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elizze: Forced Reinstatement to 30 mg mirtazapine


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Hello all

I started on Mertazapine for some slight insomnia (probably now I realise related to menopause). I had no idea about the drug. I thought it was just a sleeping pill and messed around with the dose and eventually came off 30 mg to 15 mg over a period of 3 weeks. I suffered horrible withdrawal, was then told it was the drug and was taken straight off it to 0 mg at which point I became a total insomniac and suicidal and was detained in the NHS psych ward. In hospital I was forced to reinstate - they put me straight back on 30 mg after 2 days on 15 mg. I felt slightly better and was able to convince them to let me leave after 2 weeks. This took an enormous act of will, but I knew I could not stay in there. I was also given zopiclone, promethezine, and then propanalol. I am now a week out of hospital and suffering all the tortures of hell. I stopped taking the zopiclone, promethezine, propanalol not wanting to add any more to the cocktail. The sleep has returned to the tune of maybe 5-6 hours a night. I take 5 mg of diazapam also at night which I started in February to try and relieve the sleep anxiety which it did temporarily. But the panic, anxiety, numbness in my limbs, burning brain/body and akasthisia have not relented (not even bothering to list all symptoms). 

 

So I am 3 weeks into reinstatement of 30 mg mertazapine, and staying on the 5 mg diazepam out of pure fear of adding any withdrawal from that to the horrible reinstatement symptoms.

 

After reading around on this site (when I can at least focus) I've come to the conclusion I have to endure the 30 mg reinstatement and pray for some kind of stablilization, before making any further tapers. 

 

Praying for all that are going through this and wishing you strength.

 

 

 

 

November 2021 prescribed 15 mg mertazapine for slight sleep problems/anxiety

December 2021 doctor doubled dose to 30 mg

January 2022 I messed around with the dose (didn't know any better), episodes of complete sleeplessness, prescribed 5mg Diazepam daily

February 2022 over course of 3 weeks i reduced mertazapine from 30 mg to 15 mg and went into a suicidal tailspin

March 2022 was taken off the 15 mg mertazapine by the doctor, became suicidal, was detained in the psych hospital and was put back on 30 mg

April 2022 managed to get released from hospital. Now on 30 mg mertazapine and 5 mg diazepam nightly. Horrible symptoms continue despite reinstatement.... 

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  • ChessieCat changed the title to elizze: Forced Reinstatement to 30 mg mirtazapine
  • Moderator

@elizze

 

Welcome to SA. We are a volunteer ran site helping members taper off psychiatric medications, or have tapered off and are now healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that each member only have one introduction page so we can keep all your information in one place.

 

First, can you please create a signature of your medications. Here is a link that will help you do that.

 

Instructions:  Withdrawal History Signature

 

I'm very sorry you have had to endure what you did. Unfortunately, most dr.'s don't know anything about these medications and it is difficult for them to taper you off correctly. We don't suggest more than 10% a month and some find that too fast.

 


Why taper by 10% of my dosage?

 

What is withdrawal syndrome?

 

The Windows and Waves Pattern of Stabilization


Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Here is a link on tapering off Mirtazapine, although, right now you are smart in holding on this dosage until you read stability. Then tapering off very slowly to avoid as many withdrawal symptoms as possible.

 

Tips for tapering off mirtazapine (Remeron)

 

As far as the Diazepam goes, your body becomes dependent on it in as little as 14 days, so you will need to take it on a regular schedule and don't miss doses. You can always taper off of it after you taper off the Mirtazapine. Because it should help with your taper when you are ready.

 

We don't suggest a lot of supplements on here except 2 because they can be activating to the nervous system. If you want to try one, try a small amount and wait a few days before introducing the other.

 

Magnesium

Omega-3 Fish Oil

 

I hope I have been able to provide you with information to get started. Please don't hesitate to reach out with any questions that you may have after reading the links provided.

 

 

PREVIOUS medications and discontinuations: Have been on medications since 1996. 

 Valium, Gabapentin, Lamictal, Prilosec and Zantac from 2000 to 2015 with a fast taper by a psychiatrist.

 Liquid Lexapro Nov, 2016 to 31-March, 2019 Lexapro free!!! (total Lexapro taper was 4 years-started with pill form)

---CURRENT MEDICATIONS:Supplements:Milk Thistle, Metamucil, Magnesium Citrate, Vitamin D3, Levothyroxine 25mcg, Vitamin C, Krill oil.

Xanax 1mg 3x day June, 2000 to 19-September, 2020 Went from .150 grams (average weight of 1 Xanax) 3x day to .003 grams 3x day.

19-September, 2020 Xanax free!!! (total Xanax taper was 15-1/2 months-1-June, 2019-19-September, 2020)

I am not a medical professional.

The suggestions I make are based on personal experience.

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Thank you Frogie!!! 

I think I already have a signature, I can see it at the bottom of my intro so I'm hoping that that's what's needed.

 

I am now actually considering tapering off the diazepam first. Because I am going to try propanalol instead. It seems to be touted as less addictive and actually seems to work well for me. Do you have an opinion on this? 

 

In whatever case, and for the sake of getting prepared, I am trying to understand what to use to dissolve diazepam to make a liquid. I have seen water or full fat milk? Which if either would you recommend?

 

For Mirtazapine, when that time comes, I am fairly confident that 50/50 water/maple syrup is a good dilutant. 

 

I take magnesium citrate and omega 3 fish oils, plus some turmeric, and a little melatonin.

November 2021 prescribed 15 mg mertazapine for slight sleep problems/anxiety

December 2021 doctor doubled dose to 30 mg

January 2022 I messed around with the dose (didn't know any better), episodes of complete sleeplessness, prescribed 5mg Diazepam daily

February 2022 over course of 3 weeks i reduced mertazapine from 30 mg to 15 mg and went into a suicidal tailspin

March 2022 was taken off the 15 mg mertazapine by the doctor, became suicidal, was detained in the psych hospital and was put back on 30 mg

April 2022 managed to get released from hospital. Now on 30 mg mertazapine and 5 mg diazepam nightly. Horrible symptoms continue despite reinstatement.... 

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  • Moderator
Posted (edited)

@elizze

 

We don't suggest tapering off of a benzo first. A benzo acts like a break and the antidepressant is an accelerant. So you want to keep the breaks on as long as possible. Propanalol is used to control a fast beating heart, so I guess I don't understand why the dr is putting you on this?

 

Diazepam dissolves in vodka.

 

When it comes time to taper the Mirtazapine, it will dissolve in water. 

Edited by Frogie

PREVIOUS medications and discontinuations: Have been on medications since 1996. 

 Valium, Gabapentin, Lamictal, Prilosec and Zantac from 2000 to 2015 with a fast taper by a psychiatrist.

 Liquid Lexapro Nov, 2016 to 31-March, 2019 Lexapro free!!! (total Lexapro taper was 4 years-started with pill form)

---CURRENT MEDICATIONS:Supplements:Milk Thistle, Metamucil, Magnesium Citrate, Vitamin D3, Levothyroxine 25mcg, Vitamin C, Krill oil.

Xanax 1mg 3x day June, 2000 to 19-September, 2020 Went from .150 grams (average weight of 1 Xanax) 3x day to .003 grams 3x day.

19-September, 2020 Xanax free!!! (total Xanax taper was 15-1/2 months-1-June, 2019-19-September, 2020)

I am not a medical professional.

The suggestions I make are based on personal experience.

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@Frogie

 

They put me on propanolol in hospital, supposedly to control akasthisia from the promethezine (which they then took me off). I didn't take it (put it under my tongue spat it out), and the akasthisia seemed manageable at the time. Then 2 days ago I had an awful day with extreme panic and what seemed like very bad akasthisia (writhing around, couldn't rest, crawling out of my skin) so I tried the propanalol 10 mg at 2pm and it worked. I even slept well for 7 hours with no early morning anxiety. So I thought, great! It kept working all yesterday morning and I felt like 85% normal which was incredible so I took it again at 2pm. But Last night was horrific. Heart beating out of my chest, feelings of dread and terror each time I started drifting off to sleep (I usually get this just during the day when I try to nap, so I never can). Eventually somehow got a couple hours sleep and woke at 5am still with heart still beating madly and agonizing anxiety in my chest and throat. I'm writing this at 8 am and anxiety has hardly abated. Plus headaches coming back. Feeling of wired exhaustion. I don't think I dare try the propanalol again.

 

Is Mertazapine really an accelerant? I was given it originally for sleep and it used to knock me out. Am i kindled from being put back on it after cold turkeying for 2 weeks?

 

Is it possible I'm getting interdose anxiety from the Diazepam? The anxiety has been so much worse this last week. It used to just be early morning. After I took my 30 mg mertazapine and 5 mg valium at 10 pm that used to be the time when I could get 5 minutes 100% peace. Now the anxiety is worse all the time (even notwithstanding the experiment with the propanalol). 

 

What do you do when you get tolerant to a drug and you have worse and worse symptoms even when on a constant amount? How can you stabilize? How can you taper? I feel this is happening with both the Mertazapine and the Diazepam. I'm fighting with the urge to increase the Diazepam dose so hard.............I feel like the only way out it is to start tapering, or else I will just have to keep increasing? 

 

Thank you so much. 

 

 

 

November 2021 prescribed 15 mg mertazapine for slight sleep problems/anxiety

December 2021 doctor doubled dose to 30 mg

January 2022 I messed around with the dose (didn't know any better), episodes of complete sleeplessness, prescribed 5mg Diazepam daily

February 2022 over course of 3 weeks i reduced mertazapine from 30 mg to 15 mg and went into a suicidal tailspin

March 2022 was taken off the 15 mg mertazapine by the doctor, became suicidal, was detained in the psych hospital and was put back on 30 mg

April 2022 managed to get released from hospital. Now on 30 mg mertazapine and 5 mg diazepam nightly. Horrible symptoms continue despite reinstatement.... 

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  • Moderator Emeritus
1 hour ago, elizze said:

Is Mertazapine really an accelerant? I was given it originally for sleep and it used to knock me out.

 

Generally mirtazapine is more sedating at lower doses.  From https://www.psychdb.com/meds/antidepressants/nassa/mirtazapine

 

I have used red to emphasis the relevant information.

 

Quote

 

 

Why Do Lower Doses of Mirtazapine Cause More Sedation?

Mirtazapine acts mainly on 3 receptors: histaminergic, noradrenergic, and serotonergic receptors. However, at low doses (e.g. - 7.5 mg), mirtazapine has a higher affinity to (and thus preferentially blocks) the histamine-1 receptor, compared to the other 2 receptors.[2][3]At higher doses, this antihistamine activity is offset by increased noradrenergic transmission, which reduces its sedating effects.[4][5] Although sedation is expected at low doses, it is usually most noticeable in the first few weeks of therapy and diminishes with continued treatment.[6]

 

 

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full tapering program     My Intro (goes to my tapering graph)    My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

Please DO NOT TAG me - thank you.

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Thank you for your reply! @ChessieCat

I did know this, but unfortunately they put me on 30 mg which I don't understand given I need to sleep. But nevermind, I now have to taper from 30mg so not much I can do about it....When I tried to go from 30 mg to 15 mg in just a matter of weeks it was not pretty. 

 

@Frogie Thank you. You said Diazepam dissolves in vodka, that's unfortunately not an option for me. Full fat milk is what I have read but have no idea, just wondered if you had ever heard of that at all.

November 2021 prescribed 15 mg mertazapine for slight sleep problems/anxiety

December 2021 doctor doubled dose to 30 mg

January 2022 I messed around with the dose (didn't know any better), episodes of complete sleeplessness, prescribed 5mg Diazepam daily

February 2022 over course of 3 weeks i reduced mertazapine from 30 mg to 15 mg and went into a suicidal tailspin

March 2022 was taken off the 15 mg mertazapine by the doctor, became suicidal, was detained in the psych hospital and was put back on 30 mg

April 2022 managed to get released from hospital. Now on 30 mg mertazapine and 5 mg diazepam nightly. Horrible symptoms continue despite reinstatement.... 

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  • Moderator Emeritus
1 hour ago, elizze said:

You said Diazepam dissolves in vodka, that's unfortunately not an option for me. Full fat milk is what I have read but have no idea, just wondered if you had ever heard of that at all.

 

Yes you can use milk.  See the following.

 

Also note the transition from tablet to liquid.  Do not make a reduction at the same time or any other changes.

  

On 3/27/2020 at 10:05 AM, Shep said:

 

Valium doesn't dissolve well in water, but some people do use water and don't have a problem.  The important thing is to be consistent with your method.

 

You can also use milk because valium is fat-soluble (whole milk works best),

 

...

 

You'll want to transition over slowly to liquid, keeping 3/4 of your dose in pill form, 1/4 in liquid for a few days. And then 1/2 in pill form and 1/2 in liquid for a few days. And then 1/4 in pill form and 3/4 in liquid for a few days. And finally switching over to 100% liquid. 

 

 

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full tapering program     My Intro (goes to my tapering graph)    My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

Please DO NOT TAG me - thank you.

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@ChessieCatThank you so much. I tried 2 days dissolving in milk, the whole 5 mg, and after that, yesterday had to take an extra 2 mg. It was a particularly stressful day, so that may have had a lot to do with it too, but I wonder if going to the liquid all at once might have made things worse. 

 

The longer I stay on this drug (diazepam) the more I worry/know it will be harder to get off. My total time on diazepam has been less than 3 months. But I think your message is, that trying to get off now, while still trying to cope with the mertazapine reinstatement, would be a mistake, and the trade off wouldn't be worth it.

 

I just can't help being desperate to reduce it, even just by a little. 

November 2021 prescribed 15 mg mertazapine for slight sleep problems/anxiety

December 2021 doctor doubled dose to 30 mg

January 2022 I messed around with the dose (didn't know any better), episodes of complete sleeplessness, prescribed 5mg Diazepam daily

February 2022 over course of 3 weeks i reduced mertazapine from 30 mg to 15 mg and went into a suicidal tailspin

March 2022 was taken off the 15 mg mertazapine by the doctor, became suicidal, was detained in the psych hospital and was put back on 30 mg

April 2022 managed to get released from hospital. Now on 30 mg mertazapine and 5 mg diazepam nightly. Horrible symptoms continue despite reinstatement.... 

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  • Administrator

Hello, @elizze

 

On 4/12/2022 at 4:20 AM, elizze said:

The sleep has returned to the tune of maybe 5-6 hours a night. I take 5 mg of diazapam also at night which I started in February to try and relieve the sleep anxiety which it did temporarily. But the panic, anxiety, numbness in my limbs, burning brain/body and akasthisia have not relented (not even bothering to list all symptoms). 

 

What times o'clock do you take your drugs, with their dosages? Why are you taking diazepam at night?

 

Are your symptoms better or worse at any particular times of day?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hello Altostrata, and thank you.

 

I take the diazepam 5 mg at 10pm and then the mertazapine 30 mg about 15 minutes after.

 

I was prescribed the diazepam at night for severe 'sleep anxiety' following a number of nights when I did not sleep at all. At the beginning of February. When I was detained in hospital and reinstated to the mertazapine 30 mg, they just kept prescribing the diazepam.

 

Symptoms: I would say in general, although not always, my symptoms are worse in the morning, especially the anxiety (not the same kind of anxiety as the same 'sleep anxiety', much more of an extreme sensation, with physical pain, tingling felt in my chest and throat). I will wake up with that between 3-5 am. Thinking most likely a cortisol spike, from my reading of others' experiences here. 

November 2021 prescribed 15 mg mertazapine for slight sleep problems/anxiety

December 2021 doctor doubled dose to 30 mg

January 2022 I messed around with the dose (didn't know any better), episodes of complete sleeplessness, prescribed 5mg Diazepam daily

February 2022 over course of 3 weeks i reduced mertazapine from 30 mg to 15 mg and went into a suicidal tailspin

March 2022 was taken off the 15 mg mertazapine by the doctor, became suicidal, was detained in the psych hospital and was put back on 30 mg

April 2022 managed to get released from hospital. Now on 30 mg mertazapine and 5 mg diazepam nightly. Horrible symptoms continue despite reinstatement.... 

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