☼ MirtNoMore -15 mg Mirtazapine extended withdrawal

[MirtNoMore]

Hi All,

 

I've been following the forum for months now, but finally decided to post, as my recovery isn't coming along as anticipated.

 

I was introduced to psychiatric drugs this year, after a bout of insomnia and some anxiety surrounding it. After reading in Consumer Reports how people generally did best with drugs and therapy, I decided to give it a shot.

 

My doctor prescribed 5 mg Lexapro, which I took for four weeks. It was miserable. I'd never felt depression before, but the drug introduced it to me. After three weeks the anxiety was controlled, but I was still wired all the time and sleep was suffering.

 

So my doctor had me cut the dose of Lexapro in half for three days then stop, and put me on mirtazapine 15 mg, to help with sleep. After a couple weeks, I felt okay except, of course, sleep. I was always wired, and could stay up for two nights and still not feel sleepy.

 

Mid-April, I went to 7.5 mg for four days (doctor's instructions), then stopped mirtazapine. It was rough for a few weeks, but at about 6 weeks out, I was mostly okay, and approaching 6 hours sleep per night.

 

Then a life stressor came my way, and I wasn't falling asleep again. I took a Xanax once, and decided the rebound anxiety the next day wasn't worth it. Other than that, I'd had a beer once, melatonin for sleep, and occasionally magnesium. No caffeine or any other drugs.

 

I had a rocky week or so, then a couple sleepless nights. At 3 am one night I got desperate, and tried 0.25 mg of Xanax (only the second time I'd tried it). I got 3-4 hours sleep but then I was wired with anxiety. The next night, I took the full 0.5 mg Xanax. Same thing. The following night, I got crazy and tried drinking a beer. Same thing - totally wired after a few hours. Then I decided I'd try naproxen (Alleve) to help with  the muscle tightness in my legs, which was keeping me up. I did that for two days before learning that NSAIDs affect GABA as well.

 

That stopped one week ago today, and I've taken nothing since, not even melatonin. I'm still super anxious most of the day, not triggered by anything in particular. I wake up and it's there. The last couple nights I woke up at least 5 times during the night, and usually managed to fall back asleep while experiencing varying degrees of anxiety. It feels like my nervous system is incredibly sensitive to the slightest bit of stimulation. For example, filling out a registration form for my son last night was an gut-wrenching ordeal. Everything feels so difficult!

 

We're at 10 weeks out now, and all other withdrawal symptoms are gone. It's just this intense anxiety! It's like the Xanax messed with GABA and restarted the whole process.

 

Has anyone had this sort of experience? I was on a low dose for a short time, and never anticipated this sort of ordeal - the biggest challenge in my life by far. Before I started antidepressants, I had occasional anxiety, but always related to a particular stressor. Not this "always on" sort of thing I have now.

 

I'm guessing I'm too far out to reinstate, and don't really want to, since I didn't do well on mirtazapine anyway.

 

Any advice is greatly appreciated!

 

 

[LoveandLight]

It's so horrible this anxiety!

 

Someone with more experience will be able to help with some advice soon.

 

Welcome and take care.

[dalsaan]

Hi Mirt

 

Welcome to SA. Sorry you've been struggling.

 

Given you didn't do well on mirtazapine and you are to weeks out I would probably agree with you about not reinstating. I would say that your system was sensitised during your mirt wd and reacted adversely when you added the other drugs.

 

We have threads on managing insomnia and anxiety in the symptoms forum

 

http://survivingantidepressants.org/index.php?/topic/604-important-topics-about-symptoms-including-sleep-problems/

 

http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

Are you taking any supplements? We generally recommend magnesium and fish oil but as with everything start low and see how it goes

 

D

[MirtNoMore]

I'm only taking 250 magnesium, most days. No fish oil, but I do eat fish regularly. I'm skeptical, but I'll pick up some fish oil at Trader Joe's since I doubt it could hurt.

 

dalsaan, I'm also hoping that it's just a matter of my system being sensitized, and that it will calm down soon. My biggest fear is that this is the new normal. I guess all I can do is avoid messing with my GABA receptors and see what happens.

[Petunia]

You weren't on these drugs for long, I'm sure you will recover completely and be back to your normal self, it may take a little more time though. My advice is to avoid all psychotropic drugs from now on and do what you can to avoid stress, until you are feeling better.

[MirtNoMore]

I wonder about avoiding stress. On the one hand, calm is always nice! On the other, to the degree that it involves avoidance, or just putting your life on hold, I'm not sure it's worth it. Guess it's about striking the right balance.

 

I had salmon last night and took my first fish oil pill (Trader Joe's) this morning. My body is slightly less amped up today, so far.

[Altostrata]

Welcome, MirtNoMore.

 

Did the mirtazapine ever help? How about when you reduced it to 7.5mg?

 

I am wondering if your sleeplessness was not withdrawal syndrome from the Lexapro.

 

Going on and off psychiatric drugs can make our nervous systems more sensitive to other drugs, which is why you have paradoxical reactions to Xanax. If I were you, I'd avoid benzo.

 

It sounds like you were sensitive to begin with, so I am cautious about reinstating mirtazapine, but a very low dose might help you sleep. Do you have any left?

[MirtNoMore]

The mirtazapine helped with anxiety, which wasn't that much of a problem before I started ADs! Over the three weeks, I got progressively more and more wired until sleep became near impossible (and almost felt unnecessary at times!). I was only on 7.5 for four days.

 

I threw out the mirtazapine I had left. I don't think it would be worth reinstating just to get a little more sleep. It didn't really help that much to begin with!

 

I'm thinking I'm messed up now from the Xanax, since I had a pretty good week before I dabbled with it out of desperation.

 

The last three nights have been better though. I'm up every hour or so to empty my bladder, but I manage to fall back asleep most of the time, and I'm not too sleepy in the day. The few days before that, I'd wake up with so much anxiety, there's no way I was getting back to sleep.

[Altostrata]

Sleeplessness is a very common withdrawal symptom.

 

Many people do better with fish oil and magnesium supplements, see
http://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/

[MirtNoMore]

Took both this morning! I've got some magnesium powder on the way too, so I can mix it in water.

 

Thank you!

[MirtNoMore]

Major stressor today!

 

I've got cataracts brewing in both eyes (and I'm young!), but figured I could hold off surgery until I was fully recovered. This morning, out of the blue, the vision in my right (better) eye is far worse. Reading is difficult, especially on the computer. I know vision varies, and it could be better tomorrow, but I don't want to be at the mercy of daily fluctuations. I emailed my optometrist to find out what the next step is.

 

I'm of course super anxious about the surgery itself, but more importantly, I don't want to be given Xanax or anything else that might set back my recovery. I read another thread about surgery and learned that propofol is okay as an anesthetic. Hopefully they can work with me. I know sometimes they just go topical, but I have a history of fainting at the optometrist, so he wanted me under.

[Altostrata]

It would be an ophthalmologist, an MD, who does cataract surgery. Go to the best you can find and explain carefully that you are sensitive to benzos. Cataract surgery is something they know how to do, a good doctor will be very fast.

[MirtNoMore]

I've been taking magnesium and fish oil, and eating a lot of salmon, for the past few weeks. Things were progressively getting better: little anxiety, deeper sleep with less awakenings. I thought I was out of the woods, but I couple days ago I hit a bit of a wave. High anxiety, racing thoughts, stomach issues. At first I wondered if it was "normal" anxiety, but it's lingering without any corresponding thoughts. My stomach feels really messed up today, but it's nothing like those first few weeks.

 

I figured a solid 2-3 weeks of "normal" meant I was done with these setbacks, but I guess not so much!

[Altostrata]

That's why we call them waves! The Windows and Waves Pattern of Recovery

[MirtNoMore]

Well yeah, but I just figured there was a statute of limitations or something.

[MirtNoMore]

Annndddd.... back to not sleeping, after several weeks of 4-6 hours. I can't put my finger on any particular cause or stressor. Hopefully I'll start doing better than 4-6 hours in my  next window!

[westcoast]

I start sleeping again after almost 2 years of never feeling "sleepy." Brain never stopped whirring. I'd be awake tormented by all that had gone down, and morning dread was almost lethal.

 

Then I got into medium-chain triglycerides and/or coconut oil. I am not a hippie or health supplement freak, I promise. By accident, today I found two posts that tell the story. I had forgotten how dramatic the change was. 

 

Before (Jan 1) In this post I was mainly complaining about morning dread. Insomnia was a given.

 

 

 

..."the icy-hot head pain and the cosmic despair."

I have a hunch that those of us with black mornings are not getting the kind of sleep that lets the brain regenerate new neurotransmitters for the day.
I know that feeling of dread that comes with going to bed. Yup, here we go again, and how bad will it be?
 

 

http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

 

 

 

After (Jan 4)

 

I've made progress on the morning terrors and other things, and I can only think of one thing I have changed. (No, this is not an ad.)

Okay, so I've been doing this only since Dec 28th [6-7 days] with any regularity.

I got interested in a recipe called "bulletproof coffee," which is black coffee, BUTTER, and medium-chain triglycerides (MCTs). There's a web site by the inventor and a recent NYTimes.com article which I will link below. [i switched to coconut oil in Trader Joe's instant after running out of the MCT coffee]
I bought something on Amazon that was an instant coffee with the MCTs added, and added my own organic butter. You blend that with hot water. It's not made by the original inventor.

Since then:
For the last 3-4 days, I am not waking up with terror or dread. I'm back to just waking up and getting out of bed to deal with the dogs, and drink the coffee.

 

The last two nights, I have gone to sleep without any pills of any kind, have not awakened in the middle of the night with insomnia.

I don't feel like I need a cup of tea to "wake myself up" at any time during the day.
I'm not especially following the rest of the diet in this article, but I guess I avoid starch and sugar, esp. sugar. (One casualty of my w/d has been my sweet tooth--yay.) 

I'm just reporting that I tried the bulletproof coffee for the mental benefits, and seem to have found those as well as physical ones.

 

http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/?view=findpost&p=115501


Here's a genius dismissing it out of hand in the NYT link below. She's wrong. Google ketogenic diet if interested.

Joan Salge Blake, a clinical associate professor of nutrition at Boston University, was skeptical, because it’s carbohydrates, absent from the drink, that are brain food. “This is not a breakfast of champions,” she said.

Here's the article that inspired me to try it:

http://www.nytimes.com/2014/12/14/style/the-cult-of-the-bulletproof-coffee-diet.html
 

[MirtNoMore]

Very interesting!

 

I've been off caffeine for months, and have never been a coffee drinker, so I'm not eager to try that.

 

Fortunately, my sleep has been good lately after that last wave, and in fact, I wonder if I'm all the way back or just in the middle of a nice window. I feel close enough to "myself" that I'm not sure, so no complaints!

[MirtNoMore]

It's been a couple months! Thought I'd check in.

 

The past few weeks have been great! My symptoms were mild enough that I almost couldn't tell if they were real, or just my worrying that they were real. Going on vacation and getting out of my usual routine seemed to work wonders. I added back caffeine without incident.

 

Unfortunately after being woken up by snoring multiple times the past couple nights (coincidence?), I'm having a bit of a relapse. I've got the old dread and overwhelmed feelings, like I don't know what to do with myself and don't really want to do anything but sleep, which doesn't tend to come anyway, at least during the day. Even a little bit of nausea, and not feeling hungry when I really should be!

 

It's all more manageable than it used to be, and I'm sure it'll pass over the next few days. I'm trying to look at it as a good sign - I thought I was all the way back, but more adjustment is needed, so after this it'll be even better.

[tgirl]

Hello Mirt,

 

Hope you continue to improve. Remeron is a nasty drug, please read the information on windows and waves.

 

I believe this is what you are experiencing.

 

Good luck,

Tgirl

[MirtNoMore]

That's absolutely what I'm experiencing. I was just hoping I was done with the last wave. It's all good - it'll pass.

[Altostrata]

Hello, Mirt. Yes, sounds like your nervous system just needs a bit of support. See Important topics about symptoms, including sleep problems
 
Very happy to hear that in general, you're doing better. I added our cheerful "here comes the sun" symbol

☼

to the title of your Intro topic, to show you're recovering.

Please continue to let us know how you're doing. I hope you will add your story to our Recovery Success Stories eventually!

[MirtNoMore]

Thanks for the ☼!

 

I hope to be adding my story in the not-too-distant future!

[tgirl]

Hey Mirt,

Just checking in to see how you are doing?

Hope you are well,

Tgirl

[MirtNoMore]

Thanks for asking!

 

I'm doing mostly okay. The wave appears to be easing after a week and a half. I still have mild racing thoughts/anxiety, anhedonia, and excess muscle tension, and I'm not getting a full night's sleep. But I try not to let it get me down, since it's so much easier than it was a few months ago.

[tgirl]

Hey Mirt,

 

Checking in to see how your doing?

Tgirl

[MirtNoMore]

Thanks again for thinking of me!

 

I haven't had a true window, but symptoms have been settling down. I'm getting more comfortable with being alone, or not having anything to do - though it's still best if I keep busy. Still feeling a little "stimulated" overall - a general anxiousness (or excitement, to reframe it positively), which makes it tough to fully relax. Which means I'm still operating on less sleep than I used to, but I know it'll keep getting better.

[MirtNoMore]

Two weeks later, I'm having another wave. But it's so much more manageable than it used to be. A swell, perhaps?

 

I've had a night of poor sleep (but at least a few hours, unlike a few months ago when I could go a couple nights in a row on basically none), anhedonia, a little nausea, and anxiety - a sort of underlying overexcitement. The idea of not knowing what I'm going to do is monumentally stressful. Which makes weekends tough, because there's no set routine.

 

But nothing that gets in the way of getting done what I need to get done. Of course, I don't always feel like doing what needs to get done, or anything at all, but that's another story.

 

We're at 6.5 months. I never would've thought I'd still be having symptoms, but it is what it is.

[KLA324]

Hi Mirt - 

 

A swell is definitely better than a wave! 

 

I can relate to the morning dread - that is definitely how I start each day. Makes it much worse when it's the weekend and I could actually sleep in. But no....the anxiety gets me up and then, like you, I have no routine and I start feeling myself falling into a panic. 

 

Keep forging ahead...you will make it out the other side!

 

Karen

[MirtNoMore]

Karen, you remind me of how much better I have it now!

 

It used to be exactly as you describe, but these days I sometimes actually feel groggy when I get up, and could perhaps fall back asleep. Earlier in the day is still worse in general, but it's not like it used to be, where I'd eagerly look forward to late afternoon or early evenings when symptoms would let up.

 

Now I wish my brain would settle for what I have now as "good enough," and stop dwelling on symptoms.

[MirtNoMore]

*topic moved from symptoms forum

 

Even now when I'm most of the way back, I find myself waking up every morning struggling to get a handle on my symptoms. Or on a good day, my lack of symptoms! Every day I reinvent the wheel.

 

It's like if I just find the right way to look at it, or the right motivational phrase ("the only way out is through" or "be reckless"), I'll be back to normal.

 

Sometimes though, it actually helps, and I stumble upon a "solution" that may work for a day or two, but never longer than that.

 

Even if the "solution" is just to accept whatever I think or feel, my mind searches for the best strategy to carry out that acceptance - all the while knowing that acceptance should be a non-event.

 

To the degree that searching for answers helps, it's easy to conclude that the symptoms are something I've done to myself, by not approaching them the "right" way.

 

Anyone else going through this pattern?

Edited November 14, 2015 by Petunia
added note

[dalsaan]

I think most of us would have been there.   Some are stuck there and heavily invested in the idea of finding a fix.   This issue is not simple, its not about finding the right lever to push  to make something change and be cured.    I haven't discovered recovery, I have created the conditions for it. Its not about one right way, its about 100 little things and my 100 little things are different to yours (with some overlap).   

 

I am not to blame for having a disregulated nervous system but I am the only one that can take action in response to that and I have to do that cautiously, thoughtfully and gently.   

 

As much as I have felt like a child at times, let down by the grown ups and scared, I have to be adult about what I do, take responsibility for my recovery and practice acceptance.   

[MirtNoMore]

Great perspective Dalsaan!

[Petunia]

Hi Mirt,

I moved the topic you started in the symptoms forum to your introduction thread here because it was related to your own situation specifically. Please use this thread to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want. Please bookmark it or follow it so you can find it again.

 

How are you doing now?

 

 

Even now when I'm most of the way back, I find myself waking up every morning struggling to get a handle on my symptoms. Or on a good day, my lack of symptoms! Every day I reinvent the wheel.

 

It's like if I just find the right way to look at it, or the right motivational phrase ("the only way out is through" or "be reckless"), I'll be back to normal.

 

 

I've been in this pattern too, but my situation is a lot different from yours, I was on drugs for much longer, but the pattern is the same. 

 

Its probably related to the daily cortisol cycles which cause many people to have worse symptoms earlier in the day, including temporary loss of cognitive function and memory issues. It seems to me that any progress I make through the day gets lost overnight and I have to start all over again every morning. But its improving and like I said, my situation is different, you will recover much faster.

 

It would be great if you would put your drug and withdrawal history in your signature. Doing this helps people understand your context, it appears below each of your posts. Here are instructions for how to do it:

 

http://survivinganti...your-signature/

 

Petunia.

[MirtNoMore]

Totally understood on moving the topic.

 

I'm doing better! In fact, I recently decided to stop keeping track, which I think is a helpful step. It makes it easier to accept moods and sensations as they come, without trying to figure out if they are part of a larger wave/window cycle.

 

Of course, this only works because my symptoms are so manageable that I usually can't tell if they are "normal" or not. Maybe in part because I don't completely remember what normal feels like. But it gets me out of the "waiting to get better" mindset.

[MirtNoMore]

I'm checking back in after a few months of silence to post my success story. At this point, I can't tell whether or not my "symptoms" are just normal day-to-day fluctuations, so I'm calling this whole withdrawal saga done.

 

If I had to do it all over again, here's the advice I'd give to myself:

 

1. No alcohol, drugs, or pills, period. Not even magnesium, fish oil, or melatonin. If they helped me, I couldn't tell.

 

2. Eat salmon 2-3x/week. Fish oil accomplished!

 

3. Meditate 20 minutes per day first thing in the morning.

 

4. Be open to the present moment, whatever it brings, instead of just waiting for symptoms to pass. Life goes on, whether we're ready for it or not.

 

5. Learn to rest in uncertainty. Be spontaneous and avoid making plans as much as possible. This will help develop psychological flexibility.

 

My biggest mistake was pursuing the Cognitive Behavioral Psychology approach. In my humble but very strong opinion, CBT made things worse rather than better. Engaging with your thoughts is a mistake. You can't outthink the thinker.

 

Instead, meditation trains the mind to accept all thoughts, and to understand that you aren't your thoughts. I suggest downloading the Headspace app, completing the foundation series, then the anxiety pack followed by the depression pack. That's what helped me far more than anything else.

 

Once you've been meditating regularly for a couple months, read Sam Harris' "Waking Up" to gain a more thorough understanding of consciousness. That's when things really started to open up for me, but the first time I read it, I wasn't ready. Only after experiencing the benefits of meditation firsthand could I really connect with the book.

 

Honestly, I'm already better off than I was when I started this whole misadventure, and I'm guessing there's still improvement to be had.

 

I wish you all the best in your misadventures! As you've read here so many times before, it really does get better, even when it sometimes seems it will last forever.