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Shy: Switching dosage formulations of Remeron


Shy

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For several years I have been on varying doses of Remeron SolTabs - the orally disintegrating tablets. I'm not sure why my original Psychiatrist prescribed them this way..my best guess is that at the time, he had the samples in the office, and I stuck with them. Also, I was put on it because of nausea and GI issues, so there's that.Anyway, these orally disintegrating tablets are not only expensive, but they contain Aspartame - an artificial sweetener that has literally given me seizures when I accidentally drank some diet soda on a few occasions.To be frank, after my research of Aspartame, I want off of these SolTabs, which contain it-- to switch to the regular tablet dosing formulation until I am ready to taper off the Remeron itself (benzo tapering first).My concern is switching to the regular tablet form of Remeron. The orally disintegrating SolTabs bypass first-pass metabolism and absorb via the mucous membranes in the mouth and throat area, sort of getting into the bloodstream faster and more directly. The tablets on the other hand, the regular ones-- have to be digested in the GI tract, go through first-pass metabolism, and so on, and this then sort of becomes a bioavailability issue.As a teen and before I knew any better I was on the tablets once and I recall having issues and having to go back to the SolTabs.I'd like to switch to the regular tablets that do not contain aspartame, but this bioavailability issue concerns me.... Thoughts? :(I intend to taper my Remeron when I am finished tapering off of Diazepam as Remeron becomes less activating at lower dosages and benzodiazepines have been adverse to me in a very severe and acute way since I began taking them.

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  • Administrator

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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Hi.  Iam not familiar of Remeron or its various preparations, but wanted you to know that others are listening and do care.  Perhapssharing the category of the drug would help us help you.  Just a thought: Do you think you could ask for a one week supply of the tablets (either samples or an Rx) and just give it a try?  You'd still have the SloTabs right there to switch back to in case you ran into problems.  Sorry that I know nothing about the drug, but I DO understand your valid concern of potential withdrawal symptoms.  Keep us informed. 

insomnia, anxiety, depression- since childhood

lyme disease, dysautonomia, chiari malformation- dx 4/1997

nortriptyline- 75mg since childhood

clonazepam- 3mg since 4/1997

trazodone-100mg since 4/2013, now tapering

rotating antibiotics and antimalarials for lyme disease

midodrine- 10mg for dysautonomia

repeated skull surgeries for chiari malformation

 

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  • 4 weeks later...

I have had soltabs, regular and liquid. Liquid and soltabs hits faster. Not all that much though. I'd take regular pills maybe half to an hour earlier than liquid or soltabs. Thats the only thing i have noticed. Do not feel that they differ in resulting serum strength. I have found one brand of regular mirtazapine weaker than the others and less sedating. Mirtazapine is a mix of two mirrored molecules. I should be a 50/50 mix. The different molecules have different profiles. I believe the faulty brand had the wrong mix. Getting a doctor or the pharma company to acknowledge this is impossible though. If you get a different effect from a brand, switch!

 

I would get the liquid remeron brand. Easy to taper, and no methanol.

 

Best way to change is to take half of each kind for a while, then continue on the new brand/type.

2010: Mirtazapine 30mg followed by Zopiclone 7.5 mg for sleep post surgery due to pain.
2012-> Tapering Mirtazapine and Zopiclone at different rates unsuccessfully.
2013: Hospitalized 10 days due to complete Insomnia. Forced back up to 45mg Mirtazapine, 7.5 mg Zopiclone and also Theralene 1 ml.
2013-03: Lab showed Vitamin D deficient. Found the vitamin d and insomnia connection. Supplementing vitamin d. Sleep improved by 1-2 hours
2013-04: Dropped mirtazapine to 30 due to severe side effects. Quit Theralene. Zopiclone 7.5.
2013-05 - 2013-11: Mirtazapine taper monthly 25 20 15 11 8 4 2.5 mg
2013-12 Holding M at 2.5. Need to taper Zopiclone due to daytime nausea and vomiting. Taper zopiclone 1/4 red every 5 d. Last Z 2013-12-19
2013-12-31 M:2.5. Reinstated Zopiclone 3.75 due to Insomnia
2014-01-06 M:2.5. Taper Z 1.9 ... 2014-01-14 M:2.5. Z 1 mg.
Jumped of Zopiclone 01-20. Jumped mirtazapine 02-16.

Theralene: 10mg 02-09. 8mg 03-09. 5mg 03-15. 4mg 03-24. 3mg 04-08. Jumped 04-21.
Zopiclone free for 251 days. Mirtazapine free for 224 days.

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  • Administrator

Excellent suggestion about switching from tablets to liquid, wulfgar.

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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  • 2 weeks later...

Hi Shy,

What doses of each do you take? My suggestion about what to taper first depends on how high your doses are. Also, how is your sleep? How is your anxiety. If you are female on 45 mg mirtazapine i would suggest taper that first. At that dose its unhealthy. Taper it down to 15 at least. Stable there make a new decision point.

 

Also stable the dose of diazepam. Do not take extra as needed. That will make it hard to gauge where,if any, withdrawal symptoms comes from.

 

For me its possible to switch taper between benzo and mirtazapine. Did that to get away from the worst side efects from high dosing of both drugs.

2010: Mirtazapine 30mg followed by Zopiclone 7.5 mg for sleep post surgery due to pain.
2012-> Tapering Mirtazapine and Zopiclone at different rates unsuccessfully.
2013: Hospitalized 10 days due to complete Insomnia. Forced back up to 45mg Mirtazapine, 7.5 mg Zopiclone and also Theralene 1 ml.
2013-03: Lab showed Vitamin D deficient. Found the vitamin d and insomnia connection. Supplementing vitamin d. Sleep improved by 1-2 hours
2013-04: Dropped mirtazapine to 30 due to severe side effects. Quit Theralene. Zopiclone 7.5.
2013-05 - 2013-11: Mirtazapine taper monthly 25 20 15 11 8 4 2.5 mg
2013-12 Holding M at 2.5. Need to taper Zopiclone due to daytime nausea and vomiting. Taper zopiclone 1/4 red every 5 d. Last Z 2013-12-19
2013-12-31 M:2.5. Reinstated Zopiclone 3.75 due to Insomnia
2014-01-06 M:2.5. Taper Z 1.9 ... 2014-01-14 M:2.5. Z 1 mg.
Jumped of Zopiclone 01-20. Jumped mirtazapine 02-16.

Theralene: 10mg 02-09. 8mg 03-09. 5mg 03-15. 4mg 03-24. 3mg 04-08. Jumped 04-21.
Zopiclone free for 251 days. Mirtazapine free for 224 days.

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