herenow: my intro - mirtazapine help

[herenow]

Hi, 

 

I'm new. Here is a synopsis of my past meds and current issues.

 

Zoloft twice in past, worked once, other gave anxiety. No WD.

 

Then, in May 2014, had tried Paxil for a couple days and didn't like. Used Elavil off-label from neuro for pain. Pain wasn't stopping and felt SI, which I thought came from Elavil. Told clinic and ended up in psych ward (no help from neuro) for SI because of Elavil.

 

In psych ward, doc there said I had created my own pain (I had been working with sore muscles and chiropractor visit with pain that night) because of my divorce. Put me on Risperdal about 1 mg I think, Prozac 20 or 40 mg, Klonopin 0.75 maybe, and a sleep pill a couple nights in the hospital. Also naproxen sodium 550 mg maybe once or twice a day. So, after hospital started to decrease Klonopin and Risperdal when I figured out they were supposed to be as needed, but after a month or so, my body needed them. Was getting symptoms and no help.

 

Ended up back in hospital in July 2015 where they tried to CT the Klonopin. Was there 14 days. Doc said I was neurotic and wanted to increase Risperdal. I left there still on Rispderal about 1 mg, Librium 25 mg to replace Klonopin, and Prozac 40 mg. I tapered off Risperdal by November 2014, Librium by February 2015 where I jumped off the last 5 mg, and I did not keep track of when I got off the last 20 mg of Prozac but probably sometime in April 2015. Looking back, my anxiety started increasing in May 2015, usually more around my period. Had lots of stressors anyway.

 

Then, in July 2015 had some neck pain and was on Flexeril a short while (had tried Tramadol like twice and hydrocodone once). Had a major stressor. Went off Flexeril. Ended up with insomnia and nausea, I think related to Flexeril. Tried Prozac for 1 day at 5 mg in September 2015, and that sent me up the wall.

Panic and anxiety worse. Went on Buspar for about 2-3 weeks. That didn't really help much and gave me chest pain and migraines. Insomnia still bad. Tried Ambien a couple days but was afraid of it and went on mirtazapine, big mistake but needed sleep and was having SI.

 

Started mirtazapine 10/9/15 at 15 mg, next day 7.5 mg and for a few days. Caused brain fog, a lot of agitation and anxiety. Was sleeping. Scared. Called doc, who said I could go off, but after 2 weeks was afraid to jump off dose. Started cutting dose every day and got down to 5.8 mg and held until saw doc. Said to stay on, seemed to help. I tried to cut from 5.8 to 5.7 this last week and a half and had some major anxiety symptoms and headache. Now I don't want on at all and don't know what to do. Only been on for a little over a month but scared. Don't know what else to use for sleep. I have a scale to weigh but I know even when it says 5.7 mg every night that can still have some variance because of the small amounts of pill I scrape off.

 

I also tried Ativan for a week about 2 weeks ago. It was horrible. Worked when I took it, but the rebound anxiety was awful. I had to take every day for a week, slowly lowering the dose. I just can't take it prn. It gives me severe rebound anxiety.

 

My family says I am dysfunctionally obsessed with medication. That may be the case, but I seem to be hypersensitive to meds and worse lately. I am having some sensitivity to light and sound and touch. Vision blurry and off in low lighting. Having trouble concentrating. At least no more brain fog from mirtazapine but have headaches almost every single day.

 

I have only been on it a month, but I am scared best way to reduce. I know WD symptoms can take 2-3 weeks to hit. I am waiting to see what will happen next week (third week of reduction from 5.8 to 5.7). AT this rate it will take me forever to get off a med I only started 1 month ago. I have read of some using valium to help with WD symptoms but am scared. Still, I need to function. I'm supposed to be getting a job but how do I work with severe anxiety, agitation, and etc. from small drops in med. I have some valium but haven't tried it yet to see how I react to it.

 

I am scared of these meds but don't know if I can manage the depression/anxiety that came about this time without something. Could maybe go back on Prozac but so hypersensitive right now and need to get off mirtazapine.

 

I am not sure best thing to do. I read on here that some of these programs that help with supplements aren't that safe. I found that now I cannot take vitamin C or vitamin D without increased anxiety/agitation. Even my progesterone cream does that unless I take it at night. I don't know what is going on. I'm worried my vitamin D will get too low because of the mirtazapine if I cannot supplement.

 

I don't know what I will do for sleep going off the mirtazapine. I went on it for new insomnia (hadn't had problems sleeping since I was a kid and very anxious), and also worse anxiety and depression.

 

 

 

Edited March 5, 2017 by scallywag
tags

[dalsaan]

Hi herenow

 

Welcome to the forum. We have found that withdrawal can take quite a while to kick in so lots of things could be happening for you given you have started and stopped lots of medication. What's clear is that your system has become very sensitive to changes.

 

We are a site dedicated to coming off or reducing drugs. With that in mind I would encourage you to explore non drug ways of dealing with your symptoms. I would also encourage you to rethink your understanding of what has happened when you have come if drugs previously. Many people, including Drs, misinterpret withdrawal initiated depression and anxiety for relapse.

 

If I was you I would hold at your current dose for 4 - 6 weeks to see whether your system calms down. Avoid supplements and any other drugs. Drink plenty of water. Read topics on here and focus on coming off well rather than quickly

 

Dalsaan

[Altostrata]

Welcome, herenow.

 

You have a long history of being overdrugged. Since you had an adverse reaction and possible withdrawal from Elavil, your adverse drug reactions have been misdiagnosed as psychiatric disorders and re-medicated. This is quite common.

 

Going on and off psychiatric drugs can eventually make the nervous system hypersensitive to all of them.

 

Ended up back in hospital in July 2015 where they tried to CT the Klonopin. Was there 14 days. Doc said I was neurotic and wanted to increase Risperdal. I left there still on Rispderal about 1 mg, Librium 25 mg to replace Klonopin, and Prozac 40 mg. I tapered off Risperdal by November 2014, Librium by February 2015 where I jumped off the last 5 mg, and I did not keep track of when I got off the last 20 mg of Prozac but probably sometime in April 2015. Looking back, my anxiety started increasing in May 2015, usually more around my period. Had lots of stressors anyway.

 

 

It sounds to me like you have withdrawal syndrome at least from when you came off this batch of drugs last spring.

 

Withdrawal insomnia is grueling. If I were you, I'd stay at 5mg mirtazapine, if it helps you sleep, for a good while, maybe 6 months, if the adverse effects don't outweigh the benefit. As dalsaan suggested, give it a trial run of 4-6 weeks. Your nervous system needs stability.

 

Eventually, you'd taper off mirtazapine, see Tips for tapering off Remeron (mirtazapine)

 

Sorry, we can't suggest what drug to try to counter all your symptoms, because we don't know of any.

 

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/
 

[herenow]

Thank you! It is all so very frustrating. I have fought some low level depression/anxiety/obsessive thinking all my life but it was mostly managable, a couple times where it was bordering paranoia, but when the stressor was removed, the paranoia left too. This time, I cannot remove my stressors. My thinking is difficult to control, obsessive negative thoughts that carry me down the road of only the worst possible things happening. It's difficult to focus and I'm supposed to be cleaning and packing up my house, watching my kids, getting a job, and instead, I wander around my house, read on the internet, get a few things done, and try to eat best I can, which is really hard, and if I don't eat enough, the depression/anxiety get worse. My counselor just saw me and said I'm severely mentally disordered and maybe need partial hospitalization. I'm afraid of more meds although if valium was a lesser evil than mirtazapine I might consider trying it just to feel calmer (Ativan made me feel real calm but worse as it wore off), although I just reread above about avoiding other drugs, which I'm sure is good advice.

 

I feel trapped by this medication but have read enough to know that if people come off too fast, and their system is not ready, it will just be worse. I really do wonder how much of my thinking has been made worse by the medications. 

 

I don't know how many people might be on here who do have some mental health issues so to speak and might need medicine. I just don't know how much medication can help. I am worried all the time about everything because of going through a divorce, bankruptcy, unemployed (worked from home for 10 years but then because of pain and meds last year couldn't), haven't worked in the real world in years, and the fear/anxiety have just built up. Is anybody else on here going through stuff like this? It is just so hard, and now this medication issue has gummed things up even more.

 

I can take krill oil and magnesium still it seem but can avoid too.

 

Right now it's difficult to get an exact measure on my scale, but I guess it's as close as I'm going to get. Holding for that long sounds so long but not sure what else to do. 

 

My short-term memory and ability to focus on things is difficult. I am not finding joy in much of anything. That was happening in July/August when my pain started before I did this last round of meds. Interestingly, my severe neck pain/possible panic attack in July this year started 2-3 days after I had tried a supplement with active folate, which I think might have set things off (before I thought it was some physical activity I had done). I have MTHFR but apparently am sensitive to active folate as well. Ugh!

 

I would prefer to be off but feel so unstable at times. I will look at nondrug ways of handling things as that's what I prefer. I feel so alone. I have a couple friends here who can help me, and I am near my children, who are staying with their father right now. I have more support if I go to my family, but they are out of state, and I fear (with my negative thinking) that I will go downhill if I have to leave them to get more help/support this this.

 

Thank you for answering my post. 

[Petunia]

I am worried all the time about everything because of going through a divorce, bankruptcy, unemployed (worked from home for 10 years but then because of pain and meds last year couldn't), haven't worked in the real world in years, and the fear/anxiety have just built up. Is anybody else on here going through stuff like this?

 

I went through a lot of this 8 years ago, but I was still taking lexapro at the time, so I wasn't in withdrawal, I can't imaging how hard it must be to have all this on your plate at the same time.

 

Once I had got my life issues sorted out, that's when I tapered off lex too fast and went into withdrawal. Unfortunately, more life issues came up and I also had to deal with some stressful situations while in withdrawal.

 

I don't have any more advice to offer, besides what you've already been given, I just wanted you to know you're not alone in having to deal with these struggles.

[herenow]

Thank you Petunia! I have had some more happen since I posted last. Ended up in hospital and trialed on a new med, which didn't feel good. Was tapered by 0.7 mg off the mirtazapine down to 5 mg and now they have added Paxil, which I'm on at 4 mg. Cognitively, I'm having more issues with thinking. Sometimes at night, I'm more myself when I'm around people I feel safe with. I'm not the same person I was between all these meds and the stress. I'm so scared!

 

Has anyone else had a feeling like with their nervous system where they can't even tolerate most movies or TV anymore because it triggers overactive emotions. I'm feeling like a kid sometimes and having flashbacks to childhood. Can't tolerate a lot of emotional stuff.  I have become somewhat agoraphobic. My anxiety is awful. I can't hardly concentrate/focus/sit still. Been trying to learn Vivation meditation. I have Valium but don't take it because of the nervous system issues, but the psych was insisting I take it to calm my anxiety down.

 

I have been able to add vitamin D3 back along with my magnesium.  I had tried l-theanine. It seemed to help calm me down at night (when I don't really need it as much), but during the day, it made my anxiety worse.

 

I'm still having some weird vision issues, which I think are from the mirtazapine.

 

My fear, anxiety and depression are really hard to deal with. I'm having to move out on my own into an apartment. Something I've never done before, and I'm petrified. I'm attending a mental health day program, which seems to give me some stability, although I feel awkward going to it, but it's a nondrug way I guess to manage everything I'm going through right now.

 

To top it off, I just pulled my neck/back on the left again and am dealing with that. Don't dare take any muscle relaxers so did an epsom salt bath tonight. My muscles are already all yanked up on that side because of anxiety and now it's just worse.

 

It's so hard to know what symptoms are from all my stressors and what is from everything that has gone on/is going on with the medications.

[herenow]

I started mirtazapine in October for sleep. I have not ever felt well on it. It has helped with sleep, but I want off. I feel like it increased my agitation/anxiety, eye issues. I have had several med changes in the last while, and I know it was suggested I hold for at least 4-6 weeks.

 

Since that suggestion, I was in the hospital, and they tapered me from 5.7 mg mirtazapine to 5.0 mg. They also put me on Geodon and took me off Geodon. Had me take some valium. Since then, trialed Celexa for 2 days and off and now also on Paxil 4.0 mg. Doc wants me to take half a 10 mg tablet. I did that, didn't like it, and went down to the 4 mg. I don't want to go any higher.

 

Then, despite the advice to hold, I got antsy and started to taper mirtazapine again. I had received some information from the now defunct CITA about only tapering 1 day of mirtazapine a week, i.e., taper Monday, and leave the rest the same. Second week, taper Monday again, and leave the rest the same. Third week, Taper Monday and Wednesday, with the rest the same. They said it gives the brain a rest.

 

Well, when I did the taper from 5.7 mg to 5 mg, it was just done every day. I am about 5 weeks out from that. Last week, I started the taper where I reduce Monday (from 5 mg to 4.6 mg) and leave everything else the same. I have done that again this week.

 

It almost seems like I am experiencing more difficulty going up and down like that with the dose than when I just cut the dose every day, but I have been having so much difficulty anyway (in life, emotionally, withdrawal symptoms) and haven't kept notes so it's hard to know for sure. 

 

Also, I am having difficulty getting accurate measurements on my Gemini scale so I become obsessed measuring the same piece over and over. My scale is about 1-1/2 years old. Not sure if I need a new scale or better technique.

 

is anyone here familiar with the CITA protocol for mirtazapine that I talk about above and whether it's better than just reducing every day? Their way takes approximately 13-14 weeks for 1 dose reduction.

 

Also, I have seen some pros and cons for liquid and/or measuring on a scale for tapering and wonder what might work best for the mirtazapine.

 

Also, as impatient as I am, my poor nervous system is really messed up and needs to rest I think, especially because I have some really stressful things coming up (divorce, moving into an apartment on my own for the first time) and I don't usually ever feel well physically or mentally until sometimes later in the evening when I feel more my "normal" self. It scares me to be on these meds longer than I need, but it seems like it could be scarier if I keep cutting and my system doesn't like it.

[KarenB]

Hello Herenow,

 

I moved this post to your own topic since it's about your own situation, and you'll get more responses here.  It can take a while to get the hang of this site, but basically this thread is for any discussion of your own experience, and other threads are for more general comments on things.

 

I'm glad you've checked back in.

Karen

[herenow]

Dalsaan or Altostrata or anyone else who can answer. 

 

I didn't get much response from my post above so I'll try to be more succint.

 

Despite advice, I tried tapering mirtazapine from 5 mg to 4.6 just on Monday for 3 weeks in a row, while keeping the rest of the days the same. I was feeling desperate because it seems like mirtazapine causes me problems. It seems even though I was given this advice by CITA, my system doesn't like the jump in dose like that. So my question is this, to stabilize, should I move that dose back up to 5 mg or keep it the same? I really have a lot going on right now and realize that this may not be the time to taper. I just don't know what symptoms are coming from the mirtazapine and what's coming from everything else that I've been through.

 

Also, would it be better to taper mirtazapine just like all the other meds where you do a dose cut every day? I'm thinking of eventually microtapering once I stabilize. 

 

Not only that, I feel like the mirtazapine makes me feel worse overall ever since I started it so I'm not sure I can handle staying on it, but I won't know for sure unless I've had a few weeks where there are no med changes/alterations.

 

I have more questions but will save those for later. 

 

Also, if my depression and anxiety are worse because of the meds I got off, and I was having withdrawal from which med I'm not sure so couldn't reinstate necessarily, how do people recover from this depression and anxiety? Is is just time? 

 

Also, I will have windows in the evening, usually later at night where I don't feel depressed or anxious at all and much less fearful? Does anyone have an explanation for this? 

[Petunia]

Hi Herenow,

 

If you are trying to stabilize, then hold your dose where it is now. Continually making changes to drugs and doses is making your nervous system more unstable. It would be better to wait until your stressful life events are resolved before beginning a taper.

 

 

Going on and off psychiatric drugs can eventually make the nervous system hypersensitive to all of them....

 

Withdrawal insomnia is grueling. If I were you, I'd stay at 5mg mirtazapine, if it helps you sleep, for a good while, maybe 6 months, if the adverse effects don't outweigh the benefit. As dalsaan suggested, give it a trial run of 4-6 weeks. Your nervous system needs stability.

 

Eventually, you'd taper off mirtazapine, see Tips for tapering off Remeron (mirtazapine)

 

Sorry, we can't suggest what drug to try to counter all your symptoms, because we don't know of any.

 

 

 

 

Also, if my depression and anxiety are worse because of the meds I got off, and I was having withdrawal from which med I'm not sure so couldn't reinstate necessarily, how do people recover from this depression and anxiety? Is is just time? 

 

Also, I will have windows in the evening, usually later at night where I don't feel depressed or anxious at all and much less fearful? Does anyone have an explanation for this? 

 

Recovery from antidepressant withdrawal happens over time. Stabilization happens over time. You can do things to support recovery, there are a lot of good ideas for how to do this in our symptoms and self care forum.

 

Feeling better towards the evening is a common pattern, its caused by our daily hormone fluctuations, see:  Waking with panic or anxiety -- managing cortisol spikes ...

 

Please read our Mirtazapine tapering tips. We don't recommend taking different doses on different days or skipping days.

 

But If you are trying to stabilize, stop making changes.  Read:   The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

[herenow]

Thank you Petunia. I have done much careful reading on this site. I updosed my Monday dose on 1/25 from 4.6 mg back to 5 mg so that every dose on every day is now the same. After a couple of days, I felt my emotions more stabilized and felt somewhat less dizzy. Unfortunately, I have more head tightness now (that had lessened a bit just by dropping the Monday dose down) and have been having some headaches and a number of adrenaline rushes this morning and feel more drugged. *sigh* It's a tradeoff. I plan on holding now for at least 4-6 weeks and revisiting at that time. I see above Altostrata had recommended holding for 6 months, but I really dislike the "brain squeezing" and eye issues (light sensitivity, eye pressure, slight vision changes, difficulty scanning) I have on mirtazapine. 

 

Yes, I have a tremendous amount going on right now (divorce finalizing, having to move out on my own, not working, hypersensitive nervous system) and need to keep reminding myself now is not the time to mess with the meds anymore. Unfortunately, I don't see stressful things slowing down much, just changing.

 

Plus, my nervous system is still wonky. The light and sound sensitivity are a real pain but I can still manage grocery shopping myself. I have to live a much quieter life to handle all this. Wondering how/if/when I'll be able to get a job.

 

Thank you for explaining the hormonal issues.

 

I have ordered a graduated cylinder because I'm thinking of switching to liquid measuring from using my Gemini scale. I talked to a couple of pharmacists about making a liquid solution, and they just looked at me like I came from outer space and said that isn't usually done but could be done but expensive. One of them did give me some 1 ml and 5 ml oral syringes though.

 

I am not happy that I am now on Paxil too, but it is what it is.

 

I just haven't sorted out yet how I figure the dose I weigh out to a liquid dose. For instance, the 15 mg mirtazapine tablet weighs more than 15 mg, and I currently take 5 mg so not sure how that translates to a liquid dose. My thinking/concentrating have been so fuzzy and slow since all this medication business started.

[Fresh]

Hi herenow ,   I totally agree with Petunia.    You need to take the same amount at the same time each day to keep your cns

as stable as possible.

 

When you're more stable , you'll see that making a liquid is not so difficult.  

There's a thread at the top of the Tapering section that explains it in detail.

Basically , if you dissolve one 15mg tablet in 15mls of water , each ml you draw up has one mg of medicine.

So when you want 14mg , you draw up 14mls.   But that's a little down the track for you now.

 

I'd wait at least 2 months to see how good you can get.  

I've found that the negative effects of the ad have decreased as my dose has gotten lower , and that seems to be a common experience.

 

The trick is to go down safely , not quickly.

 

bw ,  Fresh

[herenow]

Thank you for the info and support. I am still holding at the 5 mg of mirtazapine. 

 

Maybe someone can check my math for me, but if the tablet weighs 150 mg, and I weigh out 0.050 g on my scale, that makes 5 mg of mirtazapine (150 divided by 15 mg).

 

I think I might have the paxil wrong. I  thought I am taking 4 mg of the drug because I weigh out 0.040 g on my scale, but the tablet weighs anywhere from 125 to 127 mg. So if you figure 125 mg and divide by 10 mg, that is 12.5 mg for each 1 mg of active drug, so I think I'm really taking 3.2 mg of paxil.

 

My emotions have evened out a little more although I still have so much going on in my life and am scared of these meds.

 

Bright sunny mornings used to wake me up and make me feel better about the day but now with everything going on and especially since the mirtazapine the light really irritates me in the morning, makes it hard for me to sleep. It is really hard to be patient holding the mirtazapine when it bothers my eyes/mood like this.

 

I am working on nondrug techniques such as DBT, vivation, ACT to work on my emotions, but it is still hard because I am so negative about many of the things that are going on in my life including the problems I've had with these meds.

 

I have my graduated cylinder now and some oral syringes but am afraid to take the plunge to liquid or even half liquid/half pill. I'm worried I'll get it wrong or mess up.

[nz11]

Assuming you are basing this on the 15 mg tablet of mirtz and the 10mg tablet of paxil then i agree with your calculations.

ie

0.05 g Pill Weight (PW) of mirtz = 5 mg dose (active ingredient), and

0.04 g PW of paxil = 3.2mg ai dose.

[hardy86]

Hi herenow

You have found a wonderful sight to help you through this. I'm going through bad times to and understand how you feel. This forum are full of wonderful and kind people that will help you through.

The only tip I can give you that might help and I believe is powerful to get through this time is exercise, it releases endorphins after you exercise making you feel good. I found it better then taking a benzo drug. This has saved me a lot through my bad times. Please have a go if you can, even a 30min walk, going for a swim.

Take care hardy

[hardy86]

Eat frequently small meals through out the day consisting of carbohydrates and protein, lots of fruit and vegetables to give you energy and balance your sugar levels out. Especially carbohydrates, this will help your mood and energy levels to battle through. A lot of people don't realise how important diet and exercise is.

Hardy

[herenow]

Thank you Hardy. It is so hard for me to eat although better than it was after a course of Aleve and CT off flexeril after only a few days back in September. I really had even more difficulties then. My feelings of grief and anxiety keep my stomach clenched up so much. I have to remind myself to eat. I keep losing weight.  I have been taking some walks although did not today because I ran errands. I hope to get one in tomorrow. I may try to walk in the mornings as well when that is my hardest time emotionally. I was so used to having my children home with me every day as homeschoolers and now that they are in school I am grieving. Wanting to practice radical acceptance and wondering where the switch is to make things all better.

[herenow]

New provider does not believe me about some of the symptoms I have had on the mirtazapine. Has listed me as having "sensory hallucinations."  I am concerned she will try to encourage me to wean off too quickly from the mirtazapine and paxil. It doesn't help that I have been treated poorly by some providers in the past so am a little frightened and obsessed with the medications and tend to be very anxious when I talk about all of it and thus did not come across well the first time she saw me because of all my emotion. She doesn't like to use paxil because withdrawal can be so difficult (ironic that she will recognize discontinuation/withdrawal symptoms with paxil). I'm not lowering either med right now and not having side effects from the paxil anyway on the dose I'm on.

 

What is good advice for communicating with providers about wanting to take things slowly and at least be taken seriously about the side effects/withdrawal symptoms they can't see?

[Petunia]

What is good advice for communicating with providers about wanting to take things slowly and at least be taken seriously about the side effects/withdrawal symptoms they can't see?

 

Have a look through this topic for some ideas:   How do you talk to a doctor about tapering and withdrawal?

[nz11]

Oh thats strange i thought i had posted a comment here but maybe i hadnt.

 

Herenow one option is you dont even have to tell them you are tapering just use them to get the drug.

I know of several who are on a low dose now after several years of tapering but the doc thinks they are still on 20mg.

[herenow]

Petunia, thank you for the info. NZ11, that is interesting to know. I am on Medicaid though now as of last month and already having trouble getting medications paid. I feel I need to be up front to get the correct meds, etc., but I'm not sure what to do.  I don't want to not have them get paid or run out. This is a new experience. I have always had insurance before and cannot get a prescription program card because I am on Medicaid. I may have to pay cash but don't have a lot of money to be doing that. 

[herenow]

Update on my situation:

I have stayed stable on the same doses every day since the end of January. I am on (by weight) 5.0 mg mirtazapine and 4.0 mg paroxetine.

 

Here's what I've noticed:  My emotions have leveled out even more though still "labile" so to speak. I'm not having early morning awakening/panic. I can handle some movies/TV again, music during the day, and sunshine not bothering me quite as much. I feel like me most of the day now. The terrible urgency/panic that I had most of the day is much less. In fact, I can shop now without panicking and I can drive myself most anywhere and even take my children some places. Still feel some anxiety but much more manageable. Still having crying jags.

 

In this time, I have finalized my divorce, moved from my home into an apartment, and in the last week started a part time job. It takes pretty much all my will and strength to go to this job but being at home is not a great alternative. It is a quiet job in a library putting books away. I've done this kind of work before so I know it well, and it's low stress, if only a little boring. Sometimes, waves of anxiety will hit around midshift/midmorning and I hold on until I get off work and then cry on the way home and for awhile after. Now, I still have a lot of grief/loss going on. I have a hard time being by myself so do better when I'm at work, with my friends/boyfriend, or my kids. Still even with them I have crying jags. 

 

I have also now been able to keep my children the full amount of time I'm supposed to including getting them to school 2 days a week.

 

Also, I've noticed that the last month around my period, instead of feeling a lot of anger, it was more sadness, which is an improvement.

 

I'm attending a divorce recovery class, visit over the internet with a counselor processing emotions, and attend a program during the week seeing a counselor/case manager. I hope to get back on a walking schedule now that my body is adjusting to all the extra standing, crouching, bending etc. with putting books away.

 

I've had a hard time keeping with a strict schedule of taking my meds the same time every day. With this, I have noticed something interesting. If I fall asleep before I take my meds and wake up, I will take them then. Sometimes, I have slept through the night until 7 a.m. So, my experience with this is that my sleep feels better/deeper before I take my meds than after. When I have taken my meds at 7 a.m., I have had to go back to sleep for a couple hours then can get up and not feel too drugged. When that happens, I don't resume my meds at the correct time the next day, I ease them back but that involves setting an alarm for like 5 a.m. and taking my meds then for a couple days, etc. Currently, I fell asleep last night around 10:30 or so and woke up and took my meds at 12:30 a.m. As I shift my meds back to the correct time, I feel like I'm experiencing some emotional instability/withdrawal so really am working on getting on a better schedule.

 

My question though is what would be the optimal time to take my meds? Mirtazapine was originally for sleep (insomnia due to med withdrawal/discontinuation from either Prozac or flexeril). My sleep is fairly healed now. I'm wondering if the paroxetine is what is causing the sleep upset and if I could move that to daytime. My pdoc wants to add lithium during the day since I still have emotional instability during the day, but I have told her I would consider it but don't want to yet. She has agreed. Of course, I know the emotional stuff is psychosocial but also healing from med withdrawal/changes/side effects.

 

I also still feel a lot more anxiety when I haven't eaten enough but still have a hard time getting myself to eat enough on a regular schedule but working on that still.

 

I feel that I could possibly be ready to taper the mirtazapine some. I am very excited for my new job and do not want to jeopardize it at all. I am still cutting my pills and measuring on a scale. I have been too scared to switch over to part pill and part liquid and then to liquid dosing. I have thought of just cutting from 5.0 to 4.9 (which would be 0.150 g and 0.149 g on my scale). I'm pretty sensitive to drops in the med but am hoping just this small amount might be okay to try.

 

What would you recommend? I'm all for a turtle slow taper so as to keep quality of life, ability to raise my children, and work at least part time.

[herenow]

I also want to add that I take 200 mg magnesium glycinate at night, fish oil occasionally or eat sardines, and also take 15 mg of progesterone cream daily. I find I cannot do the regular schedule of 4 days off a month because it aggravates withdrawal symptoms or causes its own withdrawal so I only miss 2 days a month. 

[herenow]

Well, I cut the mirtazapine from 5.0 mg to 4.9 mg last Wednesday, April 13. I had 2 really great days after that. My mood was up, hardly any anxiety. It was great. Still somewhat crabby. Then, my monthly cycle came and was back to crying and being worried. 

Last night, Sunday, April 17, I fell asleep putting my kids to bed and woke up around 3:44 a.m. So I got a good 6 hours of sleep without medicine. When I wake up in the middle of the night like that, I usually just feel myself, no anxiety or depression. Ended up measuring out 4.8 mg of mirtazapine (so cut mirtazapine another 0.1 mg) and 3.9 mg of paxil even though I wasn't originally planning on cutting the paxil. Anyway, between taking the paxil late and cutting 0.1 mg, I'm already having some more anxiety, pins and needles feelings in my head and feet. I will hold all this now for a week and see how I feel. I've also been having some of the morning wake-up anxiety that comes with the mirtazapine dose being altered, but it's much milder than it was before. I'm grateful I'm on such low doses but frustrated at the time it may take me to get off these and frustrated at feeling symptoms from cutting such small amounts. *sigh* 

[Hibari]

I hear you.  As a fellow Mirtazapine traveler, I understand that feeling of wanting to be off really badly.  I too am tapering two drugs at around the same time and get what that is like as well.

 

I am always surprised how the small cuts are felt but from everything I've read, it just is that way.

 

You are not so far from your goal and from what I see in your signature, you have come very far.

 

Keep the faith, you will make it!

 

Hibari

[herenow]

Need some help ---

 

I am now on 0.027 g of paxil and 0.039 g of mirtazapine. I've been tapering slowly and been fairly stable.

 

My problem is that I took my regular dose of medication last night, around midnight. Then, I measured out a dose this afternoon around noon. This went into my pill box to be saved for tonight when I went to my boyfriend's so I wouldn't have to measure it there. Somehow in the measuring, putting in the pill box, etc., I just mechanically took that dose shortly after I measured (at noon) and did not realize it until I headed out to my boyfriend's and double checked my medicine. The pill box was empty, and I remember it having a dose. Then, I vaguely remembered that somewhere in picking it up and double checking after measuring that I think I just took it. It explains why the lights looked strange at work tonight. The mirtazapine messes with my light sensation. Also, my head had that tight band feeling around it that it gets when medicine is higher or dose jumpy.

 

My question is this: What is the best way, in anyone's opinion, to level this out some? I should normally take my regular dose now, but I am thinking of waiting until morning, say around 6 or 7 a.m. I could also wait until noon, when it will have been 24 hours, and then slowly creep it up to midnight over the next week or so. I had just made a couple of cuts and was going to hold for 2 weeks. Now, I have this.

 

I'll be up for probably another hour. I know it's late so not sure if anyone can help but thought I would at least put it out there.

[nz11]

Hi herenow

 

Hey great job tapering. Why such a long time between posts.

 

I guess there are two options as i see it

1. Carry on as if this didnt happen and take the evening dose as usual or

2 Carry on as if you have taken tonights dose 12 hours early.

 

Its a curly one isnt it.

if you go with number 2 it will mean a 36 hr wait till your next dose as apposed to your normal 24 hr interval.

Its not as if you took a double dose at the same time. And people who miss a dose may have to wait 48 hrs.

The half life of paroxetine is about 20 hours (but can have a range of up to 65 hrs apparently) and remeron 20-40 hours.

 

Or you could have an option 3, split the difference and wait 30 hrs to the next dose as apposed to waiting 36hr.

 

If i had to make a choice i think i would go with number 2.

Your call either way i wouldnt stress too much.

 

Gee do you normally take your dose at midnight?

 

nz11

later

Just skimmed your intro i think you are talking pill weight not active ingredient right? sorry i overlooked that.

I did it in a hurry but i think you are talking about 2.16mg ai paxil and 3.9mg ai remeron or there abouts.

[herenow]

Yes, I wrote it as pill weight and not active ingredient. It's really the same for the remeron anyway.  Haven't posted much because I've been doing better, but I know people like to hear when things are going well, and it's good to have a record of both.

 

You came up with pretty much the same ideas I had, but it's good to hear another voice in. I may do the 30-hour bit. May see how I feel in the morning, and if I start feeling withdrawal effects before noon, then I'll take it by noon or wait as long as I can.  I fluctuate taking my meds between 9 p.m. and midnight. Sometimes I fall asleep before taking them and then take them late, but that's been rare recently.

 

Thank you for responding! I just get nervous because of everything that's already gone on. I'm hoping this is just a minor blip.

[herenow]

Just wanted to update everyone, I cut a little more than I planned in January and had some depressive/anxious symptoms, but I managed and am holding steady for a few weeks. It only interfered with work 1 day. Sometimes, a few weeks after cutting paxil, I'll have some flulike/upper respiratory symptoms and can't work. Anyway, I'm at 2.4 mg paxil and 3.4 mg mirtazapine by weight. I've been able to pretty much keep up everything else other than I got diagnosed with plantar fasciitis. My body seems to overreact to any kind of injury and cause me a lot of pain. Anyway, I hope I can get this cleared up. I use walking to help manage anxiety symptoms and mood and can't walk a lot right now. I've started back bicycling and am up to 5 miles on my bike. I'm enjoying that tremendously.

 

One of the other things from cutting doses is my sleep is disturbed. I wake up a lot and have so many bad dreams. I'm getting used to it though and know it won't always be like this.

[scallywag]

Thanks for stopping by to post how you're doing. Glad to read that things range from okay to good.

[Altostrata]

Good to hear your taper is going well, herenow.

 

I have plantar fascitis, it is frustrating. But I've found physical therapy to be very helpful. You'll get exercise tailored to your needs. Recommended.

[herenow]

Thank you for your responses Scallywag and Altostrata. I thought I would be notified if I had responses to my posting or I would have said something sooner. Perhaps there is a setting I'm missing. Altostrata, I watched some of your video talking about your experience, so brave!

 

Anyway, can't say I'm doing as well as I was in February. Not sure what I meant by holding steady in my previous post, maybe just evening out emotions because I certainly didn't stop cutting meds. I'm down to 2.1 mg paxil and 3.1 mg mirtazapine. I have sunk into some depression, which I am fighting every day, probably combination of all the med cuts, financial situation a little more unsteady, and time of year. So, I am hanging in there. At least I can still do positive self talk and find small things to help lift me. In the worst of it last year, I couldn't do that easily if at all. So, that's a positive anyway. I come on here from time to time to read and feel inspired. I have a lot more nonmedicine tools in my arsenal to help myself, so there's that too.

 

I unfortunately do not qualify for physical therapy for my plantar fasciitis. Medicaid here does not pay for that, so I am on my own. Doctor no help. I have started an every other day fasting diet in the last week and have lost 3 pounds. This has actually taken enough pressure off my foot that I feel some slight improvement. I need to figure out the food a little better because I feel I am not actually eating enough, and that is worsening my mood as well.

 

I also moved several hundred pounds of books at work in early February, which afterwards caused my left shoulder to not move very well. I told work, and they got me in to see a doctor. Well, this doctor was at a clinic I had been seen at before. They pulled in all my history, saw that I had some psych history, and that was all she wrote, so to speak. The physician was so condescending. He did say I have a "frozen" shoulder, said they would do physical therapy, and then 3 weeks later, nothing from them still. I love my job. I am trying to get more hours. I don't need an injury to slow me down or a doctor who is not taking it seriously. I called their office today to find out when the physical therapy is supposed to happen, and the nurse is supposed to call me back. The moving hundreds of pounds of books was a one-off thing for work. My day to day responsibilities, though physical, are much less so. I'm hoping this will heal but frustrated because the doctor just kind of shook his head and smiled when I told him I had a hard time getting dressed/undressed or reaching behind my back. 

 

But despite these setbacks, and feelings of anxiety, DP, DR that pop up, and the daily depression, I am finding ways to be thankful and push forward, as scary as it feels sometimes. Ya'll are a great support!

[scallywag]

herenow - about the plantar fasciitis.  I had it about 17 years in my left foot and then 14 years ago in the right foot. 

 

What worked for me was taping the foot and applying ice. I used a 250 ml (8 oz) coca-cola bottle filled with water for the "icing" because the shape of the bottle has enough curves and contours that I could roll it and get all of the sole of the foot with a little wiggling. I learned about taping on a website, heelspurs.com.  The site is still active and I'm sure the founder keeps the information updated.

 

I'm glad you're finding ways to keep yourself positive and focused on the progress you've made. Keep on doing what works!

[herenow]

Thank you! I will look into the taping and rolling with the bottle of ice! 

[herenow]

Quick update everyone:

 

I'm now on 1.8 mg paxil and 2.8 mg mirt and holding. I had been diagnosed with a frozen shoulder in March  (work injury). Was slowly improving from that. Increased PT (I thought) made it worse on June 3. A day after the increased exercises, I felt this spasming start in my upper left shoulder blade area similar to an issue I had 2 years ago due to some neck positioning issues. Anyway, both times I have also been dealing with med issues so don't know if the pain was exacerbated by med withdrawal or caused by it or the physical things that happened at the time. Regardless, I have stopped cutting as the stress from the pain has been horrible. Doctors just say I shouldn't be in so much pain for a frozen shoulder and say I'm just going to have to soldier through. Found a medical massage therapist who is helping some, and I'm going to try some myofascial release techniques, anything that I can find calming to my system. I had tried muscles relaxers for a few days but found that dumped me into WD feelings and I was crying every morning, abrupt awakenings in mornings, and startle response at sleep and feeling like things would never get better. I'm glad to say a lot of that has passed but it helps that the pain is getting better. Two years ago there was some thought it was cervical radiculopathy. It took me some time to remember that and also myofascial pain syndrome  because I had trigger points. This time has not been quite as bad. I'm already back at work although in a lot of pain at work at times. HR not very sympathetic, but my boss is so I mostly deal with her. Ironically, I had also started trying to lose weight about the week or two before this all started, cutting out sugar and simple carbs and had lost almost 10 pounds, and a lot of my foot pain was getting better.

 

I also had a really funky rash under my arm around the same time as the pain started, itchy burning rash (first week of June). Worker comp doctor called it intertrigo. I finally saw my doctor after it started healing, thinking maybe it was shingles. He said he wasn't sure so not much to do about that. Could have been from the hot tub too. I was using that to ease my shoulder.

 

The pain is really aggravated by driving. So the 15-minute drive to work puts me in pain. If I get there early enough, sometimes I can lie down for a bit. 

 

I'm considering whether or not to start liquid tapering with the paxil.  I feel that I need to hold for maybe another month or so, but want to taper at 2.5% or 5%, and at 1.8 mg (0.018 g), weighing on a scale pretty much makes that near impossible. 

 

I have found that all the techniques I have learned in the last year have helped with my self-talk and dealing with things. The next big hurdle is I need to work a little more to support myself. Studying proofreading to do proofreading for court reporters and hoping to finish that soon. I can do that from home, even lying down

 

I also have several people in my life I can go to for support, which has helped tremendously as well. 

 

It is so heartening to read of some of the latest jumps off medication, incuding brassmonkey and dalsaan. 

[herenow]

I'm continuing to do better for now, but the panic and pain I endured earlier in June were pretty hard. I still have some ways to go and more fighting yet. I'm not on here much and don't always chime in. Tonight, this poem kind of burst out of me as I was thinking of the path I took to get here from all the medication madness.

 

Untitled

Manmade darkness

Pulling me down into a pit

I couldn't climb out of

Slippery walls

Far-off echoes of a life

Where I knew felt better

Fought the shackles that would hold

  me down

Stretched my arms and hands

  to those who would help

  pull me out

As my legs grew stronger

  my sight grew brighter

  my brain grew clearer

And windows started to open

  As I felt myself again

  And I began to win the fight