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atimirt: Mirtazapine withdrawal help


atimirt

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Brief history: Prior to 2018 I was a healthy, happy, highly productive professional (31 then, 34 now). In March of that year, had a medical procedure that went wrong and got anxiety and panic attacks. Given ativan which proved impossible to get off of quickly only two weeks later. Hospitalized and put on remeron 22.5mg. Tapered slowly off Ativan over 2 years, ending in June 2020. Decided to start tapering mirt in August of 2020 using a liquid microtaper as I did for ativan. Dropped fairly quickly from 22.5->7.5 mg over 5 months. Then started final descent from 7.5mg on January 25 and hit somewhat disabling withdrawal symptoms on April 18th.

 

My withdrawal symptoms through the taper generally are malaise, head pressure, brain fog, fatigue, allergy symptoms, etc. that wax and wane in intensity with some good days scattered among mostly crappy days (for three years... feels the same as ativan withdrawal). Despite the speed, I actually started to feel better the lower that I got up until recently. My mind has been somewhat clearer, personality coming back, memory improving. Part of the reason I have been going so quickly is that I was eager to be off by July when I will be starting a new intense job and also I have had pretty bad dry eyes and dry mouth on this drug as a side effect even before tapering. Even during the taper from 7.5 I felt pretty okay until April 18 when I think I was exposed to a lot of pollen and other allergens. That is when things started to unravel. Intensification of all my withdrawal symptoms plus congestion, dizziness, etc. So I held my dose hoping it would resolve. Then on March 30, I started to have pretty bad insomnia which has been up and down since then. Often not falling asleep until 5 am with some nights where I sleep generally okay. With the insomnia has also come bad physical anxiety and now somewhat depressed and despairing. I updosed to 2mg on maybe 5/10, but didn't write it down so I don't remember the exact date. At this point I am really struggling and considering a further updose and would like some advice about how much to updose if I do so, and at what pace. Should I titrate up or just reinstate a dose? Seems like titrating up would be safer, but I don't see that talked about much here so unsure of the experience.

 

Any advice from those experienced with this would be helpful. I am nearing my wits end and feel like I have no hope for recovery. 


Thank you,

Steve

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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I should add that I am not taking any other medications or supplements currently. I tried antihistamines (unisom and hydroxyzine) a few times, but they didn't really help and I don't want to keep using them for obvious reasons. Melatonin I took three times, and all three times I felt awful. Could be correlation, but I am reluctant to keep using for the time being. I am also attempting meditation to calm my anxiety and starting CBT-i in two weeks. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator Emeritus

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  Congratulations on successfully getting off of the Ativan!  This is a major accomplishment.  I'm sorry you are having to deal with all this, all because of a medical procedure.  Thank you for supplying your drug signature.  

 

Your symptoms sound like classic psych med withdrawal.  I would like to reassure you that you have every hope of getting better.  You are young, intelligent, and have not been on the drugs that long.  Many of us here are older, and were on the drugs for decades, and have recovered.  Go to the main page of the forum and read some of the success stories, after you read this post.  Recovery is a long, slow process, because the brain is so complex.  

 

On 5/20/2021 at 8:02 PM, atimirt said:

Despite the speed, I actually started to feel better the lower that I got up until recently.

I'm very glad to hear this.  It shows the mirtazapine did not agree with you, and you are healing. 

 

Here is some information about how these drugs actually work.  

 

How Psychiatric Drugs Remodel Your Brain

 

This helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Withdrawal Syndrome?

 

Tapering is best done extremely slowly, and we taper by 10% of the current dose, so that the taper becomes exponentially smaller.  It could be that since you were tapering faster than this, your nervous system could not keep up, and became destabilized.  No worries, this will resolve itself in time. 

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Mirtazapine

 

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important. 

 

Considerations About Stability Stop Jumping Around

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

Windows and Waves Pattern of Stabilization

 

Here are some techniques to cope with symptoms: 

 

Withdrawal Insomnia

 

 

Audio:  First Aid for Panic (4 minutes)
 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

 

Magnesium

 

Omega 3 Fish Oil

 

When you updosed from 1.68 to 2 mg, did you feel better, worse, or the same overall?  I need to know, so we can suggest whether or not you should updose further.  

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

Edited by getofflex

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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  • getofflex changed the title to atimirt: Mirtazapine withdrawal help

Hi Getofflex,

 

Thank you very much for your response. 

 

I agree that the fact that I’ve felt better overall the lower that I’ve gotta is encouraging. I have been around this site and BB since the beginning of my journey in 2018, so am quite familiar with psych drug tapering and withdrawal and the recommendation for 10% per month. I thought that since I was able to handle the taper from 22.5 to 7.5 at a relatively rapid rate despite discomfort that I might be able to continue at a higher-than-recommended rate further down. Or at least I figured that if things got worse I could hold and get better even at this rapid rate. I was hopeful that I would be one of the luckier ones, but now it seems that I may have flown too close to the sun. 

 

When I updosed to 2mg, I think that I did feel slightly better for a short time, but it certainly didn’t last. Some of my symptoms have improved, particularly the allergy-type symptoms like congestion. I have been following a very strict low histamine diet since the downturn so maybe that is helping those symptoms. Also, to clarify, in my introduction it says that the insomnia started on March 30. In fact is was April 30, so it has been about three weeks. To be honest, I don’t even really mind the insomnia THAT much… it is frustrating, but I generally still get 3-4 hours (usually falling asleep at 5 am) and some days more. Often it feels as if I feel worse on the days that I get more sleep for some reason that is unclear to me. I am able to lay in bed and mostly relax, do meditation, and get physical rest even if my mind won’t turn off entirely to fall asleep. In a way, I enjoy not feeling so sedated as I have for the past three years. BUT, the physical symptoms that come along for the ride  (malaise, muscle tension, hypnic jerks) and mental symptoms (anxiety and I guess now more depression) are becoming quite unbearable and I am not functioning. It honestly feels like I have been poisoned. 

 

So, that brings me to the question of updosing further. What do you think based on what I wrote? I don’t have a very clear picture of the pace of my withdrawal symptoms because I have never done cut and hold to see when they typically hit. I just taper daily aside from the month of January that I was recovering from the first part of the taper. My thinking is that maybe I should go back to the dose I was at a month before April 18 (D day) which would be 3.75mg. I was tapering ~0.5mg per week so I think that’s where I was a month before (which would have been a 50% drop over the month — no bueno). What do you think about this option? Would you recommend to try to stay lower? Would you reinstate it or titrate up? Any insight would be appreciated. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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Also, for the first time ever, I accidentally updosed last night to approximately 3.2 mg (took an extra mg). I didn't sleep well, but I did feel better today. Not great, but better. Still trying to figure out how much I should aim for with the permanent updose to stabilize. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

Link to comment

Sorry to keep posting, but I am desperate for some guidance. Afraid to go too high and fry my brain, afraid of not doing anything and fry my brain as well.  

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

Link to comment
  • Moderator Emeritus
23 hours ago, atimirt said:

I thought that since I was able to handle the taper from 22.5 to 7.5 at a relatively rapid rate despite discomfort that I might be able to continue at a higher-than-recommended rate further down

Not necessarily.  For one thing, tapering rapidly tends to sensitive the nervous system, and make it have a harder time handling subsequent tapering.  Also, there is a high occupancy rate even at the lower doses.  This link explains it well: 

 

SERT Transporter Occupancy Studies

23 hours ago, atimirt said:

When I updosed to 2mg, I think that I did feel slightly better for a short time, but it certainly didn’t last.

 

So, would you say after you stopped feeling better, did you feel about the same as before the reinstatement to 2.0, or worse overall?  I need to know this, so I can properly advise you whether to updose further or not. 

23 hours ago, atimirt said:

So, that brings me to the question of updosing further. What do you think based on what I wrote?

It's hard for me to say, because I'm not sure if the last reinstatement helped you or not.

 

23 hours ago, atimirt said:

I don’t have a very clear picture of the pace of my withdrawal symptoms because I have never done cut and hold to see when they typically hit. I just taper daily aside from the month of January that I was recovering from the first part of the taper.

This is why we suggest you hold for at least a month after you taper.  It is important to taper very slowly and carefully.  

 

23 hours ago, atimirt said:

My thinking is that maybe I should go back to the dose I was at a month before April 18 (D day) which would be 3.75mg. I was tapering ~0.5mg per week so I think that’s where I was a month before (which would have been a 50% drop over the month — no bueno).

Please reread this link carefully:   Considerations About Stability Stop Jumping Around. The more you keep changing your dose and not giving your nervous system time to heal and stabilize, the more likely it is you could make yourself even worse.  As you can see in your quote, you were tapering every week, while we suggest staying on the same dose for at least 4 weeks. 

 

Please also read this: 

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

For now, my suggestion is to stay on the dose you are currently on, until I get a feel for if the prior reinstatement from 1.68 to 2.00 helped you, hurt you, or did neither. 

Edited by getofflex

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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21 minutes ago, getofflex said:

So, would you say after you stopped feeling better, did you feel about the same as before the reinstatement to 2.0, or worse overall?  I need to know this, so I can properly advise you whether to updose further or not.

@getofflex It is hard to say for sure. My symptoms sort of changed over the month and as I got less and less sleep, my anxiety and negative thoughts increased. But it didn't make me feel markedly worse as if I was reacting negatively to the slight updose I don't think. It didn't make me feel significantly better either. So I can't say with any certainty what the effect was from 1.68 to 2. I took 3.2mg again last night since if made me feel somewhat better yesterday. I didn't feel too well after dosing it, but I did end up sleeping relatively okay. Do you think the jump from 2 to 3.2mg will be too much too handle? I was sort of going off what Wulfgar has written about updosing helping their insomnia after a month or so of it not resolving. I just feel stuck right now and not sure what to do. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator Emeritus

If I were you, I would stay on my current dose, and use non drug coping skills to deal with the symptoms.  Reinstatement is a crap shoot as it is.  Once our systems are dysregulated, things are pretty unpredictable.  A reinstatement may help, but it may also make things worse.  One thing I do know - that TIME is the great healer of a nervous system messed up from psych drugs.  

2 minutes ago, atimirt said:

it didn't make me feel markedly worse as if I was reacting negatively to the slight updose I don't think.

That's good to know.  

 

3 minutes ago, atimirt said:

 I took 3.2mg again last night since if made me feel somewhat better yesterday.

I don't suggest this.  As I said jumping around on our dose is not a good idea.  It can make things worse for you.  If you read the links I supplied in my first post, you will understand why.   

7 minutes ago, atimirt said:

Do you think the jump from 2 to 3.2mg will be too much too handle?

Personally, I do not suggest this.   

 

Please go back to my initial post, and read carefully the links I have supplied you.  You are jumping around on your drugs, and this is likely to further destabilize and make your symptoms worse. 

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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But what if I continue to get worse at 2mg, @getofflex? It was becoming unbearable and I have been non-functional. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator

The more you jump around with your dose the more unbearable things will get. Right now your body is screaming out for stability and every time you change your dose you are resetting the clock. Best advise for now is pick a dose and stick with it for many months until things stabilize.

 

Looking at your signature I cans see that you have tapered much too fast by going from 22.5mg to 1.68mg in less than a year. This will leave your body in a very unstable condition and cause a lot of very acute symptoms. You could try to updose, but it would be very risky. Because of the fast taper and all the dose switching your body is highly sensitized to changes and doing an updose will quite likely cause "kindling", and you really, really don't want to go there.

 

What ever dose you chose 1.68, 2, 3.2 isn't going to make a whole lot of difference. If you felt better on a specific one then go with that. The trick is to not change that dose until your body stabilized and your symptoms start to resolve.  This is going to take a frustratingly long time, but it will happen. Once stable then it will be possible to start to taper again following the guidelines that we have suggested. Until them read, reread and learn to use the nondrug coping methods that are discussed through out the site.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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  • Moderator Emeritus

Well said, @brassmonkey.  

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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  • Administrator

If you feel better at 3.2mg, I would continue to take 3.2mg at the same time each night for at least a couple of months. Let your nervous system settle down before you taper off the last bit.

 

It will take at least a couple of weeks for a mirtazapine change to take full effect. If after a couple of week you feel 3.2mg is too high, you might reduce it slightly.

 

Please do not jump around on your drugs.

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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Thank you @brassmonkey, @Altostrata, and @getofflex. I appreciate all of your time and input to help me with this withdrawal. 

 

I certainly realize that I tapered too fast -- it was a mistake, particularly at these low doses. I intend to hold for a long time until I stabilize before attempting to withdraw any further. I just feel like staying at the 1.68mg to stabilize is be untenable as I have not been sleeping and I can't really function like that. I have been encouraged by some others' stories of updose or reinstatement being successful (Wulfgar, @Bayboy, @ten0275). Though, I realize that my system is highly sensitive due to the rapid taper and I need to be careful. How does one balance the need for relief with the hope to stabilize and taper slower in the future with the risk of "kindling" or worsening withdrawal symptoms? This is the question that I have been struggling to answer.

 

Alto, how will I know if 3.2 mg is too high?

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Administrator
2 minutes ago, atimirt said:

Alto, how will I know if 3.2 mg is too high?

 

You'll have to observe the effect for 2 weeks or so. It may be fine.

 

Please let us know how you're doing.

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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May 21st (first night at 3.2mg): Slept poorly, 5am - 9:45 am, felt okay the next day

May 22nd (3.2mg): Slept decent, 1:30 am - 9:30am, felt okay most of the day until evening time, head pressure, malaise

May 23rd (3.2mg): Took my dose at the regular time, 10pm, and actually felt... well. During my of my taper I always looked forward to taking the remeron because even if I felt bad during the day, it would ease my symptoms at night. That hasn't been the case since the rapid taper and sometimes it even made me feel worse. But last night I felt pretty good. Unfortunately, I only slept an hour (1-2) and then 2.5 hours (6-830), woke up feeling bad with muscles feeling keyed up like electricity running through them. Not feeling well so far today. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator Emeritus

I'm glad you were feeling better on May 21 through the 23.  Just remember that we go through windows and waves.  Recovery is non linear, and it can seem like we are going backwards when we hit a wave.  It is frustrating and discouraging.  The important thing is to bite the bullet, and try to deal with the discomfort using non drug coping techniques.  Hang in there - this is a difficult process, but it will not go on forever, and will gradually improve with time.  

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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Is it possible to recover from this? I am feeling very despairing about what I've done to myself in my haste. Seems like many on this site that did similar are no longer around... 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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You’re going to be okay. You’re brains had a bit of a kicking - it’s nervous system disruption, same thing everyone in the success stories has experienced. Give it time and it’ll settle down. It might take lots of time, or it might not, but it will get better.

25/8/2020 - 15/9/2020 - 15mg mirtazapine

16/9/2020 - 30mg mirtazapine

17/9/2020 - 22/9/2020 - 7.5 mg mirtazapine

23/9/2020 - 6/10/2020 - 3.75mg mirtazapine

7/10/2020 - 15/10/2020 - 7.5 mg mirtazapine

16/10/2020 - 20/10/2020 - 15 mg mirtazapine

21/10/2020 - 22/10/2020 - 7.5 mg mirtazapine

23/10/202 - 26/11/2020 - 15 mg mirtazapine

27/11/2020 - 10/12/2020 -13.5 mg mirtazapine

11/12/2020 - 17/12/2020 - 12 mg mirtazapine

18/12/2020 - 26/12/2020 - 11.75 mg mirtazapine

 

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  • Moderator Emeritus

@atimirt


Thanks for the message. I am in agreement with all the admins/mods who have given their input here.


Personally, were I in your shoes right now, I'd hold at that 3.2mg for the foreseeable future and use any coping mechanisms you can until you stabilize. As Alto noted, it's going to take you a couple weeks to really feel any consistent stabilizing on your current dose. The fact that you noted you felt some stabilization after your dose on the evening of May 23rd is promising. You're at a dose of Mirt (3.2mg) that should offer you some anxiolytic action.


When the symptoms start dealing on you, it's hard to rebuff that knee-jerk reaction to "change something." But you need to abstain from making any more changes. As others noted here, your nervous system is seeking stability so every time you make a change, it's getting rather frustrated with you and letting you know it with the symptoms you feel. If you look at my signature, you'll see how long it took me to taper from Mirtazapine. There were times when I held for upwards of a half a year at a single dose. I don't regret it.

 

Trust that I went through a period as well when I didn't follow that wisdom of no, or even slow, change. And I suffered the results of that. As humans, we are often impulsive and think that "if I only change this or that, it will make all the difference." And that isn't always the case. It's like a child when they get lost in a crowd of people. The impulse is to run around frantically looking for their parents or guardians when often, the best thing they can do is just sit down in the chaos and wait to be found.


Anyway, those are my two cents thrown into the collective knowledge bank on what you are dealing with. My sense is that if you hang out awhile at the 3.2mg, you're going to see some improvement. No guarantees of course, but that seems to be a pattern for people - and it certainly proved true for me.


Hang in there,

Dave

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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Thanks all. Really appreciate the support from this community.

 

One question regarding stabilization at this dose... how long am I supposed to weather the insomnia? I know some people are more sensitive to it than others. I really don't seem to handle it well at all. Last night I got only 2 hours of broken sleep and feel miserable as a result. I am employing all of the techniques suggested to get sleep, but curious as to what I am supposed to do if I continue to not sleep? I fear that it will also have a destabilizing effect, no? 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator Emeritus

@atimirt

 

 

I've found this post about sleep by apace41, a moderator here and a true veteran of the sleep wars, helpful.  I hope you'll find it helpful too.

 

There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  

 

So, what do you do?  In no particular order, some of the things to try:

 

  • Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
  • Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
  • Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
  • Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
  • Use lavender essential oils in a diffuser at bedtime
  • Exercise early in the day so that you aren't activated near bedtime
  • Get outside and get some sunlight early in the day so that your rhythms are reestablished
  • Make sure you have a consistent bedtime 
  • Try not to be too activated in the couple of hours before bed and, of course, no caffeine
  • Add a meditation practice
  • Try yoga
  • Go for walks in nature
Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

 

 

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 of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

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

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Feb. 22: 7.6mg

Taper is 90% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotics, zinc, melatonin .3mg, anti-candida, iron, serrapeptase, nattokinase


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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May 24th: only slept ~3 hours, but don't feel as bad as yesterday

May 25th: 2-3 hours... part of the reason I am not sleeping is eczema. Itchy, painful, worried that it is infected. Worried to put anything on it that might worse my symptoms :(.

Today: Slept poorly, almost fell asleep but something sparked my mind and kept me up last night. Slept from 6-9:15. Feel very tired today, but not much anxiety or physical symptoms. Feels llke I am too tired to have anxiety or something. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Administrator

Does the itching get better or worse after you take mirtazapine? Did the itching start when you started mirtazapine?

 

Are you taking anything else to which you might be allergic?

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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Hmm, well it is worse at night and I take mirtazapine at night, but eczema in general is known to be worse at night. 

 

I started developing the rash back in December (after being on mirt for 2.5 year) and it has been there since. I haven't used anything except moisturizers on it, mostly vaseline. Doctor says it is nummular eczema. Currently trialing bleach baths in case it is infected. Been getting worse lately. 

 

I do not take anything else. My diet is pretty strict low histamine, not sure if I am allergic to anything that I'm eating. I cut out gluten and dairy a couple weeks ago -- no effect yet. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Administrator

In December, you had reduced mirtazapine by 2/3. Did you have withdrawal symptoms then?

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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Yes I did. Held for a month, not severe like this though. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Administrator

Did you ever have this kind of itchy rash before? Have you started using unscented laundry detergent, hypoallergenic soap, etc.?

 

Some people develop itchy rashes when they also have withdrawal symptoms. We don't know why this is, it could be a hypersensitivity caused by upset of withdrawal. It's also possible you have become allergic to mirtazapine. Are you taking any other drugs?

 

Or, you could have coincidentally developed eczema.


 

 

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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I never had a rash like this before, no. I have had one or two instances of possible eczema that went away quickly with a moisturizer, but nothing like this. I do use unscented detergent, hypoallergenic soap, etc. 

 

I do suspect that it is likely related to mirtazapine's mechanism of action and withdrawal rather than an allergy to the mirtazapine itself, though, I suppose that is possible. Could be one of the binders in the mirtazapine as well. I guess one would expect that the symptoms would get better the lower I get and while that is true for some of the symptoms it isn't true for this. I think that the antihistamine properties of mirtazapine have exacerbated either mild allergies that I had previously or have lead to new ones. We got a dog that we had to rehome, for example, because I turned out to be allergic after never experiencing allergies to dogs that I can recall. I do not take any other drugs at all. I am extremely careful about what I put on my skin or what I take. Currently exploring possible food causes, but it has been a challenge while I attempt the already restrictive low-histamine diet. 

 

 

 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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Hi Aitmirt

 

I developed awful rashes from Mirtazapine as well.  They were in my armpits and showed up about two months into starting the drug.  They were bright red, covered my entire armpit, and were so incredibly itchy that i was nearly scratching myself until i bled.   I had the same thoughts you did about them possibly being from the binder used, or else the anti-histamine qualities of the drug.  I had gone into urgent care and saw a young doctor who said it was "doubtful" that it was from the Mirtazapine, even though i told her when i stopped the drug for a couple of days, the rashes would go away, even though so would my sleep.  She insisted, asking me if i had changed laundry detergents or was showering with new soap, and i had to tell her i don't use laundry detergent (just hot water) and hardly ever showered and was using the same natural soap i always use when i did and told her to go and google Mirtazapine and rashes and she left the office for moment and when she came back had said "well, it could be from the Mirtazapine."  🙄   I actually saw two doctors who denied mirtazapine was causing the rashes, of course, the redness went away as soon as i quit the drug, but then i was in mirtazapine withdrawal which is particularly awful with nausea and headaches that never seem to go away due to the poor sleep quality once quitting the drug. 

 

Poetjester   

Court committed to take Prozac, Paxci, and Respiradol from 8/95 to 3/96.   developed severe akithisia and brain damage.  Was unable to speak and walking in circles 15 hours a day.  Went in for 5 sessions of ECT during a 10 day period in March of '96 and my forced medication was discontinued at that time.  My akithisia and brain damage cleared up within a few days of stopping the meds.

 

On Zoloft (200 mg) and Zyprexa (17.5 mg) March 1998- Feb 2014

In between was placed on Effexor 200 mg and Abilify for six months in 2004.  Developed mild akithisia which went away once I stopped the Abilify.  Developed severe GI issues in Dec 2001 and from that time on suffered from fatigue and hypersomnia where I would sleep between 12 and 20 hours a day and rarely ever left my apartment. 

 

Had tapered to 100 mg of Zoloft and 7.5 mg of Zyprexa at the time of going cold turkey Feb. 2014

Went 5 days without sleep at the beginning while vomiting all over my apt.  Had brain zaps for a number of weeks and also lightheadedness which both eventually went away.  However 2 1/2 yrs later I still struggle with insomnia, depression, and fatigue.

 

 

 

 

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  • Moderator Emeritus

@atimirtI have issues with eczema and itching on my face, and I use a cortisone cream which helps quite a bit.  CVS has one that contains 1% hydrocortisone.  I would not suggest skipping doses of your mirtazapine, as that can confuse your nervous system and cause many other significant withdrawal symptoms.  How are your other symptoms at this time? 

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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  • Administrator

If the rashes are an allergic reaction to mirtazapine, it's not good for you to continue to take it. But only @atimirt can decide where the rashes come from.

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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I am doing relatively okay these days. Sleep has been much more consistent with some off days. Still working on my diet to get the histamine down and trying to cut out grains and other things that might be influencing my eczema. This is a struggle, though, because it limits what I can eat and as a result I am probably losing weight which isn't good for a guy with my build. Anxiety is definitely better, but not gone completely. 

 

Regarding the rash... it was definitely infected and when I started treating it with a topical antibiotic (mupirocin), it calmed down significantly. If the mirtazapine is the cause of the rash, it would seem odd to appear after 2.5 years on the drug and get worse when I lower the dose... that doesn't exactly make logical sense, but I suppose it is possible. Many allergens can appear after years of exposure so who knows. The type of eczema that I apparently have (nummular eczema) is often caused by an environmental trigger so I am looking into patch testing. 

 

If not directly a result of the mirtazapine, I do believe it is related to withdrawal. The immune system seems to get thrown out of kilter in withdrawal so it wouldn't at all surprise me if this was related to that dysfunction. Would getting off of it entirely help? Couldn't say for sure, but I don't think I could handle tapering off of it entirely based on the symptoms that I have experienced for the past 6 weeks that are finally improving back to a more manageable baseline (albeit one with eczema :( ). My vitamin D was 17 ng/ml so I am working on supplementing that as well (I know -- not too fast!). 

 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator Emeritus

It sounds like overall you are doing well for someone in AD WD.  I'm glad the antibiotic helped the rash.  Let me know if you try the cortisone cream, and if it helps.  

 

I'm very glad to hear that your symptoms have settled down to a more manageable level.  

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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Hi @getofflex, I am doing well overall, but this eczema is making me really stressed out. It itches like crazy and the infection is back despite the current topical antibiotics so I have to try other strategies. I have been very reluctant to use anything with steroids because I have read stories of people getting significant setbacks even from topicals. Sounds like you have done fine with it? Have you had any issues at all with hydrocortisone? I am getting a little desperate. My doctor gave me protopic to use which is a non-steroidal, but I can't use it until after the infection clears. 

lorazepam:

3/2018 - 6/2020

tapered from a short course of 1 mg over two years

Stopped June 2020

It sucked, but I did it 

 

Mirtazapine: 4/2018 - current

22.5mg until August 2020 when I began taper using daily liquid taper.

22.5mg->7.5 mg from 8/4/2020 - 12/25/2020 (66%)

7.5mg -> 1.68mg 1/25/2021 - 4/18/2021 (~75%)

Slight updose to 2mg ~5/10/2021

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  • Moderator Emeritus
On 6/6/2021 at 1:40 AM, atimirt said:

I am doing relatively okay these days. Sleep has been much more consistent with some off days. Still working on my diet to get the histamine down and trying to cut out grains and other things that might be influencing my eczema. This is a struggle, though, because it limits what I can eat and as a result I am probably losing weight which isn't good for a guy with my build. Anxiety is definitely better, but not gone completely. 

 

Regarding the rash... it was definitely infected and when I started treating it with a topical antibiotic (mupirocin), it calmed down significantly. If the mirtazapine is the cause of the rash, it would seem odd to appear after 2.5 years on the drug and get worse when I lower the dose... that doesn't exactly make logical sense, but I suppose it is possible. Many allergens can appear after years of exposure so who knows. The type of eczema that I apparently have (nummular eczema) is often caused by an environmental trigger so I am looking into patch testing. 

 

If not directly a result of the mirtazapine, I do believe it is related to withdrawal. The immune system seems to get thrown out of kilter in withdrawal so it wouldn't at all surprise me if this was related to that dysfunction. Would getting off of it entirely help? Couldn't say for sure, but I don't think I could handle tapering off of it entirely based on the symptoms that I have experienced for the past 6 weeks that are finally improving back to a more manageable baseline (albeit one with eczema :( ). My vitamin D was 17 ng/ml so I am working on supplementing that as well (I know -- not too fast!). 

 

Hi Atimirt

I am reading your topic and i really can relate with your situation. I used to have eczemas too during my withdrawal or rashes in my skin which required scratching and risked getting infected.

Now to explain the main reasons behind that, as you might now Mirtazapine in itself is a giant antihistaminic. So as you go on lowering it, you will not only have wd effects related to your brain but also related to the allergies. As your body get accustomed with a high amount of antihistaminic med in your system when you lower it very fast you become prone to allergies. That is the main reason of your eczema. Now in order to minimize the alergic effects while you drop you need to control your diet as well. So you does not need to consume foods which have high levels of histamine otherwise you will have problems. Try to stay put on your dose for now and monitor the symptoms on your body. Very soon the alergies will clear and you can go on to taper slowly. You can read my topic for a reference and i also have a success story of my own in the success stories sections. You will make it my friend.

All the best

Santino

2015 -  2016 Xanax only rescue doses of 0.125 mg 1-2 times per month
 March 2016 0.125Mg * 2 Xanax for 10 days.

20 March 2016 0.25 Mg * 2 Xanax for one week. 1 April 2016 Tranxene 5 mg and Fevarin but bad reaction for 5 days.4 April 2016 25 Mg Amitryptiline + 6 MG bromazepam at night

Started tapering Bromazepam 6 days later reached up to 3 MG in 10 days and withdrawal. Pdoc asked to go 6 MG again.

10 of May started Remeron 15 MG and started tapering Bromazepam again.

SINCE 09/06/2016 BENZO FREE - Started Tapering Remeron 04/07/2016

 

04/Jul/16 12.8 Mg, 11/Aug/16 12 Mg, 20/Aug/16 11Mg, 3/Sept/16 10Mg, 11/Sept/16 9 Mg, 30/Sept/16 8.1 Mg, 14/Oct/16 7.25 Mg, 17/Nov/16 6.7, 23/Nov/16 6.5, 2/Dec/16 6.25, 9/Dec/16 6Mg, 25/Dec/16 5.7Mg, 4/Jan/17 5.4Mg, 20/Jan/17 5.2Mg, 07/Feb/17 5 Mg, 15/Feb/17 4.8Mg, 27/Feb/17 4.5Mg, 15/Mar/17 4.2Mg, 23/Mar/17 4Mg, 1/Apr/17 3.7Mg, 14/Apr/17 3.4Mg, 27/Apr/17 3.1Mg, 06/May/17 2.8Mg, 22/May/17 2.6Mg, 31/May/17 2.3Mg 09/Jun/17 2Mg, 20/Jun/17 1.7Mg, 29/Jun/17 1.4Mg, 11/Jul/17 1.2Mg, 20/Jul/17 1Mg, 31/Jul/17 0.8Mg, 11/Aug/17 0.6Mg, 23/Aug/17 0.5Mg, 05/Sept/17 0.4Mg, 13/Sept/17 0.3Mg. 22/Sept/17 0.2Mg, 03/Oct/17 0.15Mg, 10/Oct/17 0.1Mg, 23/Oct/17 0.05Mg, 22/Nov/17 0.025Mg, 06/DECEMBER/2017 MIRT FREEE.

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