Terry4949: withdrawal help

[KarenB]

Terry,

 

Very important:  Do not start any new topics in this intro forum.  Simply reply to this already existing thread of yours.  Thanks for your understanding,

 

Karen

[Songbird]

It's very common to have a pattern of moods changing over the day, although which moods at which times can vary between individuals and even for the same people at different stages of withdrawal or tapering.  I guess it is because the body has a daily rhythm of changing hormones and neurotransmitters, but this can go a bit wonky in w/d.

[Terry4949]

As you can see my from my history I have come of 2 drugs in the last 14 months very quickly down to my doctor , I have been suffering withdrawal effects now for 12 months hell on earth , my doctor put me on mirtazapine in September to help me with withdrawal , since I have started this med I have felt no benefits at all from it , I have constant depression ,suicidel thoughts , is this the mirtazapine or the withdrawal

From the other meds still affecting me , I read that mirtazapine is not a good med when you are in withdrawal to be taking . Really at my end now the thoughts of not being strong enough watching my life disappear as I am stuck in this state kills me . Should I stop this mirtazapine

[nz11]

Terry just a gentle reminder that there is just one intro per person.

 

I am so sorry to read of this heartbreaking position, your doctor has let you down.

 

Have you considered changing doctor and file an immediate complaint against your ex doctor.

 

 

[Fresh]

Hi Terry ,   it's almost impossible to guess at this stage which symptoms might be leftover w/d from your fast

tapers last year , and which might be from the mirt.

Having been taking mirtazapine for 5 months , you've certainly given it a good chance to help you stabilize.

 

If you want to go off it (as it isn't helping) you'll need to taper slowly so as not to exacerbate withdrawal

symptoms.  This means following the recommended 10% maximum decrease at a time.

 

Please read the thread on tapering  here Tips for tapering off Remeron (mirtazapine)

 

bw ,   Fresh

[Terry4949]

Sorry for posting in the intro post , I am not very good at these sort of things , I really feel like I have been let down by the mental health profession , doctors who laugh at me , think that I need a good kick up the Arse , literally , I have been in with my go in a suicidel state and they have sent me packing without a kind word just keep telling me to take the pills and you've got to give them time , when I mention withdrawal from previous meds all I get is they will pass , absolute joke . I know I have got to get of this mirtazapine before it kills me ,

[AliG]

You're not on your own  You  still have to taper slowly.  There is no way around it .

Hang in there.  You will be  fine .

Ali

[leahy]

It is very common that doctors prescribe mirtazapine for wd from benzos or other AD's oe even for side effects from other AD's.

 

I can understand violent impulses from these meds because I am APPALLED and ANGRY about this. I would seiously like to hurt these people who so nonchalantly mess with our brains.

 

Mirtazapine should be illegal. I have been tapering from 60 mg to 13 mg for 371 days! It is a nightmare.

 

Yes, taper and get out. You don't need two demons on your back.

[Terry4949]

Wow leahy that is amazing ,tapering down to that amount well done as 60mg must have knocked you for six , I am on 30 mg and I can't imagine having any more than that in my system , I am going to taper of this but am going to do it slowly , I have come of Effexor over a period of weeks after being on it for many many years , stupid doctor , and it was so bad , so I am not going to let them make the same mistake twice . I figure if I feel this bad on them with all the side effects I might as well feel bad of them , and I might even feel better , but I am not going to know untill these drugs are out of my system . I will say this about mirtazapine it has to be the worst med I have ever taken , horrible drug , just wish I had never let them talk me into taking it but when you are at your lowest you will take anything you think will help , they have no idea ! Call them selves professionals

[leahy]

Hi Terry,

 

Getting the drugs out of our symptoms doesn't help us as much as we might think. There is an unfortunate process that has to take place. It is the changes in our brains that the drugs created that needs to grow back. That's what takes time. This following is a quote from our Rhiannon. I absolutely LOVE this piece. Thank you, Rhi.

 

"A lot of people, including healthcare practitioners in fact, I guess, most people are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin, as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to re-stabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy non-drugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

So it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning, well, it can't be good. All of which is why an extremely slow taper is recommended, particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected."

[Terry4949]

Good reading leahy , I read in one of altostratas write ups back in 2007 that mirtazapine was not a good med to take when you are in withdrawal , as it raises cortisol , when I was on Effexor and it stopped working I had terrible anxiety sweating flu like symptoms , noises in the head , etc , it wasn't until I started mirtazapine did I start to feel really depressed , I wish I had had this information to give to my doctor when they gave me this mirtazapine , it also knocks me out at night which I read is not good for the brain to recover as it slows it if i tell this to my doctor they will just say we need to try something else and sleep is important for to help treat depression ,but it's the wrong kind of sleep , it leaves m so frustrated

[leahy]

Good reading leahy , I read in one of altostratas write ups back in 2007 that mirtazapine was not a good med to take when you are in withdrawal , as it raises cortisol , when I was on Effexor and it stopped working I had terrible anxiety sweating flu like symptoms , noises in the head , etc , it wasn't until I started mirtazapine did I start to feel really depressed , I wish I had had this information to give to my doctor when they gave me this mirtazapine , it also knocks me out at night which I read is not good for the brain to recover as it slows it if i tell this to my doctor they will just say we need to try something else and sleep is important for to help treat depression ,but it's the wrong kind of sleep , it leaves m so frustrated

 

OMG. I can't begin to imagine what almost two decades of mirtazapine. I didn't see the 2007 write up by Alto. Do you remember where it was? I'd like to read it. Thanks for telling me about how mirt effected you. I feel less crazy. Do you think the rise in cortisol would make me fearful and anxious? My doctor doesn't listen to a damn thing i see or feel. She's an idiot. Seriously. Really stupid I almost feel sorry for her - but she's hurting ppl every day with her ignorance. Yea. My brain really took a hit from mirt. I am embarrassed now that I have some ability to remember things. It makes me cringe. Cringe. Yes. It is definitely the wrong kind of sleep. Good God. I was on 90 mg for many years...

[Terry4949]

Hi leahy , i can't seem to find the page that I saw it on it just happened to come up on something I googled about discontinuation from antidepressants , and up come this article by altostrata in 2007, I will keep looking for it and try to find the link , you could maybe try to message her to see if In fact this is still true, as you know how things can change and I certainly don't want to be giving false information , but it is something I am sure it said ,

[leahy]

I found it Terry. Thanks for trying. I googled alto mirtazapine. Great article. ou are correct in what you said. I'm in a bad palce when my wd from AD happens to be mirt which is noradrenergic  

 

 

"Theories of serotonin or dopamine deficiency etc. are particularly stubborn red herrings. (The serotonin imbalance theory waspromoted by drug companies as part of their marketing.) 

 

The mythology of neurotransmitter imbalance is irrelevant in withdrawal. In withdrawal syndrome, interventions that reduce cortisol are helpful.

 

Noradrenergic medications such as buproprion (Wellbutrin) and mirtazapine (Remeron) are not. Celexa and other SSRIs may be activating. Benzodiazepines may rapidly go paradoxical."

[Terry4949]

Hi leahy , I know it's horrible to think that these people put us on these meds mirtazapine , and they do not know what they are doing , they have no clue as to what we are going through , I have been of Effexor for 12 months now after a fast taper by my gp and then place on a drug that's making me worse , I am still going through horrible withdrawal from the Effexor and now I have got to go through it all again with this bloody mirtazapine , I told them I didn't want to go on it and they said it's the best med for me it would help to counter the Effexor , they have not got a clue , if they could feel what we go through for one day , I'm sure they would think twice before dishing out this crap , sorry rant over !

[leahy]

It is obscene the way doctors prescribe remeron and every other drug. I cannot comprehend the stupidity and pure ignorance of these doctors who obviously are suffering from a 'god' complex. They are messing with people's brains and lives. Could they give this some serious thought and consideration? No. Apparently not. 

 

I think mirt causes the anxiety and then they put a person on a benzo to calm down. 

 

Please REMEMBER that you have control over depression. Sun, exercise, good food and one good friend/spouse and/or child will do the trick. Even a pet seems to help if you like pets. I don't like pets so I can't say first hand. Terry, you can beat this with the knowledge you are gaining every day. 

 

Ranting is free and is very much encouraged.  

[SquirrellyGirl]

Hi leahy , I know it's horrible to think that these people put us on these meds mirtazapine , and they do not know what they are doing , they have no clue as to what we are going through , I have been of Effexor for 12 months now after a fast taper by my gp and then place on a drug that's making me worse , I am still going through horrible withdrawal from the Effexor and now I have got to go through it all again with this bloody mirtazapine , I told them I didn't want to go on it and they said it's the best med for me it would help to counter the Effexor , they have not got a clue , if they could feel what we go through for one day , I'm sure they would think twice before dishing out this crap , sorry rant over !

 

I'm on another forum where a gal said she is in WD from coming off Effexor rather quickly, and her doctor gave her Wellbutrin - Wellbutrin is a rather weak antidepressant to begin with and most assuredly will do nothing to counter the Effexor withdrawal, but apparently my explanation went over her head and she is going to take the Wellbutrin. I had suggested a small reinstatement. Sigh.  I was put on mirt when in Effexor WD and it couldn't hold a candle.  I was so depressed, agoraphobic, completely apathetic that I didn't care to bathe, dress, eat...then I reinstated Effexor and BINGO, within an hour I was dramatically better!  Not suggesting that's what you should do, but it worked for me.  Of course, I didn't know I was in Effexor WD, just thought, like everyone else, that I was a sicko who needed to be on meds forever.... but then I learned the truth!  Unfortunately, I ended up on two psych meds, not one, before learning this!

 

I'm sorry you are in the horrible position of Effexor WD and being on Mirt, Terry. 

 

SG

[Terry4949]

I have been in w/d for roughly 3years now from Effexor as that is when I believe it stopped working ,I have not taken Effexor fo 12 months now after a fast taper by my gp.

 

As you can see by my history I have been put on mirtazapine which I have been taking for 6 months now , the mirtazapine has done very little for me and the side effects are terrible , so I have started a very slow taper , I started a 10% reduction 6weeks ago , I have had severe w/d for 3 years with only the odd day of relief , I do not seem to get window and waves. , its constant .

 

My gp feels that I need to take something to help me get of the mirtazapine , as he says that my body is so sensitive to any reductions and because the severity of my depression and anxiety ,mood swings etc he is really concerned that even with a very slow taper that it might be to much for me to handle , since the Effexor has stop working I have not even stabilised once or felt well enough to consider withdrawing , so it's plain to see that no medication to this stage has had any benifits .

 

To be honest I am desperate just to find a foothold of some sort of stability after 3 years , I no this is a site for people who are trying to come of the meds as I am but the reason for this discussion is should I try and withdraw from this mirtazapine using , doctor has suggested sertraline or Prozac ,small dosage , so I can find some sort of stabilise base , or would it really not make any difference , I have been struggling for so long now that I just want to find a little bit of peace , has anyone had any experience with this that they could share , don't want to take another med , but need some sort of help

[SquirrellyGirl]

Hi Terry, 

 

Welcome, and thank you for filling out your signature block - it really helps!

 

It looks as though you have already done some reading on the site about windows and waves.  I'm sorry that you are having such a rough time with what sounds like protracted withdrawal from Effexor.  

 

It might be helpful for the mods to know what your symptom pattern was in Effexor withdrawal before going on mirtazapine, and to know what your symptoms were while on mirtazapine. You have been on Mirt long enough for it to get its hooks in you, and it is known to be equally difficult to come off of as Effexor. It is not advisable to stop it suddenly and switch to Prozac; it should be tapered, and SA recommends a 10% taper schedule, based on the previous dosage, with cuts every 4-6 weeks only as long as you are free of WD symptoms.  

 

It would be helpful to read the following:

 

What is withdrawal syndrome?

Why taper by 10% of my dosage?

Why taper?  Paper demonstrates....

Tips for tapering mirtazapine

 

It might seem strange to taper a drug that seemingly isn't working or is making things worse, but the reason is because it still has caused remodeling that will cause you further trouble if you come off too fast.  However, if one has an adverse reaction to a drug or the symptoms are so severe as to be intolerable, then a faster taper or cold turkey may be warranted.

 

 

I have a similar history as yours, on Effexor for 12 years, others for 8 years prior, feeling it wasn't working and the negatives definitely outweighed the benefits (none), and then came off too fast over a year ago.  My withdrawal did not show up right away, so I was not thinking WD when it did build to a fever pitch.  I also ended up on Mirt because of the severe depression and anxiety that developed (due to WD!), which ultimately didn't work, and I realize now that this was because it couldn't hold a candle to protracted Effexor WD.

 

The difference between you and me is that my doctor reinstated Effexor at 10 months out when continuing to increase Mirt left me apathetic, agoraphobic, and totally non-functional.  Within an hour, my symptoms dissipated!  He did not reinstate knowing that I was in withdrawal, but decided we could try it again since I had tolerated it in the past. 

 

Now, reinstatement so far out is very risky, not as likely to work, a real gamble, so I am not suggesting you do this, but it did work for me. The risk is that one can have an adverse reaction to the med rather than benefitting.   You can read about reinstatement here to get a better understanding of the why's and how's:  

 

http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

If reinstatement is considered, it should be at a very small dose, maybe 2 mg to start, so that if an adverse reaction is encountered, it would be easier to stop and recover.  If you were on the extended release with little beads inside the capsule, you would need to count how many beads are in a few different capsules, take the average and then divide the dosage of that capsule by the number of beads.  Then, take the equivalent of 2 mg.  It takes four days for a med to reach a steady state in the system, so if there are no adverse reactions then you would wait that long to assess whether or not there has been any benefit and decide whether to increase by a bit more.  Of course, this should be discussed with your doctor before any med changes.  

 

 

Give the above a read and come back here to ask questions and give updates.  You can click "Follow this topic" above to receive notifications when someone has responded in your thread.

 

I am now tapering mirtazapine, since I stayed on it when the Effexor was reinstated.  Once I learned about withdrawal and what these drugs had done to me, I wanted nothing more to do with them!  Unfortunately, we don't have the luxury of just stopping them when we want out, because of all the brain and nervous system remodeling that went on in their presence.

 

You can read about that here:

 

http://survivingantidepressants.org/index.php?/topic/1160-brain-remodeling/

 

Your system has become sensitized due to withdrawal and adding another drug on top of withdrawal.  Each drug has it's own mode of action which causes physiological changes; Effexor and Mirt work on different receptors.  More changing could lead to adverse reactions so caution must be exercised.

I will leave it to more experienced Mods here to discuss whether starting Prozac would be helpful and preferable to reinstatement of a tiny dose of Effexor. It may be that tapering mirtazapine and not making any other changes is the best fit as well.

 

I've given you lots to read, so have at it and we'll see you back here soon :-)

 

SG

[Fresh]

Hi Terry ,  I've joined your new post with your Introduction topic.

 

What dosage of Mirt. are you taking now?    How did the first reduction affect you?

[SquirrellyGirl]

Sorry, didn't realize this wasn't the first intro post!

 

SG

[Terry4949]

Hi fresh I am currently taking 22.5mg mirtazapine having been on 30 mg have been on this dosage for 1 month now , I feel no different on this after making the cut , I have been in full withdrawal from Effexor since it stopped working and the mirtazapine has just added to the problem ,

 

I just need to find a little relief to be able to try and tackle this but the anxiety and depression is unrelenting , I have been reading the forums on supplements and I might try the magnesium , fish oil , as I am not currently taking any supplements , my doctor wants to add something to the mirtazapine to try and help lift the depression ,but like many on here I don't want another a/d but I don't think I can carry on like this without some sort of help

[leahy]

I am sorry you are feeling so badly, Terry. It's so hard to suffer from wd from Effexor and then get put on mirtazapine. I wish I had some answers for you. Many people say fish oil and magnesium help them. Many people also say that mirt causes anxiety for them as well. You are not alone.

 

A mod will be along soon to help you sort this out. I just want you to know I am thinking about you.

[Terry4949]

Thank you leahy , I find some days and weeks are really hard as I have been saying to myself that it will get better but I have been in this awfull state for so long , and am starting to think that I am not going better and that the damage is permanent . I do all the right things ,no alcohol don't smoke , eat well exercise , I even still manage to go to work , even though I stand in silence , the worst bit is I want to do things and enjoy life but this w/d makes me feel so bad , and the random crying spells are bloody awful , sorry if I am rambling on , some days it's just nice to get it of your chest , again thank you for your kind words

[leahy]

The thing is, Terry. I feel exactly the same way and I appreciate your rambling. I do all the right things, too. This takes TOO LONG.  It's exhausting and wearing on my soul.  

 

In spite of my weariness, I must emphasize to you that this cannot possibly be permanent damage. Our brains are wonderfully neuroplastic and will be come stabile again as well as our bodies.

 

Somedays it doesn't feel much like things will get better,  though.

[Fresh]

Magnesium definitely helps many people with anxiety , body tension , and helping our organs function better.

 

That was a huge drop , from 30mg to 22.5mg.

 

Please could you update your signature.   Hopefully you'll start to feel better as your dose of mirtazapine goes down.

Remember that going too fast is pushing the envelope , and may not pay off in the long run.

[KarenB]

Hello Terry,

 

I don't have much to add, but wanted to let you know I'm thinking of you and will be watching to see how things go for you in the next wee while.  As Fresh says you'll want to be sure not to rush things and end up more destabilised.  

 

Do you have some soothing things you can do during this time?  Guided meditations?  Hot bath with epsom salts?  Some gentle yoga?  You deserve some good things in your life.

 

Hugs,

Karen

[Terry4949]

How do I up date my signature , can't seem to work it out ,

[AliG]

Terry . It's the same process , as when you first put in your history .   Make sure you " save changes". 

 

Please put your withdrawal history in your signature

 

Ali

[leahy]

How to add or edit your signature

1. Click on the small downward arrow next to your name in the top right corner of any page.
2. Select My Settings from the list.
3. On the left of the My Settings page, click on the Signature tab. Scroll down to edit your signature.
4. Click on the big black Save Changes button at the bottom when you are done

[Terry4949]

I have taken my last tablet last night and this evening I am due to start on liquid form of mirtazapine , I am just curious as to wether switching will make a difference , as the tablet goes straight to the stomache and then is absorbed from there , how does swallowing the liquid compare , surely it does not make it to the stomache aswell as the tablet there for it must be digested differently . Has anyone who has used liquid form from tablet experienced any changes from switching over , feeling a little nervous

[Fresh]

Yes Terry , switching to liquid is problematic for some people for exactly the reason you suggest -

it is absorbed more quickly and so metabolized differently.

It may take a while to settle with the liquid.

If you are able to get more tablets , you may want to take half your dose in liquid and half in tablets

if the change is too unsettling.

[Terry4949]

Hi fresh I see from your history that you took mirtazapine , did you use liquid form to taper , how did you come of it , I am currently on 22.5 mg and I am not going to drop any more at the moment want to get the used to the liquid , the only trouble is I am worried that I may feel worse as I don't think I could handle any more worsening of my mood , but need to change over to liquid to be able to make the recommended drops

[Fresh]

Well , if your symptoms get a bit worse , you'll know what it's from. It would be good to have tablets

on standby , just in case. But if that's not possible , you'll manage.

 

When I came off mirtazapine I'd been on it about 3 weeks. I finally made the connection that

as soon as I took the dose , my akathisia kicked up. I made myself throw up the last dose , and

that was that. However , I did start pristiq a few weeks later because I was spiralling into a

serious depression.

 

Don't make any drops until you've adjusted to the liquid. Crossing my fingers it will be a smooth

transition for you.

 

[Terry4949]

Hi fresh thanks for your reply , it's been 24 hours since I took 22.5 mg of liquid form and all ready I feel nervous and agitated a spike in anxiety and also the feeling of wanting to cry , was hoping that I wouldn't feel the difference as I was struggling before the switch without being made to feel worse , it's never ending

[SquirrellyGirl]

Hang in there, Terry.  I had trouble switching to a homemade liquid mirtazapine but still had pills left so was able to switch back to dry cutting, which fixed me up.  My symptoms were similar, with anxiety rising up.  I then did a cross taper from dry to liquid, now fully on liquid, and that went well.  I know that you are out of your pills, so give this four to seven days to settle out.  If things are just unbearable in that time, then ring up your doctor about getting a refill for your tablets.  You can then get stable on the dry again and commence a dry to liquid cross-taper once you are stable again.

 

I am hoping that hanging in there will pay off so that you don't have to go to that hassle, but we must listen to our bodies and do what is needed.

 

SG