Krisz1977: Cipralex 10 mg 9 years

[Altostrata]

11 hours ago, Krisz1977 said:

am 9 hours sanax 0.25 benzodizaepim am 15 hours sanax 0.25 benzodizaepim am 21 hours sanax 0.25 benzodiazepim am 23 mirtazapine 30 mg.

 

Is this your drug schedule?

 

9:00 a.m. 0.25mg alprazolam

3:00 p.m. 0.25mg alprazolam

9:00 p.m. 0.25mg alprazolam

11:00 p.m. 30mg mirtazapine

 

What is your work schedule, with the times o'clock, such as 6:00 p.m. to 1:00 a.m.?

 

I have repeatedly requested that you use the pharmaceutical names, such as alprazolam, to refer to your drugs. Please use the pharmaceutical names.

 

Please read my questions carefully and answer them fully. Please answer these questions:

 

On 8/2/2021 at 7:02 PM, Altostrata said:

If you mean reinstate escitalopram, which symptoms do you think would be helped? What is adagon?

 

 

 

Your daytime dopiness is not a withdrawal symptom from escitalopram, it's because you're taking a high dose of alprazolam and add mirtazapine at night. What is it you expect to accomplish by taking escitalopram again? If it caused your stomach problems before, it will cause your stomach problems again.

 

This is a site for going off drugs, but it appears to me your interest is in adding escitalopram to your current cocktail. We cannot counsel you abou that. You can, of course, take any combination of drugs you wish. You don't have to ask permission for that here.

[Krisz1977]

On 8/3/2021 at 4:02 AM, Altostrata said:

What do you mean by "reset the cipralex"? I don't understand the question.

 

If you mean reinstate escitalopram, which symptoms do you think would be helped? What is adagon?

 

What times o'clock do you take each of your drugs, with their dosages? When do you work? When do you go to bed?

Hi! I would like some help on how many days per day I can safely reduce my mirtazapine antidepressant. I found some things about this in a magazine but I just don't understand. And I don't know how many days a day I should safely reduce it.

 

In the 636 who discontinued their antidepressant medication, there was a significant random effect of medication in the model of number of tapering days (F = 2.67, p = 0.007). Compared to the reference category of paroxetine, all medications took less days to taper (from -78 days to -13 days), with the exception of mirtazapine (+21 days). However, none of the direct comparisons with paroxetine was statistically significant.

 

What do they mean by +21 days for mirtazapine compared to 21 days. Or can 21 days be reduced little by little?

 

How many daily reductions would you recommend? Thanks for your help.

[Altostrata]

Have you read this? Tips for tapering off mirtazapine (Remeron)

 

I don't know what paper you're quoting from, but the section you quoted is not relevant to your situation. One of the problems in tapering mirtazapine is that if you go too fast, you may get rebound insomnia. You will not want to taper so fast as to get this withdrawal symptom. 

 

You will have to answer questions from the staff in order to get detailed guidance from the staff.

[Krisz1977]

7 hours ago, Altostrata said:

Have you read this? Tips for tapering off mirtazapine (Remeron)

 

I don't know what paper you're quoting from, but the section you quoted is not relevant to your situation. One of the problems in tapering mirtazapine is that if you go too fast, you may get rebound insomnia. You will not want to taper so fast as to get this withdrawal symptom. 

 

You will have to answer questions from the staff in order to get detailed guidance from the staff.

Hi! I don't want to move quickly with the downsizing. However, I would like to ask what percentage reduction and how many days of reduction is ideal for mirtazapine? For mirtazapine, can I also use the Brassmonkey method to progress with the reduction? 2.5% per week for 4 weeks, then a 2 week break? Is this ideal? Thank you very much.

[brassmonkey]

It would be a good place to start. We have a number of members who are tapering Mirtazapine using the Brassmonkey Slide. 

[Krisz1977]

12 hours ago, brassmonkey said:

It would be a good place to start. We have a number of members who are tapering Mirtazapine using the Brassmonkey Slide. 

Hi brassmonkey! Thank you very much for developing this method. I looked at the mirtazapine stories. And many people can't decide whether to put mirtazapine or alprazolam down first. Because of the properties of mirtazapine. Do you think the method and pace that you have worked out would be a way to go down both mirtazapine and alprazolam at the same time? I am currently reducing alprazolam by titration every 7 days at 3%. If I were to reduce mirtazapine by 2% every 7 days for 4 weeks in addition to this. Then 2 weeks of maintenance. Could this work at the same time? Thank you for your answer!

[Krisz1977]

On 8/4/2021 at 11:44 PM, Altostrata said:

 

Is this your drug schedule?

 

9:00 a.m. 0.25mg alprazolam

3:00 p.m. 0.25mg alprazolam

9:00 p.m. 0.25mg alprazolam

11:00 p.m. 30mg mirtazapine

 

What is your work schedule, with the times o'clock, such as 6:00 p.m. to 1:00 a.m.?

 

I have repeatedly requested that you use the pharmaceutical names, such as alprazolam, to refer to your drugs. Please use the pharmaceutical names.

 

Please read my questions carefully and answer them fully. Please answer these questions:

 

 

 

Your daytime dopiness is not a withdrawal symptom from escitalopram, it's because you're taking a high dose of alprazolam and add mirtazapine at night. What is it you expect to accomplish by taking escitalopram again? If it caused your stomach problems before, it will cause your stomach problems again.

 

This is a site for going off drugs, but it appears to me your interest is in adding escitalopram to your current cocktail. We cannot counsel you abou that. You can, of course, take any combination of drugs you wish. You don't have to ask permission for that here.

Hello! I have been taking mirtazapine 30 mg for 1.5 months now. But like I said I work nights from 7pm to 7am. I can't work with mirtazapine. So the doctor told me to stop the Mirtazapine and take back the cipralex 10 mg SSRI I stopped taking six months ago. And to take Miagen/ mianserin/ 10 mg antidepressants at night to help me sleep. But I don't want to take 2 antidepressants. Because I'm making more trouble for myself. I would like to ask you if 1.5 months of mirtazapine can work? 1 week 2mg cipralex 24 mg mirtazapine 2 weeks 4mg cipralex 18 mg mirtazapine 3 weeks 6mg cipralex 12 mg mortazapine 4 weeks 8mg cipralex 6 mg mirtazapine 5 weeks 10mg cipralex 0 mg mirtazapine. I do not want to take any more antidepressants unnecessarily. What advice would you give? It is important that I can work in the evening. But neither with mirtazapine nor with Miagen /mianserin/ could I. Because, in my opinion, I couldn't even take Miagen back and skip it in the evenings. And if I could do it the way I described I could finally start tapering off the cipralex. Or do you think this is not feasible? Can 1.5 months of taking Mirtazapine cause permanent insomnia if I quit in 1 month?

[Altostrata]

Clearly, if you take a sleep-making drug such as mirtazapine at 11 p.m. in the middle of your work day 7 p.m.-7 a.m., it will make you sleepy. This can also be true of alprazolam.

 

What time do you intend to sleep, on that nighttime work schedule? Please note that breaking your natural sleep cycle, where you sleep at night, can cause other problems, including mood issues. Your body may not like an inverted sleep cycle.

 

Please also note this is a site for going off drugs. We're not going to help you adapt your current drug schedule to your work schedule or help you concoct another drug cocktail so you can continue taking the drugs -- that's your doctor's job.

[Krisz1977]

8 hours ago, Altostrata said:

Clearly, if you take a sleep-making drug such as mirtazapine at 11 p.m. in the middle of your work day 7 p.m.-7 a.m., it will make you sleepy. This can also be true of alprazolam.

 

What time do you intend to sleep, on that nighttime work schedule? Please note that breaking your natural sleep cycle, where you sleep at night, can cause other problems, including mood issues. Your body may not like an inverted sleep cycle.

 

Please also note this is a site for going off drugs. We're not going to help you adapt your current drug schedule to your work schedule or help you concoct another drug cocktail so you can continue taking the drugs -- that's your doctor's job.

Hi Unfortunately, doctors are not clear on this issue either. The reason I wanted to go back to my first medication cipralexet SSRI is because I read in this forum in several places that the original antidepressant is best to withdraw from the body. And I want to leave the medication by reducing it gradually. I know it will be a long time. I just don't want to lose my job in the meantime. The doctors don't care. They think I can get off it in 3 weeks. But I know that's not true. That's why I wanted to ask for advice

[Krisz1977]

9 hours ago, Krisz1977 said:

Hi Unfortunately, doctors are not clear on this issue either. The reason I wanted to go back to my first medication cipralexet SSRI is because I read in this forum in several places that the original antidepressant is best to withdraw from the body. And I want to leave the medication by reducing it gradually. I know it will be a long time. I just don't want to lose my job in the meantime. The doctors don't care. They think I can get off it in 3 weeks. But I know that's not true. That's why I wanted to ask for advice

Mirtazapine 30 mg Soltab. Do you think that dissolving this alone in water and withdrawing it with a syringe would work for the taper? What monthly percentage reduction rate do you recommend? Which would be better to reduce first alprazolam or Mirtazapine? Thanks for any tips

[Altostrata]

@Krisz1977, I cannot answer your questions without the information I've asked for:

 

21 hours ago, Altostrata said:

What time do you intend to sleep, on that nighttime work schedule? Please note that breaking your natural sleep cycle, where you sleep at night, can cause other problems, including mood issues. Your body may not like an inverted sleep cycle.

 

[Krisz1977]

1 hour ago, Altostrata said:

@Krisz1977, I cannot answer your questions without the information I've asked for:

 

 

Hi After dark at 8 am. I would take mirtazapine But then I would have to take it again in the evening if I want to sleep. But you can't take it twice in 1 day. Example of how I work Monday morning from 7 am to 7 pm Tuesday from 7 pm- Wednesday from 7 am to 7 pm Thursday day off Friday from 7 am to 7 pm Saturday from 7 pm to 7 pm Sunday 7 am to 7 pm Monday off and so on. Not ideal I know

[Altostrata]

You seem to intend to use drugs to sleep during the day and drugs to sleep when you are working on a different schedule at night. 

 

This is a site for going off drugs. I have no idea how to use drugs for this purpose. Constantly changing your drug and sleep schedule seems like a good way to make yourself very sick. Good luck.

 

 

[Krisz1977]

6 hours ago, Altostrata said:

You seem to intend to use drugs to sleep during the day and drugs to sleep when you are working on a different schedule at night. 

 

This is a site for going off drugs. I have no idea how to use drugs for this purpose. Constantly changing your drug and sleep schedule seems like a good way to make yourself very sick. Good luck.

 

 

Hi! I do not want to use antidepressants. I want to put it down. I want to reduce them. I just can't decide which to go off first, alprazolam or mirtazapine? Which do you think I should stop taking sooner? And if I use Mirtazapine Soltab I would dissolve it in water and use a syringe to remove the part I want to reduce is that feasible? I no longer want to use these products. I would like to leave it with reduction. That is why I ask.Thank you for your answer

[Altostrata]

I'm sorry. I'm only an ordinary person who volunteers to help people go off drugs. I am not going to be able to tell you how to go off mirtazapine or alprazolam and be able to sleep and work on your alternating day and night shift schedule. That's just too much to ask.

 

You're physiologically dependent on both drugs. Any changes in your drug-taking schedule for either drug are likely to cause sleeplessness and possibly other withdrawal symptoms. That may disrupt your ability to work.

 

Obviously, if 30mg mirtazapine makes you dopey when you don't want to be dopey, it's too high a dose for you. You might lower the dose. See Tips for tapering off mirtazapine (Remeron)

 

You can take mirtazapine once a day to make you sleepy, but I cannot even imagine what taking it for sleep on your rotating schedule would do. I do not want to put in the hours to figure it out. You might be able to get away with it, or not, but that's not my responsibility.

 

Your dependency on alprazolam is another complicated problem that you will need to address later. You will need to taper off it gradually.

 

On 8/4/2021 at 2:44 PM, Altostrata said:

9:00 a.m. 0.25mg alprazolam

3:00 p.m. 0.25mg alprazolam

9:00 p.m. 0.25mg alprazolam

 

It's possible the way you take alprazolam on this schedule (which you never confirmed) might keep you awake at night with interdose withdrawal. Currently, you don't notice it because of sedation from the mirtazapine. If you reduce mirtazapine, you may feel the interdose withdrawal from the benzo.

 

So, you see, reducing either of these drugs may affect your ability to work on that schedule, as would changing the dosing schedule for either of them. So I cannot help you achieve reduction of your drugs and guarantee your ability to sleep on an alternating shift schedule.

 

fyi https://www.sleepfoundation.org/shift-work-disorder/tips

[Krisz1977]

11 hours ago, Altostrata said:

I'm sorry. I'm only an ordinary person who volunteers to help people go off drugs. I am not going to be able to tell you how to go off mirtazapine or alprazolam and be able to sleep and work on your alternating day and night shift schedule. That's just too much to ask.

 

You're physiologically dependent on both drugs. Any changes in your drug-taking schedule for either drug are likely to cause sleeplessness and possibly other withdrawal symptoms. That may disrupt your ability to work.

 

Obviously, if 30mg mirtazapine makes you dopey when you don't want to be dopey, it's too high a dose for you. You might lower the dose. See Tips for tapering off mirtazapine (Remeron)

 

You can take mirtazapine once a day to make you sleepy, but I cannot even imagine what taking it for sleep on your rotating schedule would do. I do not want to put in the hours to figure it out. You might be able to get away with it, or not, but that's not my responsibility.

 

Your dependency on alprazolam is another complicated problem that you will need to address later. You will need to taper off it gradually.

 

 

It's possible the way you take alprazolam on this schedule (which you never confirmed) might keep you awake at night with interdose withdrawal. Currently, you don't notice it because of sedation from the mirtazapine. If you reduce mirtazapine, you may feel the interdose withdrawal from the benzo.

 

So, you see, reducing either of these drugs may affect your ability to work on that schedule, as would changing the dosing schedule for either of them. So I cannot help you achieve reduction of your drugs and guarantee your ability to sleep on an alternating shift schedule.

 

fyi https://www.sleepfoundation.org/shift-work-disorder/tips

 

Hi You are right in what you wrote to me. I need to find a job where I only work during the day so I can sleep every night. Which would you start to reduce first. Mirtazapine or alprazolam? I couldn't find an answer to this in the forum for mirtazapine reductions. Nor how they can make a liquid from the Soltab Mirtazapine tablets for the reduction.Here in Hungary they don't make liquid from tablets in the pharmacy. I want to start the reduction but I don't know which one to start with. My life is completely unlivable at the moment because of the narcosis

Or do you think it would be feasible to reduce the alprazolam by 1% per month and add 2.5% per week of mirtazapine 30 mg for 4 weeks and then 2 weeks of maintenance. Do you think this would work?

[Altostrata]

23 hours ago, Altostrata said:

Obviously, if 30mg mirtazapine makes you dopey when you don't want to be dopey, it's too high a dose for you. You might lower the dose. See Tips for tapering off mirtazapine (Remeron)

 

[Krisz1977]

13 hours ago, Altostrata said:

 

Thanks for the advice. Do you think it would work if I lowered the Mirtazapine down to 0 and then started lowering the alprazolam? Is that a viable option? Considering how many years I have been on antidepressants

[Krisz1977]

https://proceedings.med.ucla.edu/wp-content/uploads/2016/11/Dose-Dependent-Sedating-and-Stimulating-Effects-of-Mirtazapine.pdf

[Altostrata]

15 hours ago, Krisz1977 said:

Do you think it would work if I lowered the Mirtazapine down to 0 and then started lowering the alprazolam? Is that a viable option?

 

Lowering the dosages of either drug is likely to cause insomnia. That is why it is impossible for me to suggest a plan for you while you are working. If you don't mind risking insomnia day after day, you can start tapering mirtazapine now.

 

You've been taking alprazolam nearly 6 months and are likely physiologically dependent on it. You will need to taper it very carefully.

 

We do not recommend tapering two drugs at once, particularly these drugs. The risk of insomnia and other withdrawal symptoms is very high.

 

If I were you, I would very gradually reduce mirtazapine first, at least to a tolerable level so it is not still making you dopey 10 hours later. Have you read Tips for tapering off mirtazapine (Remeron) yet?

 

You cannot show me any journal articles about mirtazapine that would change this advice. We've been doing this for 10 years.