mirtlady: mirtazapine withdrawals, would like some reassurance

[mirtlady]

Hello,

 

I was on 15mg for 2 months, moved up to 30mg for 6 months, then down to 15mg for another month after which I tapered off by alternating between 15mg and none for 2 weeks before stopping as per advice of my GP. I completely stopped taking mirtazapine beginning of August. Now I realize I tapered off too fast and I have seen advice about reinstating meds on here, but if I can I would prefer not to go back on mirtazapine or any other antidepressant. I took it for depression and anxiety, and I've been off it for around 10 weeks now. I was never on any antidepressants before that, although when I went to my GP, they put me on sertraline first, but had a really bad reaction so only took that for 2 days.

 

First wave of withdrawals hit me about 10ish days after I stopped taking them. Mainly nausea (vomited once or twice), muscle spasms/tremors, fatigue, lots of itching, and panic attacks/paranoia. I wasn't too bothered by them as I expected some symptoms to occur, and I don't remember how long they lasted, but maybe a week or a bit more?

Anyway, 2 or 3 weeks after, the 2nd wave started. I cannot tell you if physical symptoms were worse or not this time round, but because it was unexpected, I definitely handled it worse.  I think it lasted longer as well. At first I thought I had sinusitis because I started having headaches I normally have when my sinuses are all screwed up. I didn't have a fever, but my temp was elevated. Then my GI tract went to hell. Diarrhoea, and generally unhealthy looking poo for about a week (sorry for tmi), feeling sick, but no vomiting or fever. Zero appetite, food tasted like nothing and I couldn't stomach more than a bite. Finally a migraine hit me. Usually I recover after a day from these, but this time the next day was hell. Dizziness, nausea, stomach pain, tightness and pain in my chest/throat. It all got too much to handle and I went to the emergency GP thinking it was some weird infection (few lymph nodes in my neck were slightly swollen as well) or appendicitis. All tests came back clear and they sent me home with anti-nausea meds (stemetil), Omeprazole for heartburn (not sure if I even had heartburn, but still took them), and antibiotics just in case. Symptoms started easing up after that, except nausea although this could be due to antibiotics as I didn't tolerate them well. I'd say it all lasted for about 14 days, followed by a couple of days of intense feeling of dread and panic.

And then I was perfectly fine for a week. Now I am in what I think is the 3rd wave. Symptoms started a few days before my period, same as with 2nd wave. Does anyone know if periods can make withdrawal symptoms worse?

I'm currently on day 6 of having symptoms. It started with some morning/evening nausea but nothing I couldn't handle. I I took stemetil if i felt it getting worse. I experienced breathlessness for a few days (like i couldn't take a deep enough breath), but breathing exercises helped, although I still struggle a bit. That heavy feeling/discomfort in my chest and throat is back but it's manageable. It was all relatively fine until yesterday when my period actually started. Now I'm starting to feel more light-headed in the morning again, nausea seems to be getting worse, there's fatigue and my limbs feel heavy, and insomnia (although that seems to come and go, it's not a daily thing). I am also feeling more anxious and paranoid about everything, experiencing brain fog as well. Had some headaches, my head would just feel very tense and eyesight would get a bit strange (kind of like migraines I guess, but not as severe). I'm at least able to eat normally for now, and it actually seems to help my nausea short term. I also have a weird aftertaste in my mouth, not sure if that's due to omeprazole (today was my last pill).

So I guess I decided to join this forum to seek some reassurance that what I am experiencing are actually withdrawal symptoms from mirtazapine and not serious health concerns, lol. I have developed quite a lovely case of health anxiety due to all this and not sure whether to soldier through or seek medical help due to recurring symptoms. I did mention to emergency doctors that I used to take mirt and had withdrawal symptoms when I stopped, but they didn't really seem to acknowledge that. My GP obviously knows about mirt as well, but she didn't mention it either when I called about nausea (although tbh that was when I was taking antibiotics and still didn't think it was due to mirt).

Edited October 20, 2020 by Gridley

[Gridley]

Welcome to SA, mirtlady.

 

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.  Please give the details of your taper, including dates.  No symptoms.  A list format is best.  You'll need to use a computer rather than a phone.

 

Account Settings – Create or Edit a signature.

 

The symptoms you describe, including health anxiety, are typical of withdrawal, a result of your very fast taper of mirtazapine.  Withdrawal symptoms can be physical, emotional or mental in any combination.  They can go and go and return again.  If you want to seek medical help, that would be up to you.  You should know that doctors don't believe in significant antidepressant drug withdrawal symptoms, so be prepared to be disbelieved.  They are equally unaware of safe tapering practices. Here is some information on withdrawal and the healing process.

 

 

What is withdrawal syndrome.

 

The following is a list of typical antidepressant withdrawal symptoms.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric 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. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

If you prefer not to reinstate, that's up to you.  Reinstatement of a very small dosage of the original drug is the only known way to alleviate withdrawal.  The   other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  Reinstatement isn't a guarantee of diminished symptoms but it's the best methods available.  Reinstatement is best done as soon as possible after your last dose and works most predictably up to 3 months after the last dose, though some have successfully reinstated later.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If you change your mind and want to reinstate, please let me know and I'll suggest a reinstatement dose.  Please don't reinstate without letting me suggest a dosage.

 

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. Get supplements that are single ingredient (not mixed with other types of supplements).

 

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

 

 

 

 

 

 

 

 

 

Edited October 20, 2020 by Gridley

[mirtlady]

Hi Gridley,

 

thank you for your reply! I am most certain I won't reinstate, but will give the rest of your links a read. It's nice to have a list of all the possible symptoms, and it seems that the ones I'm experiencing are quite common. I think I'm currently at the end of my wave as I'm starting to feel decently clear headed, and it's amazing how easy it is for me to realize it's withdrawals now, but in the moment when I'm feeling ill, I just can't convince myself it's something that will pass with time, especially with how general and all over the place my symptoms are.

 

I have started taking omega 3 with vit D after the previous wave and been taking them daily. I'll start magnesium as well. I'm also on iron and vit B complex supplements long term due to a history of anaemia. I've been doing lots of breathing and grounding exercises and listening to guided meditation/hypnosis videos. Not sure how much the last one helps, but at least they take my mind off things.

[Gridley]

4 minutes ago, mirtlady said:

vit D

You might want to take vitamins D in the morning.  Some people find them activating.

 

While some members do fine with strenuous exercise, many find it too stimulating.  A gentle walk in nature can be calming.

 

If you have questions, please don't hesitate to ask.

[mirtlady]

Quote

You might want to take vitamins D in the morning.  Some people find them activating.

 

That's what I have been doing I have fish oil pills with added 5 μg of vit D. Do you think I should take a larger dose? Here in the UK we don't get any sun at all at the moment, but i still worry about taking too much.

 

 

Quote

While some members do fine with strenuous exercise, many find it too stimulating.  A gentle walk in nature can be calming.

 

I found walking is great, but too much of it makes my nausea/chest pain worse during the worst days. I did some light exercising today, and it made me feel really good, but this could also be because i generally feel good today aside from some dizziness in the morning. Honestly think breathing exercises helped me the most somehow.

 

And thank you! I'll definitely come back with any questions after I read the links you posted. Would also love to hear about experiences from anyone who was on mirtazapine and stopped.

[Santino]

Hi Mirtlady

You can read my topic and my success story. I am completely mirtfree now and living a normal life. You will be good tooo.

All the best

Santino

[ChessieCat]

46 minutes ago, Santino said:

You can read my topic and my success story.

 

☼-santino-how-do-i-keep-on-the-sane-side

 

santino-made-it-and-stayed-sane

 

[Mimi79]

Hi @mirtlady, welcome to SA!

 

I can surely answer to this question:

On 10/20/2020 at 1:16 PM, mirtlady said:

And then I was perfectly fine for a week. Now I am in what I think is the 3rd wave. Symptoms started a few days before my period, same as with 2nd wave. Does anyone know if periods can make withdrawal symptoms worse?

 

Yes, indeed, our menstrual cycles affect tremendously the recurring of waves and windows. Of course, everyone is different, but for me it is obvious! Almost each month, during the first few days of my periods, a wave starts. Sometime it even starts few days before, like pms. Almost all my waves are linked to my cycle. I often observe an uptick in symptoms around my ovulation too, but less intense and not every month. And on the other side, the last 2 weeks of my cycle bring windows. 
 

I hope it helps you figuring your pattern of symptoms. Since I’ve understand my own pattern of symptoms, I can deal with them more easily.

 

Have a nice day!

 

Mimi.

 

 

 

[mirtlady]

On 10/22/2020 at 10:54 AM, Santino said:

Hi Mirtlady

You can read my topic and my success story. I am completely mirtfree now and living a normal life. You will be good tooo.

All the best

Santino

 

 

Thank you, Santino!

I've read through your success story and it's awesome you're doing so great now. I hope I will be symptom free at some point as well.

 

 

On 10/22/2020 at 2:39 PM, Mimi79 said:

Yes, indeed, our menstrual cycles affect tremendously the recurring of waves and windows. Of course, everyone is different, but for me it is obvious! Almost each month, during the first few days of my periods, a wave starts. Sometime it even starts few days before, like pms. Almost all my waves are linked to my cycle. I often observe an uptick in symptoms around my ovulation too, but less intense and not every month. And on the other side, the last 2 weeks of my cycle bring windows.

 

 

Hi Mimi, thank you for your reply. Good to know there's other people experiencing similar things. I think I'm on my last day of period now and i felt pretty great for the past two days. But as i was going back home from work I had a panic attack, and then I saw I have rash on my arm which made me panic even more. Feeling a bit better now, but I probably set myself back by panicking over nothing, lol. I assume rash is just another symptom as I've read mirt can cause those as well (and indeed I had a horrible itchy rash during my first wave, it doesn't even itch now, I'm just panicking).

 

I have started keeping a track of my daily symptoms, hopefully that will help some.

[Mimi79]

Hi mirtlady, 

Maybe you already know that Mirtazapine is known for causing histamine issues. It is possible that the rash you experienced is linked to that. Some people have had great result with a low histamine diet. I’m actually trying to follow this diet (but it is so hard!). I’m not sure it is helping, but when I stick to this diet for numerous days, I can see some improvement in my symptoms. I even feel less anxious. But It is too soon to make conclusion. I need to follow it for a longer period. 
 

Have a nice day!

 

Mimi

[mirtlady]

Good idea about making a diet plan! I'm not too good at following diets, but will try to increase the amount of 'good' foods i eat. The rash is all gone now, makes me think I just scratched my arm absent-mindedly and that's what caused it, hah.

 

But, I've had some pretty bad heartburn for the past two days, and coupled with my panic attack/anxiety, it's been a pain. Luckily it seems to be a nightly thing rather than a constant thing. I originally thought it wasn't heartburn, but now i'm having pretty common symptoms of it. I will probably see with my GP if I can continue omeprazole or take something else for it.

 

Has anyone had any experience with chronic heartburn during withdrawals? How did you handle it?

[marie123]

Hi Mirtlady. I am taking mirtazapine and tapering it. I get heartburn during tapering Mirt but it is not too bad. I find I get it especially when I eat spicy, tomato sauce and orange juice. Tums work and ginger candy. I hope it gets better soon for you. Be well. Marie.

[mirtlady]

Hi Marie, thank you and good luck with your taper!

 

I've adjusted my diet since yesterday, and heartburn is still present but doesn't seem as bad. The worst thing is it wakes me up during the night and then I can't fall asleep again. I've also started to feel really anxious around meal times because of all of this. Eating now and not having the best time 😛

[mirtlady]

Hello, I'm back with some more questions Please let me know if I should make a separate topic for this, not quite sure how the forums work yet! Also it's really great there's so many sticky topics about different things, but if I'm honest, reading too much about withdrawal syndrome is a bit triggering for me and i think I do better when I just accept my symptoms and don't worry about how long they will last, etc. so I kind of want to steer clear of getting too deep into it, if that makes sense. I've basically just accepted I need to go through them, stay as stress free as I can, and hope that they will be gone at some point in the future, hah. I guess I'm lucky that i don't have much of a social life so it's not really impacting my daily life too negatively. In fact I think there's even been some positive impact as I am now going out of my way to eat healthy, do some light exercise and go on walks to curb the worst of it. Silver lining, eh?

 

So the worst of my withdrawals are over for now, but for the past couple of days I have been experiencing this thing where I would get symptoms usually in the morning or in the afternoon (mostly feeling light-headed or nauseous with fast heartbeat, feeling buzzed and lots of dread). They are relatively manageable although sometimes I do need to stop and lie down for some time, do some meditation before I'm able to continue with my day. But then as soon as they pass I feel absolutely fine, both mentally and physically. Has anyone experienced this as a consequence of their withdrawals? I know about waves, but can they come and go throughout the day as well? Or is this just your typical panic attack?

 

On another note, I went to my GP, and seems my heartburn/nausea issues might be due to IBS (ie my poop is chilling in my bowels not wanting to come out...), getting some tests done just to make sure there's no food allergies or bacterial infections. I did ask if IBS could be due to mirtazapine, she didn't really say yes nor no, just that it's more likely to be mechanical, whatever that means. I imagine it probably is though as mirt had quite an impact on my metabolism and digestion while I was talking it, makes sense that it would be all messed up now.

I completely changed my diet now, stopped taking iron supplements and will not take magnesium till I've had all my tests done (plus i think it made my heartburn worse the few times i took it), and GP told me to stop fish oil as well. But this morning when i was feeling nauseated and dizzy, I ended up taking it because I was too anxious about the whole thing. I think it helped, but I also took antacids, so who knows which one of those helped. I'm also unsure whether I should continue taking probiotics. The ones I'm taking should have a positive impact on constipation, but i guess i won't know unless i try stopping them for a while (I was taking them before as well and don't think i've had any issues).

 

If anyone has any general advise about IBS and how to be a vegetarian with IBS, as well as recipes or foods I can try, please get in touch!

[mirtlady]

It's been a while since I checked this forum, I thought I would make an update in case anyone finds it helpful. I have realised reading about withdrawals made my anxiety that much worse so I stopped informing myself about anything mirtazapine related and just soldiered through. I originally planned on keeping a diary on all my withdrawal symptoms as they progressed but due to anxiety I decided not to as I kept checking myself for symptoms multiple times a day and it made my health anxiety worse.

Anyhow, stomach issues lasted for another week or so after my last reply. I started taking fybogel powder as a fibre supplement (GP recommended it), and after that everything kind of settled down and went back to normal. I stopped taking this supplement a few weeks ago, and have had no recurring issues aside from normal issues which I have had my whole life.

Once my GI issues stopped being in the centre of my attention, I started worrying about getting a migraine. I have recurring aura migraines and I guess because of how anxious I was feeling, it suddenly became an issue and it was all I could think about. I've also noticed my eyes became quite sensitive to light, and it was hard to focus or even read. When I think about it now I realise I have always had sensitive eyes, and obviously always had migraines as well, but at the time it seemed like a huge issue due to increased anxiety. I decided to seek help regarding my health anxiety and got in touch with an online counsellor. They really helped me get through the worst of it. I started structuring my days around breathing exercises, meditation, exercise, and walks. Anxiety was still there, but I was able to live with it and not let it overwhelm me. At this point I haven't had a panic attack for quite a while. In fact, I don't even remember when was the last time I had it.

Beginning of December, I finally had my aura migraine, and wasn't nearly as bad as I anticipated. I think it happened due to stress as I was due to fly out the next day. I already have a fear of flying and with this heightened anxiety state I was even more worried about it. The migraine came and went, but my vision was left kind of messed up from it. I still sometimes see the aura in the mornings, which was worrying as normally it goes away 30 min or so before the migraine. I was anxious about it for about a week, but that anxiety went away as well. The messed up vision and sensitive eyes are still here (had some tests done, it's all fine as far as I know), but anxiety is not. I genuinely can't tell if the eye thing is withdrawal related as I have always had pretty sensitive vision.

 

The physical symptoms were very real, but anxiety definitely ramped them up quite a bit. All in all, I stopped taking mirtazapine in August, and now in January I can safely say I'm back to my normal self, except maybe the eye thing. It's nothing i can't live with (unless it turns out to be some kind of a tumour pressing on my nerves, but let's hope not, lol). I can finally eat anything I want, and I love food again. And that's all I could ever ask for :p I think the moment I knew it will all be ok was when during my last PMS I noticed the lack of super anxiety that has been a constant companion through my previous cycles during withdrawal.

 

This has been an experience and a half, but I can't say I regret it too much. My depression is under control, my anxiety is back to normal levels. And most importantly for me, I learnt how to be more in tune with my body and mind. I finally understand why people keep on blabbering about meditation and exercise as this magical cure. It's definitely not an instant solution, but it helps immensely with my healing process.

 

Regarding the supplements, I'm still taking (whenever i remember) omega 3, B complex, and Magnesium. I gave up coffee, but I still drink matcha tea. Even though it has more caffeine than coffee, it somehow has this relaxing effect on me that coffee definitely doesn't.

 

I'm not sure how often I'll come back to check this forum, but feel free to contact me with any questions.

 

 

[ChessieCat]

3 hours ago, mirtlady said:

It's been a while since I checked this forum, I thought I would make an update in case anyone finds it helpful.

 

Thank you it is very much appreciated.  It's not just members who can be helped.  Part of SA's mission is to educate the medical profession about psychiatric drugs.  Alto was recently interviewed - the link is in my drug signature.

 

See also:

 

SurvivingAntidepressants.org mentions and honors

 

How member's Introduction topics can help:

 

about-survivingantidepressantsorg

 

Alto was heavily involved in the writing of this research paper:

 

 

[Jav1]

Hi Mirtlady! Thanks for updating us on your recovery. I also took 30mg Mirtazapine from Dec 2019-Nov 2020. This was prescribed by my 2nd pscyh to wean me off of Clonazepam and Alprazolam which I took for about a month! Was not told by 1st psych is was only to be taken as needed and for 2 weeks only!

 

Anyway from aug to early Nov I tapered bu taking 15mg daily for 30 days then 15mg every other day (30tabs). I felt fine after taking the last dose. Only complaint was slight headache. Then on Dec 9 I had a stressful day at work and had an anxiety attack! And basically I have been in withdrawal hell since. I have burning head, tingling (sometimes burning skin) on my back, buttocks and legs and daily anxiety. Did you ever get these?

 

Would also like to know what supplements worked for you. Hopefully my recovery is around the corner as its been almost 3 months since my rebound anxiety.....

 

your story gives me hope. 

[Jav1]

If you are not doing well, please do not respond anymore...I wish you well.