing myself. 

6:00 anxious again. But somehow forced myself to physically relax for an hour. Noticed legs felt a bit better for a while when I got back up.

7:00 dinner. Right arm feeling very stiff in particular. Wrist and forearm tight muscles.

8:00 felt relaxed for a while

9:00 feeling of anxious breathing returns 

10:15 50 mg Gabapentin, 1 mg Mirtazipine, 3mg Melatonin, 450mg Valerian

10:30 bed - fell asleep after about 10 minutes. No strong twitches.

1:00 awoke to strong anxious breathing. Did deep breathing to calm down and go back to sleep.

3:00 awoke again with even more anxious (almost panicky) breathing. Did deep breathing to calm down/sleep again.

4:45 awake again, anxious breathing.

5 am-7am restless sleep off/on

7:30 officially awake. No noticeable anxiety symptoms. No twitching.

 

Edited August 16, 2020 by ChessieCat
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[Altostrata]

18 hours ago, Mike1972 said:

What has unfortunately been **increasing steadily,** however, has been a general and consistent increase/sense of heightened anxiety (sub-panic levels however.) I have been aware of this, and would probably have paid more attention to it as a possible WD symptom, but I ended up chalking it up to being “simple COVID and work-from-home stress/anxiety”....and so I soldiered on with the tapering.

 

Going on and off drugs can make your nervous system hypersensitive. In this context, your mirtazapine taper might have shaken up your sensitized nervous system, producing mirtazapine withdrawal symptoms. A slight increase in mirtazapine, perhaps 0.5mg, might help. Please let us know the effects of this.

 

Magnesium is more effective when taken in small doses throughout the day. 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/

 

You might try adding a little bit of fish oil to begin,  to see how it affects you.

[Mike1972]

15 minutes ago, Altostrata said:

Going on and off drugs can make your nervous system hypersensitive. In this context, your mirtazapine taper might have shaken up your sensitized nervous system, producing mirtazapine withdrawal symptoms. A slight increase in mirtazapine, perhaps 0.5mg, might help. Please let us know the effects of this.

 

@Altostrata, that's an interesting consideration, I have been wondering about that possibility for a while as well. (Doing a slight increase in the Mirtazipine). 

 

Is that something that's an option, when I have (just now, as of last night) tapered completely back off from the Gabapentin?

 

[Altostrata]

You went off 50mg gabapentin in one day?

 

Making additional drug changes while having withdrawal symptoms from another drug is likely to further destabilize your nervous system and make your withdrawal symptoms worse, even if you think the second drug isn't doing anything. Do not continually make drug changes, the more changes you make, the worse it can get.

 

 

[Mike1972]

@Altostrata,

Yes, I concluded the taper off from the Gabapentin last night.

Out of context, I am sure this appears ill-informed by SA standards.....but hopefully not within context? My pain doctor only **just** started me on Gabapentin about three weeks ago (July 16), I titrated up and reached/held  a maximum dose of 600mg/day for three days.
 

Almost immediately after reaching 600mg/day, I developed the body-wide reaction (Full-body electrical tingling and muscle twitches). That was when I had been about 10 days on Gabapentin..The pain doctor then chose to immediately taper me back off from it ;(dropped me first to 400mg/day, then from there dropped by 100mg and held every three days. When it reached 100mg (the last three days), I opted to split the dose into two 50mg doses per day so that there would be less up/down to the dose concentration during the day between morning and evening.

I apologize if this was not understood, I have done my best to try to communicate and explain that the lion’s share of my symptims/issues seem to have cropped up shortly after being put on this most recent short course of Gabapentin, which I was nearly done tapering back off from when I re-initiated this thread.

I had handled a Gabapentin taper quite well a year ago, and each drop (at that time) was 100mg, so the pain doctor was confident I could readily do a similar taper since this had been such a short course.

So very sorry if this is not what the understanding was, and I hope to have not violated any policies. Have earnestly been attempting to communicate and navigate this situation as best as I can. Please let me know if I have dropped the ball here somehow, I value your experience and insight/knowledge above anyone else.

 

Mike1972

[Altostrata]

Okay, it's less than a month. You'll need to watch for a week to see results of going off gabapentin. If you increase mirtazapine, you won't want the effect to be confused by gabapentin withdrawal symptoms. Please let us know how you're doing.

[Mike1972]

5 minutes ago, Altostrata said:

Okay, it's less than a month. You'll need to watch for a week to see results of going off gabapentin. If you increase mirtazapine, you won't want the effect to be confused by gabapentin withdrawal symptoms. Please let us know how you're doing.

Ok! Absolutely. Will maintain current medication levels/doses unchanged for one week. Will maintain this thread with the daily symptom/activity/medication log updates. 

 

Re: your other supplement guidance - I’m already taking fish oil (Carlson’s Cod Liver Oil every day). Not sure if that’s adequate, will research. Also now aiming to spread out my Magnesium supplements throughout the day as you’d indicated.

 

Thank you again so much.

Mike1972

[Mike1972]

August 10

 

NOTE: Today - no more Gabapentin (final taper dose was 50mg last night at bedtime.)

 

7:30 am - officially awake. No noticeable anxiety symptoms. No twitching.

7:30-9am -lie in bed fatigued.

9:00am - get up. Arms and legs feel heavy/stiff and fatigued. Left arm/leg in particular.

9:10 - eat breakfast. 

9:30-10:00am - force myself to go for relaxed bike ride to keep legs moving. 

10:15am - try to relax. Arm / Leg muscle burning sensation.

11:00 - anxious 

12:30 -snack/lunch

2pm - 200mg Magnesium

5pm - 15 mins on exercise bike

5:15 - ridiculous amounts of leg exhaustion, this makes me anxious as heck

7:30 - dinner

8pm - try to watch TV but too anxious/wound up (and exhausted)

8:45-10:30 - try to nap, only intermittent broken sleep

11:10 pm -200mg Magnesium, 1 mg Mirtazipine, 3 mg Melatonin

11:20 -bedtime. (First night without Gabapentin.) Sleep just doesn’t want to seem to happen very easily.

1:30 am - awakened. Arms and legs feel hot and restless.

2:30 am - awake again, same uncomfortable sense.

3:30 am - awake again. Anxiety.

4:30 am - awake again. More anxiety.

5:15 am - awake again. 

6:30am- 7:30am: intermittent mini-sleeps of maybe 10 minutes.

7:30am - morning, officially no more sleep.

 

Edited August 16, 2020 by ChessieCat
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[Altostrata]

The gabapentin may have been helping you sleep or you may be having some withdrawal from going off gabapentin. This may resolve in a few days.

[Mike1972]

@Altostrata, I’ve been hoping for the sleep to improve as you’ve indicated, as more time elapses (post-Gabapentin.) This last night I did get better sleep for the first 2/3 of the night. (Until a panic about a very peculiar numbness in my extremities woke me up at 5:15am.)

 

August 11

7:30-8:30am - lie in bed 

8:50am - breakfast (anxious while eating)

9:15am -  go to grocery store for a few items. Extreme amounts of fatigue, arms/legs very weak.

10:15am - snack and try to relax

2pm - 200mg Magnesium

3pm attempt to relax again. Can’t stop anxious thinking about my weird muscle and nerve symptoms.

4:30 pm muscle twitches again

7pm attempt to relax and meditate.

8pm dinner - forearms and hands extra sore/weak and cramping while eating. Leg muscles cramping after dinner.

9pm try to relax on couch. Arms and hands super cramp-ish.

10pm - 200mg Magnesium

10pm - try to relax listening to classical music. It works! I fall asleep for an hour

11pm - 1 mg Mirtazipine, 450mg Valerian, 3mg melatonin 

11pm - bedtime/fall asleep fast. Sleep deeply and uninterrupted for 6 hours.

5:15am - awake to find that both big toes,

and all of left leg from knee down are completely dead numb. Very alarmingly no tingling whatsoever when they regain feeling. Panic/fear, ruminating on possible neurological condition. No more sleep tonight.

5:15-8am - awake.

8:00 - time to get up

 

 

Edited August 12, 2020 by ChessieCat
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[Altostrata]

Slightly better sleep is an improvement. Recovery will be very gradual and frustrating.

 

Were you lying on the leg that went numb? You may want to change your sleeping position.

[Mike1972]

Not sure, don’t believe I was lying on that side. (But it’s possible.) Btw, realized I mis-spoke, it was the entire right lower leg (and left big toe) that went numb. 
 

What really alarmed me was that there was dead numbness on *both* extremities — the left toe AND the entire right lower leg and foot...and that the numbness came/went without any of the usual sensory element of pins and needles. (Never experienced that ever before.)  

 

Is random limb/extremity numbness ever expressed as a symptom of WD from either Mirtazipine or Gabapentin?

[composter]

On 8/13/2020 at 5:52 AM, Mike1972 said:

Is random limb/extremity numbness ever expressed as a symptom of WD from either Mirtazipine or Gabapentin?

There’s a thread on parasthesia and numbness. You can go through it to see if others have had this symptom. In general, WD symptoms can really manifest as anything since the nervous system controls so much of the body.

 

I wouldn’t worry too much or fixate on this since you’ve only felt it once. Also, as you stabilize the many symptoms you experience will improve.  
 

paresthesia-pins-needles-numbness-tingling-burning-sensations-aka-neuropathy

 

 

Edited August 14, 2020 by ChessieCat
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[Mike1972]

Thanks @composter, I’ll give that a read

.

Certainly hopeful for most of this to resolve and turn out to be withdrawal (or kindling) symptoms. I’m quite fearful of a secondary actual medical/neuromuscular condition existing underneath all of this however.....I went through some uniquely physically traumatizing and damaging experiences in the past with the overdose of vitamin B6 two years ago (it caused systemic polyneuropathy, which I seemed to have recovered from).
 

Been wondering lately if the Mirtazipine I was taking the last two years had been doing a good job of “suppressing” pain symptoms of that condition for the last couple of years (up until

two months ago, I had been feeling 100% great!)....and also that the recent CT’ing/reinstating/tapering of Mirtazipine (and subsequent huge stress) may have enough to destabilize my immune system in some fashion (and possibly cause something autoimmune in nature to happen, targeting those vulnerable previously-damaged nerves.)

 

Working with Neurologists and Doctors to try to make sense of it. So far no answers, and my muscle weakness and pain continues to develop.

 

August 12

9am - finally got out of bed 

9:30am- breakfast

10:00-11:00am - highly stressed due to physical symptoms and worry about employment (currently using vacation days because physical symptoms are preventing work)

11:00am - shower, again very stressful (physically exhausting), hard to stay calm

In shower

12:00-1:00pm - paperwork and phone calls with HR. Very anxious / wound up

1:00 pm - 200mg Magnesium

1:05 pm - Quick Lunch

1:15 pm - leave for Doctor appointment. Stressed about how that might/might not go.

2:00 pm - Doctor appointment. Goes quite well, they give me referral I was hoping for. Huge relief. 

4:00 pm - arrive back home. Alternate rapidly between elation for productive day, and anxiety over undiagnosed muscle/nerve symptoms.

5:00 pm - snack

5:15-6:45pm attempt to relax. Mind keeps racing with “what do I do to solve my situation next?” questions.

7:00-8:00pm  - lengthy phone call with concerned parents, update them on everything.  Exhausting.

8pm - 8:30pm - attempt to lie down and relax. Kind of works.

8:45 - late dinner 

9:30 200mg Magnesium

10:30 bedtime

10:45-3:30am asleep

3:30-6:30 awake, uncomfortable, anxious racing thoughts, arms and legs restless 

6:30 time to get up (8am Doctor appointment)

 

 

 

Edited August 14, 2020 by ChessieCat
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[Mike1972]

August 13

6:45 am - get up. Exhausted, almost no sleep. Sore and weak/painful everywhere.

7:00 am - breakfast

7:15 am - leave to go to Doctor appointment. 

7:45 - check in for appointment. Feel extraordinarily terrible. Muscles and nerves ache and fatigued and weak. Overall sense of despair.

8:00 am - Neurologist appointment begins. Nurse and PA are both very nice, very empathetic, very thorough. I feel better about things.

8:30 am - Doctor comes in. Totally tone-deaf to my issues. Tried to tell me that my pain and weakness symptoms are all probably simply stress, and that everyone is worried about COVID, that’s why there’s so much stress. I begin to despair.

9:00 am - appointment concludes. Doctor agrees to send me to Neuromuscular group for nerve testing. I feel better. 

10 am - back home. Sense of accomplishment for successful Doctor visit.

10:15 - decide to try to exercise somewhat. Bounce around Basketball, soccer ball; juggling, some light resistance band work. Arm muscles start to burn quickly.

11am - coordinate with Doctor’s nurse for hopeful doctor approval for time off work.

12 noon - lunch/collapse on couch. Overwhelmed.

1:00 - 2:00pm - phone calls with Human Resources groups at work. More attempts to coordinate time off work. Basic phone calls are draining me of the last of my energy.

2pm - 200mg Magnesium

2pm - 4pm work on computer doing form work for time off. Keep telling myself I just need to make it across the finish line and then I’m allowed to collapse.

5pm - exhausted on couch. Can’t relax. Stare at ceiling and into space. End up researching scary neurological conditions on my phone.

7pm dinner

8 pm - exhausted and arms are sore/burning. Try to relax with girlfriend. 

9 pm - 200 mg Magnesium

9pm - 10pm - head to bed to try to chill out. Listen to classical music to on headphones. Pretty relaxed.

10:30 pm - 1 mg Mirtazipine, 450mg Valerian, 3mg melatonin

11 pm - lights out.

2am - awake abruptly to find that the skin on both arms and also my back are suddenly burning with hot tingling neuropathy. Are you kidding me. 

2am - 7:30 minimal sleep. No positions are comfortable and the electrical/burning skin sensation is incredibly distressing and unpleasant.

8 am - girlfriend’s alarm goes off. She gets up and I lie in bed for another hour, noticing burning skin sensation has diminished slightly. I almost fall asleep but not quite.

9am - time to get up

 

Edited August 15, 2020 by ChessieCat
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[ChessieCat]

Hi Mike,

 

When copying and pasting into a post your font is a large size which makes it difficult to read.  You can either select the entire post after pasting (Ctrl + A) and then click on the drop down arrow next to size (top right of reply box) and select 14.

 

The other option( if the post doesn't contain any fancy formatting like italics, colour or bolding) is to paste the text and immediately after click on Paste as Plain Text which will appear at the bottom of the reply box.

[Mike1972]

11 hours ago, ChessieCat said:

Hi Mike,

 

When copying and pasting into a post your font is a large size which makes it difficult to read.  You can either select the entire post after pasting (Ctrl + A) and then click on the drop down arrow next to size (top right of reply box) and select 14.

 

The other option( if the post doesn't contain any fancy formatting like italics, colour or bolding) is to paste the text and immediately after click on Paste as Plain Text which will appear at the bottom of the reply box.

Hi @ChessieCat,

Sorry for the font size issue. I’ll make sure not to let that happen again. (I think the font size issue stems from compiling my day’s log entries in the “Notes” app on my phone, and then just copy-pasting it across (again while still on the phone.)  

 

Not sure if I’ll have to log in from an actual computer (vs. on my phone) to do the font correction each time, but I will make it happen.

 

Again, my apologies. Just thankful for the group attention and perspectives on my situation.