☼ Miami1 Stabilizing on mirtazapine

[Miami1]

Thx CYM !

Makes sense. And there must likely is a component of benzo WD.

 

But the sxs I get with this poison are far from any benzo sxs I've experienced. Like the nausea akathisia high level of tenitus. I'm feeling worst than my first couple of months in acute.

 

I just have to adjust to the liquid where it won't revve me up all night and there's no telling the exact amount I was taking prior to liquid.

Anyway you look at it it's a horrific situation. If I can only stabilize and feel 50% for a little while!

[cymbaltawithdrawal5600]

Miami,

 

You need to re-read Rhi's post over and over till you get the full meaning of it. This will NEVER be like your benzo symptoms and we know they are hard. If you want them to abate, you have to grit your teeth and follow the best directions from the mods.

 

You tried a CT of mirt while still in benzo WD and you are now adding back in a small amt of mirt to head off worsening CT symptoms. Your symptom pattern for your individual body will never match anyone else's nor will it match any of your other previous symptoms. It will be LIKE those that some of us have, that's why you should find out waht you can do for what you've got in the Symptoms and Self Care Forum.

 

Did you make your own liquid? How did you do it? Did you know ahead of time before you took the liquid that just that change might have additional symptoms associated with it? You would do well to research and ask questions to make sure you have understood what you read before you try it.

[Miami1]

Hi CYM ;

This is my 5th batch of liquid. The other four where not tolerated. They all come from compounding pharm. The first batch was clumping the following batch had large pieces not dissolved. The third I went to a compounding Pharm in Orlando and it was great. Simple syrup solution with flavoring but they used alcohol to remove coating ,gave me burning skin reaction. Any way whats important is the last batch was made with almond oil and aside from feeling over dosed I tolerated it well. I hear what you are saying and I truly appreciate you and others for your concern and help doing this the best way possible. CYM I really do feel the general sxs are from the mirtz but regardless I have to do this correctly and with all the good guidance I just may succeed.

 

Thk you!

[cymbaltawithdrawal5600]

When cimetidine (weak inhibitor of CYP1A2, CYP2D6 and CYP3A4) is administered with mirtazapine, the mean plasma concentration of mirtazapine may increase more than 50%.The mirtazapine dose may have to be decreased when concomitant treatment with cimetidine is started or increased when cimetidine treatment is ended. Caution should be exercised and the dose may have to be decreased when co-administering mirtazapine with potent CYP3A inhibitors, HIV protease inhibitors, azole antifungals, ketoconazole, erythromycin, cimetidine or nefazodone.

 

 

You can ignore the mumbo jumbo except for the list of meds at the end. Are you taking (or recently taking) any of them??? Any on this list: https://en.wikipedia.org/wiki/Histamine_antagonist? Vistaril and benadryl are mentioned as well as stuff like claritin and allegra. When you are in WD everything is important.

 

It appears the pills have a film coating which makes it so you don't have to eat powder, not to delay absorption, I don't think. There are different generics and you may just want to note for future reference (and if you can find it out) which pill the pharmacy used to make the suspension and when you get one you like make sure they use it all of the time. Some members react when different fillers in the different generics are used. A casual search reveals that a true (not compounded?) liquid may not be available in the US but can be ordered online. I am out of my depth with that one.

 

According to this same literature, it appears that the sleep inducing effect wears off after your body gets used to the drug so I would consider it a non-starter if you think it will help with sleep ever again.

 

If all of this is in error, I hope a mod will swoop down, delete it and roundly chastize me for butting in.

 

Are you taking anything else, including supplements? Grapefruit juice? Cranberries?

 

Rember this note from Rhi: "Your situation isn't as straightforward as some people's."

 

But you will still recover.

[Miami1]

Don't know any of those but I have been and Tuesday night I took a vistaril to help with sleep. I have been cutting back taking that as I was warned about it from Wulfgar. I also take on ocation Zolfran for nausea and haven't taken for a while promethazine. I will also add to my signature which I forgot and reading here I see all is inportant , Prevacid 15mg daily.

 

Thks

[Altostrata]

Please read this regarding Prevacid http://survivingantidepressants.org/index.php?/topic/4361-tips-for-tapering-off-stomach-acid-blockers-or-ppis-esomeprazole-lansoprazole-omeprazole/

 

It could be responsible for some of your problems.

[Skyler]

Hi Miami... I almost asked you if you were on a Proton Pump Inhibitor... I'd hitch my wagon to that... here's hoping for you! Do read the link Alto gave soonest. You were reading about what happened to RebMaven yesterday... some of her problems seemed to have been caused by a Vit. B deficiency caused by her PPI. The burning she complained of. That was the other reason I suggested the thread.. I thought you might find her discussion of burning familiar, and that was before you shared you were on a PPI.

[Miami1]

Very interesting ! This could be the cause of quiet a few current problems. So while I'm tapering off should I take b12? I tried taking it after benzos and it would revv me up.

[Altostrata]

Be careful with taking B supplements. If B12 revved you up before, it might cause you problems now.

 

Better to taper off your PPI so you can absorb B vitamins from foods as nature intended.

[Altostrata]

Where were y'all hanging out with RebelMaven?

[Miami1]

I'm feeling so nervous and scared I might have to go to ER. Been feeling so bad for so long feel like I this mirtz is driving me insane.

I'm wondering since I had to stop back in feb 3.75mg cause it was just to stimulating then when I reinstated at 1.87 now I'm in a similar place can it be the dose is to high for me again but I'm still withdrawing? This drug&wd is making me extremely ill. My mind can't stop thinking about what a horrible situation I'm in. I've stopped going day to day I'm now at min to min. If I go to ER ill be pumped with benzos and right about now that may not be a bad option. Has there ever been a scenario ( post) where someone just had to ct because each dose was worsening there condition?

[Skyler]

Where were y'all hanging out with RebelMaven?

I gave Miami the link to point to a cautionary tale about what can happen when one crashes off psychotropics, etc. No more than that.. though the reason the Maven came to mind as an example was the burning she experienced.

[Skyler]

Has there ever been a scenario ( post) where someone just had to ct because each dose was worsening there condition?

Sigh....

 

Miami... what can you do to refocus. Maybe it's because I have not been to the obsessive place you are now in, but gosh.. that kind of thinking is putting you at risk. Far as I'm concerned, the ER is not for anyone who can stand on two feet. This from someone whose sister spent 25 years as an ER nurse.

[Altostrata]

Please seriously consider reducing your PPI starting NOW.

[Miami1]

I'm trying to focus and relax!

Alto I'm not sure about what you mean about rebelmaben

[Altostrata]

Skyler referred to a new development with RebelMaven.

[Miami1]

Hey Skyler; Thks for helping me focus. I'm not very articulate when it comes to describing my sxs and hope I'm not in this place too much longer where I would need to be. There's just such insecurity and mental anguish in this state that its easy to loose focus.

Tonight I dosed for the second night with the liquid rem. I had a 1mg at 8:30 and .80 at 9:30. Again after the second dose I'm getting amped up. Apperently this dose is too stimulating. Can I reduce I bit if this continues ?

[Miami1]

Second night on liquid suspension mirtz. Still getting revved up after taking second dose. I'm splitting dose first at 8:30 pm 1mg and the next at 9:30 pm .8 mg. after the second dose I'm getting amped up. Any thoughts? Thks

[cymbaltawithdrawal5600]

I have questions but no advice.

 

Why did you decide to split the dose, how did you arrive at a schedule of 2 doses spaced one hour apart and so close to bedtime?

 

Did you read the info on why you need to start reducing your prevacid NOW?

 

Did you completely stop vistaril and any activating supplements?

 

Are you eating properly and drinking enough water? If you are consuming too many sugars and starches, a dip in blood sugar (after the initial rise) could be sensed as 'amping up'. If you do not drink enough water, the med is too concentrated in your system.

 

The body works as a whole. You can't assume all of your symptoms are related to the drug.

 

You were told that your symptoms would be up and down for a bit due to your recent actions. You will have to use many tools to cope with this and call into action the sheer force of your will to withstand the sh*tstorm you may find yourself in. Don't think we don't know how bad it is for you. We do. I do. All of us do. We can only guide you.

 

Question everything you put into your mouth and if you are given advice, please try to follow it. We are all volunteers here and struggling too. Unfortunately, you are having a bad time right now but until a mod suggests otherwise, you need to resist the temptation to change your doses or put something in your mouth to aid sleep. Once sleep has been broken, it resists all efforts to hurry it back. Even Alto has to work at hers. We just have to work through it.

 

Lie quietly and rest as much as you can and use any distraction you can find to keep your mind from yanking you around.

 

You will recover from this.

[Miami1]

Ok. Got it!

I did stop the vistaril. I am on half dose of 15 mg of Prevacid and will continue to taper. I will drink more water. And am splitting dose dose one hour apart which was a suggestion here because the liquid dose all at once will wire me. Btw my doc had suggested to take 1/2 dose at 8 pm and the other 1/2 @ 8 am to try and level out. I have not tried this cause it my be more destabilizing. I am for the most part gluten free and have learned to stay away from sweets know the outcome when I consume them. My appetite is not good but I usually have a fruit smoothie in the morning or gult free oatmeal w/ blueberries. Lunch sometimes but usually have lunch/ dinner at 5/6 pm.

 

Thks

[cymbaltawithdrawal5600]

It is so easy to forget what to do or not do.

 

I forgot to mention caffeine. Chocolate has caffeine.

 

I am guessing you avoided the ER last night. If you did, remember that you survived, and call that back into mind when the going gets rough. The more threads you read the more hints you will pick up to try. This is the hard part, the fight for stability.

 

Just saw your post. So it is still not clear why you took both doses at bedtime.

 

Keep on keeping on!

[Skyler]

Btw my doc had suggested to take 1/2 dose at 8 pm and the other 1/2 @ 8 am to try and level out. I have not tried this cause it my be more destabilizing.

That would be the suggestion here... you can make a smooth transition by migrating one of your doses 1 hour a day, so in 11 days you would be at 8AM/8PM.

 

Liquid is absorbed faster, and it's not unusual for people to have a reaction to the difference.

[Miami1]

Hey CYM:

I took both doses one hour apart to avoid the rush I get if I take it all at once.

I don't do coffee or caffeine and have on occasion gluten free chocolate chip cookies.

I did avoid the er last night but thought about it again this afternoon,the anxiety and the thought that I am where I am only feeds the monster. Come June will be a year, that was the last time I felt like myself.

My doctor says a lot of this is most likely protracted benzo WD .

[Miami1]

Hi Sky;

Yea ,that's interesting about spacing out the doses increasing by one hour daily until reaching 12 hr dosing.

My doctors theory is dosing every 12 hrs would keep the med at a steadier level.

Doctors say to me, what your on 1.8 of remeron! "That's nothing,I should write a case study on you and publish it"

Oh well ...

Maybe relief is around the corner.

[Skyler]

My doctors theory is dosing every 12 hrs would keep the med at a steadier level.

Your doc is right on about that.. there are quite a few on the forum, yours truly included, who take 2 or more doses a day to keep blood levels steady. I would be a very unhappy camper if I tried to take only one dose a day.

[Miami1]

Thks Sky

 

Extending by hour eleven days I'm sure is the correct way. Doc did not mention doing that and I imagine adjusting sooner is not a good idea ? Today was one of the worse days yet New level of Anxiety , panic and feel like my brain is floating in my head. It's hard to think of the possibility of improvement. I've been thinking most of the day that I was better off on benzos than my current situation.

[Skyler]

Hi Miami--

 

Like I said here: "You're probably still experiencing benzo withdrawal, as well as increased sensitivity to changes in the mirtazipine due to the benzo withdrawal. So stabilizing is probably not going to be an overnight or straightforward process. At this point if you can reinstate to a daily dose (same amount, measured accurately, same time or times every day) the hope will be to get some relief of symptoms, but you're probably going to continue to have ups and downs for a while. Don't be alarmed. This will resolve over time."

 

Your situation isn't as straightforward as some people's. Your benzo withdrawal is compounding your mirt withdrawal, and vice versa. Unfortunately our nervous systems are not made of separate little compartments. Everything interacts with everything else. 

 

I think your best bet is to just hold still with your current reinstatement for two or three weeks and see what happens, and study our Symptoms and Self Care section for nondrug approaches to help with symptoms. And talk to people here and get lots of support for getting through this.

 

After two or three weeks if you feel you want to reinstate a bit higher you can give that a try, but only in very tiny steps (say from 1.87 up to 2 max) and then hold and wait for a long time again.

 

Benzo withdrawal, all by itself, tends to go in a roller coaster fashion. It will get better and people will think they're fine and out of the woods, and then it will hit again and people will be sick for weeks or months. This is typical. I've never met anyone who did a benzo CT who was feeling consistently well five months later. 

 

So the fact that you're not getting daily improvement is not a bad sign and is not a surprise.

 

 

Please read this regarding Prevacid http://survivingantidepressants.org/index.php?/topic/4361-tips-for-tapering-off-stomach-acid-blockers-or-ppis-esomeprazole-lansoprazole-omeprazole/

 

It could be responsible for some of your problems.

 

 

Please seriously consider reducing your PPI starting NOW.

I support Rhi and Alto, most of your symptoms are probably because of a too precipitous benzo taper. The WD symptoms may take some months to slowly subside. The remeron may be stirring things up, but is most likely not the real cause. In the meantime, you should seriously consider reducing the PPI, starting NOW.

[Miami1]

Thk u all for your support ! I am find it very difficult to deal with the low mood borderlining depression anxiety restlesness and just plain losing hope. Physicaly I am also a mess. I am now not hungry at all and a just enough nausea to keep me sick. My thought was to consider going inpatient to a treat ment center for a month and have them handle my taper. I assume they will get me down to 1mg fairly quick and cut me off.

 

I know and understand what I'm advocating and this is just a thought.

I've been now almost a month with this going on and every night I dose I feel worst. I truly feel my mind is rejecting the remeron.

 

I am on a dose of 1.8mg. Is there anyone that may have jumped off of 2mg or less that was taxed but successful ?

I also have been less than 4 months on remeron.

 

Again this is a thought which is a result of my desperation. If I could just stabilize, one moment I'm depressed the next I'm panicking I have internal shaking and as a result my mood is sinking deeper by the day. Also I feel that being at home obsessing about my condition is adding tons of misery therefore being at a place with one on one ,group therapy and a full schedule etc.. may help.

 

Below is one of the treatment center I've looked into;

 

http://www.hanleycenter.org/

 

Again this is a thought that I would appreciate your expertise on considering my overall psychological condition.

 

I thank you all

[Skyler]

Do you take any drugs other than 1.8 mgs remeron, and the prevacid? At what time do you start to feel worse in the evening? Are you taking any supplements at bedtime? Would you put the times you now take remeron in your sig line...

[Miami1]

Hey sky: other than the rem and Prevacid I have been taking 400mg of magnesium as follows:

100 morning 100 noon 100 4/5pm 100 before bed. I've been on this schedule for 2/3weeks.

That's it.

Thks

[Miami1]

Should I up dose ? I'm not doing well.

[Altostrata]

What is your symptom pattern?

[Miami1]

Shaking , lethargic ,sensitive to any noise, at the door depression , thinking ill never come back ,this may ruin the rest of my life, nausea anxiety.

[Altostrata]

Shaking , lethargic ,sensitive to any noise, at the door depression , thinking ill never come back ,this may ruin the rest of my life, nausea anxiety.

 

The red part is the worry part. This makes you worse. This is the part you can control. Try to manage it, say to yourself, "I'm going to be all right, I'm going to be all right" instead.

 

When did you reinstate Remeron? Has 1.87mg helped at all?

 

You've said it's activating, how does that symptom play out?

 

Was it activating when you first took it?

 

You've only been on the liquid about a week, is that correct?

 

Where are you with the Prevacid? Have you had any symptoms from reducing it?

 

Hello everyone ; I maybe got 3 hrs sleep last night. My switch from pill to liquid kept me up and racing last night. I hope I can tolerate it better tonight. I dosed 1.8mg last night in two doses.First dose 1mg at 8:30 pm second dose .8mg at 9:30 pm. initial one mg dose was initially a bit stimulating but tolerable the second dose of .8 mg wasn't felt as a rush but did keep me amped up for a while.....

 

I'm feeling so nervous and scared I might have to go to ER. Been feeling so bad for so long feel like I this mirtz is driving me insane.

I'm wondering since I had to stop back in feb 3.75mg cause it was just to stimulating then when I reinstated at 1.87 now I'm in a similar place can it be the dose is to high for me again but I'm still withdrawing? This drug&wd is making me extremely ill. My mind can't stop thinking about what a horrible situation I'm in. I've stopped going day to day I'm now at min to min. If I go to ER ill be pumped with benzos and right about now that may not be a bad option. Has there ever been a scenario ( post) where someone just had to ct because each dose was worsening there condition?

 

Ok. Got it!

I did stop the vistaril. I am on half dose of 15 mg of Prevacid and will continue to taper. I will drink more water. And am splitting dose dose one hour apart which was a suggestion here because the liquid dose all at once will wire me. Btw my doc had suggested to take 1/2 dose at 8 pm and the other 1/2 @ 8 am to try and level out. I have not tried this cause it my be more destabilizing. I am for the most part gluten free and have learned to stay away from sweets know the outcome when I consume them. My appetite is not good but I usually have a fruit smoothie in the morning or gult free oatmeal w/ blueberries. Lunch sometimes but usually have lunch/ dinner at 5/6 pm.

 

Thks

Do you only eat twice a day?

[Miami1]

I came of rem feb8 @ 3.75 dose reason being it was revving and with that came no sleep.

After 9 days heavy WD I reinstated 5 days after at aropx 1.87 dry cut.

I soon after stabilized.

 

3 1/2 weeks ago doctor told me to start dosing every other day. First night I skipped the following day slammed.

I went back to the same dose that night. Have not been able to stabilize.

 

When I first took remoron it was not activating it put me out.

 

I have now been on the liquid 5 days.

 

Thx

 

 

I cut the dose to aprox 1/2 os 15 mg and am feeling the effects with some indigestion not too heavy.

[Altostrata]

We suggest reducing PPIs by 25% at a time to reduce the possibility of rebound gastric symptoms.

 

1) You probably have benzo withdrawal syndrome and sensitivities from that.

 

2) Your latest round of problems (with mirt) started 3.5 weeks ago. It can take several months to stabilize.

 

3) Changing to liquid is another factor that might rile your system for a time.

 

Does the 1.87mg of mirt help you to sleep at all? How do you feel after the first dose of the night? After the second dose?