Beardeddad22: Introduction, mirtazipine withdrawal

[Beardeddad22]

Hi all. My name is Paul. 36 years old. Been on psych meds since I was 16. Have just recently come to accept that these medications are truly poison. I'm now in the process of healing from a Mirtazipine taper. Been completely off for 16 days. This is hard. Not as hard as when my psych CT me off of Seroquel last summer and I ended up in the hospital, but the emotional Rollercoaster and histamine intolerance I've formed is just insane. I can't wait to see what life is like without meds. I've been on them since I was 16, truly feel like I wasted a lot of my life on these things. Anyway, just wanted to introduce myself, getting away from social media like fb and twitter (another form of poison) but wanted to join a community to help me cope with what I'm dealing with. Thanks for having me. 

[Onmyway]

On 10/5/2021 at 5:37 PM, Beardeddad22 said:

Hi all. My name is Paul. 36 years old. Been on psych meds since I was 16. Have just recently come to accept that these medications are truly poison. I'm now in the process of healing from a Mirtazipine taper. Been completely off for 16 days. This is hard. Not as hard as when my psych CT me off of Seroquel last summer and I ended up in the hospital, but the emotional Rollercoaster and histamine intolerance I've formed is just insane. I can't wait to see what life is like without meds. I've been on them since I was 16, truly feel like I wasted a lot of my life on these things. Anyway, just wanted to introduce myself, getting away from social media like fb and twitter (another form of poison) but wanted to join a community to help me cope with what I'm dealing with. Thanks for having me. 

Welcome to SA @Beardeddad22, 

I am sorry you are going through the emotional rollercoaster.  But you have found yourself in good company here - we are a supportive community trying to help each other. Please have a look at other members' intros and join conversations and offer support. It's the easiest way to connect. 

 

I will post a few links here to help you get started. Can you first create a signature please? This will help us help you with advice if and when it's needed. If you'd like advice from a specific person, you can use the @ symbol together with their username to send them a notification. The moderators are volunteers so don't always have the bandwidth to read every post but will do so if you alert us and/or ask for a response. 

How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

When you say that you tapered your medicines, how long did you taper for? At what rate? If your taper was too fast (for example, I did a 5 month taper but it was too fast and my jumping point was too high, so I had pretty bad withdrawal symptoms) you may benefit from reinstating a tiny amount of your drug - 0.5 or 1 mg to reduce some of the withdrawal symptoms and taper much more slowly from there. These drugs are very potent at the low doses so one needs to be extra careful with the last jump. Reinstatement doesn't always work but is wort a try sometimes. 

 

About reinstating and stabilizing to reduce withdrawal symptoms - Symptoms and self-care - Surviving Antidepressants

 

In the meantime, you may benefit from reading and participating in some of these threads - 

Are We There Yet? How Long Is Withdrawal Going To Take? - Tapering - Surviving Antidepressants

Non-drug techniques to cope with emotional symptoms - Symptoms and self-care - Surviving Antidepressants

The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants

I find the following threads the most important in explaining what is happening in your brain right now. The first one is about benzodiazepines but applies similarly to other drugs as well as they are very interconnected.  

What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants

 

And please don't forget to stop by the success stories thread - it has kept many of us going during the worst of it. 

Success stories: Recovery from psychiatric drug withdrawal - Surviving Antidepressants

 

A warm welcome to SA, Paul! May you find some respite soon!

OMW

 

 

[Beardeddad22]

Thank you @Onmyway,

Thank you for the reply. I tapered over 6 months from 22.5 and then jumped off at 1.87mg, I was doing ok until that final drop off. One of the worst symptoms aside from the chemical induced anxiety and depression is the histamine intolerance i've formed. I can't eat anything without exacerbating my wd symptoms or getting hives it's truly insane.

[Santino]

Dear Beardeddad22

I red your description and i can surely say that you have jumped off from a considerably high dose. In my case i jumped when i went up to 0.025 Mg of mirt and still i experienced slight problems.

In your case the best way with Mirtazapine is that after 16 days you have been off and your symptoms are starting to raise their head, you could reinstate mirt to a lower dose (lets say 0.5 to 0.75 Mg) and monitor for 2-3 days. If your symptoms improve stay put on that dose for 2-3 weeks and than continue to taper  with 10% of the current dose rule until a very miniscule dose remaining.

I really believe you will be OK. 

All the best

Santino

Edited October 9, 2021 by Karma
update name

[Beardeddad22]

@SantinoThank you.

 

As scared as I am right now with what I am experiencing I'm just as afraid to go back on it. I heard that reinstatement doesn't always work and can sometimes make things worse? Is that true?

[Santino]

You are going on just a very small dose my friend. I do not believe that can make things worse than it is now. If the symptoms improve immediately then you will know that you have been in WD and you can manage the process better.

You can check my topic to understand what i have been through and how i survived.

All the best

Santino

[Beardeddad22]

@Santino

 

Is there a good resource here for making liquid? I was just cutting and weighing. I only have 7.5mg tabs. My doctor wanted me to come off of them after 2 weeks and im not even sure if they have lower mg tablets.

[Beardeddad22]

Also, would it maybe be wise just to go back to the dose i originally came off of?

[Beardeddad22]

Sorry for so many questions, I just want to make sure I'm making the right decision. No one in my family can really offer any support or advice since they have no clue about how to handle this

[Onmyway]

On 10/6/2021 at 9:37 AM, Beardeddad22 said:

@Santino

 

Is there a good resource here for making liquid? I was just cutting and weighing. I only have 7.5mg tabs. My doctor wanted me to come off of them after 2 weeks and im not even sure if they have lower mg tablets.

Hi Paul, 

the right thing to do here is to reinstate - yes, there is the possibility that things may worsen but since you haven't been off of them for so long it's likely that you will be OK. A slow dose is better than a large one. I would start with 0.75 (some adjustment will have happened since you jumped). While it looks like a small amount 1.75mg is not that small. The majority of the effect of those drugs happen at the lower doses. I am tapering citalopram and it's receptor occupancy at 20mg is around 80% but at 1mg is around 30%, it's not linear, it's almost a vertical line at the beginning and then slowly flattens Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants

 

If you can measure correctly, you should measure the way you used to - note that the weight of the pill is not the same as the weight of the active ingredient. If that is too hard, you can go to liquid. Look how to do it for Mirtazapine in the tapering forum. 

 

Good luck to you and hopefully you will get some improvement soon, 
OMW

Edited October 9, 2021 by Karma
Name update

[Beardeddad22]

I just realized it was 3.75mg that i jumped off of and not 1.87. This whole time I thought they were 3.75 pills i was weighing...I dont know what I have been thinking..do you still recommend only the .75mg reinstatement?

 

My mind is a mess i don't even know what I'm talking about i'm clearly confused

[Gigi68]

Hi Beardeddad22, I am also tapering mirt, currently at 3.84ml. I can’t answer your question about reinstatement. However I make my own liquid and it is very easy to do. I think you can find info on how to do it on this website but there are great instructions about it on the Facebook group Mirtazapine: support, withdrawal, recovery. Info about it is under tapertools in the Topics section. There are also many people in the group who have successfully reinstated. Hope you get some relief soon.

 

 

Edited October 9, 2021 by Karma
name update

[Beardeddad22]

@Gigi68 thank you, im in that group too. i feel like i spent hours today trying to figure it out. my brain is just so fried right now, i am having trouble figuring it all out and collecting a list of what i need to get started.

[Gigi68]

If you decide to make the liquid and need help, feel free to message me. I would be happy to help. 

[Beardeddad22]

From what I've been reading, Cutting pills is not a good way to go about things because of inaccurate dosing. I'm super nervous to reinstate by cutting but also super nervous to not reinstate. I just am not prepared to start the liquid tonight as I don't have anything to prepare or or syringes or anything . I'm unsure what do to! 

[Onmyway]

Hi Paul, cutting should be ok if you have a very sensitive scale - see the Tapering thread. Otherwise liquid is better. If you're just dissolving the pills yourself it's the same but if you are taking a pre created liquid it's pharmacokinetics may be different. 

 

We suggest a small reinstatement in case things go south. If things get better but not as much as you hoped you can increase the dosage after a week and more if you want/need to. If you'd like you can start with 1mg and go from there. 

 

Do check out the tapering thread to get more info on mirtazapine.

 

OMW

 

[Beardeddad22]

@Onmywaythank you so much for the helpful reply. is there a good recommendation for a digital scale? I found a link on here but the link was dead. I have a .001 scale but it was like $20 so not sure how accurate it is with very low amounts. 

 

Edited October 7, 2021 by ChessieCat
removed post from quote box

[ChessieCat]

If you can let us know which link was dead we can try to fix it or delete it.  If a link is broken try using an internet search engine and add site:survivingantidepressants.org to the search term.

 

Many members use the Gemini 20 scale.

 

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

 

The following is a link to a search in the above topic for Gemini:

 

https://www.survivingantidepressants.org/search/?q=gemini&quick=1&type=forums_topic&item=1596

 

 

 

 

[Beardeddad22]

Mirtazipine reinstatement (title of new topic #1)

 

If I reinstated 1 night at a low dose after 2 weeks completely off is it OK to not continue reinstatement? I'm so lost and confused as to what to do. I don't want to be on this anymore. I have no guidance in life from anyone. 

 

Edited October 7, 2021 by ChessieCat
added topic title before merging with intro topic

[Beardeddad22]

Mirtazipine reinstatement (title of new topic #2)

 

Hi all,

 

So I was originally on 22.5mg of mirtazipine, started in sept of 2020. After a few weeks, my depression lifted and I felt better overall. Since then I have gained 40lbs and my anxiety has increased significantly. I started a taper 6 months ago and got down to 3.5mg without any trouble. I sat at that dose for 4 weeks and decided to jump off. That’s when the trouble began. Histamine intolerance, Nausea, loss or appetite, Feelings of doom, racing thoughts, uncoordinated, not able to be present mentally, depersonalization and sometimes increased anxiety. Very distressing. I reinstated last night at 1.87mg because that’s the most accurate weight I could get with my current scale. I found that afterwards my upset stomach went away and I was finally able to eat.  I fell asleep at a reasonable time and woke up with a heavy foggy brain, ramped up anxiety and questioning whether I did the right thing. 

 

Edited October 7, 2021 by ChessieCat
added topic title before merging with intro topic

[Beardeddad22]

So I reinstated last night. Feeling a lot better today. Woke up with some anxiety which I've always thought mirtazipine gives me anyway specially in the am. Took the day off of work but I am a lot better now. Went to the store to get everything I need to make the liquid for tapering and administered my first liquid dose about an hour ago. Fingers crossed doing it the right way this time prevents me from falling into that out of despair. Thank you everyone for your knowledge and advice. 

[ChessieCat]

Please add the date that you reinstated in your signature.  This allows the staff to see your drug history at a glance.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  However, it is possible to feel some improvement before this.  Whenever I missed a dose it only took about 4 hours for my withdrawal symptoms to start being relieved.

 

It is generally suggested that you give the current dose some time, because of the above, before considering updosing.  And if you do decide to updose to only increase by small amounts and again wait for it to get to full effect.

 

Monitor your symptoms and keep notes of what improves or worsens.  This allows you to be more objective.

 

 

[Beardeddad22]

Day 2 of reinstatement and feeling a heck of a lot better. Groggy in the morning and yesterday had some anxiety but I felt pretty calm today. Also appears my histamine intolerance has subsided quite a bit. Happy all around about this. Am going to hold on this dose for another 4 weeks and then see what dropping 10% looks like. Thanks again for all your help and support

[ChessieCat]

Please do not be in a hurry to start tapering.  It is better to hold for longer than to risk reducing too soon.

 

I think that holding for at least 3 months on your current dose would be a good idea and then reassess then.  Keep notes for yourself during this time.  It can be difficult to recall what happened when if you need to look back to assess the situation.

 

Also, when you do make your first reduction I suggest that you make a very small reduction, no more than 2.5% of current dose or even 1%, to see how you respond to the lower dose.  Think of this a "testing the waters".  If you make a 2.5% reduction and after 2 weeks have had no issues then you could make larger reduction the next time (but do not go over 10% reduction in a 4 week period).  After my original updose after I joined SA I only held for 2 months before I made a 10% reduction.  I was trying to reduce my drug quickly because I was experiencing serotonin syndrome.  When I made the 10% reduction I got very painful ears so I updosed and about 4 hours later the pain had gone.

 

It is better to start slow and go down gradually instead of going down and up and down and up.  The brain can get confused because it is always trying to regain homeostasis, ie levelling things out.  If you mess around with the dose changes there might come a time when an updose does not work like it had before.

 

Deciding now to hold for 3 months allows you to relax and not worry about trying to make a decision about whether you should make another reduction.

 

During my taper I have made a couple of long holds, even though my taper was going well.  I wanted to give my brain the time to make an adaptions that it needed to, even though I wasn't experiencing any issues.  One hold was for 3 months and the other for 7 weeks.

[Beardeddad22]

What does everyone do to cope with Anxiety and the feeling of being a burden on your family? I'm having a really hard time with it right now, depressed, anxious, over thinking everything.

[ChessieCat]

I hope you can find something helpful in the following:

 

ways-to-cope-with-daily-anxiety

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Link to a search for Claire Weekes on YouTube

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk
 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk
 

Anxiety Self Help - getselfhelp.co.uk

 

withdrawal-dialogues-encouragement

 

helping-family-understand

 

support-for-those-in-withdrawal-who-struggle-with-family-friends-not-understanding-from-baylissa-frederick

 

And this:

 

  

On 8/9/2021 at 5:06 AM, brassmonkey said:

 

AAF is one of the foundations of self care.

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.

 

There is a lot of other information around the site, a site search on AAF will bring it up.

 

 

[Beardeddad22]

Finally starting to feel like I'm stabilizing from my reinstatement, past couple of days have been better. Thank you everyone for your help and support.

 

I do have a question about tapering with liquid however. As I go lower and lower and the dose decrease gets smaller and smaller using the 10% method. How do I go about getting an accurate dose? I'm using a 1ml liquid syringe and it seems it will be hard to get an accurate dose as the decreases get smaller.

[ChessieCat]

If you are making your own liquid you can change the dilution ratio.

 

If you are using a prescription liquid then if the ingredients include water, you can dilute it.  I found this information online:

 

From https://www.medicines.org.uk/emc/product/2023/pil

What Mirtazapine Oral Solution contains

• The active substance is mirtazapine. Mirtazapine 15 mg/ml oral solution contains 15 mg mirtazapine per ml of solution.
• The other ingredients are L-methionine, sodium benzoate (E211), saccharin sodium (E954), citric acid monohydrate (E330), glycerol (E422), liquid maltitol (E965), orange tangerine flavour No.: PHL-132597 (contains ethanol) and purified water.

 

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

 

how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators

 

You might find posts by other members about how they get their doses:

 

tips-for-tapering-off-mirtazapine-remeron

 

[Beardeddad22]

Hi all. Is there a recommended 1ml syringe to use for liquid taper? Also is it recommended more to use a full water liquid or a 50/50 suspension or does it not really matter? 

[Beardeddad22]

Are there any online support groups that do video chats for ad withdrawal? I'm having a hard time finding a therapist that understand and family sure as hell doesn't understand either.  Very lonely and text chats just dont do it for me. 

[ChessieCat]

 

5 hours ago, Beardeddad22 said:

Hi all. Is there a recommended 1ml syringe to use for liquid taper? Also is it recommended more to use a full water liquid or a 50/50 suspension or does it not really matter? 

 

There is a huge amount of information in the liquid taper topic.  If you go to the topic you can search for a word in the search bar and click on topic in the drop down box, eg syringe, pipette.  Check out the last few pages of the topic and you will see that there is a member using a syringe/pipette which you can dial in the amount.

 

In general it is not necessary to use a suspension liquid.  Just make sure you stir the mixture before extracting the liquid with the syringe.  Suspension liquids are expensive.

 

It is always a good idea to keep notes whenever you do something different so that you can look back if issues arise after the change to assess whether the issues might be caused by the changes.

 

And only make one change at a time.

[Beardeddad22]

So i reinstated 12 days ago, withdrawal feelings are still pretty consistent, should I stay at this dose and just wait it out?

[Altostrata]

Hello, @Beardeddad22 Here's an online group Global PsychMed Support Network It's on Meetup.

 

You reinstated 1.8mg mirtazapine? What times o'clock do you take your drugs, with their dosages?

 

What effect do you feel from 1.8mg mirtazapine? What effect does lamotrigine have on you?

 

 

[Beardeddad22]

21 minutes ago, Altostrata said:

Hello, @Beardeddad22 Here's an online group Global PsychMed Support Network It's on Meetup.

 

You reinstated 1.8mg mirtazapine? What times o'clock do you take your drugs, with their dosages?

 

What effect do you feel from 1.8mg mirtazapine? What effect does lamotrigine have on you?

 

 

Yes I reinstated at 1.8mg. I take that full dose around 8pm via homemade liquid. I have increased anxiety and foggy/pressure in the head as well as an overall gloomy outlook and no motivation. I did have a window mood wise this afternoon though which was very much welcome. 

 

As far as lamotrigine goes, I'm not really sure it does anything, it's such a low dose. Never did anything for my mood. As far as side effects the only thing I can really pinpoint is a clenched jaw. 

[Altostrata]

When do you take lamotrigine? Why was it added?

[Beardeddad22]

5 hours ago, Altostrata said:

When do you take lamotrigine? Why was it added?

Hi @Altostrata - I take lamotrigine in the morning, I was put on it for depression. I also should probably note that other w/d effects I've been experiencing are insomnia and very upset stomach/diarrhea