Rosalind: 6 weeks off Remeron

[Rosalind]

Hello Everyone,

 

I suppose I came across this site the same way many do...while researching my withdrawal symptoms after quitting Remeron. I have read many topics and have felt both comforted and somewhat frightened at what I have learned.

 

I took my last dose of Remeron after Christmas 2012. I was on 15 Mg for 6 years. My guess is that I tapered too fast. I cut down to 7.5 for one month, then alternated 7.5 and 3.75 for one month,

3.75 for one month, then 3.75 on alternate days for one month. All in all four months. The problem is that, here in Asia, only Soltabs are available and they are very difficult to split.

 

I did not do the taper with the the help of my Dr. I think by now, you all know why. She is of the opinion that there is no such thing as a withdrawal from AD meds.

 

I have experienced all of the symptoms, except for dizziness. Of course, the insomnia is the worst. Little or no sleep just intensifies all the other symptoms. I have had better days but they are few and far between. I know that we are all different and there is no timeline with withdrawal symptoms but I am honestly at my wits end. It's only six weeks but it has felt like an eternity.

Well meaning friends have advised that I go back to the last dose and go from there but I am not sure how I could taper lower with a Soltab. On my better days, I tell myself that I need to stay away from these meds for good...and I have come this far. I have not even resorted to taking an Ambien for sleep. Instead, I have Calms Forte and they do help me sleep some nights, if only for a few hours. I am also taking Omega 3 and Magnesium.

 

Any advice would be much appreciated!

 

Thanks so much!

 

Remeron - 6 years 15mg

Tapered 4 months

Last dose Dec 27. 2012

Edited February 10, 2013 by Karma
Added member name to introduction

[peggy]

Welcome Rosalind!

 

What kind of symptoms are you experiencing besides the insomnia? As you are aware you are in withdrawal and it is not possible to predict the course of any individual withdrawal. At 6 weeks or so from your last dose there is no guarantee if reinstatement would help, but i think i would probably try. You may be able to get some stability from 3.75mg. Certainly fish oils will help support your withdrawal, and many people find some benefit from magnesium for anxiety.

 

here is a thread that talks about reducing from remeron:

remron tapering

 

also instructions on weighing tablet pieces or making a liquid from crushed tablets here:

tapering techniques

[dalsaan]

Hi Rosalind

 

I am coming off remeron too and have been where you are

 

In my experience you can't wait this stuff out, you have to reinstate the medication and taper more slowly. We recommend a taper of 10 percent every four weeks or so.

 

You should be able to do this by dissolving your tablet and then measuring out your dose with a syringe (if it dissolves completely).

 

There are instructions on tapering in the tapering section. I am writing this on my phone so can't provide you with a link to this info -sorry

 

From here you might try reinstating a small dose (a couple if ml) to see if it helps your withdrawal symptoms

 

I wish you all the best

 

Dalsaan

[tezza]

Hi,

 

I'm tapering Remeron too and fully agree with Dalsaan, you need to reinstate a small amount. The link below is the one Dalsaan was referring to.

 

I cannot get liquid remeron and have been crushing my tablet and mixing with water. Mine is in tablet form and makes a suspension instead of a solution. Possibly your Soltabs will dissolve better but if any settles in the bottom, simply shake it and withdraw what you need while the particles are suspended.

 

You don't need to wait longer because that will reduce your chances of reinstatement helping. Please seriously consider our suggestions. I would mix with 15ml of water and each ml will equal 1mg. As Dalsaan suggested, 2ml of that solution may be enough to get you stabilized.

 

It may take a month or so to become stable enough to begin to taper. It will be worth it in the end. You are at risk of developing 'Protracted Withdrawal Syndrome' if you try to wait this out.

 

Tezza

 

 

 

http://survivingantidepressants.org/index.php?/topic/2028-how-do-i-taper-off-mirtazapine/

[Rosalind]

Hello Peggy and Dalsaan,

 

Thank you so much for your considerate replies to my post!

 

Peggy, my symptoms at first were agitation, confusion, fatigue, nausea, loss of appetite, pronounced anxiety, insomnia. All of these symptoms showed up within 7 days of my last dose. Along with those symptoms, the persistent negative thoughts, the feeling of dread and being fearful ...fight of flight overdrive! The simple everyday business of life has become a massive chore. At one pont, I couldn't even remember my own mobile number. The nausea has subsided but all the other symptoms have stayed with me. Also, I have been in menopause for over a year and I have had 3 periods in 3 weeks! As I said, there have been a few days of 'windows' over the last few weeks. On those days, I have felt almost back to 'normal' but extremely tired. Then bam, the next few days are tough and you can hardly get out of bed.

 

In November of 2011, I went on holiday and forgot to pack my meds. I was a little worried at first but did not experience any symptoms that week and so did not resume taking them when I got home. It took a full 6 weeks for me to experience any withdrawal symptoms. The only symptom then was the awful insomnia. I had a lot on my plate at that time, so,I just started

 

It is quite paradoxical that I took this medication for so long without questioning the long term side effects of an anti-depressant. Now, I am in a quandary as to whether or not I should re-instate at 3.75mg! I know you both know that confusion is part of the problem. I am also suffering from an acute sense of humor failure.!! Still, I know there is no point looking back as it is counter productive. I have learned so much in the last few weeks.

 

Dalsaan, I am curious to know if you are experiencing any withdrawal symptoms during your taper?

 

I suppose I am wondering if, despite a slower taper, there will still be hell to pay at the end of the road?

 

My heartfeltt thanks to everyone out there....much appreciated!

[Karma]

Hi Rosalind

 

Most of us who manage a slow taper do not experience bad withdrawals. As we slowly taper off there can be slight disruption in how we feel, but in general the reason we do a slow taper is to avoid withdrawal symptoms.

 

One example on the forum is Shanti http://survivingantidepressants.org/index.php?/topic/1306-shanti-tapering-off-paxil/page__p__11824__hl__shanti__fromsearch__1#entry11824. Shanti switched from Paxil to Prozac and tapered off of Prozac slowly. She did not experience problems after she slowly tapered off Prozac. I am not suggesting that you switch to another med; I am simply providing a real life example of someone who did a slow taper and was fine afterwords.

 

I understand your feelings around the med and why you don't want to reinstate, but there is a limited window in which reinstatement has a good chance of helping.

 

Karma

[Altostrata]

Welcome, Rosalind.

 

I've updated the tips for tapering mirtazapine topic http://survivingantidepressants.org/index.php?/topic/2028-tips-for-tapering-off-mirtazapine/

 

My guess is you can dissolve Remeron SolTabs in water and titrate with an oral syringe.

[dalsaan]

Hi Rosalind

 

Ito answer your question, I have felt withdrawal symptoms despite tapering but not all the time. I have only felt them if I have gone too fast- too big a drop or not holding long enough between drops. Patience is not one of my virtues

 

I believe if you go slow, allow your body plenty of time to adjust to decreases in dosage you can limit your withdrawal symptoms. Like you, my biggest one is insomnia

[dalsaan]

Sorry I hit send a bit prematurely!

 

Extreme insomnia has always been the experience that tells me I have got my taper wrong and once that kicks in I have to updose to fix it.

 

In the early days, before I had worked out that I was suffering withdrawals (my dr was clueless on this like many others and thought a six week taper was a long one), I tried to outlast the insomnia. I went for two months with less that 14 hrs sleep a week. It didn't go away. This is not the same as say a cigarette addiction where withdrawal symptoms diminish over time

 

Please do yourself a favour and try reinstatement while it is still an option, the longer you leave it, the less likely it is to work. This isn't a failure in any sense, it's simply recognition that your system needs a chance to adapt to change and for some people that adaption takes a lot of time

 

I believe that prior experiences of going cold turkey, like your accidental holiday experience, can make your system extremely sensitive to reductions and thus more likely to have withdrawal symptoms

 

I'm not saying any of this to scare you. In fact my key message is that by being gentle and accommodating to the needs of your system and what it's telling you, you can come off safely and end up in a good place

 

I was on 30mg, now on 2ml (having got mine converted to a liquid)

 

Feel free to ask me any questions

[Rosalind]

Hello Tezza, Karma, Altostrata and Dalsaan,

 

Thank you all for your examples, links and advice. I believed that I could get through this nasty withdrawal if I just held on. I was okay at my first few drops while tapering. When I reached the last month (on 3.75 on alternate days) I did begin to feel anxious and jittery but I didn't 'listen' to my body.

 

I decided to act on your advice and last night, I re-instated at 3.75mg. Today I am experiencing the sluggish sleepiness that Remeron induces. However, after poor sleep for 6 weeks, I can't complain!

 

I'm glad I found this forum.

 

Thank You So Much!

[tezza]

Hi Rosalind,

 

I'm glad you got some sleep. If I were you I'd wait a few weeks, maybe a month to six weeks, and then do the 10% reductions.

 

I'm glad you found this forum, it's been a lifesaver for me. Alto is super! I've followed her advice for a little over a year and have gotten a lot better. I was in harsh withdrawal when I found this site.

 

Other members have also been a great help to me with advice and support.

 

The 3.75 might be too much for your nervous system since it has become sensitized. You might be able to stabilize on a smaller dose by dissolving it in water and using a 1mL oral syringe. You can get one at a pharmacy for free usually.

 

Alto will be on later to advise you further.

[Altostrata]

Give 3.75mg a chance for at least a week. See how you do. You may need more, or you may need less.

[Rosalind]

Hello Tezza and Altostrata!

 

I will surely follow the advice I've been given here. I honestly wish I had found this site before I embarked on my taper.

Still, I must look forward and not back.. Tezza, I am in Thailand now and could not find a syringe so as to make a liquid solution.

I am hoping that my system can take the 3.75mg. I will wait for a week as Alto suggested.

 

Thank You Again!

[tezza]

Rosalind, by all means follow Alto's advice. She is the true expert! I do hope you can eventually get some syringes before you start to taper though. It's important to taper slowly to avoid the withdrawals.

 

I had a problem getting them from a pharmacy too so I googled and found a company that had a catalog to send out to me. Maybe that will be an option later. You may be able to order directly from the Internet, that wasn't an option for me.

 

I hope you continue to feel better and better!

 

Hugs,

Tezza

[Skyler]

Rosalind, by all means follow Alto's advice. She is the true expert! I do hope you can eventually get some syringes before you start to taper though. It's important to taper slowly to avoid the withdrawals.

 

I had a problem getting them from a pharmacy too so I googled and found a company that had a catalog to send out to me. Maybe that will be an option later. You may be able to order directly from the Internet, that wasn't an option for me.

 

I hope you continue to feel better and better!

Hi all.. just an fyi. Baxta syringes are the best.. the markings do not wear off the syringe barrel anywhere near as fast. You can read about them at baxta.com, and there are many different sites, etc. that carry them. I paid .50 each at a compounding pharmacy.

[tezza]

Thank you for the info, Skyler

[Rosalind]

Dear Tezza and Skyler,

 

My lovely hubby drove around town today and managed to find me a couple of syringes:-). I know it will be a few weeks until I make another drop.

Tezza, I will go very slowly this time as I have learned my lesson. Skyler, thank you for the info on the Baxta syringes. I will check into them.

 

I feel blessed to have connected with such kind and supportive people. I hope that I can return the favor to somebody else who needs support. I wish you all success with your tapers too. I should continue to post on my progress as it may help someone else who is thinking of reinstating.

 

Hugs Back,

Rosalind

[Altostrata]

See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__2643

[Rosalind]

Hello Everyone,

 

It's been a while since I posted but I wanted to update and share my experience with re-in statement to help alleviate withdrawal symptoms.

 

I re-instated at 3.75mg of Remeron. I tried it for a week and it did take the edge off the anxiety and it certainly helped me to sleep. The problem was that it was far too sedating. I could sleep for 14 hours at a time and experienced flu-like symptoms. I wasn't able to do anything other than lie in bed in a catatonic state. It's a slippery slope with Remeron because, at the lower doses, it is a potent anti-histamine. I crushed my Soltab, made a liquid solution and tried 5mg for a week. Same thing...couldn't function in a vertical position. At that point, my emotions were all over the place as I lay there ruminating about my condition, worrying about everything on my agenda and wondering if I was ever going to get out of the hole. At one point, I thought about going back up to my original dose of 15mg and starting this all over again!

 

I decided to try 7.5mg. At first, I beat myself up....felt like I had failed in some way (why do we do this?). I just wanted to attain a level of functionality. What I noticed almost immediately with 7.5mg was that I woke up earlier in the morning and felt far less sedated. I did feel depressed and a level of apathy but honestly, the experience of withdrawal can be so traumatizing....how should one expect to feel? As with dropping doses, re-instatement does not guarantee an overnight success. I have to keep reminding myself that one has to be PATIENT!!

 

I am now on day 11 of 7.5 mg. Each day is a little better but not without hiccups. I no longer wake up feeling that early morning 'dread.'. There is still a little anxiety but it is nowhere near as bad as before. My concentration has improved. I no longer have motion sickness. I can drive again. I can focus on things which can distract me from focusing too much on my symptoms. I no longer experience feelings of 'derealization.' I took my dogs for a long walk this morning :-)).

 

I would have preferred that this be a post about a reduction in dose rather than a reinstatement. Hopefully, those posts will follow. I have chosen to take the 'glass half full' attitude. I am now on half my original dose and when I am ready, I will start making tiny reductions with long pauses between drops. I know that it will not be smooth sailing but thanks to SA and the wealth of information provided here, I will be better equipped.

 

I have no idea where I would be now had I not discovered this site. It is in a class of it's own.

 

To Alto, Staff and Members

Thank You....Peace And Love,

 

Rosalind

[peggy]

Hi Rosalind - please don't beat yourself up - i think you did great to find a dose that you are functional on and can begin to stabilise. You have learnt some valuable insight that will serve you well in your future taper.

[Rosalind]

Hi Peggy,

 

Thanks for your suoort! That was a tough lesson but if I can eventually get off my AD, it will have been worth it.

 

Wishing You Well!

[tezza]

Hi Rosalind,

 

You should never beat yourself for listening to your body and reacting to what your body needs. This is something we all have to learn to do. Only you can decide, ultimately, what it is that you can be functional with.

 

I'm so glad you are felling better!

 

Tezza

[dalsaan]

Functional, feeling ok in the world with happy dogs and a plan for coming off-I would say that's a good result.

I know it's hard to be patient and the desire to be off is strong. Patience is not my forte. But it does pay off

 

I will be cheering you on and if you have any questions don't hesitate to ask

 

Dalsaan

[basildev]

Hi Rosalind,

 

you listened to your body and that was the smartest thing you could have done.

 

I know how it feels to beat yourself up. I just updosed to the full dose of my meds after an awful bout of insomnia. I felt terrible about it but at the end of the day it's your body and you have to do what's right for you.

 

I'm on day 9 of the updose and things haven't gotten back to normal yet. I expect to wait at least another 4-6 weeks before they do.

 

And yes it's terribly difficult to be patient. Even harder when you're going through awful withdrawal.

 

I feel for you.

[Rosalind]

Hi Tezza, Dalsaan and Basildev,

 

Thanks for the words of support!

 

Another good day here! Perhaps it's because I gave myself a long list of things to do which got me out of the house for most of the day.

I'm still a bit 'wobbly.' I can't describe the feeling...it's as if I've had ten double espressos (I wish...had to stop caffeine a few weeks back) and yet I'm tired at the same time...as if it's the first day back at work after you've had the flu. I think I'm going to need several weeks on the current dose before I attempt another taper. Also, when I do start again, I'd like to be mindful of but not obsessed with every little twitch and symptom...as I have been lately. I guess what I'm trying to say is that my recent scare is all bit too fresh....need more time and heaps more patience so that this experience is past rather than present tense.

 

Dalsaan, like you, patience has never been my strong point! You know that I'll be coming back to you for advice about micro-tapering off Remeron ...

I know that I'm going to have to go really slow next time, particularly below 5mg. Yes, I'm still determined to get off this med, even if it takes a year or two.

 

Basildev, I know (as do many members here) how awful withdrawal induced insomnia can be. I only had it for six weeks and it was torture!

At the end of the day, we have to do what we need to do to function and keep going. Our nervous systems are a littler raw and we might need more time for a re-in statement to help. I'm now on day 12 and have noticed that every day it gets better. I wish the same for you:-)

 

Hugs to All

Rosalind

[Docc]

Hey Rosalind,

 

How are you doing now? Did the reinstatement work, did you start tapering off? Im interested in your story and progress.

 

Regards

[tgirl]

Hello Rosealind,

How are you feeling?