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Nomansland: mirtazapine - my biggest enemy


Nomansland

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Nomansland

Hello everyone,

 

ive posted the german translation and the original royal college leaflet in some quite big german "psychiatric disorder" and tapering facebook groups (added up, in all those groups were 20.000+ members). Some responded it was very welcomed. In some groups i had to "adjust" the explanation of what iam about to post, because i wasnt sure if the mods there would delete it or not.

 

I was surprised it got through. In all groups. Hope it will help some.

It was hard for me to read people complaining about symptomes after stopping these drugs via docs advice...its crazy.

But a lot of people in there recognize heavy withdrawal exist.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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If your nervous about making a change the it would be a good idea to wait until you feel better about it. There should not be a problem with changing to the powder. Your body might react a little diff

Welcome to SA, Nomansland.  Thank you for completing your signature.   You've made a lot of changes in the last several months, and you are right that you need to hold where you are for seve

Part of my job here is pointing out the obvious (1mL water = 1g). Every post becomes an educational forum for the rest of the community.   Just sticking with the water is a good idea, it's a

Nomansland

Hello everyone,

 

recently i cutted this meditation music (https://freesound.org/people/sunnyflower/sounds/360352 copyright free, its from this sleep meditation video) in loops and uploaded 3 different version in google drive. 30 minutes, 2 hours and 10 hours.

The 10 hours version....could be helpful for sleep? I find this music very calming. The name of the audio is in german, so dont be confused.

 

If you want to download and use it for whatever you want, see these links (mp3):



30 minutes meditation music (27 mb) : https://drive.google.com/file/d/1A0DixV ... sp=sharing

2 hours meditation music (107 mb) : https://drive.google.com/file/d/1LXaHn7 ... sp=sharing


10 hours meditation music (549 mb) : https://drive.google.com/file/d/1b_EOrG ... sp=sharing
 

 

I could not find the right place here for this, so when a moderator knows where it belongs, feel free to quote it in the right thread.

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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ChessieCat

Here is the topic.

 

music-for-self-care-calms-hyperalertness-anxiety-aids-relaxation-and-sleep

 

I had to do an internet search and enter site:survivingantidepressants.org music to find it.  Just searching for survivingantidepressants.org music didn't bring it up.

NEW!!!     INTERVIEW with Altostrata, SA's founder    NEW!!! 

 

Plodding along inch by inch:  12" = 1',  3' =  36 " or 1 yard,  1760 yards  = 63,360" or 1 mile

Current from 17 Apr 2021:  Pristiq 0.2665mg  now holding each dose for 3 weeks

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 Oct 2015 

My tapering program   My Intro (goes to my tapering graph)  My website

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

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Nomansland

Hello @ChessieCat,

 

thank you! Seems important to use the "site:" command in google. Without this it will also show other sites than SA.

 

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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Nomansland

Hello everyone,

 

i had to update the 2 hours version of the medititation music, because uploading it to google drive deleted half of the audio. Its now changed and works. Download-link stays the same.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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Nomansland

Hello @Gridley@brassmonkey,

 

in the near future (have not decided when yet) i want to crossover to DIY liquid. I want to explain my plan about the crossover and method of dosing.


If you think there could be improvements, please give me an answer.

 

Right now iam taking 102 mg pillweight, with an AIC of 0.1 i take a dose of 10.2 mg Mirtazapine. I plan to crossover in 75% tablet/25% liquid, 50% tablet/50 % liquid, 25 % tablet/75 % liquid and 100 % liquid steps like SA suggest. Want to give every step a week or longer, if it causes problems.

 

So it would look like this:

 

                                 solid tablet                                           liquid                                                         total                                     

              |

step 1:   |  75 % (77 mgpw = 7.7 mgai)      +       25 % (25 ml = 2.5 mgai)      =       100 % ( 7.7 mgai + 2.5 mgai = 10.2 mgai)

              |

step 2:   |  50 % (51 mgpw = 5.1 mgai)      +       50 % (51 ml = 5.1 mgai)       =       100 % ( 5.1 mgai + 5.1 mgai = 10.2 mgai)

              |

step 3:  |   25 % (25 mgpw = 2.5 mgai)     +       75 % (77 ml = 7.7 mgai)       =       100 % (2.5 mgai + 7.7 mgai = 10.2 mgai)

              |

step 4:  |                  0 % (0 mgai)               +     100 % (102 ml = 10.2 mgai)   =       100 % (0 mgai + 10.2 mgai = 10.2 mgai)

 


Dosing method:

 

I will suspend 150mg pill weight in 150 ml of tab water (weighted with scale). This gives me 15 mg active ingredient in 150 ml of water and 1 ml will be 0.1 mg Mirtazapine.


I let it stir with the magnetic stirrer for about 10 minutes (i tried it and saw that its about two times "finer" than when i stir it by hand). While it stirs, i pull out a little bit more than 48 ml with a pipette and weight the liquid in the container on the scale again (tared the container before). Then i will fill the last ml to 102 ml with the liquid from the pipette. I will drink this and refill the container with water and drink this again.

 

Here you can read why i think weighting the liquid can be very accurate.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

That looks like a good plan. See how you react to each step and take longer hold periods if necessary.

 

Weighing the liquid can be quite accurate if you continue to work with water. By definition 1mL water = 1g.

But if you want to use a suspension media like oraplus then you will have to determine it's density and revise your calculations accordingly.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

thank you for your answer and iam glad you are back.

 

Iam aware of the density issue, if something is added to the water. For now, i plan to only use water. Its next to impossible here

to get Ora-Plus. Well, you can import it but it would be very expensive. As far as i know, we dont have a "medical" alternative to Ora-Plus here in germany.

 

I also thought about useful alternatives like "ThickenUp Clear" or "Thick&Easy Clear" or "Methylcellulose", but these thickener would just make the dosing more complicated. Have the feeling that using the magnetic stirrer will provide a good distribution. I mean...why wouldnt it, right? Others stir there water suspension with something else and doing mostly fine. I hope it will work...

 

Of course, there is always (big!) fear when we make changes.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

Part of my job here is pointing out the obvious (1mL water = 1g). Every post becomes an educational forum for the rest of the community.

 

Just sticking with the water is a good idea, it's a lot easier.  The magnetic stirrer should work well. There are some interesting "water thickening" agents available, like you mentioned. I think they could be a viable alternative to the commercial suspension media. Ah, another avenue to explore.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

of course! Its always good to point it out for other members. Hope it didnt sounded "reproachful". Sometimes its a bit hard for me to

find the right english words.

 

Yes, there are a lot of different ways to make your suspension/water thicker. I read that Ora-Plus acts like an preservatives for the drugs, so

this feature would be unique to Ora-Plus. But if you just want to make water a bit thicker, there are a lot of alternatives to try.

 

Not all of them make it thicker AND stay clear, so that you can see the distribution. But some of them seem to work that way.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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Nomansland

Hello @brassmonkey,

 

have another question. What do you think about these two options to do the crossover:

 

1. Use the 102 mg tablet weight as base and do the crossover from this tablet. Which means in each step i dissolve more of the 102 mg pillweight in water. With this option, i would know i get "exact" the 102 mg together in liquid and tablet. because in the crossover i would only use this amount. Also i wouldnt have to use the magnetic stirrer and other things in the crossover. Just suspend more and more of the 102 mg pillweight (which i take right now) in water until its all liquid. Simple and easy.

 

2. Use the 150 mg (15 mg active ingredient) in 150 ml water suspension, so 1 ml contains 0.1 mg active ingredient, as base for each crossover step and  the rest as "solid" tablet. With this option i would have to use the magnetic stirrer and a pipet. And the actual dose i get could differ during the crossover, because i use more than the 102 mgpw i take right now.

 

 

Option 1 seems alot "safer" in the crossover for me, because i wouldnt have to worry about different doses, just about if i tolerate the DIY liquid. The base stays the same with what iam taking right now. Just the proportion of liquid would get bigger each step.

 

But i would like to use option 2 for the actual taper later . So there could be a difference when i switch to option 2. But at least i would know then, that i tolerate the DIY liquid (which is the more important question right now). There would also be the option to use 102 mg in 102 ml later, which would avoid this problem.

 

Want to start soon and need to make an informed decision. Personally, i would really prefer option 1 for the crossover period. What to do after that (if all goes well), can be questioned later.

 

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

I would use option 2. You want the crossover liquid to be as close to the taper liquid as possible to help condition your body and see how it reacts to that liquid. Option 1 gives you a variable concentration of medication in the liquid and will confuse the body and cause inconsistent results. The variable dilution ration will affect the bioavailability, absorption rate, absorption position in the digestive tract and several other factors, all of which need to be kept constant for the body to adjust to the different delivery system.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

i would use the scale to make sure i do the crossover in 25/75 50/50 75/25 and 100 % steps, but from the 102 mg pillweight "base". Also i plan to use the same water/ingredient ratio like the actual "taper liquid" in each step. Which means 0.1 mg active ingredient in 1ml of water, for each step. This will avoid different ratios in the crossover period.

 

Of course i need to refill the beaker with water to make sure i get all of the medication. So in theory i would always drink more water after i make every dose in the whole taper.

 

Hope i could explain what i meant. What do you think brassmonkey?

It would be all the same, except that i use the 102 mgpw as a base. To make sure the actual dose doesnt change.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

As long as you keep the ratio of the original mix the same it should be fine. I would use as little water as possible to "rinse out the beaker". 

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

thank you for your answer.

 

Does this mean i should always take appr. the same amount of water? Even for like 30 min before and after taking the dose, for the whole taper? Because until now ive always drink like half a liter to make sure i get down the tablet. And of course a bit more later when iam thirsty. So it has differed a lot. Also, it could be that sometimes i drink like a glass water 15 min or so before i take my dose. Do i have to take all of that into account? I mean its right before going to bed....so shouldnt be "too big" of a problem to create a routine.

 

Right now iam not sure which option i should take....i would like to trust the even distribution of the suspension, guess iam just scarred. Maybe i should use option 2....

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

Consistency is the real key, not exact measurement. There are always going to be small variations in the strength of the dose because there are so many variables. But as long as you do things in the same manner each time those small variations will average out and not be a problem.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

i get what you mean. Guess i will use option 2...i have to gain trust in this method.

 

But i didnt know that i have to be that precise when it comes to the amount of water after taking the dose. I thought it would sure need some more water to get all of the particels down in the stomach. This would make sense to me... Maybe i should always drink exact 1 glass of water after taking the dose, but just one and make this a routine to create consistency. That would keep my mind at ease and the ratio stable.

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • 4 weeks later...
Nomansland

Hello everyone,

 

if you read this post. Please take a look at this survey! It doesnt matter where you live or which citizenship you have.

 

It would be very welcomed, if you participate and share you experience with tapering antidepressants.

 

I want to give you a few reasons why you should participate:

 

- Dr. Mark Horowitz and Dr. Ed White both experienced withdrawal, are known for their important research on AD withdrawal and Horowitz also

 worked on this important "Stopping Antidepressant" leaflet from the UK Royal College, which can help convincing ignorant doctors (it is the first official leaflet worldwide which acknowledged severe withdrawal symptoms and tapering in 5 % - 10 % steps)

 

- They state that they work on informing not only the medical system of Great Britain, but also many other medical system around the globe, to make AD withdrawal public and inform the medical staff

 

- The survey is aimed at members from peer-support groups, which you and i are. To learn about their awful experience, severe symptoms and the denial of support form the medical system worldwide.

 

Please take your time and fill out this survey, its not hard and not too long. In the end, this is the beginning of making antidepressant withdrawal public!

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

Link to post
  • 3 weeks later...
Nomansland

Hello everyone,

 

if you read this post. Please take a look at this survey! It doesnt matter where you live or which citizenship you have.

 

It would be very welcomed, if you participate and share you experience with tapering antidepressants.

 

I want to give you a few reasons why you should participate:

 

- Dr. Mark Horowitz and Dr. Ed White both experienced withdrawal, are known for their important research on AD withdrawal and Horowitz also

 worked on this important "Stopping Antidepressant" leaflet from the UK Royal College, which can help convincing ignorant doctors (it is the first official leaflet worldwide which acknowledged severe withdrawal symptoms and tapering in 5 % - 10 % steps)

 

- They state that they work on informing not only the medical system of Great Britain, but also many other medical system around the globe, to make AD withdrawal public and inform the medical staff

 

- The survey is aimed at members from peer-support groups, which you and i are. To learn about our awful experience, severe symptoms and the denial of support form the medical system worldwide.

 

Please take your time and fill out this survey, its not hard and not too long. In the end, this is the beginning of making antidepressant withdrawal public!

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

Link to post
  • 3 weeks later...
Nomansland

Hello everyone,

 

i have successfully crossed over from solid pill to DIY liquid mirtazapine with the method described before in this thread. Was quite bumby, but thats not new to me. Currently iam on day 30 of 100 % DIY liquid and have mostly quite good days, with single bad days in between.

 

@brassmonkey, i would like to ask for your opinion.

 

As you probably remember, i fill down tablets to 150 mg and suspend them in 150ml of water.

 

The thing is, really everyone who makes DIY liquid does not do that, they suspend/dissolve a whole pill without making adjustments. I know you say that its all evenly distributed and iam quite sure it is. If i would ask @Gridley, for example, he would tell me that there no way to exactly know how it is for my specific tablets. So there are some "contrary" opinions on that topic. And both are absolutly justifiable.

 

I did read the Myths about your drug thread and searched for papers and informations. With "mixed" results (yes, silly pun intended).

 

For myself, i would feel more calm if i would suspend just a whole tablet without making adjustments on them (i dont really want to use powder). Of course i cant be sure, if using a whole tablet would be better as what iam doing right now. But i really want to do it, i guess.  I know this would mean a dose change, but maybe in the long run i can benefit from it. Have to decide if i continue doing what i do or not.

 

Mostly because i could not really stabilise when i was filling down tablets to 102 mg pill weight and because everyone else uses whole tablets instead adjusting them for DIY liquid.

 

Do you think i can change from adjusting tablets to just use a whole tablet for my DIY liquid without making adjustments on the dose i take right now (102 ml =(?) 10,2mg). Would like to here your opinion on that. Here, again, is the weight variation of my tablets:

 

1: 152 mgpw

2: 150 mgpw

3: 155 mgpw

4: 156 mgpw

5: 151 mgpw

6: 156 mgpw

7: 155 mgpw

8: 153 mgpw

9: 152 mgpw

10: 154 mgpw

11: 152 mgpw

12: 152 mgpw

13: 155 mgpw

14: 151 mgpw

15: 150 mgpw

 

AIC= 0.1 mgai/mgpw

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
Gridley
43 minutes ago, Nomansland said:

If i would ask @Gridley, for example, he would tell me that there no way to exactly know how it is for my specific tablets.

I was talking in terms of making powder for weighing with a scale, not for weighing with a liquid.  I'm not very familiar with the ins-and-outs of making a liquid.

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg 1986-1991 CT, soon reinstated.  CT 2000. RI 1 mg 2011-2016.  Sept. 2016  0.625mg X 3

Nov.27, 2020, 7-week Ativan-Valium crossover + change to one 18.75mg dose, w/1 month hold.

Feb. 9, 2021, begin 10% every 4 weeks taper.  Current dose as of June 15: 10.5mgai.  Taper is  44% complete.

 

Imipramine 75 mg daily since 1986.  Jan. 2016 began every 3-weeks 10% taper, down to 16mgai (44mgpw).  Aug 2016, discovered SA, holding at 16mg.  Taper is 78% complete.  

  

Supplements: omega, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg.


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

Link to post
Nomansland

Hello @Gridley,

 

thank you for your answer.

 

Iam talking about weighting und filling pills at the moment, because i use them to prepare my DIY liquid, so its not about weighting the liquid. Instead of suspending a whole pill to make my DIY liquid, i currently file all of them to 150 mg pill weight and use those filled pills to make the liquid. And thats where problems (probably could or could not) arise. The "base idea" is the same, wether for making capsules or suspending them in liquid. Hope i could describe it properly in english.

 

And this is where i see your opinion differs from @brassmonkey about filing them down. Again, i think both opinions are reasonable. But iam unsure how to decide and proceed. I see everyone using whole pills for DIY liquid and i think i want to do the same.

 

Greetings

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

There should be no problem with using a whole  pill to make your liquid. By filing a pill to 150mg and dissolving it in 150mL of water you are making a liquid with a 1:1 dilution ration, that is 1mgai for every 1mL of liquid.

 

If you use the same amount of water as the strength of your full pills you would get the same thing. If the bottle states that the pills have a strength of 175mg then use 175mL of water, if the bottle says 200mg then use 200mL. Mix up your liquid and draw out as much as you need for your does. You can save the "extra' for a few days and get a "free dose".

 

Technically this counts as a "dose change event" but I wouldn't expect there to be any problem just switching over.  There may be a small difference between the filed liquid and the whole pill liquid, but probably not enough to notice.

 

Even distribution of the active ingredient is an ongoing debate. There were some problems fifteen years ago with some pills from an unlicensed/unregulated manufacturer that caused quite a stir. But they were shut down and the pills pulled from  the market. We can't know for sure what goes on in the factories, because we can't personally oversee the operations. But the industry is one of the most highly regulated ones in the world with many checks and balances, safety and quality inspections. Because of the nature of the manufacturing process and materials used the AI will be evenly distributed throughout the pill and will remain so even if the pill is crushed into a powder.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

thank you very much for your answer.

 

Yes ive read all of that like again and again, but i struggle to make a decision. Iam doing a 1:1 1 : 0.1 dilution with a filed down 150 mg tablet in 150 ml water (15 mgai mirtazapine tablets).

When i use the whole tablet it would be between 150 mg to 156 mg per tablet. I will not change the amount of water i use. Not much difference you would say. And technically it makes sense to me to adjust the tablets, but everyone else uses whole tablets, assuming their dose would be constistent enough. 

 

Just to eliminate my worries about distribution and what iam actually filling down, i would like to directly switch to use the whole tablets (which can differ 6 mg in weight...but will they differ 0.6 mg in dose? Guess no one can give a clear answer...so iam not sure if iam doing me a favour with that).

 

Greetings

 

 

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

"When i use the whole tablet it would be between 150 mg to 156 mg per tablet."

 

Are you talking about the actual weight of the tablet on the scale or the strength of the tablet from the bottle?

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

iam talking about the actual weight of the tablet on the scale. The strength is 15 mgai mirtazapine. And the tablets weigh from 150 mgpw to 156 mgpw. Average is 153 mgpw.

 

Right now i file down every tablet to 150 mg and suspend them in 150 ml water. But regarding the worries, i would like to use the whole tablets instead, also in 150ml of water.

 

Oh and i made a mistake in my previous post, i said its a 1:1 dilution, which is wrong. Its actually a 1 : 0.1 dilution. So 1 ml = 0.1 mg of active ingredient.

 

 

Greetings

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

Okay, now we are on the same page. The small differences in the weight of the tablets, which we usually refer to as mgpw (milligrams pill weight) isn't going to make any difference in the strength of your liquid. So it would be fine to use any full tablet and 150mL of water to make it.

 

As you pointed out this will give a 1:0.1 dilution from which you can calculate your dose volume.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

thank you. I will then use the whole pill.

 

Another thing:

 

Ive found a very nice alternative to the pharma compounding agents.

I know in the mirtazapine withdrawal facebook group they recommend using maple syrup instead of ora-plus (if you cant get it).

 

So i tested it (didnt drank it) and it wasnt clear, so couldnt see the distribution and overall just not thick enough.

I looked at the supermarket and found rice syrup. The one i bought is totally clear and mixes very, very well and fast with water (50 : 50), does not separate back in two phases and keeps the parcticels very good suspended . Taste is slighty sweet and is quite cheap, when you compare it to other suspending agents. There are no additional ingredients, just rice and water. I really think about using it in my taper.

 

The problem:

 

I can not use it in a 1: 0.1 dilution because i would need 75mg syrup every day, which is too much sugar in the evening and

in general would use to much of syrup. And i could not use the weighting method anymore.

 

The solution:

 

Both, the 1: 0.1 dilution and the weighting, i would give up for a better distributed suspension. The math for a 2:1 dilution (15 mgai in 15ml water + 15 ml of syrup) would not be the problem and i have lab pipettes in all sizes (even a 1 ml one with marking of 0.01 ml) so it should be equal to the weighting precision, with the advantage of a really evenly distributed suspension.

 

Another advantage would be that (after some time of getting used to the method) i can easily prepare dosages for 3 or 4 days and keep it in the fridge, because its not too much liquid. For example, 4 dosages ( 60 mgai mirtazapine in 60 ml water and 60 ml syrup).

 

What do you think?

 

Ive found Bridgetini, who also tapered mirt succesfully with a similar method. And also Gigi68, who is currently tapering succeyfully with a similar method.

 

Greetings and sorry for all the questions. Guess i just need some encouragement.

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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Nomansland

Hello,

 

also, if you think that the different dilution ratio would be a problem regarding bioavailability. I can dilute the measured amount to my current dilution ratio before i drink it and to getting used to the new method.

 

Greetings

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

That sounds like a very good idea and worth a try.

 

There is also something called "thick water" available for people who have problems drinking regular water that could be a low sugar alternative.

 

I don't think there will be a bioavailability problem with either dilution, but to be on the safe side further diluting your current method would be fine. You might try a "crossover" type approach and work up to the new dilution amount in several steps. Say 25% more liquid for a few days then 50%, 75% and then the full amount.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

thank you for your opinion.

 

I should say the dilutions more clearly, sorry. Right now iam having a 1 : 0.1 dilution (15 mgai mirtazapine in 150 ml water, so 1 ml = 0.1 mgai mirtazapine).

 

The new method would be a 1 : 0.5 dilution (15 mgai mirtazapine in 15 ml water + 15 ml syrup, so 1 ml = 0.5 mgai mirtazapine).

 

But with the advantages of the "suspension agent" (rice syrup) i posted before. To get around the possible issue of bioavailability, i would take out what i need with the pipette and then dilute that further with water,  so that i have the same dilution ratio iam having right now, 1 : 0.1.  I have to rinse the pipette either way after taking out the dose, so its no problem.

 

Again iam not sure if i do myself a favour with changing to that method...because a change is always risky. I know everyone in the german taper forum just uses water with, lets say, mixed results. And of course its possible to taper using only water.

 

But i think having a suspension agent is always an advantage and would at least put my mind at ease. And later i can prepare more than one dosage at once, because its not like 1 liter of water i would have to prepare. Not easy to decide whats the right thing to do... Guess iam scared to make a mistake or that the change will go wrong (for example dont get the right dosage), but really would like to go that "new method" route.

 

Ive seen the "thick water". Looks quite useful and interesting of course. Its hard to get where i live, sadly.

 

 

Greetings

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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  • Moderator
brassmonkey

"The new method would be a 1 : 0.5 dilution (15 mgai mirtazapine in 15 ml water + 15 ml syrup, so 1 ml = 0.5 mgai mirtazapine)."

 

Basic math error, should be 0.05mgai

 

As with mistakes in math, mistakes in dosing can be corrected especially when they are small. Fear of making a mistake can actually have a greater negative impact than the error itself. All the variations you have been talking about are keep the dose within a very acceptable tolerance from the exact amount. The small differences in theoretical bioavailability will have very little affect on actual bioavailability. What you have eaten in the past several hours, time of day, how well you slept, room temperature, how tired you are are just some of the factors that affect absorption and bioavailability. Using the exact same mixture will work just a little differently from day to day. There just isn't a way to control it that exactly.

 

If you change methods there may be a transition period of a few weeks while you body adjusts to the new way of doing things. Then again there may not and it will go quite smoothly, there just isn't any way of knowing. Unless you have an immediate adverse reaction, which is quite unlikely in this case, things will be fine with any of these methods. The thing is to settle on a method that you can work with long term.

 

I like the idea of using a thickening agent of some kind because plain water tends to let the material settle out and requires careful mixing each time it is used. Poor technique is probably the cause for most people who have trouble with a water suspension, because of miss-measuring their doses due to poor preparation and measurement. Tiny day to day fluctuations in dose are of no consequence because we are working with a range of blood serum concentration that changes from hour to hour. As long as we can keep within that range things stay stable. When we get outside that range is when we start to get problems. As we taper we are slowly lowering the range and letting the body adjust to the changes as we go.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Nomansland

Hello @brassmonkey,

 

thank you for your answer.

32 minutes ago, brassmonkey said:

"The new method would be a 1 : 0.5 dilution (15 mgai mirtazapine in 15 ml water + 15 ml syrup, so 1 ml = 0.5 mgai mirtazapine)."

 

Basic math error, should be 0.05mgai

 

Iam not sure i see the error here. Or do i misinterpret this? 15 mgai in 30 ml of liquid...so 5 mgai in 10 ml of liquid and 0.5 mgai in 1 ml of liquid. Did i do something wrong?

 

32 minutes ago, brassmonkey said:

If you change methods there may be a transition period of a few weeks while you body adjusts to the new way of doing things. Then again there may not and it will go quite smoothly, there just isn't any way of knowing. Unless you have an immediate adverse reaction, which is quite unlikely in this case, things will be fine with any of these methods. The thing is to settle on a method that you can work with long term.

 

Guess its a good thing that i already use liquid, so it should be not really a "shock" to the system.

 

32 minutes ago, brassmonkey said:

I like the idea of using a thickening agent of some kind because plain water tends to let the material settle out and requires careful mixing each time it is used. Poor technique is probably the cause for most people who have trouble with a water suspension, because of miss-measuring their doses due to poor preparation and measurement. Tiny day to day fluctuations in dose are of no consequence because we are working with a range of blood serum concentration that changes from hour to hour. As long as we can keep within that range things stay stable. When we get outside that range is when we start to get problems. As we taper we are slowly lowering the range and letting the body adjust to the changes as we go.

 

Because the dilution ratio is a bit "stronger" with the new method, there is a bit less room for mistakes (current method: 1 ml = 0.1 mgai, new method: 1 ml = 0.5 mgai). But as you said, if we practice carefull measurements every day and create consistency, it shouldnt be a problem. I also would really like to use a thickening agent.

 

Iam not quite sure how to measure out the 15 ml of syrup. I cant pipette it up because without water its too thick. I could make the 50 % water, 50 % syrup liquid before i draw up 30 ml of liquid (15 ml water and 15 ml of syrup), then it works. But the tablet does not really dissolve in the liquid, much better with water alone. So i need to add the syrup after that. But how to make sure to get 15 ml of syrup when i cant pipette it up?

 

- Use an accurat container and then fill it up to 30 ml? (i could make a mark myself when i fill one with quite exactly 30 ml of water).

 

- Weight the syrup (which is not easy because of course its not 1 g = 1 ml, its more) and make sure that everytime the liquid (water+syrup) weigh the same? This would be quite accurat. But then a little difference in the ratio of water to syrup would result in different weights.

 

Could you think of another good method? Think iam overcomplicating it...just a good container with an accurat 30ml mark should be fine...i think?

 

Greetings

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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brassmonkey

Okay, I rechecked the math and things look fine. Sorry about that.

 

The container idea is going to be the easiest.

 

You could calculate the weight for the correct volume of the syrup if you can find it's true density. But the preparation would be pretty messy.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hello @brassmonkey,

 

Thank you for rechecking it. Sometimes i dont trust myself.

 

I finished a test right now with preparing 50 % water and 50 % syrup, pipetting it up and add this 30ml liquid in a container. Then i added 15mgai tablet and let the magnetic stirrer do the work. It takes about 40 to 50 minutes to "dissolve" in very fine particels (instead of like 10 minutes in pure water), which should be no problem, especially if i can later prepare more than 1 dose.

 

Another really interesting thing: In pure water, the coating dissolves and makes it quite yellow. When you have a lot of liquid, thats not a problem, but with not sooo much liquid, its hard to see the distribution through the yellowish liquid.

 

In the mixed 50 % : 50 % liquid, the coating (its really just the coating, no tablet fragments) does not "dissolve" so i have little fragments. Which is actually a good thing, because now its not yellowish and the even distribution can be perfectly seen.

 

I think the coating fragments will not do any harm, so this should be the method of choice, because i can easily prepare exact 30 ml of mixed liquid (maybe this information will be helpful for someone in the future).

 

Will think about when to start...and try to encourage myself not to worry so much.

 

Greetings

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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INTERNATIONAL WITHDRAWAL SURVEY IS STILL OPEN, PLEASE PARTICIPATE:

 

Hello everyone,

 

if you read this post. Please take a look at this anonymous, international survey! It doesnt matter where you live or which citizenship you have.

 

It would be very welcomed, if you participate and share you experience with tapering antidepressants.

 

I want to give you a few reasons why you should participate:

 

- Dr. Mark Horowitz and Dr. Ed White both experienced withdrawal, are known for their important research on AD withdrawal and Horowitz also

 worked on this important "Stopping Antidepressant" leaflet from the UK Royal College, which can help convincing ignorant doctors (it is the first official leaflet worldwide which acknowledged severe withdrawal symptoms and tapering in 5 % - 10 % steps)

 

- They state that they work on informing not only the medical system of Great Britain, but also many other medical system around the globe, to make AD withdrawal public and inform the medical staff

 

- The survey is aimed at members from peer-support groups, which you and i are. To learn about our awful experience, severe symptoms and the denial of support form the medical system worldwide.

 

Please take your time and fill out this survey, its not hard and not too long. In the end, this is the beginning of making antidepressant withdrawal public!

 

Greetings

 

Nomansland

2021 IMPORTANT WITHDRAWAL SURVEY, PLEASE PARTICIPATE: https://uelpsych.eu.qualtrics.com/jfe/form/SV_0AR9IsQ61jsiXBk

 

non-native speaker of english

3-March 2020: started Mirtazapine 15mg
3-March to 6-april aprx cutting to 0 mg
6-April to 20-April -> ~ 7,5 mg,

21-April to 31-April -> 15 mg,

1-May to 13-May -> ~ 10 mg (approx),

15-May to 19-July -> 15 mg (psychosomatic clinic)
started taper with scale and file: 19-July 2020 -> 14 mg (-6,6%), 08-August -> 12 mg (-14,3 %), 27-August -> 10 mg (-16,6 %), 15-September -> 8 mg (-20 %, bad idea, heavy WD) 23-September -> 10.2 mg (+20 %, 102 mgpw), 2021: 12-April to 12-May crossover from solid pill to DIY liquid, still 10,2 mg

 

Supplements: 2 x 250 mg magnesiumbiglycinate daily, low histamin diet

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