Agony248: Mirt and What dose to reinstate?

[Agony248]

Hi guys,
Have had a lot of problems with tapering of mirtazapine. Finally got my head around fact that I need to do it slowly. But unsure as to what is a stable dose? Was on 7.5mg then went to 5.75 which did not work out. So went back to 7.5 and don't feel any better on that dose. Do I stick it out at 7.5 or perhaps go higher to 10 or 15mg. Any suggestions?

Edited July 21, 2016 by scallywag
tags added

[SquirrellyGirl]

HI Agony, 

 

Welcome to SA!  I moved your post create an Intro for you so that we can get your history and have it all in one place.  Your intro is a place for you to put all the info that pertains to your particular situation, document your journey, ask questions about your case, and the like.  By clicking "Follow" above, you will be notified when someone responds.  Bookmark this page so you can find it easily when you want to post.

 

I also moved your post from the tapering forum because there is no answer without particulars, and so we start with your Intro.

 

First we always ask people to fill out their signature block with their med history.  This should include all meds including OTC, and a brief history of AD use with dates to the best of your recollection.  Include your taper history with Mirt.  Instructions are here:  Please put your Withdrawal History in Signature

 

I am going to give you some important links to read up on, and then you can come back here with answers to the particulars and ask questions.

 

Introduction to AD Withdrawal Syndrome

About reinstating and stabilizing to reduce withdrawal symptoms

Why taper by 10% of my dosage?

Tips for tapering off Remeron (mirtazapine)

Rate symptoms daily to track patterns and progress

 

First we need to get you stable, but then you will have all the info needed to taper off successfully.

 

Meanwhile, you can surf around SA.  Check out each subforum.  At the top of each forum, you can use the search box to search within that forum.   Another really good way to work the sight is to use Google.  Enter "survivingantidepressants.org" plus a search term and you will get relevant hits.  An example:  "survivingantidepressants.org mirtazapine."  If you have general questions about symptoms, for instance, first search to see if anyone has already posted about it ie. the same as above but with "anxiety" added or "fatigue,"  If you don't get results that way, then start a topic.  If you have a question that relates very much to your particular situation, then pose the question on your thread.  All the mods are notified when people post on their thread, so it is the quickest way to get a response.

 

SA is moderated by volunteers who share your experience, so it is not a real-time solution.  Please be patient as it may take some time for a response.

 

I'm glad you found your way here!  You will find tons of support!

SG

[Agony248]

* post moved from Symptoms and merged

 

Hi all,

I have been pretty stupid when it comes to coming off this drug. I originally took about 4 weeks to come off (after 4 months on it) but felt awful. I subsequently reinstated at 2mg, which didn't work. Then went to 7.5mg. Felt stable again, so did this for a week and then went down to 5.75mg. After 5 days felt terrible again. So thought I would go back to 7.5mg. Which is what I am on now. Unfortunately still feel pretty awful. I know i went wrong and need to taper much more slowly but am really unsure where now to start, esp after I have chopped and changed so much. Should I stick with the 7.5mg or move higher to more like 9 or 10mg? Any advice greatly received. Much thanks

Edited June 7, 2016 by bubble

[bubble]

Hello Agony and welcome from me too.

 

As you can see, I merged another post you started in the Symptoms section with your main thread. Having all the info about you in one place will make it easier for us to help you.

 

Did you have a chance to go through any of the links Squirelly provided for you?

 

Were you on any other psychiatric drugs before November 2016 when you were put on Mirtazapine?

 

When we destabilize our central nervous system by tapering faster than it can adjust to functioning without a drug it takes some time for things to stabilize. Since you say that 7.5 mg gave you a relief I would try to stabilize on that dose. But stabilizing might take months during which your brain will heal in windows and waves pattern. It's very important to understand that healing is not linear and that there are no quick fixes. Similar to how a bone heals our brains need time and rest. http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-stabilization/.

 

When did you go back to 7.5 mg and what are your symptoms now?

 

It's very useful to write down your symptoms and rate them so that you can see a pattern. Since you haven't been on this drug long it shouldn't take too long to recover and taper off safely. However it will probably take more time than you initially expected.

 

Let us know how you are doing.

 

Best,

Bubble

[Agony248]

Hi Bubble,

Thanks for your welcome and good advice. Yes I did read the links. In answer to your questions. Was not on any meds prior to Nov 2015. Well have been on zopiclone for a number of years. As for mirtazapine went back on 7.5mg on sat and finally feeling a little better today.

One thing that has effected me since the beginning has been a really fuzzy head, extremely light headed. Is there anything you know that can be done for this? Also is there any rule of thumb for when people usually drop off completely?

Any help on these two points would be greatly appreciated.

Thanks Andy

[bubble]

I'm really happy to hear you are finally noticing some improvements. It's a very good sign. There wil still be ups and downs and it is very important to stay put because it is stability over time that heals.

 

Could you just put the date when you went to 7.5 mg in your signature?

 

I'm afraid I'm not aware of anything in particular to help with light headiness. People mention it a lot during withdrawal (just Google as Squirelly described and you will see you are not alone in that). It passes over time. It seems for you it was actually a side effect of the drug because you First experienced it when you started taking Mirtazapine. In that case it should also get better as you get stable on a much lower dose from the initial one and then start a slow taper. In the meantime find something that eases things for you whether it is resting as much as possible, taking things slow and easy and in general treating yourself gently in the same why you would treat your leg if it was broken. Don't make your brain jump around.

 

Luckily your history with psychiatric drugs is short but I'm a bit worried about zopiclone. Can you give more details about it? How long where you taking at, at what dose, when did you stop or if you are still taking it? This all might have impact on your current situation.

 

If you check the graphs in this thread yo will see how important it is to go slow on low doses: http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/.

 

Based on experiences of people here it is good to reduce even below 1 mg (you can Google other remeron/mirtazapine taperers). At the moment your biggest priority is to keep the dose steady and surf the waves of sympotms which are to be expected. I would recomment that you don't start tapering for at least 2 to 3 months. I know it sounds frustrating but your brain seems to be fragile and any attempts to rush the process will traumatise it further. But if you can feel well on 7.5 mg of a drug whiel you were taking 30 mg before, that's a big progress.

 

Any time frames in this process are very individual. The best thing is to listen to your body through the symptoms but also allowing enough time after the change of dose (at least 30 days) for the symptoms to play out.

 

I hope this helps and keep us posted on how you go.

[Agony248]

Hi Bubble,

Thanks again for your prompt reply and helpful advice. I have been on zopiclone at 3.75mg every night for probably 7 years. Can't really remember exactly when I started. My new doctor was very surprised when he heard how long I had been on it. As I was then put on mirtazapine, I eventually stopped taking the zopiclone in Dec 2015. However since I have had some issues in reducing/coming off the mirtazapine I have asked for some more to help with those nights I simply can't sleep.So now take some now and again.

In terms of the time frame I have calculated that if I use the 10% rule every month then I will take roughly 3 years to come off the mirtazapine. Does that seem right? I know I have to taper slowly but 3 years seems to be a little excessive. Considering that I was only on them for 5 months before I started to reduce and come off.

I know that I must be patient but with the dizziness I get it, it makes it very difficult to concentrate on anything for long. Multi tasking is very difficult. All of which makes it so hard for me to able to work again. I have been off work since Nov 2015 and I have a little money saved but that won't last long. I also need the work to feel relatively normal again, to feel useful I guess. I hope this makes sense.

I know perhaps you can't give me all answers that I need but I suppose I need to tell someone who understands and maybe there is something I haven't thought of.

Thanks for your all your patience.

[bubble]

I understand how you feel and I also wouldn't taper the drug so much longer than you were on but first things first. You need to stabilise and take it from there. The best strategy is to start slow, listen to your body carefully and you will soon be able to determine what is the most comfortable rate of tapering for you.

 

I will repeat my concern over your zopiclone use. For some reason I also neglected my benzo and focused on the antidepressant thinking little of that other drug. But after 7 years of use and stopping it I have a feeling it is playing a much bigger role in what is happening to you than you might think.

 

We have a benzo subforum here where we discuss non benzo hypnotics as well.You will see there are members tapering zopiclone as well. I would warmly recommend that you start a thread there and discuss your zopiclone situation with our expert.

 

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

 

I also understand your situation regarding work very well. I'm repaying a mortgage and can't save anything and if I can't work I'm losing it all. It's so nice you were able to fall back on your savings and I believe you will soon be able to return back to work. Hope it is not a too stressful environment and you can take it slow.

[Agony248]

Once again thanks for all your advice Bubble.

I had not thought about the zopiclone effect, esp after I have been off it for the last4-5 months. Only recently returning to it due to trouble coming off the mirtazapine. But as per your advice have posed a question in the benzo's forum. Let's see if anyone has anything to say.

Reading a lot of the comments the levels at which others were taking seem to be much higher than me but let's see.

I have been writing down all my mirtazapine amounts and mood levels every day, as suggested too.

I really hope I can get back to some normality some time soon. The whole thing is driving me crazy.

How are things with you?

[SquirrellyGirl]

How are you traveling, Agony?  I hope things are getting better!

 

SG

[Agony248]

Hi SquirellyGirl,

Am feeling a little better than I was.Thanks for asking. Now been some what stable at 7.5mg for about 15 days now. Which in some ways is ok but am still worried about when to drop and by how much?? I am hoping that if I can stay stable for a longer period, than I have been, then, if the next drop is not successful, it won't take me as long to get stable again.

I am trying to think about going back to work, having not worked since November 2015. But am still only operating at 40-50 % at best. So perhaps looking at voluntary to begin with. To get a feel for things and getting used to being around people again. But its all quite scary really.

Agony

[SquirrellyGirl]

Hi Agony, 

 

That is good to hear, that you are feeling better.  There is no rush to get tapering again; be as stable as you need to be to feel ready.  And when you begin again, you can do it as small as you like, too.  I have found 5% cuts every two weeks to be uneventful, and that's what you want.

 

I think volunteering is a wonderful way to reintroduce yourself to work in as low-stress a way as possible, build confidence and all.  Very good to listen to your needs :-)

 

SG

[Agony248]

Swapping Lyrica capsules to liquid?

 

Hi

I am having real difficulty coming off pregabalin. Am down to 50mg a day but can’t get any further.

I have tried making a solution but still get massive withdrawal. Now I am trying liquid lyrica. But my system doesn’t seem to detect it. So again gone into massive withdrawal.

Has anyone else switched from capsules to liquid and had any difficulty??

Also was thinking perhaps combining the two. Capsule and liquid. Capsule in morning and liquid at night.Thereby easing the liquid in. Again has anyone tried this??? 
Really clutching at straws as nothing seems to work

Thanks

Edited December 18, 2022 by Shep
added title after merging from another topic

[Shep]

@Agony248Please note I moved your latest post from the tapering forum to here in your intro / update thread. Please continuing posting here so all your information is in one place.

 

Here is tapering information on Lyrica:

 

Tips for tapering off pregabalin (Lyrica)

 

And information on combining tablets and liquid:

 

Combining tablets or capsules with liquid to taper

 

How are you making your solution? 

 

Since you haven't been on the forum for more than 6 years, please let us know what drug changes you've had. Are you still taking mirtazapine and zopiclone in addition to Lyrica? 

 

Please update your signature so we have your full history. 

 

How to Summarize Your Drug History in Your Signature