GreenOwl: on mirtazapine for 3.5 weeks - help to quit please

[GreenOwl]

Hi, 

I've yet to do my full signature story, but need to ask this quickly as I'm worried I'm in a time race here. Is it possible I've not been on Mirtazapine long enough to need to do a slow taper? Roughly three and a half weeks on 15 mg - was on 30 for four days last week but cut back down to 15 the last 3 days. Do I move fast now to get off it before it takes hold in my brain or is it too late and best to go slow? Thank you.

[Gridley]

I'll be offline for most of the day but I'll bring your question to the attention of the other staff plus ask a question.  

 

3 1/2 weeks at 15mg

4 days at 30mg

3 days at 15

total 31 days

Is this correct?  Or is it around 24 as your title states?

 

Edited October 12, 2020 by Gridley

[GreenOwl]

Thank you.

 

14 days on 15 mg

5 days on 30 mg

and last three days on 15 mg again

22 days altogether. 

 

Oh! Forgot to mention about 7 days of the first 14 I was on 50mg of Fluvoxamine (stopped it then) which would have upped the serum plasma levels or some such science I don't understand, but yes, would have affected the Mirtazapine as they interact.

[manymoretodays]

Hi Green, and welcome aboard,

You might be able to sneak on off, without consequence, before a month has passed.

If it was me, and I did not want the interference of medication, I think I'd go one more day of 15 mg, which would be a total of 4 days. 

Then go to 7.5 mg for 4 days.  Then go to 3.75 mg for 4 days, and then off.  If you need to, then stay with the 3.75 mg dose.  Sometimes less is more, and you'd have less to taper off from later.

Helpful links for your case now, and may also help answer your questions:

Tips for tapering off mirtazapine(Remeron)

^ you can find more information here about this drug, and how to get smaller doses, as well. 

Also, in general, please use Drugs.com to not only educate yourself, before trying new drugs.  Use the top box to check on drugs singularly.  Special attention to the myriad of side effects/adverse effects, which often make them worse then whatever you sought out drugs for.  You can also check drug interactions there as well.

Why taper by 10% of my dosage?

Usually with AD's(antidepressants), it'll take about a month until dependency is created.  You'd be off in just about a months time.  You may, however experience some bumps and would need to deal with those with non-drug coping as best you can. 

 

Please see:  Symptoms and Self Care

some of that ^ applies in or not in WD(withdrawal), and I don't know, but you might experience some bumps of WD. 

 

Try and avoid other drugs now, or self medicating with things on hand.

And please summarize in a signature for us:  Please do a drug signature

This ^, really is not too difficult, just follow the instructions.  Best done from a PC.

 

And let us know if you are taking any other drugs.  I always like to know if new members are coming in after a long history of medications too.   

Thanks for letting us know on the Luvox.

 

Best intentions, please keep us updated too,  as we are really not a drive by site, it gets taxing on us all.  We'd love to be part of your journey and educate you some more, but you do need to provide a little bit of information and of course, be patient.

 

L, P, H, and G,

mmt

[GreenOwl]

Can someone help?

 

I've gotten myself into more trouble. The withdrawal syndrome from coming off fluvoxamine cold turkey earlier this year has done in my head so completely that I'm losing touch with logic now. My life has gone so downhill I can't recognise it, leading to more and more desperation as I keep trying to fix it. As you can see from my signature, I have panicked and gone on and off medication up and down the last few months. Incredibly stupid and reckless and looking back I don't know why I did it or how I made these choices - only that I just have not been thinking right or acting in character (I usually am such a careful person, incredibly health-conscious and risk-averse). So, latest bad thing is that after I came off Mirtazapine I panicked and put myself back on the Prozac I had from earlier in the year, trying to find a way to stabilise. So so stupid.

 

I went to my doctor and made them aware and they continued to prescribe it, and I continued taking it - again, just in a desperate attempt to stabilise - just wanting and needing to fix things. I have started to feel less panic this last week, and my thought was to stay on Prozac for 3 months to stabilise, then try to taper off. But I have now started freaking out again at the idea of being stuck on medication. It is keeping me awake at night, this feeling of being trapped for months and months.

 

I am on 20mg, have been for about 32 days. I am now in the thinking that I don't want to be on this dose, want to only be on 10mg so that the side effects of anxiety and shakiness might be less, and more importantly, so that later when I try to come off it it will not take so long (I get so desperately trapped feeling on meds, like a person with fear of small spaces getting stuck in an elevator, or I guess more aptly like a person with a fear of heights becoming so swamped with fear that they get a paradoxical urge to jump). Because I have only been on the Prozac again for 32 days, can I drop the dose in half like this now? (I know this question is disturbingly similar to my original one with the Mirtazapine - I keep getting myself into these things and I feel so unbalanced looking back and seeing what I've been doing - how did I get to this?? ) 

 

I told my doctor I want to lower the dose and asked if it was safe and he doesn't want me to but says that if I do it'll be fine because stopping Prozac in doses under 60mg doesn't cause withdrawal issues. But then he also doesn't believe in protracted withdrawals at all or that my issues originated from when I cold turkey quit the Fluvoxamine in March (keep getting told this new panic is just progression of my OCD - but I've had OCD for 28 years but it has always been the kind where I could clearly tell the difference between my normal thoughts and the irrationality of the OCD obsessions, could identify my compulsions, could see what was what, and certainly never included panic that made it hard to leave my house, not until I began withdrawals from Fluvoxamine.)

 

Can someone give me advice again? I'm so lost and have been dealing with months of insomnia (this has greatly reduced my thinking capacity), hyperarousal, panic and body pain that it's worn away at my mental health and my judgement. What I've done to myself - trying to fix the original problem of coming off meds by going back to meds and then abruptly cutting them, back and forth... it feels insane. It was insane. Like I said, I look back at it and don't know how I let it happen. Now I don't trust myself to make good choices, am terrified of making things worse, and I don't know what to do anymore. 

 

I worry I won't be able to stick at Prozac 20 mg due to the feelings of being trapped, the knowledge of how long it will take to slow taper off and the thought that I might be stupid again and panic and take myself off the medication too fast and cause myself even further withdrawal hell. So I keep going back and forth between wanting to see if I can feel better right now by staying on Prozac 20 mg (because, like I said, I do feel the way its beginning to make my anxiety calmer) and wanting to drop it down to 10 so I know that I won't be trapped on it for as long when I do the slow taper later. Of believing the doctor when he says that I need to be on the medication as the only way the anxiety can go away and my own thoughts that I don't want to be on medication, that it makes me feel too trapped. 

 

I'm also worrying because going on the Prozac was horrible, mostly because it increased my insomnia to debilitating levels - so if I cut down to 10, find it causes withdrawals and then have to increase back up again, will that be like starting from scratch with the onboarding effects of anxiety and jitteriness and insomnia all over again? (See, there is my brain already going back and forth, thinking about going back up again - the anxiety has taken away my ability to make decisions, because I know now how much damage a wrong decision about medication can cause and so now I am paralyzed by fear of doing anything that can cause more damage... so I  choose one thing, get scared its wrong, flip back to another, get scared, panic... Go in circles. I never know what to do. I just want to feel safe in my body again.  

 

 

[GreenOwl]

Anyone?

[manymoretodays]

Hi GreenOwl,

When did you go back on Prozac/fluoxetine?  The date or day in September?

Please go to:

Account Settings and then from there, click/tick signature on the left hand side, and you can edit/update your signature.

 

When do you take the Prozac now? 

And then, can you give us an idea of what a day looks like by doing some:  Notes/daily drug and symptom log

Just keep it simple, time on the left, and then note all drugs and supplements, by name, with dose, on the right.

Also on the right, not symptoms as they occur throughout the day.......again, time on the left, then symptoms.  Describe your symptoms and some will even use a rating scale of 1-10, 10 being the worst.

This gives us a better idea of how your symptoms relate to your drug, and helps us to answer your questions, or make suggestions.

 

GreenOwl, I think that you ARE experiencing some WD(withdrawal) from your previous, more recent pattern of on and off medications quickly, and so am going to give you some further links that I hope will help your understanding now.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal. 

 

Is your sleep okay now?  I did see mention of when you have  lowered your dose of Prozac, that you get insomnia.

 

Why taper by 10% of my dose?

 

Brain Remodelling

What is withdrawal syndrome.

The windows and waves pattern of stabilization

 

Dr.Glenmullen’s withdrawal symptom list.

 

And I know this is a lot to take in right now.  Try to attend to updating your signature, and then doing some Notes/drug and symptom 24 hours.  Post those right here.

Some of the links you will have here too, to read and refer to further, when you feel a bit calmer.

And you will, feel calmer.

 

The rule of 3KI's: Keep it simple, slow, and stable

 

As far as the OCD tendencies and fears/anxiety:

https://www.survivingantidepressants.org/topic/3882-obsessive-compulsive-disorder-or-ocd-repetitive-intrusive-thoughts-

 

 

Dealing with emotional spirals

Easing your way into meditation for a stressed out nervous system

 

Best, L, P, H, and G,

mmt

 

Edited November 24, 2020 by manymoretodays
link

[manymoretodays]

Hi GreenOwl,

How are you going?

I have not seen any posts from you lately.

On 11/23/2020 at 6:33 AM, GreenOwl said:

I'm also worrying because going on the Prozac was horrible, mostly because it increased my insomnia to debilitating levels - so if I cut down to 10, find it causes withdrawals and then have to increase back up again, will that be like starting from scratch with the onboarding effects of anxiety and jitteriness and insomnia all over again? (See, there is my brain already going back and forth, thinking about going back up again - the anxiety has taken away my ability to make decisions, because I know now how much damage a wrong decision about medication can cause and so now I am paralyzed by fear of doing anything that can cause more damage... so I  choose one thing, get scared its wrong, flip back to another, get scared, panic... Go in circles. I never know what to do. I just want to feel safe in my body again.  

 

No doubt that your brain/body is craving some stability right now.

Most always, the fear, and the "damage" IS reversible, with time and patience.

Look at the 3KI's post if it is still hard to focus and feel safe......that might help your understanding.

 

Update when you can.

 

L, P, H, and G,

mmt

[GreenOwl]

Hello,

 

Do not know where to start.  Ive made so many mistakes trying to deal with the anxiety of the withdrawal, panicking and trying various different medications because no doctor I go to listens about withdrawal syndrome and just tries to remedicate me and I was so desperate for help and so worn down and not in my right mind that I keep on making that mistake. But the absolute phobia of medication makes me jump back off again within a month and so Ive compounded the damage done to my brain several times over. Basically became completely unstable.

 

Only calmed right now by being on a mix of baclofen and valium (which I resisted for 6 months but had to give in to due to not being able to deal with the death of my mum recently). All of this has made my initial mental illness - ocd - come swinging back and its so much worse than Ive ever had it, new compulsions and non-stop obsessions.

 

I'm not sure now what to do as I feel I need to go back onto an ocd medication if I've any hope of getting this under control. But the most recent doctor I saw prescribed lamotrigine - not because he believed me about withdrawal syndrome and wants to try it for that, but because of my impulsivity (which I never had problems with until a brief try at moclobemide at the start of this year which sent me into a state of agitated manic behaviours completely out of character which has complicated things as I wondered myself if I was someone who had undiagnosed bipolar. Though I have read that srri withdrawal can bring on mania in people without bipolar too. I do have cptsd and also wonder if some of my symptoms could be that becoming worse due to the anxiety withdrawal has caused. Unfortunately this last psychiatrist didnt even know what cptsd was.)

 

So now here I am with a chance to try lamotrigine which as I understand from Allostat's posts on this board could help with the dysregulation of the alerting system. But I also asked him to prescribe me my original ocd medication back, which is fluvoxamine, the one that I went off cold turkey in March 2020 which started this whole nightmare. Im no doubt long past the window where reinstating the original medication *may* help alleviate withdrawal symptoms, but part of me wonders if that could still happen if I do just go onto the fluvoxamine again (have tried to make myself do that several times this last year but was honestly terrified of it and kept opting for medications that I deemed to be less scary because one of my main symptoms of withdrawals has been chronic debilitating insomnia thats lead to sleep deprivation and fluvoxamine contributes to insomnia so I never let myself try it, and other reasons, such as the activation it causes on start up which I didn't think I could handle). 

 

I feel torn between trying the fluvoxamine because I honestly need it for the ocd and hope it may even maybe possibly break some of the withdrawal symptoms (a huge one being constant repeated song lyrics going over and over in my head every waking minute of the day - this was on and off last year but since April this year has not ceased. Have read about it and know it to be called musical obsession and that it can be linked to ocd but I never experienced it in all my 28 years of having ocd until the withdrawals and know it can be a symptom of that, which I think it is in my case too.) I would think of stabilising on the fluvoxamine until it helps get the ocd under control and then hopefully one day if possible trying to come off it again in a much more controlled way. I'm concerned that taking only the fluvoxamine will help the ocd again (hopefully) but won't fix the CNS withdrawal symptoms of panic and extreme anxiety due to constantly being in flight mode. I could take it with the lamotrigine but am concerned that would not work in the way Allostat describes lamotrigine possibly being able to rebalance things that have gone wrong because the fluvoxamine will interfere with other neurotransmitters. I could take the lamotrigine script only and do the doctors dosage (25 mg) with hope that I could stabilise on that and then come down eventually or take the script and try, at my own discretion to microdose it. This is probably my only shot at having a script of this particular medication as generally the doctors in my country don't prescribe off-label medication and I haven't been diagnosed with any of the conditions its used for here.

 

(Obviously a goal here is to also come off the valium and baclofen before my body becomes more dependent on them, though I admit the baclofen is the only thing that has let me get any proper sleep in over a year. I take 25mg of baclofen a night (am prescribed it twice a day but do not do that) and am prescribed 5mg of valium once a day but only actually started taking it daily for the last two weeks, previous to that I was taking it every few days for two months.)

 

Any insight on my choices here would be so incredibly appreciated. 

 

 

 

 

[GreenOwl]

P.s. Also had a question regarding baclofen. Does it regulate glutamate and GABA the same way lamotrigine does? Is it possible it can be used the way lamotrigine is proposed to be used for restabilising after withdrawals? I ask that with zero understanding of the science and only in a grasping at straws hope because lamotrigine as possible answer to withdrawals still scares me due to it being known for contributing to insomnia. 

[ChessieCat]

I did site search for "baclofen" and found this.  See Post #1:

 

fluyau-2018-challenges-of-the-pharmacological-management-of-benzodiazepine-withdrawal-dependence-and-discontinuation

 

[GreenOwl]

Thank you. That looks as though I should withdraw from the diazepam first then, when the time comes, if baclofen can possibly help diazepam withdrawal?

 

I'd still like to know if baclofen can help srri withdrawals. I would choose to stay on the baclofen and not add in lamotrigine if that were the case. Just don't know what to do now, regarding lamotrigine. 

 

"Additionally, diazepam will cause cross tolerance with other drugs that utilize GABA receptors."

 

This was concerning, as it implies being on baclofen at the same time as diazepam will cause even more problems. And if lamotrigine utilizes GABA receptors then I'd be on three medications that could effect each other in that regard?

[ChessieCat]

If SA knew of anything that would help then everyone would be told about it.  The only supplements which SA recommends are magnesium and omega 3 fish oil.

 

You could try doing a search to see if other members have tried it/them.  Please note that SA is a site for getting off psychiatric drugs, not for what drug/s to try next. Drug shopping is not permitted on this site.  Please be careful how you post any questions to other members.

 

What works for one member may not work for someone else.  For example, many members take magnesium with no issues, but there are a small number of members who have a bad reaction when they try it.

 

We are all an experiment where N=1.

 

Whatever you try, you do so at your own risk.

 

[GreenOwl]

Drug shopping? I apologize if I have done the wrong thing. I was trying to find out more about the lamotrigine protocol that has been talked about on this site by the founder. I do wish I knew of a doctor who was familiar with it or a site or study with information on it that I could show a doctor here.

 

It has always been my goal to come off the medications, that is why I stopped the fluvoxamine in the first place.

 

Reinstememt and/or the lamotrigine protocol to restabilise would be steps towards still aiming for that after getting myself functional again.

 

The instability that withdrawal syndrome has caused has destroyed my mind and my life and that is not an overstatement. My finances, mental health and family have been ruined. It wrecked the last year I had with my mother, and it contributed greatly to her health decline. I will never be able to make it up to her for what I put her through. 

 

I regret with all my heart the  choices of jumping back onto other medications, wish I had stayed away from them and would stay away now if I could cope with the symptoms I have but I cannot. Now I'm just desperate for information so I don't make another wrong choice. I know SA cannot give medical advice. I just need guidance and have no access to a doctor who understands srri withdrawals or the changes it causes in the brain and body.  😢

[ChessieCat]

23 minutes ago, GreenOwl said:

Drug shopping? I apologize if I have done the wrong thing. I was trying to find out more about the lamotrigine protocol that has been talked about on this site by the founder.

 

You were asking about baclofen.  If you do a search for baclofen you will see that it is not mentioned very much on SA.

 

I did not say that you were drug shopping but I was drawing your attention to being careful not to do so.  I was concerned that you might start asking members what they were taking and how much, which would be classed as drug shopping.

 

30 minutes ago, GreenOwl said:

I was trying to find out more about the lamotrigine protocol that has been talked about on this site by the founder.

 

SA's topics:

 

lamictal-lamotrigine-to-calm-post-acute-withdrawal-symptoms-paws

 

tips-for-tapering-off-lamictal-lamotrigine

 

Here is the search results for posts made by Altostrata.  I searched for lamotrigine and lamictal.

 

https://www.survivingantidepressants.org/search/?&q=lamotrigine lamictal&author=Altostrata&search_and_or=and

 

[GreenOwl]

Thank you. I am currently going through the posts regarding usage of lamotrigine for soothing withdrawal symptoms. I'm not having any success in finding a source from a study or doctor that I can take to my own doctor to show her information on the protocol (currently she is going on instructions to give a script of lamotrigine to dose at 25mgs, go up to 50 mg next, etc... to reach 'theraupeutic' levels and I would very much like to be able to show her the idea of microdosing because I am not wanting to be on that level of dose at all). Does Altostrata have somewhere doctors can be directed or the name of a doctor known to use this protocol, please? I've found it impossible to get a doctor to consider withdrawal syndrome as a serious subject so far.

[ChessieCat]

9 hours ago, GreenOwl said:

I'm not having any success in finding a source from a study

 

I have NOT looked through these.  Just did the search in the Journals and Scientific Sources forum for lamictal and lamotrigine.  There will most like be some overlap but there might be some that are in one search and not the other.

 

https://www.survivingantidepressants.org/search/?&q=lamictal&type=forums_topic&quick=1&nodes=16&search_and_or=and&sortby=relevancy

 

https://www.survivingantidepressants.org/search/?q=lamotrigine&quick=1&type=forums_topic&nodes=16

[ChessieCat]

9 hours ago, GreenOwl said:

Does Altostrata have somewhere doctors can be directed or the name of a doctor known to use this protocol, please?

 

I have NOT looked through these.  Just did the search in recommended-doctors-therapists-and-clinics

 

https://www.survivingantidepressants.org/search/?q=lamictal&quick=1&type=forums_topic&item=14971

 

https://www.survivingantidepressants.org/search/?q=lamotrigine&quick=1&type=forums_topic&item=14971