Malbec37: tapering off mirtazapine / Remeron and hit major WD

[Malbec37]

Hi everyone

 

Great to have found this website...I have been on SSRI's and more  recently SNRI (mirtazapine) for past 17 years and the mirtazapine for past 5 - I have been depression free for past 5 years (previously had between 10 to 12 major breakdowns since age of 21 including whilst on the drugs..I am 38 now)...phew it's been tough but I have made it this far!

 

I decided that, if I could go 5 years without a major depressive episode, that I would try and come off my meds as a I feel I have developed the coping skills and resilience skills to manage my mental health drug free...I reached 5 years and started in August 2019 - I managed to cut down from 30mg to 22.5 and then 22.5 to 15mg over the course of 5 months...I had a period of about one week of WD during both reductions and it was very unpleasant but I just toughed it out and it passed and I felt better again - so I made it to 15mg which I thought to be quite an achievement! With this in mind and also wanting to get off this drug as fast as possible (within reason) I decided to cut the 15mg pills and start on approx 11mg around 9 days ago (with my doctor approval who is, by the way, absolutely clueless)....I have been suffering WD since day 1 including anxiety, foggy head, insomnia, slight ringing ears and generally just feeling low and not myself - I thought that this will pass if I just tough it out again but now, 9 days in and after reading a lot of stuff online I'm not so sure...it seems that with mirtazapine (and possibly other drugs) it gets harder as the doses get lower...which is hard to believe when you see the size of the 11mg in your hand. 

 

I have now found this website and it's incredibly helpful and I'm so glad to be here and able to talk to others about this! 

 

My first and REALLY important first question to ask for advice is should I go straight back up to the 15mg where I felt ok and stabilise there before thinking about my next approach which could well be the 10% reduction advocated on here? I just want to feel better again so I can cope with stresses in my life...I would appreciate some responses ASAP as I may do this tonight! Could I possibly use a quality weighing scale and go to 13mg or will this just further confuse my nervous system more?

 

I'm sure I'll have lots more questions in time but this will do for now

 

Lovely to meet you all

 

Big love and strength from Malbec37

 

[Gridley]

Welcome to SA, Malbec37.

 

Your withdrawal symptoms likely stems not only from the drop from 15 to 11 but are an accumulation of the large previous drops.

 

In the 9 days since you've been at 11, your system has made some accommodations to the lower dose.  If you can get a scale

(many members use the AWS Gemini-20 scale, available on Amazon) I'd updose to 13mg rather than 15 to avoid possibly overwhelming your system.  It is true that you should go more slowly at the lower doses.

 

About reinstating and stabilizing to reduce withdrawal symptoms.

 

The GEMINI-20 Scale

 

Using a digital scale to measure doses

 

It will take about a week for it to get to steady-state in your bloodstream, and the effect should get stronger during that time.

Keep daily notes on paper to track how the updose is working.

 

Once you've begun to stabilize, you will need to hold there for at least three months before any further tapering.  

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

[hezzer78]

@Malbec37 Hello! I'm tapering mirtazapine as well. How long were you at 15mg? I am on day 5 of a rather big drop - from 15 ->7.5mg and the worst thing is the insomnia. I've had some tingling, head pain, and ear ringing, but it hasn't been bad at all. I'm currently using ativan and benadryl to muscle through the insomnia, but I'm hoping to be able to lower those after a week or so. 

 

Are the WD symptoms you're experiencing now unbearable? If so, I would probably follow @Gridley s advice and reinstate to 13mg.  I plan on tapering MUCH slower after I stabilize at this 7.5mg. 

[Malbec37]

Hi @Gridley and @hezzer78 amazing to get your responses and I'm so delighted that I have found this site and can get support from people who actually know about these things...and also offer support to others. What a fantastic resource!

 

@Gridleyyes you're probably right that this is a culmination of the two previous reductions and now the new one to approx 11mg...it's a lot for the system to take and I didn't understand this fully although I have been tapering relatively slowly and carefully (or so I thought) - funnily enough today my mood has evened out quite a lot and I feel better this evening so I'm thinking I will stick to the 11mg for tonight as I don't have the scales yet anyway to measure13mg...I have ordered some which will arrive tomorrow so can always increase to 13mg tomorrow night. I just thought that I am feeling considerably better than yesterday or even this morning so good to continue with 11mg and not confuse my system more...what do you think? I'll see how I sleep and feel in the morning

 

Also thanks for the tip to stay for at least 3 months I think that is sensible to stabilise at whichever dose I choose (11 or 13)

 

@hezzer78....I was pretty much ok on 15mg - I suffered about 4 to 5 days of pretty horrible WD symptoms but they went away...I did a lot of bare foot walking in nature, yoga, healthy food and more and it seemed to do the trick...now the symptoms have today become easier but I think if they get bad again then I'll go up to 13 as suggested using scales...I do agree that I will take things much more slowly now that I have more info and understanding

 

To both of you is it ok to break up the pills to achieve the 13mg or better to try and make into a liquid? Might sound like a silly question...I guess if the measurements are correct o the scales then breaking the pills will work

 

Also how do I add my signature to the bottom? Is there a special way or I just write it out?

 

Thanks you SO much for your kind help

 

[Gridley]

24 minutes ago, Malbec37 said:

I am feeling considerably better than yesterday or even this morning so good to continue with 11mg and not confuse my system more...what do you think? I'll see how I sleep and feel in the morning

 

That's great that you're feeling better.  If you continue to feel better, I would stay with the 11mg.  . On the other hand, if you're feeling rotten, an updose is the tool we have to make withdrawal tolerable.

 

26 minutes ago, Malbec37 said:

 

To both of you is it ok to break up the pills to achieve the 13mg or better to try and make into a liquid? Might sound like a silly question...I guess if the measurements are correct o the scales then breaking the pills will work

 

Stay with the tablet and break up the pills.  You should make only one change at a time, and you don't want to to be updosing at the same time you're changing to a different form of the drug.  A crossover to liquid involves a gradual switch that takes a minimum of 12 days and generally more.

 

29 minutes ago, Malbec37 said:

Also how do I add my signature to the bottom? Is there a special way or I just write it out?

 

Use this link.  A list is better than a long paragraph.  You can use my signature as a model.

Account Settings – Create or Edit a signature.

[sunnysideup69]

Hello @Malbec37, I see you're in Bristol. Is that Bristol, UK? If so, waving at you from just down the road in Chippenham. ( where I grew up, just visiting parents this weekend.)

 

The moderators and support from people you will get here is fantastic, based on years of actual experience, rather than some dodgy dealing with Pharma ( or just general ignorance.)

Welcome 😊

[Malbec37]

@GridleyI did feel much better last night and did everything possible to get myself in the right state for a decent sleep but I had insomnia again and now feel pretty exhausted...mood is ok and I understand better what is happening but think I will start at the up dose of 13mg tonight as you suggest. Clearly my nervous system is struggling much more with this reduction from 15 to 11mg and there is no telling how long it could take for it to even out and give me decent sleep and I need to feel better soon so think this is the best option now. Any further thoughts would be welcome

[Malbec37]

@sunnysideup69 Hi there! Yes I'm in Bristol and I know people who live near Chippenham ha ha! Great to meet you

 

It's great to be on this site...I have many years of experience with these meds and mental health in general (like most on this forum) but little to no experience of tapering off and really want to succeed so I'm very glad to have found this site and the amazing resources and amount of experience that people have. I thought it would take me no more than a year to get off the meds but now I'm seeing it may take a whole lot longer than that but I can accept that more easily now and I feel that the less drug that is in my system the better I will feel...I know that I am strong enough now to handle my mental health without drugs...depression has forced me to develop so many wellbeing tools so that is one of the great gifts of such a horrible illness

 

Lovely to meet you, I would like to hear more from you and stay in touch

 

Enjoy Chippenham!

[sunnysideup69]

@Malbec37, haha, small world! Yeah, it's nice to be back in Chippenham.

 

I'm going to 'follow' your thread, so yes, will keep in touch. Good to meet you and good luck with the updose,sounds like a good idea.

SSU x

[Gridley]

2 hours ago, Malbec37 said:

Any further thoughts would be welcome

Sounds fine.  Remember that it takes a little more than a week for the new dose to reach full state in the blood.  You might feel better after just a day or two or it might take a few days longer.

[Malbec37]

Hi @Gridley...so I bought some scales and decided it was sensible to go up to 13mg and stick on it until stable (3 months as you suggest)...I did have a lot of problems with the scales jumping around and not seeming very precise...they weren't the cheapest ones and had good reviews. I got into a bit of a panic about it all thinking that the measurements weren't in any away precise...but with perseverance the scale seemed to start to behave more and I managed to break up the pills to get approx ranges between 12.8 and 13.3mg - it was still jumping around a bit but I couldn't get it to stick to 13 precisely but really not very far off at all. I did this for hours and now I have ten doses prepared around these amounts....I know its not ideal and would rather have exactly 13mg but I have done my best - I have taken the first one tonight. Would be grateful for your thoughts on this? 

 

Many thanks as ever as I am new to this and really need support and reassurance 

[Malbec37]

Is it a problem to move to using different brands of mirtazapine as my latest prescription is a different brand? I would imagine they would have to contain the exact right and same amount of the chemical... just thought I'd check

 

Thanks!!

[jozeff]

Hi malbec,

 

A different brand could be a bit problematic because it might contain a slightly higher or lower dose of active ingredient and other substances that could be present in 1 brand and not in the other.

 

If possible stick to 1 brand. If not, take a couple of days to switch from 1 brand to another (if possible).

 

I had the same with citalopram and decided to take only 1 brand although I have to pay extra for it.

 

On the other hand, it might not be a problem at all for you. My wife switches brands all the time and she doesn't feel a difference.

 

I know what you mean with the scale problems.

 

What might help is:

 

Add a 100 mg weight and weigh your 13 mg on top of that. The scale might work better that way.

Try not to add mg by mg but try to weigh a chunk as close to 13 mg as possible.

 

I had this problem a few years ago and I mixed my medication with powdered sugar and grinded this to dust. Make it very homogeneous and weigh the stuff. This way you can weigh more mgs so it is more accurate.

Disclaimer: your substance might react with sugar and you must create an absolute homogeneous powder. Just wanted to tell you how I handled this issue a few years back. I'm not telling you should do this!

 

 

Good luck and let us know how it goes!

 

Jozeff

 

 

 

 

 

 

 

[Gridley]

57 minutes ago, Malbec37 said:

I know its not ideal and would rather have exactly 13mg but I have done my best - I have taken the first one tonight

 

We just have to do the best we can.

 

50 minutes ago, Malbec37 said:

Is it a problem to move to using different brands of mirtazapine as my latest prescription is a different brand?

 

We recommend a gradual crossover from brand to brand.

3/4 old brand, 1/4 new brand for 3 to 7 days

1/2 old brand, 1/2 new brand for 3 to 7 days

1/4 old brand, 3/4 new brand for 3 to 7 days

all new brand thereafter

 

Some members do fine with a short switchover, others need longer.  I've experienced both situations.

 

Once you've made the crossover, I'd wait 2-3 weeks before making any other changes, such as a taper.

[Malbec37]

Hi all so I thought I'd give you all an update for those of you following this:

 

So I was on 11mg mirtazapine from 15mg (originally 30mg) and struggled significantly with WD for 10 days up to yesterday including insomnia, anxiety, ringing ears and possibly muscular pain...I decided last night to update to 13mg after advice on here so bought some microgram scales and eventually after many hours of effort and a fair bit of stress fuelled panic managed to create a few doses of around 13mg give or take a tiny fraction either way....took this last night alongside half a clonazepam (not ideal I know but needs must sometimes) and also had ear acupuncture in the daytime...today I woke feeling much more myself and was able to relax in bed and get more sleep and then I've had a great day so far and feel much more my usual self...thank goodness!!!

 

So I'm learning a lot and it seems the updose from 11 to 13mg has done the trick and now let's see how I am tomorrow...I am planning on staying on 13mg for 3 months now before I start a 10% reduction regime. I think I will just have to keep breaking up the pills and making my own amounts and I will also buy a more expensive scale to ensure that, as things get lower, I can be more precise. I am also going to speak to the pharmacist and make sure that I get exactly the same brand throughout the withdrawal/tapering process.

 

Thanks for all your help so far it's been invaluable 

 

Much love to all those trying to get off these meds...who would have known the reality of withdrawal!

 

Malbec37

[Gridley]

14 minutes ago, Malbec37 said:

buy a more expensive scale

Have you looked into the AWS Gemini-20 scale, available on Amazon?  

 

I'm very glad the updose is working.

 

I notice in your signature you're taking B vitamins, which many in WD find overstimulating.  Since anxiety and insomnia are among your symptoms, you might consider eliminating the B's.

 

Hypersensitive to B Vitamin or B-Complex  

 

I've found this restorative yoga pose helpful with anxiety.

10 minute Restorative Yoga for Relaxation | Up the wall

 

 

[Malbec37]

Hi @Gridley Yes I'm going to buy the Gemini scales today thanks! Then I'll have two sets and can compare to make sure they are precise

 

Yes I have been taking B vitamins for a while now to help with anxiety ironically but, after reading the link, then I think I'll stop them for a while as if they have interactions with the WD process then I should stop...also I eat a lot of very healthy food, mostly organic so really I should be getting everything I need from my diet

 

What do you think about fish oils as a support?

 

Yes I love legs up the wall pose...I'm a yoga teacher and it's had a huge effect on my recovery from mental health illness

 

Thanks for all your help it's been invaluable!!

 

I love this site there is SO much here

[Gridley]

7 minutes ago, Malbec37 said:

What do you think about fish oils as a support?

We recommend fish oil (omegas).

 

Omega-3 fatty acids (fish oil) 

[Malbec37]

@GridleyYes I take fish oil but not at the high amounts suggested...currently take 800mg EPA and 400 DHA a day (which is what the bottle says is the most I should take)...it's called Super Hi Strength Omega 3 fish oil...I could take more potentially? I also eat mackerel about twice a week so would imagine I get a fair bit form that also...as well as eating a LOT of walnuts ha ha 

 

I've ordered the scale now thanks!

 

I see you take melatonin...is that helpful? Can't get it here in the UK and would need to order from overseas

[Gridley]

12 minutes ago, Malbec37 said:

currently take 800mg EPA and 400 DHA a day

Seems right to me.  That's about what I take.

 

I'm don't know whether melatonin helps or not.  Some interesting things I've read say with melatonin more is not better.  Some tests have show that 0.3mg is the best dose.  I'm going to cut my 0.5mg half pill in half tonight and see if it works better.

 

If you do happen to order from the States, here's a link to a company that sell the .3mg dose.  My next order from the U.S. I'm going to try this (nothing available in Ecuador).

 

(available on Amazon) is exactly 0.3 mg. 

[Malbec37]

Thanks @Gridley

 

Funny you live in Ecuador as I was travelling there for 6 weeks in early 2019 and loved it! I started in the Amazon near Tena then Banos, Cuenca which I loved, Vilcabamba which is amazing, then treking in Andes then to Quito and on to Colombia for 6 weeks which is an INCREDIBLE country.

 

I am very jealous of you living in such an amazing country and continent 

[Gridley]

12 minutes ago, Malbec37 said:

Vilcabamba

Sounds like a great trip.  I live in the mountains above Vilcabamba, about 15 minutes from the village.  We've been here 8 years, previously lived for two years in Cuenca.  We may well have seen each other when you were in Vilcabamba.

[Malbec37]

@GridleyWow I am so jealous of you living in the mountains near Vilcabamba...that has to be one of the best places to live on the planet!!? You are so lucky it's incredible there and the nature is abundant and beautiful....and Cuenca is a great city as well. I want to come live in Vilcabamba but it's a long way from home!

 

As regards supplements is there anything on here about whether Maca root powder is recommended? I use it in smoothies every day and it's great for energy and meant to be good for mental health but perhaps it's not good for the anxiety in WD? When the WD goes away then I guess we can reintroduce things like this?

[Malbec37]

Hi everyone...so my latest update is that I'm having another good day having taken second updose of approx 13mg - still have some ringing in the ears and didn't sleep perfectly but a LOT better than before...so things are obviously levelling out and no doubt will continue to do so so very happy about that and also to have this resource SA to help me in my long term goal of coming off my meds.

 

Remember every reduction however small is a positive step in the right direction

[Gridley]

24 minutes ago, Malbec37 said:

whether Maca root powder is recommended?

Some members have mentioned using it for anxiety.  It does seem to have psychological and, as you said, energy-enhancing properties.  This of course is all in the context of not being in WD.  If it's working for you, fine.  As with all supplements, I'd recommend you stay at the low end of dosage.

[Malbec37]

@Gridleyor anyone else...I’m on day 3 of the updose from 11 to 13mg (3 nights of taking 13) and struggling a bit now with anxiety, little nausea feeling which is a new  symptom, lacking concentration, sleep wasn’t so great but not as bad as before...is this to be expected after doing an updose and will it level off? I know it takes at least a week for the new dose to get into my system 

 

I’m ok just looking for some support and reassurance 

 

who would have thought this process could be so hard 

 

thanks 😀

 

 

[sunnysideup69]

1 hour ago, Malbec37 said:

@Gridleyor anyone else...I’m on day 3 of the updose from 11 to 13mg (3 nights of taking 13) and struggling a bit now with anxiety, little nausea feeling which is a new  symptom, lacking concentration, sleep wasn’t so great but not as bad as before...is this to be expected after doing an updose and will it level off? I know it takes at least a week for the new dose to get into my system 

 

I’m ok just looking for some support and reassurance 

 

who would have thought this process could be so hard 

 

thanks 😀

 

 

 

Sounds pretty normal to me......you'll have symptoms which will increase for a while and then fade out again. It will settle. 

[Gridley]

1 hour ago, Malbec37 said:

so great but not as bad as before...is this to be expected after doing an updose

 

I think these little twists and turns are to be expected. As you said, you're only on day 3.  You had a good reaction initially, so your system is accepting the updose and your sleep is better, so all in all it's well.

[Malbec37]

original title: Thoughts on why to stop the meds and is it worth it? (mod note merged introductions)

 

Hi everyone

 

Since starting to taper mirtazapine after being on it for 5 years (and Sertraline and citalopram for 12) I have encountered WD symptoms and found my way to this amazing website which is a total godsend....I never realised it could be this hard and take so long to get off my medication. The idea of slowly tapering for up to two more years and the effort and difficulty that this will involve really does make me wonder why I am doing it in the first place....I never had any side effects from the mirtazapine I just thought that after 5 years of being free of depression I was strong and resilient enough to come off my meds and lead a med free life! But I didn't know how hard to would be to do this 

 

I would love to hear from others as to why they are coming off their meds as it may give me the hope and inspiration that I need?

 

Thanks

Edited January 7, 2020 by manymoretodays

[Gridley]

22 minutes ago, Malbec37 said:

I would love to hear from others as to why they are coming off their meds as it may give me the hope and inspiration that I need?

 

 

These drugs were never intended to be taken long-term, and no tests were done on their long-term effects on your health.  

If you want to be convinced beyond any doubt how bad these drugs are in the long term, read "Anatomy of an Epidemic" by Robert Whitaker.  I predict you will never again question your decision to get off these drugs.

[pinciukas]

22 minutes ago, Gridley said:

 

These drugs were never intended to be taken long-term, and no tests were done on their long-term effects on your health.  

If you want to be convinced beyond any doubt how bad these drugs are in the long term, read "Anatomy of an Epidemic" by Robert Whitaker.  I predict you will never again question your decision to get off these drugs.

And what to do when any other techniques don't works? I have tried everything meditation yoga mindfulness clinics and so on and I mean not for 1 month I am practising everything every day but I can't be without meds. I did 3 tapperings and never improved. With the last one I have tappered almost 2 years until 5 mg and then I just crashed can't work can't do anything after updose I came back into the normal state. A lot of people suggesting to quit drugs it is cool. But what do to when you can't?  

[Gridley]

8 minutes ago, pinciukas said:

But what do to when you can't? 

I wish I could tell you.  You have to do what you feel is best for you.  

 

I'm hoping the updose will help, but it's a little too soon to tell, since it takes a bit over a week for the new dose to reach steady state in your blood.  Have you noticed any change in your symptoms since the updose?

Edited January 7, 2020 by Gridley

[pinciukas]

1 minute ago, Gridley said:

I wish I could tell you.  You have to do what you feel is best for you.  

 

I'm hoping the updose will help, but it's a little too soon to tell, since it takes a bit over a week for the new dose to reach steady state in your blood.  Have you noticed any change in your symptoms since the updose?

Yes it is already one week on updose. Yesterday I had one anxiety attack and today nothing. Like after 3 days everything improved 80% crazy 🤯 I want to go to work already left my house took a walk I don't have nausea and etc. I will stay now on this dose and we will see later what I can do.

[mikeyboy]

Malbec. I would take it very slowly with Mirtazapine. I have been on it for 14 years and started to taper two years ago from 15mg (although I had only been taking that dose for 4 months). I did it way too fast and jumped at 1.8 last April. My doctor told me 1.8mg was "not a therapeutic dose" so I that's why I jumped. I reinstated at only 1mg but didn't stabilise, partly because I had too many life stressors.

 

Mirt works on so many receptors that it can really throw you off. Under 7.5mg it gets tough, and also hard to dose with the tabs. I used the scales until 1.8 but I don't think they're that accurate TBH. I've been diluting the soluble tabs in water (dilute 15mg tab in 15ml water, use use syringe to take dose). I am in the UK too (same region as you), so they are available on the NHS. 

 

Good luck with asking your pharmacy to keep the same generic, I've been taking Zoplicone (unfortunately) and they change nearly every time I get a new Prescription.

 

I hope your stabilisation goes well. If I could go back in time I would taper very slowly and be thinking about doing it over several years. I wish I had discovered this site earlier.

 

 

[Malbec37]

I'm just finding it so hard to get my head around how small the doses have to be and how long it takes to get there...I mean I believe it it's just overwhelming...I spoke to my doctor yesterday and he said it was rubbish and there was no way that under 1mg could do anything...when I look at the tablets part of me believes him or wants to believe him but then I read on here about the many years of efforts people make....so much courage. 

 

And then I read somewhere on here from someone experienced saying that being stable doesn't mean being symptom free...it just means being stable with what symptoms you have and learning to live with them...I'm not sure I can! When I was on the medication and settled I had no symptoms and was able to manage my life really well and I had a very full and enjoyable life...I'm just really worried that now I am going to be having WD symptoms ongoing 

 

Sorry I think I'm just starting to panic a bit about this whole situation and like EVERYONE else I just want to feel myself and feel able to function normally 

[Gridley]

43 minutes ago, Malbec37 said:

there was no way that under 1mg could do anything

Doctors know nothing about tapering or withdrawal.  We used to think that jumping to zero at 1mg was a good place to jump, but experience has taught us otherwise..

 

These drugs are very powerful and it is at the low doses that we have to go slowly and carefully.

 

Yes, it's hard to wrap your mind around how long it takes.  It's always a shock; I know it was to me.  But that's the reality.

 

Being stable means having basically the same symptoms day to day and that they are tolerable.