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Kidlacassa: in need of hope


Kidlacassa

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Hello everyone.

 

Sorry for being abrupt with my introduction, but I just checked some threads that are similar to my situation and I'm freaking out. 

Male. 31yrs old. 

After 11years of paxil usage my doctor told me to come off it since apparently the med wasn't doing its work anymore. He suggested to quit paxil cold turkey and start venlafaxine. No paxil withdrawal at all. I took venlafaxine for 12 days, but I stopped after reading about side effects and horrible withdrawals. 

I went to a dif doctor who put me on mirtazapine, so I stopped venlafaxine cold turkey. That meant 28 days of brain zaps. 

After a month and a half of taking 15mg of mirtazapine nightly I started to notice emotional blunting and numb feet. I tried to go from 15 to 7.5mg and I had a sleepless night. I kept trying every now and then til I got to sleep at least 5 hours. I maintained the 7.5 dose for a week, then jumped to 3.75mg, stayed on that dose from another week and this past week I have been alternating between 3.75 and 0.

I have been experiencing intrusive thoughts and panic attacks in the mornings. The emotional blunting hasn't lifted.

My doctor prescribed Prozac as an AD and quetiapine for sleep, but I refused to take an antpsychotic as I'm aware of the permanent brain damage they might cause. 

I can cry a bit in very extreme circumstances and chuckle every once in a while, but most of the time I'm flat. 

 

Please give me some hope on getting all my emotions back once I'm completely off the drug.  I'm terrified of the other mirtazapine "no emotions" posts. 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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  • ChessieCat changed the title to Kidlacassa: in need of hope
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Hi Kidlacassa and welcome to SA,

 

Skipping doses is NOT recommended.  Please see: 

 

NEVER SKIP DOSES TO TAPER 

 

If you have been taking 3.75mg for one week and before that you were taking 7.5mg you could try taking 2mg every day.  Post #1 of this topic explains how to get the dose you need:

 

Tips for tapering off mirtazapine (Remeron)

 

It can take as little as 4 weeks for the brain to fully adapt to a drug.  Once this happens the drug needs to be tapered carefully.  Before 1 month a person might be able to do a very fast taper.  SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  If a person has been on the drug for a short time, 2-3 months, they MIGHT be able to taper faster, but you need to listen to your body/symptoms and hold when needed, ie have withdrawal symptoms.

 

Why taper by 10% of my dosage?

 

The difficult thing with your situation is that you have changed drugs (you haven't given any dates - please see the below request for drug signature) so it is hard to know if you are experiencing withdrawal symptoms from previous drugs and/or side effects/adverse reaction from the current drug.

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

25 minutes ago, Kidlacassa said:

I kept trying every now and then til I got to sleep at least 5 hours.

 

Qs:  What were you trying?  Supplements?  Drugs?  Changing doses?  Please provide details of this.

 

We ask all members to create a drug signature for ALL drugs/supplements both current and previous.  Please follow these directions.  We need to see the drug name followed by date and dose, for each time you changed the dose. 

 

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

 

It would also be helpful if you could keep daily symptoms notes for the next 3 consecutive days.  Please post a 24 hour period in one got.  This post explains why we need these and what we require. 

 

Keep Notes on Paper

 

This is your own Introduction topic which is the best place to ask questions about your own situation and journal your progress.  This way your history is in one place and you will not need to repeat yourself.  Also, the mods regularly check for new posts in the Introduction forum.  Because of how busy SA is and the large number of members if you post elsewhere the mods might not see the post.

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Yes; I can complement the post once I get myself back together. 

I just can't get those other mirtazapine cases out of my head. I'm battling the feeling of inexorable doom. 

Please, I need some reassurance. Some hope to grasp so I can stablish a little sanity to bounce from. 

 

These are the latest events. 

 

1:00am- I went to sleep after taking 10 mg of ambien. 

6:46am-Opened my eyes. My left hand was numb, although this could be due to my sleeping position. I fell back asleep, this time a less deep rest. 

7:45am- Panic attack. Those posts circled my head nonstop.

 

I don't know how to give myself the proper indivual time and patience my own case deserves. I'm falling appart with these worries about being in the same boat as others who couldn't find a solution.

I'm unfocused, anxious and the only gap where I feel some kind of relief is right after I take the ambien. I could also take the mirt 3.75mg and almost immediately fall asleep, but I feel like it's poisoning me. 

Sorry for the unstructured, possibly unhelpful info, but right now I can only say what it comes by impulse since I can't gain enough composture to pick my thoughts wisely. 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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16 hours ago, ChessieCat said:

Qs:  What were you trying?  Supplements?  Drugs?  Changing doses?  Please provide details of this.

 

Kept trying to jump from 15mg to 7.5mg til one night I got the minimum ammount of sleep. It took about 3 or 4 attempts.

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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Have you started taking mirtazapine every day now?  What dose?

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Just to clarify.  You are currently taking:

  • mirtazapine
  • fluoxetine
  • Zolpidem

 

Please put ALL the drugs you are currently taking (including any other non-psychiatric drugs) into the Drug.com Interactions Checker  and copy and paste the results OR a link to the report here in your Introduction topic.  Thank you.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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3 minutes ago, ChessieCat said:

Just to clarify.  You are currently taking:

  • mirtazapine
  • fluoxetine
  • Zolpidem

Correct.

 

This is the link I got: https://www.drugs.com/interactions-check.php?drug_list=2333-0,1115-0,1640-0

 

I didn't realize there were such interactions. This could be the reason why I'm experiencing confusion after taking fluoxetine every morning.

 

I'm thinking about talking to another doctor so he takes me off the fluoxetine before it builds up in my system. Is this advisable? I don't want to add any other values to this tangled mess I'm currently in.

 

15 minutes ago, ChessieCat said:

Have you started taking mirtazapine every day now?  What dose?

 

No, I haven't. Last night I skipped the dose. Since I took the fluoxetine today wouldn't it be risky to restart mirt tonight?

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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6 minutes ago, Kidlacassa said:

so he takes me off the fluoxetine before it builds up in my system

 

It depends.  Was he planning on doing a Prozac bridge/switch?   the-prozac-switch-or-bridging-with-fluoxetine

 

If the drug was being added (in addition to the drugs you were already on and not to do a bridge/switch and you have only been on it since 28th October 2020, then you could probably stop taking it straight away.

 

8 minutes ago, Kidlacassa said:

Since I took the fluoxetine today wouldn't it be risky to restart mirt tonight?

 

You need to decide what drug/s and dose/s you are going to take and take them at about the same time every day.  The brain likes consistency.  Chopping and changing drugs/doses can destabilise/sensitise your nervous system.

 

Because you've only been on the fluoxetine for 4 or 5 days, and you have already been taking mirtazapine as well, it should be okay to take the mirtazapine tonight BUT only take 2mg and take it every night.  BUT I think it would be a good idea not to take any more fluoxetine, unless the doctor is doing a switch. You need to find out if he is planning to do this and how he plans to do it.  If this is the case, please post what he suggests you do.

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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5 minutes ago, ChessieCat said:

You need to find out if he is planning to do this and how he plans to do it.  If this is the case, please post what he suggests you do.

 

Got it. I have an appointment on tuesday. I'll come back by then.

I just hope nothing is permanently broken at this point.

 

I'm very grateful for your attention.

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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If he is not planning on a bridge/switch tell him that you did a drug interaction check and that there is a major drug interaction for fluoxetine and mirtazapine and you can tell him that you are very concerned about serotonin syndrome.  If it was me, I'd be mentioning this and seeing how he responds.  If he doesn't seem at all concerned about it I'd be finding a different doctor if possible.  However, keep in mind that at this time (covid) the situation could be difficult and you need to have a doctor to write prescriptions for you so don't get him offside.  Just let him know that you started feeling horrible after starting the fluoxetine and have been doing your own research.

 

If he suggests changing to a different drug say something like I would like to do my own research before trying it.  Or I'd rather try stopping the fluoxetine and see how I feel.

 

Did the sleep issues start AFTER you added fluoxetine?  Or did you see the doctor about the sleep issues and he prescribed fluoxetine?

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Are you taking Ambien / Zolpidem 10mg EVERY DAY?

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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8 hours ago, Kidlacassa said:

 

I just can't get those other mirtazapine cases out of my head. I'm battling the feeling of inexorable doom. 

Please, I need some reassurance. Some hope to grasp so I can stablish a little sanity to bounce from. 

........

 

 I'm falling appart with these worries about being in the same boat as others who couldn't find a solution.

 

 

Hi Kidlacassa,

 

I'm very familiar with those feelings and understand how unpleasant they are.  One thing I can tell for sure is those feelings will pass. For sure!  I actually started to write myself specific reminders to read so that when I have them I can be reassured.  Unfortunately they came back but they  always left again.  As you heal from your medication reaction, they will occur less frequently.  Eventually there will come a time when you wonder what you were so scared of :)

 

I suggest that you not read about the bad reactions others have had to mirtazapine when you experience this.  Perhaps focus on success stories?  And whenever the feelings come try not to entertain any associated thoughts - like obsessing about why you have them, how bad it feels, or how long until it goes away.  Part of the cycle is becoming scared of the fear and that adds to it.  Changing what I was doing when they came on also helped me.  I changed the situation that might have triggered it.  If reading, talk to someone.  If watching a show on TV, take a walk.  Focus on breathing in through your nose and out from your mouth.  Later after it passes if you recall having the feeling, make it a point to tell yourself that you got passed it and how.  You will get better!  🤗

Cymbalta:  Currently 48.5 mg.  Previously 60 mg, 2011-Oct 2020.  

Taper Oct 11-13 (three day reduction of 30 mg relieved many Serotonin Toxicity symptoms but WD became too harsh). Oct 14- 24 (eleven day reduction of 10%, 54 mg).  Oct 25  (began second reduction of 10%, 48.5 mg; holding to stabilize and work on schedule).  

Zoloft  100 mg. 1993-2000 Stopped CT for pregnancy twice, then it pooped out.  Reinstated 2011-2020.    

Taper attempt:  Oct 17-24 (seven days at 87.5 mg was discontinued; reinstated to 100 mg). 

 

Buprenorphine: 8 mg (4 mg 2x day @ 4pm and 1am)  Atenolol: 25 mg (max 2x day; prn).  Xanax: .125 mg (max 3x day; prn; average 2x).  HRT: Transdermal weekly patch.  Melatonin OTC:  2.5 mg, sleep.  Magnesium Citrate OTC: 125 mg, dinner.

Oct-Nov 2020:  Discontinued Simvastatin 20 mg, Magnesium Glycinate, Vitamin D, and Chia Seed Extract. Growing sensitivities.

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1 hour ago, ChessieCat said:

Did the sleep issues start AFTER you added fluoxetine?

 

No, the sleep issues started when I decided to take less mirtazapine after I realized I had emotional blunting.

1 hour ago, ChessieCat said:

Or did you see the doctor about the sleep issues and he prescribed fluoxetine?

The one who prescribed the fluoxetine was a different doctor. He suggested me to go off the mirtazapine and zolpidem cold turkey and replace them with 25mg of quetiapine. I refused to take an antipsychotic and after researching about what those things do to the brain, my decision got completely settled. You could say I followed his plan partially and that left me hanging with the mirt withdrawal and zolpidem dependence.

 

1 hour ago, ChessieCat said:

Are you taking Ambien / Zolpidem 10mg EVERY DAY?

 

Yes. The doctor who initially prescribed it said it's safe long-term. Now I know that's very questionable.

 

The ammount of distrust I have gathered towards doctors and the obsessive research is making me switch from one specialist to another, and another, and another... It's just hard to stick to one program I know will led me to another hellish journey of withdrawals or brain damage. I want to save mylsef and while trying to do so I feel like I'm just making everything worse.

 

The only thing I don't regret about this constant nitpick is that so far I have ducked antipsychotics and benzos to treat insomnia.

 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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1 hour ago, AJ716 said:

I'm very familiar with those feelings and understand how unpleasant they are.  One thing I can tell for sure is those feelings will pass. For sure!  I actually started to write myself specific reminders to read so that when I have them I can be reassured.  Unfortunately they came back but they  always left again.  As you heal from your medication reaction, they will occur less frequently.  Eventually there will come a time when you wonder what you were so scared of

Hey, thanks for those words. I've read similar messages over the forum, but it feels way better when the intentions are personalized.

 

I have all kinds of crazy anxious thoughts. The other morning while I was having a panic attack I thought about all the meds I've taken so far and how they are, as a paradoxical team, melting my brain. I counted the number of meds and that number appeared in my imagination as a judgemental antrophomorphic being. That made me jump out of bed in total alarm.  

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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Hello again.

I'm back after having an appointment with my doctor.

 

First of all he advised me to give specialists a truce for at least two months before continuing with the feverish research and skepticism.

 

I told him about the other doctor's plan to put me on fluoxetine and he disagreed; He said the sleeping issues should be the main priority right now and an activating AD is the least fitting option for this phase.

 

After telling him about the mirtazapine WD he istructed me to try going back  to 7.5mg for at least a week and then add Valdoxan for a smoother mirtazapine taper.

 

According to him the mirt dose is too low to be worried about serotonine syndrome during the Valdoxan introduction.

 

Does it sound rational?

 

Also, when I took the first fluoxetine pill I started feeling dizzy and somewhat sedated. That sensation hasn't diminished yet and I'm a little worried. It should go away after the it leaves my body completely, right? I understand this substance has a long half-life. The doctor said it's probably all in my mind, but it's hard to believe it. I have read many user experiences where they claim to feel "high" even after the very first dose. 

 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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5 minutes ago, Kidlacassa said:

Also, when I took the first fluoxetine pill I started feeling dizzy and somewhat sedated. That sensation hasn't diminished yet and I'm a little worried. It should go away after the it leaves my body completely, right?

 

Fluoxetine Oct 28 2020-Present.

 

Are you still taking fluoxetine?  Please add the dose, and if relevant the date stopped.

 

Account Settings – Create or Edit a signature

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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8 minutes ago, Kidlacassa said:

After telling him about the mirtazapine WD he istructed me to try going back  to 7.5mg for at least a week and then add Valdoxan for a smoother mirtazapine taper.

 

What are your thoughts on this?

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Did you start taking mirtazapine 2mg every day yet?  From the information below (from Tips for Tapering mirt) skipping days would most likely be causing interdose withdrawal due to the half life:

 

  

On 4/11/2012 at 10:07 AM, Altostrata said:

Plasma levels are linearly related to dose over a dose range of 15 to 80 mg. The mean elimination half-life of mirtazapine after oral administration ranges from approximately 20 to 40 hours across age and gender subgroups, with females of all ages exhibiting significantly longer elimination half-lives than males (mean half-life of 37 hours for females vs. 26 hours for males). Steady state plasma levels of mirtazapine are attained within 5 days.

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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44 minutes ago, ChessieCat said:

Fluoxetine Oct 28 2020-Present.

 

Are you still taking fluoxetine?  Please add the dose, and if relevant the date stopped.

 

No, I just forgot to update my signature. My last dose was on Oct 31; couple days ago. I took 20mg for 4 days.

 

36 minutes ago, ChessieCat said:

Did you start taking mirtazapine 2mg every day yet?

 

I went back to 3.75. My meds come in tablets and I don't have a scale. The smallest amount I can evenly cut is 3.75, which is a quarter of the 15mg piece.

 

If things go the way my doctor is predicting I shouldn't need a scale, but I don't know. Seems like there's a huge gap between what professionals think things are like and real experiences.

 

 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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54 minutes ago, Kidlacassa said:

After telling him about the mirtazapine WD he istructed me to try going back  to 7.5mg for at least a week

 

One thing that you need to know is that doctors get their drug prescribing information from the pharmaceutical companies.  They think in terms of "therapeutic dose", which is an arbitrary term which the drug companies decide on.  SA prefers "lowest effective dose".

 

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

 

If it was me I would be trying to get stable on the mirtazapine before even considering introducing a new drug.  If there has been improvement after 1 week wait another week.  If after 2 weeks you find that there are still bad issues, then a very tiny updose might be needed.

 

Please note that the idea of reinstatement/updosing is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

And if you add Valdoxan to get off mirtazapine then it's just another drug that you are going to have to taper later.

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

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44 minutes ago, ChessieCat said:

If it was me I would be trying to get stable on the mirtazapine before even considering introducing a new drug.  If there has been improvement after 1 week wait another week.  If after 2 weeks you find that there are still bad issues, then a very tiny updose might be needed.

 

I'll follow your advise, Cat. So should I try to get stable at 3.75mg for now? I'm planning on getting a scale to go lower, but it will take about a week to arrive.

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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Hello, @Kidlacassa?

 

What exactly are you taking now, at what times of day?

 

What were your drug changes over the last week?

 

What are your current symptoms?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Hello, @Altostrata

 

On 11/5/2020 at 4:09 PM, Altostrata said:

What exactly are you taking now, at what times of day?

I'm taking 3.75mg of mirtazapine and 10mg of Ambien just before bedtime. 

 

Current symptoms: Extreme anxiety, frenetic breathing and intrusive thoughts when I wake up, emotional blunting, some brainfog, constant sensation of being worthless, lack of hope regardless of the implied arguments.

 

I know the drug is still bossing my system around, because even at 3.75mg I'm constantly craving for carbs like I never did before taking mirt. 

 

Since I can't feel much worse, wouldn't it be a good idea to adventure myself into going to 0mg for a couple weeks? 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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Please add the information (dates and dose) about when you were skipping days to your drug signature.  If I recall correctly it was at the start of November for 1 week.  Thank you.

 

Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020.  Mirtazapine  3.75mg  Oct19 2020-Present.

 

2 hours ago, Kidlacassa said:

Since I can't feel much worse, wouldn't it be a good idea to adventure myself into going to 0mg for a couple weeks? 

 

You've been taking mirtazapine for 3 months.  It can take as little as one month for the brain to fully adapt to a psychiatric drug.

 

Jumping off from 3.75mg could possibly make things much worse than they currently are.  Even if you are experiencing an adverse reaction after being on the drug for 3 months you probably still need to taper, however you might be able to do a fast taper.  But I think 3.75mg is still too high a dose to stop at.

 

Please do not change your dose until Alto responds to the information you have provided.

 

From this post:  are-we-there-yet-how-long-is-withdrawal-going-to-take

 

On 7/6/2020 at 5:44 AM, brassmonkey said:

 

I will be blunt.  Unless there is a serious medical reason, Do Not Cold Turkey or Fast Taper.  Take your time tapering.  The pain and suffering are just not worth rushing it, and over time you will get off the drugs and recover much faster by doing a gradual taper.

 

For this discussion, a Cold Turkey (CT) is defined as stopping your drugs abruptly from a “normal” dosage. There is very little information about how many people do manage a CT successfully.  Doing a CT is a gamble. You won't know if you've lost until it's too late and develop severe withdrawal symptoms.

 

Don’t be in a rush to go off the drug with a too-fast taper, either.  A too-fast taper is one where you have withdrawal symptoms while you are tapering.  The 10% taper we recommend is intended to avoid withdrawal symptoms.  If you experience many withdrawal symptoms while tapering it means that your body is having a hard time.

 

However, like cold turkey, a fast taper may be justified by a serious medical reason, something like liver damage, severe allergic reaction, or other life-threatening conditions, but not just ordinary adverse effects.  In these situations, the risk of withdrawal symptoms may be equal to the problems being caused by the drug.

 

Psych drugs work by making physical changes to the body.  The body then requires the presence of those drugs to maintain stability and to keep functioning.  Remove the drug abruptly and often the body doesn’t know how to work.  It then starts to scramble to fix itself.  While that is happening the bodies systems cannot function correctly and we get WD symptoms.  Because the body is in such chaos after CT, those symptoms can be very acute and unpredictable.

 

Because the body is in such chaos those symptoms may last for a very long time. In the nervous system alone, there are hundreds of billions of electrical connections that have to be reviewed and repaired.  Throw on top of that the endocrine system, hormonal interactions and a lot of other things, the body doesn’t know what hit it.  Over many months the body takes inventory and starts making the changes it thinks will correct the situation. Then, it needs to adjust to those changes.  This is where the familiar pattern of “Waves and Windows” comes from.

 

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

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I'm starting to panic as I suspect most of these issues might be coming from the paroxetine CT. What if I have to go back to paxil and I'm just losing that possibility of reinstatement as time passes to be condemned to a WD lifestyle wondering what drug injured me the most? 

Sure I didn't feel any brainzaps nor any apparent symptoms when I stopped paroxetine, but what if the chemical imbalances appeared in the form of these symptoms through an accumulative delayed process? 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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Your nervous system probably is upset because of all the drug changes you made starting with the switch from Paxil to venlafaxine in August.

 

20 hours ago, Kidlacassa said:

Current symptoms: Extreme anxiety, frenetic breathing and intrusive thoughts when I wake up, emotional blunting, some brainfog, constant sensation of being worthless, lack of hope regardless of the implied arguments.

 

What time of day do these symptoms start, how long do they last? What times of day or night do you take each drug?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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5 minutes ago, Altostrata said:

What time of day do these symptoms start, how long do they last? What times of day or night do you take each drug?

They start around 8 am and get much worse between 9 am and 11 am. These sensations gradually set o a manageable level as the day passes. By 8pm I feel like I can start coping without the immense efforts that define the first half of the day.

 

I take ambien 10mg around 9pm two hours prior my sleeping time and the 3.75mg of mirt just when I'm convinced there's nothing left to do in my day, usually at midnight. 

 

The reason why I take the ambien that early is because experiencing some of the effects while I'm awake gives me the only couple hours of what I can distinguish as peace and humanity: I feel relaxed, collected and more like my former stable self. One of my doctors told me this is due to the drug bringing down my anxiety levels and that all I needed was a benzo for a longer sedative effect. I tried a small piece of alprazolam and I immediately knew it wasn't the same. The benzo made me feel way worse; not only anhedonic, but lobotomized and unaware of existence. Just terrible. 

 

I never felt this bad before starting mirt. I'm a stranger to my own eyes. 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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It appears you're dependent on the zolpidem and probably experiencing rebound anxiety when it is fully metabolized by the morning. If I were you, I'd start gradually tapering it. This will lessen the comedown in the morning. @Frogie can get you started.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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15 minutes ago, Altostrata said:

It appears you're dependent on the zolpidem and probably experiencing rebound anxiety when it is fully metabolized by the morning.

I remember taking zolpidem for months (I can't recall the specific dates) before and I didn't experience these reactions. Are you saying part of this is happening as a result of its conjunction with mirtazapine WD? 

 

When I was on the 15mg mirt dose I didn't rely on zolpidem as much to sleep. It was when I started the tapering when it became necessary. 

 

Maybe it's reasonable to go back to mirt 15mg, get off zolpidem and gradually discontinue the mirt? 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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Going on and off psychiatric drugs can make your nervous system hypersensitive, which can cause odd and severe reactions.

 

I don't know what increasing mirtazapine would do. You might have an adverse reaction to it. The safest thing to do is to gradually taper the zolpidem.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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12 hours ago, Altostrata said:

The safest thing to do is to gradually taper the zolpidem.

 

I should start tapering the zolpidem before trying to get off the mirt. Did I get that right? Or could it be the other way around? 

 

Thanks for the extraordinary support. 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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18 hours ago, Altostrata said:

The safest thing to do is to gradually taper the zolpidem.

 

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PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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@Altostrata, could I continue with the mirt tapering before trying to quit zolpidem? 

 

Ambien discontinuation would take at least ten months and I'm scared of the damage mirtazapine might do during that time. The dampened emotions is what freaks me out the most. It's like that Allan Poe's story about a man who loses his breath. 

 

I know it's likely mirtazapine's fault because I can feel how that sensation magnifies after I take the nightly dose. 

 

Thanks for your patience. 

 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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You're having adverse reactions to both your drugs. What you might do is taper mirtazapine down to a level where you're not having that sensation any more, then taper zolpidem.

 

You can expect to have rebound from Ambien as long as you're taking it at 10mg.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 2 weeks later...

Still waiting for the scale and other needed supplies to start the proper tapering. 

 

This situation is progressively luring me into a dark place; first the anhedonia, then extreme anxiety, then brain fog and now depression leaking in. 

 

I've made so many drug changes I don't know what's going on or what direction I should take to get the minimum of relief to keep going. 

 

Last night I had a nightmare about some party/gathering where the most active members of drug related forums attended. One of them told me I should go back to venlafaxine, that all my symptoms are coming from that CT and those who tried SSRI or SNRI can't never function the same without the reinstatement of a similar drug. Another attendant told me to go back to paxil, then an anonymous voice told me to step back to mirt 15 mg, and so on... "Drop all ADs first", "start tyrosine and lithium ororate", "Isolate yourself in the forest til this passes"... Yes, it was that vivid. 

 

As things are going ending up in a mental hospital is sadly one of my most optimistic thoughts. 

 

I think I'm desperately looking for an instant solution that may not exist. This is so confusing.

 

Looking for another doctor is pointless. He or she will try to put me on some random SSRI; fluoxetine, escitalopram, fluvoxamine, duloxetine... 

 

I haven't reached for family support. I don't want them to worry about this Twilight Zone kind of curse, so they think I'm just being lazy and unmotivated. So humiliating. 

 

Sorry for the pointless post. 

Paxil 20mg 2009-2016. Paxil Extended Release 25mg 2016-Aug2020. Venlafaxine 75mg Aug 2 2020-Aug 12 2020. Mirtazapine 15mg Aug 13 2020- Oct 10 2020. Mirtazapine 7.5mg Oct 11 2020 - Oct 18 2020. Mirtazapine 3.75mg  Oct19 2020-Oct27 2020. Mirtazapine alternating between 3.75mg and 0mg  Oct28 2020-Nov 1 2020. Mirtazapine back to 3.75mg daily Nov 2 2020-. January-Present Mirtazapine 0 mg Fluoxetine 20mg Oct 28 2020-Oct 31 2020. Zolpidem 10mg Aug 2020- present. Supplements: Omega3, Magnesium and Zinc.

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6 minutes ago, Kidlacassa said:

 

As things are going ending up in a mental hospital is sadly one of my most optimistic thoughts. 

 

I think I'm desperately looking for an instant solution that may not exist. This is so confusing.

 

 

I posted this earlier today:

 

18 hours ago, ChessieCat said:

 

Q:  How do you think that going to the ER is going to help you?

 

Q:  What do you think they would do if you went there?

 

We tend to think/dream that there is a safe place that will "magically" solve our problems.  We want someone to fix us.

 

I actually think that you make things worse for yourself if you keep entertaining the thought of going to the ER.  It gives you an excuse not to use the non drug coping techniques to get through the rough patches because you keep thinking that there is a possible solution without making any effort.  I think it would be better if you stop using it as an option and start using coping techniques earlier in the piece.

 

 

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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