AnxietyQueenn: reinstated for 3 months but feel so low

[AnxietyQueenn]

Hi all, I am new here and found this site through a FB group. 

 

I feel like I need some help or insight because I'm currently lost and feel really hopeless. I tapered too quickly over the course of 5 months off of remeron/mirtazapine, I was on 15mg and got down to 7.5mg but I took a big jump in order to get to 7.5mg. I was crying everyday, vomiting, having two to three anxiety attacks per day, lost my appetite, had headaches, nausea, among other symptoms. I was a complete mess. 

 

I decided to reinstate after speaking to my doctor, I've been back on 15mg for three months now and I just feel so numb. No motivation to do anything. The nausea is gone and randomly crying but my nausea and anxiety is still there. It's gotten to the point I haven't left my bed for a week because I feel short of breath and have muscle aches. 

 

So after 3 months of being back on 15mg remeron I don't know if I should continue taking it at this dose because I can't go on feeling like this, or if I should try cutting down again? I am scared to cut down due to my fragile mental state of mind right now, but I also want to get better so I don't know if staying on this will help me? 

Edited October 15, 2020 by manymoretodays
moved from S and S care, name added to title

[Gridley]

Welcome to SA, AnxietyQueenn.  I'm sorry you're feeling bad.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

I think what you're experiencing is a combination of withdrawal when you jumped from 15mg to 7.5mg, plus the effects of reinstating too much (all the way back up to 15), which was likely too much for your brain to handle.

 

At this stage, I would not recommend tapering.  It can take several months (more than 3) to stabilize from a reinstatement, and I'd wait until you're more stable before thinking about reducing your dose.  Although when you're in the middle of it, it's often hard to see that you've made progress, but you have.  The nausea and random crying are gone, and many of the symptoms you describe you were experiencing when on 7.5mg have faded or disappeared. That is a sign of healing. The anxiety,  numbness, lack of motivation, shortness of breath and muscle aches are typical withdrawal symptoms and will fade with time.  It's important to remembers that the purpose of reinstatement isn't to eliminate withdrawal symptoms altogether (although it does for some) but rather to make them more tolerable, and from what you've written you're moving in that direction.

 

When the time does come for you to taper, as you probably know, we recommend tapering by no more than 10% of your current dose every four weeks.  In your case, when you're ready to taper, I'd try a 5% reduction to see how that goes.

 

Why taper by 10% of my dosage?

 

There are many ways to get the small doses you'll need for a 5% or 10% taper.  You're not limited to the doses available from the manufacturer.  The following link is specifically about tapering mirtazapine, including how to get nonstandard doses.  Mirtazapine liquid is available in the U.K., and this would be an easy and accurate way to taper.  You can also make your own liquid Mirtazapine, or you can use a compounding pharmacy to make your doses.

 

Tips for tapering off mirtazapine (Remeron)

 

As I said, I wouldn't recommend tapering now.  This information is for your future use.

 

The following restorative yoga pose I've found very helpful for anxiety.

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

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

 

 

 

 

 

 

 

 

 

 

 

Edited October 15, 2020 by Gridley

[AnxietyQueenn]

Hi, Gridley.

 

Thank you for your reply. So, you think I will stabilize even more if I continue taking this medication? I forgot to mention that a couple weeks ago i forgot to take my pill and the next day I felt relief. Like, I could clean and cook and do normal day things. My anxiety was still there a little bit but I wasn't confined to my bed. Then when I took the pill that night, the next day I woke up feeling super numb and anxious again. 

 

I've been on this medication for about 7 years now, I just want off of it asap but I realize I'll need to taper very slowly. I asked my GP about liquid mirtazapine and she said they don't do that because it costs the NHS too much money. 

 

I hope it doesn't take too much longer for my mood to lift. I desperately need it. 

[Gridley]

44 minutes ago, AnxietyQueenn said:

I forgot to mention that a couple weeks ago i forgot to take my pill and the next day I felt relief. Like, I could clean and cook and do normal day things. My anxiety was still there a little bit but I wasn't confined to my bed. Then when I took the pill that night, the next day I woke up feeling super numb and anxious again. 

That is very interesting and causes me to rethink my previous suggestion.  I'd give it another month at your current dose.  Then, if you see no improvement, you could try a 5% reduction from your current dose as described in my previous post.  If the prescription liquid is not a possibility, that would mean I guess that the NHS wouldn't pay for a compounding pharmacy.  That  leaves making your own liquid.  The following instructions are from the link provided earlier,  Tips for tapering off mirtazapine (Remeron)

 

"While water solubility of mirtazapine is "slight" according to http://www.drugbank.ca/drugs/DB00370 you can make a suspension of it yourself with a tablet and water or a pharmaceutical liquid such as Ora-Plus. See How to make a liquid from tablets or capsules

Refrigerate the DIY suspension for up to 5 days, then discard."

 

Many members taper making their own liquid.  Mirtazapine doesn't completely dissolve but if you shake the bottle well you can use a syringe to get your dose.

 

SA recommends this method over weighing tablets using a digital scale, but that option is also a possibility.

 

"Reduce by splitting tablets
Request that your prescription be filled with the lowest dosage tablets or combination that includes the lowest dosage and split them into quarters for the smallest decrements. (A quarter of a 7.5mg tablet would be 1.875mg.) If you are very sensitive to dosage reductions, you may wish to weigh tablet fragments, see Using a digital scale to measure doses"
 

 

 

 

Edited October 15, 2020 by Gridley

[AnxietyQueenn]

I should have mentioned before, that before I heard of the 5%-10% tapering process, my GP advised me to take 15mg alternative days and I did that for a month. It wasn't until my withdrawals hit that I found a FB group after doing research and they all recommended only 10% reducting so I tried that for two months instead of the alternative days and then I made a big jump to 7.5mg for the rest.

 

 I don't know if i've messed my brain up too much that the 15mg i'm back on is just too much for me maybe. I'm not sure. 

 

I am not sure if i'd trust myself to make the liquid accurately but I could try. Is cutting up the medication just as effective or no?

[Gridley]

3 minutes ago, AnxietyQueenn said:

my GP advised me to take 15mg alternative days

That is a terrible idea much beloved by doctors who don't know any better.

 

4 minutes ago, AnxietyQueenn said:

 

I am not sure if i'd trust myself to make the liquid accurately but I could try. 

 

When you're ready to try, I'll alert one of our other moderators who's very familiar with this process and she can help you.

 

5 minutes ago, AnxietyQueenn said:

Is cutting up the medication just as effective or no?

It's not as accurate and the scale won't measure the very, very low doses.

 

7 minutes ago, AnxietyQueenn said:

 

 I don't know if i've messed my brain up too much that the 15mg i'm back on is just too much for me maybe. I'm not sure. 

Your brain is only temporarily dysregulated.  It is not permanent.  

 

It very well may be that 15mg is just too much for you.  It's also possible that the drug has "pooped-out," in which case it's time to taper down.

[AnxietyQueenn]

Thank you so much, I really appreciate this as I feel like I've had no one to turn to recently and this has been overwhelming. 

 

I feel like it has pooped out also, and my GP wanted to increase the dose to 30mg after I told her, which I declined. 

 

So, if the medication has pooped out, does this mean I will still get horrible withdrawals from it while tapering? Or just the same ones I already currently have? I'm scared of more symptoms showing. Like I seen one lady say in the fb group she had a seizure from tapering and never experienced one before. I just don't want to feel worse than I already do because I feel this is rock bottom for me. 

[Gridley]

14 minutes ago, AnxietyQueenn said:

 

I feel like it has pooped out also, and my GP wanted to increase the dose to 30mg after I told her, which I declined. 

That what doctors do in poop-out.  Eventually (or even fairly soon) the drug will poop out again. More of this drug is not what you need. You made a wise choice.

 

14 minutes ago, AnxietyQueenn said:

 

So, if the medication has pooped out, does this mean I will still get horrible withdrawals from it while tapering? Or just the same ones I already currently have?

They shouldn't be any more horrible.  It sounds like the drug is having a bad effect on you, and I'm hoping that as you reduce your drug burden as you get lower in dose that you'll feel better and better.

 

14 minutes ago, AnxietyQueenn said:

I just don't want to feel worse than I already do because I feel this is rock bottom for me. 

 

I understand.  That's why I want to start out tapering very slowly.

Edited October 15, 2020 by Gridley

[AnxietyQueenn]

It did work for some time that I was on it, like it helped me with depression and sleep which is why I was put on it in the first place but I feel like it has opened a gate of new things for me such as anxiety. I have never experienced this or even knew what it was until I tried coming off of this medication. It's like it opened up a doorway in my brain. 

 

With tapering slowly, is it possible to experience zero withdrawals? Or will there always be some? I honestly just want them to be manageable, that's all I am looking for. 

[ChessieCat]

Hi AQ,

 

To help us out, please create your drug signature so that we can see your drug history at a glance.

 

Instructions:  Withdrawal History Signature
Account Settings – Create or Edit a signature

[ChessieCat]

13 minutes ago, AnxietyQueenn said:

With tapering slowly, is it possible to experience zero withdrawals? Or will there always be some? I honestly just want them to be manageable, that's all I am looking for. 

 

The idea of tapering is to try and keep withdrawal symptoms to a minimum.  The 10% every 4 weeks is a guideline, not a rule.  It is important to listen to your body/symptoms and hold for longer if you are not at withdrawal normal.  WDnormal

[AnxietyQueenn]

18 minutes ago, ChessieCat said:

 

The idea of tapering is to try and keep withdrawal symptoms to a minimum.  The 10% every 4 weeks is a guideline, not a rule.  It is important to listen to your body/symptoms and hold for longer if you are not at withdrawal normal.  WDnormal

 

Hi, i'm not sure if I did it correctly but I posted the drug signature. 

 

I feel like my body is still going through extreme withdrawals but at the same time taking 15mg isn't doing me any favours at the moment. So I'm at a loss.

[Gridley]

47 minutes ago, AnxietyQueenn said:

With tapering slowly, is it possible to experience zero withdrawals? Or will there always be some? I honestly just want them to be manageable, that's all I am looking for. 

Manageable is a more realistic expectation. If you go slowly enough, they will remain manageable.  It is normal after a reduction to feel some tolerable withdrawal symptoms, but these should resolve before your next reduction.  If they don't resolve, you're tapering too fast and need to slow down and wait until they resolve before your next reduction.

 

Your drug signature is there, thank you.

 

 

[AnxietyQueenn]

Thank you for taking your time to answer my questions, I appreciate that. I have one last thing to ask.

 

I was reading about CBD oil and how it has helped some people so I thought of buying some from a store I live near by and its only 2.75% - do you know if this will have any interaction with my mirtazapine and if it will help manage anxiety symptoms while I taper?

[Gridley]

20 minutes ago, AnxietyQueenn said:

CBD oil

We have several threads on CBD oil.  Reactions are mixed.  Google SurvivingAntidpressants. org CBD oil and see what others' experiences have been before making a decision.

Edited October 15, 2020 by Gridley

[ChessieCat]

42 minutes ago, AnxietyQueenn said:

do you know if this will have any interaction with my mirtazapine

 

Drug.com Interactions Checker

Medscape Drug Interaction Checker

 

SA suggestions only making one change at a time and if trying anything to new to start with the small test dose to see how your react:

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

 

Edited October 15, 2020 by ChessieCat

[Gridley]

13 hours ago, AnxietyQueenn said:

So, if the medication has pooped out, does this mean I will still get horrible withdrawals from it while tapering? Or just the same ones I already currently have?

Brassmonkey, one of our moderators who tapered Paxil while in poop-out, wrote the following:

 

 

"Tapering out of Poop-out or tolerance is the second option and it can be a very frustrating process because there may be no visible results for quite a while.  There is not a lot of information available on time frames because Poop-out is not a well-documented phenomenon.   Once improvements have started to apear they will increase in fits and starts.  Progress can be monitored by comparison with the poop-out baseline."

 

We can't predict with certainty what kind of withdrawals you will have.  We can only give you information based on our experience.  

 

 

[AnxietyQueenn]

12 hours ago, Gridley said:

Brassmonkey, one of our moderators who tapered Paxil while in poop-out, wrote the following:

 

 

"Tapering out of Poop-out or tolerance is the second option and it can be a very frustrating process because there may be no visible results for quite a while.  There is not a lot of information available on time frames because Poop-out is not a well-documented phenomenon.   Once improvements have started to apear they will increase in fits and starts.  Progress can be monitored by comparison with the poop-out baseline."

 

We can't predict with certainty what kind of withdrawals you will have.  We can only give you information based on our experience.  

 

 

 

 

Ohh, okay. I understand now. 

 

Does reinstating the meds also give you an upset stomach? I've had a dodgy stomach for the past 3 months after reinstating, and some stomach pains. 

[Gridley]

43 minutes ago, AnxietyQueenn said:

 

Does reinstating the meds also give you an upset stomach

We just don't know.  There is so much we don't know about these drugs.  Stomach problems are not listed among the common site effects of Mirtazapine.

[AnxietyQueenn]

Ah, maybe I should get checked out in that case

Thank you

[AnxietyQueenn]

Experiencing withdrawals but reinstated 3 months ago

 

Hi all,

 

I am currently such a mess mentally and physically. I have been on mirtazapine 15mg for about 7 years and couple months back I tapered too fast and my body was hit with horrendous withdrawals. I reinstated back to 15mg after 5 months because I felt suicidal and was having panic attacks everyday. Nausea, vomiting, couldn't sleep or sit still or concentrate.

 

I've been back on 15mg for three months, and I'm still getting withdrawals I believe? I am vomiting, losing weight quickly, no appetite and my anxiety is through the roof. Sometimes I have panic attacks, sometimes I make it through a lucky day without having one. 

 

I'm at a complete loss on what to do and i'm desperate for some relief. First of all, I need to know this is only temporary and that I will be okay because at the moment I don't feel okay at all and I keep hoping every day I will wake up and feel some relief. I had to go to the ER last night because I had severe chest pains and in the end they put it down as anxiety and gave me valium to take home. 

 

I took 2mg of valium an hour ago and ended up vomiting 7 minutes after I took it. I feel like my body is just not coping well at all and my moodswings are the only thing I am struggling to manage. Is the 15mg just not doing anything for me anymore and do I need to start cutting down or is the medication causing this? 

 

Edited October 18, 2020 by ChessieCat
added topic title

[Gridley]

2 hours ago, AnxietyQueenn said:

Is the 15mg just not doing anything for me anymore and do I need to start cutting down or is the medication causing this? 

As I said earlier, I thought the fact was significant that you felt better the day you missed your dose and worse after you took the next dose.  You might consider a 3% decrease from 15mg with a hold for four weeks.

 

This link tells you how to get the small dose you'd need to decrease by 3%.

 

Tips for tapering off mirtazapine (Remeron)

 

 

Edited October 18, 2020 by Gridley

[AnxietyQueenn]

2 hours ago, Gridley said:

As I said earlier, I thought the fact was significant that you felt better the day you missed your dose and worse after you took the next dose.  You might consider a 3% decrease from 15mg with a hold for four weeks.

 

This link tells you how to get the small dose you'd need to decrease by 3%.

 

Tips for tapering off mirtazapine (Remeron)

 

 

Thank you, I think I'm going to do it tonight and see if it makes any difference over the week. 

[ChessieCat]

It takes about 4 days for the dose change to get to full level in the blood and a bit longer for it to register in the brain.

 

It is a good idea to keep notes of any change in your symptoms so you can be more objective about it.

[AnxietyQueenn]

Last night i cut a tiny part of my pill off and weirdly enough it actually made me sleep longer than the full 15mg.. 

[AnxietyQueenn]

Remeron pooped out?

 

Hi, all. I'm fairly new to the site and posted previously about my struggle coming off of remeron. 

 

I reinstated and for the past 3 months it made me more sick than anything. I didn't really understand what was going on with my body until i accidentally skipped a dose and the next day I wasn't feeling anxious or vomiting. Then, when I took the pill that night the next day I was super anxious and a mess mentally. So I discovered the term "pooped out" thanks to this site and I think that is what is going on. Last night I cut a small part of my pill and it actually hit me a lot harder - as in I slept fast and longer and I woke up today not really feeling panicked and not super anxious. 

 

Is this too early to tell if its making a difference ??

 

Edited October 19, 2020 by ChessieCat
added topic title

[AnxietyQueenn]

Confused what's going on. 

 

I cut down to 13mg Mirtazapine a couple days ago but the past 2 days I have started taking it during the day instead of at night because it is actually helping me feel less anxious and I haven't had a panic attack since taking it during the day. 

 

I am, however, bedbound and very sick. I keep throwing up every other day and have horrible body aches. I get windows of feeling relaxed but not sure if that's bc I take mirtazapine during the day instead of at night. It doesn't put me to sleep, just makes me feel relaxed, but as for my mood it doesn't make me happy or anything. 

 

Should I continue to taper down or wait? I read that if a drug poops out on you, you will not stabilize on it and either need an increase or you will just have to continue to taper while suffering withdrawal symptoms, not sure if this is true.