ReddLedd: Mirtazapine Reinstatement help!

[ReddLedd]

Hi all, thanks for accepting me. 

I’m in need of some help, all of this is so new to me and I’m trying to make the best decisions I can since making some rather poor choices. 
May gp put me on 15mg mirt after a panic attack episode in Oct21 and diagnosed me with GAD. Took it on/off for two weeks (stupid mistake) and didn’t get much of the anti anxiety benefit so she upped me to 30mg. Took that for 3 weeks and no anxiety, but the numb-like state and lack of sex drive really got to me, so went back to 15mg for a week and came off CT as I was advised that would be fine… 

We all know that’s no the case! 
 

I’ve done 2 weeks of CT, first 2 days fine, next 3 days nausea and dizziness, next week or so, just headaches and disturbed sleep. All the while no real panic or anxiety, but the physical symptoms were too much to be able to work. 
 

So last night, I decided to reinstate on 7.5mg. Slept okay, but woke this morning with pretty bad anxiety and have been restless and irritable most of the day. 
 

My question is; I can accept that RI may take days or weeks to stabilise, but how would I know if I’ve missed my window of RI,or need to up or down the dose? 
 

Apologies in advance, some of this is fundamental for you all, but I feel like I’m flying blind here as my doctor doesn’t have the knowledge about anti depressants

I’m aware nobody can specifically diagnose me, but any help or advice regarding reinstatement would be appreciated. 

[ReddLedd]

Just looking for help to decide whether I should stop (given I feel worse after 24 hours) or continue with the 7.5mg to potentially see if it’s the right dose

[Frogie]

Hi @ReddLedd

 

Welcome to SA. Sorry you had to come here because of what you are going through, but you've come to the right place.

 

We ask that you only create one page so we can keep all your information in one place. This is your page to receive information, ask questions, and meet new members that are going through or have gone through what you are.

 

Thank you for creating a signature. What day did you exactly go off Mirtazapine? Then I see you reinstated just yesterday (January 5th).

 

Here is some information to get you started.

 

Tips for tapering off mirtazapine (Remeron)

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

Dr Glenmullen's withdrawal symptom list

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Digestive problems:  Nausea, Diarrhoea, Bloating, GERD

 

Fear, terror, panic, and anxiety

 

You might try a small amount of magnesium and omega and see it that helps. Just take one at a time, and a small amount before introducing the other one at a small dose.

 

Magnesium

 

Omega-3 Fish Oil

 

If you really think reinstating would help, I would start at 3.5 mg and you could always go up.

 

You might read this information that I've provided. 

 

Let us know any questions that you may have or how we can help you🙂

 

 

 

 

[Frogie]

11 hours ago, ReddLedd said:

Just looking for help to decide whether I should stop (given I feel worse after 24 hours) or continue with the 7.5mg to potentially see if it’s the right dose

I've answered this question, I hope.

[ReddLedd]

Thanks @Frogie this is the second night I’ve had 7.5mg and woken up with elevated heart rate, so not sure whether to try again at 3.5 or if just stop. It doesn’t seem to be agreeing with me but and it’s scary..

[Frogie]

If it has only been a few days, I would probably stop it and see how you feel.

 

Here is some information on elevated heart rate. You can also google "survivingantidepressants.org elevated heart rate" and see what else might come up.

 

You might want to keep notes and post them here so we know how you are doing.

 

Keep Notes on Paper

 

Keep us posted please.

[ReddLedd]

27 minutes ago, Frogie said:

If it has only been a few days, I would probably stop it and see how you feel.

 

Here is some information on elevated heart rate. You can also google "survivingantidepressants.org elevated heart rate" and see what else might come up.

 

You might want to keep notes and post them here so we know how you are doing.

 

Keep Notes on Paper

 

Keep us posted please.

Thanks @FrogieI’m a bit worried that so many events of starting and stopping I’ve done damage to myself (see signature). 
the RI doesn’t seem to agree with me but am I being too impatient in waiting for the drug to start working again, or does it seem more like I’m having no a reaction with the elevated heart rate and anxiety on waking. Only had this since I started the RI two nights ago..

[ReddLedd]

@Frogie22nd of Dec came off mirt until RI 5th jan. Felt like it was making me a zombie and gained 5kgs in 3 weeks. Also hearing about the horror withdrawals was a factor

[Frogie]

@ReddLedd

 

I would stop it and see how you feel in a few days. Hopefully a little better, but it could take a while.

 

In the meantime, keep notes and post them so we know how you're doing.

 

Keep Notes on Paper

[ReddLedd]

Thanks @Frogie I’m going to try this. 
have only just got up and felt slightly better but still have a HR between 80-100 just sitting having a cup of chamomile tea.

Will Keep updating my diary and this post, given most of the info I’ve read it seems like I may need to prepare for a long road back. 
These drugs are really dangerous, I wish there was more restrictions around prescriptions for doctors, or at least education and access to important studies. 

[Frogie]

I wish there was too. I really wish these dr's had to be certified on how to prescribe, what they do and how to taper off of them correctly. I think if my dr took them, then got them ripped away like he did me, he'd think twice. Or I hope he would.

 

Keep notes and let us know how you are doing.

 

My heart has been out of the norm for me since Christmas. I think it was all the junk I ate. I just need to get back to normal eating and it will subside.

 

Enjoy your tea.

[ReddLedd]

Thanks man. Here is my first days notes;

 

6th jan - went to bed feeling slightly anxious but no excessive. Took 7.5mg @ 930pm. 
Slept at roughly 1030pm fell asleep easily. 
woke at 330am, rapid heart rate, moderately anxious. Performed breathing excercise throughout the morning, didn’t fall back asleep but was able to provide minor relief. 
Woke at 630am feeling slightly elevated HR and slightly anxious but manageable. 
monotonous thing RI seems to have helped with us the headache which is now 2 out of 10 as opposed to 6 out of 10. 

[Frogie]

Keep them coming so we can see how you are doing

[ReddLedd]

Update for the afternoon; 

Felt okay this morning going to work, a little light headed and nauseous at times but manageable. 
Actually felt semi-normal before lunch for about an hour. Although, my adrenaline has been high since my first night of the RI. Very restless and weird energy.  Now sitting down, it’s just 100+ HR on the couch and mild headache, with mild dizziness. Its so hard to judge whether this is the work of the RI or whether it’s a latent healing from withdrawal or a window. 
hopefully my body gives me some indication tonight, because I don’t want to flip-flop on ‘do or don’t’ continue RI. 
We’ll see I guess..

[ReddLedd]

Evening update;

So since later afternoon, I’ve actually felt pretty good for the first time in weeks. Drink lots water, went to acupuncture and had a healthy veggie dinner. Still feeling okay now, Herat rate seems to be calming down. 
Now im really torn about whether the RI is working, but I know that whatever choice I make tonight is likely the path I’ll have to commit to

[ReddLedd]

Evening/sleep/morning update;

So went to sleep last night, didn’t take a dose. Fell asleep quite easily and slept from 1030 to 430(ish), but woke up with everyone’s favourite cortisol spike. HR wasn’t super elevated but def faster than resting. Couldn’t go back to sleep so got up at 530 and let the dog out. Anxiety kicked in shortly after, about the same as yesterday (post 7.5mg dose), but went back to bed and did some breathing excercises and managed to get it back down to tolerable. Mild tension headache as morning progresses. 
so the only difference I can notice immediately is that I’m not waking up with immediate racing heart, otherwise I’m serviceable as the day goes on. 
I felt not too bad yesterday, but not sure if it was a result of the RI or just a coincidence. 
not really sure how to make the decision of whether to continue cessation or continue the RI @7.5 and hold for a while. 
@Frogieany thoughts here?

[Frogie]

@ReddLedd

 

That is a very common wd symptom. You did the right thing, breathing exercises and didn't panic.

 

Here's a topic that you might find interesting and helpful:

 

But overall, it sounds like you are doing ok. Glad to hear!

[ReddLedd]

Thanks @Frogie was reading that post when I woke up this morning so will try a few different things. 
obviously not asking for concrete advice, but at what point do I need to consider either committing to some form of RI or continuing the cessation? Maybe the better question is, what do I need to consider before making the choice?

[Frogie]

@ReddLedd

 

I wouldn't wait more than a couple of weeks, and not more than a month to make the decision if you want to reinstate. The longer you wait, the less chance that it may work.

 

About reinstating and stabilizing to reduce withdrawal symptoms

[ReddLedd]

9 minutes ago, Frogie said:

@ReddLedd

 

I wouldn't wait more than a couple of weeks, and not more than a month to make the decision if you want to reinstate. The longer you wait, the less chance that it may work.

 

About reinstating and stabilizing to reduce withdrawal symptoms

Thanks @Frogiethat’s what I suspected. Maybe I should give it another day or two without a dosage and see how I feel, as you suggested initially. 
I’m just concerned about taking on and off again, but tbh, if I can get off this stuff I would be so happy. 

[Frogie]

@ReddLedd

 

I would be very happy if you could stay off of it also.

 

Why don't you give it through the weekend and let me know how you are doing.

 

You might keep notes over the weekend.

 

Keep Notes on Paper

 

We can revisit it after the weekend, unless you feel worse. Then tag me. I'll be off and on all weekend.

[ReddLedd]

@Frogiewill do and thanks, really appreciate the help. 

[Frogie]

@ReddLedd

 

No problem. 

 

Let's hope your weekend is almost symptom free.

[ReddLedd]

Quick update; Headache is already brutal. Already had some magnesium and drinking plenty of water. Will update later this evening. 

[ReddLedd]

So feeling a little flat today. Pressure/tension headache is prob 5/10. 
Spent the morning planting some new ferns in pots, nothing too strenuous but very low energy after (this may also be due to something else I’m dealing with at the same time). 
Nausea on and off, prob 5/10 but manageable. 
Anxiety has been present but manageable, maybe 4/10

Inflammation/sore joints prob 5/10. 
heart rate still fluctuating mildly but between 65-100 most of the day. 
 

@Frogiemost symptoms are okay as long as they don’t get worse. The thing I keep hearing on one of the other forums though, is that as soon as you experience WD symptoms it’s best to RI. I’m sure that’s the best way to hedge bets, but do you know anyone who’s had experience with a few weeks of moderate symptoms that disappeared eventually? 
I haven’t had any extreme days yet (🤞) but dealing with the moderate symptoms for months or a year sounds like a hellscape

[Frogie]

@ReddLedd

 

There are success stories you could read. Just google “survivingantidepressants.org mirrazapine success stories “. I’m sure quite a few will show up.

 

If you so want to reinstate it is best to do as soon as possible. You could do a very low dose, hold for a moth or so and do a long slow taper.

 

But that’s a decision only you can make. It sounds like you are doing relatively well for just ct’ing off the medication.

 

Let me know what you think.

[ReddLedd]

@Frogieappreciate the response. I’ve only been taking mirt for a short while, but I really want off it, get myself right and move on to other methods to kerb my anxiety (which is was mild before my Covid ‘episode’). 
I’m a little concerned about doing long term damage to my CNS with CT, everybody seems to have horror stories about this drug. I mean, the physical symptoms suck, but I can push through over time. It’s just the anxiety episodes that make it hard. 
I think I may push through to tomorrow and see if I’m still feeling the same or worse. 

[Frogie]

There are long term horror stories about everything in life. Don’t read into them. I think you’re doing pretty well for just ct’ing off of them. 
 

Keep a positive attitude and you’ll do just fine😊

[ReddLedd]

Thanks @Frogie  

feeling a little rough this morning. Still falling asleep easily, but even with the blinds blacked out and very little light on my room I was bolt upright at 430am (sun normally rises at 5am here currently). 
Anxiety was present immediately but is slowly going down I hope. 
A little jittery this morning, muscles feel a slight weakness and upset stomach. 
Tension headache present maybe 3/10 currently. 
Im sure mirtazapine shares many symptoms with other ADs, but it also seems to be a beast of its own. I know the short half-life means your body starts to experience WD quickly by comparison to others. 
The other issue is it’s messed up my histamine tolerance, but I’ve heard to avoid taking any antihistamines (or sleep aids like melatonin) for a few weeks months to avoid prolonged WD issues. Can you or any other mods shed any more light on that? 

[Frogie]

@ReddLedd

 

Have you tried an anti-histamine diet? I know a lot of members on here follow them. You might check it out.

 

 

[ReddLedd]

@Frogie have been doing it for a couple of weeks now. It’s really tough, especially trying to figure out which foods/smells/situations cause flare ups. 
I’m sure it’s working, but the difference is very hard to notice. I’ll persist though, as I’m sure it will be a benefit in the medium-long term. 
it’s really just the sleep and early waking/anxiety that’s difficult to manage currently, but I’ll keep trying to push on with the techniques others have provided and hopefully it will begin to sort itself out over the weeks. 

Im really Impatient to seek out some alternative therapies/medicines as soon as I can, as long as they don’t interfere with the withdrawal process. 
these drugs are definitely not the answer for a lot of people, just a lazy solution for doctors to ‘hit and hope’. CBD has always been a great help, but it utilises the same liver enzymes that mirt does, so I’m hesitant to mess my withdrawal. It really sucks not being able to take anything to help, but my assumption is; get through it and start healing faster and hopefully back to feeling human again 🤞

[Frogie]

I hope you can get through it and start the healing process. It is a hard process to go through. Try lots of self care and keep me posted 😊

[ReddLedd]

Hi @Frogie just keeping you updated. 
felt okay this morning, but not too long ago I had a weird dizziness while standing which turned into a mini panic episode. 
haven’t experienced one for while, may be an indication that I’m not in for a good time if I continue cessation

Will see how my situation changes this afternoon/evening

[Frogie]

Keep notes on how you are feeling. Then we can see if there is a pattern or not.

 

Keep Notes on Paper

 

Hope your day gets better.

[ReddLedd]

Thanks @Frogiefeeling pretty average currently. Very similar to the first 2 days I started my cessation. Feel like I have the flu, lethargic, fatigued, headache. 
going to see how I’m feeling tomorrow, hopefully some improvement. 
if not, might be time to concede and RI. 
 

[ReddLedd]

Evening update. Other symptoms have subsided, but the headache now is quite bad. Trying to stay away from painkillers, but pretty tough to deal with tbh