Simon47: lost and feeling out of hope

[Simon47]

im 47. Since 1992 I’ve been on all the so called anti depressants at some point . Amitriptline in 92 after a major car accident , for 4 years , then duloxetine for a couple of years , then citalopram switched to eicitalopram , then to fluoxetine , then to Effexor ( which actually was only one that helped apart from gave me non alcoholic fatty liver ) then switched to sertraline for 2 years , then next was venlafaxine 75 mg generic , then dr switched me about very quickly to roboxetine , which had me climbing the walls for 3 weeks , then at end of 2019 swapped me straight from robixetine to mirtazpine 30 mg along side venlafaxine 37.5mg .

 

By. Early 2020, I felt like someone had put my brain to sleep . Did not have the get up and go mentally to do anything really . No interest in me life wife kids , just flat . Knew this had to be the mirtazpine . Dr said cut it in half , so 15mg for a week then stop . I said no , and dropped from 30 to 22.5mg . Felt very low for three months . But seemed to settle . But still felt mentally screwed . No Drive no excitement no anger no anything . I stayed put for rest of 2020.in 2021, I had to close my new business as I didn’t have it in me to run it . Bookkeeping . I then declared myself bankrupt .

In June 2021,my mother passed away sadly . I had been caring for her when I could for 4 years . I hit a massive void . I have been out of work so I could be there to help her when needed . I was 3 weeks in to a too large reduction (33%) of my 37.5 venlalic when she passed away . I ended up in A and E convinced that I was dying .

 

Drs increased venlafaxine to 75mg Effexor . I didn’t want it but I needed some immediate help . And it did. A bit . I began to taper slowly in august from mirt by 10%  or less . I was on 22.5mg in august , I am now on 18.5mg . My last reduction of only .5mg ( 2.5%) two weeks ago.

 

I have severe joint and muscle and tendon aches and cramps . I seem to have become intolerant to histamine ( if I eat a banana in am , 4 hours later I feel like I’m going to pass out ) but this only happens in morning . 

is this really all possible ? The pains in my joints are if I am100 years old . I’m 47 . And this has all come about since reducing mirtazpine ? Why is this at such small reductions ? How please can I get round this ?? I have crohnes disease and had a bowel resection 20 years ago . This has now flared up , no doubt due to the histamine and stress issues ? I can’t touch cod liver oil or vitamins as it makes me feel hot and anxious ?? What can I do ? No one is listening at the Drs or anywhere ?

 

To add , since June ( at that point I was on 37.5mg venlalic and 22.5mg mirtazpine)

 

I changed from tablet venlalic 37.5 to venlablue capsule in June with three tablets inside , and then tried to reduce this by 1 of the tablets , ( so, 33% for 3 weeks ) failed, so put back to tablet venlalic at 37.5mg.

 

I was also diagnosed adhd 8 months ago . In July , they started me on various stimulants , elvanse 30mg for a week then 50mg for a week. I stopped as didn’t like how I felt . So they put me on dexamphetamin 5mg twice a day , and told me to start to also take the venlalic in eve with mirtazpine , so I switched the venlalic to eve straight away . Went through 2 weeks of feeling proper rough . Stopped the adhd meds as too anxious . Mid July  So then I am back to the 37.5 Venlalic in a.m. 22.5mg mirt in eve .

 
started to slowly reduce mirt 22.5 to 20mg. 

Got real bad due to grief and all, Drs upped venlafaxine to 75mg Effexor capsule in around September .

 

since then done 2 more small mirt cuts so now on 18.5mirt and 75mg Effexor .

 

im hurting . I’m aching everywhere . I can’t eat certain foods with histamine .

 

have I gone wrong ? 

 

Edited August 6, 2022 by ChessieCat
added spacing for easier reading resized font

[Kiasofia]

Welcome @Simon47

I am sorry you are going through this and are suffering, but relieved you have found us. This forum is run by others like you who have been through and survived, or are surviving, the negative effects of psychiatric drugs. Hang in there.

 

Personally, I would disregard the ADHD diagnosis. Going on and off psychiatric drugs can cause symptoms that are interpreted as disorders, but are in fact effects of the drugs.

 

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

As these threads show you are not alone in your symptoms:

Overwhelmed, demotivated, apathetic? Cannot get going on interest or action

Tension, pain, twitches, excruciating spasms in muscles and joints

 

Since your symptoms have gotten worse after you reduced Mirtazapine, I recommend not reducing any further until you are feeling better.

Keep it simple, slow and stable

 

Once you are stable you can considering tapering more following these guidelines:

Why taper by 10% of my dosage?

Why taper? Importance of gradual change in plasma concentration  (This explains why you are struggling with small reductions.)

Taking multiple psych drugs? Which drug to taper first?

Tips for tapering off mirtazapine (Remeron)

Tips for tapering off venlafaxine (Effexor)

About going off mirtazapine plus venlafaxine (Effexor) aka "California rocket fuel"

 

What date did you start taking 18.5mg

Mirtazapine? What dose where you on before that and for how long?

 

To give members the best information, we ask them to summarize their drug history in a signature. Please make it clear what dates you have been reducing Mirtazapine, the doses, what other drugs you are currently taking, as well as what drugs you have taken and the date you quit them the past two years.

How to List Drug History in Signature

This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here.

Please stay in touch and let us know how you are doing.

[Simon47]

Tolerance withdrawals or mixed side effects

 

Anyone help ? 48 years old . Crohn’s disease . Half bowel removed 25 years ago . On off antidepressants since 1992 . Recently diagnosed adhd and ASD .

 

most current medication since 2020 mirtazpine and Effexor xl.

 

in Jan 2020 dr added 30mg mirtazpine to 37.5mg venlafaxine .

 

after couple months , could feel the mirtazpine was no good for me , so dropped from 30mg to 22.5mg in one go . Because suicidal . So dropped no more ( despite dr saying I could just quit it ). During next year I lost mum and business . In July 2021 I began cutting the mirtazpine pill by 10% each month , but it was hit and miss as scales not so accurate . During this time , I seem to then develop histamine intolerance and extreme anxiety especially in morning . Then weirdly , every morning when i took mu 37.5mg venlafaxine , 4 hours later , I started to get very thick headed and dizzy , this lasts for about 1 hour . Every day . It’s quite scary . After much back and forth with useless Drs and mental health people , they suggested as things were hard for me , to up their venlafaxine to 75mg Effexor xl. After a week or so , the issue in the morning where I felt faint etc 4 hours after taking , went away . 

min January of this year , I continued the withdrawal very slowly of mirtazapine, and it’s very painful and makes me so so anxious and panicky and raising thoughts , all negative . In may of 2022 dr agreed to give me the liquid mirtazpine . I’m currently down to 13.5mg mirtazapine . Over last month though , the issue where after I’ve taken Effexor xl, 4 hours later my head becomes very thick and spaced out has returned . No one seems to know why , but it is scary . It’s like each day , I’ve taken the first Effexor again and it hits my head hard .

 

ivr had brain scans , other scans , all bloods , was picked up having low 11am cortisol , but on future tests it is fine . I’m at my wits end and feel something is wrong . Someone has mentioned tolerance withdrawals , I don’t know Much about that . I do know the mirtazapine has given me many issues with foods that effect me , and histamine issues , can’t really eats sugar bread yeast products processed foods , as all make me feel spun Out . Could the Effexor be causing histamine problems ?! Anyone any ideas please . I no longer can take any supplements as all make my head very thick and dizzy . Help .

 

Edited August 6, 2022 by ChessieCat
added spacing

[ChessieCat]

On 11/12/2021 at 8:21 AM, Kiasofia said:

To give members the best information, we ask them to summarize their drug history in a signature. Please make it clear what dates you have been reducing Mirtazapine, the doses, what other drugs you are currently taking, as well as what drugs you have taken and the date you quit them the past two years.

How to List Drug History in Signature

 

As requested previously (above), please create your drug signature.

 

 

[Altostrata]

Hello, @Simon47

 

Please stop any drug changes at this point, until your symptom pattern is sorted out. 

 

On 8/6/2022 at 5:03 AM, Simon47 said:

In may of 2022 dr agreed to give me the liquid mirtazpine . I’m currently down to 13.5mg mirtazapine . Over last month though , the issue where after I’ve taken Effexor xl, 4 hours later my head becomes very thick and spaced out has returned .

 

Have you accidentally forgotten to take Effexor, or changed your dosing schedule of your drugs, in the last several months?

 

Are you taking any other drugs? What times o'clock do you take your drugs, with their dosages? Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

As @ChessieCat requested, Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Simon47]

https://www.drugs.com/interactions-check.php?drug_list=296-0,2296-0,1640-0&consumer=1&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication

 

here is the link I think to the interaction checker.

 

i currently take 13.5mg mirtazpine liquid solution at around 8.30/9pm and I take the Effexor xl 75mg around 8.30/9am with breakfast .

 

the only other medication I take is Azathioprine 100mg, an immunosuppressant in the morning about an hour after food . 
 

it’s really hard for me to do a complete timeline of all the various anti depressants I have been on as these span back to 1992 .

 

from 2017 to end of 2019 , I was only on 37.5mg venlafaxine . 
 

my father died in 2017 , but I seemed to cope as was then focussed on caring for my mum . 

late 2019, everything went to crap , and my dr added robexetine to the venlafaxine , only for 2 weeks as it made me on the ceiling and could not sleep . 
 

He then added phenagrin ( can’t spell it ) to try help me sleep , and then after another week , as I was a mess , he got me to quit the roboxetine over 2 weeks , and then started me on mirtazpine 15mg for 2 weeks and then up to mirtazpine 30mg every even , along with the venlafaxine 37.5mg in morning .

 

so from start of 2020

 

37.5mg venlafaxine extended release tablet in a.m

 

30 mg mirtazpine p.m

 

by march 2020

 

reduuced from 30mg mirtazpine to 22.5mg mirtazapine in one go, as we’re making me feel totally numb and depressed . Dr said could just half it 2 weeks then quit , but had read bad idea .

 

after few weeks , felt suicidal . So left any further reductions .

 

in March 2021, reduced down to 21mg mirt , still on 37.5mg venlafaxine .  Things for pretty bad few weeks after . Seem to have become histamine intolerant , many foods making my head spin and anxiety to sky high. Also whenever I take the venlafaxine in am , head gets very spinny 4 hours later .
 

May 2021 , asked dr if he could change the venlafaxine 37.5 tablet ( called venlalic ) To a capsule, as wondered if the venlafaxine tablet venlalic was not good in the mix .
 

dr changed the venlalic tablet 37.5mg extended release to Venlablue. A capsule with 3 tablets inside .  After a month of taking , felt even worse 
 

June 2021 , I decided to see if I could reduce or get off of the venlafaxine ( now taking venlablue capsule that has 3 tablets each 12.5mg in ), so took one out . 
had not touched the mirtazpine reduction since March .

 

June 11th, my mum died . Had massive fall out with siblings , and never felt so lost and a mess in my life . Ended up in a and e with the worst panic and anxiety .

 

june 28th Mums funeral and also put the venlafaxine back to the venlalic at full 37.5mg .

 

things did improve somewhat after a week . 
 

I left any more reductions as of this point, but the dizziness and weird head came back every 4 hours after taking venlalic after a month . This was the reason I tried to come off the venlafaxine .

 

ok, it gets a bit crazy here . Come September 2021, after years of waiting and assesments and such , i received my diagnosis of adhd and ASD ( runs in family ) through a private company funded by the nhs .

 

the private psychiatrist, all done online zoom calls , decided he wanted to try me on some stimulants . 
 

he took into

account everything I am on . 37.5mg venlafaxine, 21mg mirt . 
 

organised ecg and blood pressures etc , and started me on elvanse 30mg for a week . Just made me a zombie , but DID get rid of the spinny dizzy head every 4 hours after taking venlafaxine . I took elvanse before breakfast .

 

He then put it up to

50mg daily . And yes , I felt focussed , Organised , no intrusive thoughts , but two weeks in to this , my anxiety hit an all time high , and I was up

crying all night . 
 

they wanted me to stop this and try another adhd med, but I said no ,I can’t , I’m not a Guinea pig . And left it all there . 

I had called out for help so many times in the two years prior , and was put under the local mental health services , who have done very little. I did get to know the psychiatric pharmacist.

The psychiatric pharmacist, through the mental health team , who actually was the only one who seemed to get my struggles , suggested may be putting the venlafaxine up to

75mg , as I was clearly very depressed , and years ago it had helped me a lot . So I did put it up around Nov 2021 and it really did help .

 

the spinning and dizziness stopped that I was getting every 4 hours after taking .
 

.

its all A bit of a blur . All I know is that I am now down to 13.5mg mirtazpine in liquid form . 
 

i have been at this amount for 3 weeks. 
 

the Effexor has been at 75mg for some time now, and over the last month , I have the dizzy and spinning head returning every 4 hours after taking the Effexor 75mg .

 

this probably doesn’t make much sense to anyone . If you do reply , please be gentle , it’s been a rough few years .

 

Edited August 8, 2022 by ChessieCat
Resized font

[Altostrata]

I'm still finding it difficult to follow your more recent drug changes. Please condense your earlier history in your signature and provide more detail in your signature for drug events of the last 3 years.

 

Please review adverse effects of azathioprine. Could you have developed any of them?

 

On 8/7/2022 at 1:44 PM, Altostrata said:

Have you accidentally forgotten to take Effexor, or changed your dosing schedule of your drugs, in the last several months?

 

 

As I understand it, these symptoms are your current concern:

On 8/6/2022 at 5:03 AM, Simon47 said:

min January of this year , I continued the withdrawal very slowly of mirtazapine, and it’s very painful and makes me so so anxious and panicky and raising thoughts , all negative . In may of 2022 dr agreed to give me the liquid mirtazpine . I’m currently down to 13.5mg mirtazapine . Over last month though , the issue where after I’ve taken Effexor xl, 4 hours later my head becomes very thick and spaced out has returned . No one seems to know why , but it is scary . It’s like each day , I’ve taken the first Effexor again and it hits my head hard

 

Obviously, if you have the same symptoms at the same time each day, they are related to something else you're doing earlier, on a regular schedule.

 

12 hours ago, Simon47 said:

i currently take 13.5mg mirtazpine liquid solution at around 8.30/9pm and I take the Effexor xl 75mg around 8.30/9am with breakfast .

 

the only other medication I take is Azathioprine 100mg, an immunosuppressant in the morning about an hour after food .

 

You are taking Effexor and azathioprine at about the same time in the morning. Your symptoms following that probably are either adverse effects from Effexor or azathioprine, or an interaction between the two drugs. This is basic pharmacology and your doctors should know it.

 

Is there a reason you must take azathioprine at about 10 a.m.? Can you move it later in the day, well clear of the Effexor? If your symptoms move with the azathioprine, they are caused by azathioprine. If they do not, they probably are caused by Effexor.

 

Azathioprine is not a psychiatric drug and not within our purview of peer support here, nor did I get paid to research this drug. Strongly recommend you have a stern chat with your doctors to remind them they need to attend to drug adverse effects, they get paid for it.

[Simon47]

Thanks for the reply .

 

i take the mirtazpine in eve , same time every night 

 

the Effexor in a.m.

 

it is related to the Effexor , as if I take the Effexor a bit later or a bit earlier , the weird spaced out light headed dizziness always occurs around 4 hours after taking it .

 

as said . I had this last year when just taking the 37.5mg Effexor in a.m , and it only really went when they upped the doseage to 75mg .

 

it has been mentioned on a face book group that I could be getting tolerance withdrawls every day , as I’ve been on the venlafaxine / Effexor for some time , albeit at small dose ? 
 

 

[Simon47]

Also , as I mentioned , I was getting this happen last year when my venlafaxine dose was less (37.5mg)

 

and at that point . I wasn’t taking azathioprine , so I do not believe it is the Azathioprine.

 

im pretty scared to be honest . My anxiety is high due to my autism , and health anxiety . 
 

if I could just stop the Effexor I would ( and the mirtazpine ) but I’m not feeling on a strong place mentally and emotionally .

 

I think when this happened last year , and they switched me from venlalic 37.5mg to Effexor 75mg , and it stopped , I presumed it was just the brand venlalic that was causing me issues , 

 But now it’s back , I’m lost .

[Altostrata]

We need to see this: your drug and withdrawal history in your signature 

 

On 8/8/2022 at 3:00 AM, Simon47 said:

the only other medication I take is Azathioprine 100mg, an immunosuppressant in the morning about an hour after food . 

 

Are you taking azathioprine daily?

 

9 hours ago, Simon47 said:

the weird spaced out light headed dizziness

 

Is this your worst symptom? It appears to be related to either the Effexor or azathioprine you take at about the same time in the morning. 

 

You could move the scheduling of either the Effexor or azathioprine to see if that affects the dizziness.   

 

You're taking Effexor XR, it's unlikely you're getting interdose withdrawal. Tolerance withdrawal would not appear every day shortly after you take the drug.

 

In my opinion, it's possible you are suffering adverse effects from azathioprine and effects of Crohn's. I have advised you to review azathioprine's adverse effects but you are set on blaming Effexor. Please note that addressing adverse drug effects is your doctors' responsibility. We do not provide free services here to treat drug adverse effects.

 

Do you have a question related to psychiatric drug tapering or withdrawal?  

[Simon47]

Yes I take Azathioprine daily .

 

I was getting this happen prior to being on azathioprine when on a lower dose of venlafaxine 

 

im sorry if you feel I am blaming the Effexor XL , but the worrying symptom seems to follow the four hours after taking this .

 

I haven’t meant to come here and annoy people , but seems my question has and I apologise for that . Was just really needing some support / and was pointed this way.

[ChessieCat]

 

 

You have been asked 5 times to create your drug signature.  This is the 6th time.

 

 

 

On 11/12/2021 at 8:21 AM, Kiasofia said:

To give members the best information, we ask them to summarize their drug history in a signature. Please make it clear what dates you have been reducing Mirtazapine, the doses, what other drugs you are currently taking, as well as what drugs you have taken and the date you quit them the past two years.

How to List Drug History in Signature

 

 

On 8/7/2022 at 8:01 AM, ChessieCat said:

As requested previously (above), please create your drug signature.

 

On 8/8/2022 at 6:44 AM, Altostrata said:

As @ChessieCat requested, Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

 

On 8/9/2022 at 9:00 AM, Altostrata said:

Please condense your earlier history in your signature and provide more detail in your signature for drug events of the last 3 years.

 

6 hours ago, Altostrata said:

We need to see this: your drug and withdrawal history in your signature 

 

[Altostrata]

You do not consider this support? Did you read this? 

 

 

On 8/8/2022 at 4:00 PM, Altostrata said:

You are taking Effexor and azathioprine at about the same time in the morning. Your symptoms following that probably are either adverse effects from Effexor or azathioprine, or an interaction between the two drugs. This is basic pharmacology and your doctors should know it.

 

Is there a reason you must take azathioprine at about 10 a.m.? Can you move it later in the day, well clear of the Effexor? If your symptoms move with the azathioprine, they are caused by azathioprine. If they do not, they probably are caused by Effexor.

 

YOU TAKE EFFEXOR AND AZATHIOPRINE AT THE SAME TIME. EITHER COULD BE CAUSING YOUR SYMPTOMS.

 

You would need to move the dosing apart by several hours to see if the symptom moves with the drug. I would not mess with the Effexor dose if your problem is the azathioprine, or an interaction between the two.

 

If you want to taper Effexor, see Tips for tapering off venlafaxine (Effexor)

 

If you want peer counseling, summarize your drug and withdrawal history in your signature before further discussion.