LiaJ: overwhelmed by deluge of information, mirtazapine tapering, ? updose

April 11, 2021

I'm glad to hear you are doing better today! It sounds like you are doing a lot better than you were when you first started getting off psych meds.

I don't believe it's too slow of a taper. We at SA suggest a taper of no more than 10% of your current dose every 4 weeks at most, and some do better tapering even slower than that. Slow and steady wins the race. Yes, it takes a very long time to taper properly. I started my taper in August of 2017, and I'm still working on it.

And yes, exercise intolerance and sensitivity to medical treatments are common too. When you short tapered off Celexa, that could have sensitized your nervous system. These threads go into other people's experiences with these issues:

Nervous System Hypersensitivity

Exercise in Withdrawal

January 16, 2022

Recovering from a "destabilizing event"

I have reached a point in my WD where I was functioning well. I completed graduate school and became a licensed psychotherapist while healing and tapering.

Last weekend I moved from KY to Arizona for an amazing job opportunity. I start my job on Tuesday.

This past week my sleep has completely worsened to my early withdrawal days. My heart rate is about 20 beats higher than normal and my anxiety is through the roof. I had to move without my husband, who will be coming here eventually. So everything is new and nothing us familiar.

I'm surprised about how poorly my body has handled this transition. It seems as though this event has destabilized me and I am having doubts about whether or not I should even start my job. It's an amazing opportunity and I don't want to fail there or make them regret that they hired me. I've had thoughts about moving back home to my husband. I have become increasingly more anxious, sleepless, and today a migraine from hell.

Has anyone else had this experience? I need some encouragement.

Edited January 16, 2022 by ChessieCat
added topic title before merging with intro topic

January 16, 2022

It is not at all surprising that you are experiencing insomnia.

Any of these can cause insomnia and/or anxiety issues, even for someone who is not trying to get of a psychiatric drug.

Putting it in black and white you are experiencing at least 3 major life stressors; moving and starting a new job and being separated from your husband until he moves, which will be even more stressful if you do not know when he will be arriving.

Q: Are you also selling your old residence? If yes, then that is another major stressor.

Q: Are you also moving away from other relatives/friends that you are emotionally close to?

January 17, 2022

Help.

I have hit an unexpected rough patch and I'm not sure what to do. My signature reflects my current dose of 1.5 mgs of mirtazapine.

Last week I moved from KY to AZ for a new job. I left my home, and my husband, who was not able to move with me.

Over the course of a week, my sleep and anxiety levels have reached early withdrawal proportions.

I realize this would be a huge, anxiety provoking transition for anyone, least of all for someone contending with medication withdrawal.

I felt like 2021 was my best year, and my sleep was finally normalizing on a consistent basis. So I'm somewhat surprised that my body has responded in this way.

I am wondering if I need to increase my Mirtazapine dosage again to assist with the anxiety and sleeplessness. I am sleep deprived and want to make a good decision about whether or not this is advisable, especially after I have worked so hard to be where I'm at. I also don't want to fail in this new job, that I care about very much and have also worked equally hard for.

If a dosage increase is something that could possibly be of a benefit, how much is advisable? I need some guidance.

I know this isn't exactly a question about tapering but I don't know how else to reach a moderator on this site.

Thank you,

Lia

January 17, 2022

3 hours ago, LiaJ said:

Help.

I have hit an unexpected rough patch and I'm not sure what to do. My signature reflects my current dose of 1.5 mgs of mirtazapine.

Last week I moved from KY to AZ for a new job. I left my home, and my husband, who was not able to move with me.

Over the course of a week, my sleep and anxiety levels have reached early withdrawal proportions.

I realize this would be a huge, anxiety provoking transition for anyone, least of all for someone contending with medication withdrawal.

I felt like 2021 was my best year, and my sleep was finally normalizing on a consistent basis. So I'm somewhat surprised that my body has responded in this way.

I am wondering if I need to increase my Mirtazapine dosage again to assist with the anxiety and sleeplessness. I am sleep deprived and want to make a good decision about whether or not this is advisable, especially after I have worked so hard to be where I'm at. I also don't want to fail in this new job, that I care about very much and have also worked equally hard for.

If a dosage increase is something that could possibly be of a benefit, how much is advisable? I need some guidance.

I know this isn't exactly a question about tapering but I don't know how else to reach a moderator on this site.

Thank you,

Lia

Hi LiaJ, @LiaJ

You found me. And you can always notify one of us too. You just type in the @ symbol, and then when you begin to type in a name, a dropdown menu appears that you then use to select who you want to notify. As a reminder though, please don't overuse the feature for moderators. We often do follow members too, and do see your posts.

We do very much prefer you post your questions around your particulars right here, in your Introduction topic.

I did merge your post in tapering on back here. And must have done it backwards too, as it wound up in tapering, and now I've got you back to Introductions.

Did you see Ccat's questions above?

I will, offer you this too, from me. I got hit pretty bad with what could have seemed like unsurmountable problems for some, after a recent loss. Yet, for me, now, this far out from drugs.......I did not even dream of medication or using any. Well.....in all honesty, if that idea arose, I checked it and chucked it quickly.

I mean I know that it feels like your job is at stake now......and I don't want you to chuck that opportunity out the window.

I am going to stop here just to make sure that my changes all took. The merge of your post in tapering to here, and my then re-titling of your topic and will continue in my next reply to answer your last post.

So....bear with me please.

Edited January 17, 2022 by manymoretodays
minor

January 17, 2022

Okay, that all worked out okay.

****and adding in that I think this is very much a question that relates to your tapering plan and you now. And so totally appropriate to put right here, in your Introduction. With either a notification, and or quote to try to engage with a moderator as soon as possible. We are, doing our best too LiaJ, to catch posts that do seem to need a reply from someone, as fast as we can. I mean moderators routinely do check all the posts coming in through the feed here.

And anyway, on how I related to what is happening with you right now......I'll elaborate a bit.

So anyway, lost my Mum. And had been in a bit of what I'll call a life slump, or bit of overwhelm anyway when that occurred. I too, had to travel, to get to Mum for her last days, and then also deal with the family and siblings, and the chaos of course when a loved one is hospitalized. And then, her death too. All in short order. It was tough. Old trauma surfaced. And I was able to not only use non-drug coping, but even add in more. And so persevered in that way.

For me, it wasn't all anxiety, or all about that particular symptom of fear......but a whole lot more to work on, and around. Which I have.

And okay, so you have had a week now.....total time of the worsening symptoms?

And you continue alone in a new location?

When does the job start? Day of, date?

And......I am hoping, I don't know for sure but hoping.......that your first days at work will be lighter weight, orientation even in their nature.

What have you tried for insomnia coping thus far? In itself, it can be one of the toughest symptoms , that then leads to other symptoms. And even though......it arose, or I think it may have from so many life changes at once, this may help to have a look at, read through, and then try something from.

Tips to help sleep: so many of us have that awful withdrawal insomnia

^ this one in particular has some invaluable tips to help with sleep problems

including a indexed list of more tips.

Do you use melatonin or anything now for the onset of sleep?

Do start low, if not, and you do try this or milk peptides.

Do perhaps try some magnesium, either or though.......just one addition or change at a time.

I find magnesium very calming at present. And it IS a go to for me, when stressed or "anxious".

I use Epsom salt baths prn, or as needed to relax. And also Magnesium citrate, or glycinate. I found one that mixes with water, lemony flavored that is great with magnesium gycinate.
Magnesium, nature's calcium channel blocker

Again though, and important now, is that you do not overdo with supplements. I stress that. Look at the links, and start low, and then only one new thing at a time. With magnesium, don't be doing several different types of either......I mean like Epsom salt baths and then orally, and I'm sure you get it. I don't mean to minimize your intelligence now and forgive, as I don't recall all your specifics right at this moment.

And well, I do see now A magnesium listed in your signature. Depending on the type, you might be able to do a bit more. Or......if you don't already, spread it out throughout the day......the total dose.

And of course, after how well you have done until now........I'm not going to immediately say to updose. And I also think it may be more than WD at play right now. Yes, of course you still have autonomic dysfunction to deal with.......in that way that we do.......tend......to......be.......more sensitive........to our environmental changes, or situational changes. Right, you know this.

And neuroemotions, including anxiety. Not always our BFF's......LOL, I hope I'm entertaining you at least.....I mean they never were our best friends. Ever.

If you do decide to updose. And I am against that right now, with the information given so far. But, if you do, it's only going to be by a smidgen really. I just don't see it, you undoing all that you have done to this point, with your careful tapering. I mean it's possible opinions might vary on that, but that's how I feel right now. A smidgen....meaning perhaps, and if it were me.......I might just go back to 1.65 mg. Your previous dose.

I hope that helps LiaJ. I do. And sending all you need right now too, in encouragement, support, anything that might pull you out of isolated/lonely/scared for your life and career feelings too. And big hugs, of course, big virtual hugs.

Best, L, P, H, and G,

mmt

Edited January 17, 2022 by manymoretodays
more, always more.....

January 18, 2022

On 1/16/2022 at 5:11 PM, ChessieCat said:

It is not at all surprising that you are experiencing insomnia.

Any of these can cause insomnia and/or anxiety issues, even for someone who is not trying to get of a psychiatric drug.

Putting it in black and white you are experiencing at least 3 major life stressors; moving and starting a new job and being separated from your husband until he moves, which will be even more stressful if you do not know when he will be arriving.

Q: Are you also selling your old residence? If yes, then that is another major stressor.

Q: Are you also moving away from other relatives/friends that you are emotionally close to?

We don't yet know if the former house will be sold. Thinking about keeping it for a rental. So, ambiguity there.

I do have a couple of friends back home, and everyone is now on the other side of the country.

January 18, 2022

15 hours ago, manymoretodays said:

Okay, that all worked out okay.

****and adding in that I think this is very much a question that relates to your tapering plan and you now. And so totally appropriate to put right here, in your Introduction. With either a notification, and or quote to try to engage with a moderator as soon as possible. We are, doing our best too LiaJ, to catch posts that do seem to need a reply from someone, as fast as we can. I mean moderators routinely do check all the posts coming in through the feed here.

And anyway, on how I related to what is happening with you right now......I'll elaborate a bit.

So anyway, lost my Mum. And had been in a bit of what I'll call a life slump, or bit of overwhelm anyway when that occurred. I too, had to travel, to get to Mum for her last days, and then also deal with the family and siblings, and the chaos of course when a loved one is hospitalized. And then, her death too. All in short order. It was tough. Old trauma surfaced. And I was able to not only use non-drug coping, but even add in more. And so persevered in that way.

For me, it wasn't all anxiety, or all about that particular symptom of fear......but a whole lot more to work on, and around. Which I have.

And okay, so you have had a week now.....total time of the worsening symptoms?

And you continue alone in a new location?

When does the job start? Day of, date?

And......I am hoping, I don't know for sure but hoping.......that your first days at work will be lighter weight, orientation even in their nature.

What have you tried for insomnia coping thus far? In itself, it can be one of the toughest symptoms , that then leads to other symptoms. And even though......it arose, or I think it may have from so many life changes at once, this may help to have a look at, read through, and then try something from.

Tips to help sleep: so many of us have that awful withdrawal insomnia

^ this one in particular has some invaluable tips to help with sleep problems

including a indexed list of more tips.

Do you use melatonin or anything now for the onset of sleep?

Do start low, if not, and you do try this or milk peptides.

Do perhaps try some magnesium, either or though.......just one addition or change at a time.

I find magnesium very calming at present. And it IS a go to for me, when stressed or "anxious".

I use Epsom salt baths prn, or as needed to relax. And also Magnesium citrate, or glycinate. I found one that mixes with water, lemony flavored that is great with magnesium gycinate.
Magnesium, nature's calcium channel blocker

Again though, and important now, is that you do not overdo with supplements. I stress that. Look at the links, and start low, and then only one new thing at a time. With magnesium, don't be doing several different types of either......I mean like Epsom salt baths and then orally, and I'm sure you get it. I don't mean to minimize your intelligence now and forgive, as I don't recall all your specifics right at this moment.

And well, I do see now A magnesium listed in your signature. Depending on the type, you might be able to do a bit more. Or......if you don't already, spread it out throughout the day......the total dose.

And of course, after how well you have done until now........I'm not going to immediately say to updose. And I also think it may be more than WD at play right now. Yes, of course you still have autonomic dysfunction to deal with.......in that way that we do.......tend......to......be.......more sensitive........to our environmental changes, or situational changes. Right, you know this.

And neuroemotions, including anxiety. Not always our BFF's......LOL, I hope I'm entertaining you at least.....I mean they never were our best friends. Ever.

If you do decide to updose. And I am against that right now, with the information given so far. But, if you do, it's only going to be by a smidgen really. I just don't see it, you undoing all that you have done to this point, with your careful tapering. I mean it's possible opinions might vary on that, but that's how I feel right now. A smidgen....meaning perhaps, and if it were me.......I might just go back to 1.65 mg. Your previous dose.

I hope that helps LiaJ. I do. And sending all you need right now too, in encouragement, support, anything that might pull you out of isolated/lonely/scared for your life and career feelings too. And big hugs, of course, big virtual hugs.

Best, L, P, H, and G,

mmt

Firstly, thank you for getting back with me so quickly!

Yes, my insomnia started exactly a week ago, the night before I dropped my husband off at the airport to fly back to Louisville. That night I got four hours of sleep, the next couple of nights six, and the last several nights about 4.5 hours. I rented a room from someone in AZ temporarily, so I'm not technically alone, but in a house of strangers, essentially.

My job starts today, first day, and yes, there will be an onboarding and orientation period, likely for the next couple of weeks.

The night before last I took some melatonin, about .75mg, and it successfully made me very drowsy, but my heart was pounding in my chest so it was difficult to fall asleep. I have been waking up at 230 in the morning with heart pounding, like I did this morning, and wasn't able to fall back to sleep. I think if my anxiety would abate, I would successfully fall and stay asleep.

I also got a massage last night and for several hours I felt no anxiety. It was blissful relief. But now back to the old anxious feelings. What that tells me is that my body IS capable of relaxing and letting go, I just don't know how to get there myself. I'm feeling desperate because it seems like nothing I do is helping, not deep breathing, not grounding, yoga, walking, cold water, etc.

I think tonight I'll try an epsom salt bath. Is my nervous system always going to behave like this?

January 18, 2022

15 hours ago, manymoretodays said:

Okay, that all worked out okay.

****and adding in that I think this is very much a question that relates to your tapering plan and you now. And so totally appropriate to put right here, in your Introduction. With either a notification, and or quote to try to engage with a moderator as soon as possible. We are, doing our best too LiaJ, to catch posts that do seem to need a reply from someone, as fast as we can. I mean moderators routinely do check all the posts coming in through the feed here.

And anyway, on how I related to what is happening with you right now......I'll elaborate a bit.

So anyway, lost my Mum. And had been in a bit of what I'll call a life slump, or bit of overwhelm anyway when that occurred. I too, had to travel, to get to Mum for her last days, and then also deal with the family and siblings, and the chaos of course when a loved one is hospitalized. And then, her death too. All in short order. It was tough. Old trauma surfaced. And I was able to not only use non-drug coping, but even add in more. And so persevered in that way.

For me, it wasn't all anxiety, or all about that particular symptom of fear......but a whole lot more to work on, and around. Which I have.

How did you learn how to work through this? How did you cope?

15 hours ago, manymoretodays said:

And okay, so you have had a week now.....total time of the worsening symptoms?

And you continue alone in a new location?

When does the job start? Day of, date?

And......I am hoping, I don't know for sure but hoping.......that your first days at work will be lighter weight, orientation even in their nature.

What have you tried for insomnia coping thus far? In itself, it can be one of the toughest symptoms , that then leads to other symptoms. And even though......it arose, or I think it may have from so many life changes at once, this may help to have a look at, read through, and then try something from.

Tips to help sleep: so many of us have that awful withdrawal insomnia

^ this one in particular has some invaluable tips to help with sleep problems

including a indexed list of more tips.

Do you use melatonin or anything now for the onset of sleep?

Do start low, if not, and you do try this or milk peptides.

Do perhaps try some magnesium, either or though.......just one addition or change at a time.

I find magnesium very calming at present. And it IS a go to for me, when stressed or "anxious".

I use Epsom salt baths prn, or as needed to relax. And also Magnesium citrate, or glycinate. I found one that mixes with water, lemony flavored that is great with magnesium gycinate.
Magnesium, nature's calcium channel blocker

Again though, and important now, is that you do not overdo with supplements. I stress that. Look at the links, and start low, and then only one new thing at a time. With magnesium, don't be doing several different types of either......I mean like Epsom salt baths and then orally, and I'm sure you get it. I don't mean to minimize your intelligence now and forgive, as I don't recall all your specifics right at this moment.

And well, I do see now A magnesium listed in your signature. Depending on the type, you might be able to do a bit more. Or......if you don't already, spread it out throughout the day......the total dose.

And of course, after how well you have done until now........I'm not going to immediately say to updose. And I also think it may be more than WD at play right now. Yes, of course you still have autonomic dysfunction to deal with.......in that way that we do.......tend......to......be.......more sensitive........to our environmental changes, or situational changes. Right, you know this.

And neuroemotions, including anxiety. Not always our BFF's......LOL, I hope I'm entertaining you at least.....I mean they never were our best friends. Ever.

If you do decide to updose. And I am against that right now, with the information given so far. But, if you do, it's only going to be by a smidgen really. I just don't see it, you undoing all that you have done to this point, with your careful tapering. I mean it's possible opinions might vary on that, but that's how I feel right now. A smidgen....meaning perhaps, and if it were me.......I might just go back to 1.65 mg. Your previous dose.

I hope that helps LiaJ. I do. And sending all you need right now too, in encouragement, support, anything that might pull you out of isolated/lonely/scared for your life and career feelings too. And big hugs, of course, big virtual hugs.

Best, L, P, H, and G,

mmt

January 18, 2022

8 hours ago, LiaJ said:

I think tonight I'll try an epsom salt bath. Is my nervous system always going to behave like this?

Atta girl you!!!! Not like I don't love epsom salt baths.

And no, it won't always behave like it is now.

You'll have gotten it all nicely reorganized and neurogenesis-ed, if you will....... and instead of reacting, it will go much more quickly into relax mode. At least that is what has happened for me, more often than not. And if it doesn't relax, you'll begin to remember what non-drug coping helps calm it(your nervous system) best.

When anxious, we often forget what tools we have to help.......sometimes keeping a little card handy in your purse or somewhere is a good idea. I use tapping, EFT, breathing(pranayama), writing, movement.....oh all kinds of stuff. Try some movement LiaJ.......just gentle movement to music......see where that goes. Something where you are not thinking or that might take away some of the multitude of thoughts.

8 hours ago, LiaJ said:

How did you learn how to work through this? How did you cope?

I'm still learning LiaJ, but what helps me a ton.......is just plain faith in the process too. That whatever it is pulling me down, or that I struggle with.......will pass, and it always does. Sheesh, my Mum's death was so huge......I actually started to wonder if I'd ever be back to how I was. And I didn't expect that response to her death at all. It just was huge. Somehow we function though, or can......or I could do a lot of faking, or hiding out a bit, and I have my own confidential people who help me too......just be with me and it, the state I was in, and they don't get all worried or bent out of shape. I have angels too......like that kind of faith......that look out for me and after me.

This is all huge too, for you, now......of course it is. And congratulations on day one!!!! Wooohhooooooo. Recognize your achievement and what you have managed to do! You sometimes have to be your own best buddy, when all else fails.....when friends are far away, or you can't stand anybody(oh no, I mean sometimes I need breaks from people as much as I also love people).

I'm only guessing, but I think you may feel exhausted with this week, and so much anxiety that you might just get to a natural exhaustion, and get your sleep back. I mean if you need to sleep all weekend or a good part of it, do so.

Sounds like you are courageously doing what you need to do. I hope hubs can carry most of the selling or renting of your home stuff. And your friends will come visit eventually too, for the winter sunshine! Meantime.....you make new ones. And maybe seek out some support for just you now too, either therapy or yoga class, or something alternative.

L, P, H, and G,

mmt

March 30, 2022

Assistance w/calculating drop

Hi there,

I'm feeling some WD anxiety. I made a drop a couple weeks ago. I don't think it was that large of a drop, but my body is telling me somethings not right.

I am using a syringe and I was taking .5 ml of 3 mgs (which is 1.5 mgs). Now I'm at .47 ml of 3 mgs. Is that 1.47 mgs? My brain is farting and I am wondering if I screwed the math and made too far of a drop.

Also I thought perhaps since I'm at the end of the bottle maybe the amount of active ingredient is not right. I would imagine that now the dose is so low, how can this really matter as much, right?

Can someone help? @ChessieCat, perhaps? Did I reduce the dose too much?

Thanks for your help!

Edited March 31, 2022 by ChessieCat
added topic title before merging with intro topic

March 31, 2022

9 hours ago, LiaJ said:

I am using a syringe and I was taking .5 ml of 3 mgs (which is 1.5 mgs). Now I'm at .47 ml of 3 mgs. Is that 1.47 mgs?

The way you have stated what you are taking is very confusing.

Q: What strength is your prescription liquid?

Q: Was your previous dose 0.5mL of prescription liquid?

Q: Did you drop from 0.5mL of liquid to 0.47mL of liquid? If yes, then it was a 6% reduction (this can be calculated without knowing the strength of the liquid).

percentage-decrease-calculator

The following is only my assumption from the information that you have provided.

If you multiply 0.5mL x 3mg = 1.5mg (which is what you have stated above)

If you do the same with the other information then:

0.47mL x 3mg = 1.41mg (not 1.47mg)

Please note that I do not know if this is correct. If you want further assistance, please provide more information in an understand way. Thank you.

April 1, 2022

On 3/30/2022 at 7:57 PM, ChessieCat said:

The way you have stated what you are taking is very confusing.

Q: What strength is your prescription liquid?

Q: Was your previous dose 0.5mL of prescription liquid?

Q: Did you drop from 0.5mL of liquid to 0.47mL of liquid? If yes, then it was a 6% reduction (this can be calculated without knowing the strength of the liquid).

percentage-decrease-calculator

The following is only my assumption from the information that you have provided.

If you multiply 0.5mL x 3mg = 1.5mg (which is what you have stated above)

If you do the same with the other information then:

0.47mL x 3mg = 1.41mg (not 1.47mg)

Please note that I do not know if this is correct. If you want further assistance, please provide more information in an understand way. Thank you.

Sorry about the confusion. The strength of the medication is 3 mgs per ml. I was taking .5 ml, or 1.5 mgs. I moved the syringe down from .5 to .47. Does that make more sense?

From what you've stated I would multiply the level in the syringe I'm currently at to the whole amount of the syringe dose?

April 1, 2022

6 hours ago, LiaJ said:

Sorry about the confusion. The strength of the medication is 3 mgs per ml. I was taking .5 ml, or 1.5 mgs. I moved the syringe down from .5 to .47. Does that make more sense?

From what you've stated I would multiply the level in the syringe I'm currently at to the whole amount of the syringe dose?

Thank you for clarifying. What you state above is what I thought you meant but I needed to be sure.

You might find it easier to start diluting your prescription liquid. If you need help with that please let me know.

1mL = 3mg is an unusual concentration; the ones that I am aware of are 1:1, 1:2 or 1:5.

I find it easier to work out by breaking down the equivalency. I will list some below and you can see the pattern. What you do is to divide by sides by the same number.

1mL = 3mg concentration of prescription liquid

0.5mL = 1.5mg both sides divided by 2

0.33mL = 1mg both sides divided by 3

0.1mL = 0.3mg both sides divided by 10

0.01mL = 0.03mg both sides divided by 100

You can use this information to work out what dose you are taking.

You are taking 0.47mL so you use the 0.01mL = 0.03mg. You select this information because the amount you are taking has 2 places after the decimal point.

You multiply 0.01mL by 47 to get 0.47mL and because you have to do the same to both sides you multiply the 0.03mg by 47 which equals 1.41mg.

If you were taking an amount with only 1 decimal place, eg 0.4mL, you could use the 0.1mL = 0.3mg information and multiply both sides by 4 (0.4mL = 1.2mg)

Another example:

Taking 0.35mL

0.01mL = 0.03mg multiply both sides by 35

0.35mL = 1.05mg

April 2, 2022

15 hours ago, ChessieCat said:

Thank you for clarifying. What you state above is what I thought you meant but I needed to be sure.

You might find it easier to start diluting your prescription liquid. If you need help with that please let me know.

1mL = 3mg is an unusual concentration; the ones that I am aware of are 1:1, 1:2 or 1:5.

I find it easier to work out by breaking down the equivalency. I will list some below and you can see the pattern. What you do is to divide by sides by the same number.

1mL = 3mg       concentration of prescription liquid

0.5mL = 1.5mg      both sides divided by 2

0.33mL = 1mg          both sides divided by 3

0.1mL = 0.3mg         both sides divided by 10

0.01mL = 0.03mg    both sides divided by 100

You can use this information to work out what dose you are taking.

You are taking 0.47mL so you use the 0.01mL = 0.03mg. You select this information because the amount you are taking has 2 places after the decimal point.

You multiply 0.01mL by 47 to get 0.47mL and because you have to do the same to both sides you multiply the 0.03mg by 47 which equals 1.41mg.

If you were taking an amount with only 1 decimal place, eg 0.4mL, you could use the 0.1mL = 0.3mg information and multiply both sides by 4 (0.4mL = 1.2mg)

Another example:

Taking 0.35mL

0.01mL = 0.03mg   multiply both sides by 35

0.35mL = 1.05mg

This does help clarify for me. I actually think it's easier to multiply both sides by 2, and work from 0.5ml=1.5mgs. But calculating the drops is another matter. I've just started moving the dropper down ever so slightly each time I make a drop, because at this point the drops seem to be so small and I've been tapering this medication for 4 years now. I only started from 7.5mgs.

It is an unusual amount. At one point in time, when I was taking 3 mgs per ml, I just asked my doctor to leave the strength as is and I would manipulate the amount taken by moving the dropper. The compounding fee is expensive, so a greater strength bottle will last longer. That was the logic there. Now, I'm afraid to ask my doctor to change anything because I don't live near her anymore and I want to make it easy for her to keep writing refills.

That being said, how would I dilute the compound?

And I just noticed in your signature that you don't like to be tagged, I apologize for tagging you on this message.

April 2, 2022

8 hours ago, LiaJ said:

I actually think it's easier to multiply both sides by 2, and work from 0.5ml=1.5mgs

It's all the same. We do it the way it make sense to us. The main thing is that the result is correct. My husband used to tell me that I was calculating things the wrong way but I said it doesn't matter how I do it as long as I get the right answer.

8 hours ago, LiaJ said:

That being said, how would I dilute the compound?

If you add 3mg dose (1.5mL) to 28.5mL of water (total liquid 30mL) then 10mL:1mg dose, or 1mL:0.1mg.

If you added 3mg dose to 300mL of water then 10mL:0.1mg, or 1mL:0.01mg. Because of the larger quantity of water adding 1.5mL of prescription liquid to 300mL of water is not going to make much difference with the total measurement. Just make sure you make it the same way each time so that you don't change the dilution.

Please double check my calculations.

You should be able to keep the remaining dilution covered in the fridge for about 3 days, which will give you 4 doses, ie day you make it plus 3 more days.

April 8, 2022

On 4/2/2022 at 3:12 PM, ChessieCat said:

It's all the same. We do it the way it make sense to us. The main thing is that the result is correct. My husband used to tell me that I was calculating things the wrong way but I said it doesn't matter how I do it as long as I get the right answer.

If you add 3mg dose (1.5mL) to 28.5mL of water (total liquid 30mL) then 10mL:1mg dose, or 1mL:0.1mg.

If you added 3mg dose to 300mL of water then 10mL:0.1mg, or 1mL:0.01mg. Because of the larger quantity of water adding 1.5mL of prescription liquid to 300mL of water is not going to make much difference with the total measurement. Just make sure you make it the same way each time so that you don't change the dilution.

Please double check my calculations.

You should be able to keep the remaining dilution covered in the fridge for about 3 days, which will give you 4 doses, ie day you make it plus 3 more days.

It sounds like either way, I need to make 30 mLs of liquid. A 3 mg dose is 1 mL currently. So I'm adding 1 mL to 29 mLs of water. 10 mLs=1 mg? Wouldn't that equal 3mgs? I'm very confused.

If I add 1 mL to 29 mLs of water, then the solution would equal .03 mgs per mL. Taking 10 mLs would mean I've taken 3 mgs. Or am I just very bad at math? (entirely possible)

April 8, 2022

Sorry it looks like I might have made a mistake above. It's early here so my brain isn't ready to go back and try and work out what I did wrong.

7 hours ago, LiaJ said:

If I add 1 mL to 29 mLs of water, then the solution would equal .03 mgs per mL.

No, 1mL = 0.1mg (see my calculations below)

The total solution 0f 30mL still contains 3mg.

30mL = 3mg dose (you added 1mL prescription liquid).

7 hours ago, LiaJ said:

Taking 10 mLs would mean I've taken 3 mgs.

No, taking 10mL will be a 1mg dose.

This is what I've worked out (fresh calculations):

So if 1mL of prescription liquid contains 3mg dose then:

30mL (29mL water + 1mL prescription liquid) = 3mg dose

10mL of liquid will contain 1mg dose

1mL liquid contains 0.1mg dose

Please double check my calculations.

April 29, 2022

On 4/8/2022 at 2:29 PM, ChessieCat said:

Sorry it looks like I might have made a mistake above. It's early here so my brain isn't ready to go back and try and work out what I did wrong.

No, 1mL = 0.1mg (see my calculations below)

The total solution 0f 30mL still contains 3mg.

30mL = 3mg dose (you added 1mL prescription liquid).

No, taking 10mL will be a 1mg dose.

This is what I've worked out (fresh calculations):

So if 1mL of prescription liquid contains 3mg dose then:

30mL (29mL water + 1mL prescription liquid) = 3mg dose

10mL of liquid will contain 1mg dose

1mL liquid contains 0.1mg dose

Please double check my calculations.

I'm considering just skipping the compounding pharmacy, making a homemade solution w/crushed pills and water. Is this advisable?

April 29, 2022

Post #1 of this topic explains how to get non standard doses of mirtazapine, including making your own liquid:

tips-for-tapering-off-mirtazapine-remeron

July 12, 2022

Tapering too long?

Sometimes I wonder if my taper is too slow. Lately I'm not sure if my symptoms are due to thyroid issues, hormonal changes, or withdrawal.

Any insight?

Edited July 12, 2022 by ChessieCat
added topic title before merging with intro topic

July 12, 2022

Q: What symptoms are you currently experiencing?

Q: What stage of life are you at with regards to menstruating?

Q: If you are still getting regular menstruation, do your symptoms throughout a month have a pattern?

July 12, 2022

At the bottom of this post is the information from your drug signature showing the percentage reductions.

Q: What were the reasons that you held so long before making another reduction?

You have been a member of SA since June 2017 with your first post made Jan 2018 when you were provided the link by Gridley for the 10% taper information, yet after having this information you made 3 reductions >10% and one of 30%.

What I cannot understand from the information below is why you are making the reduction amounts you do and holding for longer when I think it would be better to make smaller reductions and possibly reduce more often. Generally it is better to taper more slowly than too quickly and even if a person's taper is very slow it is going in the right direction of getting them off the drug. And of course it is important to listen to your body/symptoms and taper according to those.

(I do not have time to go back and read through your topic.)

Q: Have you considered the Brass Monkey Slide?

Mirtazapine (in mgs)

Feb 2018 5

June 2019 3.5 30%

Sep 9, 20 2.9 9.3%

March 3, 20 2.85 1.7%

June 20, 20 2.5 12%

Oct 3, 20 2.3 8%

Nov 30, 20 2.1 8.6%

Jan 1, 21 1.95 7%

Mar 19, 21 1.86 4.6%

Sep 1, 21 1.65 11% 3 months

Nov 30, 21 1.5 9% 3 months

March 1, 22 1.41 6% 4 months

June 28, 22 1.37 2.8%

August 9, 2022

Unsure about symptoms, WD or something else

I've been in WD since August of 2017 (rapid taper off Celexa).

Since November of 2017, I've been tapering off 7.5 mgs of Mirtazapine. I am now taking approximately 1.4 mgs of Mirtazapine.

Some weeks/months I don't feel like I'm in WD at all anymore.

Then suddenly, out of context, out of nowhere, I'll stop sleeping. Last night I fell asleep at 430 am (I go to bed at 830-9 pm) and I slept for 2 hours. The past week it's been a struggle to get 5 hours of sleep. Normally I get 7-8.

I had to call off work today. I'm a psychotherapist, and I can't treat other people's mental health problems when my own mental well being is in the toilet. These episodes make me feel like I'm truly damaged, and that life will always revolve around damage control. I am afraid I'll never be functional again to lift weights competitively. Withdrawal already robbed me of any last chance to have children. I feel hopeless and so very angry.

Lately I've developed what seems to be restless leg syndrome. Legs are twitching and crawling. Mostly at night. This sensation used to occur often, but it felt more like vibrations, or buzzing in my legs, brought on by stress. Now the sensations are different, and I'm more distressed by them. Lately my sleep has been broken due to adrenaline and anxiety surging in my body, similar to what I experienced in the acute phase of WD. On such a low dose, tapering at a ridiculously slow rate, can this possibly be what is happening? Am I ever going to be rid of this?

I can't differentiate between issues related to withdrawal and other medical conditions, or changes in hormone levels.

All I know is I am ***** sick of dealing with this.

Am I tapering too slowly? Is this related to the drug at all? Do I still need to be taking it?

Someone please respond. I need a seasoned moderator @Altostrata to help demystify what might be occurring at this late stage of the game.

Thank you so very much for listening.

Edited August 9, 2022 by ChessieCat
added topic title before merging with intro topic

August 9, 2022

7 hours ago, LiaJ said:

Lately I've developed what seems to be restless leg syndrome.

Non-drug treatments for restless legs

7 hours ago, LiaJ said:

Someone please respond. I need a seasoned moderator @Altostrata to help demystify what might be occurring at this late stage of the game.

Please provide daily symptoms notes. This explains why they are being asked for and gives an example of what is required:

Keep Notes on Paper

August 9, 2022

Q: Do you drink alcohol or caffeinated beverages, or foods contain MSG or aspartame/phenylalanine (these are both neurotoxins)?

Edited August 9, 2022 by ChessieCat

August 26, 2022

Hi Friend.

The sudden interruption of sleep is possible even in the very low doses. For me that was a normal pattern when i was at your dose. I would be good with light symptoms during a month and then suddenly i would have a sleepless night or maximum two. After those on the third night the brain would be sooo tired to think that i was sure i was going to sleep properly on the third nigh and that was happening for sure.
On the very bad nights when such interruption of sleep cycle would occur i would take strong tea of Chamomile and Linden. That would always do the trick and would secure around 3-4 hours of sleep.
You are mentioning that you are struggling to get 5 hours sleep and i would assure you that if you are able to have that amount that is fine. There are people who still live their lifes normally even with 1-2 hours of sleep or no sleep at all for a number of days. For example after my holidays i am in such a cycle and not being able to sleep more than 5-6 hours. But as soon as i wake up i go to work, take a coffee and i am good after that.
Try not to scare yourself my friend. When in a wave our brain plays tricks with us and we worry. You are writing that you had many weeks with almost zero problems and that is something that should convince you that you are currently in a wave. If you could function normally for many weeks than that is a sign that your CNS is not damaged, but it is only recuperating and the wave is its way of telling you that the healing is continuing.

Try to wait out this wave my friend. On the mean time do not avoid work. Even if you think that you are too tired or that is too much to handle stand up from the bad and go out. Work and distraction are the best cure in times when the brain is on a ruminating mode. Try some hypnosis videos from youtube as well Michael Sealey is my favorite...

All the best

Santino

November 8, 2022

Elevated prolactin levels in withdrawal

Nearing the end game of my taper off Mirtazapine. Approximately 1.27 mgs to go.

About eight weeks ago I initiated hormone replacement therapy, testosterone and progesterone only. Doc tested my prolactin levels before initiating treatment, and they were borderline high then. Levels were tested again at four weeks and again last weekend, prolactin is steadily increasing. Of course, now I have to get an MRI as my doc supposes I have a prolactinoma (benign pituitary tumor).

Unfortunately, she won't refill my RX for hormone therapy, and this is devastating, because I have never felt better since initiating that treatment.

I'm curious if anyone has developed high prolactin levels here being in W/D.

And also, I'm concerned about the course of treatment for pituitary tumors--dopamine agonists. I was under the assumption (from the information I have learned here) that any medication that impacts the dopaminergic system can potentially cause akathisia. Am I correct about this? Just trying to evaluate my treatment options in the even I have a tumor and need treatment.

Thank you.

Edited November 8, 2022 by ChessieCat
added Intro topic title before merging with intro topic

November 8, 2022

drug-induced-hyperprolactinemia-high-prolactin

November 9, 2022

Good to know ADs influence prolactin levels. I haven’t taken Citalopram for 5 years. Been tapering off of Mirtazapine since 2018. My prolactin levels jumped in the last two months, and now I’m concerned I’ll have to take dopamine agonist medications to treat. Is there a risk in taking those sort of medications from a WD standpoint?

November 9, 2022

5 hours ago, ChessieCat said:

drug-induced-hyperprolactinemia-high-prolactin

Good information. Does anyone happen to know about dopaminergic drugs to treat high prolactin, and whether or not they might cause similar symptoms as psych meds?

November 9, 2022

SA staff are not medical professionals and do not counsel about general medical conditions. SA is a site for tapering psychiatric drugs and support for members who have tapered too fast or cold turkeyed their drug.

You will need to ask your medical professional about treatment for this condition and also do your own research.

November 9, 2022

7 hours ago, ChessieCat said:

SA staff are not medical professionals and do not counsel about general medical conditions. SA is a site for tapering psychiatric drugs and support for members who have tapered too fast or cold turkeyed their drug.

You will need to ask your medical professional about treatment for this condition and also do your own research.

I understand the function and purpose of the site. I’ve been a member for years while tapering off antidepressants.

I am doing my own research. Part of that information gathering process is reaching out here about the possibility of any drug impacting the dopamine system and whether it could cause akathisia, and also if anyone else has had a similar experience/diagnosis while in WD.

November 9, 2022

You could do a search for the term prolactin in each forum. You could also do a search in each forum for the drug name that you would be prescribed.

You could also post in the topic that I linked above, because other members with the same issue are more likely to see it there.

Edited November 9, 2022 by ChessieCat

December 7, 2022

Titled: Wondering about the impact of drug when I reach 0.0 mgs

Hello.

I'm 5 years into my withdrawal/tapering journey. I started taking Mirtazapine in December of 2017 following CT off Celexa to ease insomnia and immediately began to taper the Mirtazapine. I'm now at about 1.15 mgs of Mirt, and each month and year that passes, the more healing I experience. I am 1000x better now than I was at this time five years ago, when I was utterly sick and hopeless and wondered if I would ever have a normal life again.

I've been thinking lately about what will happen when I'm actually done with my taper. Is it common to experience another withdrawal? I've intentionally tapered MUCH slower than what is suggested in the lay WD community, 5-8% every 2-3 months or so, which is why it's taken me so long to come off of this drug. I'm hoping that the slowness of the taper will positively impact by way of eliminating any potential WD symptoms I may experience at the end of the taper.

In your experience assisting thousands of individuals throughout this process, and given the information you know about my taper and overall progress in WD, theoretically, should the end of my taper be problematic? I don't really experience any negative effects after my reductions at this point. Thankfully my hormone replacement therapy is working beautifully to preserve my sleep.

Of course, I live in constant fear of needing medical intervention that might disrupt any progress I've made. I frequently wonder how long I need to be mindful about the possibility that an antibiotic or anesthesia may derail my life. This experience has given me health anxiety like I have never known.

I wish I could just talk to someone about WD. There are so few resources available in the US and finding someone who really understands has proven to be impossible.

Thanks for listening and responding, in advance.

Edited December 12, 2022 by manymoretodays
added title after merging to members Introduction

December 12, 2022

Hi LiaJ,

I found this in the tapering section, and merged it back here.

I can comment on your question and also look to see, as we might actually have a topic specific to experiences after tapering to zero.

My own experiences. Are you interested in those at all? I'll tell you about it. Briefly, as I can. I was drugged with different drugs and since about 1988, and came off completely in December of 2016. Oh my gosh......it's almost that anniversary time..... 🙂

For me, the first couple of years were a bit tough, to be honest. Keep in mind I had had some abrupt drug changes, and previous WD's(without even knowing it), and adverse reactions to drugs, and may have come off my final drug a bit higher in dose, than I would have.....if I was doing it today.

After 2-3 years off though.......I pretty much didn't go with thinking or blaming WD anymore at all for any residual symptoms. I went with iatrogenic changes, or even harms, if you will......that had resulted from so many drugs and so many years on them.

Anyway......after 3 years for sure, it got easier.........I was definitely more healed. And perhaps healing sped up a bit from there to now. I'll be 6 years off real soon. I did hit some WAVES.....best way to describe it........after my Mom died......and likely with more emotional things-stressors, that used to be not stressors........if that makes sense to you.....I don't know.

So me, I'm glad.....I'm happy to be drug free/psychiatry free today. There have been times where I wondered though......I was really struggling, and wondered if I should go back. I think those days are gone now......I mean never say never. I feel fortunate and grateful. And glad that I had enough of my career prior to WD to be satisfied.......and wonder if maybe I should have made life changes, way back when......instead of buying into psychiatry........anyway.

I have some residual fears, but I no longer live with huge fear or anxiety. It has not always been easy. I work hard. Nothing has completely derailed.....be it antibiotics, or vaccines(oh lordy and I've had a few now), or procedures with anesthesia, or other.........I mean nothing has even come close to derailing me. I haven't needed anesthesia since off. Minimal drug for dental procedures......oooh, I think Nitrous oxide threw me for a bit......and then that was over. And I won't use that again, in the way they administered it for a dental procedure. I did brief topical steroid cream recently and no problem.

I know at first I thought, oh.....off the drugs......life will be jolly all the time.....LOL, .........not realistic. I'm almost thankful for all my experiences, or most days am........and so I've grown.....yay, and more to come.

Okay:

It Doesn't End at Zero

Experiences after tapering to zero and symptom management

-tapering-to-almost-zero-and-staying-there/

-zero-you-could-do-more-harm-than-good/

I hope you do find something there that answers your question(s).

You do know how to search for topics now don't you? Several ways to do so.

I'll just give you the link to that topic on how to search here:

How to do a site search on Surviving Antidepressants

That way you can see if there is already a topic on something before starting one new, and feel free to go to any of those topics(with the exception of the one in brassmonkey,s essay, as it is kind of in the middle of a lot of stuff) and discuss, talk about with other members.

Okay, Happiest of Holidays to you.

L, P, H, and G,

mmt

And no, those that I have been able to follow all the way, to the end and beyond of their taper.......no, they don't do worse at the end of their taper. I have not seen that. Or after. Sometimes after they are surprised by having some waves and windows still.......but manage them, and I expect that they lessen with time. As mine have.

Remember waves and windows........that's a good sign of healing.

Edited December 12, 2022 by manymoretodays
additional at end

LiaJ: overwhelmed by deluge of information, mirtazapine tapering, ? updose

Recommended Posts

getofflex

Link to comment

Top Posters In This Topic

Top Posters In This Topic

Popular Posts

Santino

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

manymoretodays

Link to comment

manymoretodays

Link to comment

LiaJ

Link to comment

LiaJ

Link to comment

LiaJ

Link to comment

manymoretodays

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

ChessieCat

Link to comment

Santino

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

ChessieCat

Link to comment

LiaJ

Link to comment

manymoretodays

Link to comment

Create an account or sign in to comment

Create an account