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namastejen

namastejen: Remeron, Klonopin, cannot tolerate SSRIs any longer, getting saliva testing

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namastejen

Hi All,

 

I am new to the group--my name is Jennifer.  I have had quite the journey post-partum with my 16 month old son.  I was originally put on Zoloft 50mg about 3 weeks after my son was born and stayed on it until mid-March (so about 9 months).  I was feeling great that I wanted to come off of the medication. I tapered off of it over a month...it was a difficult taper which makes me wonder if I should have stayed on it longer.  But then 5 months after that I went on an intensive yoga retreat and came back with crying jags, anxiety, and insomnia.  I went on some herbs for a while to help with adrenal function prescribed by a chiropractor and felt a little better energy wise but was not getting anywhere with the insomnia or crying jags.  I discontinued the herbs.

 

Then on the very next day, I went on a nasty ride with psychotropics again with my regular doctor. I wanted relief so I went back on Zoloft but it was so agitating, they needed to give me Lexapro (it's supposedly a little less activating) and Trazadone to sleep. Trazadone worked for one night but I still was so agitated.  Then, they ordered me Xanax.  After taking one, I felt I wanted to jump out of my skin.  I called a psychiatrist and was put on Remeron and Klonopin right away and told to stop everything else.  The Remeron helps me sleep but I still feel so overwhelmed at times since coming back from that intensive yoga retreat. The Klonopin helps at times too but I do not want to take it everyday.  I am in therapy which is EMDR-based.  It has helped but I find it focuses on the negative aspects too much.  So we have done some CBT to keep me in the moment.

 

What I am looking for is advice from anyone out there that has had a similar experience with antidepressants and what you did to help yourself. I will be taking saliva tests for cortisol and female hormones tomorrow.  Thank God I can send them out on Monday. 

 

Other things :

 

1) I would like to know if anyone knows of a good doctor who understands conventional and holistic care that can help me to slowly get off the Klonopin.  I only take 0.25mg twice a day but I am so sensitive to any movement in drugs right now.

 

2) I would like a doctor's viewpoint/knowledge person on this forum on how Remeron works with the adrenal glands.  Could the Remeron be making things worse, better (because I am getting sleep), or is there no difference to the adrenal glands while taking it.

 

3) If the saliva tests come back with issues with both cortisol levels and female hormonal imbalances, how do I use herbs such Ashwagandha (adrenals) and/or Shatavri (balance female hormones) with Remeron?  Or are there other suggestions out there?

 

My biggest concern is adding these new herbs, if needed, while taking Remeron and Klonopin.  I know I need my sleep but I also want to be as proactive as possible in finding the best solutions out there. And I have a feeling that there are some veteran people on the forum that could really help me.

 

Thanks,

 

Jennifer

 

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lexicon

Hi Jennifer,

I am so sorry that you are going through this distress :(

You are in a good place here, with caring knowledgeable people to help you.

Someone with expertise will come along shortly.

Meanwhile, you may want to check out Dr. Andrew Pundy at 847-518-8490 ..He is located in Park Ridge IL.

There is also a website for Dr. Pundy at drpundy.com /

He is considered a very good doctor, as well as a benzo wise doctor.

I hope all works out for you, so that you can get your life back.

Love, Lexi

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mammaP

Hi Jen, what a time you've had! Alto is just the person to help, she knows all there is to know about AD's

and what they can do.  She will be along but in the meantime I just want to say hang in there, things can get better.

This is the best place in the whole world for advice and help with coming off these drugs..

 

Edited by ChessieCat
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Meimeiquest

What happened at the yoga retreat? Sorry you are having such a hard time!

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Altostrata

Welcome, Jen.

 

You may indeed be suffering still from Zoloft withdrawal, even though you're on Remeron. (You may also have suffered an adverse reaction to Lexapro. Lexapro is more activating than Zoloft; your doctor was mistaken.)

 

What we've seen is alternative treatment for withdrawal symptoms is not any more informed than that provided by conventional doctors. There is no silver bullet. It's unlikely the saliva testing for cortisol will be helpful.

 

If the Remeron is helping you sleep, that's a good thing and goes easier on your adrenals. Do you have any other symptoms from Remeron?

 

What is your daily symptom pattern? You may wish to keep notes on paper.

 

PS Lexicon -- how did you hear of Dr. Pundy? He does seem to understand benzo tapering http://drpundy.com/benzo-addiction/

 

 

Edited by ChessieCat
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Jemima

Welcome to the forum, Jen. It would be very helpful if you could put your psychiatric drug history in your signature, like so:

 

How To Add Your Drug History To Your Signature

 

I think what you'll find after the bumpy ride you've had with antidepressants and benzos is that most supplements, herbal or otherwise, are just going to make things worse.  The drugs sensitize a person's nervous system to the point that even coffee can be upsetting.  The only supplements that seem to help most people are high quality fish oil and magnesium. (There are topics about these two in 'Symptoms and self-care' if you want to read them.)

 

You'll find lots of good information and friendly support here.

 

Edited by ChessieCat
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Altostrata

I agree, you'll have to be careful with herbs and supplements. Always try a very small amount first to see if you're sensitive to it.

 

About fish oil and magnesium supplements, seehttp://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

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Petunia

What happened at the yoga retreat?

 

That's exactly the question which popped into my mind :)

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namastejen

Hi All,

 

I am new to the group and looking for some help.  I was on Zoloft 50mg for about 9 months after my son was born--they thought it was postpartum depression and that I needed to take something to help--so I did.  I was in a very bad place by week 3.  I phased off of Zoloft over one month's time.  At the time of tapering, I felt a little grouchy but for the most part was okay.  I functioned fairly well until I went on a retreat 5 months later.  It was an intensive yoga retreat and I did not rest much even though I wanted to do so.  I came back after that week and was having crying jags, anxiety, and insomnia.  Most symptoms I still have now.  Currently, I have been on Remeron 30 mg now and Klonopin 0.25mg as needed for about 6 weeks.  Before that my GP tried reintroducing Zoloft on my request but they did so at 50 mg.  This was too much then Trazadone, then stop Zoloft try Lexapro, then here's some Xanax.  It was awful. The SSRIs made me wig out.  Then I found a psychiatrist who put me on Remeron and Klonopin.  The Remeron worked at times but he too tried me on Zoloft again without taking the other two away--it was too much--and then Celexa--still too much. 

 

After reading about how Remeron is stimulating the fight or flight response in my body--I wonder if I should still take it. How can I safely get off the Remeron and Klonopin?  I was sleeping nicely on Remeron when we left things alone but not so much anymore and I have had no other reintroductions in about 2 weeks...although he upped the dosage to 37.5mg--and I was losing sleep again so I went down to 30 mg--slept pretty good one night but am back to 2 nights of terrible sleep.  I just want to have restful sleep but am doing my best to trust in my bodies healing process too.  I am having my adrenals and female hormones saliva tested and also have had my thyroid hormones looked as I have been on Levothyroxine for about 13 years. 

 

At night I get this wired feeling, at times, just when I am about to relax to sleep but then I am jolted awake.  Does it sound as if I had withdrawal effects?  Was this newest incident a relapse?  Adrenals gone haywire? What did you do to get off of whatever you were on and then regain sleep?

 
Thanks so much. I look forward to positive feedback on my road to recovery.Jennifer

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namastejen

I would like to get my thyroid checked out today because my resting HR has gone up and I am losing weight. Also it looks as if my T4 to T3 conversion is not optimal, which can cause anxiety and depression.

 

At the retreat, we went from 7 am to 9:30pm each day for about a week. There were breaks but they were not enough and I felt really wired most of the time there.

 

I think my cortisol may be off. Has anyone treated their adrenals with natural hydrocortisone cream or even natural progesterone cream? I am doing the saliva testing to see if this could work. Because if either of these hormones, cortisol or female, are off, they can also cause anxiety and depression.

 

With the Remeron, I was getting some good sleep but the past couple of weeks I am waking up between 1 and 4 am with a racing/adrenaline feel an have trouble getting back sleep if at all.

 

Then I feel I crash in the afternoon by needing to release a cry jag. Sometimes this happens in the morning too esp when I know my husband leaves for work and I am home with a lovely but demanding toddler. I feel like any little stressor can sometimes really get to me and other times I am okay.

 

So I feel like I need the best guidance out there but do not want to be all over the place to find answers.

 

Thanks to all of you that responded with encouragement and information. I reached out to Dr Pundy but have not heard back yet.

 

Jennifer

 

Past Rx History

2000-2001 Orthotricyclen--had difficulty with birth control has to discontinue

2000 to 2013 Levothyroxine (hypothyroid)

2001-2002 Paxil

6/2012-3/2013 Zoloft 50mg post-partum

9/2013-10/2013 Remeron 30mg and Klonopin 0.25 mg as needed (after yoga retreat)

 

Between 8/2013-8/2013 various SSRI trials alone and with Remeron (Zoloft, Lexapro-both without Remeron and Zoloft and Celexa with Remeron); it's as if my body has a difficult time handling the addition of the SSRIs.

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Skyler

Hi Jennifer.. do you drink coffee in the AM? Caffeine can make cortisol driven issues much worse.  Do you drink coffee in the AM.  When I switched to decaf there was a significant improvement.

 

I'm sorry the retreat activated your theretofore sleeping WD dragon.

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Karma

I have successfully treated adrenals, but this site does not support adrenal treatment - it is not in the area of our knowledge base.  I would refer you to a different site for support with thyroid and adrenals, but keep in mind that AD and benzo withdrawal is not the area of their expertise. So you will have to do some self education and use your body's reaction to guide you through this. 

 

This is a link to a thread I started about my thyroid symptoms and things I've observed, learned, read, etc. http://survivingantidepressants.org/index.php?/topic/1593-thyroid-symptoms/?hl=thyroid.  See the 18th post (middle of the post) for a group that can provide more information about adrenals.  I've personally worked with this group and found their suggestions very helpful to me.

 

One thing I've learned is that evidently when you are still on ADs and benzos those drugs can skew your saliva cortisol test results.  I didn't know this when I did the test and I forced treatment.  I say I forced treatment because traditional medical practitioners will generally either not treat adrenals at all, or only treat adrenals with supplements that don't always achieve the benefit the patient desires.  Having said that, I did get treatment and it did make a major difference for me. 

 

Karma

 

 

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namastejen

I do not drink any coffee.  I have been sensitive to caffeine and alcohol.  So I do not drink hardly any wine or alcohol--none when I am on any type of rx drugs for depression/anxiety.

 

I will check out what you have, Karma, for treating the adrenals.  I see that one can treat with progesterone cream--usual adrenal function, thyroid function, and progresterone go hand in hand.  Am I correct on this?  That is what I am reading right now in the book What Your Doctor May Not Tell You About Premenopause.

 

I am not sure where to start.  I guess I will wait until I get the saliva test results back and see what comes up.  ZRT does take into account the use of hormones and AD in their analysis.  But once I receive them--hopefully this Monday, I will have a better picture of what to do. I am just not sure where to start.  Treat hormones first--feel better--then taper off meds.  Sometimes I question if I really need these meds if my hormones are being treated well and I feel better.

 

Thanks so much!

 

Jennifer

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Altostrata

The paradoxical reaction -- waking in the middle of the night -- to Remeron suggests to me you might try decreasing it. See http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/

 

Quite often, withdrawal syndrome sensitizes your nervous system. It wants to stay at a higher "wired" state than normal. When you use drugs or supplements to reduce this, they may work for a while but eventually the alerting system rebels with paradoxical reactions.

 

The tendency to "wired" needs to be managed with very gentle techniques so as not to set off the alerting system. The alerting level is reduced very gradually.

 

It sounds to me like the yoga retreat was overstimulating. People with withdrawal syndrome often need to avoid excess stimulation. This may be light, noise, exercise, heat, etc.

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namastejen

So are you saying that I should lower the Remeron to 15mg from 30mg so that I can sleep better?  Remeron at lower does helps with sleep.  Do you think that I could have a paradoxical now after it being okay for a while?

 

If sensitized, how to do get back to a homeostasis?

 

Thanks,

 

Jennifer

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Altostrata

No, I did not say to lower the Remeron from 30mg to 15mg. That is a 50% decrease. We recommend much smaller decreases. Please read http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-remeron-mirtazapine/

 

Large decreases disturb nervous system stability.

 

Regaining nervous system stability and healthy homeostasis is a gradual process over time. Carefully used supplements may help; see the Symptoms and Self-care forum.

 

Many people do well with fish oil and magnesium supplements, seehttp://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

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namastejen

Alto,

 

How small of a decrease is best to come off of Remeron?  My pdoc put me on 37.5mg a couple weeks ago because he wants me to feel less depressed/be happier but it felt too stimulating. So I dropped back down to my usual 30mg...and am still having some sleep problems after a week but they seem to be a little better.

 

Also pdoc told me that people just stop taking Klonopin or Remeron.  I am now aware that this is not the case...that you must taper each one at a time.  Which do you start with and how do you taper?  I am concerned that I got on these now but have to ride it out for whatever benefits I am getting right now.  I was taking 0.25mg of Klonopin 2x per day but am doing this as needed.  Could I have withdrawal from changing this up too?  Ugh!  Too overwhelming at times...

 

But I appreciate your help,

 

Jennifer

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Altostrata

If you take Klonopin regularly, you may have problems stopping that, too.

 

We suggest going off the antidepressant first, as the benzo might cushion some withdrawal symptoms.

 

If your side effects from Remeron are going away, you may wish to hold for a bit before starting a 10% taper so as not to destabilize your sleep again.

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namastejen

Okay, I can understand that. How long do you stay at a 10% taper? Remeron is more sedating the lower you go...so how far would I go down without knocking myself out for hours upon hours?

 

I am not ready to do this yet. I need to first see what the saliva tests reveal and prioritize thyroid, adrenal if necessary, female hormones if necesary, and then see how I feel as to when I decide to come of Remeron and Klonopin.

 

Thanks again!

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Altostrata

If you are getting side effects from Remeron and a slight reduction also reduces the side effects, that indicates you are taking too much Remeron. You would continue to taper at 10%.

 

I would not worry about it being excessively sedating in lower doses. Most often, the problem in reducing it is rebound insomnia, which you want to avoid.

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namastejen

Oh Alto, I wish I would have known this before...so I called my psychiatrist today and he wants me up to 45mg because he thinks we have maxed out our potential at 30mg.  He wanted me to make this switch about 2 weeks ago...but I did 37.5mg for a little over a week but was not sleeping well and then on my own (sh*t) went back to 30mg for 6 days.  I have insomnia like nobody's business.  He told me to stop thinking of Remeron as a sleeping aid and more of as anti-depressant.  I am going to take the 45mg tonight along with Klonopin 0.25mg and Melatonin 2mg.  He wants to get me happy and sleeping again--that is my main goal for now too--I need to function.  Although I have been on this chase to find other reasons as to why I had this happen to me again in such a short time.  I still think there are some hormonal problems.  I will do what he wants at this point because I need to take care of myself and my 17 month old son and be more present in life in general and not to mention being the partner I want to be with my hubby.  Then, I will see what the adrenal and female hormone tests reveal tomorrow.  I can also do the other natural therapies, I am sure, with the support of the psych meds.  I wish I did not have to have someone (my Mom) or myself slap me upside my head to get actual help sometimes.  I would like to be so natural but sometimes it works and sometimes it may not.  I am very interested in the results tomorrow.

 

Thanks for writing this--now I know I have to taper with a lot of care.  Is it always 10%?  And for how long?

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Altostrata

You may wish to get a second opinion. See http://tinyurl.com/7cp8l8v

 

More is not always better when it comes to psychiatric drugs. Side effects of benzos can be depression and rebound anxiety.

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namastejen

Thanks for letting me know. Take care.

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namastejen

Hi All,

 

Here is a question for you.  How low do you go?  Because at 15mg (when I first started Remeron), I sleep for 10 hours or more and feel so sluggish even after that.  So I went up to 30mg after two days.  I have a toddler to take care of.  I am currently at 30mg but not without some craziness in between.  And would like to taper a little higher because I can cut the 15mg into quarters (3.75mg) and will reduce that way.  I am getting my high cortisol and low progesterone levels treated at this time. This may help to buffer the tapering.  I am probably going to go to another psych because mine now wants to put me on nortriptyline after being on Remeron for maybe 6 weeks...but I requested we taper slowly before just taking me off one and putting me on another.  This is getting crazy.  I think I will do the following:

 

30mg 2weeks

26.25 mg 2 weeks (12.5% decrease)

22.5mg 2 weeks (14.3%)

18.75mg 2 weeks (16.7%)

15mg 2 weeks (20%)

 

So where do I go from here?  I cannot be sleeping hours upon hours.  My hubby and family cannot be around all the time to watch my toddler.

 

Thanks

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Altostrata

Continue to taper off 15mg as gradually as you can.

 

You have a belief that the lower dosage is more sedating, but I don't think this is generally so.

 

If I were you, I would not stay on the psychiatric drug merry-go-round. It's your choice, not your psychiatrist's.

 

I hope the holistic treatments help you. To my knowledge, nothing "buffers" withdrawal or we would be recommending it here.

 

Let us know how you're doing.

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namastejen

Because I have been on Remeron for 6  or 7 weeks...how long should I stay on each decreasing point?  I do not wish to participate in the medication merry go round and this will be discussed at my next appt.   I may stay on 30 for a while to allow the holistic treatments to take affect and have some stability with the Remeron.

 

I am feeling better already (little steps of wellness) so send me positive vibes =o)  I do a lot of affirmations to keep myself up. Your body responds to the messages you give it so I need all the encouragement and positivity as I can get.  I send positivity and love and light to everyone on this forum.  I wish for such wonderful health for everyone here. 

 

How do I change my title to this message?  Thanks! Take care.

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Narcissus

Hello Jen.  I'm sorry to hear that you've been struggling.  I agree with the others, be careful with the supplements.  It's important to be able to tell what's affecting you and how in order to care for yourself properly, overloading in supplements can make this difficult to do.

 

It sounds like Alto suggested a 10% reduction for the Remeron.  Please read over the thread she posted above, as it details a safe course for tapering Remeron:

 

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

 

Since you have not been on the Remeron for all that long you might be able to go somewhat quicker.  Your original plan didn't seem like an unreasonable place to start, but then I don't know much about Remeron.

 

Edited by ChessieCat
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Altostrata

Jen, the danger in too-fast Remeron reduction is rebound insomnia. You may think that since it seems to be making you oversleep now, this is not possible -- but it is, and you will like it much less than you like oversleeping.

 

Even though you've been on it only 6-7 weeks, you are at risk for this and other withdrawal symptoms.

 

Very gradual reduction enables your nervous system to re-adjust. You might try a 10% reduction for a week and see how that goes. If you have no problems at all, you might want to try another 10% reduction for a couple of weeks. I wouldn't reduce more often than 10% every 2 weeks.

 

Edited by ChessieCat
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namastejen

Okay...I had a horrible night last night that confirms what you are saying.  I was on 30 and then on 45 for 2 days (doc rec) and then went back down to 30 now for 2 days.  The first night I slept well but last night was no sleep as you say rebound insomnia.  What should I do now to help myself get a good's nights rest?  I want to have good sleep again!  Do I stay put at 30 and my body will regulate itself because it was only 2 days or do I do something different?  Please help!!

 

Also have people tried Ashwaganda or Phosphatidylserine to help with high cortisol while taking Remeron and Klonopin?  I wonder if this is a good choice--they have similar properties.  I am not sure if this would over-tax my system or not.

 

Thanks.

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Altostrata

It's up to you. You can see if the rebound insomnia goes away after a few days (it may not) or you can reinstate now, stabilize, and taper more gradually.

 

Ashwaganda or Phosphatidylserine can have powerful and unpleasant effects on nervous systems destabilized by dosage changes in psychiatric drugs. I would not take anything more until you understand your withdrawal symptom pattern.

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namastejen

So how do I taper down instead of waiting for a good night's sleep?  I know, I am moving too fast with a holistic and regular approach.  I need to slow down.  Thanks for your help.

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namastejen

Just to let you know I so jittered that my legs tremble and shake today...it is pretty bad...and I have to see a few clients tonight...

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namastejen

I am not sure what you mean by reinstate...can you please clarify?...as my chest is so tight...this is a new symptom of my anxiety. i will read and await your reply.  It is as if I between 45 and 30 right now...so where do I start with my next dose?

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Altostrata

You dropped from 45mg, where you were sleeping, to 30mg, correct? Reinstatement would be going back to 45mg.

 

It sounds to me like you have withdrawal symptoms.

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namastejen

Yes..I was at 45...it was too stimulating, so the doctor told me to go down to 30....I slept the night before last okay with melatonin 3 mg and Klonopin .25.  Then yesterday, I started the herbs not knowing that this could throw things off if not stabilized and did not sleep at all.  So you are saying that I should go back up to 45 again even though it was too stimulating and then taper from there?  Or is there a happy medium that anyone has tried that it would still give my body some relief without now bumping all the way up to 45?  I have a feeling you are going to say go all the way up to 45--I want to know what is best.

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