ReddLedd: Mirtazapine Reinstatement help!

[ReddLedd]

@Frogienot really feeling better, just slightly different. Still very anxious and eyes jumping around, so not sure whether to hold or not. Feel wired from no sleep as well, which is worrying as mirt always helped with sleep if nothing else. 

[Frogie]

@ReddLedd

 

I think you might try an updose then. Hopefully that will help.

[ReddLedd]

22 minutes ago, Frogie said:

@ReddLedd

 

I think you might try an updose then. Hopefully that will help.

Will give it a try. 
At what point do you think I would have to start tapering off as opposed to just stopping. The higher we go in dosage the more it will likely exacerbate my histamine intolerance (which was originally triggered by mirt). The doctor honestly couldn’t have prescribed a worse drug for me in the start. 
The reason she started me on it was to combat the sudden panic attacks that had come out of nowhere. 
I’ve been having such a hard time trying to sort my gut out through all of this, I’m so worried that the RI will mess things up again 

[Frogie]

@ReddLedd

 

If you go above 2 mg and you are still having the same exact symptoms, then I would say you could try up to 3 mg before knowing it wouldn't work and you could do a fast taper off of it. You might have some bumps but it would be like reinstating, you would come down about the same fashion.

[ReddLedd]

Thanks @Frogie

Definitely feeling worse than I did last week so far, but will try UD at 2mg and see if it offers any relief at all. 
feels like the physical symptoms have been somewhat replaced by early morning waking and constant anxiety. 
Not sure what the right choice is tbh

[ReddLedd]

I really want to sort out my anxiety and panic episodes, if RI fails though I’m guessing I’ll just have to wait it out to see if my CNS ever returns to normal?

Obviously another AD is risky but I’m just trying to come up with a plan B. 

[ReddLedd]

Afternoon update; 

it’s now been 2 nights of 1mg then 3 nights of 1.5mg and feeling horrendous. Felt nauseous and low energy most of morning and eyes have been very jumpy. Body having weird temperature regulation issues also. Did 3 hours of moderate work, but even simple tasks like reaching down to grab a tool made me tired. 
felt wired upon completion, heart rate tachycardic when I arrived home with extreme fatigue. ☹️

[Frogie]

@ReddLedd

 

Do you want to try a little updose to see if it would help? Or do you think this is not going to work? 
 

You’ve been on it a short enough time that you could just stop if you feel things are going to become worse.

[ReddLedd]

I honestly don’t know @Frogie  

last night really spooked me to start. Mirt at low dose is supposed to be super sedating so I’m worried it’s messing with my night cycle already. Also below 15mg it’s basically a strong sleeping pill/antihistamine so I wonder if it’s even worth trying to mitigate anxiety without going back to full dose. Mind you, the attacks have only been reoccurring since I started RI… 

Also today felt like 3 months ago, very fatigued, sort of feverish, nausea. 
I feel like if the RI might work, I’d be seeing some small evidence of it in the first few days (maybe that’s wishful thinking). 
I know there’s no certainty here, and I’m just praying for something to show me the way. 

 

Either way, I guess I only have two options. 
stay with Mirtazapine and hope for the best over a few weeks/months, or continue the cessation and try my best to use natural healing choices to get myself better over the journey. 

[Frogie]

@ReddLedd

 

If you don't think it is helping I would stop it now before you have to taper off of it.

 

At this point it is hard to decide because you only reinstated a few days ago, so you are going through the initial symptoms that usually happen during a reinstatement.

 

But I don't want you suffering either. Only you can tell if you feel if you hold on a few more days this might work.

 

I can give you a link on things you can do to help with the nausea. You might read that and see if something might work.

 

Digestive problems:  Nausea, Diarrhoea, Bloating, GERD

 

Let me know what you decide to do. Hang in there.

 

 

[ReddLedd]

@Frogie

Thankyou so much. Will have a solid read and have a big think about it. Worst thing is, I don’t feel too bad in the evenings so it’s hard to be objective trying to think ahead. 
Today was so weird, it didn’t feel transitional at all, it really felt like full on WD. One thing i know is it certainly hasn’t helped as yet, but It sounds like I may not see that potentially for a week or two if at all? 

 

Its a really hard choice but will have a serious think about it before bed time. 
Dealing with a lot of regret so I’m trying to wipe that from my mind before I make a choice. 

[Frogie]

@ReddLedd

 

No you won't feel "normal" for about a week to 10 days, and like I said you may need to updose again. That's why we do it slowly so your body can get used to it again.

 

Think about it and see how you feel for a couple of days and let me know what you decide.

 

It is a hard decision to have to make right away.

[ReddLedd]

It really is @Frogiebut I’m super scared of stopping and starting again so want to try and keep some consistency either way. I’m driving south to see my dear old mum for the weekend tomorrow so freaking out a little as I don’t think I could’ve done that drive today. 
I think it’s a lot of the fear of going through a few weeks of dosage changes and holds, potentially ending up in coming down the mountain again. I know this shouldn’t factor In to my choice, but I’ve always been someone who likes to prepare. 
 

[Frogie]

@ReddLedd

 

I completely understand. I am the same way. I like to prepare for everything and it throws you for a loop when things don't go the way you have planned.

 

Hopefully you will feel better soon. Have a nice visit with your mum😊

[ReddLedd]

@Frogie

I’m guessing its prob not ideal for me to skip a dose tonight, so if I decide to continue with the RI, would it be better for stability to hold at 1.5 or worth a shot updose tonight to 2mg do you think?

[Frogie]

@ReddLedd

 

No skipping doses is not a good idea at all.

 

NEVER SKIP DOSES TO TAPER

[ReddLedd]

@Frogie 

unfortunately another sleepless night at 1.5. 
A little worried that I’ve ruined my sleep cycle totally now. It wasn’t great before but at least I was getting 5 or 6 hours at times. 
 

[Frogie]

@ReddLedd

 

Since you've only taken it a few days, you can stop. You may have some wd symptoms.

 

Let me know what you think.

[ReddLedd]

Thanks @Frogie

Ill monitor how I feel today and weigh it up. 
i must have slept an hour or two, as I’m remembering quite a vivid dream so I guess that’s something. 
If by some miracle I don’t feel horrendous today, then maybe I should continue and updose to 2mg, although if it doesn’t assist my sleep I’m assuming I’ll have to continue with the RI until some sort of result is achieved? If that’s the safer thing to do of course. 
(Last nights dose makes 2 nights at 1 and 4 nights at 1.5)

[Frogie]

@ReddLedd

 

If you remember a dream, you are getting REM sleep. The best you can get. I am lucky to get a couple hours a night, but I know some day I will sleep again.

 

If you can catch a nap during the day, that might help too.

 

It's rough starting out. You could updose to 2 mg if you think it may help. We just need to find your "sweet spot" and that's why we go so slowly on reinstatements.

 

Let me know what you decide over the weekend. Just rest and do lots of self care.

 

 

[ReddLedd]

Will do @Frogie

 

an observation I’ve made today; it seems anything at all I do to excite the nervous system throws me into a bit of a sweat, even just lifting something first thing in the morning. Hard to say whether this was as present before the RI, but it def is now. 
My nervous system seems really destabilised and I’m worried that this is how I am going to be now. 
mom really trying hard to practice calm and self care, but anything outside of calm and quiet really throws me for a loop. 
Seems to be the one thing that I can’t really see a professional about either, outside of therapy which I’m already trying. 

[Frogie]

@ReddLedd

 

Those are all normal symptoms, but you may just need to re-evaluate over the weekend and see if this is what you want to do.

 

You might want to keep notes and see how you are over the weekend.

 

Keep Notes on Paper

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Then you can weigh the pro's and con's.

[ReddLedd]

@Frogie

 

Not sure if it’s just being away from the city, the security of the family home or some stability from RI but I felt less horrid today. Not going to lie, in a perfect world I’d just spend a month here and heal up, but modern life rarely affords us convenience does it?!
I guess I should hold at 1.5 maybe and weigh it up over the weekend, although I’m tempted to see if 2mg will work out my poor sleep for the night..

Already have a copy of the symptoms checklist and keep day notes on my phone. 
 

Have been keeping a pros/cons list and they’re very balanced atm, will add to them if anything comes up. 
 

[Frogie]

@ReddLedd

 

That sounds like a really good report.

 

I think I would stay at 1.5 mg, at least through the weekend and see how you feel.

 

After the weekend, you can decide if 2 mg would be more helpful or not.

 

Enjoy!

[ReddLedd]

@Frogie

 

Maybe spoke too soon. Had a bit of a rough night sleep, feeling pretty rough this morning again. Congested, extremely groggy and not well rested at all. Tinnitus is off the charts also. 

It’s like the best I feel all day is the few hours before I take my dose. Then the worst part of my day is first thing In the morning when I wake up. 

 

last night I was really tired before I took my 1.5 dose, then It took a good 2 hours before I was ready for sleep again. Weirdly my sleeping seems to be worse since RI. 
 

 

[Frogie]

 

@ReddLedd

 

Do you want to continue, or try an updose and see if that may help a bit?

 

[ReddLedd]

4 hours ago, Frogie said:

 

@ReddLedd

 

Do you want to continue, or try an updose and see if that may help a bit?

 

Hi @Frogiei think I might try an updose to 2mg tonight. Need to try and sort out the sleep if possible. 
Will keep you posted. 

[Frogie]

@ReddLedd

 

That sounds good.

 

Keep me posted

[ReddLedd]

@Frogie

 

2mg rocked me to sleep but sweet Jesus I’m anxious and irritable this morning. 
Woke at 5am feeling like I’d been hit by a freight train and have been awake since then. 
I’m supposed to do a cardio stress test tomorrow but I’m a little worried if I’m feeling like this. 
My new cardio suspects I may be suffering from Dysautonomia to some degree after my Pfzr Jab. 

[Frogie]

@ReddLedd

 

I don’t know much about the covid vaccine. I took the Moderna and the booster and I was sick for a week with a migraine.

 

Hopefully it eases for you soon.

[ReddLedd]

@Frogiei sincerely wouldn’t wish my

experience on anyone tbh, it’s been incredibly difficult. 
 

I’ve enrolled in a 12-month daily practise program which is built around, total health and meditation/mindfulness/nutrition etc. 

i guess I’ll hold on 2mg for a week or so, but if it’s not feeling effective then what would you recommend for a taper after that? 
roughly the same rate I tapered on to RI?

[Frogie]

@ReddLedd

 

If you want to taper off since you weren't on but a few days, you could taper off at the same speed.

 

Hopefully in a couple of days it will even out and you will feel better.

[ReddLedd]

@Frogie

 

ill give the 2mg a couple of days to see if I level out I guess. If so I’ll hold for a while and monitor.
It’s tough because mirt even at low doses is an appetite agonist. Aside from the anxiety, I’ve been eating like a horse this week which is making intermittent fasting near-impossible. 

[Frogie]

@ReddLedd

 

I hope you level out.

 

It is really tough I understand. I had a racing heart rate while going through my Lexapro taper and gained 60 pounds! Those are all normal symptoms and nothing to be upset about, because it isn't you.

 

Hang in there.

[ReddLedd]

Hi @Frogie

Just an update, 2mg again last night and seemed to sleep well after doing some nighttime meditation so that’s a win I guess. 
If I could do something about these little panic episodes throughout the day I could start to function again. 
Will continue to hold for a few days and keep you posted, I’m praying I stabilise a little more. 

[Frogie]

@ReddLedd

 

Sounds like a good update except for the panic you had. Hopefully it will drop off soon.