ReddLedd: Mirtazapine Reinstatement help!

[ReddLedd]

@Frogie just an update from the last week. Saw the new doc and she is great, but she wants to mainly focus on diet and lifestyle changes first while she tests for autoimmune issues, rather than go straight on antidepressants. I like this solution but am a little worried where I’m at with my mirt CT. 
She does focus on mental health, but she did say “you weren’t on it long it should be okay”. Now, speaking to other people with vast experience of mirt, even short stints can leave people with a long slow taper, or a long time with withdrawals. Apparently it’s a bit renowned for being a tough one to get off. 
Now, it’s been 4 weeks today since I started my CT. The symptoms aren’t debilitating 24/7, but I’d say they’re constantly there and somewhere between 3/10 and 6/10. I get an hour or two window and then symptoms come back. I’m still able to work, but occasionally I have to leave early when I get flu-like symptoms or adrenal issues. I wish there was someway to know if this will pass and I could push through, but I’m terrified of over committing and being stuck  in this state for years (I know i should focus on the positive, but there’s plenty of stories of people having protracted withdrawal). 
I will def ask doc again when I see here next week, but it’s starting to feel like I just don’t have many that can help me with this side of my treatment. There’s a lot of “it should be fine” which is no good. 

Will keep you posted, just feeling so unsure about all my choices and making more of the wrong ones. I’d rather go the healthy route and get my body Repairing properly, but also starting to wonder if I actually do need some med help at some point 

[Frogie]

@ReddLedd

 

So sorry I missed your post. My internet is down so I’m using my dumb phone as I call it lol…

 

You have to make the decision as to whether you want to reinstate or not.  No one can make that decision for you. 
 

I’ll be happy to help you if you come to a decision.

 

Keep me posted.

[Frogie]

@ReddLedd

 

Just checking in on you?

[ReddLedd]

Hi @Frogie thanks for checking in. 
struggling a bit, but just doing my best to hang in there. 
My situation is rather complex so it’s making life difficult..

in Oct I had a sever reaction to a certain mandated medicine and I have been battling this ever since. When my doctor put me on mirt for GAD (lazy diagnosis) it actually made me much worse, hence the reason I came off it. 
Since then, it’s very difficult to figure out which symptom is WD and which is my ongoing battle with ‘the product that shall not be named’. Being constantly gaslit by doctors and having absolutely no support hasn’t helped. Not to mention the impending law changes which means I may be now out of a job after 22 years of long, hard graft..

To say this has been a trying time is the grossest understatement I have ever made. But I’m hanging in there, as much as one could expect in this modern day dystopia. 
 

[Frogie]

@ReddLedd

 

I'm sorry to hear of all the struggles that you have been going through.

 

And so, so sorry you hear about the job situation. Hopefully you'll be able to keep it.

 

Dr.'s are fun, aren't they? It's a hard choice as to who to trust when in this mess.

 

I can only send good wishes.

 

 

[ReddLedd]

Hi @Frogieand anyone reading, thought I’d come back and check in. 6 weeks since too-fast taper and eventual CT..
Still having a bit of a rough time, trying to discern between my jab reaction and withdrawals is making life tough. 
mum able to go to work most days, but am constantly plagued with blurry( sort of) vision, sinus-type headaches, mild insomnia/early waking, tinnitus and GI issues. I stupidly read some horror stories on SA about protracted Withdrawl lasting years from Mirtazapine and I wish I didn’t. 
I know it’s not healthy to focus on the negative, but the mere fact it’s a possibility is terrifying enough..

im hanging in there for now but really hoping I’m progressing and not stalling still the bad stuff is coming up. I’m hoping the fact that symptoms seem to be either plateauing or slightly improving means it’ll healing, I guess only time will tell. 
Tbh, I’ve entertained shifting to a different AD, but if I can get through this without I’d rather as pharmaceuticals have been the source of all my woes in the last 5 months. 
Hope you’re all doing okay out there and I’ll try and keep you all updated even if it’s sporadic. 
❤️

[ReddLedd]

Hi @Frogie and anyone else again. 
just me, the guy who makes rash decisions and doesn’t ever seem to follow logic 😬

week 8 from my last 2 day RI. 
last week was actually pretty good, had 3 days in a row where I felt like a normal human again, and was super pumped that I was on the mend. 
However… the last 3 days have been a fresh version of hell. Same as the original days, weird sort of fever, shortness of breath and anxiety as well as elevated heart rate throughout most of the daylight hours. Cortisol wakeups have been bad, and I’ve been waking at 4am like clockwork since i started my cessation. 
being that it’s been 2 months since my last 3-day 7.5mg RI I’m not sure whether to attempt to RI at lower dose or just continue to stick to out. My big concern is that RI so far one may mean I have to commit to feeling shorty for a decent period. 
Tbh, it’s the elevated HR that is the hardest to deal with, especially when it’s the moment you wake up 😭
 

I know, I’m all 6s and 7s again, but would love any helpful input from someone who feels they could offer it. 
 

Thanks team ❤️

[ChessieCat]

 

REDUCING CORTISOL, THE ANXIETY HORMONE

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

Gianna Kali's toolbox for coping with withdrawal syndrome

 

Best CBT techniques for anxiety and/or depression?

 

"Forest bathing" reduces cortisol, aids mood, immune system

 

More about how light stimulation affects our body clocks

[ReddLedd]

Or alternatively, is it an option to rotate to maybe an SSRI (as TCAs def don’t agree with me it seems). 
Is that a stupid idea maybe?

[ReddLedd]

Thanks @ChessieCatappreciate the info. 
Ive already attempted to implement most of the tips here (except for the forest bathing, which is really tough where I live. Fair bit of a drive with anything green around ☹️). 
Unfortunately I’ve still had no respite. The sleep issues are really hard to deal with and I don’t feel like I’m healing from other issues so it sucks. 
do you or any of the other mods have experience with Mirtazapine at all? 
I know most ADs are similar, but this one seems to have its own quirks so wonder if others have made the same mistakes I have?

[ReddLedd]

Hi to anyone reading. 
Had another rough week unfortunately. Had to put our dog down last week and it’s really knocked me about..

Have been quite fragile and shakey this week, so tough considering how good I was doing previously. Still have some symptoms (mainly anxiety, 4am wakeups and elevated heart rate most of the day). Had my first (near) panic attack in months a few days ago. Nothing happened, my body just went through the initial wave sort of..
Being that’s it’s now 9 weeks since my brief RI in Jan, I’m seriously considering doing a 1mg RI. I’d rather not, but am pretty scared of protracted withdrawal and would love to try and alleviate some of the symptoms of possible. Tbh if I could Sorry out my heart rate I’d actually be able to achieve a few things, the other symptoms are manageable. 
Before I do though, I’d love any input at all from anyone able to provide it. 

Looking forward to any options at all. Pushing all the positive energy out to you in internet land ❤️⚡️
 

TIA

[Frogie]

@ReddLedd

 

I'm so sorry to hear about your fur baby. They become part of the family. I went through that while going through wd.

 

You could try a 1 mg reinstatement and see if that helps. It takes about a week for it to register in your body to know if that will work. You could always updose a little more if needed.

 

About reinstating and stabilizing to reduce withdrawal symptoms

[ReddLedd]

Thanks @Frogie

It was pretty traumatic tbh, not sure my partner has been able to deal with it yet but it’ll take time. Unfortunately it really put me back to how I felt back last year, like it rattled me proper!

 

I was thinking the same dosage (1mg) and see how that goes for a week to 10 days maybe. If symptoms improve I’ll hold for 6-8 weeks, if not I’ll wait and try and do an updose to maybe 2mg?

[Frogie]

@ReddLedd

 

That sounds like a good starting point, 1 mg. You could always go up to 2 mg in 7-10 days if needed.  The I would hold a good 6 months or so after the reinstatement and then begin to taper, but I'll be glad to help you when the time comes.

 

I'm truly sorry for your loss. And hope your partner is doing ok through this.

 

Keep me posted.

[ReddLedd]

Thanks @Frogie  

Given I’ve had issues with my immune system, my doc wants me to do a proper detox on my liver (with a product called Toxaprevent) and that I can’t take antidepressants while I do this. 
Im not sure if she believes withdrawal can last this long tbh, but I agree my body does need a detox. 
I’m going to have to make another really tough decision on my own, whether I start RI or detox and continue my cessation. I wish there was a professional that could actually help..
I was doing so good before our dog passed and it feels like my nervous system is re-sensitised all over again. 

[ChessieCat]

liver-detox-gallbladder-flush-internal-cleansing-enemas-fasting-other-detoxification-methods

 

[ChessieCat]

Please note this post by SA's founder Altostrata:

 

  

On 6/16/2011 at 1:28 AM, Altostrata said:

 

Hmmm, I feel I must point out here that withdrawal symptoms are not due to toxicity, but to the ABSENCE of a drug upon which the body has become dependent. The liver has done its job properly and caused what it can to be excreted.

 

Given that we urge gradual tapering, anything of the drug remaining in fat or tissues could be considered to cushion, however minimally, the lack of the drug the body is craving. If you are in the middle of tapering, which means you're deliberately slowing the passage of the drug from your body, why would you want to speed the drug out of your system with liver detoxification (assuming that would work)?

 

My belief is that, our bodies and nervous systems being under so much stress from withdrawal, detoxing the liver or any other ritual of purification only adds further stress and doesn't do anything positive for proper withdrawal. (Liver detox was developed for serious, identifiable heavy metal poisoning.) Liver cleansing is one of those things naturopathic medicine routinely recommends for all kinds of ills, with very little evidence it helps any of them. I do not think it's appropriate for withdrawal syndrome.

 

 

[Frogie]

@ReddLedd

 

Personally, I wouldn't do a liver detox. It seems to be very stimulating on the body after reading everything that @ChessieCat has provided to you.

 

I looked up Toxaprevent on the internet. You can buy it on Amazon, if that might tell you anything.

 

https://www.naturalchemist.com.au/froximun-toxaprevent-from-biopractica-advanced-detoxification/

 

It is very hard to lose a fur baby. I lost mine when I was going through my horrendous taper off of Lexapro. I had my little chihuahua for 16 years. Her and I were connected by the umbilical cord so to speak. I was lost for 3 years before we decided I needed a new companion. She will never replace my baby, but she sure is special and has my heart.

 

What might help you the most is some therapy. I think at this point they would be more of use to you than a liver detox. 

 

I'm not going against your dr at all, this is just my opinion after reading about it.

[ReddLedd]

Thanks @ChessieCatappreciate the info. 
I suspected that may be the case. 
My situation is so tough; prescribed mirt by original doctor after I had an adverse reaction to my Pfzr jab, since then have been going through hell and my functional doc has been trying To help me with supplements and diet changes so far to no avail. 
Now we’re at the stage we’re she’s trying a detox (which effectiveness is debatable it seems) and I’m at the stage where my anxiety and heart rate are giving me grief. Could be lingering issues after my ‘event’ but also could be withdrawal. It’s so tough to figure out which. 
Safe practise dictates RI @ low dose of ~1mg to start but this would mean scrapping my whole wellness plan (or the detox part of it anyways). 
I don’t expect anyone to have the answers, but thought it would be a good idea to lay it all out there, in the off chance someone may have some insight. 
 

Honestly, some short-term respite would be so good, but I’m so scared that it may be at the detriment of my long term healing. 
 

I really appreciate you all trying to help ❤️

[ReddLedd]

Thanks @Frogiehave just posted before I saw your reply. 

appreciate your honesty. I’m going to therapy atm, meditation every morning, lunchtime yogi practice, evening tapping and vagus nerve exercises currently. It’s only been a week so hard to tell if they’re making a difference, but I’m sure they will in the long run. 
I’m swimming in completely uncharted waters here so I’m understandably worried and I cannot believe how unlucky I’ve been in getting here to start. 
 

Not sure what I’ll do as it seems I’m damned if I do or don’t, but ultimately I’ll have to make some sort of decision. 

[Frogie]

@ReddLedd

 

It's a decision only you can make. If you do decide to reinstate, I will be happy to help you.

 

I really think all the therapy and meditation you are doing at the moments is 1,000 times better than putting your body through yet something else it has to heal from.

[ReddLedd]

Hi @Frogie reinstated last night at 1mg from my liquid. Slept fine, but woke up this morning feeling a little wonky and quite restless and irritable. Not sure if I’m too destabilised or just my body acclimatising again. Is it better to hold off or to continue with the RI and seek stability?

[Frogie]

@ReddLedd

 

I would continue with the reinstatement and see how it goes. It takes about a week for your body to fully register the dose.

 

Keep me posted.

[ReddLedd]

@FrogieAlso, wondering if anyone has any tips regarding liquid. I’ve followed the guide and made up a 15mg crushed pill with 7.5ml of water and 7.5ml of maple syrup, however the crushed pill hasn’t fully dissolved. There are still the tiniest fragments of pill in the liquid after I give it a gentle shake (basically dust, not chunks). 
Is there something else I need to add to the liquid or is it maybe some sort of filler in the pill? 
Just want to make sure I’m getting a consistent amount each time I measure as we don’t have the fully dissolvable tables available here. 

[ReddLedd]

@Frogiepls disregard the last post, have asked a question in the appropriate thread. 
Just wondering though, at what point will I know if the RI is not going to work, should I be able to stabilise within the first week if it’s successful?

 

[Frogie]

@ReddLedd

 

If it’s successful you will feel better. Maybe not totally stabilized, but better than you were.

[ReddLedd]

Thanks @Frogiewas a little shakey and had restless adrenal energy today. Bit of anxiety but I am hoping it’s just my body trying to readjust. 
on the contrary, if RI isn’t successful in minimising any symptoms this week, is it time to start a slow taper off or just continue to hold for a while?

[Frogie]

@ReddLedd

 

I would make sure you take it for at least 7 days and you can always go up a little after that is the symptoms are still there and see if that helps. That's why we suggest such a small amount to start on.

 

 

[ReddLedd]

@Frogiethanks. Woken this morning with a very restless energy again. Went straight to sleep fine but both mornings so far have been weird wakeups. Stomach is pretty upset and feeling real shakey. 
Mirt at low doses is supposed to be sedating, but have woken up quite suddenly yesterday and today which is a little different from the last few weeks. My tinnitus is really bad too, maybe Mirtazapine and me won’t ever get along..

[Frogie]

@ReddLedd

 

You could try a small updose, maybe 0.5 mg and see if that helps.

[ReddLedd]

Thanks @Frogie

just going back on my diary notes when I was on mirt early on. Feeling is rather similar, early waking, a little dizzy and vision is a little strange. 
Am I running a risk of going too far if mirt doesn’t really agree with me here?

[Frogie]

@ReddLedd

 

I think you could try a small updose and see if that helps. Just keep notes. You’re on a small enough dose that hopefully it will even out in a few days.

[ReddLedd]

@Frogiecheers, just getting worried. Feeling a few symptoms that haven’t been here since I was on it. Kind of like floating rather than walking and it’s very uneasy. 
already feeling like this may have been a mistake. 

[Frogie]

@ReddLedd

 

Those are normal symptoms when you reinstate. Just keep track of them for a few days. But I’m sure you’ll even out.

[ReddLedd]

@Frogiethe afternoon fatigue is really brutal 🤕

just so I know he plan going forward, if I start feeling worse than this, is it time to stop or is that too risky? Or do I just keep persisting with 1/1.5 or 2mg indefinitely until I get a result? 
 

Edit; just got home and sat down, my heart rate is jacked at ~135 and blood pressure was a hit higher than normal. 
This really sucks, I have no idea whether I’m feeling worse or better. 

[ReddLedd]

It seems 1mg for mirt isn’t going to do a lot for mitigating the anxiety, given that it’s basically a potent antihistamine only lower than 15mg. 
In which case, do I just cut my losses now and either stop the very low RI or try and switch to a low dose of something like fluoxetine or something that may not make me feel so horrible? 
 

I have an appt with my cardio next week also, I sure he’s going to put me something to lower my heart rate, which will be very problematic if I’m in the midst of trying to stabilise