Mystagogy: Is This Mirtazipine Withdrawal?

[Mystagogy]

I've had issues with acid reflux for years, treated with ranitidine. Ranitidine was taken off the market last year. I did try a couple of other medications but did not do well on them.

 

In March 2021 I had an endoscopy. The GI doc said my stomach spasms and Mirtazapine would fix it. I would be on it for 6 months and should be fixed. I was pretty happy; I don't do well with other drugs used for reflux and none of them are a permanent fix. He started me on 7.5 mg and increased to 15 mg.

 

At first it was my miracle drug. I had been getting a lot of nausea when I had no medications, and it immediately took the nausea away. And I had no side effects. But about two months later I started feeling out-of-it. I think it's called depersonalization...like things weren't real. (I've since read that this is a side effect for some.) It started quite suddenly.

 

I called my doctor. He decreased me to 7.5 mg, then 1/2 of that. I even went off for a few days. On the 1/2 dose my nausea came back. Ultimately he increased me back to 7.5 mg. 

 

Going back to 7.5, the nausea and the depersonalization went away.  I was good again for a couple of months again. Then the depersonalization came back. I cannot express how much I hate that symptom.

 

The rest gets a little fuzzy; I lose track of time but in a nutshell, at the advice of doctors I've been off, back on, and off again. Every time I go off, a week or so later I get full of nausea and some fogginess and some depersonalization. I have found a doctor who listens and agrees it might be withdrawal, but he doesn't know for sure. With his support, I found a way to get ranitidine and it seems to me the reflux symptoms are better (no more heartburn, and the globus sensation has improved.) But could this actually be reflux or something else, or does it sound typical of withdrawal? 

 

A couple of things: I do better in the evenings, and sometimes even by later afternoon. Now and then I even feel close to normal before I go to bed but I dread bedtime, because the next day I have to start this over. Lately I've been declining but I have had periods where I've been better for a few days to a couple of weeks. Last time I felt good I was taking 7.5 mg every third day (per doctor's advice) and taking rantidine. But the depersonalization came back so I just quit the mertazipine altogether per doctor's suggestion.

 

Next week I see my doctor again, but also a new GI doctor. Is it worth mentioning withdrawal to him or does this not sound like that? Since I do not do well on 1/2 of 7.5 mg, would that rule out withdrawal?

 

[Kiasofia]

Welcome @Mystagogy

I am sorry you are going through this and are suffering, but relieved you have found us. The symptoms you list are common withdrawal symptoms and if you feel worse at lower doses or when you quit and better when you restart, then withdrawal is likely the cause.

 

What is withdrawal syndrome?

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

 

Starting and stopping psychiatric drugs is bad for the central nervous system (CNS). Each time we start and stop it becomes more and more sensitized. The risk of a bad reaction to restarting the drug or starting other drugs or supplements, increases. Taking the drug every other day (or every third day) is the same as starting and stopping many many times. So never do this!

 

Unfortunately medical professionals have a poor understanding of how these drugs affect people. I found this post helpful to understand how these drugs actually work.

How Psychiatric Drugs Remodel Your Brain

 

You have two options at this point. Either start taking Remeron again, same dose every day and once stable, slowly taper off. If you do this, start with a very small dose like 1mg and then you can attempt slowly increasing. Please read this:

About reinstating and stabilizing to stop withdrawal symptoms

 

Or stay off it and find ways to manage the symptoms while giving your body time to heal from exposure to Remeron.

Symptoms and self care topics

 

Important topics about tests, supplements, treatments, diet

 

Take some time to read the information I have provided and then we can take it from there. This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here.

Edited November 23, 2021 by Kiasofia

[Mystagogy]

Thank you so much! I've been doing a lot of reading here and plan to do a little more. I'm glad I'm here too. It makes me feel a little less crazy to not be alone in this. 

[ChessieCat]

Hi Mystagogy and welcome from me too.

 

12 minutes ago, Mystagogy said:

It makes me feel a little less crazy to not be alone in this. 

 

I felt the same way.  The title of my Intro topic is:  So I'm not the only one.

 

I was very relieved to discover that there was a reason for the way I felt with the withdrawal symptoms. 

 

When we understand what is happening and why, it can make it easier to cope.

[JesusSavemefromWD]

On 11/20/2021 at 8:24 PM, Mystagogy said:

I've had issues with acid reflux for years, treated with ranitidine. Ranitidine was taken off the market last year. I did try a couple of other medications but did not do well on them.

 

In March 2021 I had an endoscopy. The GI doc said my stomach spasms and Mirtazapine would fix it. I would be on it for 6 months and should be fixed. I was pretty happy; I don't do well with other drugs used for reflux and none of them are a permanent fix. He started me on 7.5 mg and increased to 15 mg.

 

At first it was my miracle drug. I had been getting a lot of nausea when I had no medications, and it immediately took the nausea away. And I had no side effects. But about two months later I started feeling out-of-it. I think it's called depersonalization...like things weren't real. (I've since read that this is a side effect for some.) It started quite suddenly.

 

I called my doctor. He decreased me to 7.5 mg, then 1/2 of that. I even went off for a few days. On the 1/2 dose my nausea came back. Ultimately he increased me back to 7.5 mg. 

 

Going back to 7.5, the nausea and the depersonalization went away.  I was good again for a couple of months again. Then the depersonalization came back. I cannot express how much I hate that symptom.

 

The rest gets a little fuzzy; I lose track of time but in a nutshell, at the advice of doctors I've been off, back on, and off again. Every time I go off, a week or so later I get full of nausea and some fogginess and some depersonalization. I have found a doctor who listens and agrees it might be withdrawal, but he doesn't know for sure. With his support, I found a way to get ranitidine and it seems to me the reflux symptoms are better (no more heartburn, and the globus sensation has improved.) But could this actually be reflux or something else, or does it sound typical of withdrawal? 

 

A couple of things: I do better in the evenings, and sometimes even by later afternoon. Now and then I even feel close to normal before I go to bed but I dread bedtime, because the next day I have to start this over. Lately I've been declining but I have had periods where I've been better for a few days to a couple of weeks. Last time I felt good I was taking 7.5 mg every third day (per doctor's advice) and taking rantidine. But the depersonalization came back so I just quit the mertazipine altogether per doctor's suggestion.

 

Next week I see my doctor again, but also a new GI doctor. Is it worth mentioning withdrawal to him or does this not sound like that? Since I do not do well on 1/2 of 7.5 mg, would that rule out withdrawal?

 

Sorry to hear ur suffering. My opinion is u have derealization (things not looking real, like ur detached from the surroundings) and not depersonalization. I have suffered both both DP and DR just after 3.5 weeks of Zoloft; I hate it as much as you do, mine is so bad that keeps me bedridden. If u look at the leaflet of most ADs among the side effects depersonalization is mentioned, bad most doctors don’t even know what it is and the ones who do know tell u it cannot be from ADs…. They are clueless regarding these drugs. Wishing u fast healing 

[Mystagogy]

19 hours ago, ChessieCat said:

Hi Mystagogy and welcome from me too.

 

 

I felt the same way.  The title of my Intro topic is:  So I'm not the only one.

 

I was very relieved to discover that there was a reason for the way I felt with the withdrawal symptoms. 

 

When we understand what is happening and why, it can make it easier to cope.

Thank you, @ChessieCat. I am really struggling today. I saw a GI doc and he said he doesn't think my problem is intestinal and did agree that it could be withdrawal, but also is asking for an MRI of my brain. Because in the last couple of months I've had an issue with smelling things nobody else smells, he's concerned about it being a brain tumor.

 

I am consistently better at night so don't expect it to be a tumor. But of course, since there's no real test for withdrawal, I get afraid that it isn't actually that either and I'll just never have an answer. I can handle a lot of things when I know they will end and life will get back to normal; I don't do the "endlessly sick" thing well at all. I am really struggling emotionally today. It helps so much that people here do think it's withdrawal; I wish there was a way to just be certain. Because this needs to end.

[Mystagogy]

9 hours ago, JesusSavemefromWD said:

Sorry to hear ur suffering. My opinion is u have derealization (things not looking real, like ur detached from the surroundings) and not depersonalization. I have suffered both both DP and DR just after 3.5 weeks of Zoloft; I hate it as much as you do, mine is so bad that keeps me bedridden. If u look at the leaflet of most ADs among the side effects depersonalization is mentioned, bad most doctors don’t even know what it is and the ones who do know tell u it cannot be from ADs…. They are clueless regarding these drugs. Wishing u fast healing 

Thank you, @JesusSavemefromWD. I get how that feeling can keep a person bedridden. It's horrible. I am lately having problems even with meds I used to take and handle just fine. Any medication that can make me tired (Hydroxyzine, Meclazine) seems to bring it on. It's driving me crazy.

 

I wish you fast healing, too. Living like this is ... difficult. 

[JesusSavemefromWD]

4 hours ago, Mystagogy said:

Thank you, @JesusSavemefromWD. I get how that feeling can keep a person bedridden. It's horrible. I am lately having problems even with meds I used to take and handle just fine. Any medication that can make me tired (Hydroxyzine, Meclazine) seems to bring it on. It's driving me crazy.

 

I wish you fast healing, too. Living like this is ... difficult. 

I am glad ur dpdr is not constant. Mine has been constant for 13 months since I quit Zoloft, that’s why is unbearable. 

[ChessieCat]

4 hours ago, Mystagogy said:

is asking for an MRI of my brain. Because in the last couple of months I've had an issue with smelling things nobody else smells, he's concerned about it being a brain tumor.

 

Other members have had the smells issue.  However, if you and/or your doctor are concerned about whether something is due to a medical issue then it is better to get it checked out.  It can help to reduce any stress you are experiencing.  If it is something then it can be addressed as best as possible, and if nothing is found then at least you know.

 

There are many existing topics on SA.  You can use the site search function or use an internet search engine and add site:survivingantidepressants.org to the search term.

 

olfactory-disturbances-changes-in-the-sense-of-smell

[JesusSavemefromWD]

4 hours ago, Mystagogy said:

Thank you, @ChessieCat. I am really struggling today. I saw a GI doc and he said he doesn't think my problem is intestinal and did agree that it could be withdrawal, but also is asking for an MRI of my brain. Because in the last couple of months I've had an issue with smelling things nobody else smells, he's concerned about it being a brain tumor.

 

I am consistently better at night so don't expect it to be a tumor. But of course, since there's no real test for withdrawal, I get afraid that it isn't actually that either and I'll just never have an answer. I can handle a lot of things when I know they will end and life will get back to normal; I don't do the "endlessly sick" thing well at all. I am really struggling emotionally today. It helps so much that people here do think it's withdrawal; I wish there was a way to just be certain. Because this needs to end.

I bet u don’t have brain tumour, I ve had these smell sensations on and off after I quit Zoloft, they are gone now. It is WD, I don’t understand why doctors don’t get it. ADs affect every part of the brain. Some people get visual snow cause their visual cortex was affected more, some people get tinnitus cause their auditory system was affected more and some people get to smell things that are not there because their olfactory cortex (responsible for smell recognition) is deregulated and misfires and sends wrong signals waking up memories of smells u had in the past. It’s as simple as that, anyone with basic brain function knowledge , like doctors, should just get it , but they don’t…. 

[Greatful]

@Mystagogy  Hi there, welcome to SA.  I was reading your intro and I don't know why, but I am still amazed the doctors don't know how much these drugs change our brains.  Why in the world would you prescribe  anti-depressant for acid reflux. Sadly they don't know  what all these drugs affect.

That d/r is crazy and unsettling, but it will get better.  Sounds like you have already started to look around the site.  There is so much to learn. The more you learn the less scary it will be.

Know that you will heal.

Please post and ask all the questions you want.  Connect with other members, we are all here for the same reason, learning about what is happening to us, and finding comfort and encouragement.☺️

 

 

 

[JesusSavemefromWD]

38 minutes ago, Greatful said:

@Mystagogy  Hi there, welcome to SA.  I was reading your intro and I don't know why, but I am still amazed the doctors don't know how much these drugs change our brains.  Why in the world would you prescribe  anti-depressant for acid reflux. Sadly they don't know  what all these drugs affect.

That d/r is crazy and unsettling, but it will get better.  Sounds like you have already started to look around the site.  There is so much to learn. The more you learn the less scary it will be.

Know that you will heal.

Please post and ask all the questions you want.  Connect with other members, we are all here for the same reason, learning about what is happening to us, and finding comfort and encouragement.☺️

 

 

 

This doctor‘s license should be removed or at least temporarily banned till he/she learns not to prescribe ADs for acid reflux….Unbelievable!! 

[Mystagogy]

On 11/24/2021 at 3:23 PM, JesusSavemefromWD said:

I am glad ur dpdr is not constant. Mine has been constant for 13 months since I quit Zoloft, that’s why is unbearable.

@JesusSavemefromWD, I don't know how you even handle that. Every time I go through dpdr I get afraid it will never end.

[Mystagogy]

On 11/24/2021 at 3:25 PM, ChessieCat said:

Other members have had the smells issue.

That's really good to know. I don't believe I have a brain tumor; I am debating cancelling my MRI because I REALLY don't want to do it and I'm certain they will find nothing.

[Mystagogy]

On 11/24/2021 at 3:56 PM, JesusSavemefromWD said:

I bet u don’t have brain tumour, I ve had these smell sensations on and off after I quit Zoloft, they are gone now.

I don't think I have one either. It is good to hear that you've had those too and that they stopped. Mine seems to have been gone for a couple of days now; I'm just hoping it's the start of the rest of withdrawal (mainly nausea) to go away.

[Mystagogy]

On 11/24/2021 at 5:56 PM, JesusSavemefromWD said:

This doctor‘s license should be removed or at least temporarily banned till he/she learns not to prescribe ADs for acid reflux….Unbelievable!! 

He offered me Reglan but I don't tolerate Reglan. The idea behind Mirtazapine is to stop the stomach spasms. And it DID immediately get rid of my nausea...until I went off of it. But he doesn't know as much about Mirtazapine as he should, in my opinion Including about withdrawal. He apparently has used it successfully. He said patients use it five or six months and then go off of it and are just fine. Sounded like a dream come true; so much better than Proton Pump Inhibitors (which have their own issues) for the rest of my life.

[JesusSavemefromWD]

3 hours ago, Mystagogy said:

@JesusSavemefromWD, I don't know how you even handle that. Every time I go through dpdr I get afraid it will never end.

Believe me I don’t know how I keep surviving each day. All other symptoms I can kind tolerate even the inner agitation/Akathisia but not the DP. If it’s is not constant, you can rest assured it will slowly but surely completely vanish 

[JesusSavemefromWD]

3 hours ago, Mystagogy said:

He offered me Reglan but I don't tolerate Reglan. The idea behind Mirtazapine is to stop the stomach spasms. And it DID immediately get rid of my nausea...until I went off of it. But he doesn't know as much about Mirtazapine as he should, in my opinion Including about withdrawal. He apparently has used it successfully. He said patients use it five or six months and then go off of it and are just fine. Sounded like a dream come true; so much better than Proton Pump Inhibitors (which have their own issues) for the rest of my life.

I cannot justify the use of an AD for stomach issues…. For me its like trying to fix ur stomach but risk to mess up ur brain cause u cannot predict how each individual responds to an AD. 

[Mystagogy]

On 11/26/2021 at 5:23 PM, JesusSavemefromWD said:

If it’s is not constant, you can rest assured it will slowly but surely completely vanish 

Thank you so much for this encouragement.

[Mystagogy]

On 11/26/2021 at 5:28 PM, JesusSavemefromWD said:

I cannot justify the use of an AD for stomach issues…. For me its like trying to fix ur stomach but risk to mess up ur brain cause u cannot predict how each individual responds to an AD. 

Of course, I knew nothing about all that can go wrong when he prescribed it. I had no idea it could mess up your brain. Obviously I agree with you now. I've realized if I ever need any of these types of meds for mental health in the future I'll be very scared to try them.

 

Once again, thanks. It's so good to talk to folks who understand.

[JesusSavemefromWD]

4 minutes ago, Mystagogy said:

Of course, I knew nothing about all that can go wrong when he prescribed it. I had no idea it could mess up your brain. Obviously I agree with you now. I've realized if I ever need any of these types of meds for mental health in the future I'll be very scared to try them.

 

Once again, thanks. It's so good to talk to folks who understand.

It’s not ur fault, Your doctor should have known that ADs are dangerous But most doctors are idiots when it comes to ADs. Please excuse my frustration for these doctors prescribing ADs like candies… it only took 10 mins talking to a family doctor to put me into immense suffering over a year (and counting) following just 3.5 weeks Zoloft poison. The thing is as a neuroscientist I was suspicious about the safety of these drugs so I asked many times my doctor how safe these drugs are, I asked so many times that my doctor got annoyed and she told me “Zoloft is a safe, mild and beneficial drug, it will relief ur chest tightness (the only symptom I had) and u ll be able to easily quit in 6 months, as an established scientist urself u shouldn’t doubt medicine”. I was convinced and took the poison… look at me now… 13 months bedridden suffering no stop except when I sleep at nights. I slept good thank God. Sure chest tightness is gone but so is every other aspect of normal life for me. Wishing you fast healing and stay away from these poisons.

[Hamster]

On 11/21/2021 at 12:54 AM, Mystagogy said:

A couple of things: I do better in the evenings, and sometimes even by later afternoon. Now and then I even feel close to normal before I go to bed but I dread bedtime, because the next day I have to start this over. Lately I've been declining but I have had periods where I've been better for a few days to a couple of weeks. Last time I felt good I was taking 7.5 mg every third day (per doctor's advice) and taking rantidine. But the depersonalization came back so I just quit the mertazipine altogether per doctor's suggestion.

 

Hi @Mystagogy,

 

I'm a Mirt survivor ... I can relate to what you are talking about.
For three years now I'm constantly doing better in the evenings and worse in the mornings. It's so exhausting, be it slowly has become better over time. On some days I'm completely fine in the morning now ... I'm sure you will be also fine again some day.

 

For me it looks like you cannot tolerate the side effects of mirtazapine any more ("out of it" feeling) and when you stop it you end up with withdrawal symptoms (nausea, mood swings, depersonalization, ...).  So depending on your situation right now you can try to ride it out - this can be be tough or simply unbearable, as quite some mirtazapine users had to find out.

 

Or you ask a moderator about reinstatement. As you mentioned that 7.5 mg/3 days was OK I'd start with maybe 1.0 mg per day. But please take it every day - skipping doses is not a good idea with WD symptoms. After stabilization you can do a proper taper, you will find a lot of helpful information here.

 

One thing I'd keep in mind: Mirtazapine is a potent antihistaminic. You mentioned issues with some other drugs which are antihistaminics as well (Meclizine), and Ranitidine is another antihistaminic drug ... As far as I can see they are affecting different types of histamine receptors, but it may be something to talk to your doctor about.

 

Best wishes, Hamster

 

[Mystagogy]

I think I'm going to have to reinstate. I get worse every day. I keep wondering...is all of this really withdrawal? I do have a history of hard-to-diagnose illnesses. (For example, I ended up with a ruptured appendix, after 14 months of trying to get help, and in the end it was only discovered because I insisted on surgery. Docs said they wouldn't find anything. And yet, there it was, a ruptured appendix.)

 

I used to handle antihistimines just fine. I'm wondering if Remeron messed that up or what. Today I am more sick than I have been yet. It's not getting better. I am scared of living a life like this.

 

 

[Mystagogy]

How are you certain what you're going through is withdrawal? My doctor thinks it's what's happening, but we're not certain. My primary symptoms is nausea, awful in the morning, better at night. I am having some mental health symptoms, too, but I've been sick most of the year and it's taking a toll. 

 

I was on Mirtazapine for stomach spasms. I was supposed to only need it 6 months and was told I could just go off of it. (7.5 mg). Unfortunately I developed side effects and can't go back on to taper off. (I did go back on a couple of times, long story, but I can't anymore.) I really need a way to know if this is what I'm dealing with. I also am wondering if there are treatment centers that deal with this kind of thing.

 

 

[Kiasofia]

Hi @Mystagogy

I've merged your new topic with your Introduction topic. SA works differently to many other forums. Each member has their own Introduction topic (only one).  Your Introduction topic is the best place to ask questions specific to your own situation and where you can journal your progress.  This keeps your history in one place and means that you do not have to repeat your story.

 

If the symptoms happened after quitting a psychiatric drug and are among the symptoms listed for withdrawal (see attachment) then it is likely withdrawal. But if there are other factors involved, or a health issue that coincidentally started at the same time, then it's not possible to know for sure. So spending time trying to rule out other causes is wise.

 

According to medical knowledge, reinstatement is the only way to alleviate withdrawal. The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis. At a low dose side effects are often less of a problem. But unfortunately we do not know for sure how the individual will react.

About reinstating and stabilizing to reduce withdrawal symptoms

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

The Windows and Waves Pattern of Stabilization

 

 

Perhaps our self care section can be of help:

Symptoms and self care topics

 

 

What to do for dizziness , queasiness, nausea

Drglenmullen_withdrawal_symptoms.pdf

Edited December 4, 2021 by Kiasofia

[Mystagogy]

Thank you, @Kiasofia. I did try reinstatement at 1/4 of 7.5 mg. The next morning I was in pretty bad shape (having some dizziness and a few other symptoms) and i don't think I can do that again.

 

Really appreciate everything on this site.

[Kiasofia]

17 hours ago, Mystagogy said:

I did try reinstatement at 1/4 of 7.5 mg

Was this after Nov 7?

 

(When you tag someone make sure to select their name from the drop down menu and see that it turns blue. @Mystagogy)

[Mystagogy]

7 hours ago, Kiasofia said:

Was this after Nov 7?

Yes. I'll update my signature. I took it December 2. The doctor figured if the nausea went away on it, then it meant my symptoms are withdrawal and he'd taper me more slowly. But I couldn't handle the dose I took.

 

I did wake up pretty nauseated, and overly drugged (derealization), but by noon I was feeling better, which is pretty early for me. That afternoon I was the best I've been in ages. I've declined since. This morning was terrible, but I'm slowly coming back again. His next thought was to try Prozac and then wean off of that. I'm very nervous about it but I might have to give it a try. He said Prozac is a lot easier to get off of.

 

 

[Kiasofia]

23 hours ago, Mystagogy said:

He said Prozac is a lot easier to get off of.

This is true for some people, just like it's true for some people that starting and stopping Mirtazapine is not a problem. There are many who struggle to withdraw from Prozac. Starting another psych drug or reinstating has risks of an adverse reaction since the withdrawal brain is so sensitized. Which is why no more than 1mg to start with for reinstatement is the general advice. It is generally not advised to take a different drug to ease withdrawal, than the drug causing the withdrawal.