AdviceNeeded: introduction - mirtazapine and zopiclone

[AdviceNeeded]

I’ve checked my blood pressure a couple of times the past week and it’s high. It was never high prior to ADs approximately 6 months ago.

 

Any one got any ideas whether this is likely a legacy effect from my reaction to mirtazapine, or maybe tapering?

 

I’m hesitant to see my GP about it if it’s something that’s likely to pass.

 

[AdviceNeeded]

So, in my anxious, drug addled mind I’ve been getting paranoid I’ve given myself some sort of brain injury. So what did I do? I phoned Dr. Singer in the states. What a nice guy.

 

I talked him through the situation and asked his opinion... which was that the drugs do more harm than good. He reckons I experienced negative effects from the start... hence why I felt better dropping the dose. Going up to full dose again exasperated the negative effects. Basically, from my understanding, he was saying that drugs like mirtazapine can injure the brain and wider CNS (by causing imbalances) so taking the drug injures the CNS, and then jumping doses and increasing further injures an already injured system.

 

So the bad news is I can consider what I have to be a form of brain injury. The good news is that, from the symptoms I described, he reckons it sounds minor and should completely resolve in time. He even acknowledged the sensitisation of the CNS... and reckons this should become more resilient in time too. And as for the autonomic dysfunction, he said that’s likely a result of the imbalances caused by the drug along with poor sleep. Should all resolve in time.

 

His recommendations to aid recovery included eating healthily, something like tai chi to calm the CNS, continuing to taper, and some form of therapy to tackle underlying anxiety and any trauma.

So, he seems pretty much in tune with @Altostrata and the SA ethos.

 

It felt so good to speak to a medical professional that listened, took questions and was happy to explain concepts. Completely different to the drug pushers I’ve encountered so far.

 

My plan:

 

Exercise with a bit more regularity, slowly increasing intensity over time (I’m hoping this might aid building some resiliency back into the CNS and promote neuroplasticity).

 

Continue to taper (I’ve slowed down a fair bit) at current rate.

 

Look into macrobiotic eating and incorporate it into my diet.

 

Do some tai chi on a regular basis. 
 

Not sure about the therapy at the minute.

 

Re-assess the whole thing in four weeks. I’m open to medical advice/support in some areas (definitely no ADs, APs, benzodiazepines, etc) but I want to give nature more of a chance to do its bit first.

 

[AdviceNeeded]

Also, I read that they give mirtazapine to cats as an appetite stimulant. The sick *****.

 

I was on a cat forum and a lady was distressed cause it had been given to her 17 year old cat which was now roaming the house, unable to settle. Sounds like the dose was too high and the cat was experiencing agitation and insomnia. Nice.

 

When I’m recovered I want to help raise awareness about the use of ADs in animals, cause that’s just sick 🤢.

[Altostrata]

Do you mean Dr. Shipko?

 

On 4/7/2021 at 3:45 AM, AdviceNeeded said:

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?

 

Yes, you will need to observe your symptom pattern and not make another reduction until you've been stable for a good while.

 

How much sleep are you getting now? How have your symptoms changed in the last week?

 

Saying your nervous system is destabilized is more accurate than calling it nervous system damage.

[AdviceNeeded]

@Altostrata, hi.

 

It was Dr. Raymond Singer, the neurotoxicologist. 
 

Sleep wise I’m doing a bit better, tend to fall asleep relatively quickly around 10:30 pm and wake up anywhere between 3:45 - 5:30 am. Once I’m awake though, that’s it, I’m quiet fidgety and alert and there’s no drifting back off (I’m guessing that could be either remnants of ‘alerting’, or the stimulating aspect of mirt, or a combination of the two).

 

Symptoms over the last week have been pretty consistent, the general autonomic dysfunction has been rumbling on and I have days of heightened anxiety and low mood.

 

Prior to slowing it down I’d been tapering at a rate equivalent to around 10% every two weeks. I’ve not felt well from the start but the overall level of ‘alerting’ such as sleeplessness, tired but wired, racing heart, etc, has slowly decreased. It’s hard to say if I’ve really felt the drops thus far in an overly negative way, possibly not. I’ve not noticed much in the way of hypersensitivity to foods or supplements (although I’ve been abstaining from caffeine, too much sugar, etc, just to be on the safe side). Don’t get me wrong, I’ve not felt well and having a destabilised CNS is very uncomfortable and no fun, but I’m guessing it could be a lot worse.

 

I don’t want to risk further destabilisation, but at the same time I’d like off the mirt, so it appears to be a bit of a tight rope walk.

[Altostrata]

Your sleep is not too bad for withdrawal.

 

11 hours ago, AdviceNeeded said:

Prior to slowing it down I’d been tapering at a rate equivalent to around 10% every two weeks.

 

Obviously you're tapering too fast to preserve sleep, if sleeping is a concern for you.

 

Mirtazapine has a very long half-life. 20-40 hours. If you make a reduction on the first of the month, it may not register in your system for more than a week. If you make another reduction in a week, it compounds the decrease over the next week.

 

You probably would do better making reductions at monthly intervals to allow your system to accommodate between reductions.

 

If you want to go faster than that, you will have to cope with rebound insomnia or other withdrawal symptoms. We do not have any magic potions to make this go away.

[AdviceNeeded]

@Altostrata

 

Noted. I’d rather avoid insomnia if possible so I’ll slow it down from here on in. Now I’m on a lower dose I’m guessing the adverse effects should be reduced and hopefully some healings happening 🤞🏼

[AdviceNeeded]

@Altostrata

 

Greetings from the UK. Hoping all is well across the pond.

 

I believe I’m down to a dose of mirt where adverse effects are minimal. For example, I was waking up a couple of hours after dosing dripping in sweat and having restless legs. Since my last post I’ve been holding, and this hasn’t been happening. I’m sleeping around 5 - 6 hours a night with no restless legs a or sweats. Anxiety has been turned down a good few notches too.

 

However.... I’ve still got a bucket load of other stuff going off which I’m guessing is due to general destabilisation, one of the most notable being high blood pressure. Top and bottom numbers are both high, but it’s the bottom number that seems the most abnormal. This has never been an issue previously.

 

In my shoes, would you be in a rush to get this attended to medically or put it down to iatrogenic autonomic dysfunction and give it time to settle naturally?

 

As always, thanks.

 

 

[AdviceNeeded]

Also, do you think that following destabilisation the body has a ‘memory’ of what it’s correct functioning should be, and that’s what it’s working towards attaining?

[Altostrata]

7 hours ago, AdviceNeeded said:

Also, do you think that following destabilisation the body has a ‘memory’ of what it’s correct functioning should be, and that’s what it’s working towards attaining?

 

Yes, that's normal homeostasis.

 

If the high blood pressure pressure showed up while you were tapering, it's more likely due to the drug reduction. But if you haven't had a checkup recently, you might want to have one.

 

Since your sleep is better, you might want to hold on further reductions for a while. Other symptoms may settle down, too.

[AdviceNeeded]

Thanks @Altostrata

 

Slept fairly well again last night and noticed BP was a little lower this morning (still sky high - just not quiet so bad). And I feel a little better in general so far today. I’m guessing BP could well be a good indicator of underlying nervous system stability.

 

I’ve developed a bit of an interest in the possible underlying mechanisms behind drug withdrawal, destabilisation, etc. To be honest, I’d love to pick your brains about so much. I’m going to refrain though, I get the feeling your probably more than a little busy.

 

I’ll keep holding for a while before resuming my taper (and then I’m going to slow it down). I’ll update again in a few weeks.

[Altostrata]

It's very possible all your symptoms will settle down after a while and you'll be able to resume tapering.