SenatorBirch: Possible Remeron withdrawal

[SenatorBirch]

Thanks Shep.  I will try the micro-taper (2.5%/wk).  Starting from 3.75Mg though, I can only do about 6 or 7 reductions before it goes beyond the scale precision.  After that, I guess each reduction has to be 1Mg.   We'll just have to play it by ear.  I'll check into compounding, or liquid.  There ARE pharmacies here that advertise as compounding pharmacies.

 

The taper order (Remeron/Effexor) is more problematic though.  

We're pretty certain Remeron magnifies the effect of his sleep disorder - since starting Remeron several years ago, he has multiple vivid suffocation dreams EVERY SINGLE NIGHT.  Since the event in Dec 2020, this is MUCH worse, and wreaks havoc on his mental state.  (He DOES, in fact, suffocate every night.  But there was a time he was not aware of it.  He would not get restful sleep, but nor did he get consciously traumatizing sleep.  With Remeron, he does).  He is hoping that that might subside with a lowering and/or eventual elimination of Remeron.  His mental health absolutely won't survive the time required to get off Effexor first.  Again ... we're going to have to play it by ear.  And try to work on the sleep disorder, but that is a whole other battle.

 

Thanks again

[ChessieCat]

3 hours ago, SenatorBirch said:

There ARE pharmacies here that advertise as compounding pharmacies.

 

Get quotes before committing yourself.  In Australia the prices can vary by a large amount.

 

And you might need to get a special prescription written by the doctor.

[Faure]

Mirtazepine does give me vivid dreams too. Definitely a side effect of it. 
 

I believe compounding pharmacies are allowed a 10% or so variance in pill weight so watch out as this will cause havoc. Brass Monkey got all the way to zero with his scale. I’m planning to do the same. 

[Shep]

On 4/30/2022 at 7:40 PM, SenatorBirch said:

I will try the micro-taper (2.5%/wk).  Starting from 3.75Mg though, I can only do about 6 or 7 reductions before it goes beyond the scale precision.  After that, I guess each reduction has to be 1Mg. 

 

This is how Brassmonkey described how he had to get the tiny doses using the scale method at the end of his taper off of Paxil:

 

  

On 11/13/2017 at 2:35 PM, brassmonkey said:

I won't say that using a scale to taper is the method of choice around here, but quite a few members are doing it that way.  Gridley is correct, I used the Gemini-20 for my entire taper.  It does have some trouble at the very bottom of the range around 4mgpw so to get the last few drops I used the visual method of dividing a known amount into equal piles. Using the scales is the most accurate while being the least "scientific" method you can use.

 

So your son may need to eyeball the last bit of the drug and visually divide it.

[SenatorBirch]

My son began a taper of Mirtazapine last year, from 3.75 mg.  He used the slow taper method (the brass monkey slide method, if I'm recalling that correctly). He stopped the taper for many months. 

Recently he dropped to 1mg, and then about a month or so ago he went to 0.5mg.

 

He thinks that since the drop to 0.5, he may be having withdrawal symptoms. It is hard to know for sure because he has several health issues that make it all murky. Also, I unwisely stopped keeping detailed notes for the last couple of reductions. 

 

He is holding there for now.

 

I know from reading the forums here that pretty much anything is possible! It varies from one person to the next.  But it is a pretty small dose.  That said, I realize it was a 50% decrease. I may look into preparing a suspension so we can taper more finely from this point. 

 

I am just wondering though, if anyone else has seen withdrawal symptoms at this low a dose? Especially with this particular drug. 

 

Thanks. 

[Emonda]

Welcome back, @SenatorBirch. 

 

I've just moved your new post back here to your original thread. It's best to keep everything relating to yourself in one spot so we can track your son's progress and see what others have advised.

 

5 hours ago, SenatorBirch said:

Recently he dropped to 1mg, and then about a month or so ago he went to 0.5mg.

 

He thinks that since the drop to 0.5, he may be having withdrawal symptoms.

 

I haven't taken this particular AD; however, I'd be surprised if he didn't experience WD with this sort of reduction.

 

5 hours ago, SenatorBirch said:

I realize it was a 50% decrease. I may look into preparing a suspension so we can taper more finely from this point. 

 

Yep, it's strongly advised to taper no more than the maximum 10% possible. Obviously, at lower doses, this becomes harder. Is he using liquid or tablet form these days?

 

5 hours ago, SenatorBirch said:

But it is a pretty small dose. 

 

Some of these medications are incredibly powerful. I've read of others at much, much smaller doses, experiencing unpleasant WD Symptoms.

 

Could you please update your signature to show the date your son dropped to 1mg and then 0.5mg?

 

Emonda