AdviceNeeded: introduction - mirtazapine and zopiclone

[AdviceNeeded]

@Altostrata and @ChessieCat

 

Daily notes
 

0200: woke up - wide awake, stayed in bed till 0630 feeling low

0630: cereal and decaf tea for breakfast 

0800: 20mg propranolol

0900: drove for 1 hour, low mood, feeling weak and hopeless with the situation 

1000: fruit and cereal bars

1015: 4 mile walk

1200: lunch

1240: 4 mile walk, mood improved, more hopeful

1430: 1 hour drive home

1645: 20 mg propranolol 

1700: evening meal

2000: watched film, feeling okay

2130: 12.15 mg home made mirtazapine solution

2200: went to bed, fell asleep quickly. Slept solidly till 0200 - woke up wide awake. Took m  as m  as magnesium tablet. Drifted in and out of sleep till 0600 (improvement?)

 

 

[Altostrata]

How has your sleep pattern changed in the last month?

 

Why are you taking propranolol?

[AdviceNeeded]

Hi @Altostrata

 

Sleep pattern has been poor from the start. In the last month though it has fallen into a pattern of 10pm till 2am and then (if I’m lucky) some light sleep between 2am and 530am.

 

I take the propranolol for the elevated heart rate. I have found it to be slightly calming. It was on the advise of GP (I was sceptical at first but gave it a go due to a feeling of daily internal restlessness).

[Altostrata]

Have you darkened your bedroom? Are you using a sleep mask?

[AdviceNeeded]

Yep. I’ve been practicing some decent sleep hygiene for a while. 
 

I think I’m resigning myself to the very real possibility my sleep could be quite poor until I’m off the mirtazapine and recovered.

 

I’m hoping for the best whilst mentally preparing for the worst.

[AdviceNeeded]

Hi @Altostrata

 

Firstly, thank-you for looking over my posts and offering your advice.

 

Secondly, i’d like to ask a pretty blunt question (or questions). Given your knowledge and experience, does it look like I ‘kindled’ from the mirtazapine, as most of my bad symptoms (anhodenia, raised pulse, very poor sleep, complete lack of libido, restlessness, anxiety) started at the same time as the updose to 15 mg?

And since dropping (firstly to 13.5, then 12.15) some things have improved (sleep slightly, anhodenia and libido slightly, anxiety definitely, restlessness and pulse slightly). Does this indicate I should continue with 10% drops every two weeks (symptoms permitting)?

 

And finally, given all the cases you’ve seen, would you say full recovery is feasible? And if so, are we looking at years as a realistic timescale?

 

Thank-you, I know I’m asking a lot above and that your answers are only your considered opinion rather than set in stone, it’s just your opinions on this are important to me. I’m starting to put my life back together for the new year and and am looking for indicators of what I’ll be dealing with.

 

Thanks again.

[Altostrata]

Yes, I think the dosage changes in August-October sensitized your nervous system and the increase in mirtazapine to 15mg October 16 caused a kindling reaction, symptoms of which were activation: heart rate increase, anxiety, restlessness, insomnia.

 

(Anhedonia and lack of libido are drug effects, not a kindling reaction.)

 

It appears this is settling down. 15mg mirtazapine was too much for you, as you're reducing it, we are seeing small, gradual improvements, which is what we would expect.

 

With patience, I believe you can slowly go off mirtazapine, strengthen your sleep, and recover.

[AdviceNeeded]

Thank-you for the reply.

 

I'm truly gutted. Looks like it'll be patience that wins the day.

[AdviceNeeded]

@Altostrata

 

As always, thanks for your time and effort looking over my posts.

 

I’m not particularly functional at the minute, and I don’t expect to be for quite some time. That being said, if I could calm my system down a touch and get a little more functional work wise it’d be great. What I’m seeking is just enough inner calm to get a decent nights sleep and some better cognition - they’re the two things that are hugely holding me back. I’m not expecting miracles and certainly don’t think I’ll be running marathons or running a corporation any time soon.

 

So, in the hope of getting functional I was planning to slowly (as slow as it takes) taper and hope that the trend of my system settling down continues. My GP isn’t so great (in fact I get passed between two). One gets the idea of stability but wants me to achieve it at 15 mg, the other suggested 7.5 mg for two weeks then quit. As such I was pondering the idea of a private psychiatrist and floating the idea of low dose lamictal. This is were I seek your advice. Is low dose lamictal whilst tapering a definite ‘no’? 

If it is feasible whilst tapering (and I could convince the psych) I’d take full responsibility for going down this route. 

As always, thanks for looking over this. 

[AdviceNeeded]

I’ve checked for drug interactions and nothing came up. Due to the ‘alert’ level of my CNS I’m guessing that a hypothetical starting dose (either during tapering or in withdrawal) would be sub 2 mg. And all this is purely speculative and depends on finding an experienced prescriber and whether it’s even applicable to my circumstance.

 

I’m just exploring all avenues right now. I know the key ingredient in all of this will be patience. I’m just looking for a way to be as comfortable and functional (within reason) as possible whilst I wait it all out.

[Altostrata]

I don't know what lamotrigine would do for you. A probe dose should be 2.5mg or less.

 

If your GPs are not in tune with your tapering plans, you might make a liquid to taper gradually yourself, see Tips for tapering off mirtazapine (Remeron)

 

Please let us know how you're doing.

[AdviceNeeded]

Crikey. I think I may be having a window. This is possibly the first time I’ve felt almost like myself for months. I’ve been feeling increasingly angry with the medical profession for a few days (don’t get me wrong - it was me who messed about with the dosage - nobody informed me I was playing with a loaded gun though). I genuinely can’t believe some situational anxiety has led me down a path that has temporarily (and could possibly permenantly) ruin my life. And all this happened without ever seeing a doctor or psychiatrists face. Everything done over the telephone and not a single mention of the potential dangers.

 

I’ve felt suicidal at times over the past couple of months, and I’m sure I will again at some points in the future. But for now I fully intend on doing all within my power to recover. Meditate, light exercise, good food, plenty of rest, patience (that’ll probably be the hardest part) and faith.

 

 

 

 

[RickyIsHealing]

@Ripley that's good to hear !

i also think im in a window , I've felt less stressed and more like myself past 2 days and slept better last night due to feeling less stressed !

kind of hoping its not just a window but progress that i can feel and hopefully growing on . im doing everything right so i like to think its progress! 

hope this is the start for us!

[AdviceNeeded]

I've been busy looking at success stories. I think I may be here for a while... is it possible to change my username to something a little more positive? Thanks.

[ChessieCat]

A name change is only done in extreme circumstances.  Much of the change of member name process has to be done manually.  SA is staffed by a small number of volunteers (who are also tapering/post taper).  The manual part of a name change takes up moderator time that we prefer to spend helping members with their drug issues.

[AdviceNeeded]

No worries, I understand.

[AdviceNeeded]

Hi @Altostrata

Just letting you know how it’s going. I’m just over a week into 12.15 mg, things seem okay. I slept better than I have in a while last night, still woke up early but managed to get back to sleep then drifted in and out (and it felt fairly natural). Actually felt a tad tired during the day today too. Still have a general feeling of weakness and a sense that bodily things are out of whack, random song looping and mild tinnitus. It could be a lot worse to be fair, I’ve been looking at ten0275, Wulfgar and Bayboy for inspiration.

 

As it stands I’m undecided whether to cut again at 2 weeks or leave it till 4 weeks (symptoms permitting). On the one hand I’m tempted to get down to a lower dose fairly quickly as I get the distinct feeling the drug is causing havoc internally (hormone levels, transmitters, etc), but equally I don’t want to shock my CNS too much as the feelings I had at the time of the original updose are fresh in my mind and I’d rather not re-visit them. I think psychologically I’ll feel happier at a lower dose and more comfortable with longer holds. 
 

As always, thank-you, and I welcome your comments or input with any of the above. 
 

PS I’ve decided not to pursue the private psychologist and lamictal route. 

[Altostrata]

I think your slow taper will go fine.

[AdviceNeeded]

Hi @Altostrata and all the team at SA

 

Firstly, I hope you've all managed to get some enjoyment out of Christmas. I believe I have.

 

Secondly, I'd like to ask your advice/opinions. I've dropped down to 11.75 mg mirt (as per my signature). I genuinely feel a little bit better on the lower dose, not loads better but a little, and I've not really felt that much discomfort whilst dropping. Looking back at my history I've never really stabilised for any good length of time since my updose to 15 mg (16th October). My CNS feels sensitive (though not as much as it did) and I don't think it would be unreasonable to attribute a lot of the dystonomia type symptons I'm experiencing to the mirt being too much for me and causing activation.

 

So, I was considering going over to 2.5% drops per week (with holds every 4 weeks (symptons permitting)) until I hit a level were the mirt isn't as activating and then holding there for a while. So that's my question really, in your collective experiences and wisdom does that approach sound reasonable?

 

Also, for the benefit of anyone follwing, symptons that seem to be improving include my mental clarity, sleep quality and duration (still not great but improving), anxiety, weakness and heart rate (take that one with a pinch of salt though as am taking a couple of propranolol per day).

 

[Altostrata]

4 hours ago, AdviceNeeded said:

So, I was considering going over to 2.5% drops per week (with holds every 4 weeks (symptons permitting)) until I hit a level were the mirt isn't as activating and then holding there for a while. So that's my question really, in your collective experiences and wisdom does that approach sound reasonable?

 

Yes, some people do it this way. Also see

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide Method of Micro-tapering

[AdviceNeeded]

Hello community of healing,

 

I’m after some more advice. After a mis-hap with mirt I’m in the process of tapering off. As I’ve said before, things aren’t going too badly (definitely been some small improvements). One thing I feel that is really holding me back though is sleep. I’m currently dropping 2.5% per week and my sleep is seriously patchy - some nights I have some of the best sleep I’ve had in months and others some of the worst (just all out insomnia). So that’s my quandary, push on with 2.5% drops and take the insomnia, or slow it down to 10% every 4 weeks, or hold where I am for a while? Given my specific situation, what would be the best course of action?

 

Appreciate this community so much, this is easily the hardest thing I’ve faced in my life and this forum has been an incredible support.

[Ripley]

Hi Adviceneeded

 

If I were you, I would not push on through the insomnia and probably hold if possible.

 

Last spring, my situation had similarities to yours. My sleep was overall very good with 7 or 8 hours a night but with the occasional 'zero night' of complete insomnia. As these usually seemed to have an explanation like hormones or going to bed too late, I thought they were probably 'WD normal' and started a slow brass monkey taper in June.

 

By September I had to stop tapering and by November I was back in insomnia hell! In hindsight I can only assume that the occasional zero nights were telling me that my system was still not settled enough or ready to taper. It was very discouraging. 

 

Thankfully things have improved a lot now but I'm thinking i need to hold for a good while and wait and hope for the 'zero nights' to fade completely. I don't think I should try to taper until they do and this is the advice I would give to you. Everybody's different of course and you may be fine with your taper but this was my experience. I notice that you feel much better with reductions so you'll need to consider this as well. 

 

Best wishes

Ripley 

[AdviceNeeded]

Hi Ripley,

 

Thanks for that - that’s some really good advice and gave me something to think about. 
 

In the end I decided to push on with the taper, so I’m at 11.25 mg now. The reason being, despite the insomnia, I’m feeling better as the dose goes down. Not loads better, but better none the less. Even the insomnia feels slightly improved. I’m not adverse to a nice long hold and, unless circumstances force me to do it earlier, I’m planning on having one once I get down to a lower dose to give my body and brain a bit of a rest.

 

Glad to hear things have improved for you, I hope it stays that way.

 

All the best - RB

[Ripley]

Hi RB

 

Ultimately, listening to your own body is the best thing to do and it sounds like you are! I hope it continues to go well for you.

 

Rx

[AdviceNeeded]

 

Now that the distraction of Christmas is over I'm back to obsessing over my situation. I've been reading around the site and the answers I've already recieved and would like to ask if I've got the correct understanding of the general consensus of what's happened...

 

I started taking 15 mg mirtazapine (in hindsight I think I was quite sensitive to it from the start as I experienced night sweats and poor sleep). As I changed the dosage up and down I sensitised my nervous system. Updosing to 15 mg overwhelmed by CNS and caused a 'kindling reaction'... this is where I've got a few questions.

 

I've read the info on kindling but am unsure what it actually means in my situation. At the point of the updose things went seriously downhill; my ability to sleep deteriorated, I became anxious and restless, my heart began to pound and resting heart rate increased, my sexual function disappeared, my cognitive abilities went downhill, anhedonia, SI, general weakness and lack of appetite. I'm sure there's more, it was purgatory. From this would I be correct in thinking 'kindling' meant that 15 mg mirtazapine was now too strong for me? For example, it still put me to sleep but I'd be wide awake 3 hours later, which could be attributed to the activating qualities of increased norepinephrine overiding the sedating effects?

 

A few days after my first decrease (to 13.5 mg) I noticed a few things start to improve, most notably I became less restless, sleep became a little more restorative, anhedonia was a little better, sexual function was slightly improved. Would this indicate that my CNS is tolerating the lower dose better than the higher dose? Further slight improvements occured at the next reduction to 12 mg. Would this indicate it'd be beneficial to continue with a slow taper, possibly having a long hold to allow for stabilistaion once I hit a lower dose where my symptons are more manageable? And should I be looking to minimise the stress I place on my CNS during tapering and recovery?

 

Also, having a read around the site I get the feelng that given my situation I'm actually not doing too badly, I'm not bed bound and if I didn't feel so sorry for myself I'd probably be capable of being a lot more functional than I currently am. Should I take this as a good sign recovery wise?

 

And one last question... I'm sleeping a little better these days, it's not great but is improved. However, I tend to wake up around 3:30 and can't really get back to sleep. Then, once I'm up I feel quiet disheartened in the mornings, sometimes if I think about my situation during these times I'll feel physically sick. Could some of this be attributed to raised morning cortisol?

 

@Altostrata @ChessieCat @Gridley @ten0275 Thank-you! I can't imagine where I'd be right now without you guys and this site. It makes me so angry and upset to think about the hurt I've caused myself and my family by getting involved with these drugs. I'm finding it hard not to get drawn into negativity, I know there are some horror stories out there concerning mirt, but on the flipside there's probably just as many success stories. And objectively, given what's happened, I don't think I'm actually doing too badly.

 

Happy New Year and Good Health to all.

 

 

[AdviceNeeded]

Hello Community,

 

Thought it might be worth an update so I can document whats been happening and leave myself open for any potential feedback and/or guidance.

 

So, I'm currently at 10.75 mg (I've been dropping approximately 2.5% every 7/8 days), with a couple of 20 mg doses of propranolol thrown in per day. Compared to where I was at in October and November last year things are better. I felt a complete lack of emotion back then (definitely a lack of positive emotion anyhow), this seems to be abating... however, now I'm getting huge waves of guilt and sadness. Sleep seems to be improving, don't get me wrong, it's not great, but I can't deny the fact it's improved - I still wake early but can often drift back into a fitful sleep for a few more hours. The horrendous, pit-of-despair anxiety I was experiencing has largely gone, and the restlessness is greatly reduced. I get windows where I almost feel normal, they only last a few hours and are normally in the evening. They're nice. The rest of the time I'm generally feeling uncomfortable in my own mind and body - don't get me wrong - it's not wild akasthesia - just a general sense of unease. I think this may, in part, be stemming from obsessing over my situation and fearing for the future - cause I'm doing both of those things A LOT.

 

Tapering wise I'm considering holding where I am for a little longer on this dose, possibly the full 4 weeks. I'm wondering whether the accumulation of all these small drops (despite seeming to alleviate some 'activation' are contributing to my unease).

 

In terms of exercise I'm walking a couple of miles most days and doing a bit of light weight training. I've not noticed any negative impact. I'm considering trying to add in some slightly more intense cardio. I know a lot of members don't find it be helpful when dealing with a sensitised CNS, but I think I need to try it for myself and see what happens - I'll report back with the results.

 

One of the things I'm struggling with most is acceptance... accepting my situation and accepting the uncertainty of the future. I'm also questioning how much of this is 'me' and how much is the drug. I was struggling with some insomnia and anxiety prior to all this (it came on pretty quick though - I was, for the most part, happy and relaxed). However, I've never dealt well with uncertainty and have always been my own harshest critic. What I really want is someone to hold my hand, reassure me that if I follow steps X, Y and Z, I'll be healed and back to my best self by a given date. I know that's not going to happen though, and looking for reassurance on-line throws up an array of horror stories that are like car crashes... impossible to turn away from. But, there are success stories out there. Are their circumstances exactly the same as mine? Of course not. What's the common theme though? We're all, for the most part, dealing with battered nervous systems and withdrawal.

 

So, that's where I'm at. I'm nervous, and I'm scared, but I'm better than I was and I'm moving forward. I could be a lot better, but I could be a lot worse.

 

Peace.

[AdviceNeeded]

I've been noticing that my days are starting to follow a set pattern. In the morning I generally feel groggy, uneasy, fatigued, almost hungover and low. By late afternoon (4ish) it starts to ease up and I start feeling a little bit more like myself (or the 'me' i recognise anyhow). So, it seems to be the further away I get from my last dose the better I start to feel. Is this normal for WD? And would it further indicate that the mirt isn't doing me any favours? And that, hopefully, the lower I get in dose, the better I'll feel in the day?

 

Still can't believe I ever got involved with this poison... man I must have felt desperate. Still working on acceptance.

[AdviceNeeded]

@Altostrata, hi, just checking in.

 

I'm currently at 10 mg and definitely feeling better than where I was at following the kindling event in mid-October lst year. I've been dropping around 2.5% per week.

 

Sleep has improved, I normally drop off pretty quickly and sleep through till the early morning (4ish) and then get some tossing and turning with a few vivid dreams for an hour or so. None of it's particularly restful but it is so much better than it was.

 

I've had a few days and nights where I've felt agitated and restless... this could possibly be following days where I've attempted slightly more vigorous exercise, which is a real shame as I used to love vigorous exercise. Some days my digestion also feels a little 'off'... I did have quiet an appetite for a month or so but it seems to have diminished as the dose has decreased. I've also noticed a slight improvement in the trouser department (I don't want to be any more graphic than that but figured it's significant as that completely shut down back in October/November). In general, I don't feel very physically or mentally robust right now, but again... this is still better than where I was last year.

 

So, I'm thinking that I'm seeing improvements as the dose decreases (as 15 mg was too much for my sensitised CNS). I'm also guessing that I'm dealing with a fragile CNS as too much exertion appears to be causing agitation. So going forwards, do you think it would be worth trying to reduce 5% every couple of weeks? And in terms of the fragile CNS, am I best holding back on any vigorous exercise, perhaps trying to incorporate a bit every couple of months to see how I react?

 

And lastly (this is the bit were I blatantly seek reassurance), things seem to me, to be going in the right direction, and probably quicker than I expected (but obviously not as quick as I would like). Would you say that's a fair assessment?

 

Thanks, I know your time is in demand, just seeking some knowledgable input as (most probably like most on here) it's in short supply in the real world.

[Altostrata]

Hello, AN. If you've started to feel a little rocky, you might stop tapering for a month or two, let your nervous system calm down, then resume tapering. Our members often do this.

[AdviceNeeded]

I just worked out that my spell of anxiety back in August occurred after a few nights of taking zopiclone. Makes me wonder if that was the cause... as the anxiety I experienced was like nothing I’d ever felt before.

 

I’d give anything for a quick go in a time machine. I feel like it could be a long road home.

[AdviceNeeded]

@Altostrataand the team, just checking in.

 

After my unfortunate updose back in Oct I’ve been diligently tapering and am currently at 7.5 mg, I know this was fast but I noticed improvements as I dropped and seemed to be handling cuts quiet well. I’m intending to stay here for a while before resuming my taper and slowing it down.

 

So, I’m feeling okay. Not great, nowhere near great, but a whole lot better than I was. As it stands:

 

I’m normally dropping off to sleep okay but have many vivid dreams and wake early (between 4 and 5) and then that’s it. I never really feel rested.

 

Libido is better than it was but is still really not right.

 

My level of agitation is much lower than it was but I still feel uncomfortable in my own skin and find it hard to relax.

 

I’ve got low level crackling and tinnitus in one ear.

 

I get the odd surge of unnatural anxiety.

 

My thinking isn’t too clear, most of the time I feel vacant and just have random snippets of songs looping in my head.

 

I don’t seem to be tolerating exercise too well and have a general feeling of weakness.

 

So, things are a lot better than they were but I’ve still a good way to go. I am experiencing a lot of negative thoughts though... largely along the lines that I’ve done myself permanent damage. Given my situation/history, how realistic is that? And am I doing the right things... tapering slowly off, living clean and minimising stress? Is there anything I’m missing?

 

SA Team, thank-you.

[Altostrata]

This sounds like a good time to take a break from tapering. You probably will see gradual improvement as everything settles down.

 

Many people find fish oil and magnesium supplements helpful, see

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

Please let us know how you're doing.

 

 

[AdviceNeeded]

Currently holding at 7.5 mg mirtazapine, tapered off the propranolol last Sunday and have caught my heart rate at pre-mirtazapine ‘adverse reaction’ levels at least a couple of times this week. I’ve started getting a bit more tired I’m the evenings as well, doesn’t exactly translate to a good nights sleep - that’s still elusive. Would it be fair to say these are signs things are starting to settle down?

[AdviceNeeded]

I'm experiencing some obsessing over the 'kindling' event. I keep exeriencing the overwhelming thought that this event, and it's adverse effects mean that I'm left with a wholly fragile nervous system that won't calm down, ever. And man, I miss the days were I'd just sink contentedly exhausted into the settee.

 

Looking round the forum I can find examples of people that have been off and on various drugs before quitting and have made some pretty decent recoveries (albeit over years). I'm also terrified of mirtazapine. I try and tell myself I'm not, but I've just got a deep feeling that it's a particulary nasty drug.

 

So, is it safe to say that jumping up and down dosage, or going on and off the same and/or various drugs causes destabilisation irrespective of the specific ADs involved? For example, I've got a friend who was started on sertralene a few years back, he reacted badly to it before being switched to citalopram - which he reacted even worse to (he said it sent him back to below 0), before finally landing on prozac - which he finally stabilised on. So, would it be fair to say his experiences with sertralene sensitised his nervous system, he could have 'kindled' on citalopram (hence the severe reaction) and finally started to stabilise on prozac? This is just conjecture - I'm checking I've got an understanding of sensitisation, kindling, etc. I've not mentioned any of this to my friend either, he seems happy enough now and I can't see any point rocking his boat.

[AdviceNeeded]

Just looking back at my tapering and I think it's fair to say I've tapered a little fast. After a hold of about six weeks on 15 mg (following a really poorly judged and ill informed re-instatement on mine and my GPs behalf), there was no let up in anxiety, insomnia or SI (all the real 'fun' stuff). Since then I've tapering at a rate of about 10% every two weeks and there's been improvements across all fronts (things are still not exactly great though).

 

However, on Altos and others advise, I'm going to hold for while before tapering further. In fact, I'm inclined to be guided by symptons rather than time frames (if I'm clear of symptons for 4 weeks, I'll make a cut, if not, I'll wait abit longer). So, I'm guessing I'm on the look out for signs of CNS destabilisation. So far, I've get these penned down as:

• insomnia/sleep disturbances
• anxiety
• depression/negative rumination
• worsening sexual dysfunction
• tremor/shakiness
• fatigue
• weakness
• raised heart rate
• worsening exercise intolerance

How does this look, anything I'm missing?

 

Community, thank-you. Good vibes to all.

[AdviceNeeded]

Hello community,

 

I had an appointment with a psychiatrist last week. Biggest waste of money I’ve ever made.

 

After explaining the rough time I’ve had with mirtazapine, the only comment I got was that some drugs don’t suit some people. I walked out with a script for lexapro and lorazepam (for any anxiety during a two day wash out from mirtazapine). I have no plans to take either.

 

I’ve been cutting fairly quickly since my updose and adverse reaction back in October. I’m currently having a hold and then I’ll be resuming my taper. I’m planning on being symptom led from here.

 

I’d experienced some anxiety (felt chemical) after my last cut. Sleep is very hit and miss but the general trend has been one of improvement. Other than that most symptoms (whilst still there) are generally improving. 
 

So, community, what I ask is this... am I going about this the right way? Updosing to 15 mg was way too much and sent me bananas, hence a relatively quick taper. Now I’m about half way things are more settled so I’ll slow it down. I’m guessing cuts have the potential to destabilise an already precarious nervous system, so is being symptom led the wisest move from here on in?

 

Also, I’m relatively functional... I go to work, my sleep’s rubbish but I cope, I’ve not noticed any real food or supplement intolerances (although I’m avoiding caffeine and alcohol), I feel the cold a bit more and am generally lethargic, I’ve got sexual dysfunction but I feel it’s improving. Should I take this as an indicator that my CNS destabilisation wasn’t too severe and that it’s slowly on the mend? (Did I mention I’m also constantly seeking reassurance?)