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Malbec37

Malbec37: Tapering off Mirtazapine and hit major WD HELP needed!!!

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Gridley
11 minutes ago, Malbec37 said:

here is 15 milligrams of active ingredient in each pill...it says so on the packet 

 

And what is the average weight of 10 15mg pills?  Is it the 15.46mg you said earlier.  If so, the active ingredient mg and the pill weight mg would be almost the same, which would be very unusual.  For example, I'm using 20mg Lexapro for my taper and the average weight of the tablets is 200mg, so I have a 10:1 ratio mgpw (pill weight) to mgai.  

 

Please double check.

Edited by Gridley

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Malbec37
3 minutes ago, Gridley said:

And what is the average weight of 10 15mg pills?  Is it the 15.46mg you said earlier.  If so, the active ingredient mg and the pill weight mg would be almost the same, which would be very unusual.  For example, I'm using 20mg Lexapro for my taper and the average weight of the tablets is 200mg, so I have a 10:1 ratio mgpw (pill weight) to mgai.  

 

Please double check.

Yes it's exactly as you say...the typical pill weights around 15.5 but some are slightly less and some slightly more....so 10 tablets average weight would be 15.46 - it's the way that it is with the 15mg mirtazaine tablets they weigh almost the same amount as the active ingredient 

 

That's why I thought measuring a consistent amount of 13mg on the scales would be ok as it was consistent...but now I'm realising that the amount of AI in each 13mg would have been slightly different so I have not been getting consistency and is this contributing to my ongoing WD after 40 days?

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Hamster
5 hours ago, Malbec37 said:

Update on my taper

 

@GridleyAnother terrible night of sleep...I feel wretched, low mood - this is just unbelievable really I'm almost 40 days into the updose to 13mg and there is no stability - I feel despairing of my situation....I know I've had better days but I feel like I'm really running out of coping skills now :(

 

...

 

I thank I'm mostly confused because I'm so tired

 

...

  •  

Hi Malbec,

 

this sounds very familiar to me. I am also tapering from Mirt and I had to wait for quite some time before something like stability set in. 

Same with coping: With a lot of experience, quite some talk therapy sessions and a lot of trial and error I can nowadays cope with most "normal" lows of Mirt withdrawal. For example, distraction works - but to a certain point, then it breaks down and my mind gets into fighting mode against itself and the bad mood. Completely useless and I am totally exhausted afterwards, but from a certain point onwards, I haven't found a reliable way around yet. It will become better over time, though.

 

Concerning doseage: The best way for me was to get "soltabs" of mirt, dissolve / suspend them in a defined amount of water and then get out the dose I need with a syringe. Good descriptions can be found using the search function. Grinding down normal tablets using a mortar and making a suspension worked for me too, but is way more time-consuming.

 

Regards,

 

Hamster

 

 

 

 

 

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Gridley
6 minutes ago, Malbec37 said:

Yes it's exactly as you say.

 

13mgai is .87% of 15mgai.

 

So you would multiply .87 X 15.46 (or you could round to 15.5) and whatever that weight is would be 13mgai.

10 minutes ago, Malbec37 said:

so I have not been getting consistency and is this contributing to my ongoing WD after 40 days?

 

You have been getting consistency if you're weighing 13mgpw every time.  It's just not exactly 13mgai.   15.5 X .87 = 13.49 (I would round to 13.5) mgai  So you've been short 0.5mgai and thus didn't updose quite high as you intended.  

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brassmonkey

What is the exact readout on the display of the scales? (0.155?)

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Malbec37

@brassmonkeyDo you mean when I turn on the gemini scale? It says 0.000

 

@Gridleythanks so much for confirming that....Yes I agree I have been taking 0.5 short of intended amount but I have also been very consistent in the 13mg so would have thought that the symptoms would have got a bit easier or more consistent by now 

 

Also in order to weigh out the 13.5 dose I would have to crush the 10 pills so they're all mixed in together and then extract and weigh the amount is that correct? So instead of just measuring out 13.5 from cutting each pill individually?

 

Sorry for all the questions and very grateful for your input this evening...my brain is so tired at trigging to compute all of this 

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brassmonkey

The exact readout when you are weighing a whole pill.

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Malbec37

@brassmonkeyI have just weighed one pill and it is 0.154...but they do vary but not by much although I found one that definitely weighed 0.140 today which I am baffled about....but must be an anomaly 

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Gridley

 

 

8 minutes ago, Malbec37 said:

Also in order to weigh out the 13.5 dose I would have to crush the 10 pills so they're all mixed in together and then extract and weigh the amount is that correct? So instead of just measuring out 13.5 from cutting each pill individually?

 

It's not necessary to crush all ten pills.  The ten pill average is just to establish your average.  If you want to make enough doses, say, for a week's worth (which is what I do), just crush enough pills to make that many pills. Then weigh out your pills one by one and put the powder in your capsules.  

Edited by Gridley
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hezzer78

If your pills weigh 0.150g, that’s 150mg - not 15mg. 
 

A pill that weighed 15mg would be crumbs :) 

 

Are you weighing out 0.130g? (130 mg) or 0.013g? (13 mg)

 

 

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brassmonkey

That gets us on the same page.

 

Units of measure and decimal point location is very important when tapering.  As Hezzer pointed out 0.155 on the scale is 155mg and because this is the weight of pill material we refer to it as 155mgpw (milligrams pill weight). If you were to write it as .155mgpw you would be referring to an incredibly small amount, about 1/1000th of what you really mean. This could cause real problems when trying to do a reduction.

 

I gather the strength of the pill is 15mg (as listed on the bottle). This refers to the weight of the actual medication in the pill or the Active Ingredient as it is called. We refer to it as 15mgai (milligrams Active Ingredient)  By using these designations we can tell which is pill weight and which is strength when someone is talking about their dose. We almost always refer to doses by their strength or mgai.

 

It looks like you are trying to get a dose with a strength of 13.5mgai. This would be a reduction of 10%.

 

To calculate the dose weight in mgpw you would multiply 155 X .9 = 139.5 mgpw. The scales would read 0.140 because the additional .5mgpw is too small for them to measure.

 

If you are trying to get a dose strength of 13mgai then you would do a Gridley explained and multiply by .87.  155 X .87 = 135mgpw.

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Gridley

@Malbec37

 

How are you doing?  What are your plans?

 

As it turns out, even though you made an error with the scale and calculating method, the 139.5mgpw that Brassmonkey came up with is not significantly different from the 13.5mgai that you came up with your method, since you were calculating pw and ai as basically the same.  So if you're taking 13mgai, per your calculations, by good luck you're not that far off from where you should be.

 

Does the make sense?

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Malbec37

@Gridleythanks SO much for checking in to see how I am doing 😀

 

Yes it makes sense...I had assumed that consistently taking 13mg weight would be suffice to for me to eventually stabilise on the dose and minimise WD symptoms but, aside from a few windows, most of that 40 day period was a wave and by the end I had run out of coping skills as I have been so sleep deprived from insomnia that I was starting to fall apart. I had taken my first day off sick from work due to WD and was panicking....all part of WD I know but I was no longer able to push on. 

 

So two days ago I decided to updose back to 15 as I felt so confused by the amounts (due to sleep deprivation) and the consistency of 15 and not having to weigh and measure was appealing. I was aware of possibility of further destabilisation but went ahead anyway. I went with my gut instinct. 

 

Good news is is so far it has seemed to have done the trick and I am feeling much better in mood and sleep has improved. Last night I slept well with with no aides. I think my CNS just wasn’t at all ready for the previous drop I made from 15 to 11 then up to 13 and just needed consistency which it is now getting. There is also likely an element of placebo involved. 

 

So I am going to hold at 15 now until very stable....the DR has given me a 4 month supply of same 15mg tablets which provides consistency. When I am stable I will make the switch to either liquid mertazapine (if I can get it) or use the orally disintegrating tablets and then I will start to taper again probably at 5%. I will be able to plan this properly and start with a clear head.

 

What a 6 weeks it has been! But I have learnt a lot and got some WONDERFUL support from yourself and others and I’m just now relieved to be feeling somewhat better and quietly hopeful that I can settle down. 🤞

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Malbec37

Final thing I forgot to mention is that despite the updose I am still 50% of the way there so major progress has been made, so this makes me very happy. This drug is very powerful and is teaching me the lessons I need to learn to eventually fulfill my goal of coming off it and living med free 🙏🏔☀️

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Gridley
1 hour ago, Malbec37 said:

 

Good news is is so far it has seemed to have done the trick

That's great, Malbec.  I'm very happy for you and you have a good plan in place.

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Malbec37

Thanks Gridley I’m hoping you are well and enjoying the clean and clear air of the beautiful Vilcabamba valley 😊

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