Hopefull: suffering from PGAD

[Hopefull]

Hi everyone,

 

First of all I appreciate your advice and support. I find this site comforting knowing that I am not the only one who has had bad reaction to AD'S. Since I have decreased the dosage I am beginning to feel really down. I have not had any PGAD symptoms since Sunday and that is fantastic. My doctor and his colleagues still have doubts that mirtazapine is causing the problems and that made me really angry and disappointed. As you know my trouble has started from Zoloft and has continued on and off since. The 7.5mg is helping me a little bit but I feel the dosage is not enough. I feel that I am slipping back a little bit in regards to obsessive thoughts. Can antidepressants permanently change the chemistry of the brain? Once you stop the medication does the brain return to its original chemical balance? I am torn between continuing on with antidepressants but if I go back to the original dose I know that I will very likely get flare ups again. I wish that there was a magic pill. If anyone suffers from anxiety and obsessive thoughts knows that it can feel like you are a prisoner of your own mind. That leads to depression and so on. I would like to ask, when you were on antidepressants did they work for you? And please if there are people out there that got PGAD from AD'S please post your experiences. Are you still experiencing issues after taking AD'S? The most frustrating thing is that doctors are not educated in this area.  There really needs to be greater awareness that AD'S can cause unwanted sexual sensitivity. I am seeing a psychologist for further help and I wonder whether people found AD'S useful together with CBT? Thank you.

[Hopefull]

Can you please tell me who is Dr. Rob Purssey? I looked him up and he seems to practice in Queensland, Australia. Thank you.

[Altostrata]

See http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/page-3#entry47108

[Hopefull]

Thank you.

[wulfgar]

Hi Hopefull,

 

62 to 65 is not all that much. I gained 13 kg in total, from an already bit to heavy 82 kg. I think weight gain is biggest in the beginning months on mirtazapine. Try avoiding sugar, allow for good fats and maybe count calories if you want to stop gaining weight. I were able to stop weight gain for long periods when on mirtazapine, so its possible. A little bitt of my problem is that i tend to comfort eat when i feel bad. If you can, avoid eating after you taken your dose, i know its hard. I changed to a eating monster each night. A dr Jekyl mr Hyde thing.

 

Swollen ankles and wrists i suggest you ask your doctor about. You are retaining water and thats not a good thing.

 

Being on mirtazapine for more than 2 months i sure think calls for a careful reduction. The end result is the important thing. If you feel better, and then shake everything up by a quick withdrawal, you might get worse again. Living with withdrawal symptoms puts a big strain on. It has wounded my spirit somehow. If i could wind the clock back an do it over again i would have started to get of earlier and gone more slowly and lived more during my taper. If you feel fine and taper slowly you just might feel fine all through the 4 month taper. A win, wouldn't you say?!

 

/Wulfgar

[Hopefull]

Hi Wulfgar,

 

Thank you for your reply.  When I first started mirtazapine I felt really hungry. Now I am ok. I exercise and I try to watch what I eat which is hard since I did not have to do this before. I am used to eating what I want.  From what I can see in your medical history you have been mirtazapine free for a while. Have you started loosing weight? I have read that once you stop the medication the weight slowly drops off.  I hope I don't gain anymore weight.  TS I will read your posts. I will follow your thread.  Wulfgar are you feeling better now? I know what a withdrawal feels like I had one from Zoloft and it took me a while to recover. I am still recovering and feeling much better. It good to share stories with people that are going through similar things. Wishing everyone all the best!

[Hopefull]

Hi Wulfgar and ts, silly question, but how do I follow your thread?  I clicked on Content I follow, but nothing comes up to set it up. Thank you.

[wulfgar]

Hi,

 

I have started to loose some weight, but i have to help it along with counting calories though. It works quite good so being of helps. Im not all that young any more so weight tend to stay on even without drugs. I do feel much better now in comparison to withdrawal and side effects from the meds. There is still a long way to go i think. When i where on higher doses of meds i where bedridden, and that put a big strain on my body. Healing is slow. I was an competitive power sport athlete before the meds and now i can only walk a few kilometers so there is a long way to go. Still, I'm happy because i don't feel all that ill any more.

 

When you eventually decide to go of your meds, please go slow. Not 25% per week or 50% every two weeks or every other day regimes.

 

It is good that you are on only 7.5 mg mirtazapine. That is about where i got better from many side effects.

 

You can follow a topic by clicking on the follow button up in the right corner when reading a topic. Also, by clicking your name up in the right corner you get a menu in which you find "my content" and "followed topics" which both are good. "My content" gives you a list of topics you have posted in and it displays if there is a new post in them.

[Hopefull]

Hi Wulfgar,

 

I am following your thread. I will keep your advice in mind when I decide to taper down. If I did not gain bit of weight then I would not worry as much. A bit vain I know! . I don't want extra problems to deal with. I did not even own scales before AD meds. Now I am weighing my self every day and wanting time to go quickly so that I can get off the meds and loose the 3 kg that bug me! Do these medications slow down your metabolism  and is it permanent? Sorry, I keep going on about the weight thing, it sucks being on these meds! But I guess sometimes you have to choose sanity over vanity! )))))

[wulfgar]

In all reports I've read the weight gain from mirtazapine is usually quite quickly lost after the taper is complete. I do not think you should worry about loosing the weight later on. Gaining weight can be quite upsetting, it was for me also. I am so very sure though that you are as lovely or more at 65 as at 62!

I do not think mirtazapine slows down metabolism. It increases appetite and increases the tendency to store excess calories as fat. Keeping your intake of calories at correct level so that your body uses the same amount per day will make you stay at the same weight. So, avoiding sweet stuff or high calorie stuff, comes a long way. Same principles apply for avoiding weight gain now as when not taking mirtazapine.

 

I advise against going on a diet when on mirtazapine. Diet causes extra stress and can cause depression as well.

 

Easiest/best way to allow for or compensate for extra calories is to walk. Walking does not raise cortisol and can even lower it so its good for stressed out people like we are. You can also add a back pack with some extra weight. Gives a fantastic extra effect. Start slow though with just 1-2 extra kilos, so that your knees can get used to it.

[Hopefull]

Hi Wulfgar,

 

I was walking a lot when I went through the difficult period, I am going to start again. I do aerobics, and Zumba. I exercise at least 3-4 times a week since I have started on mirtazapine to avoid excessive weight gain. It is really true that after you go through a really tough time, you have no choice but to start taking care of your self. I have found exercise very relaxing. I am feeling better everyday. To all the people on this forum that are going through rough time, hang in there, find the strength inside your self and things will get better! I honestly feel sometimes that I am getting better on my own and there fore question whether I should be taking medication? Can such a small amount of medication really make the difference?

Since you have been off Mirtazapine, has your appetite returned to normal? Do you avoid carbs? White bread, etc.?

Thank you so much for your advice, I presume your are older and wiser than me! :  I really do appreciate it. I hope you are going good. Have you tried pomegranate juice for blood pressure?

[Altostrata]

That's good news, Hopefull.

 

How much mirtazapine are you taking now? Please put that in your signature.

[wulfgar]

Hi Hopefull,

 

7.5 mg of mirtazapine for girls is still a large enough dose to have some "anti-depressive" effects. Its about twice as strong for girls. If you feel better mirtazapine just might be the cause. I have herd somewhere that it actually helped some, short term at least.

 

Exercise, especially low intensity is quite good for me, and i think for all that is well enough. High intensity exercise has its benefits to but i think thats for healthy people. I think its a good idea to find the intensity that one feels good from and that does not affect sleep, and then try to stay on or below that level. One should also keep in mind that training stress is accumulative so rest is very important.

 

I have read up on pomegranate per your recommendation and it looks promising. Its hard to find any good pomegranate juice where i live though. What I've found is usually some mixed juices with lots of sugar in it. I will continue to search for it though!

 

Yes, i believe my appetite has normalized. I have managed to go to sleep without night snacking, and a skipped breakfast does not cause me teenage hunger cravings anymore.

 

I do not avoid carbs. I avoid pasta and processed rice, as those bring lots of calories with a small amount of nutrients. No soft drinks, cakes, candy or other sweet stuff. I eat white bread sometimes but only a slice because of the low nutrient content.

 

My 2 cents about carbs: Carbs/sugar is an excellent and needed source of energy for our body and brain. (Same with fat) We have a big capacity to store carbs in our body as carbs/sugar to be used as energy when exercising. When we exercise or work/walk etc we use this store of carbs. Its a highly dynamic system. As long as it does not get completely full or empty. The problem with carbs is when we have a greater intake of energy/calories than we use up. Our body then starts to convert carbs to fat for long term storage. Fructose is little more problematic as a percentage eaten is converted directly to fat. That would also not be a big problem if out energy/calorie intake is balanced, but fructose is so readily available in everything, its the sugar form that taste the most sweet, so it acts almost like a drug. We want more... Carbs needs to be eaten with protein and fats. Fat and protein slows down the uptake of carbs (lower the meal GI) and you keep longer on a meal. My preferred carbs is green vegetables, tomatoes, swedes, potatoes, parsnip, carrots, brown rice and some fruit like apples, pears, oranges, grapefruit. (Grapefruit should not be eaten while on mirtazapine, as it causes your liver to slow the metabolism of the drug, and the blood serum goes up)

 

If you are doing aerobics you probably need some carbs. To low on carbs when exercising and you get nausea and a large increase in cortisol.

 

Regards

Wulfgar

[MomOf5]

Hi Hopefull.  I just wanted to say that I'm on 7.5 mg of mirtazapine too, since last September.  I've tried to come off it a couple of times and ended back on.  Next time I try I'm going to have to go even slower and make sure to plan the final cut during a time when there are minimal other stressors.  I don't have much advice to share, but I just wanted to say hello.  Hope you're having a good day.

[Hopefull]

Hi just to update,

 

I have not had any PGAD symptoms since early March and I can say that I am free! It has taken 4 months to recover and I am feel better. I am  still on mirtazapine 7.5 mg, and in couple months time I hope to get off. I hope to give others hope!

[Altostrata]

Thank you for that good news. I am sure you will be fine.

[wulfgar]

Fantastic! I am glad things are stabilizing. Just remember to go slow when you start your taper!

[Hopefull]

Hi Wulfgar,

 

I am seeing my doctor in 2 weeks time about getting off mirtazapine. I will need your help and guidance. I am a bit scared but if I get off the medication slowly then I hope it won't be a problem.  Cheers!

[Altostrata]

It's highly likely your doctor will not be able to give you any informed guidance about tapering mirtazapine. Few have that knowledge.

 

You may wish to ask him or her for a prescription for the compounded liquid, so you can taper by very small amounts.

[Hopefull]

Hi Altostrata,

 

That is what I will do next time I see him. I will then ask for your guidance please. Thank you.

[Hopefull]

For the last few days I have started to feel really down again. I take 7.5mg of mirtazapine at night and when I take it I fall asleep pretty fast. The last couple of days I have noticed a change. I can't fall asleep easily and I have had mood swings. I don't know if it is mirtazapine or me? I am seeing my doctor soon, I would like to come off it,but I have a feeling that he will suggest to increase the dose.  Not sure what to do.  I have been doing really good, but lately I feel like I am taking few steps back. I still feel anxiety even on medication except I no longer have panic attacks. Does anyone know anything about INASITOL a natural supplement that is supposed t help with anxiety/depression and insomnia. Thank you.

[Narcissus]

Hello, Hopefull.  It seems like the drugs have consistently given you problems since you've started them, even if they've helped take the edge off of some of your obsessive thoughts.  My own inclination would be to taper the mirtazapine and seek psychological help.  Are you still seeing that psychologist?

 

Setbacks are a normal part of the recovery process, so they're to be expected if you're still recovering from the Zoloft.  Still, they're hard to accept.  I'm right here with you, riding a nasty wave/setback myself.  Hang in there and keep us updated.  

[Altostrata]

Hopefull, you will still have waves and windows. Try not to worry about short-term variations.

 

You are asking about inositol, please see our topics about it in the Symptoms forum.

[cymbaltawithdrawal5600]

Hi Hopeful,

 

Here is one likn to a topic where inositol is mentioned:

 

http://survivingantidepressants.org/index.php?/topic/5322-much-improved-sleep-with-inositol/

 

For others, type this into your favorite search engine:

 

"survivingantidepressants.org [your search term]".  It will return results where the term is mentioned on this site specifically.

 

Several members have tried inositol with varying results.

[Hopefull]

Thank you.

[Hopefull]

First of all I want to thank you all for taking your time to answer my questions. It really means a lot to me especially when I am not feeling so good. I must be still recovering from Zoloft because I have great days and not so good days. I guess I did not think that I was in that category because I only took 3 tablets. But it is obvious to me now that I am.  I was feeling down this morning but I am feeling better now.  I try to be positive because I have had really good days and I try to push on. I am getting psychotherapy, ( CBT), can't say that I am seeing improvements as yet, it will take time. Narcissus, it seems like AD'S have been giving me trouble and I do want to get of mirtazapine, but I am also scared of withdrawal  symptoms, because I went through Zoloft hell! How are you coping? I will ask my doctor about inositol and how much to take. Has anyone tried it? I did read about someone on this forum who tried inositol and has worked for them but not for the other person.  It has been six months since I had bad reaction to Zoloft and 4 1/2 months since I have taken any supplements due to sensitivity.How long does the nervous system remain sensitive? I know that this differs from person to person, but I would like to try fish oil, not sure if I should give my self little more time before trying any supplements. Thank you all for your support, I really appreciate it.

[Hopefull]

Latest update:

 

I saw my doctor recently and I have decided to get of mirtazapine. He told me that I can quit cold turkey since 7.5 mgs is a small dose. I told him that I was scared to do that. He then told me to half 7.5 mgs tablet and take it for two weeks and then stop. I decided that I will not follow his advice. Once I obtain mirtazapine in a liquid form how much do I take and for how long before I make the next cut? Please help. Thank you.

[wulfgar]

It all depends on the concentration of the liquid. You usually get a dropper that you can measure down to about 1/8 of an milliliter. What i did was slowly drip one milliliter from the dropper and counted how many drops there were on on milliliter. With a little math you can then figure out how many drops 7.5 mg is. I would suggest you start of not tapering and just go with 7.5 mg worth of liquid for a week or two so that you will know that the liquid works the same. I believe there can be some concentration differences and also liquid acts a bit faster which could change things a bit. For me one drop was about .5 mg mirtazapine.

Going slow is key for success! 

/Wulfgar

[Hopefull]

Thank you, Wulfgar. My doctor only gave me one script and no repeats. If I find the liquid form not suitable then I am a bit stuck. Wulfgar, do you think that 50% drop is too fast to taper as the doctor suggested? He said to cut the 7.5 mgs tablet in half and do that for two weeks.  I can see that you no longer take mirtazapine. How have you been? If I take the liquid form for 2 weeks and find it ok. then do I take 6.5mgs for a month then, 5.5 and so on? Thank you for your help. I just want to be free from medication.

[mammaP]

Hi Hopefull, glad you got the liquid  to start tapering. I agree with Wulfgar that you should take the liquid for a 

while before starting your taper so you know you are ok with it. 

 

Your doctor hasn't a clue has he?  !   My doctor has no clue either and told me the same thing, to just

stop effexor because the dose is so low!  50% drop is far too much, 10% of the current dose should be the

maximum drop, holding at least 4 weeks between cuts. 

 

I am useless with figures but I'm sure Wulfgar or one of the others would help you with the figures. 

[wulfgar]

A taper down to between 6.5-7 mg would probably be an ok start. Evaluate after 4 weeks. Keep a diary. Adjust taper speed depending on how rough it was and how stable you get. Try reading through the thread on tapering mirtazapine and general tapering thread found here at the forum.

 

If you are unsure how to measure dose, just post when you get the liquid. Someone will help you then.

 

Don't forget to work with stress reduction during taper! Don't start a taper if you know the next two weeks are going to be stressful. Remember, stressors can be both emotional and physical and they are equally problematic when tapering mirtazapine! (Light physical stuff like gentle walks can be helpful though.)

/Wulfgar

[Hopefull]

Thank you, Wulfgar and Mamma P for your help! I will keep you posted. Some doctor's don't know much about tapering. As soon I get the liquid I will ask for help how to measure the liquid form. Thank you all so much! Have a great day!

[Hopefull]

Hi,

 

If any Aussies are reading this, can you please tell me where I can find top psychologist and psychiatrist in Melbourne.  Thank you.

[Petunia]

Dr Purssey is the only Australian doctor I've seen recommended by anyone.  He recognizes withdrawal and understands the need for careful tapering.  He may be located in Queensland, but will consult with anyone via skype.

 

http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/page-3#entry47108

[Hopefull]

Hi Petu,

 

I e-mailed Dr Purssey 2 or 3 months ago and never got a reply from him. I did not bother to e-mail him again.

[Petunia]

That's unfortunate, sometimes email can be unreliable.  Another member - Acetyl, has been having Skype consultations with him, perhaps you could ask him about his experience to help you to decide if you want to pursue it further.