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Ivan: Mirtazapine withdrawal - 2nd time


Ivan

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Hello everyone.

I will try to briefly introduce my story.

In Dec 2015 it was first time for me to experience anxiety/depression (I stopped eating, sleeping). Moreless related to my health anxiety and some stressful period. I tried citalopram, trazodone and finally in Feb 2016 I started 15mg Mirtazapine and 10mg Escitalopram. In May 2016 I cut to 7,5mg Mirtazapine and stayed on that together with Escitalopram 10mg. In Jan-Apr 2017 I weaned myself off Escitalopram and in May-Aug 2017 I weaned successfully myself off Mirtazapine. I was doing really well. Until Oct 2020.

At the end of October 2020 same issue happened to me again - no eating, no sleeping, depression, sadness, ...

In November 2020 I started 10mg Escitalopram again and only 4,2mg Mirtazapine (cutting and weighting pills). After first 2 weeks I got a little better and I started to wean myself off Mirtazapine. I got from 4,2 to 3mg over the period of 3 weeks (I chose similar rate like in 2017). I was having pretty good time. Then, first week in December, I had very bad experience - I had to go to bathroom, having really painful spasms in abdomen like colic, sweating, heart rate sky high. I spent 1 hour in bathroom, then moved home from the office. Since then it's been slightly better but I am just wondering about my symptoms:

 

- nausea on/off

- lower appetite (though better than before)

- random abdominal pain, spasms, cramps

- extreme fatigue (even after 10 hours of sleep) - gets better as the day goes on

- ill feeling (like you are coming down with a flu or cold)

- burning feeling in my eyes, sometimes tongue, mouth

 

Are these related to tapering of Mirtazapine or side effects of it? Or is it Escitalopram?

 

Thank you very much in advance for any comments, support or experience.

 

Edited by manymoretodays

January 2016 - January 2017: Lexapro 10mg; Mirtazapine 7,5mg

January 2017 - April 2017: tapering Lexapro to 0mg; Mirtazapine 7,5mg

April 2017 - August 2017: ; tapering Mirtazapine to 0mg

August 2017 - November 2020: med free

01.11.2020 - Started Lexapro (10mg) and Mirtazapine (4,2mg)

14.11.2020 - Lexapro (10mg) and Mirtazapine (4,2mg - starting tapering)

03.12.2020 - Lexapro (10mg) and Mirtazapine (3mg - stopping tapering due to bad symptoms)

 

No change in dosing since 03.12.2020.

Sleeping pretty OK. Eating pretty OK.

Symptoms: bloating, gas, abdominal pains, cramps, urge to go to bathroom, fatigue

Supplements: Vit B-complex, vit C, vit D, magnesium, zinc

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  • manymoretodays changed the title to Ivan: Mirtazapine withdrawal - 2nd time
  • Moderator Emeritus

Hi, Ivan.

 

Welcome to Surviving Antidepressants.

 

Yes, those symptoms sound like both side effects and especially withdrawal symptoms of these drugs. For more on these symptoms, please see:

 

Digestive problems: nausea, diarrhoea, bloating, GERD

 

Flu-like withdrawal symptoms or real virus flu, how to tell?

 

Paresthesia: pins & needles, numbness, tingling, burning sensations aka neuropathy

 

Burning skin, burning feet

 

Burning mouth syndrome

 

 

 

On 1/21/2021 at 6:56 AM, Ivan said:

At the end of October 2020 same issue happened to me again - no eating, no sleeping, depression, sadness, ...

In November 2020 I started 10mg Escitalopram again and only 4,2mg Mirtazapine (cutting and weighting pills). After first 2 weeks I got a little better and I started to wean myself off Mirtazapine. I got from 4,2 to 3mg over the period of 3 weeks (I chose similar rate like in 2017). I was having pretty good time. Then, first week in December, I had very bad experience - I had to go to bathroom, having really painful spasms in abdomen like colic, sweating, heart rate sky high. I spent 1 hour in bathroom, then moved home from the office.

 

Are you completely off both of these drugs now?

 

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Please continue to use this thread to ask questions and let us know how you're doing. 

 

 

 

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Hello Shep!

 

Thank you very much for your answer.

 

On 1/23/2021 at 12:43 PM, Shep said:

Are you completely off both of these drugs now?

 

I am actually on both still - Lexapro @ 10mg and Mirtazapine @ 3mg - it's been like this for almost 8 weeks already.

I am currently struggling with GI issues. Nausea on/off during the day (morning is worse), strange feelings in my abdomen, sometimes minor pains, cramps.

I am stuck right now as I do not know where to move - up/down with Mirtazapine, up/down with Lexapro?

 

January 2016 - January 2017: Lexapro 10mg; Mirtazapine 7,5mg

January 2017 - April 2017: tapering Lexapro to 0mg; Mirtazapine 7,5mg

April 2017 - August 2017: ; tapering Mirtazapine to 0mg

August 2017 - November 2020: med free

01.11.2020 - Started Lexapro (10mg) and Mirtazapine (4,2mg)

14.11.2020 - Lexapro (10mg) and Mirtazapine (4,2mg - starting tapering)

03.12.2020 - Lexapro (10mg) and Mirtazapine (3mg - stopping tapering due to bad symptoms)

 

No change in dosing since 03.12.2020.

Sleeping pretty OK. Eating pretty OK.

Symptoms: bloating, gas, abdominal pains, cramps, urge to go to bathroom, fatigue

Supplements: Vit B-complex, vit C, vit D, magnesium, zinc

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  • Moderator Emeritus

Thanks for the additional information, Ivan.

 

Please note there is a major drug interaction between Lexapro and mirtazapine which may explain some of your symptoms: 

 

Drug Interaction Report - Lexapro / mirtazapine

 

On 1/25/2021 at 7:58 AM, Ivan said:

I am stuck right now as I do not know where to move - up/down with Mirtazapine, up/down with Lexapro?

 

Generally, mirtazapine is taken at night, since it tends to be sedating fo most people. Please correct me if that's not the case for you. 

 

For this reason, we recommend tapering the Lexapro first and keeping the mirtazapine for last in order to preserve sleep. Please see:


Taking multiple psych drugs? Which drug to taper first?

 

For information on tapering Lexapro, please see:

 

Tips for tapering off escitalopram (Lexapro)

 

Why taper by 10% of my dosage?

 

On 1/25/2021 at 7:58 AM, Ivan said:

I am currently struggling with GI issues. Nausea on/off during the day (morning is worse), strange feelings in my abdomen, sometimes minor pains, cramps.

 

What time(s) of the day do you take your drugs? Do the GI symptoms get worse after taking one or both of your drugs? 

 

 

 

 

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I am sorry you are suffering. Shep is right about the mirtazapine. A low dose of mirtazapine is usually given at night for sleep. My doctor prescribed it that way for me.

 

When I have tapered, I have only tapered one drug at a time. If you change 2 drugs at once and you have a problem, you won't know which change caused the problem. 

 

Please do not lose heart. Many people have been through terrible tapers and have successfully completed them and are now better. You will get better, too.

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On 1/26/2021 at 3:07 PM, Shep said:

What time(s) of the day do you take your drugs? Do the GI symptoms get worse after taking one or both of your drugs? 

I take Lexapro at 8am and Mirtazapine at 8pm. My GI issues are worst in the morning but generally I can "feel them" all day long. In the morning mostly it is abdominal cramps, I go to bathroom, having BM, and after 10 minutes I have a feeling that I need to go again ... and during day this happens many times. I feel bloated a lot, also I have some pains in the chest, probably caused by bloating. I am not sure if it is even right time to taper off :-(

January 2016 - January 2017: Lexapro 10mg; Mirtazapine 7,5mg

January 2017 - April 2017: tapering Lexapro to 0mg; Mirtazapine 7,5mg

April 2017 - August 2017: ; tapering Mirtazapine to 0mg

August 2017 - November 2020: med free

01.11.2020 - Started Lexapro (10mg) and Mirtazapine (4,2mg)

14.11.2020 - Lexapro (10mg) and Mirtazapine (4,2mg - starting tapering)

03.12.2020 - Lexapro (10mg) and Mirtazapine (3mg - stopping tapering due to bad symptoms)

 

No change in dosing since 03.12.2020.

Sleeping pretty OK. Eating pretty OK.

Symptoms: bloating, gas, abdominal pains, cramps, urge to go to bathroom, fatigue

Supplements: Vit B-complex, vit C, vit D, magnesium, zinc

Link to comment
  • Moderator Emeritus
18 hours ago, Ivan said:

I take Lexapro at 8am and Mirtazapine at 8pm. My GI issues are worst in the morning but generally I can "feel them" all day long.

 

Do they get worse after you take the Lexapro or do you wake up with a lot of GI issues, even before you take the Lexapro? 

 

When do you take your supplements and what are the doses? 

 

 

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