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Pokey: Tapering Doxepin after 30 years


Pokey

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I have been on doxepin for 30 plus years. I am 65 and think it's time to get off. I went through a long arduous taper off Xanax and finally got off it in 2008. I have struggled with Valium off and on since then but took my last dose of that in September. I have conferred with my doctor and will begin a slow taper off doxepin with 10% cuts every 3-4 weeks. I am starting from 100mg and will go to 90 then 80 then 75mg and hold for a while. After that cutting no more than 5mg per cut. I will do holds for a period of time again at 50 25 and 10mg. Would like to know what folks think of this taper plan. Thanks

Pokey

Edited by scallywag
tags added

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Hi Pokey - are you the same Pokey who used to be on PP years ago?  My personal approach to tapering is to not cling too rigidly to a schedule, but adjust according to how I am feeling, always waiting to stabilise after each drop before starting the next one.  Well done for getting off Xanax, that's a big achievement.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

2021   29 Aug 2.4mg   15 Nov 2.3mg

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  • Member

Hi Pokey and welcome to SA. I moved your first post to the Introductions forum because it is specific to your personal journey. You may use it as a journal to track your progress, ask questions and receive support from other members.

 

You will find a lot of helpful information here.

What happened and how I arrived here: http://survivingantidepressants.org/index.php?/topic/4243-cymbaltawithdrawal5600-introduction/#entry50878

 

July 2016 I have decided to leave my story here at SA unfinished. I have left my contact information in my profile for anyone who wishes to talk to me. I have a posting history spanning nearly 4 years and 3000+ posts all over the site.

 

Thank you to all who participated in my recovery. I'll miss talking to you but know that I'll be cheering you on from the sidelines, suffering and rejoicing with you in spirit, as you go on in your journey.

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  • Moderator Emeritus

Welcome from me too Pokey,

 

I'm glad you found us, you have been on doxepin a long time, it may take a while for you to come off it, but we will be able to support you through the process.  As Songbird wrote, having a plan is a good idea, but its always best to allow some flexibility and to listen to your body and symptoms, being guided by what your nervous system can tolerate.

 

We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising.  Please read through this which will explain why:

  

Why taper by 10% of my dosage?  (The general philosophy of gradual tapering)

 

Here are our Doxepin tapering tips:

 

Tips for tapering doxepin (Sinequan, Zonalon)

 

Please put your drug and withdrawal history in your signature.  Putting a short version of your drug and tapering history in your signature helps people understand your context, it appears below each of your posts.  Here are instructions for how to do it:

 

http://survivinganti...your-signature/

 

How are you feeling at the moment?  Are you currently experiencing any symptoms? Do you feel like you have stabilized after coming off Valium last September?

 

Please feel free to write whenever you want, you will find a lot of friendly help and support here.

 

Petu.

 

 

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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  • 8 months later...

Pokey how are you doing now ?I have come off doxepin after 40 years I am 15 months off and it is a nightare this is the first time I've seen your post but it's 9 months old and I'm wondering what is your present state

I was originally on 350 mils doxepin started in1975 through the years I tapered down to 100 mils

I stayed on this dose for many years

I have now been off for 7 months ago

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  • 10 months later...

I'm an idiot. I successfully tapered off xanax a few years ago. Then I tapered off doxepin that I had been on a long time, but I continued to have trouble with my sleep. Often waking feeling very tired. My doc convinced me to try 15mg of remeron and by golly I slept well and felt much better for a while. But then it seemed like the positive effects were wearing off. Ive heard remeron will do this.  Then I recently went on a two week trip in June. I dont travel well, it boogers up my sleep and I get really tired and cranky so while traveling for those two weeks I upped my Remeron dose to 30mg.I did not consult my doctor which I know I should not have done too.  Was sleeping good and feeling better.When I came home I did ask to go up to 30 and my doc approved.  Now after a month of that I could not sleep at all last night and felt so "ON", like a light bulb in my head.. I was at our local hospital for a sleep study last night which may have had something to do with the insomnia being as how I was in a strange place and bed with a gazillion wires hooked up to me, but I think there's more to it than that.  I fear the remeron is having an activating rather than sedating effect now at 30mg. Its like a switch has been flipped and turned a bunch of lights on that wont shut off. Does this sound familiar to anyone and after being on 30mg for a month do I need to slowly taper back down or can I just go back to 15mg?

 

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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I can't speak knowledgeably about Remeron, but someone will be along with an answer on that. However, If your sleep study was done for possible obstructive sleep apnea (OSA) then I want to mention that treatment with CPAP was a godsend for me. If that's what you're dealing with, take heart that the treatment is simple and effective. And for me at least, CPAP therapy almost immediately relieved my insomnia and was able to go off the ambien I'd been on for years. Hope you get answers about your sleep situation soon. Lack of sleep is the worst.

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The sleep was to see why I sleep for 6-7 hours and wake up exhausted. I had a study 5 years ago which showed nothing. The docs can't figure why I'm so tired all the time. After many tests showing I am convinced it's from many years of psych meds. They have affected my brain. I don't think I'll ever sleep well again. With this recent set of circumstances I'm about at the end of my rope. I can't do this withdrawal crap anymore.

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Hi Pokey, 

 

I merged your new intro with your old one since it is one per member.  If you bookmark your Intro page you will be able to find it more easily.  Please post any questions and updates about your situation here.

 

Remeron is super sedating at low dosages because it is primarily blocking the H1 histamine receptors while not really affecting serotonin as much.  But at higher dosages, it blocks serotonin more selectively, which is more activating.  This may mitigate the sedation.

 

I, myself, am tapering Remeron, and while above 12 mg I was feeling alert during the day, but now that I'm at 11.0 mg I am zonked during the day.

 

Since you have been on 30 for a short time, I would suggest dropping back to 15 mg, first going down to 22.5 mg for a week and then 15.0 mg.

 

When you say that you slept well at 15 mg but then the positive effects wore off, are you speaking of the sleep, or other positive effects?

 

I was put on Remeron when I was in protracted WD from Effexor but didn't realize it.  Initially, it was heaven to be able to sleep on 7.5 mg, but I still wasn't feeling well otherwise so began raising the dosage.  It never did work well on it's own other than for sleep.  I don't think Remeron can hold up at all to withdrawal of any other AD.

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

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

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SG. Hope I'm doing this reply correctly. This site works a little differently.

 

When I say the 15mg remeron wasn't working as well as it was I meant sleep was not as good, fatigue was returning and a sense of uneasiness. When I was stressed while traveling I bumped it up to 30 as I noted which I did without conferring with my doc. I figure he'll get over it. But now I'm thinking the higher dose is having an activating affect and that's what kept me awake last night. It was like someone flipped a switch. Do you think remeron can do that..keep a person awake or is it that its just not sedating at 30mg and something else kept me awake last night? I will take your advice and see where going down to 22.5mg tonight and for 7-10 days and see if I can comfortably back to 15mg. Thanks for your help.

 

By the way how do I bookmark my thread?

 

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

I can't say for sure why you couldn't sleep during the study.  It could have been a combination of being away from home AND the higher dose.  I can never sleep well on the first night away from home, but usually restless, not completely wide awake all night :-)

 

Mirtazapine has a high affinity for histamine receptors and is therefore sedating at low doses. This is countered to some extent by its enhancement of noradrenergic neurotransmission at higher doses, making mirtazapine less sedative as its dosage is increased.

 

That is from Tips for tapering off Remeron (mirtazapine)

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

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

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  • Moderator Emeritus

Oh, to bookmark your thread, it depends on your browser, but usually there is a Bookmark drop-down menu at the top of your browser, and you should be given the option to bookmark this page.  Which browser do you use?

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

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

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Morning SquirrelyGirl???? I love that screen name.

I heard back from my internist this a.m. I asked him for a combo of 15&7.5mg tabs for tapering. He informed that "this is not a Benzo" so I should be able to alternate between 30 & 15mg for a couple weeks then another week of 15 and stop. Where do these guys get such ideas. He was all for me slowly tapering off doxepin but somehow thinks I can go much faster with Mirt. I thanked him and told him I'd take his suggestion and let him know how it goes and that I can always cut the pills into halves and quarters. I did not see the point in arguing with him via email and pissing him off as I may need to persuade him later that I need to take it much slower than he proposed. Medical politics!!! I took 22.5 last night as you advised and slept ok. Will see how it goes. I think I want to get back to 15 and hold and then go to 7.5 and maybe stay there so I have a backup for my irratic sleep issues. I guess I don't see any harm in having a 7.5mg script on hand and leaving it at that.

Pokey.

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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P.S. SG- is there no way to put my posts on the front page of the website or under a topic so others can see it and offer their thoughts as well? BTW, I figured out how to bookmark this page. thanks

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Administrator

Hi, Pokey. When you put a new post in your Intro topic, it goes to the top of the topic list and View New Content (see link at upper right).

 

Good to hear you've managing your mirt taper. Sometimes you can't get doctors to agree with you, if you get the prescriptions you need to taper, that's good enough.

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

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Alto- so when I post a new reply here it will fall under the "View New Content" button??

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Pokey, when you post a reply your thread moves to the top of the Introductions forum. It moves down the page as other people post in introduction threads.

 

Whenever you click on View new content, you'll see a list of topics that you haven't read either since you last looked at them or ever.

 

If you click on View new content immediately after posting a new reply, you won't see your introduction thread in the list because the software knows there's no new posts in your thread since you last looked at it seconds before.

 

I hope I've explained that well enough.

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 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • 1 month later...

I have been trying to taper mirtazipine from 30 mg with a goal of reaching 15mg and holding there a while to decide if I want to stay at that dose, go lower to 7.5 or get off entirely. But first I have to get to 15.  I have gone from 30 to 26.25mg to 22.5mg without much issue. However, it seems after I am at 22.5mg now for about 2.5-3 weeks I start to get pretty blatant insomnia and have to up dose a night or two to 26.25 and then come back to 22.5. I have done this twice and insomnia has come back both times. My question is based on the 1/2 life (20-40hours) of mirtazipine and how its eliminated from the body when should I be having such a WD symptom. Wondering if I need to stay at 26.25 a few days and then make smaller cuts to 22.5mg. The only way I can make smaller cuts to 22.5mg is to ask my doc for 7.5mg tabs as I can't cut 15mgs much smaller than quarters. I'm getting ready to be gone from home for about 4 weeks and wondering what tack I should take at this time???? Advice would be appreciated

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Administrator

Hi, Pokey. I moved your post here as we'll have to discuss your particular situation, which will be off-topic in http://survivingantidepressants.org/index.php?/topic/5301-tips-for-tapering-off-remeron-mirtazapine/

 

It's possible that drop from 26.25mg to 22.5mg was too much for you. Perhaps you could updose to 24mg and that will be enough.

 

Please read the first post in http://survivingantidepressants.org/index.php?/topic/5301-tips-for-tapering-off-remeron-mirtazapine/carefully. At this point, you could get a prescription for 15mg tablets and take the difference between 15mg and 24mg as a liquid.

 

A liquid would enable decrements smaller than 10%.

 

http://survivingantidepressants.org/index.php?/topic/5301-tips-for-tapering-off-remeron-mirtazapine/contains instructions for making a liquid.

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

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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DO you think I can alternate between 22.5 and 26.25 for a few days and have that work. I'm going to be traveling in Alaska for 4 weeks starting Friday and I'm not going to have the luxury of being in my home where I can fret with this nit picky stuff? I can't ask my doc for 7.5mg tabs this soon after just seeing him about this as he's getting impatient with me. I dont want him to  write me off entirely.  I will read the links you sent, maybe I can figure a way to do liquid while I'm traveling.

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Hi Pokey,

 

SA's recommendation is to  NOT alternate doses.  It confuses the brain.  It is important to take the same dose at a similar time every day.  Consistency is necessary.

 

Here are a couple of links which you might find helpful for tips on talking with your doctor:

 

What should I expect from my doctor about withdrawal symptoms?


How do you talk to a doctor about tapering and withdrawal?

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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I think I jumped to fast from 26.25 to 22.5 mg. I was fine for about 2.5 weeks, then the insomnia came back.  I may have to hold longer at 26.25mg. Im looking into the things I need to make small cuts via liquid. I told my doc my brain is likely not like many of his other patients who had no trouble getting off mirtazipene. If they had not been on an AD and benzo for 25 years like I had which took me months to get off then maybe they could get off painlessly rather quickly. He capitulated and told me to go as slow as I needed. My target for now is 15mg and hold for a while. I have so muich trouble with sleep that I'm willing at this point in my life to stay on something idefintely if it will help with my sleep in general and mirtazipene seems to be one of the safer ADs. Or I may go on down to 7.5. For now I just want to slowly and painlessly get to 15.

 

I'm startihng towonder if I should go on my 4 week trip to Alaska coming up. I lived up there 25 years and its like going home. I go back every summer, but I can just bet I will have sleep trouble. I always do whenever I travel somewhere, even if its familiar territory that Im going to. Leaving home just increases my anxiety level and despite my best attempts at what I have learned through CBT it does not always work and I end up laying awake until I get so tired from several days of poor sleep that I finally crash or I updose to finally get to sleep.

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Hi Pokey,

Perhaps you could put your taper on hold for now, enjoy your trip to Alaska and then resume tapering when you return home. Insomnia is a common withdrawal symptom, indicating you may have been tapering too fast. After a long hold, you may want to consider slowing your taper down to hopefully avoid experiencing withdrawal symptoms.

 

Alto suggested updosing to 24mg. If I were you, I would try that and hold there. I hope you continue with your vacation plans. Alaska sounds lovely.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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  • 1 month later...

I'm in the midst of a remeron taper going from 30 mg towards a target of 15mgs. Remeron helps me sleep, 30 mgs was to activating so thats why I'm going back to 15. Time will tell if I stay there or not.  I'm now down to 20mg. I'm sleeping fine, but wake up each morning feeling really crummy and often have mild nausea and feel shaky and kind of weak during the day. Has anyone else had any symptoms like this tapering off remeron(mirtazipene)?? Im beginning to wonder if something more serious is going on with me.

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Administrator

Pokey, I moved your post here, as discussion of your particular situation would take the other topic off-topic.

 

Please click the Follow this Topic button at the top right of this topic so you will be notified of responses.

 

I see there's already been some discussion here of your mirtazapine dosing. Please read those recent posts. If you have any questions, please post them in this topic.

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

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 5 months later...

I have been on 15mg of mirtazipine for a while now and Id like to know if some things I am experiencing could be side effetcs of the mirtazipine. The info out there on the web is rather general and not that helpful thus far. Here's what's going on. I wake up in the morning feeling like I'm coming out of a deep coma or unconsciousness. It reminds me of coming up from anesthesia after surgery. I feel awful in general and more specifically "heavy" and lethargic, legs are stiff and heavy, some times slightly out of breath. My BP is low and my HR as low as 50. If I get up to go pee I have to sit on the edge of the bed before standing so I'm steady. I take a BP pill and have switched to taking that in the morning which has made no difference. After I get up and have a couple cups of coffee I usually feel much better. I have a leaky mitral valve, but my cardiologist does not attribute this to my leaky valve, Ive had multiple blood test which have showed nothing, so I'm thinking it must be the mirtazipine, but I have no way to prove that except to get off. I have started a slow taper, but that will take weeks. In the mean time I was wondering if anyone here can relate to the symptoms I have been having? Thanks in advance.

 

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Pokey, hey.

 

I can relate to a lot of what you describe, so it is absolutely not unlikely that the mirtazapine is causing those side effects. I remember that heavy feeling. My heavy feeling was particularly strong in my head - "lead head" i used to call it. Because it felt like someone had poured molten lead in there and my head weighed 100lbs. I also had a great deal of shortness of breath, particularly in the morning, and terrible dizziness. After a careful and slow taper, i started noticing that these side effects were waning. Now, at 1.3mg, I rarely experience them - except occasionally when I make cuts. As you taper down, you will likely also experience a lessening of the side effects. Mirt is a strange one since it activates at the higher doses and brakes at the lower doses. It's side effect profile is fairly expansive as a result - dosage-dependent. I would say if your other health concerns are in check, then what you are experiencing is probably the mirtazapine side effects.

 

hang in there,

 

dave

1996 - .5mg Ativan as needed, 7.5mg Remeron daily2008 - .5mg Xanax, Ativan discontinued, Remeron continued2012 - .5mg Xanax, .25mg Ativan 3x daily, Remeron continued2/2012 - Jumped from Remeron, continued .5mg Xanax .25mg Ativan 3x daily4/2012 - Began rapid taper of .5mg Xanax .25mg Ativan 3x daily6/2012 - Jumped from Xanax and Ativan, voluntary hospitalization followed7/2012 - 2nd voluntary hospitalization, reinstated Remeron, bumped to 30mg, also given risperidone.8/2012 - discontinued risperidone, tried gabapentin, dicontinued gabapentin, Remeron 30mg continued10/2012 to current - tapered Remeron 10% every 4 to 6 weeks (sometimes more time) using liquid compound12/2014 - 2mg Remeron 1/16/2015 - 1.9mg Remeron 8/1/2015 -1.6mg Remeron - 03/1/2016 - 1.5mg Remeron - 1/2/2017 1.3mg - 5/7/2017 1.2mg - 5/13/2017 - syringe size change - 6/8/2017 - 1.1mg - 7/10/2017 - 1mg - 9/1/2017 - 0.9mg - 10/22/2017 - 0.8mg - 11/22/2017 - 0.7mg - 2/2/2018 - 0.6mg - 3/13/2018 - new compound pharmacy - 5/20/2018 - 0.5mg - 8/31/2018 - 0.4mg - 11/16/2018 - 0.3mg - 12/24/2018 - 0.2mg - 4/1/2019 - 0.1mg - 5/1/2019 - .05mg - 0mg achieved 2019-06-15. 🤞

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Hi Pokey, '

 

I definitely have those symptoms and still do even though I have tapered down pretty low.   In fact, Mirtazapine is known to be more sedating on the lower end of the medication. 

 

When I first took it I slept 12 hours a night and woke up in stupor-it would take 3 or 4 hours to wake up and lots of coffee.  When I went up in my dosage these symptoms got better. 

 

Now I am sleeping the same way again, 10 hours a night and groggy in the morning.  I also am tapering Lamictal at the same time so that contributes to my grogginess too.

 

I know from other SA members who got off Mirt that their energy and health returned.

 

Wishing you well.

9/2013-4/2014:  After moms death, was prescribed a series of meds for short periods of time that didn't work. Zoloft, Lexapro,  Nortriptyline, Liquid Prozac, Cymbalta. 

1/2014-9/2014. Clonzapam: Given Lamictal, stopped Clonzapam at .125mgs  

1/2015-4 2017 Remeron: 41.25 -0.025mgs

7/2015-11/2018 Lamictal: 200mgs-0.05 mgs Had paradoxical reaction to Lamictal wd, broke my heart to take a benzo but wasn't sleeping. 

3/28/2019 -2/5/ 2021  Clonazapam: 0.625mgs-.00115 Med Free 

July 27th, 2022**Severe Setback due to surgery/ anesthesia. 

9/7/22-10/4/22 Trazadone 50-100mgs for sleep, 10/13/22-11/13/22 Trazadone 1 mg to stabilize

10/4/22-11/20/22 Remeron 7.5mgs (for sleep doesn't work) 11/20/22 7.3 - 12/31/22 6.3 

2023: 1/18/23 6.1 - 6/6/23 3.6  6/16 3.4  6/28 3.0 7/12 2.7  7/28 2.5 8/11 2.2 8/23 2.0  9/5 1.8  9/16 1.6  9/30 1.4  10/13 1.2  10/26 1.0  11/9 0.8  11/22 0.6  12/6 0.4  12/23 0.2.

2024 1/4/24  Remeron/Mirtazapine free 

Additional Support:  Armour Thyroid 75mgs, Magnesium Glycinate 300-500mgs,  L-theanine 

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Hibari and Dave: thanks for the come back. I think the best thing for me to do is get off the stuff. Its caused me to gain weight too and I dont need the extra pounds at my age. LAst summer I was at 30mg, but it jazzed me up to much. Seems like you can't win with these drugs. I was on xanax for a long time and that took 20 months to get off. Anyway thanks for the details of your experience. Would appreciate any other folks who want to share their experience. Thanks much folks

 

Paul aka Pokey.

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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I gained 30 lbs. Just list 10 and am looking forward to losing the rest!

9/2013-4/2014:  After moms death, was prescribed a series of meds for short periods of time that didn't work. Zoloft, Lexapro,  Nortriptyline, Liquid Prozac, Cymbalta. 

1/2014-9/2014. Clonzapam: Given Lamictal, stopped Clonzapam at .125mgs  

1/2015-4 2017 Remeron: 41.25 -0.025mgs

7/2015-11/2018 Lamictal: 200mgs-0.05 mgs Had paradoxical reaction to Lamictal wd, broke my heart to take a benzo but wasn't sleeping. 

3/28/2019 -2/5/ 2021  Clonazapam: 0.625mgs-.00115 Med Free 

July 27th, 2022**Severe Setback due to surgery/ anesthesia. 

9/7/22-10/4/22 Trazadone 50-100mgs for sleep, 10/13/22-11/13/22 Trazadone 1 mg to stabilize

10/4/22-11/20/22 Remeron 7.5mgs (for sleep doesn't work) 11/20/22 7.3 - 12/31/22 6.3 

2023: 1/18/23 6.1 - 6/6/23 3.6  6/16 3.4  6/28 3.0 7/12 2.7  7/28 2.5 8/11 2.2 8/23 2.0  9/5 1.8  9/16 1.6  9/30 1.4  10/13 1.2  10/26 1.0  11/9 0.8  11/22 0.6  12/6 0.4  12/23 0.2.

2024 1/4/24  Remeron/Mirtazapine free 

Additional Support:  Armour Thyroid 75mgs, Magnesium Glycinate 300-500mgs,  L-theanine 

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  • 2 weeks later...

Hi to everyone,

 

The weight gain from Mitrazapine has made me feel low latley.

I have gained 10kg. I have always been slim and had fast metabolism.

I never carried fat around my stomach and since I have been on Mitrazapine, I have gained fat around my abdomen. Not only that, I feel like I look a bit puffy in the face. I don't feel like I look like my normal self.

This is starting to really bother me.

I have not lost any weight, despite taking a low dose of Mitrazapine. I have not gained any more weight appart from 10kg.

 

Can someone please let me know, if you start loosing weight after you completely stop taking Mitrazapine? Have any of you developed a little pot belly from taking Mitrazapine? Does it mean that my metabolism has permanently been altered by Mitrazapine?

It did not bother me so much before, but it is now.

I really would appreciate your feedback.

DRUG HISTORY:

 

November 2013- Zoloft, ( Bad reaction).

January 2014 - March 2014 Seroquel.( Quit Cold Turkey).

January2014- Mirtazapine, I was taking 15mg at one stage, reduced to 7.5mg, Pgad reactions to Mirtazapine. Doctor kept increasing it to 37.5mg, until July 2014. No improvement, experiencing panic attacks, on 37.5 mg. I had enough by October 2014. Began tapering.

October 2014- Started tapering Mirtazapine from 37.5mg.

September 2015- Down to 4mg of Mirtazapine. Crashed.

September 16th- Up dosed to 5mg. Held this dose for almost 5 months. Stabilised.

February 2016- Began tapering again. From 5mg to 4.5mg of Mirtazapine. (Rocking the boat, again)! Lol. :(

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HI Hopeful,

 

People have lost weight after Mirtazapine.  I have just lost 13Lbs of the 30 I put on. 

 

 

My lasts posts on my thread from #531 onward talk about it and you will see Free Spirit's response. 

 

 

It can be done!

9/2013-4/2014:  After moms death, was prescribed a series of meds for short periods of time that didn't work. Zoloft, Lexapro,  Nortriptyline, Liquid Prozac, Cymbalta. 

1/2014-9/2014. Clonzapam: Given Lamictal, stopped Clonzapam at .125mgs  

1/2015-4 2017 Remeron: 41.25 -0.025mgs

7/2015-11/2018 Lamictal: 200mgs-0.05 mgs Had paradoxical reaction to Lamictal wd, broke my heart to take a benzo but wasn't sleeping. 

3/28/2019 -2/5/ 2021  Clonazapam: 0.625mgs-.00115 Med Free 

July 27th, 2022**Severe Setback due to surgery/ anesthesia. 

9/7/22-10/4/22 Trazadone 50-100mgs for sleep, 10/13/22-11/13/22 Trazadone 1 mg to stabilize

10/4/22-11/20/22 Remeron 7.5mgs (for sleep doesn't work) 11/20/22 7.3 - 12/31/22 6.3 

2023: 1/18/23 6.1 - 6/6/23 3.6  6/16 3.4  6/28 3.0 7/12 2.7  7/28 2.5 8/11 2.2 8/23 2.0  9/5 1.8  9/16 1.6  9/30 1.4  10/13 1.2  10/26 1.0  11/9 0.8  11/22 0.6  12/6 0.4  12/23 0.2.

2024 1/4/24  Remeron/Mirtazapine free 

Additional Support:  Armour Thyroid 75mgs, Magnesium Glycinate 300-500mgs,  L-theanine 

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That is great Hibari!

Thank you for your response.

I hope that I loose weight after I completely stop taking Mitrazapine.

I will have a look at your thread.

DRUG HISTORY:

 

November 2013- Zoloft, ( Bad reaction).

January 2014 - March 2014 Seroquel.( Quit Cold Turkey).

January2014- Mirtazapine, I was taking 15mg at one stage, reduced to 7.5mg, Pgad reactions to Mirtazapine. Doctor kept increasing it to 37.5mg, until July 2014. No improvement, experiencing panic attacks, on 37.5 mg. I had enough by October 2014. Began tapering.

October 2014- Started tapering Mirtazapine from 37.5mg.

September 2015- Down to 4mg of Mirtazapine. Crashed.

September 16th- Up dosed to 5mg. Held this dose for almost 5 months. Stabilised.

February 2016- Began tapering again. From 5mg to 4.5mg of Mirtazapine. (Rocking the boat, again)! Lol. :(

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What's the general consensus here on taking melatonin on a daily basis while tapering off an AD. I'm coming off mirtazipine and taking 3mg of melatonin at bed time. I sleep but wake up like I'm coming out of a coma. I'm wondering if the melatonin could be causing this and if there are any downsides to long term use of melatonin.

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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  • Moderator Emeritus

Hi Pokey,

 

We have lots of topics on this site.  The easiest way to search for existing discussionsi s to use a search engine and type in survivingantidepressants.org + topic

 

Here is the link to SA's topic:  Melatonin  Alto's first post has lots of excellent information and will probably answer your questions.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 3 weeks later...

I'm slowly tapering off mirtazipine. I'm curretnly @ 11.25mg. I take 1.5mg of melatonin at bedtime when I take my mirt dose. I often wake up feeling like I'm waking up from a coma. Heavy, groggy, stiff, tired, lethargic. It takes a couple cups of coffee to get me going. I have definitely noticed the lower I get in dose the more sedating the mirtazipine. But  I have been wondering if the combination of the two is a contributing factor to how I feel when I awake up. Thinking I should maybe try stopping the melatonin to see if it helps. What's the collective knowledge here on taking melatonin with mirtazipine or have others experienced similar symptoms? Thanks.

 

Pokey

Was on xanax and doxepin for 25years. Got off both without to much trouble after long slow tapers. Still have issues with cognition, insomnia and fatigue. Was on 30mg mirtazapine.  Have tapered down to 9.375. When I get to 7.5 will hold there for a while to get good and stable again, then start down from there with liquid. Also take prevacid for GERD and bystolic for a mitral valve issue plus probiotic. 

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