Marija: Help needed with reinstating mirtazapine after severe WD

[Marija]

Hi all,

 

I would really appreciate if anyone could shed some light on my situation please. I believe I might know what's been going on but some reassurance/advice, particularly on my decision to reinstate would be GREATLY appreciated. 

 

I was first prescribed 15mg of mirtazapine in 2018 for insomnia and anxiety following some very stressful and upsetting health-related news. I only took the full dose once or twice due to extreme sedation and inability to function the next day. I started breaking tablets in half (7.5mg) and taking them as and when required for insomnia mostly induced by anxiety (advised by GP at the time that this was okay to do). I still experienced bad sedation so started taking approximately half of 7.5mg as and when required (anywhere between once a week to more prolonged periods of time - for a couple of weeks every night depending on the severity of anxiety and insomnia). I've been toying with mirtazapine this way until about 10 days ago (I was very uneducated about the dangers of this, never thought I'd get WD because I was taking it irregularly and was usually fine for 3-4 nights after stopping it).
About 10 days ago I realised that the reason I start feeling horrendously after 3-4 days of not taking mirtazapine isn't because it's my anxiety and insomnia returning but because I'm having WD from the drug. Or at least I think that's what it is..? If I don't take it after my 3-4 day break during which I'm ALWAYS fine - doing better than I normally am if anything -  I get SEVERE insomnia (0 hours of sleep) and anxiety/panic attacks at night. After having this realisation about 10 days ago I decided to stop taking it completely (another BIG mistake on my behalf). I haven't been coping at all. I haven't slept at all for 4 nights now, I get severe anxiety at night, including adrenaline surges as soon as I start falling asleep which prevent me from sleelong. It feels like I'm losing my mind. Last night I was 100% certain I could hear voices. I've done copious amounts of reading on this website and decided that I need to reinstate tonight - I will try taking 0.5mg. Can someone kindly advise if this is a good idea in my situation please? I've never gone through anything harder in my life and seriously considered going to A&E last night asking them to admit me to a psych ward...

 

Thank you so much in advance

 

 

Edited February 20, 2021 by Shep
increased font to regular size

[Marija]

Hi all,

 

I think my intro has been missed and I also can't seem to find it myself anywhere either. Not sure what's happened. Any advice would be appreciated. 

[Marija]

Sorry for creating another intro! I can't seem to find my original one, it's just disappeared. Is it because it hasn't been approved yet? Should I do another one? Sorry everyone, I'm pretty sleep deprived so my brain isn't functioning that well.

[Marija]

So I ended up taking 0.5mg mirtazapine last night. It made me feel really quite drowsy and 2 hour after taking it, around 00:00 I started experiencing a very intense surge of anxiety, sheer panic, feeling like my throat was closing up, my entire body was shaking uncontrollably, difficult to breathe, depersonalisation, detached from by body, scared I was going insane. I eventually calmed down but I caved and took 1mg of lorazepam (this is not a habit of mine, last time I took one was maybe 5 months ago, i take it ONLY in emergency situations) because I was scared of it happening again. Not sure if I made a big mistake by taking it... I fell asleep in the end and slept for 9 hours straight. Woke up with mild anxiety but overall feeling better... I think... Can anyone advise me why I had such a severe reaction to 0.5 mirtazapine please? Could sleep deprivation been an added issue causing it such an intense reaction? At that point I had four zero hour nights. Should I take 0.5mg mirtazapine again tonight?

@Altostrata @Gridley @brassmonkey @ChessieCat @Shep any guidance at all would be so so appreciated. 

 

Thank you so much

Marija

[Shep]

Hi, Marija. Welcome to Surviving Antidepressants.

 

I've merged all of your threads into one. Please don't start any new more intros. 

 

The first post in this thread explains why you had such a severe reaction to a reinstated dose. Because your nervous system is destabilized from withdrawal, it's hyper-reacting to even small doses. 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

For more on mirtazapine: 

 

Tips for tapering off mirtazapine (Remeron)

 

Before we can give details on reinstating, we need to know your drug history. Besides mirtazapine and lorazepam, have you taken any other psychiatric drugs? 

 

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

• Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• This is a direct link to your signature:  Account Settings – Create or Edit a signature.

As you provide more information, we can better guide you in reinstating and provide other information, as well. 

 

 

[Marija]

Hi @Shep,

 

Many thanks for your reply and for merging my two topics together. I shall stick to the rules! I was somewhat panicked overall yesterday and worried about not being able to find my original intro.

 

I have now included my signature. Any advice about what to do in my current situation would be appreciated. This website has been keeping me sane the last 10 days!

 

Best wishes,

Marija

 

[Shep]

Quote

7th Dec 2021 tried to stop taking it completely. Severe insomnia (several 0 hour nights), panic. Had no idea it was WD. Was determined to stop still. Was prescribed lorazepam 1mg before bed. Took it 6 times over 3 weeks for sleep and anxiety, it helped. Discontinued.

 

Do you remember the dates that you took lorazepam? 

 

 

[Marija]

Approximately. I think it was between 10th Dec and 6th Jan. As I said, I took 6 tablets if I remember correctly and I spread them across that time (didn't take 6 in a row). 

[brassmonkey]

Your experience last night is sounding like an adverse reaction to the Mirtazapine. When a person stops taking this drug at too high a dosage it can leave the body in a sensitized state causing it to react badly to any sort of reinstatement. You could try another small dose and see what happens, but it will probably be the same reaction, and there is a good chance it won't clear up as fast and as well. It would probably be best to avoid taking this drug again. Stopping at a higher than recommended dose frequently will cause a protracted period of strong WD symptoms but they will eventually settle down. Dealing with insomnia, although very common, is one of the harder parts of going through ADWD. The periods of sleeplessness tend to come in cycles that come and go but are less intense over time. Even without reinstatement things do and will get better.

[Altostrata]

Hello, @Marija

 

The way you were going on and off mirtazapine (and other drugs) may have sensitized you to the drugs.

 

17 hours ago, Marija said:

So I ended up taking 0.5mg mirtazapine last night. It made me feel really quite drowsy and 2 hour after taking it, around 00:00 I started experiencing a very intense surge of anxiety, sheer panic, feeling like my throat was closing up, my entire body was shaking uncontrollably, difficult to breathe, depersonalisation, detached from by body, scared I was going insane. I eventually calmed down but I caved and took 1mg of lorazepam

 

Mirtazapine reaches peak plasma about 2 hours after ingestion. In other words, when you first take it, a very little bit gets into your system -- this seems to have made you drowsy. Then it continued to ramp up and 2 hours later, it hit your sensitized system, which reacted with activation. 0.5mg was too much for you.

 

If I were you, I might continue to take 0.25mg for a while, then taper off by miniscule amounts later. See Tips for tapering off mirtazapine (Remeron)

[Marija]

Hi all,

 

Just a quick update. I ended up taking another 0.5mg last night before seeing all of your recommendations! I didn't have a reaction at all. It made me slightly drowsy but I still struggled to sleep - I got about 3-4 hours of very broken sleep I think. I have a feeling that's mostly due to anxiety though. The several nights of 0 sleep that I had resulted in severe anxiety about not sleeping, dying, failing at everything important in my life etc. Today (throughout the day) I have been feeling quite tired and very anxious. I've had a constantly elevated heart rate, slight headache. I ended up having one hour of broken sleep during the day from 4pm until 5pm. I woke up feeling very anxious and nauseous. Eating feels like such a chore due to nausea...

 

Brassmonkey, thanks so much for your reply. I don't think taking no mirtazapine and riding it out is an option for me. Four zero hour nights made me violently ill in every way and I couldn't function at all.  I couldn't feed myself, get any work done etc. So I need to somehow stabilise on a lower dose and then taper very very slowly. Even since I've started taking 0.5mg, I still feel very very ill. I'm guessing it's going to take a while to stabilise..? 

 

Altostrata, I really appreciate your reply. Do you think it's okay for me to stick to 0.5mg considering I didn't have a reaction last night and try to stabilise on it? I have no idea how people have the strength to quit, so far it has been the most traumatic and difficult experience of my life. I keep thinking I don't have the strength to carry on and that I've essentially ruined my life by taking this drug...

 

Marija

 

[Altostrata]

6 hours ago, Marija said:

Do you think it's okay for me to stick to 0.5mg considering I didn't have a reaction last night and try to stabilise on it?

 

Yes, it looks like you got used to it. I would be careful to take 0.5mg at the same time each day.

[Marija]

Hi all,

 

Just a quick update. I've been doing okay on 0.5mg of mirtazapine. I've been getting at least 5 hours of broken sleep, less anxiety etc since I've reinstated on 19th Feb. However, last night I had zero hours of sleep again, increased anxiety, paranoia and obsessive thoughts. I'm absolutely terrified of not sleeping again tonight. The previous episode of 5 nights of zero sleep nearly drove me insane, and I was very very unwell. I'm not sure whether I should hold and see what happens or updose slightly? I keep wondering if 0.5mg is too small of a dose for me to stabilise properly. I'm confused about which option would cause the least damage. I'd really appreciate any advice and encouragements. @Altostrata @brassmonkey

 

Warm wishes to everyone. Knowing this website exists, brings me some peace and reassurance.

[Marija]

@Ripley I'm wondering if you are able to offer any advice due to your own experience with mirtazapine? I've read your story and I know our circumstances are different but I'd be grateful to hear your thoughts too.

[Ripley]

Hi Marija

 

Purely from my own experience, I would probably stay at 0.5mg as 5hrs of broken sleep isn't bad for a reinstatement at this stage. I realise you had a zero night but I found that they continued to happen for a while after reinstatement unfortunately, including when I updosed. They will probably happen in the coming weeks but overall your sleep should be recovering so try not to panic. Easier said than done I know. 

 

Having said that, my sleep became deeper about a week after my updose. Previously it had been very light and broken. So, depending on overall sleep quality, you may want to do a small updose. I just wouldn't do it on the basis of one zero night as, if you're like me, they will happen unfortunately. Give each dose plenty of time.

 

This is the advice I wish I had been given but I had not yet found SA and was flailing. 

 

Ripley

[Marija]

Thanks so much for you reply @Ripley, I really appreciate it. I shall stick to 0.5mg for a bit longer than and see how I sleep tonight. I find the zero hour nights way WAY worse than any other symptoms I've experienced such as severe anxiety, paranoia, nausea etc. I feel that when I get at least 5 hours of sleep (even if it's broken), I can cope with all of those symptoms a lot better but once I get two nights in a row of zero sleep, it all goes downhill and I become very unwell in every sense. If I have a zero hour night again tonight, would you increase the mirtazapine a little or try to ride it out? I can definitely handle a night or two of zero sleep but once it's three, four etc nights in a row, I simply cannot cope. There's so much dread I feel in relation to sleep. My life quite literally stops completely once I've had two nights of zero sleep. Do you have any advice on coping strategies? I often worry that I'll become very physically ill due to such lack of sleep and run my immune system to the ground... I do understand that excessive worry is not helpful but so far my experience with mirtazapine WD and particularly the insomnia, has scared the life out of me!

 

All the best,

Marija

[Santino]

41 minutes ago, Marija said:

Thanks so much for you reply @Ripley, I really appreciate it. I shall stick to 0.5mg for a bit longer than and see how I sleep tonight. I find the zero hour nights way WAY worse than any other symptoms I've experienced such as severe anxiety, paranoia, nausea etc. I feel that when I get at least 5 hours of sleep (even if it's broken), I can cope with all of those symptoms a lot better but once I get two nights in a row of zero sleep, it all goes downhill and I become very unwell in every sense. If I have a zero hour night again tonight, would you increase the mirtazapine a little or try to ride it out? I can definitely handle a night or two of zero sleep but once it's three, four etc nights in a row, I simply cannot cope. There's so much dread I feel in relation to sleep. My life quite literally stops completely once I've had two nights of zero sleep. Do you have any advice on coping strategies? I often worry that I'll become very physically ill due to such lack of sleep and run my immune system to the ground... I do understand that excessive worry is not helpful but so far my experience with mirtazapine WD and particularly the insomnia, has scared the life out of me!

 

All the best,

Marija

Hello Marija

What is happening to you sounds really familiar to me. During my tapering of Mirtazapine i used to have time after time these episodes of one or two nights of zero sleep. IN the beginning this would terrify me but i would notice that if i do not make any changes in my regimen and continue after 2 days of zero sleep the third night my brain would be very tired and late in the evening it would literally stop thinking about worrying things. Than taking the normal dose i would sleep very good and once i had the sleep i need i would be refreshed for the next day and my sleep would stabilize.

I stopped mirtazapine completely in 2017 and continued normally with these episodes which were near one another in the beginning some times monthly but after they started happening further periods apart. So if you keep stable on 0.5mg for a while you will notice  the same pattern i believe. I suspect that your system might also be a little bit kindled from the irregular use of lorazepam. SO i would completely avoid that if i was you as some of the sleeplessness you notice might also be related with benzo use. IN my very bad nights during my episodes i would wake up and take a strong tea of Linden and Chamomile and that would do the trick. Stop my rumination and ensure some sort of sleep. 

All the best my friend and just do not scare yourself too much. Try taking magnesium, vit b and omega 3 fish oil. One banana before sleep and magnesium adn a vit C has helped me a lot.

Currently i was forced to start 5 mg of mirtazapine due to insomnia induced by corona virus and some very stressful factors. Currently same as you i am with 0.5mg and will continue to taper it and i hope in 1-2 months i will be free again.

In case you need further advice send me any message.

All the best

Santino

[Ripley]

Hi Marija

 

I think Santino is right. I also found that I could have 2 sleepless nights in a row but would sleep on the third. It doesn't mean you need to updose and I would keep holding at 0.5mg if I were you.

 

I've learned on this site that it isn't really about finding a 'perfect' dose to fix our situation but giving our systems time and stability to settle down. You will be ok. It's incredibly difficult right now but it does improve.

 

X

[Ripley]

PS. I just noticed Santino mentioned vitamin B helped him but I found this kept me up all night. It can be activating. 

[Marija]

Thank you both so much for your replies and and kind words @Santino and @Ripley - they truly go a long way! I shall take both of your advice and stick to 0.5mg for now. 

I will also try having a banana before bed. I'm practically living off camomile tea already! Unfortunately, I find that once those zero hour nights start, no tea will do the trick - it's like my body completely loses its ability to sleep which I find terrifying! It's very reassuring to hear that you both have had similar experiences with insomnia and that it does get better. I think my worry stems mostly from that horrendous experience I had of 5 nights with ABSOLUTELY NO SLEEP until I reinstated mirtazapine. You'd think that just like you said, Santino, by the third night, of be so tired that my body would just give me but for me the complete opposite started happening - I got more and more worked up. So, I suppose I'm just fearful that this time it won't end after one or two nights of no sleep. But I shall do my best and worry about it less and see what happens first. I'll keep you updated. I hope I'm strong enough to ride it out as I do realise my body needs stability right now and time. Hopefully the insomnia won't be as relentless this time as it was just two weeks or so ago when I stopped mirtazapine cold-turkey. I naively thought that those days were over and that is carry on getting my five hours of sleep, and improve slowly but surely! Oh well... 

 

Warm wishes to you both

 

 

[Santino]

1 minute ago, Marija said:

 

I will also try having a banana before bed. I'm practically living off camomile tea already! Unfortunately, I find that once those zero hour nights start, no tea will do the trick - it's like my body completely loses its ability to sleep which I find terrifying!

Hi Marija.

When you say "living off Chamomile tea" do you mean you are continuously taking it...????!!!!

[Marija]

I was sort of joking about that @Santino. What I meant is that I have it regularly because I've heard it's calming and I don't mix it with any other teas. I usually have a couple of cups a day but more than that. Is that oka? Should I not be doing that?

[Santino]

Just now, Marija said:

I was sort of joking about that @Santino. What I meant is that I have it regularly because I've heard it's calming and I don't mix it with any other teas. I usually have a couple of cups a day but more than that. Is that oka? Should I not be doing that?

Ok my friend

Now it seems somehow more clear to me. You should not take it continuously. Even though it is calming at one moment it intercepts with your gaba receptors. You have taken lorazepam through January and February and i believe your system is kindled. Chamomile same like Lorazepam has effect on your gaba receptors and as a result you have anxiety, sleeplessness and so on. At the same time that adrenaline rush when you are about to sleep and you wake up like a train hits you with shaking and anxiety is exactly a sign that your problem is not currently coming from the mirtazapine but from your gaba receptors and lorazepam and maybe extensive chamomile usage as well.

Now if i was you i would slowly lower the amount of chamomile tea i take per day. so for example if i am currently taking 6 glasses of chamomile for 3 days i would take five, and than another after another 3 days i would take 4 and so on. On the meantime i would continue with 0.5Mg of Mirtazapine if that ensures some sleep for me. You will still have sleepless nights and anxiety but i believe after one month you will be more stable. Try adding Magnesium 300mg and one Omega 3 fish oil and vit C at night. Introduce them gradually and check their effect. Banana and cherries before sleep are very good as they have melatonin, which induce sleep. 

In my case i stopped taking the chamomile. I would take it mixed with linden tea only on very very bad nights. Normally on the second night of no sleep around 1-2 AM. This has helped me a lot and currently i am living a very normal live, working, facing problems, caring for my family and business and so on.

You will make it. You are not a heavy user of psych meds.... i am sure about it. Try eating canned sardines they have natural vit B which helps a lot and important at 6-7 pm make some kilometers of walk, 4-5 km is perfect. Get yourself tired and do not overthink. I am sure that if you stay clean you will soon start sleeping as your system will get tired by itself. Just do not overdo with the chamomile tea. Avoid sugars (take them only from natural sources like fruits), pasta, pizza, Alcohol and caffeine are not good for your situation too. 

I hope i was helpful. Just start slowly and soon you will see that things will stabilize.

All the best

Santino



 

[Marija]

Thanks for all your advice @Santino. Just to be clear, I only started drinking chamomile tea about 12 days ago and I never took lorazepam regularly, just on a couple of instances when my insomnia was very very bad. I no longer wake up with an adrenaline rush that you've described - that disappeared as soon as I reinstated mirtazapine 0.5mg and my general anxiety reduced as well since the reinstatement. So I do think it's more of a mirtazapine issue rather than lorazepam. Not sure if you agree? I will definitely take your advice and stop drinking chamomile tea though as I don't want it to cause any problems!

Since I reinstated mirtazapine about two weeks ago and started getting a bit more sleep, I've been leading a  pretty much normal life too until last night when I could feel the anxiety and obsessive thoughts creeping in, followed by zero sleep. So today I'm obviously not feeling my best. I'm hoping that it's just my system getting accustomed to what's happening, same as what happened to you and Ripley when it comes to insomnia. It's just strange that I've been getting some sleep and doing okay since I reinstated and then last night BOOM, the raging insomnia was back! But I guess it could be a little wave I have to ride out rather than updosing..? I'm convinced I'm not experiencing any lorazepam related issues but I will stop drinking chamomile tea!! I'm keen to hear what you think.

 

thanks!

 

[Santino]

8 minutes ago, Marija said:

Thanks for all your advice @Santino. Just to be clear, I only started drinking chamomile tea about 12 days ago and I never took lorazepam regularly, just on a couple of instances when my insomnia was very very bad. I no longer wake up with an adrenaline rush that you've described - that disappeared as soon as I reinstated mirtazapine 0.5mg and my general anxiety reduced as well since the reinstatement. So I do think it's more of a mirtazapine issue rather than lorazepam. Not sure if you agree? I will definitely take your advice and stop drinking chamomile tea though as I don't want it to cause any problems!

Since I reinstated mirtazapine about two weeks ago and started getting a bit more sleep, I've been leading a  pretty much normal life too until last night when I could feel the anxiety and obsessive thoughts creeping in, followed by zero sleep. So today I'm obviously not feeling my best. I'm hoping that it's just my system getting accustomed to what's happening, same as what happened to you and Ripley when it comes to insomnia. It's just strange that I've been getting some sleep and doing okay since I reinstated and then last night BOOM, the raging insomnia was back! But I guess it could be a little wave I have to ride out rather than updosing..? I'm convinced I'm not experiencing any lorazepam related issues but I will stop drinking chamomile tea!! I'm keen to hear what you think.

 

thanks!

 

Ahaaaa

Than you are definitely on a good track. Do not let a sleepless night scare you once in a while. Waves are completely normal in this kind of game. Just make yourself tired tonight, make a walk from 6 to 8pm and then sleep 3 hours after it. Shower before sleep also helps.

All the best my friend. I am sure tonight will be a good night for you. Just do not overdo the chamomile, it really has effects on us. 

All the best Santino

[Marija]

I shall do that! Thanks @Santino. I'll give an update tomorrow about how it went for me. Fingers crossed...

 

All the best to you 

 

[brassmonkey]

Hi Marija-- Santino has a lot of good advise, pretty much what I was going to say. I would hold for a while longer and really work on not letting the prospect of a few bad nights get me too upset. Worry about not sleeping is one of the major causes of insomnia.

[Altostrata]

Quote

19/02/2021 reinstated 0.5mg. Had quite a severe reaction. Took 1mg lorazepam. 

 

Marija, what was your severe reaction? This sounds like you might want to avoid updosing.

 

How are you taking 0.5mg? Are you making a liquid? How old is it?

 

@Ripley, good advice.

[Marija]

Thanks everyone.

@Altostrata, two hours after taking it the first time, I got very anxious, heart was racing, my body was shaking - I think it was probably a panic attack. I eventually calmed down and fell asleep. I've been fine on 0.5mg since until two days ago. Last night was another zero hours of sleep night so now I've had two in a row. I've been on 0.5mg for nearly two weeks. The issue is, it's not just the insomnia that started again, I also feel intensely anxious, close to having a panic attack during the night, nauseous, my head is full of obsessive, intrusive thoughts. Essentially, it's a real throwback to were I was a couple of weeks ago before I reinstated 0.5mg of mirtazapine. I'd love to "ride it out" but I'm currently doing a master's degree and I have exams on Monday and I simply cannot afford to **** up my life. I also find it very hard to cope with these symptoms that have reappeared. I'm not sure what to do... I'm torn between attempting to updose and trying my hardest to ride it out. If I knew how long this was going to last, it'd be a lot easier to wait it out. However, if I get to a stage like before where I hadn't slept for 5 nights in a row AT ALL, I will simply not be able to cope. Updosing would feel like such a step back, I'm really not sure... I desperately don't want to mess it all up again. Any advice would be highly appreciated Altostrata.

 

I'm also very keen to hear what your thoughts are @Ripley @Santino @brassmonkey

 

I cannot express how grateful I am for your input 

[Santino]

3 hours ago, Marija said:

Thanks everyone.

@Altostrata, two hours after taking it the first time, I got very anxious, heart was racing, my body was shaking - I think it was probably a panic attack. I eventually calmed down and fell asleep. I've been fine on 0.5mg since until two days ago. Last night was another zero hours of sleep night so now I've had two in a row. I've been on 0.5mg for nearly two weeks. The issue is, it's not just the insomnia that started again, I also feel intensely anxious, close to having a panic attack during the night, nauseous, my head is full of obsessive, intrusive thoughts. Essentially, it's a real throwback to were I was a couple of weeks ago before I reinstated 0.5mg of mirtazapine. I'd love to "ride it out" but I'm currently doing a master's degree and I have exams on Monday and I simply cannot afford to **** up my life. I also find it very hard to cope with these symptoms that have reappeared. I'm not sure what to do... I'm torn between attempting to updose and trying my hardest to ride it out. If I knew how long this was going to last, it'd be a lot easier to wait it out. However, if I get to a stage like before where I hadn't slept for 5 nights in a row AT ALL, I will simply not be able to cope. Updosing would feel like such a step back, I'm really not sure... I desperately don't want to mess it all up again. Any advice would be highly appreciated Altostrata.

 

I'm also very keen to hear what your thoughts are @Ripley @Santino @brassmonkey

 

I cannot express how grateful I am for your input 

 

Hi Marija

Even though we said yesterday to reduce a bit your chamomile tea we said to do it slowly and not stop it immediately. Please keep that in mind. IN a fragile system even chamomile tea when used extensively can cause problems.

For the last night it is perfectly OK not to sleep. Why do you keep scaring your self?? Why do you anticipate the "failure" in exams this Monday?? You will be good tonight i believe. IN the afternoon your brain will be extremely tired and in the evening i believe you will not be able to think properly as your brain will be extremely tired and calm. I strongly believe you will be able to sleep tonight unless you continue to scare yourself. You need to accept the fact that on some particular days it might happen that you will spend one or two days of no sleep, but if you have not destroyed your circadian rhythm by using meds, i am sure that very soon the nature will take over and your nervous system will react with normal sleep.

Do not forget the long walk tonight. It should have finished by 19.00 if you plan to sleep at 22.00.

I will keep my fingers crossed for you.

All the best

Santino

[Marija]

It's because I can't function like this @Santino. Today I'm totally useless, I cannot concentrate or study. My head is filled with intrusive, obsessive thoughts, my anxiety is through the roof and I'm struggling to control it. I've tried meditation, mindfulness etc. Last time I didn't sleep for 5 nights straight and my mind didn't get tired or calm down. I had to take both mirt and lorazepam to break the cycle. That's why I'm anticipating failure on Monday if I don't start getting sleep. I don't know if it makes sense..? I know it sounds like ok catastrophising but I truly feel very unwell, not just from an insomnia point of view. 

[brassmonkey]

The immediate and and intense onset pf symptoms is indicative of a sensitivity to or possible adverse reaction to the Reinstatement. Updosing even more will probably just make things worse. I would try cutting down to .25mg and see if there is any improvement.

[Altostrata]

I don't believe chamomile tea is a problem.

 

@Marija, please answer:

20 hours ago, Altostrata said:

How are you taking 0.5mg? Are you making a liquid? How old is it?

 

 

[Marija]

12 hours ago, Altostrata said:

I don't believe chamomile tea is a problem.

 

@Marija, please answer:

 

@AltostrataI'm making a liquid suspension from orodispersible mirtazapine with water and honey and then using a syringe. I make it fresh every night. Is that okay?

[Marija]

So last night I was determined to ride it out and stick to 0.5mg however I got very distressed due to ZERO sleep at around 8pm, suicidal thoughts, thinking "I can't do this" etc. The lack of sleep really really affects me. So I caved and ended up updosing to 0.75mg and taking 1mg lorazepam to make sure I slept. And I did, I slept for 7 hours straight and feel much better today. Less obsessive, intrusive thoughts, less anxiety etc. Worried about tonight a little but that's all. I kno it's not ideal taking lorazepam, however, I do reserve it for those emergency situations and take once in 2-3 weeks MAXIMUM. No more than that. Is that okay or should I stop this habit completely and try and find the right dose of mirtazapine instead that'll keep severe insomnia away and then taper miniscular amounts to avoid severe WD? Not sure what to do from now on. I just know cannot "ride it out", it's not an option. I need to find some sort of balance that will allow me to sleep, at least a little bit and taper mirtazapine at the same time, ideally without having to rely on lorazepam every few weeks. Please help. I feel like I'll end up in a grave sooner rather than later at this rate as I'm finding it too difficult to cope with multiple nights of zero sleep. @Altostrata @Ripley @Gridley or anyone else who has advice regarding this please...

[Gridley]

7 hours ago, Marija said:

should I stop this habit completely and try and find the right dose of mirtazapine instead that'll keep severe insomnia away and then taper miniscular amounts to avoid severe WD?

That would be my suggestion.  That way, you're only on one drug.  You could updose Mirt very slightly until you find a dose that allows you to get adequate sleep.

 

The problem with Lorazepam for sleep is that it's a slippery slope.  That's what happened to me.  I was taking it occasionally for sleep but slowly (because I craved sleep so much) I ended up taking it more often until finally I reached tolerance and now am having to taper.

 

Vitamin D is an activator so be sure you take it in the morning rather than later.