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Ten0275: I'm Dave and if I am capable of healing, each of you are - Please hang in there.


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tsranga

@ten0275  I didn't realize that you had tapered off mirtazapine.. I stopped at 3.75mg cold turkey. I hope the ANS settles down eventually.. 

Chronic IBS since 1990

Former smoker (1992- Jun 2017)

Prescribed mirtazapine for sleep in Aug 2017 after IBS flare-up following Nicotine cessation.

Mirtazapine 7.5mg 8/17 to 5/18

Mirtazapine 3.75mg 5/18 to 1/19

Off Mirtazapine since 2/19.

Vit B, Vit D+K2 and Magnesium Glycinate as needed.

On Ayurvedic herbs for GI issues - Guduchi since Jul 2020, Indukantham since Oct 2020

On Ashwagandha 1g since Nov 2020

 

 

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8 hours ago, ten0275 said:

@Erell

 

Thank you for the kind message, it's good to hear from you 🙂 Spring is lovely. So far, I've been doing ok with the histamine-related issues. Those symptoms ebb and flow across the season as the different pollen stages evolve I find, I'm hoping for an alright year with low-level symptoms.


Yes, you present a really good question on the way I tapered. I did start my mirtazapine taper while in benzo withdrawal and feeling unstable. After I jumped from the benzos after a fairly rapid taper, the intrusive thoughts began. Having no clue what those were and fearing I was somehow a threat to myself or others, I decided to check myself into a psychiatric hospital. I did this two times - once in June 2012, and once in early July 2012. The psychiatric hospitals really don't like you to leave the place without some drugs in your system. I had been on mirtazapine before, so I decided that'd be an ok one to go on again. It seemed a better option than the antipsychotics they were trying to give me.


Because I was having intrusive thoughts and the hospital did not recognize these as a withdrawal symptom - nor did they accept withdrawal as a thing in general - they gave me high doses of the mirtazapine. I had asked to start at 15mg as that was the highest dose I'd ever been on prior (and I'd mainly been on 7.5mg in the prior use). But they started me there at 15mg for a day or two and when I noted that the intrusive thoughts were still present, they then bumped me up to 30mg. See they were trying to treat "OCD" - and intrusive thoughts aren't "harm OCD" in the traditional sense - that is to say, they don't evolve or arise from the same cause. Being more prone to anxiety than depression, that 30mg of mirtazapine was just way too much for my nervous system to handle. It really overblew my nervous system. I did somewhat acclimate to that dose after a couple months, but I never truly "stabilized" on it and I blame a large number of the earlier and harder symptoms I had on being on too high a dose of the mirtazapine upon leaving the hospital.


At a certain point, despite not being stabilized completely from the benzo withdrawal nor the high dose of mirtazapine, I did decide to start cutting the mirtazapine. I wasn't completely reckless in tapering, but it wasn't 10% per month for sure. Things began to improve for me quite a bit when I got down below 15mg. Around the 12mg mark was pretty decent. 7.5mg was a nice zone as well. A lot of the symptoms like restless legs, intense agitation, etc. started to fall away below 7.5mg.


Below 7.5mg, I'd run into periodic episodes where withdrawal of mirtazapine would catch up to me. I was cutting too fast for sure. And that's when I started doing my research and slowing things down. And it was really when I crossed over to liquid mirtazapine - after cutting the pills became untenable due to the small doses - that I began that really slow and methodical taper and was a presence here on this site.


I hope this timeline is making some sense. I had kept journals along the way in withdrawal. Unfortunately my very best journal was on a flash-drive with no backup and that flash-drive got corrupted and I lost all the data on it back in 2016. So sometimes I feel a bit disjointed when I give my timeline. This is pretty darn close to it though. And I guess the main crux of my path off of mirtazapine was getting to a dose where with my anxiety the way it was, I could actually stabilize. And being that mirtazapine sedates more at the lower doses, that was below 15mg for me. Tapering - and symptoms - became much, MUCH more manageable after I crossed that threshold where mirtazapine was no longer acting like an antidepressant and was acting more like an anxiolytic.


I hope some of this helps. Hang in there. ☀️🌻☮️❤️


Dave

@ten0275... sorry to ask your more questions...

 

I see you tapered with a liquid compound... did you make that yourself or get a compounding pharmacy to do it? I don't have the pharmacy option so will need to do myself. But my tablets have a pink enteric coating so not sure if it's possible to do well. Also, I'm willing to only dip my feet in veeeery slowly cause my cns and aka is already so bad. Like in 1% increments. But when I look at the maths (which I suck at and am scared I'll screw up), that makes for some very specific amounts (getting more so as I go down)... is that even feasible, can syringes get that exact? i. e 30mg, 29.7mg,  29.403, 29.10897... I assume I just round each time. Is that safe? 

 

Aug 2004 - Dec 2006: Aropax ( 20mg - 30mg). Aug 2007: Fluoxetine (for 3 weeks).

Sept 07 - July 12: Lexapro ( 10mg - 20mg). Pooped out July 12. Titrated down off Lexapro over 3 weeks and switched to Paroxetine (with Xanax to cover switch for 2 weeks).

Aug 2012 - Aug 2019: Paroxetine (titrated up to 20mg in first few weeks,, dose reduced to 15mg . for 7 years until it 'pooped out'.

4th Aug 2019 - Reduced dose of paroxetine to 10mg (for 1 day) - under phychiatrists directions. Last dose of paroxetine.

5th Aug 2019 - Switch to 15mg Mirtazapine.

5th Aug - 15th Aug 2019 - 15mg Mirtazapine plus intermitent use of Lorazapm (0.25- 0.5 . Also used 12.5mg Quetiapine for 3 nights for sleep.

23rd Aug 2019 - Ended up in crisis team. Mirtazapine increased to 30mg. Diazapam 10mg twice daily.

30th Aug 2019 - Mirtazapine 30mg + Diazapam reduced to 7.5mg twice daily

6th Sept 2019 - Mirtazapine 30mg + Diazapam reduced to 5mg twice daily

13th Sept 2019 - Mirtazapine increased to 45mg. Diazapam increased back up to 10mg twice daily.

20th Sept - 29th Sept 2019: Mirtazapine 45mg. Diazapam being reduced from 10mg down to 0mg this week (in 2mg increments couple of days).

30th Sept - Thursday 3rd Oct 2019: Mirtazapine 45mg. WORST ANXIETY EVER. Akathisia. Couldn't stay still. Suicidal idealization.

Friday 4th October - present: Reduced from 45mg to 30mg (straight drop to alleviate akathisia - reduction definitely helped alot but still not gone completely)

 

 

, Vit B6, Curcumin, Magnesium (no adverse effects from adding these supplements - have helped akathisia somewhat).

* Everything done from 23rd August under care of outpatient crisis team management.

 

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ten0275
Posted (edited)

@cathnz

 

I did taper with a liquid after a certain point - I did not make it myself. I had a compounding pharmacy make it for me. I understand you don't have one of those at your disposal. I found that having a 1mg = 1ml compound made was the best - it was the easiest in terms of figuring out doses. 7.3mg would be 7.3ml. Makes math easier for those of us who aren't awesome at math. If you are able to make your own 1mg = 1ml ratio, it'd probably be the preferable. I'm guessing there is someone more proficient on this than me who could advise.

 

My syringes got down to .01ml. I think those are commonly available. Some rounding will need to take place. I always rounded up to be on the side of caution. Then it is definitely safe. If you are rounding up, you won't short-change yourself or have to second guess if you went too big.

 

I hope you'll be able to find the relief you wish for. I know the task of all this seems insurmountable when you are still up on the higher doses. I know for me, that was a very claustrophobic feeling. Like I felt stuck, and scared to cut, and like the mission was impossible. But it wasn't and it's not.
    
Hang in there,

 

Dave

Edited by ten0275

1996 - .5mg Ativan as needed, 7.5mg Remeron daily2008 - .5mg Xanax, Ativan discontinued, Remeron continued2012 - .5mg Xanax, .25mg Ativan 3x daily, Remeron continued2/2012 - Jumped from Remeron, continued .5mg Xanax .25mg Ativan 3x daily4/2012 - Began rapid taper of .5mg Xanax .25mg Ativan 3x daily6/2012 - Jumped from Xanax and Ativan, voluntary hospitalization followed7/2012 - 2nd voluntary hospitalization, reinstated Remeron, bumped to 30mg, also given risperidone.8/2012 - discontinued risperidone, tried gabapentin, dicontinued gabapentin, Remeron 30mg continued10/2012 to current - tapered Remeron 10% every 4 to 6 weeks (sometimes more time) using liquid compound12/2014 - 2mg Remeron 1/16/2015 - 1.9mg Remeron 8/1/2015 -1.6mg Remeron - 03/1/2016 - 1.5mg Remeron - 1/2/2017 1.3mg - 5/7/2017 1.2mg - 5/13/2017 - syringe size change - 6/8/2017 - 1.1mg - 7/10/2017 - 1mg - 9/1/2017 - 0.9mg - 10/22/2017 - 0.8mg - 11/22/2017 - 0.7mg - 2/2/2018 - 0.6mg - 3/13/2018 - new compound pharmacy - 5/20/2018 - 0.5mg - 8/31/2018 - 0.4mg - 11/16/2018 - 0.3mg - 12/24/2018 - 0.2mg - 4/1/2019 - 0.1mg - 5/1/2019 - .05mg - 0mg achieved 2019-06-15. 🤞

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As always, a big thank you for your generous and detailed answer ❤

 

And oh I'm so glad to read that so far you're not having as much issues as usual with Spring histamine.

Sounds like healing is still happening ☺

 

Take care dear survivor !

2006 : 20mg Paroxetine + Bromazepam(no specific dose) 2008 : cold turkey of both

2010 : 20mg Deroxat + Bromazepam

2013: Switch from Bromazepam To Prazepam

2014-June2017 : Prazepam taper

2018 to August 2019 : Paroxetine 20mg taper (3% every 15 days).

- 22nd August updosed To 10mg (was at 8.4mg)

25th Sept 2019 To April 2020 : found SA, holding at 10mg Paroxetine. 

April 2020 : Paxil to Prozac bridge. Details topic/21457-

 

Current Supplements : magnesium citrate/ fish oil/ evening primrose oil 

 

Current medication :  7mg Fluoxetine (since 20 Aug 2020)

+ 1mg Diazepam (since 29 Aug 2020)

(Toothpick Paroxetine from September 2020 to 17th March 2021)

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