Mario77: Multiple medication mishaps

[Mario77]

@FrogieMy Doc raise my Lex to 15, maybe that contributes too. Don't know what to do. Go back to 12.5 lex, 18.75 Mirt and STAY there long term? With the help of Clonazepam 0.75 x 3? I am desperate, I want to take time off of work. Again.

[Frogie]

I would definitely go back to 12.5 and hold there. You need to get stable and not updose if you can help it.

 

I think going back to the 12.5 and holding for a long while, you should start feeling better.

 

 

[Frogie]

@Mario77

 

Just checking in with you?

 

[Mario77]

Hi @Frogie,

 

Thanks for checking. I am sleeping a bit better, but my anxiety is overwhelming. My Doc and family insist on staying at 15 Lexapro, that I took for 2-3 days. Not sure...Having hard time at work.

[Frogie]

@Mario77

 

Dr.'s unfortunately don't understand how strong Lexapro is. My dr. was the exact same way, as I'm sure so many other's are.

 

Is there anyway you could try even 1/2 and see how you do? Since it's only been 3-4 days I think it would be ok to try that dose to see if it brings some relief. Or trying to go back down to 12.5.

 

It takes 4 days or so for a change to be felt.

 

[Mario77]

My Doc keep insisting that I need at least 20 mg, regardless of mirtazapine...I will take 12.5 Lex for a few days to see how that goes. What was your max Lexapro?

[Frogie]

@Mario77

 

My max dose over the 20+ years of being on the Lexapro was 20 mg. But from the way you have described your symptoms, I think you were doing well on the 12.5 mg.

 

You might keep a journal and post it here for a few days and see how you do.

 

Keep Notes on Paper

 

Don't take the Lexapro and Mirtazapine at the same time. Space them out 1-2 hours away from each other also. That may help with the anxiety.

[Mario77]

@FrogieI am taking propranolol, amlodipine and my 0.75 clonazepam first thing in the morning . Lex maybe 1 hr later. My anxiety is increasing in the morning, peaking around noon or 1pm, when I take another 0.75 Clonazepam. As of now, I am waiting for my second clonazepam around 12:30. I don't see much difference, but once I am home I am a bit more relaxed. I am dragging my body through the evening and take mirt 18.75 and the third clonazepam 0.75 together, around 10:30PM.

Since introducing liquid mirt, I am waking up at 5 , but I am able to have another hour of fitful sleep with rumination. Before I was sleeping uninterrupted to 6 or so.

[Frogie]

@Mario77

 

I'm wondering if your anxiety isn't being created by the increase in the lexapro dosage? Maybe it will ease if you do decide to decrease the dosage.

 

Your body needs to get used to the liquid mirtazapine, I'm sure that is why you are waking earlier. You should start feeling better very soon with that.

[Mario77]

First day on 15 I was better. Days 2 and 3 bad. Maybe I'll go back to 12.5mg tomorrow. It is not to late to back up from 15? My Doc and wife are pushing me to stay at 15.

[Frogie]

@Mario77

 

No, it's not too late to go back down to 12.5 mg. You've only taken it a couple of days.

[Mario77]

@Frogie I am so torn. Some people are getting better at 15 , or even 20. I am anxious for 9 months now. I had 2 or 3 days when I was more relaxed. I know the magic word is STABILITY, but it is so hard when you're feeling so bad to just wait...

[Frogie]

@Mario77

 

It is a very tough decision only you can make.

 

I can only suggest what I think would work for you based on what information you have given us.

[Mario77]

@FrogieNot sure what the rules are...I have SI and my wife doesn't believe me and berates me. Should I go to ER? My doc is unreachable. 

[Frogie]

@Mario77

 

 

1-800-273-TALK (8255)

 

Please call one of these numbers

[Frogie]

Quote

 

@Mario77

 

I was checking on you?

Edited December 31, 2021 by Frogie

[Mario77]

I am a bit better. Sleep is improving, almost 10 to 6. But morning are awful. And have this new SI. I am afraid to be put on extra meds.

[Mario77]

@Frogie Happy New Year, whoever and whenever you are!

 

[Frogie]

@Mario77

 

I'm glad to see a little improvement in your update. SI can be a common side effect. Just tell yourself that you are going to be ok, But don't hesitate to call one of those numbers I gave you if you need someone to talk to. That's what they are there for.

 

I'm in Colorado, watching it snow (finally).

 

Happy New Year to you. May 2022 bring joy, peace, love and happiness to you.

[Mario77]

We are neighbors, @Frogie!  I'm in Kansas.  I am a bit better, trying to switch to liquid mirt. Still 7.5ml liquid, 11.25 pills. Not sure how to move from here. Go to 15 liquid plus half of small mirt?

 

I decided to hold on at 15 Lex. Don't send a lot of snow; I'm working tomorrow!

[Frogie]

@Mario77

 

Your signature is there!!!

 

What part of Kansas? I lived in Stratton, CO for 6 years. We were 45 miles from Goodland. We used to go there to shop at Walmart because Stratton was population of 600. Then Burlington was 16 miles west, that's where our dr and a Safeway was. Now I live in Greeley, population 109,000. I hope you don't get too much snow so you are able to work.

 

You have to stabilize on what dose you think is right for you. Then we can go from there.

[Mario77]

@Frogie I am thinking of going to a full ml liquid (15mg mirt), plus half of a 7.5 pill. Or should I try some intermediate step? Like 3/4 ml liquid (11.25 mirt) plus 7.5 mg pill for a week?

Any idea how I can deal with my rumination?

 

Thanks!

 

[Mario77]

@Altostrata

Happy New Year!

I see you are the good mother for many here...so I want to ask your advice.

I am on 15 Lexapro for 4-5 days now (my doc want to push it to 20 or more). Beside my Mirtazapine (that I am trying to taper) and Clonazepam (0.75 x 3). I am barely functional at work. Sleep is good, 7 hrs solid, thanks God. I have a lot of rumination and some occasional SI. Looking always for reassurance. Feeling cold all the time.

What would you suggest, based on your experience? Go back to 12.5 Lex, stay there for a while and taper liquid mirt? I am on benzos for 8 months now, I know I am dependent, but I am not ready to touch that...

Thanks and God bless!

 

[Frogie]

You could do the 3/4 dose of liquid. Plus the 7.5 pill for a week. I think then you could go full liquid. Then hopefully things will settle down for you some and you’ll feel better.

[Mario77]

 

@Frogie

Another question: Since I am taking Lexapro, is there any way to lower mirtazapine a little faster? In theory, I should be "covered" by Lexapro; or at least that is what my Doc is telling me. It is so hard to do NOTHING for weeks, while feeling so bad.

[Altostrata]

Please do not mistake me for anybody's mommy.

 

On 8/30/2021 at 6:03 AM, Mario77 said:

I take my Mirt 26.75 (I am trying to chip away a quarter of a 15mg)  and Ambien CR at bedtime , around 10:30. I sleep maybe from midnight to 5:30.

 

Last August, you were taking mirtazapine, lorazepam, and Ambien and showing signs of interdose benzo withdrawal.

 

Now you are taking mirtazapine, Lexapro, and clonazepam. Why again was Lexapro added? 

 

If you are taking your doctor's advice to add drugs, why not consult your doctor about reducing drugs?

[Mario77]

I apologize if I offended you. What I meant is that you are the best repository for information. That's why I was asking your opinion. My doc added Lexapro for my anxiety. She said at least to 20mg...I cannot taper Mirtazapine fast, since it's helping with sleep. Don't know what to do. I'm afraid my doc will propose additional meds. Please help.

 

[Mario77]

@Frogie I am a bit better today. Thanks for not sending all that snow to Kansas City! But the cold....

Tonight I will try 0.75 ml liquid ( that would be 11.25mg) plus 7.5 in pills. So far, I was waking up a few nights, but able to fall back to sleep. I even had a dream about someone asking for mirtazapine, while I was at a public phone. Funny.

I hope I don't bother you, but you are a tremendous help.

[Frogie]

@Mario77

 

You don't bother me at all. That's what we are here for.

 

I'm glad you are dreaming, even if it's a funny one like that. Means your brain is healing.

 

The doses sound perfect. Not long and you'll be on full liquid and it will be so much easier.

 

Glad the snow didn't hit you hard. We got about 6" and 3" on the way Wednesday!

[Altostrata]

Has Lexapro helped with your anxiety? Despite your doctor's belief, it is not an anti-anxiety drug. Quite often, Lexapro causes insomnia.

 

Does mirtazapine help you sleep? Why are you going off it rather than clonazepam, on which your doctor has gotten you dependent?

 

Confused about what's going on here, as your drugs have increased rather than decreased. Is it your intention to be treated with drugs for depression or anxiety or whatever or are you going off drugs?

[Mario77]

Hi @Altostrata,

 

Lex helped me in the beginning (maybe because I was taking time off of work at the same time, reducing stress).  Helped with sleep, but not much during the day. At the same time I was taking clonazepam and mirtazapine... My Doc keep pushing it, she wants me at at least 20 mg or more (allegedly that is the dose for anxiety ?!). Mirt is helping with sleep, but she told me to cut it to make room for more Lexapro. The clonazepam is the only one working; I know I am dependent on it already, but help with sleep and during the day.  And I thought the "brakes" should be kept on, and remove the "accelerants" (not sure where mirt is in this category). It's an AD, but helps with sleep. I am so confused and lost. I am afraid my Doc will raise my lex or even add some "adjuvant" or "enhancer". 

 

Should I say no to the doc? What if she is firing me? Who will write my scripts? What is your advice? Try to cut the benzo first, even if I am not stable? I am trying to stabilize here (now switching to liquid mirt). I am in bad shape; only sleep (mirt 18.75 and 0.75 clon at bedtime) is OK. Cut Lexapro, since was the most recently introduced? Maybe without my doctor knowing? 

I just want to fell better; obviously without drugs , if possible. I do have a psychologist that helps a little, but this website is my main crutch. I would like to get rid of all my meds. 

Thank you very much. 

[Altostrata]

This is a site for going off psychiatric drugs. We can't help you reduce your drugs if you follow your doctor's advice to increase them.

 

If you prefer to follow your doctor's advice, please talk to your doctor about adverse effects and "balancing" your drugs. We do not provide free auxiliary advice to help you get comfortable on your doctor's drug cocktail, that's your doctor's job.

 

If you want to reduce rather than increase your drugs, you will need to have a frank conversation with this doctor or find another doctor who will work with you. See How to talk to a doctor about tapering and withdrawal? What to expect?

 

Please let us know when you want help reducing your overall drug burden.

[Mario77]

@Altostrata

I do need help to reduce my medication. I don't want to be on them. But I don't know where to start...I am pulled in different directions. All I know is that I want to feel better WITHOUT drugs. Can you point me in the right direction, please? What would be the next step for me? Thanks a lot!

[Altostrata]

I would stop making drug changes for the time being. How have the drug changes you've made in the last month affected your symptom pattern?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

The benzo is of particular interest.

[Mario77]

Should I continue my transition to liquid mirtazapine?

I would say I was worse after moving from 12.5 to 15 Lexapro.

But I have had a week when I took clonazepam only twice a day. But the last 2 weeks was TID (mostly; yesterday I took only 0.5mg in the afternoon).

So, first rule, don't change anything  (maybe continue transition to liquid mirtazapine?)

I will post my symptoms tomorrow.

Thanks a lot!

[Altostrata]

Where are you in your transition to liquid mirtazapine?