Traveller: Help with Mirtazapine Withdrawal

[Traveller]

Hello to all.  My name is Traveller, and I am a mirtazapine addict.  Was prescribed mirt after I reacted badly to Lexapro.  Started at 7.5 mg for a week, then up to 15 mg.  Worked great for sleep and depression, but left me feeling a bit numb.  After complaining of the day-after sedating effects, I was bumped up to 30 mg after several weeks.  Big mistake.  At that point, my anxiety increased, and sleep became erratic.  After several more weeks, I dropped back to 15 mg.  Felt fine for a few days, then on the fourth day withdrawal kicked in with a vengeance.  I've since gone back up to 30 mg, but my sleep has disappeared, and my anxiety is still high.  I tried going back down to 26.75 mg shortly thereafter, but again, withdrawal kicked in after four days.  Chest pain, difficulty concentrating, tinnitus, anxiety worse than I've ever had in my life.  I'm trying to stabilize at 30 mg again before I taper, but I still can't sleep.  If I take an Ambien, I'm lucky to get 2 hours at this point.

 

I have a demanding job and a family to support.  Fortunately (for them) they've been out of town while I struggle with sleep and anxiety, but they're schedule to return this weekend.  Moreover, my performance at work has been noticeably inadequate.  How the heck will I ever get off mirt if I can't even get to 26 mg?  My psychiatrist believes mirt has no withdrawal, so he's no help.  Seeing a new doctor this afternoon, but I suspect he'll just tell me the same.  Will I lose my career, my family, and possibly my life to this stupid little pill?

[AliG]

  Hi Traveller,  Welcome to S.A.  A mod will be here soon to help you.  I have had some experience with ( Mianserin) which is similar.  You are in the right place, to deal with this.   Hang on for a bit, and someone will be here to walk you through this.  

[mammaP]

Hi Traveller, welcome to SA.  Mirtazepine has been a terrible drug for several of our members so you are not alone. 

 

Could you give us a timeline for your doses, if you can remember?  When you started, when you increased to 15 and when you increased to 30? 

 

How long did you take lexapro and what were your symptoms? All this gives us an idea of whether it is a reaction to mirtazapine or withdrawal. 

 

It would be great if you can put the details in your signature strip for us, here is how to do that. http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

When we have the details we will be in a better position to offer advice for you.  You are among friends here and we all understand what you are going through, most of us have doctors who don't have a clue and deny that withdrawal exists!! 

[leahy]

 

 

Hello to all.  My name is Traveller, and I am a mirtazapine addict.  Was prescribed mirt after I reacted badly to Lexapro.  Started at 7.5 mg for a week, then up to 15 mg.  Worked great for sleep and depression, but left me feeling a bit numb.  After complaining of the day-after sedating effects, I was bumped up to 30 mg after several weeks.  Big mistake.  At that point, my anxiety increased, and sleep became erratic.  After several more weeks, I dropped back to 15 mg.  Felt fine for a few days, then on the fourth day withdrawal kicked in with a vengeance.  I've since gone back up to 30 mg, but my sleep has disappeared, and my anxiety is still high.  I tried going back down to 26.75 mg shortly thereafter, but again, withdrawal kicked in after four days.  Chest pain, difficulty concentrating, tinnitus, anxiety worse than I've ever had in my life.  I'm trying to stabilize at 30 mg again before I taper, but I still can't sleep.  If I take an Ambien, I'm lucky to get 2 hours at this point.

 

I have a demanding job and a family to support.  Fortunately (for them) they've been out of town while I struggle with sleep and anxiety, but they're schedule to return this weekend.  Moreover, my performance at work has been noticeably inadequate.  How the heck will I ever get off mirt if I can't even get to 26 mg?  My psychiatrist believes mirt has no withdrawal, so he's no help.  Seeing a new doctor this afternoon, but I suspect he'll just tell me the same.  Will I lose my career, my family, and possibly my life to this stupid little pill?

I understand your feelings. I have been trying to withdraw from Remeron since February and have the same problems trying to reduce to 30. I too wonder if I can ever get to 22.5. I cannot imagine doing this and being able to perform at work. I waited till I retired and remeron took 15 years of my life. it sure feels complicated. Welcome to this forum. You will get much needed support here and excellent advice. I find days without sleep damn near impossible to get through. It's very difficult to hasten the withdrawal. Days without headache and nausea are a gift. Getting through remeron (mirtazapine) withdrawal is an arduous journey.

 

All the best to you, Leahy

[Traveller]

It's been a few weeks, so I thought I'd provide an update...

 

The new psychiatrist diagnosed me with severe anxiety (not withdrawal), and prescribed 40mg citalopram while reducing mirtazapine to 15mg.  After a few rough weeks, the anxiety is gone, but it's been replaced by a general feeling of numbness, anhedonia, loss of creativity, and memory problems.  I'm also taking Ambien CR to sleep.  I have since reduced citalopram to 10mg.  I have no idea if these symptoms are a side effect or withdrawal symptom of any of the above drugs.  How I wish I could just get off all this crap and have my brain back.

[dalsaan]

Hi Traveller

 

 

That's some journey you've been on. I agree with you that at this point it's impossible to tell what might be a side effect from any of your medication or withdrawal from the changes you have made. Unfortunately psychiatry is based on diagnosing and prescribing and if all you have is a hammer, everything starts to look like a nail.

 

If I was you I would explore non drug ways of managing anxiety and depression and develop a strategy to withdraw very slowly so as to not disrupt your nervous system.

 

Your thoughts?

 

Dalsaan

[Traveller]

Thanks, Dalsann.  I actually used to manage my depression and anxiety quite well with strenuous exercise, and the occasional beer or glass of wine.  Then my mother-in-law came to stay with us while her husband underwent cancer treatment.  She has suffered from depression and anxiety herself for the past 25 years, coupled with what my own therapist describes as a narcissistic personality disorder (I don't know which caused which).  We thought it best to keep her away from her husband for a while so he would have a chance at recovering.  Heck, if she had just stayed out the way, her husband would have gotten his cancer taken care of when it was still small and treatable.  Instead, to avoid causing her additional anxiety, he tried to treat it with some topical cream she gave him.  By the time he sought actual medical treatment, the tumor has spread.

 

Well, what was supposed to be a 2-3 month stay turned into 7, and then appeared to become permanent when the cancer did not remit.  The thought of living with this woman and supporting her financially for the next 20-30 years was the straw that broke the camel's back.  I broke down crying in my therapist's office, and he and my GP decided to start me on Lexapro.  That began my nightmare journey on antidepressants.  It's just been one drug after another to counteract the effects of the previous drug.  My last psychiatrist wanted to start me on Abilify at one point.  I'm not psychotic or bipolar, and the list of possible side effects scared the crap out of me.

 

My current psychiatrist wants to keep me on the current regimen of 15 mg mirtazapine and 10 mg citalopram for 8-12 months.  Thing is, I don't necessarily feel good on this cocktail, just numb, and I still need Ambien CR to sleep.  My next appointment is in four days.

 

Thank you for all the support everybody.  I don't have much of a support network where I live, and it's nice to have an understand ear (or four).

[dalsaan]

I'm no Dr but it sounds like you had a normal reaction to a stressful situation. You need to decide what relationship you want to have to your own well being and whether you want to medicate your ills.

 

I wish you the best in making those decisions and hope you can work through the living situation with your Mother in Law

 

D

[Traveller]

I apologize in advance for any bad grammar in this post.  My brain is not working properly at the moment.

 

I met with my psychiatrist 3 days ago and explained how the citalopram was making me numb emotionally and making it difficult to think creatively, which is required for my job.  He told me to stop taking citalopram and start taking some 5mg samples of Brintellix he had in the office.  I actually felt pretty good for the first day or two.  Now, I'm feeling the withdrawal effects of citalopram and the startup effects of Brintellix.  Anxiety is rising by the hour, and cognitive skills are dropping rapidly.  I'm at work at the moment, and I'm not sure I can even drive home this afternoon.

 

Called psychiatrist.  Told me to stop Brintellix and resume citalopram 10mg tonight.  Assuming I can make it home.

 

What the hell have I done to my brain?

[leahy]

Hi Traveler, 

 

Why? Why would a doctor think switching from one antidepressant to another would be helpful to anyone. It's infuriating to me as I sit here with my headache and nausea trying to withdraw from mirtazapine day after day after day...

 

I do hope you feel better. I wish I could be more helpful but my struggle is too difficult right now. I feel so ill. I guess we just have to keep trying to put one foot in front of the other.

 

all the best, L

[mammaP]

I would sack that doctor! The drugs and changes that he has prescribed and changed over and over on such a short space of time is reckless, but sadly very common here.  Doctors rarely understand what these drugs do and when someone complains about anything they add or change things which causes chaos for the brain and nervous system.  I suspect that you are also suffering withdrawal from lorazepam. 

 You have reduced citalopram rapidly from 40 to 10 which will be causing withdrawal, I would go back to the 20mg, or 15 to stabilise.  

You went from 2.0 to 0.5 of lorazepam, can you tell us how you took the 2mg , was it spaced doses or as needed?  There would most likely be some withdrawal from that too.  

 

Did you manage to get home ok? I hope so. I am so sorry that you are in this situation. 

[Traveller]

Thanks, mamap.  Lorazapam 2mg was only for two days, to stave off the extreme anxiety from the mirtazapine withdrawal and citalopram startup.  A genetic test revealed that I am a slow metabolizer of lorazepam, so my Dr. prescribed it as a sleep aid on top of Ambien CR.  Even then, I still only manage 6 hours of sleep most nights.  This is actually the second psychiatrist I've seen.  The first one wanted to put me on Abilify.

 

Leahy, I am sorry to hear you are suffering so much.  You will be in my prayers tonight.

[mammaP]

People tend to get what is called interdose withdrawal when taking a benzo just once a day. When taken regularly it soon becomes addictive. Take the dose and feel better almost right away, then as i wears off the symptoms 'return'  only it is actually withdrawal. If you only took the 2mg for a few days you wouldn't need to go back to that dose but it may benefit you to split the dose so you are taking a small dose 3 or 4 times a day to keep the levels the same and avoid the interdose withdrawal I am not an expert on benzos but if you would like to start a topic in the benzo forum the experts will tell you if it is something that might help.

http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-forum/

 

The best thing for you is to get a regular dosing schedule, once you have the benzo info, and stick with it for a few months to stabilise before thinking about any further changes. There will be some windows and waves along the way but you will get stable again. 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

[Altostrata]

Traveller, how did the drop from 20mg citalopram to 10mg citalopram go?

[Traveller]

I reduced dosage on a Tuesday. For the rest of the week, I was fine, though a bit disoriented at times. Friday night, I decided not to not to take the lorazepam (didn't want to get addicted). Saturday was horrible. My chest felt like there was a black hole inside, and My forehead and sinuses felt like they were on fire. It took me about a week to stabilize.

[Traveller]

Reinstated 10mg of citalopram last night.  I pray I can restabilize soon.  Made it to work fine, but still feeling extremely dizzy and disoriented this morning.  My wife and I had to give our four year-old daughter an enima last night, which was about as fun as it sounds.  She has had digestive and development problems since birth, the stress of which contributed to my original depressive episode (the mother-in-law situation just broke the camel's back as I wrote earlier).  My wife now appears close to her own breaking point, and she's about to lose her dad, the only other person that has been able to be there for her and help her with our daughter.  She's told me I need to be her rock during these tumultuous times, and she's right, but I'm failing her miserably.  I've done my best not to add to her worries, so she's doesn't know the current extent of my mental illness.  These drugs are causing irreparable damage to my marriage, my career, and my mind.  I'm having suicidal thoughts daily, but I know what a devastating effect that would have on my wife and daughter (not to mention the rest of my family, and my immortal soul).  Please, God, help me.

[Traveller]

The dizziness went away for a few hours, but is back worse than ever.  Any idea how long this will last?  Days?  Weeks?  Should I continue with the citalopram reinstatement, or just suck it up and wait for the dizziness to go away?

[Traveller]

Four days after reinstatment of citalopram, and the vertigo and mental confusion have not improved.  Starting to get really concerned now.

[leahy]

Hi T,

 

Have you tried dramamine for the dizziness? Or better yet those wrist bands people use for seasickness. I wear the bands all day long some days. I have experience with mirtazapine and Ambien that I can share. Just a 10% change in mirtazapine does me in every time. Dizzy, nauseous, severe headache, confusion, abdominal issues, and a kind of twitching of my entire body every 3 to 4 minutes. I don't know what that is but I can tell you I feel very, very, very sick. That's with just a 10% reduction of mirtazapine. And just like you, it' really hits hard 4 days later. You are taking multiple meds so it may be hard to pinpoint the triggers to feeling so sick.

 

Ambien makes me feel completely hungover the entire next day making me feel worse. I gave up on that. Maybe take a look at alternative solutions for better sleep. Check out symptoms and self care for sleep. This is a PROCESS for sure to find out what works for you. I recently covered up my windows with brown sheets and pillow cases. That doesn't look pretty but I DO sleep longer in the morning so it's been worth it. Being able to sleep even if it's a tiny bit better helps tremendously. I've been using the xanax at night mostly to help with sleep. I'll deal with the X another day.

 

All the best, L

[Traveller]

Thanks, Leahy.  I have a bad feeling I've made myself treatment resistant with all these med changes.  I only did what my doctors prescribed, but I was the one who complained about side effects, and I was the one who took the pills.  So ultimately, it is my responsibility.  Unfortunately, my family will suffer the consequences as I am rendered brain damaged and emotionally numb.  God, forgive me, and have mercy on soul.

 

Alto, anyone, is there a chance my brain can heal from this madness?

[mammaP]

When you say reinstated citalopram to 10mg, did you stop it? I read that you dropped from 20 to 10, then you were reinstating so I'm a bit confused. It is not difficult  to confuse me though! 

[leahy]

Thanks, Leahy.  I have a bad feeling I've made myself treatment resistant with all these med changes.  I only did what my doctors prescribed, but I was the one who complained about side effects, and I was the one who took the pills.  So ultimately, it is my responsibility.  Unfortunately, my family will suffer the consequences as I am rendered brain damaged and emotionally numb.  God, forgive me, and have mercy on soul.

 

Alto, anyone, is there a chance my brain can heal from this madness?

T,

You are not treatment resistant. You going to do just fine and you will recover. It is very hard to imagine when you feel so sick. IT IS MOST DEFINITELY NOT YOUR FAULT! I suffer daily too but I am starting to see small successes. My son told me that my head is so much clearer and has actually started to talk to me again. We have a relationship to heal big time which can make me sad but I will chose to view it as an opportunity to move forward and demonstrate with my actions how truly important he is to me. (another long story...)

 

 I've been WD for 3 1/2 months. It feels like an eternity. I rate my headaches from 1 to 10, 10 being the unbearable migraine type. Today I only had a 3 to 4 headache, nausea - 4, dizzyness - 2, confusion 3.

 

Exercise helps a lot when I can pick myself up off the floor, open the shades and actually venture outside. So doe sunshine on your face and body. Check out TJ - he's an inspiration. http://dominatedepression.com/how-i-got-off-antidepressants/

[Traveller]

When you say reinstated citalopram to 10mg, did you stop it? I read that you dropped from 20 to 10, then you were reinstating so I'm a bit confused. It is not difficult  to confuse me though! 

 

I complained to my psychiatrist about cognitive impairment I was experiencing on citalopram (issues with attention, short-term memory, reading comprehension, problem solving, conversation on the fly), which were affecting my job performance.  Other side effects I experienced were apathy, anhedonia, and lack of any affection toward my wife and daughter, but my psychiatrist said those were merely symptoms of depression.  So he had me try Brintellix, which I did for 3 days.  I actually felt better for the first 2 days, more excited, motivated.  But on the third, anxiety kicked up, and horrible vertigo set in, so my psychiatrist said ditch the Brintellix and go back to the citalopram 10mg.  I did that 5 days ago, and the vertigo has not improved.  The cognitive issues if anything have gotten worse.

[Traveller]

The vertigo eventually improved after 6 days of Celexa reinstatement, though mood remains flat.  I explained to my psychiatrist my fears of long-term antidepressant use and ensuing discontinuation syndrome.  He asked how much time and energy I spent research psychopharmacology.  I said probably too much.  He now says I'm suffering from obsession and prescribed Zoloft, starting at 50mg and eventually moving up to 200mg.  I suppose he wants to cure me of my fear of antidepressants by numbing me to the point of not caring?  Are these my only two choices now: crippling anxiety, or soul-crushing anhedonia?

[Altostrata]

You need a new doctor.

 

Apathy, anhedonia, and emotional anesthesia are well-known side effects of antidepressants. "Treatment-resistant" is often an iatrogenic condition -- caused by going on and off the drugs.

 

If I were you, I'd stick with 10mg citalopram and save money by not seeing that psychiatrist.

 

Anyone can prescribe 10mg citalopram, even your GP.

 

After you stabilize for a while, you may wish to taper. If you go off psychiatric drugs entirely, you will need to commit to finding non-drug ways to cope with your emotions.

[Traveller]

Thought I'd give an update...

 

After reinstating Celexa, I naively listened to my psychiatrist and tried Zoloft for two weeks.  It was awful.  He wanted to increase my dosage to 200mg in a hurry, but I had had enough.  Went back the simpler SSRI (Lexapro this time), and the same side effects returned: mentally, emotionally, and physical numbness.  I decided if I was going to get my brain, not to mention my manhood, back, I was going to have to do it on my own.  After finding a new doctor and trying Abilify for two weeks, I decided enough was enough and to taper off everything.

 

Been off the mirt for two weeks now, and this morning I took my last crumb of Lexapro.  I am now off everything but the sleeping meds, and will begin tapering off those once I can stabilize mentally and emotionally, (however many weeks/months that might take. The benzos do a good job of putting me to sleep, but I still wake up way too early, and I'm well aware of the long-term risks.  In the meantime, I am supplementing with 5 HTP, tyrosine, fish oil, vitamins, deplin, magnesium, and lots of herbal teas.

[leahy]

Hallelujah! Good for you, Traveller. Please post your updates. It's a rocky road and I am attempting to travel the same one. Are you still taking mirtazapine?

[Traveller]

Thanks, leahy.  No, I'm not taking mirt anymore.  I never want to see those pills again.  Many psychiatrists like to combine a serotonin agonist with a reuptake inhibitor.  I believe both mirt and Abilify act as the former.  Mirt made me smart, but anhedonic.  Abilify made me feel smug, but stupid.  Neither is a long-term solution to my problems.

 

I must be very mindful of my thoughts to avoid heart palpitations.  Cognitive functioning is still handicapped, and sleep is still a major issue.  Nevertheless, everyone has told me the brain can heal with enough time.  That thought and my little girl are the only things keeping me going right now.

[Traveller]

It's amazing to me that I've been trying to come off antidepressants longer than I was on them.  Had I just fought through the vertigo, I might have been healed by now.  I am not reinstating at this point.  I've come too far and suffered too much.  My dad has been taking Paxil and Klonopin for years and seems to do fine on them.  I suspect my psychiatrist will suggest that combo at my next visit.  After reading the stories on this and other websites, hell no.

[Altostrata]

I hope the method you used to taper Lexapro won't result in withdrawal syndrome. It sounds like it was fast.

 

Please update your signature accordingly.

 

You will still need to taper Lorazepam and Zolpidem CR. I would wait some months before attempting this, your adventures with SSRIs may have made your nervous system hyper-sensitive.

[Traveller]

I hope the method you used to taper Lexapro won't result in withdrawal syndrome. It sounds like it was fast.

 

Thanks.  Honestly, I felt like crap while on Lexapro, and so far I don't feel that different.  Like there's a C-clamp around my brain and heart.  A stupid zombie with a 24-hour headache.

[Traveller]

One week off the serotonin meds.  Still no change in cognition, headache, sleep, or anhedonia.  Watched the trailer for Phil Lawrence's "Numb", and it hit a little too close to home.  I hope it doesn't take that long for my brain to recover.  Does anyone know if his ever did?

[Altostrata]

See http://survivingantidepressants.org/index.php?/topic/6302-the-movie-numb/

[Traveller]

Two weeks off, still not feeling myself.  Massive headache, chest pain, difficulty concentrating.

 

Has anyone ever truly recovered from mirtazapine on here?  By that, I mean:

1. No anxiety

2. No depression

3. No insomnia

4. Not on any other medication

[freespirit]

It sounds like you're asking if there's a cure for life. I don't know any person alive who doesn't at some point, suffer from anxiety, depression, or insomnia.

 

With all the med changes you've gone through, it seems it would be hard to only blame mirtazapine for your current symptoms.

 

I've been off mirt for just over a year. Most nights, I sleep 6-8 hours. I have some nights of not sleeping well, but that's been the case for much of my life...long before AD or WD. My nervous system has always been more sensitive and even having a great, stimulating conversation with someone during the day can make it hard for me to rest. That being said, I've spent years working with different practices to help balance that out as much as possible.

 

I don't use the term depression for different moods anymore, as that word has been used as a weapon against me by doctors. Do I have my moments of not feeling happy? You bet--I'm human. Are there times of feeling anxious about the future--yep. Same thing I am human and expect to go through ups and downs. Are those more so because of WD? Possibly.

 

There are people posting on the board who have been fine off meds for a period of time, then find that some major life event brings up symptoms again. I guess this would bring up the question about whether you can find healing, but perhaps not be cured? Since my nervous system has always been like that, I don't know to what extent it will ever be normal. But, I keep doing the best I can, given that...and always hold some hope for further healing.

 

In my opinion, one of the most important aspects of going through this is attitude..and the willingness and effort put into finding non-drug means of dealing with not just symptoms of WD, but of life. Life is going to happen, with its stresses (both positive and difficult ones)...and how can a person not just cope, but thrive amid those realities?

[leahy]

Two weeks off, still not feeling myself.  Massive headache, chest pain, difficulty concentrating.

 

Has anyone ever truly recovered from mirtazapine on here?  By that, I mean:

1. No anxiety

2. No depression

3. No insomnia

4. Not on any other medication

Hi T,

 

I read your post as I finished shopping (what? out and about? a miracle.) I was waiting on line to check out - "OMG! I think I actually feel GOOD? Can this be?" I felt so sick yesterday (as per usual) with my mirtazapine WD with the exact same symptoms as yours.

 

So, I realized that me feeling "not bad" is a full blown miracle. Yesterday I thought would never end, the headache would never end, the nausea would never end, the insomnia and exhaustion would never end. I was feeling pretty hopeless and helpless and discouraged and forsaken and sad and anxious and sick and tired and disgusted...

 

Hang in there, T. There may be light at the end of this tunnel even though this process sucks. All we need is a little ray of hope to carry on and one good day of feeling "eh, not so bad" helps a lot.

 

All the best healing to you,

L