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Mimi79: Will I survive?


Mimi79

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Dearest Anne-Marie,

 

It sounds like you have a really good plan in place.  

 

4 minutes ago, Mimi79 said:

Thank you so much for your help and I hope this window you are living now, is the beginning of a wonderful healing.

Aw, thank you so much - that is beautiful.

 

I am here if you need any support. 💗

-1/06 - 3/07 Cymbalta. Fast taper (essentially CT); withdrawal symptoms after 4 mos (didn't realize was WD)

-10/07: 100 mg Zoloft; 1 mg Klonopin - tapered off Klonopin after 4 mos. Several unsuccessful slow tapers of Zoloft; went up and down in dose a lot

-Spring 2013 back on 1 mg Klonopin to counter WD symptoms; switched over 5-6 mos from Zoloft to 35 mg citalopram
-Two attempts at slow tapering citalopram, always increased dose due to WD; also increased Klonopin to 1.25 mg in 2014, then to 1.5 mg in 2015

-8/17-9/17: After holding one year at 20 mg, feeling withdrawal symptoms due to stress - slowly increased to 25 mg. No change in symptoms after 6 months (? tolerance ?)  - decided to start citalopram taper February 2018 (still on Klonopin 1.5 mg).

Supplements: fish oil; magnesium; vitamin D3; curcumin

Citalopram taper:  2/2018 - 12/2019: 25 mg - 11.03 mg I 2020: 10.89 mg - 7.9 mg I 2021: 7.8 mg - 5.26 mg I 2022: 5.2 mg - 3.36 mg I 2023: 3.3 mg - 1.47 mg 2024: 1/5/24: 1.44 mg; 1/19/24: 1.40 mg; 1/26/24: 1.37 mg; 2/2/24: 1.34 mg; 2/9/24: 1.31 mg; 2/23/24: 1.28 mg; 3/1/24: 1.25 mg; 3/8/24: 1.22 mg; 3/15/24: 1.19 mg; 3/29/24: 1.17 mg; 4/5/24: 1.14 mg; 4/13/24: 1.11 mg; 4/20/24: 1.09 mg

 

 

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Hi @brassmonkey

I need your knowledge!

I wonder if I could be in a kind of tolerance state.

I will resume the past months:
After feeling some months of stabilization, I started a ''Brassmonkey taper'' on mid october. My initial dose was 45mg of mirtazapine. I was decreasing of 2.5% each week. At the end of the first month, few days after the last 2.5% cut (I was then at 40.5mg), I started having a wave. A bad one. For the first 2 weeks, it was tolerable, but after, it was so hard that I updose bit by bit until I reached 42.75mg. At this point, I didn't want to updose again, as it haven't bring the relief I was hoping for. I decided then to stabilize on this dose and wait. It's been now 1 month that I am on this dose, 3 months that I stopped my taper. I don't see any improvements, except maybe 3-5 days few weeks ago when I had a little break of symptoms.
My question is, can I be in tolerance from my ADs?

And is it normal that it takes so much time for me to stabilize, considering I was doing a slow taper?
In my previous crash, I was stabilizing within 2-3 months, and I was doing a more rapid taper.

 

I need to see what are my options now and what I should do next.

 

Thank you so much for your help.🙏

 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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  • Moderator Emeritus

Q:  Did you, at any time, continuing making reductions even if you had withdrawal symptoms?

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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59 minutes ago, ChessieCat said:

 

Q:  Did you, at any time, continuing making reductions even if you had withdrawal symptoms?

 

Hi @ChessieCat and thank you for helping.

The answer is no, I’ve never made a reduction when having symptoms. I am too afraid of worsening my condition

to do this. Since the beginning of this wave, I’ve only updose a little bit.

 

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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  • Moderator

Hi Mimi-- I'm so sorry to hear that you are having trouble with your taper. Things will get better.

 

After all the years I've been working with ADWD I am still amazed at just how quickly things can go bad and just how long it takes for them to correct themselves. The bright thing is that they do correct themselves. Tolerance symptoms always happen quite slowly, most people don't even know it's happening until the tolerance has a good foothold. If symptoms spike "over night" it is one of two things, an adverse reaction or a wave. An adverse reaction doesn't happen during a taper but rather with a change of medication from one drug to another.

 

What your describe is a bad wave. They are very unpredictable because there are so  many factors involved in them, past taper history, past waves, situational stress and many other things. They can be triggered by just about anything and once started have to be left to run their course. Many of the selfcare/coping ideas we provide can help to take the edge off while the wave works it's way out. The really disheartening thing is that there is no way to tell just how long they are going to last, except that they last a lot longer than we would like. The 2-3 months you needed to stabilize in the past is on the quick side of the scale. Because you have had several waves in the past it is more than likely that this one will take longer to resolve, but given time it will. For right now just sitting on the dose you are currently taking and letting your body work on itself is the best course of action.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Thank you so much, @brassmonkey.

I know you are right, even if I am desperate to do something. 
I have another question that arise and I think you are the good person to answer it.

I am dry cutting my mirtazapine pills with a cutter and I weight them with the Gimini Scale. As my prescription is filled with 30mg and 15 mg (to make 45mg), when I cut them, I only cut the 15mg ones and leave the 30mg whole. 
I’ve noticed that the pills never quite weight the same. For an example, the 30mgai pills weight between 302mg to 316mg (the majority around 308mg)
My question is, does the dose of active ingredients each pill have is always exactly the same, even if the weight isn’t, or does the dose vary WITH the weight?

Because I don’t consider it in my calculation. I always use the same weight. For an exemple, for now, I want to have 42,75mg and I’ve calculated that it equals 441mg. So I cut and weigh until I reach this dose with the 30mg and the 15mg (cutted) on the scale.

I know I am not very clear in my explanation, I would like right now to be better in English!!

I am just afraid of not making it correctly and having a different dose everyday without knowing it...

Thank you for giving me your insight!

 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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Hello Mimi,

 

ive followed your topic for quite some time and iam sorry youre in a rough wave.

 

Also, ive posted some interesting information about your question in the scale topic (see: https://www.survivingantidepressants.org/topic/1596-using-a-digital-scale-to-measure-doses-weighing/page/10/?tab=comments#comment-521117)

 

Please check the last 2 posts.

 

From all ive found, i would say that its very likely pills with different pill weight, do have a slight variation of active ingridient. When you have calculated your AIC, you can estimate it. But bare in mind that your dose is quite high, so these changes should not be a "big" problem for you.

All in all youre doing it the right way to get your pills to the same weight!

 

The last post explains that it could be important to check your package insert or online information from your manufacturer.

Does it tell your tablets can be "split into equal doses"?

This can vary from different manufacturers and even different dose strengths from the same manufacturer (like your 15 mg and 30 mg tablets). A score line does not always indicate equal dose splitting.

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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10 hours ago, brassmonkey said:

The 2-3 months you needed to stabilize in the past is on the quick side of the scale. Because you have had several waves in the past it is more than likely that this one will take longer to resolve, but given time it will.

@brassmonkey

I know I was lucky last year to recover in such short period. I know everyone is different, but what kind of time frame can I expect? It gives me hope when I see that some people take more time to reach stabilization. It reminds me that I am not doomed.

Thank you.

 

@Nomansland

Thank you for your help and the link you gave me. You confirmed my doubts. 
 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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Hello @Mimi79,

 

can i ask you which manufacturer your tablets are from?

I want to check something, because youre weighting both, the 30 mg and the cutted 15mg at the same time on the scale to get your weight, right?

This is okay if both tablets have the same AIC. If this is the case, i think its even more precise than just weighting the cutted 15 mg tablet and take the 30 mg without weighting (because your 30 mgai tablets range from 302 to 316 mgpw and this will be evened out when you weight them together with the cutted 15mg tablet, to one weight).

 

Long story short...we have to check if your 15mg tablets and 30mg tablets have the same AIC. What is the average weight from your 15mg tablets and from your 30mg tablets?

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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@Nomansland

Thank you  again . 
My pills don’t come in original packaging, but in bottles filled by the pharmacist. 
The 30mg are from Mylan and the 15mg are from Sandoz. 
 

15 minutes ago, Nomansland said:

want to check something, because youre weighting both, the 30 mg and the cutted 15mg at the same time on the scale to get your weight, right?

Yes, I am weighing them together, the 30mg and the cutted 15mg. So it means that when the 30mgai has a higher weight, I have to cut more on the 15mgai pill to compensate.

 

So sorry for my English, I don’t use any

« translation tools ».

 

What is AiC?

 

 

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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Hello @Mimi79,

 

to get your AIC (active ingredient concentration), you have to weigh 10 (or more) tablets to get the average weight of them. Do this for both, the 15 mg tablets and then for the 30 mg tablets. Then we can divide the 15 mg(active ingredient) trough your average pill weight. We will know how many mg of active ingredient is in one mg of pillweight. After that we repeat the same thing with your 30 mg tablets.

 

See, if both of them have 0.1 mg mirta in 1 mg pillweight (this is for my tablets), your method of weighting is perfect! Because youre weighting them at the same time.

If the 15 mg tablets have 0.2 mirta in 1 mg pillweight (just an example) and the 30 mg tablets have 0.1 mg mirta in 1 mg pillweight, you should weigh them each on its own.

 

English is also not my main language, so dont worry.

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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1 hour ago, Nomansland said:

Then we can divide the 15 mg(active ingredient) trough your average pill weight. We will know how many mg of active ingredient is in one mg of pillweight.

So it is a kind of « Mean dose », because in fact, we don’t really know how much active ingredients there is in one pill. We suppose that each pill has 15mg. 
 

The way I did it, I was weighting all the pills I was about to use (like 7x15mg and 7x30mg if I was doing it for a week), then I divided by 7 to find the average weight of an equivalent of 45mgai. 
 

I will think about it...

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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Hello @Mimi79,

 

yes its a mean dose.

You said your 30mg tablets weigh from 302 to 316, so lets say the mean weight is 309 mg pillweight.

 

30mg / 309 mg pillweight = 0.1

 

So this is your AIC for the 30mg tablets. In 1 mg pillweight of the 30 mg tablets, you have 0.1 mg Mirtazapine (yes its calculated from the mean weight, but its the best we can do and it wouldnt change much, even if the mean weight is slightly different).

 

Because your 15mg tablets are not only a different strength, but also from another manufacturer, it would be good to know their AIC. What is the mean weight from your 15mg tablets?

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

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  • Moderator

I would suggest reading through this topic, It explains a lot about how the pills are made and the Active Ingredient distributed through out the pill.

 

https://www.survivingantidepressants.org/topic/22065-myths-about-your-drugs/?tab=comments#comment-463989

 

Because of the slight variations in weight between pills it is best to treat them as a "supply pile" for raw material and then measure a specific dose weight from that pile. This negates the variations. The average weight of the whole pills is used to calculate the initial dose weight only. From there all further doses are calculated on the previous weight. This also removes any variation in pill weight from the calculation after the first one. From there we aim for consistency in measuring rather than hitting a specific calculated number to keep the blood serum level as constant as possible. There are going to be some fluctuations in blood serum concentration due to half life, bioavailability, absorption rates, metabolism and a number of other factors, so in the end minor differences in the dose weight hardly matter. 

 

The AIC of a medication is a good indicator of just how little the variations of dose weigh have on the dose strength. Especially at the larger doses the AIC is such a small percentage of the total dose that it doesn't have much affect at all. Only when we get to the smaller doses of the Endgame Zone is it a factor.  The main use of the AIC is for making interim calculations where we only know one factor, either dose strength or dose weight. It can also be used to determine the Endgame Zone and in some cases the Theoretical Exit dose.

 

 

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hello,

 

brassmonkey is right. As long as you keep the same weight, you will get the same dose.

My thought was, if you know the AIC of both of your tablets, you can determine more exactly how big or small a change

in your dose is, when you make an updose or taper. This could be different, when you would file off 1 mg pill weight of your 15mg tablet or 30mg tablet.

So its always good to have these data. Doesnt matter now, but for later.

 

I didnt want to unsettle you. Youre doing the right thing.

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

Link to comment

@Nomansland 

I did the math and yes, both 15 and 30 mgai pills have the same ration, 1mg=0,1mgai. 
So, do you think the way I measure It is accurate?

With the comment from Brassmonkey, I understand that maybe I don’t need to weight the pills each time, I can use the same weight over again?

 

Thank you for helping me!

 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

Hello @Mimi79,

 

Its very good that your tablets have the same AIC (my tablets also have an AIC of 0.1mg).

Iam not sure what you mean. If you always use the same method of accurate weighting and always get the same

weight, you are doing it right.

 

As i said before:

 

"I think its even more precise than just weighting the cutted 15 mg tablet and take the 30 mg without weighting (because your 30 mgai tablets range from 302 to 316 mgpw and this will be evened out when you weight them together with the cutted 15mg tablet, to one weight)."

 

Greetings

 

Nomansland

2022 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

2020: 3-March -> started Mirtazapine 15mg;

3-March to 6-April -> approx. cutting to 0 mg; 6-April to 20-April -> ~ 7,5 mg; 21-April to 31-April -> 15 mg; 1-May to 13-May -> ~ 10 mg (approx.); 15-May to 19-July -> 15 mg (psychosomatic clinic) 19-July -> started taper (scale and file) 14 mg (-6,6%); 08-August -> 12 mg (-14,3 %); 27-August -> 10 mg (-16,6 %); 15-September -> 8 mg (-20 %, bad idea, heavy WD); 23-September -> 10.2 mg (+20 %, 102 mgpw)

2021: 12-April to 12-May -> crossover from solid pill to DIY liquid (water only), 10.2 mg, not stable; 10-September -> back to crushing and weighing, still 10.2 mg (102 mgpw)

2022: 13-March -> changed to DIY liquid with suspension vehicle, 10.2 mg

 

Supplements: 1 x ~125 mg magnesiumbiglycinate before bed, low histamine diet

Link to comment

@brassmonkey

On 2/22/2021 at 9:23 PM, brassmonkey said:

The 2-3 months you needed to stabilize in the past is on the quick side of the scale.


In the last 2 weeks, my symptoms have ramped up a lot, this is why I feel very discouraged. Is it normal to have a kind of «wave in a wave, if you know what I mean? 
 

And if 2-3 months to stabilize is on the quick side, what can I expect, what is the « average time » people take to stabilize? I know everyone is different, but I’m living quite hard days now and try to fix me some goal to focus on.
And I would like the know what is a normal length of time for stabilizing and what is quite anormal. I want to know if I am doing the good thing to wait. 
Thank you very much for your tremendous help. Here, you are my lifeline when I am in such a bad state...

 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment
  • Moderator

I always feel like I'm handing out life sentences to people when I talk about time frames. The thing is that they are so individual that it is impossible to apply averages to a specific person and people tend to take generalities as specific to their situation, which it's not. In general it takes six months to a year, but in some cases it can be a lot less or a lot more.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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@Erell

Hi dear Erell,

I struggle a lot these days as after some days with very high anxiety and obsessive thoughts, I am now so tired and depressed. 
My mood is so low, I don’t know how I will be able to finish my work day.

I would need your positivity and your kind and wise words. 
Hope you are doing well.

Thank you

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

Hi Anne-Marie,

I’m thinking of you.  I know how hard it is to have a wave within a wave.  When you feel it can’t get any worse it seems to do just that.  I notice that when I feel I can’t take another day my wave is almost over.  There might be one more day of pretty miserable feelings, but when I look back that was when I started to climb out.  It might be a slow climb out, too.

 

Have an Epsom salt bath?  There is Epsom salt oil, too.  You can rub it on your skin.  I’m sure hunting that stuff down right now isn’t an option, but when you do come up for air, get some to have for the future.

 

I hope you are feeling better all ready.
 

Rosetta

https://www.survivingantidepressants.org/topic/16629-rosetta-ct-may-2011-too-fast-taper-feb-2017/?page=25

2001-2011 Celexa 10 mg raised to 40 mg then 60 mg over this time period

May 2011 OB Doctor's Cold switch Celexa 60 mg to 10 mg Zoloft sertraline (baby born)

2012-2016 - Doctors raised dose of Zoloft up to 150 mg

2016 - Xanax prescribed - as needed - 0.5 mg about every 3 days (bad reaction)

2016 - Stopped Xanax

Late 2016- Began (too fast) taper of Zoloft

Early 2017 - Trazodone prescribed for bedtime (doseage unknown)

Feb 2017 - Completed taper/stopped Trazodone

Drug free since Feb 2017

2017 - Unisom otc very rarely for sleep

Link to comment

Hi Anne-Marie

 

I thought I would pipe up with my own experience with Mirtazapine last year as there are a few similarities. Although we are on different doses and have different symptoms - mine being awful insomnia - we both ran into great difficulties after a brass-monkey taper and had to stop tapering and updose.

 

I just wanted to say that around 3 months after I stopped tapering, my symptoms became even worse! It was hell. Although by the 4th month (December) things had started to improve and by January they were a LOT better. I hope this might be encouraging for you as you might be very close to things changing for the better. I was very upset and shocked by how long the suffering lasted and I really sympathise with you but hopefully the worst of it will be passing soon and you're nearly there.

 

I also think that given we both had delayed wd symptoms a brass monkey taper is probably too fluid. I feel I need to wait 3 or 4 weeks to let things fully settle before I make another cut after what happened, at least initially. I'm very frightened of being hit by delayed symptoms again and I think I need longish holds. I'm worried that a taper will be incredibly slow this way as I'm also afraid of large drops! But unfortunately I don't have a choice as I don't set the pace! I don't need to learn that the hard way again!

 

Anyway, I just wanted to say hi and hopefully give you some encouragement. 

 

Ripley

▪︎2000 - Seroxat (25mg?) 6 months C/T

▪︎2015 - 7.5mg Zopiclone 1 month C/T

▪︎ 2016 - 2018 - Diazapam and Phenergan occasionally for sleep

▪︎2017 June to Oct - Mirtazapine 7.5mg C/T

▪︎2018 April - 2019 Oct Mirtazapine 7.5mg tapered to 1.5mg.

▪︎2019 October - Mirtazapine 1.5mg (Skipped alternate doses on doctor's advice then stopped - Insomnia.) Phenergan

▪︎2020 Jan 6th - Mirtazapine 1.5mg

▪︎2020 Jan 13th - Mirtazapine 7.5mg

▪︎2020 - Feb - May, holding 7.5mg

▪︎2020 1st June, 7.35mg. 27 June, 7.2mg. 7 July, 7.05mg. 18 July, 6.9mg. 28 July, 6.75mg. 27 Aug, 6.6mg. 7 Sep, 6.45mg. 17 Sep, 6.6mg. Crash/Hold

▪︎2022 - 4 Feb, 6.45mg. 24 Mar, 6.3mg. 13 May, 6.15mg. 13 July, 6mg. 10 Aug, 5.85mg.

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Oh dear @Rosetta!

Thank you so much for your good words! You are so kind and reassuring. You give me the little glimpse of hope I needed to.

 

Yes, yesterday was the worst day since the beginning of this wave in November. The last three days were full of anxiety and obsessive thoughts, at a level I have never had, then it merged yesterday in a big black hole of depression. I was so depressed, I was afraid of myself. And I was panicking too, so I had a lot of difficulties to fall asleep. Depression feelings are new for me, as I’ve never experienced it before, even in the last 12 years I’ve been on ADs. It is so frightening! 


I have the feeling that when I have few days with a lot of anxiety, the days after I will be more in a depression state. maybe it is a kind of balance, who knows. 
 

And I think I realized something. Since this wave started, I have been working my full time job, taking care of my kids and my house,  doing all the tasks I normally do, like if everything was normal with me. But it was at a cost. The more I was pushing myself to do things, the more my energy level was going downward. I have the feeling that yesterday, I hit the bottom...

 

Today, after a not so good night, I take my day off, and fortunately, I am in vacation next week (spring break with the kids).  I will try to rest a lot and remove some stress and guilt from my shoulders. And If I don’t feel I can endure more, I will go see my Gp and ask for a break from work, with the hope that she won’t try to put me on other meds...I didn’t want to come at this point, because I’ve been in a break of work from june 2019 to June 2020. But I don’t have another choice, if I want to take care of myself. And I have the luck to have this opportunity to have a break and to be paid during this time.

 

Thank you again Rosetta, your are my wise guide through this hell. ❤️
 

Anne-Marie

 

 

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

@Ripley Thank you so much for your message! It gives me some hope! It is quite frightening to see the symptoms increase in severity when you try to stabilize since so long.
 

1 hour ago, Ripley said:

 

I also think that given we both had delayed wd symptoms a brass monkey taper is probably too fluid. I feel I need to wait 3 or 4 weeks to let things fully settle before I make another cut after what happened, at least initially


This is something I realized too late. I thought that doing the Brassmonkey was the smoothest way I could taper, and I put a lot of hope in it. This is why I was so surprised and disappointed to see that I crashed again. And right at the beginning!!


But some guys on my FB group told me that changing dose each week isn’t suitable for everyone, and maybe not for mirtazapine users.(They had an explanation about that).

What you are saying now comfirms my doubts. We are not alone to not be able to do a brassmonkey style method. 
Right now, my only goal is to stabilize. The day I will be in a better shape and I will be ready to taper, I will too make one drop each 3-4 weeks, and I will start at a very, very low decrement, like 3%. 
 

But for now, I won’t think about it too much, all I want is to feel better. 


Thank you so much for your help! So much appreciated!

 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

Hi everyone, I need some help.

I think I did a mistake.

I know that during WD I have to avoid using any meds. But for the last 3 months, I’ve been in a constant wave and since the last 2 weeks, I have the feeling it is going worst.

 

Because I am in such anxiety state almost everyday, I’ve use very occasionally some 0,5mg of Ativan. It was maybe once or twice a month, but for the last 2 weeks, I’ve taken them more often, particularly in the last 7 days. 


So since Monday, each time I take an Ativan, about 36 hours later, I fall in an awful state with mixed depression, agitation and anxiety to the roof. Maybe it is akathesia, but I’m not certain as I don’t know this symptom well. The first time it happened (Tuesday), I took an Ativan to overcome it, but 36 hours later, the same symptoms again, but worst, so took again an Ativan and so on. When I take the Ativan, it seems to alleviate the symptoms.

 

Do you think it is a kind of interdose withdrawal, even if I am not a long user of this drug? 
 

I know I should avoid it, but I have a lot of difficulties to cope and I am very afraid that I am down spiraling. Of course, if you think the Ativan is involved in this reaction, I will stop it right away.
 

Thank you so much!

 

Anne-Marie

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

Hi Anne-Marie

 

I'm not a moderator of course but it sounds to me like you may be developing a physical dependence on Ativan. I don't know if they would advise to stop straight away but I would.

 

I think @Shep is the person to ask about this so I've copied her in. I hope that's ok with you both.

 

Rx

▪︎2000 - Seroxat (25mg?) 6 months C/T

▪︎2015 - 7.5mg Zopiclone 1 month C/T

▪︎ 2016 - 2018 - Diazapam and Phenergan occasionally for sleep

▪︎2017 June to Oct - Mirtazapine 7.5mg C/T

▪︎2018 April - 2019 Oct Mirtazapine 7.5mg tapered to 1.5mg.

▪︎2019 October - Mirtazapine 1.5mg (Skipped alternate doses on doctor's advice then stopped - Insomnia.) Phenergan

▪︎2020 Jan 6th - Mirtazapine 1.5mg

▪︎2020 Jan 13th - Mirtazapine 7.5mg

▪︎2020 - Feb - May, holding 7.5mg

▪︎2020 1st June, 7.35mg. 27 June, 7.2mg. 7 July, 7.05mg. 18 July, 6.9mg. 28 July, 6.75mg. 27 Aug, 6.6mg. 7 Sep, 6.45mg. 17 Sep, 6.6mg. Crash/Hold

▪︎2022 - 4 Feb, 6.45mg. 24 Mar, 6.3mg. 13 May, 6.15mg. 13 July, 6mg. 10 Aug, 5.85mg.

Link to comment

@Ripley

Thanks a lot. I will wait the advice from @Shep
I am already in a bad state, I don’t want to put myself in more misery.

 

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment


@Shep

I need your wise advise about something that is happening to me since the last week or so.

Because I am in this unrelenting wave for 3 months now, I have been more discouraged in the last few weeks, as I have the feeling that my symptoms are getting worse.

So, I know it is not a good idea, but I have used some Ativan on and of.

 

But since Monday, each time I take an Ativan, about 36 hours later, I fall in an awful state with mixed depression, agitation and anxiety to the roof. Maybe it is akathesia, but I’m not sure as I don’t know this symptom well. The first time it happened (Tuesday), I took an Ativan to overcome it, but 36 hours later, the same symptoms again, but worst, so took again an Ativan and so on. When I take the Ativan, it seems to alleviate the symptoms.

 

Do you think I am in a interdose withdrawal or something like that? I have used maybe 6 X 0,5mg Ativan in the last 2 Weeks.

 

Thank you so much for your help. If I could relate this awful feeling to my Ativan intake, it will lessen my anxiety.

 

Mimi.

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment
  • Moderator Emeritus
On 2/27/2021 at 7:31 PM, Mimi79 said:

Because I am in such anxiety state almost everyday, I’ve use very occasionally some 0,5mg of Ativan. It was maybe once or twice a month, but for the last 2 weeks, I’ve taken them more often, particularly in the last 7 days. 


So since Monday, each time I take an Ativan, about 36 hours later, I fall in an awful state with mixed depression, agitation and anxiety to the roof. Maybe it is akathesia, but I’m not certain as I don’t know this symptom well. The first time it happened (Tuesday), I took an Ativan to overcome it, but 36 hours later, the same symptoms again, but worst, so took again an Ativan and so on. When I take the Ativan, it seems to alleviate the symptoms.

 

Do you think it is a kind of interdose withdrawal, even if I am not a long user of this drug? 
 

 

Unfortunately, dependency can happen with only a few days use with benzos. In fact, the FDA recently updated its guidelines because this has become more well known (see FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class).

 

Yes, this does sound like interdose withdrawal. Ativan's half life is 10 - 20 hours, so using a middle mark of 15 hours, you would have about 25% of the drug in your system at 36 hours. So yes, you could be dependent. 

 

Please decide if you wish to stay on this drug and taper it later or come off now. You likely will have some withdrawal symptoms if you decide to come off now.

 

It's really important to be consistent with benzos. Because you've been waiting for 36 hours to take the next dose and sending yourself into withdrawal, you're traumatizing your nervous system. This type of trauma is called kindling.

 

Benzoinfo.com - Kindling

 

From that article - "Kindling, in layman’s terms, is as if the nervous system has a memory of the past withdrawal(s). This memory of prior withdrawal(s) and/or damage still remains imprinted within the nervous system and subsequent withdrawals and/or damage are worse because the nervous system recalls that it has been sensitized/damaged in prior withdrawal(s)."

 

So it's important to be consistent with this drug.

 

There's also a "moderate" drug interaction between Ativan and mirtazapine:

 

Drug Interactions - mirtazapine and Ativan

 

So it's best to take these drug at least 2 hours apart to mitigate this interaction. 

 

Please let us know your decision regarding staying on Ativan or doing a rapid taper off. 

 

 

 

 

Link to comment

@Shep

Thank you for your help.

I would prefer to stop it right away, as I don’t want to have something new to taper. 
With the fact that I’ve only used it 5 or 6 times in the last 2 weeks, do you think I will have a lot of difficulties to stop it?

What kind of withdrawal I have to expect?

 

Thank you so much!

 

Mimi

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

@Shep

I really want to stop the Ativan now, but I have some intense symptoms.

 

According to your experience, with the fact that I haven’t used it regularly before last week, do you think those symptoms will dissipate rapidly?

 

And I was wondering, even if I wasn’t a regular user of Ativan before last week, I drink some Valerian root infusion almost every night. Do you think It can interfere with the Ativan?

 

For the moment, I will really try to stop it and I hope those symptoms of agitation and depression will abate very soon.

 

Thank you.

 

Mimi

 

 

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

@Shep

I have another question. I am facing right now a lot of symptoms (not able to sleep). I am afraid of hurting my CNS, so what if the safest way to stop the Ativan. I am afraid to take it consistently and become more hooked to it. But I am not sure anymore that stopping it is the best idea too.

18 hours ago, Shep said:

Please let us know your decision regarding staying on Ativan or doing a rapid taper off.

What do you mean by « Rapid Taper »?

 

Thank you so much!

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment
  • Moderator Emeritus
20 hours ago, Mimi79 said:

With the fact that I’ve only used it 5 or 6 times in the last 2 weeks, do you think I will have a lot of difficulties to stop it?

What kind of withdrawal I have to expect?

 

You can look to how you were feeling at the 36 hour mark to guide you in this. It was bad enough that you kept taking this drug once the withdrawal got severe enough. 

 

Unfortunately, there's no way of knowing how intense or how long benzo withdrawal will take. 

 

8 hours ago, Mimi79 said:

And I was wondering, even if I wasn’t a regular user of Ativan before last week, I drink some Valerian root infusion almost every night. Do you think It can interfere with the Ativan?

 

Valerian root is considered a "mild benzo" because it also affects GABA, just like a benzo. So it's something we recommend tapering because you can become dependent on it. For more, please see: 

 

Valerian root

 

2 hours ago, Mimi79 said:

What do you mean by « Rapid Taper »?

 

A rapid taper is, for example, 25% reduced every couple of days until you're off the drug. This is used by people who've only been exposed to a drug briefly and want to get off before dependency sets in.

 

If you're unsure if you're dependent and don't think you can handle upticks in symptoms, you may want to take the drug every day and taper it after you're off the antidepressant. 

 

It's a tough call. But I would make a decision either way and than really try to stick with your decision. Continuing to experiment will likely further traumatize your nervous system and lead to kindling. 

 

 

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2 hours ago, Shep said:

If you're unsure if you're dependent and don't think you can handle upticks in symptoms, you may want to take the drug every day and taper it after you're off the antidepressant.

If I choose this option, why can’t I stop the Ativan first before the Mirtazapine? I know you often suggest to taper the activating drug first, but mirtazapine is not exactly an activating one. Because I am so afraid of tolerance with Benzo, I would prefer to taper it first. is it possible?

And if I want to take it everyday until I taper, what dose should I take? I don’t want to take the full 0,5mg each day.

 

2 hours ago, Shep said:

 

A rapid taper is, for example, 25% reduced every couple of days until you're off the drug. This is used by people who've only been exposed to a drug briefly and want to get off before dependency sets in.

If I take this option, do you think it will lessen  the WD symptoms I seem to have when I try to stop it? 

 

Another reason why I would like to stop it as soon as possible, is that I have a bad experience in the past with long use of Benzo. Their depression symptoms always it me hard when I use it on a long period. 


Thank you a lot, @Shep.

I know I have a lot of question, but I am panicked because I have been stupid and now I am trapped! It happens so rapidly, it is incredible! And playing with « Benzo » is something totally new for me.

 

Last question, would it be a good idea to switch now on a longer half-life, like Klonopin? 
 

Thanks again.

 

Mimi

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

@Shep

Today, I have thought a lot about it and with the symptoms I had last night, I think I have to admit that I am dependent on it. It is very hard to accept, as I was aware of this risk, but couldn’t believe it could happen so fast with intermittent use.

I am so sad and angry about myself...

 

So I think the best thing for me is to do a slow taper, because if I understand well, once we are hooked, we are hooked. 
 

I know I have to choose a dose and take it everyday at the same time. I figured that 0,15mg could be something good, because I have took it every 3 days, it is 0,5mg/3.

What do you think about it?

 

Even if I seem to be dependent, because I am a short user, do you think I could do a taper a little more faster than 10% per month? 
 

Thank you so much

 

Mimi79

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

Link to comment

@Shep

I have a doubt. I said in one of my previous message that I have bad experiences with 

Z-drug and Benzo used on a day to day basis. 
It happened to me once with Klonopin and later with Zopiclone. I had a bad reaction after few weeks of regular use. The symptoms were basically deep  Depression and strong Akathisia. It was happening around the third or fourth week of use. 
 

I really would like to stabilize on a low dose, like I said yesterday, but I am very afraid of having this same bad reaction in few weeks and having to cold Turkey when I am more hooked.

 

Do you think, with this low dose I would take everyday (0,15mgai) it could still happen? I feel so trapped and afraid!!

 

Thank you so, so much!

 

2008-Today: various ADs, benzos and seroquel , initially for Anxiety Related Insomnia. (Absolutely no other mental issues than simple Insomnia!).

Numerous W/D and C/T of those meds. During those years, my GP diagnosed me with GAD, Depression, etc... It was all W/D related, I know now!

Fall of 2019, after too fast attempt to taper Mirtazapine, put myself in full blown W/D.
February 2020, found SA and staying on 45mg Mirtazapine, waiting for stabilization.

February 2021, I stupidly used some Ativan prn to cope with Mirtazapine W/D symptoms (By far worst mistake of all my life!!).

Became accidentally and rapidly addicted (within 2-3 weeks). Started taper immediately.

Actual medication: Mirtazapine: 40,0mg - holding-
Ativan Taper: Started at 0,29mg march 2021, 03-28 0.28mg/ 04-08 0.27mg/ 04-26 0.25mg/ (...) 10-29 0.18mg/ 04-05-22 0.17mg/ 08-25-22 0.16mg/ 09-15-22 0.15mg/ 10-22-22 0.14mg/…/ 01-12-2023 0.11mg /07-02-2024 switch to 1mg Valium /

14-02-2024 0,9mg Valium.

Supplements: Omega-3, Probiotic.

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