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Survivor1: Sleeping after trazodone (and benzo)

trazodone clonazepam Klonopin

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#73 Survivor1

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Posted 11 November 2016 - 11:44 AM

SW,

 

Thanks so much for your support.  I will continue to hold and hope for the best!  I have used your clearer version of my situation in my signature.  Will keep you updated.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#74 Survivor1

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Posted 14 November 2016 - 03:34 PM

Hello,

 

With a heavy heart, I have decided to add another med to my list - mirtazepine.  I had reached a crisis point, sleep deteriorated to zero two nights ago, and I was almost psychotic, with thoughts of self-harm. Depr was heavy - I lost 4 lbs last week and overnight my hair started coming out in clumps.  Got an appt with doc, and was told if I don't get sleep relief that night, I may need to go to the emergency room.

 

We discussed options: updose (told her it did not work for long the last two times), seroquel since I had been on it before (told her I may need to be on it for a few years to taper trazodone, and she was not keen on that), mirtazepine.  We decided on the last.  Last night I took 3.75mg and got about 3-4 hrs.  Today I feel better, if very groggy.  Mood is also better although I am keenly aware that this drug could peter out too, and that in itself gives me a lot of anxiety.  But I needed a short term fix ...

 

I know that this forum is about getting off drugs, but please understand why I did this. I needed to get sleep and quickly. Don't know it I made a good/bad decision ...


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#75 scallywag

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Posted 14 November 2016 - 05:14 PM

Survivor, thanks for letting us know. Every person needs to make the decision that is best for his own life. You know your life and your body far better than we do.

 

I hope this addition of mirtazapine brings you relief from insomnia. 


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#76 Survivor1

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Posted 14 November 2016 - 06:28 PM

SW, thank you.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#77 Survivor1

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Posted 24 November 2016 - 02:34 PM

Happy Thanksgiving to all...

 

Update:  Since my addition of Mirt. (dosage was 2.5 mg instead of 3.75 - preset syringe was set to 1/3 instead 1/2, serendipitously), I began to feel better.  The one downside was that even at 2.5 I was VERY sedated during the day, could barely keep my eyes open.  Four days later, I decided to reduce it to 1.5 to counter the extreme sedation, since I was on Mirt for "only" a short while.  I have been at this dose for the last 6 days, and things seem to be going well.  Now, you guessed it, earlier today I began to feel wd symptoms, the most severe being feeling very shaky and rapid heart rate.

 

My question is should I updose (to 2.5? or less?) to reduce the symptoms that are forthcoming, or tough it out at 1.5 and hope to stabilize soon?

 

Thanks.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#78 scallywag

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Posted 24 November 2016 - 08:52 PM

Hi Survivor -- The drop from 2.5 mg to 1.5 mg 6 days ago was a big jump -- 40%.  You tried it in good conscience and got mixed to negative results.
 
Sedation is both a known start-up effect anti-depressants and a known side adverse effect of mirtazapine (Remeron). It's possible that it would have resolved with time at 2.5 mg.

 

If you can stay where you are for a 3-4 days while you record and post your symptoms, please do that.

Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:
Take notes of doses and symptoms
 


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#79 Survivor1

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Posted 25 November 2016 - 08:33 AM

Thanks SW. I will hold at 1.5 mg.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#80 Survivor1

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Posted 30 November 2016 - 11:15 AM

So, on 11/27, I decided to updose to 2 mg since I was getting worse, sleep being the first casualty of course.  Today, three days later, I feel no better.  I know I should give it a few more days but it is so disheartening that due to my idiocy, I am in this soup.  If I don't feel better in a few days, I will updose to the full 2.5 and see where it goes.

 

Another thought:  I am thinking the reason for my poor sleep/other sxs prior to starting remeron was possibly the cold turkeys from seroquel.  (It's hard to imagine that the sxs were from the rapid taper of trazodone in the summer because of the severity.)  It's been a while since the ct, but do you think I should reinstate seroquel, maybe 1 mg, to give the remeron and trazodone a fighting chance?  Just a thought.   I know, this would mean I'm on three drugs, but I just wanted to see what others think.

 

Appreciate the help as always.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#81 Survivor1

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Posted 01 December 2016 - 06:09 PM

Any takers on the seroquel question above?


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#82 scallywag

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Posted 01 December 2016 - 06:34 PM

Would you take a moment to clarify what medications, if any, you currently take and their doses?


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#83 Survivor1

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Posted 02 December 2016 - 06:31 AM

They are in the signature:  62.5mg Traz, and 2.0mg Mirt.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#84 Altostrata

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Posted 02 December 2016 - 05:45 PM

You are taking several drugs that may be competing. Please put ALL the drugs you take in the Drug Interactions Checker http://www.drugs.com...teractions.html
and copy and paste the results in this topic.
 
Also look at the interactions if you add Seroquel.
 

Got an appt with doc, and was told if I don't get sleep relief that night, I may need to go to the emergency room.

 
This is a very odd thing for a doctor to say. You are the only person who can decide if your sleeplessness justifies going to the emergency room.
 
There is no point at which sleeplessness requires emergency care (generally a hefty benzo dosage). We have many people here who have gone on for many weeks with no or little sleep because of psychiatric drug withdrawal. It can be done without resorting to the emergency room or taking additional drugs.
 
It seems you are looking for just the right drug cocktail. We can't help you with formulating that. Even under the best circumstances, psychiatric drug treatment is trial and error.
 
If your nervous system has been sensitized by going on and off drugs, what might be best for you is to minimize drug experiments and keep very steady with the drugs you're taking. Take them on a very consistent schedule.
 
What other symptoms do you have, other than sleeplessness? Keep daily notes on paper about your symptoms, your drugs, their dosages, and when you take them.
 
Please read this for non-drug ways to cope with sleep problems Important topics about symptoms, including sleep problems

 

Also read http://survivinganti...hannel-blocker/You're not taking very much magnesium. Magnesium citrate or glycinate is best.
 


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#85 Survivor1

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Posted 02 December 2016 - 07:39 PM

Altostrata,  thanks for the advice.  I have printed the interactions below.  I do not have any of the symptoms of serotonin syndrome. The doctor did not think that the traz/mirt issue was severe as the doses are relatively low; I had also mentioned to her that I was looking for something longer term while I taper the trazodone (since it seems to not work as well anymore), and she did not seem keen for me to take seroquel long term, hence the mirtazepine.   At the time of seeing her, I also had severe depression and anxiety, in addition to acute insomnia.

 

I agree with emergency room and benzo use; sometimes sleeplessness leads to making decisions that are regrettable, and I'm glad that I averted that.

 

My symptoms right now are insomnia, but better than before taking Mirtazepine (at least 3 hours), shakiness, faint anxiety, alerting sensations at night, and body jerks.  It seems odd that the last four have not improved from my updose of mirt to 2.0 from 1.5, but maybe I need more time.  This lack of improvement is what led me to theorize that it is probably wd from seroquel use.

 

I will increase the dosage of Mg.

 

Thank you again.

 

‚Äč

Interactions between your selected drugs

Major trazodone  mirtazapine

Applies to: trazodone, mirtazapine

Using traZODone together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate trazodone  quetiapine

Applies to: trazodone, quetiapine

Using traZODone together with QUEtiapine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate mirtazapine  quetiapine

Applies to: mirtazapine, quetiapine

Consumer information for this interaction is not currently available.

GENERALLY AVOID: There is some concern that quetiapine may have additive cardiovascular effects in combination with other drugs that are known to prolong the QT interval of the electrocardiogram. In clinical trials, quetiapine was not associated with a persistent increase in QT intervals, and there was no statistically significant difference between quetiapine and placebo in the proportions of patients experiencing potentially important changes in ECG parameters including QT, QTc, and PR intervals. However, QT prolongation and torsade de pointes have been reported during postmarketing use in cases of quetiapine overdose and in patients with risk factors such as underlying illness or concomitant use of drugs known to cause electrolyte imbalance or increase QT interval. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). The extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s). In addition, certain agents with anticholinergic properties (e.g., sedating antihistamines; antispasmodics; neuroleptics; phenothiazines; skeletal muscle relaxants; tricyclic antidepressants) may have additive parasympatholytic and central nervous system-depressant effects when used in combination with quetiapine. Excessive parasympatholytic effects may include paralytic ileus, hyperthermia, mydriasis, blurred vision, tachycardia, urinary retention, psychosis, and seizures.

MANAGEMENT: Coadministration of quetiapine with other drugs that can prolong the QT interval should generally be avoided. Caution and clinical monitoring are recommended if concomitant use is required. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. In addition, if combination therapy with agents with anticholinergic properties is required, caution is advised, particularly in the elderly and those with underlying organic brain disease. Patients should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and/or hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A reduction in anticholinergic dosages may be necessary if excessive adverse effects develop.


Edited by ChessieCat, 02 December 2016 - 09:15 PM.
enlarged miniature font

Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#86 Survivor1

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Posted 03 December 2016 - 06:01 PM

Altostrata,

 

I don't want to beat this to death, but please understand I am not looking to add willy-nilly to the drugs I take.  I only suggested adding 1 mg seroquel because throughout this forum I read that it is preferable to reinstate at a low dose rather than tough it out.  I had actually suspected the seroquel connection before (see my Oct 15 post), but was advised to keep holding trazodone steady, as the source of my wd was nebulous. I held until Nov 14 when I added mirtazepine, since some symptoms such as insomnia,depression and anxiety had become too much to bear.

 

Since you think it is best to let it be, I will certainly follow you advice.  I must say that I feel better, even though still "off", after starting the mirtazepine, so perhaps it is helping to mask some of the seroquel wd.  My only worry is that I could take a long time to recover from seroquel ct hat I will be delaying further any tapering efforts.

 

Thanks for your help!


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#87 Survivor1

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Posted 08 December 2016 - 08:48 AM

Please help!

 

Since starting mirtazepine on 11/14, I had noticed an increase in body jerks and loud rapid heart rate.  I thought it was a wave from trazodone/seroquel ct.  After I dropped the dosage to 1.5 these had decreased, but other symptoms (anxiety, shakiness) increased.  I have updosed back to 2.5 (12/4) in the hopes of eliminating what I thought were wd from dropping to much.  But now the jerks and rapid heart rate - along with some sweating and shakiness - are back.  Serotonin syndrome?  If so, what to do? I read that the only solution is to eliminate the offending drug, but I cannot do this very fast without risking wd.  

 

To complicate matters, I reinstated 2 mg seroquel (Dec 6).  Since I had severe anx and depr before starting mirtazepine, I assumed the jerks and rapid heart rate were part of the same wd from seroquel and that this reinstatement would reduce any residual wd symptoms from the ct'ing.

 

Throughout all, my sleep had gone to bits.

 

I am really worried about possible serotonin syndrome.  I am not sure about seeing my doctor as she would likely advise me to taper over a few weeks.

 

Any advice is much appreciated!.  


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#88 Survivor1

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Posted 08 December 2016 - 10:20 AM

Was able to get a phone consult with my dr.  Advice was to start reducing Mirtazepine immediately (all at once), but I asked about tapering and then she suggested 0.5 mg very two weeks, and bump up Seroquel for sleep. Seemed surprised that I would have serotonin syndrome at the drug levels I'm on, but thinks the myoclonus, rapid heart rate, and sweating point to it.

 

Since I have been on it for less than a month, how fast can I go?  

 

Thank you for listening.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#89 Survivor1

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Posted 08 December 2016 - 12:01 PM

Hello,

 

I know this is a busy website, with many people suffering, but I'm at my wits' end.  Please help!  

 

I seem to be having an adverse reaction to mirtazepine and need to get off ASAP as safely as I can.  Can you please offer some advice.  I have been on it for less than a month (26 days).

 

Thanks.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#90 scallywag

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Posted 08 December 2016 - 01:54 PM

Decreasing the mirtazapine, started on Nov. 14, makes sense given that you had new symptoms occur after starting it. Your sig shows that you are currently taking 2.5 mg.  Have you started the 0.5 mg reduction your doctor suggested?


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#91 Survivor1

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Posted 08 December 2016 - 02:09 PM

SW,  I only spoke to the dr today.  So tonight I am looking to do my first decrease.  What do you think of the tapering schedule since I've been on it for a short time.  Can I, or should I, go faster?


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#92 Survivor1

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Posted 08 December 2016 - 02:50 PM

Since it's a rapid taper anyway, would it be recommended to stop cold turkey.  That way I am not taking it for longer than month and hopefully shorten the agony.  Just a thought.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#93 scallywag

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Posted 08 December 2016 - 02:56 PM

I would try the doctor's schedule, but use your symptoms as a guide.  If your symptoms decrease with time, keep doing what you're doing; if they increase, slow down either by smaller decreases or longer holds.

 

You started the mirtazapine to deal with insomnia. At some point you may need to find a way to live with the awfulness of having insomnia unmedicated. 


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#94 Survivor1

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Posted 08 December 2016 - 06:39 PM

Tomorrow I have an appt with the dr.  I will discuss more with her and come up with a plan.  I am completely traumatized with the trazodone rapid taper and the seroquel ct.  I don't know if I have it in me to go through another wd so soon, but I may not have a choice.

 

According to my research, serotonin syndrome should be dealt with immediately, so even though proper tapering is best for reduction of wd, I may not be able to do it with the timeline she suggests.  Thanks, and will update with more info.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#95 JanCarol

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Posted 09 December 2016 - 12:55 AM

Hey Survivor, let us know what your doctor says.

 

I just read your thread and here is the pattern I see:

 

You intend to stay on a stable dose, but when the Insomnia rears its ugly head, in desperation you make changes.

 

Since you've signed on, you have:

CT'd Seroquel after taking it irregularly (destabilising)

Fast tapered trazadone

Updosed trazadone 3 times

tried various herbs and supplements at different times

added back low dose seroquel

added mirtazapine

 

You have made frequent changes, trying this and that.  

 

Is it any wonder your nervous system is in an uproar? I understand - these were desperate moves - but this pattern has got to stop, and only you can stop it.

 

Scally has said several times, that you will need to learn to sleep unmedicated, but then you get Insomnia Panic and run to remedy it.  I understand, this is natural, given how we are taught that medicines help us, and are not told of the long term risks at all.

 

Scally last advised you to follow your doctors orders in tapering mirtazapine.  She also advised you to listen to your symptoms and slow down if your symptoms got bad.  You are claiming that your symptoms are bad - if it were me, I would hold.  Make no changes for at least a month.  See if you can get your system to settle down.

 

You have not held at any dose of any drug without interference since coming here.  That is exactly what I would advise you to do.

 

If you are worried about serotonin syndrome, then taper off the mirtazapine and stop.  Wait.  For a year.  Don't change a thing.  Don't take over the counter supplements or herbs to try and sedate yourself.

 

My first question to you is this:  why do you have hypothyroidism?  Do you have an autoimmune disorder (like Hashimoto's?)  Please see:  http://survivinganti...oid-hashimotos/  

 

There are a number of things you can do to improve your thyroid that will improve your general health.  Buy spring water that has not been fluoridated, or filter your water (it's hard to find filters for fluoride, but they do exist.  If you use reverse-osmosis, be sure and remineralize the water).  Make sure you get selenium, a thyroid co-factor.  Learn about why you are hypothyroid, and improve your lifestyle to address it.  There are excellent guidelines here:  http://hypothyroidmom.com/ and http://www.stopthethyroidmadness.com

 

You may find that, while your thyroid is "optimised" according to an MD - there are still things you can do that will improve your general health.

 

As for your drugs - perhaps now you have a little understanding as to why we kept cautioning you against adding drugs to sleep.  There is a thing called kindling, which is very similar to "tolerance" and a drug ceases to work.  Sometimes this happens after just a few days.  What worked for you in the past will likely never work again.  Limbic Kindling - Hardwiring the Brain for Hypersensitivity

 

You need to be thinking about the long term.  Not tonight, not tomorrow night, not even a week of nights.  You need to be thinking about a year of careful, stable planning, and not bouncing your nervous system with lots of drug changes.  The changes can be as bad as the drugs themselves!

 

If you need to get off the mirtazapine quickly, then do so - but be prepared for the roller coaster ride to follow, and be prepared that there are no pills or drugs or herbs or supplements you can take.  Time is the only real solution for the pickle you are in.  Time and stability.

 

(side note:  the lower the dose of mirtazapine, the more sedating it is.  It is unlikely to be hitting serotonin receptors at the low dose you are on.  The lower doses of mirtazapine hit mostly histamine receptors. So maybe what you are experiencing is limbic kindling, not "serotonin syndrome" at all.)

 

Then, plan on staying on your same drugs - no change in dose - no "extras" no "emergency changes" - for a long, long time.  At least 3 months.  Again - no pills, no drugs, no herbs, no supplements, just ride it out like the bad trip that it is.  Your body will, at some point, learn to sleep without pills.  You may need to take some time off work, if at all possible, to help ease the stress of the worst of the insomnia.

 

And then, when you are stable (3 months to a year) consider tapering the drugs you are still taking.

 

Please let us know what the doctor said.


"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.

 

Currently Lithium Orotate 1.67 mg only.  I will re-evaluate this supplement in 2017.

 

I have been psych drug FREE since 1 Feb 2016!


#96 JanCarol

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Posted 09 December 2016 - 06:10 AM

Also - Survivor - have you had a Sleep Study done?

 

Thyroid is associated with loose collagen, "floppy" connective tissue, problems with joints, etc.  I would suspect that this could also result in some sleep apnea.

 

Sleep apnea might explain why, even when you are sedated, you continue to wake up.  It would explain daytime tiredness, "zombie" feelings, inattention while driving, inability to concentrate, etc.

 

Sleep apnea is very serious.  My husband had a stroke while sleeping.  There are many members here who have gotten help for their sleep apnea, and CPAP or biPap therapy has given them their lives back.  

 

What if it's not the drugs at all?  I hope I got this to you in time to mention to your doctor.


"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.

 

Currently Lithium Orotate 1.67 mg only.  I will re-evaluate this supplement in 2017.

 

I have been psych drug FREE since 1 Feb 2016!


#97 Survivor1

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Posted 09 December 2016 - 01:08 PM

JanCarol,

 

Thanks for the very in-depth response.

 

Regarding my thyroid, I have hashimotos and am familiar with the two websites you provided.  I do go occasionally to get updates on thyroid issues.  At the time my levels got to  within "normal" ranges, I was on klonopin, which I have stopped.  So I'm assuming thyroid-wise I am OK.  My multivitamin has a selenium component.

 

Regarding sleep apnea, I did have a sleep study done while I was on klonopin and it was ruled out.  I have some personal experience with it also as my husband has it and uses a CPAP mask.  I can surely say I do not have it.

 

Now for the biggie -  my drug rollercoaster:

I met with my doctor, and she was puzzled about serotonin syndrome because the mirtazepine level is low as you mentioned.  Her advice is to get off it as best I can tolerate.  Last night, after my phone consult, I reduced to 2mg with seroquel upped to 10 mg.  She had mentioned that the standard treatment for ss is to cold turkey the offending drug and add a benzo as sleep.  So instead of the benzo, I upped the Seroquel, in preparation for the fast taper.   I will try to hold here the best I can, with the only changes being on mirtazepine.  I must mention that one of the reasons I was trying many drugs to maintain sleep was to hold my job, and am not sure about taking time off.  I am relatively new at it.

 

I get your point about limbic kindling, and it scares me.  Also, I am caught between holding mirtazepine and tapering it.  Apparently there is no test for ss so it is diagnosed based on symptoms, and there is a spectrum of symptoms of which mine are on the mild side, if ss is what I have.  If I hold, will I worsen the condition; if I taper, can I still hold my job.  One thing is for sure: if I fast taper mirtazepine, I will have to up the seroquel, because based on my experience with the trazodone taper, I could not function with days and days of 0 sleep.  I have to make this decision and soon, as you advised I should not be changing doses.

 

Based on the cut last night, I am already having episodes of sky high anxiety.  I can't imagine what it will be like if I have to rapid taper over a few months.  I will try to make as few changes as possible (mirtazepine being the only one, if any).  And I do get the holding thing, really I do.

 

I can't tell you how much I appreciate the effort you put into the replies above. I truly appreciate it and the work of the other moderators.  You all do provide that shoulder to lean on when it's needed most.

 

I will update any new developments.

 

Thanks again.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#98 Survivor1

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Posted 09 December 2016 - 02:59 PM

JC, I was very remiss in not enquiring about your husband and his stroke.  Is he OK?  A close acquaintance of mine had a stroke and is partially paralyzed, so I hope your husband is doing fine.

 

One question:  I see the advice about learning to sleep unmedicated so don't take any more drugs.  But is it possible to eventually sleep better while on the drugs.  So, if trazodone does not work for me now, will a long hold make me sleep better even if I have reached tolerance and am still on it?  This is the concept I couldn't wrap my head around, and so I thought that if the current meds do not work, I will have to either updose or add another.  Please clarify.

 

Much thanks.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#99 Survivor1

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Posted 12 December 2016 - 09:27 AM

Hello,

 

To update, I had a consult with a psychiatrist and he does not think that I have ss at the current doses of meds.  (The recommendation is to see a neurologist to determine the cause of the twitching, etc.)

 

My current symptoms are my heart rate is rapid and loud and I have myoclonus especially at night, and some small twitches also (night and day), these three can directly be traced back to starting mirtazepine.  There is some anxiety, and of course broken sleep - around 3-4 hrs per night.  I am thinking that I have kindled. 

 

I know that my system needs some stability.  And this brings me back to the question I had in my last post:  can these symptoms improve after a long hold even though I am still on the drugs.  Or does one need to be off the drugs to see improvement? I would really appreciate a response to this question.

 

Thanks.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#100 AliG

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Posted 12 December 2016 - 09:32 AM

Survivor. Yes, these symptoms can improve over time with a long hold and then slow tapering.


Many SSRI's &SSNRI's over 20 years . Zoloft - 7 years .  Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and many more - on and off . No tapering. Cold turkey -  Valdoxan - end of May 2014

 

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#101 Survivor1

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Posted 12 December 2016 - 09:34 AM

Thank you AliG for the fast response. 


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#102 Survivor1

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Posted 31 December 2016 - 12:33 PM

Update ...

 

Unfortunately not a good one.  I decided to go back to 2.5 mg Mirt as the wd from the attempted rapid taper was terrible. Some of those symptoms are now gone (myoclonus/twitching, esp).  I also upped seroquel from 2 to 5 mg (not 10 as in post above), to aid in sedation as I thought I would need it due to the rapid taper of mirt.

 

Now I have massive anxiety and rapid heart rate continues, along with insomnia, of course, and shakiness . I have a few episodes of feeling better so I hope these are windows and are not just random.  I plan to hold for a while.

 

Question: if one is having an adverse reaction to a drug ( like I seem to be with mirt), will there be an improvement even if one holds for a while, or does the offending drug have to be discontinued for the adverse reactions to disappear.  With all my drug changes it seems logical that I need to hold, but I've also seen on this forum that adverse reactions may warrant a discontinuation of the drug.

 

I am so mad at myself for adding mirtazepine, when all I needed to do was perhaps reinstate seroquel.  But I must move on...

 

Thanks everyone.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#103 scallywag

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Posted 31 December 2016 - 01:09 PM

Your mirtazapine increase wasn't huge. Hindsight can sometimes be helpful and other times it a pain in the rear end. Hopefully we learn something from actions taken when we had incomplete information or were in a fog.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14; 3.5 mg (32) Apr. 26;
Current dose: 2.6 mg (24) 2017-May-17
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#104 Sarahbobear

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Posted 31 December 2016 - 03:35 PM

Hi Survivor,

I searched to see if anyone was dealing with trazodone for sleep. My psychiatrist said that I should start at 50 mg at bedtime to see if I sleep and then take another 50 if that didn't work and then I could try another 50 mg throught out the night. This worked part of the time. My gp suggested I take 150mg of trazodone at once to initiate sleep which worked better, but it then I started noticing it not working. It seems I gain tolerance pretty fast. I notice now if I don't take it an use remeron instead my dizzy and other neurological symptoms are a lot less. So I am going off trazodone.

 

I have been on remeron for about 7 years for sleep at most 15-30 mg, which I felt saved me as my insomnia was severe. I am surprised that you can experience w/d symbptoms from such a low dose of mirtazipine. Throughout the 7 years I would bite off what seems to be a third of a pill of 30 mg and I sure the dose was quite variable for those 7 years. It finally lost it's effectiveness, in which I tapered off and experienced what seems like intense withdrawal symptoms. I went back on remeron right away but the withdrawal symptoms haven't cleared. 

 

It's just interesting how my psychiatrst thought that playing around in incremental dosages of 50 mg of trazodone was ok. Also with my experience of mirtazipine I wouldn't think that 2.5 would cause much symptoms. 7.5mg was great for sleeping when I first took it. It was a life saver at the time. It was all I needed. I was able to go off it a few times, but not for too long. And 7 years later, I noticed it lost it's effectiveness so I went off it, causing me to sleep on average 2 hours per night for about 6 months, but I still occassionally used it, which is why maybe I have my current problem.

 

How are you now?



#105 Survivor1

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Posted 31 December 2016 - 05:26 PM

Definitely insomnia fog had something to do with it.  Now feeling very shaky/fragile, with diarrhea - don't know if the latter is wd (unusual for me, but who knows) or the fish I ate earlier.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#106 Survivor1

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Posted 31 December 2016 - 06:18 PM

Hi Sarahbobear,

 

For me trazodone worked quite well, until I messed with it in a rapid taper.  I think one of the reasons that it may not be working as well for you is that you seem to be in remeron withdrawal, and wd could reduce the efficacy of other sleep meds.  This I am finding out for myself only now.  I was in seroquel wd and so trazodone stopped working as well, so I stupidly added mirtazepine (thankfully a lower dose).  After playing around with doses, I am now wd'ing from remeron also. ugh!

 

If you really need to be on trazodone, then take a consistent dose every night, and not on an as-needed basis.  If you are off remeron, then stick with the traz for a while until the wd from remeron is lessened.  For me, traz took a while to be effective, maybe about three weeks. I don't think you should be on more than 150 mg for sleep; many people do well on 100 or less.  When I reinstated, I was able to sleep well on 50 (the good ol'days) until seroquel wd kicked in.  If you are taking it with remeron, be aware of an interaction between them!

 

I used to see a neurologist when I was going off klonopin, as I had major neuro issues during the taper and later found out they were from klonopin wd.  He is also a sleep specialist, and mentioned to me that remeron can stop working. So I am not surprised to hear you say this too.

 

I really feel for you.  Insomnia is what has gotten me in this mess along with major ignorance re tapering.  My system is very desensitized so even small drops of meds cause wd.  I am hoping to stabilize, and am going on 3-4 hours sleep.  I can't imagine how you coped for 6 months on 2 hours!  I hope it doesn't get worse.

 

Of course I would say the best thing is to not use any sleep meds; however, if you need something for insomnia, then trazodone could work once the wd from remeron is under control.  Don't go on and off or up and down.  Pick a dose, stick with it, and SLOWLY titrate down later.  Unfortunately, this could mean a few more nights of insomnia.

 

Wish you the best!


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5


#107 Sarahbobear

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Posted 31 December 2016 - 09:00 PM

Thank-you Survivor for the very helpful information. I really feel for you too! I think it's good for people like ourselves to feel good about that 3 or 4 hours of sleep when it happens... and that we do still possess the ability to sleep, drugs or no drugs.

 

I wish you great gains in your recovery and a Happy New Year.



#108 Survivor1

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Posted 02 January 2017 - 04:01 PM

 In addition to the heart thumping and anxiety, I have a recurrence of the body jerks and some sweating while sleeping.  And sleep is very broken.  Could this still be withdrawal or have the meds gone paradoxical? It's been almost two weeks since the last dosage change.

 

By the way, did any remeron user suffer severe constipation.  I am only at 2.5 and regularity has gone out the window.


Klonopin: June 2014 - Sept 2015; 1mg tapered over 6 mths, withdrawal hellish

Naturethroid: 65 mcg

Seroquel:  June 14 - July 24, 25 mg alternate nights; July 25-30, 12mg most nights; Sept 1-12, no more than 10 mg for 7 nights. D/C Sept 12.  Severe wd., Dec 7  reinstate 2 mg, Dec 15 updosed to 5mg (not 10 mg as in post dated 12/12)

Trazodone: Oct 2015 - June 2016; 75 mg tapered over 2 mths, intense w/d Sx after 3 weeks. Reinstatement: 07/25/16 25 mg; 08/03/16 50mg;  10/01/16 62mg. 03/24/17 Began taper due to serotonin toxicity: 52mg

Mirtazepine: Nov 14 -17,2016 2.5mg; Nov 18-26 1.5mg to fight sedation; Nov 27-Dec 3  2.0 mg, Dec 4 updosed to 2.5, Dec 12 down to 2 mg again because of suspected serotonin syndrome (false alarm), upped again to 2.4 mg Dec 19 since withdrawal was fiercer than ever. Revised: 03/24/17 Serotonin toxicity NOT false alarm after all!  

Supplements: Fish oil and multivitamin

 

Synopsis:   Psych meds as of 12/19/2016 - Seroquel 5mg; Mirtazepine 2.4mg, Trazodone 62.5mg

03/24/17:  Began tapering traz - 52mg;  intense wd sxs by week 5






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