Docc: Mirtazapine withdrawal

[Docc]

Hello everybody,

 

Mid february i was put on mirtazapine 15 mg by my GP. For depression and mostly sleep problems. The first 15mg knocked me out. Immediately snapped to 7.5 mg. It was a hard time adjusting, besides the regular symptons i had a hard time waking up and getting my brain to function and was tired all the time. Around april/may my body adjusted and most sideeffects where gone. The drug helped me in several ways. The small "pains" in my body like RSI, tinitus, headaches seemed to reduced a lot to none. It also helped me  a lot with anxity.But i felt like my feelings and emotions where flatten, numb sort to sy. It was easy not caring bout things but without the lows the ups where gone aswell. Also my libido and sexual functioning decreased dramatically. Not fun when your are 30 and single.So decided to quit. GP told me i could quit without a problem. So tapered for a weeks. Went to a quarter of 15mg and skipped days for a few weeks. I felt great. Thought i was already there. But after 1 week of stopping all together the problems started. The regular symptons arrised, brain zaps, hot/cold. numbness in lips and thong. Anxiety got realy bad. Im now i my 5th week. While some things cleared, a few got worse. My brain hurts all the time and im so freaking tired all the time. Had to quit work for a few days this week because i couldnt take it anymore. Still can't. My brain is like mush, extremely tired and my RSI and tinnitus are all over the place. Im quite a sporty guy, but i just cant do it because of my current physical withdrawal conditon. I knew it could be a windy ride. But this long? And this severe? I know im not the only one browsing these forums but im really close on reinstating. Its getting harder everyday.Any comments, thoughts or experiences are greatly appreciated.

 

Regards

[Petunia]

Hi Doc,

Welcome to the forum, I'm sorry you are having a hard time at the moment, but you will be able to get some good help here.

 

I'm fairly new, so I can't give you any advice, but it does sound like you are experiencing some withdrawal and reinstatement of a small amount would probably be something to consider, and then you can taper slower.

 

But someone else with more experience will be along soon to help.

 

I hope you feel better soon.

[Altostrata]

Welcome, Doc.

 

Petu has it right, reinstatement of a small amount, perhaps 3.75mg, will reduce the withdrawal symptoms. You can stabilize on this for a few weeks and finish your taper.

 

See http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/ for mirtazapine tapering tips.

[tezza]

Hi Docc,

 

Welcome...I hope you stabilize soon!

[burnedbypills]

Remeron withdrawals are tough.  I am struggling myself to come off of remeron.  I hope it goes well for you.

[Docc]

Thanks for the replies everyone. Thinking about reinstating with a low dose as i just can't tackle it in these busy days. Il check back in in how things are going.

[tgirl]

Hey Doc,

How are you doing?

[Altostrata]

tgirl, you might try sending personal messages to those people who haven't posted in a long while. They may not be getting e-mail alerts on their topics.

[ChessieCat]

  

7 hours ago, Docc said:

 

Mirtazapine liquid loses potency fast

 

Hello all, I’m using a pharmacy made mirtazapine liquid that can be used for a month after opening. Now I’m currently in a burnout and super sensitive to meds etc.

 

so when I open a new bottle I get energized and my head feels like I’m updosing. During the month this slowly fades and I get really tired at the end. Like withdrawal tired.  Then I open a new bottle and the Mary go around starts again.

 

anyone has similar experiences?
 

I used the liquid a while when i was healthy and noticed the tired symptom once when it was like 1 day after expiry. (Never let it expire) but now i feel the whole degrading process during the month of use.

 

thinking of going to tablets to prevent this  

 

 

 

I moved the above new topic/post to the following topic:

 

tips-for-tapering-off-mirtazapine-remeron

 

[Docc]

Doc: Mirtazapine troubles

 

Hello, I have been on mirta for 2 years. The last 6 months on liquid. I started noticing that I would feel better (tired and relaxed) at the end of the meds shell life (a month) and get an uptick in hyperactivity when  starting a new bottle. I decided to let it run towards almost the end of shell life and withdrawal came more apparent. More tired (which is good as im in a burnout) and heavy abdominal pain (lots of toilet visits)

 

I opened up a new bottle again but besides being a bit more hyperactive this time I feel terrible. Abdominal pain is gone but I just feel I’ll all around, it’s been 2 days since opening a new bottle (well it was actually open for a week before using it). I think I have been kindling myself this past six months. I’m on 7mg currently and have 3.75mg tablets coming in as I want off the liquid. But wondering what’s wise.

I want to stabilize on a fixed dose. but which? Seems my mind has slowly growing used to less mirta so maybe 3.75mg works better. Or do a little updose to 7.5mg (2x3.75mg tablets) I’m leaning towards 3.75mg but don’t know what’s best for my mind currently. The withdrawal during liquid wasn’t that bad for me. The tiredness actually helped me sleep. But I don’t know if it was enough withdrawal to make a step to 3.75mg. But 7mg currently feels wrong

 

Edited June 21, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[Docc]

Took 3.75mg last night but the abdominal pain is now too intense.   It feels like the kind of pain when you are reeeeaaallly tired or did too intensive cardio. Could not sleep because of it. If I have to guess based on symptoms, the unwanted liquid taper was somewhere around 5 a 6mg when ended. But cant really afford to test that out. Uch It just become a **** storm with the liquid.
 

I will “updose” to 7.5mg tonight and hopefully stabilize there. Although I find 7.5 a bit too activating its better then this pain

[Docc]

Funny thing. I actually feel better on 3.75 like really tired and relaxed. Probaply because tiredness is a WD symptom. Which is actually relaxing for me. Too bad that pain is there. Otherwise I’m fine.

 

[Docc]

to clarify I took only 3.75 last night. Couldn’t get me to take 7.5mg but I’m thinking I’m making a mistake by holding out at / lowering to this dose. But I’ve been been kindling for a while and in withdraw for at least a week maybe 2 again then I took a new bottle for 2 days again (body had a hard time adjusting to the normal dose again) and then yesterday went to tablets and dropped from 7mg to 3.75

 

Anyone? Should I “updose”? Currently Really tired, spacey, abdominal pain and almost no sleep. But sleep sleep was bad before this drop anyway. @ChessieCat @JanCarol @getofflex@Shep @brassmonkey@mstimc@Altostrata

[Altostrata]

I am confused, @Docc. We haven't heard from you since 2014. You've been taking 7.5mg in liquid form, but found you're sensitive to the loss of potency of the liquid over a month, is that correct?

 

On 6/21/2022 at 7:31 AM, Docc said:

I started noticing that I would feel better (tired and relaxed) at the end of the meds shell life (a month) and get an uptick in hyperactivity when  starting a new bottle.

 

Perhaps your body was trying to tell you it would prefer a slightly lower dose, such as 7mg rather than 7.5mg?

 

On 6/21/2022 at 7:31 AM, Docc said:

I decided to let it run towards almost the end of shell life and withdrawal came more apparent. More tired (which is good as im in a burnout) and heavy abdominal pain (lots of toilet visits)

 

How many times did you allow yourself to experience withdrawal as a bottle ran out?

 

When does the abdominal pain occur, before or after you take a dose? What effect do you feel from 3.75mg mirtazapine, having reduced from 7.5mg-7.0mg?

 

What is your goal? Do you intend to go off mirtazapine altogether?

[Docc]

On 6/23/2022 at 1:17 AM, Altostrata said:

 

I am confused, @Docc. We haven't heard from you since 2014. You've been taking 7.5mg in liquid form, but found you're sensitive to the loss of potency of the liquid over a month, is that correct?

 

I successfully got off mirtazapine in  2013 but got on it again in 2020. Correct about the potency

 

On 6/23/2022 at 1:17 AM, Altostrata said:

How many times did you allow yourself to experience withdrawal as a bottle ran out?

 

When does the abdominal pain occur, before or after you take a dose? What effect do you feel from 3.75mg mirtazapine, having reduced from 7.5mg-7.0mg?

 

What is your goal? Do you intend to go off mirtazapine altogether?

Around 6 times. (Moved from tablets to liquid in January) I didn’t realize it because I’m in a burnout and thought it where burnout symptoms

 

at one point I want to be off it but not necessarily now. I have trouble feeling my boundaries with it so rather sooner then later. Main prio is to stabilize.

I just saw an opportunity in this case and jumped a bit lower. I expected potency was to be around 6mg at the end of a bottle so I jumped down instead of up with my new tablets (3.75) to stabilize on. I also never had any trouble going from 7.5 to 3.75 in my other tapers. (But yeah that’s not a guarantee)

 

abdominal pain happens 24 hour, most noticeable in the evening and night. I think it’s muscle cramps/pain.

 

I’m now 4 days on 3.75mg. I feel better mentally but physically not so much. continue to experience withdrawal symptoms (a bit worsening) which ofcourse is to expected. A lot of muscle pain.

i realize the best option was to keep the liquid. Use a little less and stop earlier. (Based on symptoms it seems you can keep it only 2 weeks instead of 4)

But I just don’t wanna take liquid currently if it has such potential in being less potent. And as its from pharma I would have to get a new one every 2 weeks. Which my GP would never approve.

[Docc]

feeling unwell, really hot and tinnitus is jumping around. But I’m calm as a cucumber.
 

I know my best option is to return to my old dose and save myself from coming misery …and yet I just can’t get myself todo it. It’s idiotic..

[Docc]

More then 2 weeks in. my brain always needs around 2 weeks for the alarm bells to settle down (hyperactivity) when changing (big) doses.
But the fatique now is crushing and very painful abdominal. Really didn’t expect the drop would be this bad. 
 

On one hand I do t want to go back yet again to 7.5 to prevent further destabilization. But I don’t see WD clear up anytime soon either  but don’t think I can tackle what feels like full on WD. 
 

The pills have a breakpoint in them so I could go to 5.6mg instead of 7.5mg 

[Altostrata]

The decision is up to you.

[ChessieCat]

On 7/8/2022 at 1:59 AM, Docc said:

But I don’t see WD clear up anytime soon either  but don’t think I can tackle what feels like full on WD. 

 

To me is seems that you are worried about something that might happen.  This is called anticipatory anxiety.  Quite often this can happen when we have had a bad experience with something before so we expect it to happen again.  For example if someone had a bad experience with a dog then they might end up expecting to have the same bad experience with all dogs.

 

And anxiety can cause symptoms which are similar to WD symptoms.  Read the labels on this diagram:

 

From https://www.getselfhelp.co.uk/anxiety-self-help/

 

[ChessieCat]

Part of the process of getting off psychiatric drugs is learning to cope with some discomfort.  SA strongly encourages members to learn and use non drug coping techniques.  I have found that the non drug coping skills that I learned during my taper have become part of my life and I use them for general life and health coping.

 

Non-drug techniques to cope

 

I have found relaxation techniques very helpful.  With the relaxation I think it is better to do short periods of it throughout the day, regardless of whether you feel you need to do it.  Think of it like an old fashioned kettle on stove, the sort with the whistle.  If you keep turning the heat on and off the whistle will never blow because the steam won't build up.  Relaxation techniques work in a similar way.  You probably won't get rid of the stress completely but you keep bringing it down a bit so that it doesn't get to the build up.

 

I now find that I more quickly pick up when I am starting to feel "different" (tired, confused, anxious etc) and it's second nature now to do some sort of non drug technique (self talk, breathing exercise, get up and look at something different) to cope with whatever it is that is happening.

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk
 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

  

On 4/28/2017 at 4:03 AM, brassmonkey said:

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.

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On 6/16/2022 at 2:53 AM, getofflex said:

APPLE Technique

 

I just came across a very nice technique that really helps me.  It's called APPLE. I have printed it and have it where I can see it every day and be reminded of it so I internalize this technique. 

 

A - Acknowledge Notice and acknowledge the thought or uncertainty as it comes to mind. 

 

P - Pause Don't react as you normally do.  Don't react at all.  Just pause and breathe.   

 

P - Pull Back Tell yourself this is just the thought or worry talking, and this apparent need for worry or analysis or certainty is not helpful and not necessary.  It is only a thought or feeling.  Don't believe everything you think.  Thoughts are not statements or facts.   

 

L - Let Go Let go of the thought or feeling.  It will pass.  You don't have to respond to it.  You might imagine the thought floating away in a bubble or cloud.   

 

E - Explore Explore the present moment, because right now, in this moment, you are OK.  Notice your breathing and the sensations of your breathing.  Notice the ground beneath you.  Look around and notice what you see, what you hear, what you can touch, what you can smell.  Right now.  Then shift your focus of attention to something else - on what you need to do, on what you were doing before you noticed the thought or worry, or do something else - mindfully - with your full attention.  

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[Docc]

Thank you for the comments. Much appreciated