Tyler84: Help - Mirtazapine WD

[Tyler84]

I was on mirtazapine 15 mg for 2 1/2 years and I tapered fairly quickly half for six months down to 5 mg for a month down to 4 mg for two months down to three for a month then to 1 mg for two weeks and then jumped off . I’ve nee off for 14 weeks exactly so a little over two months and i feel like I’m going crazy . I have the worst pain and anxiety .  Depression and suicidal thoughts .  Dizziness w vertigo and head pressure .   I need to know if i can take the Xanax I’m prescribed to to help this feeling or should i go on a diff antidepressant. I’m right after 3 months off so I’m not sure if it’s safe to reinstate mirtazapine but i cannot live like this and i know drs are going to tell me that it’s relapse when it is definitely withdrawal .  Someone please help . I’m losing it . And losing everything in my life .  Thanks in advance 

[arbor]

Hello @Tyler84

Welcome to SA.

 

To get you started and to give you pertinent information, could you summarize your medication history in a signature – only drugs, doses, dates, and discontinuations & reinstatements in a vertical list format.  

 

Account Settings – Create or Edit a signature.

 

I'm so sorry you're in the initial phase of withdrawal.  The symptoms are often excruciating--just as you're describing.  Here are some links that can be useful to share with your doctor as well.  The last two are recent publications by our founder, Alto.

 

What is withdrawal syndrome?

 

 

Framer, A. (2021). What I have learnt from helping thousands of people to taper off antidepressants and other psychotropic medications. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125321991274  

 

Hengartner, M. P., Schulthess, L., Sorensen, A., & Framer, A. (2020). Protracted withdrawal syndrome after stopping antidepressants: A descriptive quantitative analysis of consumer narratives from a large internet forum. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125320980573

 

 

As you may have read, we recommend a 10% taper that is described in this link:

Why taper by 10% of my dosage?  (The general philosophy of gradual tapering)

 

You may want to consider a very small reinstatement of Mirtazapine in order to stabilize the symptoms, and then taper from there.  You're getting somewhat late for a reinstatement, so I suggest you consider your choice soon.  A reinstatement won't get rid of the symptoms, but it can settle your nervous system enough that you can gradually taper off. 

About reinstating and stabilizing to stop withdrawal symptoms

 

The problem with Xanax, as probably know, is how quickly addictive it is.  However, when you've finished your signature, I can share your questions with the other moderators.  

In the meantime, although we don't recommend many supplements, 3 that we do recommend are magnesium, omega-3, and melatonin. 

Magnesium

Omega 3 Fish Oil

Melatonin

 

Also be sure to check out the symptoms and self care  section where there's a wealth of experience and information for dealing with symptoms.

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

This is your Introduction site where you can ask questions, report your progress, and connect with other members.

I'm glad you've found us. 

Arbor

[Tyler84]

I tried to do it best i could .  I’m suffering and spine pain and off balance / dizziness / Vertigo from head injury is back .

really just wondering if i can try a small a mount of the Xanax in prescribed to help settle nervous system . clonazepam worked great in the past . I will not reinstate mirtazapine because I’m suffering so badly and hated what it did to my Brain . 
 

[Tyler84]

Just now, Tyler84 said:

I tried to do it best i could .  I’m suffering and spine pain and off balance / dizziness / Vertigo from head injury is back .

really just wondering if i can try a small a mount of the Xanax in prescribed to help settle nervous system . clonazepam worked great in the past . I will not reinstate mirtazapine because I’m suffering so badly and hated what it did to my Brain . 
 

Oh sorry just saw your post about Xanax . I take magnesium glycinate sometimes but it’s not helping .  I really just want to fix the vertigo and balance issues . I see a psychiatrist on Friday and I’m sure she will just try to give me a diff antidepressant and i really don’t wanna ever have to do this battle again to come off of anything . 

[arbor]

Hi @Tyler84

Thanks for finishing your signature.   Many people report these symptoms, especially in the acute phase of withdrawal.  Each person is different, but it tends to dissipate gradually and eventually disappear.  I hardly ever feel it anymore though I can experience an occasional wave.  Here are a couple of links addressing the issue:

Dizziness, vertigo, light-headedness, rocking or swaying ...

 

Acta Otolaryngol. 2010 Sep;130(9):981-3. doi: 10.3109/00016481003602082.

A possible explanation for dizziness following SSRI discontinuation.

Smith PF¹, Darlington CL.

Source

ABSTRACT

Dizziness is the most commonly reported symptom of abrupt discontinuation from the selective serotonin reuptake inhibitor (SSRI) category of antidepressants. The reported dizziness is exacerbated by even slight head movement, and therefore is likely to be vestibular in origin. The SSRIs most implicated are those with short half-lives and which are most selective for serotonin (as opposed to noradrenaline), e.g. paroxetine and sertraline. Since the vestibular nucleus complex (VNC) has an abundance of serotonin receptors, the abrupt withdrawal from an SSRI is likely to have a substantial impact on the electrophysiological activity of neurons within it. Here we suggest that the abrupt withdrawal from an SSRI is likely to cause a sudden decrease in serotonin in the VNC, which will disrupt the function of VNC neurons bilaterally, causing dizziness without vertigo.

 

We also recommend acupuncture for vertigo.  It's helpful to ask for calming treatments as opposed to stimulating.

 

As for introducing new drugs-- unfortunately, this can also upset your already sensitized system further.   I wish there were a reliable method of relief from the hells of withdrawal other than the main standbys, and they are unworldly patience, good care of yourself, and time.  If this is useful, I include this link:

Considerations About Stability Stop Jumping Around

 

Again, I hate that you're having to go through this.  I wish the medical system would do real studies and find ways to correct the devastation they're causing.

If you want further consultation on Xanax I will contact the other moderators.  

Thinking of you,Tyler84.  It will get better.  You will heal.

Arbor

[Tyler84]

I had the dizziness from an explosion in my ears way before i ever took any medicine though . I’m almost positive it’s just returning . I’ve been dealing with it for over ten years .  

[Tyler84]

What dose would you recommend i reinstate after being off for 3.5 months ? I’m so confused . If i jumped off at 1mg . Would i need to do 1mg ? And thanks for all your help 

[Tyler84]

Can someone please advise me on the reinstatement process if i jumped off at 1 mg . I never stabilized on one mg .  I only took it for a week . I’ve been off 3.5 months and I’m going insane . I honestly am scared to goto the hospital because i know they will either give me Ativan that won’t help with the mental part of wds or they will send me to a suicide ward .  I really really need help and i think reinstatement would be best here . I know mirtazapine has ruined my histamine receptors so I’m not sure how safe this is . But if i jumped off at 1mg for a week what dose should i reinstate?   Like .5 ? Or .2 ?  Someone please help I’m losing my mind having thoughts of harming people and my pets and myself and I’ve never thought like this in my life .  Thank you all . 

[arbor]

Hi @Tyler84

I haven't been available until now, so I'm sorry you've had to wait for my reply.  I've sent your questions to more knowledgeable moderators, so used their advice over mine.  I would suggest a .5 reinstatement followed by micro-tapering if the reinstatement does lead to some stabilization.  Here are links I recommend:

 

 Micro-taper instead of 10% or 5% decreases

 

I know it's very hard to stay calm when going through these symptoms.  Others, including myself, are proof you won't die from them.  However, you can make them much worse by giving into the horrible neuro-emotions w/d creates.  Try not to believe your brain right now and do everything in your power to avoid stress.  I know you've tried magnesium.  I suggest you continue to take the recommended supplements, especially high dose of fish oil for its effect on the part of the cells effected by AD's.

Neuro-emotions

Stability

 

Here are links regarding Mirtazapine:

 

Tips for tapering off mirtazapine

 

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

 

16 hours ago, Tyler84 said:

I had the dizziness from an explosion in my ears way before i ever took any medicine though . I’m almost positive it’s just returning . I’ve been dealing with it for over ten years .  

Unfortunately, AD's also cause problems with ears, balance, tinnitus, and in some cases, auto-immune reactions effecting the glands under the ears.  I'm sorry you're dealing with it whether from the initial incident, or the use of psycho-drugs.

Arbor

[Tyler84]

37 minutes ago, arbor said:

Hi @Tyler84

I haven't been available until now, so I'm sorry you've had to wait for my reply.  I've sent your questions to more knowledgeable moderators, so used their advice over mine.  I would suggest a .5 reinstatement followed by micro-tapering if the reinstatement does lead to some stabilization.  Here are links I recommend:

 

 Micro-taper instead of 10% or 5% decreases

 

I know it's very hard to stay calm when going through these symptoms.  Others, including myself, are proof you won't die from them.  However, you can make them much worse by giving into the horrible neuro-emotions w/d creates.  Try not to believe your brain right now and do everything in your power to avoid stress.  I know you've tried magnesium.  I suggest you continue to take the recommended supplements, especially high dose of fish oil for its effect on the part of the cells effected by AD's.

Neuro-emotions

Stability

 

Here are links regarding Mirtazapine:

 

Tips for tapering off mirtazapine

 

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

 

Unfortunately, AD's also cause problems with ears, balance, tinnitus, and in some cases, auto-immune reactions effecting the glands under the ears.  I'm sorry you're dealing with it whether from the initial incident, or the use of psycho-drugs.

Arbor

 

Thank you so much . I suffered so badly last night .  I will try the .5 tonight when i sleep .  How will i know if reinstatement isn’t working for me ? I’m really scared but i can’t keep feeling crazy like I’m losing my mind so i think this is the best option .  

[Tyler84]

9 minutes ago, Tyler84 said:

Thank you so much . I suffered so badly last night .  I will try the .5 tonight when i sleep .  How will i know if reinstatement isn’t working for me ? I’m really scared but i can’t keep feeling crazy like I’m losing my mind so i think this is the best option .  

Also i have a very precise powder scale .  Should i just do the math and use it ? I don’t have all the stuff to make liquid . 

[Altostrata]

Yes, @Tyler84, do the math and weigh the mirtazapine so you are getting 0.5mg in a dose. Do you plan to put it in a capsule?

 

You may find making a liquid from a whole or half tablet a lot easier, see Tips for tapering off mirtazapine (Remeron)

[Tyler84]

1 minute ago, Altostrata said:

Yes, @Tyler84, do the math and weigh the mirtazapine so you are getting 0.5mg in a dose. Do you plan to put it in a capsule?

 

You may find making a liquid from a whole or half tablet a lot easier, see Tips for tapering off mirtazapine (Remeron)

Yes i can do that .   Thank you .  how will i know if i shouldn’t take anymore ? I’m scared as hell having to do this but if it helps my helpless  suicidal feelings and agitation i have to do it 

[ChessieCat]

There is a lot of information in both of these topics:

 

using-a-scale-to-weigh-and-measure-doses

 

how-to-make-a-liquid-from-tablets-or-capsules

 

[ChessieCat]

4 hours ago, Tyler84 said:

how will i know if i shouldn’t take anymore ?

 

You need to listen to your body and taper at a rate where withdrawal symptoms are kept to a minimum.

 

when-to-end-the-taper-and-jump-to-zero

 

[Tyler84]

Thank you 

[Altostrata]

First, we would like to get you feeling a bit better. Do not worry about going off, we'll help you with that.

 

Please be sure to tell us how you're doing.

[Tyler84]

Just now, Altostrata said:

First, we would like to get you feeling a bit better. Do not worry about going off, we'll help you with that.

 

Please be sure to tell us how you're doing.

Thank you so much 

[Tyler84]

9 hours ago, ChessieCat said:

 

You need to listen to your body and taper at a rate where withdrawal symptoms are kept to a minimum.

 

when-to-end-the-taper-and-jump-to-zero

 

I meant how will i know if the reinstatement is bad and i shouldn’t have done it .   Not taper .  Sorry 

[ChessieCat]

It is the same thing for reinstatement you need to listen to your body and your symptoms.  If symptoms start to worsen then the reinstatement is not working.  Remember to only make one change at a time otherwise if there is more than one variable you will not know what is causing any issues if they arise.  Please read Post #1 of this topic:

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

[Tyler84]

1 minute ago, ChessieCat said:

It is the same thing for reinstatement you need to listen to your body and your symptoms.  If symptoms start to worsen then the reinstatement is not working.  Remember to only make one change at a time otherwise if there is more than one variable you will not know what is causing any issues if they arise.  Please read Post #1 of this topic:

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

Okay thank you . I feel like my body is freaking out in need of mirtazapine .  I didn’t pay attention to my first taper at all . Drs are so stupid about it . And just told me to stop taking it in a week . I taper for many months but dropped way too much and way too fast .  I’m really hoping this works because I’m so scared and I’m tired of feeling this way . It’s like i have no love left in me . Everyone and everything  is so agitating everyday  . Even my 5 lb dog that i love very much .  I had a few hour window today and about an hour ago another Wave hit and now I’m just having anxiety and feeling like I’ll snap .  I see a psychiatrist today at 2 pm and I’m almost positive she will tell me to try something else or Xanax rhat i haven’t taken because of my battle with clonazepam .    I won’t do what she says . She is very misinformed . 
 

 

My heart pounds through my head and ears and i just can’t live this way . i really appreciate all the help and I’m praying reinstatement works . I’m going to do it this evening when i goto sleep .  Should i just take it right before i sleep or a couple hours before ? 

[Altostrata]

If mirtazapine helped you sleep, you should take it before you go to bed in the evening.

 

Please let us know how you're doing. We can help you find out if reinstatement is going in the right direction.

[Tyler84]

Thank you i will update . 

[Tyler84]

On 10/7/2021 at 7:41 PM, ChessieCat said:

 

You need to listen to your body and taper at a rate where withdrawal symptoms are kept to a minimum.

 

when-to-end-the-taper-and-jump-to-zero

 

I meant how will i know if the reinstatement is bad and i shouldn’t have done it .   Not taper .  Sorry 

 

On 10/8/2021 at 2:13 PM, Altostrata said:

If mirtazapine helped you sleep, you should take it before you go to bed in the evening.

 

Please let us know how you're doing. We can help you find out if reinstatement is going in the right direction.

I have a question . So i missed my psych appt yesterday and was only able to talk to her on the phone for about 5 min .  She told me since i felt so bad on mirtazapine to not take it again and to try a small amount of Xanax .  Is this even safe ?  I felt okay yesterday but today I’m back to feeling crazy and agitated .    dizzy and having headaches .     I haven’t reinstated yet and I’m very unsure of what to do . Can someone please help ? 

[Tyler84]

49 minutes ago, Tyler84 said:

I meant how will i know if the reinstatement is bad and i shouldn’t have done it .   Not taper .  Sorry 

 

I have a question . So i missed my psych appt yesterday and was only able to talk to her on the phone for about 5 min .  She told me since i felt so bad on mirtazapine to not take it again and to try a small amount of Xanax .  Is this even safe ?  I felt okay yesterday but today I’m back to feeling crazy and agitated .    dizzy and having headaches .     I haven’t reinstated yet and I’m very unsure of what to do . Can someone please help ? 

Please help me 

[arbor]

Hi @Tyler84  It can be so hard to make decisions when our nervous system is going through w/d.  It seems you have two choices presented right now:  follow your doctor, follow the advice of Alto, or actually, a third choice, avoid drugs and follow self care (for which there are many ideas and suggestions here on the site).  And then commit to making that decision as successful as you can.  Unfortunately, and I'm so sorry to be saying this:  w/d--even with the help of reinstatement, or low, short term Xanax, is horrendous.  No one wants you to be feeling this way, but the medical establishment isn't willing to acknowledge the situation.  If I were you, I'd take the advice of Alto.  I also have a friend who took the third option, and he is now doing ok.  My best to you Tyler84.  

Arbor

[Tyler84]

1 minute ago, arbor said:

Hi @Tyler84  It can be so hard to make decisions when our nervous system is going through w/d.  It seems you have two choices presented right now:  follow your doctor, follow the advice of Alto, or actually, a third choice, avoid drugs and follow self care (for which there are many ideas and suggestions here on the site).  And then commit to making that decision as successful as you can.  Unfortunately, and I'm so sorry to be saying this:  w/d--even with the help of reinstatement, or low, short term Xanax, is horrendous.  No one wants you to be feeling this way, but the medical establishment isn't willing to acknowledge the situation.  If I were you, I'd take the advice of Alto.  I also have a friend who took the third option, and he is now doing ok.  My best to you Tyler84.  

Arbor

Thank you so i won’t be taking Xanax .  I think she’s gonna want me to try amitriptaline.  Has anyone ever been successful on that while off of Mirtazapine that you know of ?  I have to have something for headaches and Vertigo from my injury .  It looks like this will be one of the first options . I’m going to send off for a gene sight test to see which meds I’m compatible with on Monday .   I hope it’s accurate .  Again Thanks for your help 

[Altostrata]

@Tyler84 we've suggested mirtazapine reinstatement because you appear to have mirtazapine withdrawal. We've seen this works for withdrawal syndrome.

 

Your doctor apparently does not recognize withdrawal and doesn't know about the value of reinstatement. This is not unusual. We can't advise you on other drugs to try, that's what you pay your doctor to do. If you take Xanax or another benzo every day, it's likely you will get dependent on it and when you want to quit, you will need to taper it. 

 

Any doctor can prescribe mirtazapine tablets.

 

On 10/7/2021 at 1:23 PM, Altostrata said:

You may find making a liquid from a whole or half tablet a lot easier, see Tips for tapering off mirtazapine (Remeron)

 

[Tyler84]

31 minutes ago, Altostrata said:

@Tyler84 we've suggested mirtazapine reinstatement because you appear to have mirtazapine withdrawal. We've seen this works for withdrawal syndrome.

 

Your doctor apparently does not recognize withdrawal and doesn't know about the value of reinstatement. This is not unusual. We can't advise you on other drugs to try, that's what you pay your doctor to do. If you take Xanax or another benzo every day, it's likely you will get dependent on it and when you want to quit, you will need to taper it. 

 

Any doctor can prescribe mirtazapine tablets.

 

 

Yes you’re right .   The last two days have been okay . . I really just wish it would stay like this . But i know it’s only a window and I will feel horrible again in a day or two .   Should i hold for another wave before i reinstate ?   Or should i just try to face the suffering .  I guess what I’m asking is How long is too long to wait to reinstate ! 

[ChessieCat]

3 hours ago, Tyler84 said:

I’m going to send off for a gene sight test to see which meds I’m compatible with on Monday .

 

 

Please see the following post made by Alto (bolding is mine)

 

  

On 6/16/2011 at 3:56 AM, Altostrata said:

 

These tests are quite expensive. While they may satisfy your curiosity about why you had reactions from certain drugs or drug combinations, and perhaps give doctors a guide about what medications to prescribe for you in the future for real illnesses, having this information won't help you recover from withdrawal syndrome.

 

 

[Tyler84]

1 minute ago, ChessieCat said:

 

 

Please see the following post made by Alto (bolding is mine)

 

  

 

Oh i def understand that . This is just for future medicine .  I definitely know it won’t help with wD.  Just trying to see if mirtazapine was a bad one for me .   Thanks again for everyone’s help . I will let you know when i decide to reinstate . I have a meeting with my dr again on weds .  And i hope i can stay feeling this normal but i know it prob won’t happen .

[ChessieCat]

From Post #1 of the Reinstatement topic:

 

  

On 10/9/2012 at 10:17 AM, Altostrata said:

Reinstatement is best done immediately upon appearance of withdrawal symptoms. The more time that passes, the less likely it is to work.

 

[Altostrata]

It's possible that without reinstatement, you'll continue to recover very slowly and with lots of setbacks over many weeks. Low-dose reinstatement may be more comfortable, you'd taper off later. Up to you what you want to do.

[Tyler84]

If I’m having fatigue this bad still for multiple days and can’t even hold my eyes open or barely walk should i just go ahead and reinstate ?  I had a 3 days window before the last two days . I am suffering so badly right now i don’t know what to do .  I’m losing my mind and my body isn’t working anymore .    

[arbor]

How are you doing, @Tyler84?

 

[Tyler84]

Still doing pretty bad .. haven’t reinstated yet . But jsut trying to survive .  I hope it isn’t this way for months more I’m already 16 weeks off