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Robineye: Mirtazapine and Lexapro issues and possible withdrawal


Robineye

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Hi, 

I am 67 year old male and have been on antidepressants since the mid 1990s (for low mood and anxiety):

- Prozac 15mg until November 2016.

- I wasn’t sleeping well so GP changed me to Mirtazapine 15mg (Nov 16) which worked for sleep but gradually increased anxiety to distressing and unacceptable levels (also low mood). I tried one slow taper in 2018 but sleep was immediately an issue.

- GP recently changed me (I was very unsure about it) to Lexapro 10mg (straight swop, no tapers).

- The swop has caused more anxiety and as the Lexapro is starting to work I can feel the debilitating effects it has on my sleep (as I know SSRIs can).

My preferred future would be to be drug free (I’ve wanted this for a long time) but I’m unsure where to go now. I feel caught between two very disagreeable and scary drug options. It might be good not to get caught on Lexapro for a long time which I know would make withdrawal potentially even more difficult...? 
My GP said I could take 5mg of the Lexapro if 10mg was too much. I’m thinking of doing that immediately?
Any insight or support would be very much appreciated.

 

Edited by Gridley

On Prozac 15mg from mid 90s to November 16 for low mood and anxiety.

2016 had enough of poor sleep, put on Mirtazapine 15mg. Sleep improved a lot.

Tried one very slow taper in 2018 (as per your guidelines) but at around 9mg sleep once again a big issue. Returned to higher dose.

2019/2020 increasing high anxiety and non-engagement with life.

Feb 15th 2021 put on Lexapro 10mg. Severe anxiety as a reaction to changing drugs, stopped Lexapro and returned to Mirtazapine 15mg to restabilise.

Anxiety affecting most areas of life now.

August 21 started 5% monthly taper off Mirtazapine 15mg: Aug 21, 14.3mg; Sep 21, 13.5mg; Oct 21, 12.8mg; Nov 21, 12.2mg; Dec 21, 11.6mg; Jan 22, 11.0mg.

January 22 stabilising at 11mg as WD symptoms started again. July 22 now at 8.2mg. 

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  • Gridley changed the title to Robineye: Mirtazapine and Lexapro issues and possible withdrawal
  • Moderator

Welcome o SA, Robineye.  We need a little more information before we can address your situation.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Be sure to include the date when you started the Lexapro.

 

A person is at risk of withdrawal symptoms after 3 weeks to a month on an antidepressant.  After this point a slow taper (we recommend no more than 10% of current dose every four weeks).

 

Why taper by 10% of my dosage?

 

What is withdrawal syndrome.

 

Depending on how long you've been on the Lexapro, a 50% op from 10mg to 5 might be too much.  


This is your Introduction topic, where you can complete your drug signature, questions and connect with other members.  We're glad you found your way here.

 

 

 

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 to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper.   

March 22, 2022: hold at 4.8mg and shift to Imipramine taper

Aug. 5, 2022: shift to Valium taper.  

Current dose as of Aug. 5, 2022: 4.3mg

Taper is 77% complete.

 

Imipramine 75 mg daily since 1986.  Jan-Sept 2016 tapered to 16mg.  

Held until Aug 2021, tapered for 4 weeks to 14.4mg

March 22, 2022: Begin 10%/4 week taper.  Current dose as of Aug. 5: 9.5mg 

Aug. 5, 2022: hold at 9.5 and shift to Valium taper

Taper is 87% complete.  

  

Supplements: omega-3, 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.

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  • Mentor

@Robineye welcome to SA! The anxiety and feelings you are having now are most likely from the process of changing meds. Withdrawals of one and start up side effects of the other . Especially if dr didn’t get the correct equivalent dose  correct. This has caused nervous system to become unstable. Get you signature done with dates and meds and dosages and moderators can help you decide with to hold on 10 or reduce. Gridley is right 10 to 5 mg will be too much depending on factors like how long you’ve been on 10 mg. And depending on how bad the side effects are at present. This drugs will cause worse start up side effects especially if dosage is too high which is very common with drs. Hang in there !

2000-2013 Paxil - 1 year fast taper

2013-2018 drug merry go round with dr. 
zoloft, cymbalta, lamictal, Prozac.

 Nov. 2018 lexapro 15 mgs, Dec. 2019 to Mar. 2020 10mg. Jul 2020 to October 2020 8.5 ml.
Oct 2020 reinstated to 9 ml.
Apr 2021 to Jul  7ml. Oct 2021 to Jan 2022 5.9ml, Mar 5 2022 5.8 ml, Mar 12 5.7ml, Mar 20 5.6ml, Mar 27 5.5ml, April 23 5.4ml, April 30 5.3ml, May 7 5.2ml,  Jul 9, 5.4ml, 

Klonopin as needed, present Celebrex 200 - 400 mg daily as needed, 1000 to 2000 mg  turmeric Qunol daily as needed, Trader Joe’s omega 3, Prilosec very rarely if desperate 

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Hi Heath,

Thanks for the reply. I have just done my signature as best I can. Had a really bad day with worsening anxiety yesterday (after broken sleep) so ended contacting GP who gave me some Valium to get through the day. Have only taken 5mg of the Lexapro this morning (and half a 2mg Valium) as I’m so scared of the way it attacks my sleep and then that makes me feel so bad all day (darker than any low mood). I hope to speak to a counsellor tomorrow about all this. Best wishes.

On Prozac 15mg from mid 90s to November 16 for low mood and anxiety.

2016 had enough of poor sleep, put on Mirtazapine 15mg. Sleep improved a lot.

Tried one very slow taper in 2018 (as per your guidelines) but at around 9mg sleep once again a big issue. Returned to higher dose.

2019/2020 increasing high anxiety and non-engagement with life.

Feb 15th 2021 put on Lexapro 10mg. Severe anxiety as a reaction to changing drugs, stopped Lexapro and returned to Mirtazapine 15mg to restabilise.

Anxiety affecting most areas of life now.

August 21 started 5% monthly taper off Mirtazapine 15mg: Aug 21, 14.3mg; Sep 21, 13.5mg; Oct 21, 12.8mg; Nov 21, 12.2mg; Dec 21, 11.6mg; Jan 22, 11.0mg.

January 22 stabilising at 11mg as WD symptoms started again. July 22 now at 8.2mg. 

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  • Administrator

Welcome, @Robineye

 

Yes, you may take 5mg Lexapro rather than 10mg. 10mg Lexapro is roughly equivalent to 20mg or 30mg Prozac.

 

When did you go down to 9mg mirtazapine? Why did you not simply increase mirtazapine a bit when you got withdrawal insomnia?

 

How long has it been since you took mirtazapine?

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

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

All postings © copyrighted.

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Thanks Altostrata, It was probably mid 2018 when I tried the mirtazapine taper. I didn’t really think about stabilising on the lower dose. I’m new to all this and so afraid of not sleeping.
Stopped mirtazapine about 9 days ago (very small overlap with Lexapro but felt dizzy the next day) and took the lower dose of 5mg Lexapro yesterday. Feel dreadful again today; poor sleep, strong anxiety which Valium isn’t helping much. Trying to speak to GP but just want to go back to sleeping on mirtazapine even though I’ve come to hate it. I feel totally trapped with only unacceptable choices... Mirtazapine gives me no life but sleep. SSRIs mess my sleep up and again no life.

 

On Prozac 15mg from mid 90s to November 16 for low mood and anxiety.

2016 had enough of poor sleep, put on Mirtazapine 15mg. Sleep improved a lot.

Tried one very slow taper in 2018 (as per your guidelines) but at around 9mg sleep once again a big issue. Returned to higher dose.

2019/2020 increasing high anxiety and non-engagement with life.

Feb 15th 2021 put on Lexapro 10mg. Severe anxiety as a reaction to changing drugs, stopped Lexapro and returned to Mirtazapine 15mg to restabilise.

Anxiety affecting most areas of life now.

August 21 started 5% monthly taper off Mirtazapine 15mg: Aug 21, 14.3mg; Sep 21, 13.5mg; Oct 21, 12.8mg; Nov 21, 12.2mg; Dec 21, 11.6mg; Jan 22, 11.0mg.

January 22 stabilising at 11mg as WD symptoms started again. July 22 now at 8.2mg. 

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  • 1 month later...

Hi,  After the very difficult time in February (when I first posted) in trying to switch from Mirtazapine to Lexapro I am now stabilised once again on 15mg Mirtazapine. My mood is still low and I have anxiety levels like I’ve never experienced before. My interpretation of my current condition is a slow worsening reaction to the Mirtazapine but I’ve never been in this place before so It’s difficult to interpret. My GP recently referred me to a consultant psychiatrist who in response (my interpretation) to my low mood and obvious distress from the anxiety has offered Quetiapine 25mg to run concurrently with the Mirtazapine. I have never had any kind of mental health diagnosis other than anxiety (GAD?) and mild to moderate depression. My continuing goal is to be drug free but I’m facing another difficult decision:

1. Do I start the Quetiapine 25mg and hope for some immediate psychological relief with a view to using it to get off Mirtazapine (this year?) This doesn’t appear to be a great choice as the Quetiapine can also produce withdrawal symptoms...

2. Just stay with the Mirtazapine but start a slow taper when I’m ready and stabilise when withdrawal symptoms start as per your guidelines?
I would appreciate any input at this time as I have little support from the medical profession here in the UK and even less for any taper program.

With thanks one again.

On Prozac 15mg from mid 90s to November 16 for low mood and anxiety.

2016 had enough of poor sleep, put on Mirtazapine 15mg. Sleep improved a lot.

Tried one very slow taper in 2018 (as per your guidelines) but at around 9mg sleep once again a big issue. Returned to higher dose.

2019/2020 increasing high anxiety and non-engagement with life.

Feb 15th 2021 put on Lexapro 10mg. Severe anxiety as a reaction to changing drugs, stopped Lexapro and returned to Mirtazapine 15mg to restabilise.

Anxiety affecting most areas of life now.

August 21 started 5% monthly taper off Mirtazapine 15mg: Aug 21, 14.3mg; Sep 21, 13.5mg; Oct 21, 12.8mg; Nov 21, 12.2mg; Dec 21, 11.6mg; Jan 22, 11.0mg.

January 22 stabilising at 11mg as WD symptoms started again. July 22 now at 8.2mg. 

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  • 1 year later...

Hello @Robineye

I was just reading your recent topic in the media forum and thought I'd stop by your thread to say hi. 

I see that you haven't posted here since over a year ago. In your last post you were soliciting input pertaining a possible tapering decision. 

Did you receive the guidance you were looking for? 

How are things today? 

Do you have the tapering support you need? 

Well wishes,

A.

1996-2018 - misc. polypharmacy, incl. SSRIs, SNRIs, neuroleptics, lithium, benzos, stimulants, antihistamines, etc. (approx. 30+ drugs)

2012-2018 - 10mg lexapro/escitalopram (20mg?)    Jan. 2018 - 10mg -> 5mg, then from 5mg -> 2.5mg, then 0mg  -->  July 2018 - 0mg

2017(?)-2020 - vyvanse/lisdexamfetamine 60-70mg    2020-2021 - 70mg down to 0mg  -->  July 2021 - 0mg

March-April 2021 - vortioxetine 5-10mg (approx. 7 weeks total; CT)  -->  April 28th, 2021 - 0mg

supplements: magnesium powder (dissolved in water) as needed throughout the day; 1 tsp fish oil w/ morning meal; 2mg melatonin 

August 1, 2022 - 1 mg melatonin

 

Courage is fear that has said its prayers.  - Karle Wilson Baker

love and justice are not two. without inner change, there can be no outer change; without collective change, no change matters.  - Rev. angel Kyodo williams

Holding multiple truths. Knowing that everyone has their own accurate view of the way things are.  - text on homemade banner at Afiya house

 

I am not a medical professional; this is not medical advice. 

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Hi Ariel,

It is very kind of you to be in touch and to ask how I’m doing, thank you.

I’m still on a very slow taper (after taking advice from this site) so 2.5% every two weeks and going longer between changes if I feel unstable. This process has given me a sense of control over my withdrawal that I’ve never had before. Combined with a relative stability around my worst withdrawal symptoms and a sleep pattern that often gives me enough energy to cope and to keep my head above water. I no longer fear a lack of sleep and the torture that this causes (fingers crossed). I think a bit of a breakthrough came when I read the Brassmonkey method and accepted I would be in this for the long haul.  I’m also starting to believe a little that maybe my neuro-system may recover, with patience and self-care.
I have sort support through a Jungian therapist (useful be not revelatory), I also joined a men’s spirituality group and was able to share many of my issues. These have not been ongoing though for various reasons. I have an interest in contemplative prayer so practice that most days (see Richard Rohr). I try to exercise daily. I try to share with family and friends but it’s difficult and my main issue currently is anxiety and the triggers that set it off and leave me very tortured and upset. The triggers come from interactions with family and friends, and are very distressing, hence I often avoid people. I also get very upset when people try to fix me…

 I did have anger issues as soon as I started mirtazapine and I’m hoping that this ever-present anxiety has some drug-based component which may or may not eventually subside with lower dosing (my hope anyway). The mirtazapine has little AD effect now so I also think I’m fairly depressed most of the time (feelings of dread on waking, no motivation for anything, a sense of despair close by). I generally feel mildly at the end of my patience with people and the world all the time (and I was never like this before). I still don’t know how to get help with feeling like this, nothing seems to affect it. (No professional medical help here I’m afraid).
I do feel positive about the withdrawal though, even though I know nothing is predictable. My big hope has been to attain a drug-free life (with fair sleep and no WD symptoms) and to at least know who I am again (even if that is in itself is still difficult). 
That’s probably enough for now…

Thanks again and very best wishes to you on your journey….

On Prozac 15mg from mid 90s to November 16 for low mood and anxiety.

2016 had enough of poor sleep, put on Mirtazapine 15mg. Sleep improved a lot.

Tried one very slow taper in 2018 (as per your guidelines) but at around 9mg sleep once again a big issue. Returned to higher dose.

2019/2020 increasing high anxiety and non-engagement with life.

Feb 15th 2021 put on Lexapro 10mg. Severe anxiety as a reaction to changing drugs, stopped Lexapro and returned to Mirtazapine 15mg to restabilise.

Anxiety affecting most areas of life now.

August 21 started 5% monthly taper off Mirtazapine 15mg: Aug 21, 14.3mg; Sep 21, 13.5mg; Oct 21, 12.8mg; Nov 21, 12.2mg; Dec 21, 11.6mg; Jan 22, 11.0mg.

January 22 stabilising at 11mg as WD symptoms started again. July 22 now at 8.2mg. 

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