success ☼ LLiz: still not able to jump off mirtazapine

[LLiz]

Hi, Tgirl!

 

I am doing really well. This is the best I have felt for almost two years. I can hardly believe it! I feel so thankful!!

 

After updosing from 0.11 to 0.12 mg and holding, nerve and muscle pain and hallucinations are at least 90% less. Even the nausea is less. I have been sleeping better. No more cognitive problems, burning / stinging skin, feeling that bugs are walking on me, or anxiety. Way less muscle twitching. I have been catching up on some ordinary life stuff that is normally way too hard to do. I want to enjoy this window while it lasts.

 

I did not consider before that if holds usually do not help, it doesn't mean they probably won't help *this* time. Things seem to change during withdrawals. Patterns can change.

 

I want to hold this time as long as I can, at least several months, I hope. Then I plan to try diluting the suspension more so I can drop by micrograms (0.001 mg). It seems that my body thinks 0.01 mg changes are really big! I want to focus on staying as well as I can for now instead of getting off the drug as soon as possible.

 

How are you doing, Tgirl? I hope better!!

 

LLiz

[Altostrata]

Yes, the withdrawal situation keeps changing. Good to hear you're dealing with it so well.

[Hopefull]

I am glad to hear that you are doing really well!

It is very refreshing when that happens!

Enjoy it while you can!

[AmyK]

Holds longer than about a month haven't worked well for me. Nausea starts ramping up too much around that time and then goes away with a drop--anyone else experience that?

Yes, I do. If I do'nt drop I feel worse. Sometimes just after three weeks, nowadays even after two weeks. I react the same as you described in your earlier posts, worse after taking the pill, then gradually better the day after until its time to take the pill again (I take it in the arfternoon). I guess my body never liked, in my case, zoloft.

You are almost done! But I really understand that you want to take it as slow as possible. These small doses are hard.

Take care!

[LLiz]

Thank you, Altostrata and Hopefull for your kind posts!

 

 

Thank you, AmyK for your feedback! Yes, my "feel-good" time for the last two holds only lasted about two weeks, also, and now I am gradually feeling worse again. It has pretty reliably been a pattern of "drop my dose by tiny amounts until withdrawal symptoms get too bad", and then "hold until nausea and muscle pain start increasing too much again".

 

Yes, my body never liked mirtazapine either, and apparently still doesn't, although it is nothing now like it was even around 0.25 mg.

 

From your signature, it looks like you are being very slow and patient with your taper! We'll get there yet!

[LLiz]

An update:

 

I held my dose of mirtazapine at 0.12 mg (120 micrograms) for two months. After a wonderful window of several weeks, I settled into a phase which is typical of holds for me: increasing nausea, muscle tension, and fatigue. I felt sick enough after the two months to try dropping by 2 micrograms. That only lasted for a few days because I had strong anxiety, an uncommon symptom for me. I waited a week or so and decided to try dividing my dose so that my blood level would be more even. So, for almost a week, I took 110 ug before bed and 10 ug in the morning. I was surprised to feel markedly different, with daytime nausea stopping but sleep quality worsening. To have dramatic symptom changes with such small dose changes seemed surprising, and maybe not significant.

 

For some months, I have had sensations of muscle / nerve pain and intense nausea washing over me at night. I thought at first they were just dreams, but they are becoming stronger. I can't be very exact about my descriptions because they start while I am sleeping and wake me up to varying degrees. Could they be an adverse effect?

 

In general, I feel less healthy--my fatigue and muscle tension are really problematic. I must see a massage therapist 2 - 3 times a week now instead of once a week. I spend substantial amounts of time in bed. I am unable to exercise most days (something I was consistent about before) because of fatigue or muscle pain. I have been learning mindfulness, reducing stress, and still taking 400 mg magnesium per day. These things have helped, but I am very uncomfortable with my general decline and frightened of the increasing nighttime pain and nausea. I wonder if I should stop mirtazapine now to see if things improve. Do any of you have any ideas? Thank you for reading this!

[Petunia]

Hi Liz,

I just read through your thread in an attempt to understand what may be happening, so I could suggest something. Your situation does seem a little tricky and hard to know if what you are experiencing are adverse effects or withdrawal symptoms. My guess is that its probably a little of both, but more withdrawal, given that at times in the past you have tapered pretty fast and what you are going through now could be those previous cuts catching up with you.

 

From looking at your signature, its difficult to understand how you went from 30-40mg down to less than 1mg, but reading through your thread, I see you were making daily cuts at one time and certainly tapering faster than 10% per month.

 

Nausea, muscle pain and tension are all withdrawal symptoms, I've experienced them while being in withdrawal and drug free. The fact that these symptoms start to increase when you hold, doesn't necessarily mean they are side effects. Withdrawal symptoms can begin weeks and months after making a cut or stopping a drug. Withdrawal symptoms can also change over time without being triggered by changes in drug dose. Whether tapering, holding or being drug free, recovery or stabilization tends to happen with symptoms changing in a windows and waves pattern. It can make it complicated to understand what's actually going on and very easy to attribute any change in symptoms to some change we have made in drugs, supplements, diet or activities.

 

My suggestion would be to continue holding and use other methods to manage those symptoms while your nervous system settles down more, ready for more tapering.

 

Ginger can help with nausea, I use ginger tea, and have just bought some crystallized ginger to try the next time I get this symptom. Epsom salt baths can help with muscle pain and tension. Gentle stretching and light yoga can sometimes help too.

 

Are you taking any other medications?

[LLiz]

 

Thank you, Petunia, for your thoughtful reply and wading through my thread!

Here is a more complete listing of my withdrawal history:

 

********************

Jul, 2012 : on 45 mg mirtazapine, 20 mg ziprasidone, 10 mg dextroamphetamine

 

Aug 1, 2012, 22.5 mg mirtazapine, minimal reaction to the drop

(Aug 15, 2012 to end of 2012, ziprasidone withdrawal)

 

Jan 1, 2013, 22.5 mg mirtazapine

Feb 1, 2013, 21

Mar 1, 19

Apr 1, 19

May 1, 17

Jun 1, 16.6

Jul 1, 15.7

(July 15 to Aug 3, dextroamphetamine withdrawal)

Sep 1, 15.0

Oct 1, 13.0

Nov 1, 12.7

Dec 1, 11.1

 

Jan 1, 2014, 11.7 mg

Feb 1, 12.0

Mar 1, 11.2

Apr 1, 10.2

May 1, 9.3

June 1, 8.2

Jul 1, 7.2

Aug 1, 6.0

Sep 1, 2.6 mg (Cut rapidly for worsening serious adverse effect and it resolved!)

Oct 1, 0.7

Nov 1, 0.5

Dec 1, 0.5

 

Jan 1, 2015 0.42 mg (Cut rapidly for severe nausea and muscle spasms)

Feb 1, 0.28

Mar 1, 0.28

********************

 

The rest is in my signature. It was kind of therapeutic typing out the above. It wasn't too long ago that I wouldn't have been able to do that. Looking it over, I did make some really large cuts by percentage. I wish I had made long holds at those points.

 

The only other drug I take regularly is 75 mcg thyroid. A few times a year I take single doses of lorazepam for extremely severe muscle spasms when I can't see my massage therapist.

 

I will keep on holding for now. I will manage my symptoms the best I can. I am really encouraged about my progress with mindfulness and pain!

 

BTW, ginger doesn't work anymore for me, although I have eaten pounds of it to good effect throughout the last several years. I hope it helps you! Trader Joe's candied ginger is the best, I think--it is really strong, and you don't have to prepare anything while you are feeling so sick.

 

Thank you so much, Petunia! I feel really alone with this sometimes. Reading your post was wonderful. I found especially helpful your explanation of delayed withdrawal symptoms. Somehow, I didn't consider those in my case, even though I have certainly read about them.

 

Your history sounds really bad. I really hope you keep improving!

 

LLiz

[LLiz]

An update:

 

I am doing better! Right now, I am sleeping a lot, done with nausea, have much less pain, and am able to do more normal activities, like take walks, do basic chores, plan a little, and even start to study a little again. I think continuing to hold for a really long time is the best option for me, because I simply feel too close to the edge. Any small stresses in life seem to throw me into withdrawal again, I can't miss my dose for more than a few hours without getting really sick, and I am tired of failed attempts to drop. I still have daily hallucinations and impressive fatigue, and I still wake up with "pain waves" at night, but I am hopeful from what some of you have written that these problems will lessen in time. And, the results of dropping have been much worse. I don't at all like the fact that I am so dependent on a drug, but for now at least, I simply *am* LLiz who still can't jump off mirtazapine, and I think I can learn to accept that.

[ChessieCat]

Hi LLiz

 

"I don't at all like the fact that I am so dependent on a drug" - I don't think any of us do.

 

" but for now at least, I simply *am* LLiz who still can't jump off mirtazapine, and I think I can learn to accept that."

 

" but for now at least, I simply *am* LLiz whose brain needs mirtazapine, and I think I can learn to accept that."

 

All we can do is be the person we are at this moment in time, and understanding that seems to make it easier to accept.

 

Wishing you all the best.  CC

[dalsaan]

You sound like 'LLiz who is making good decisions for herself' to me.   You are choosing to reduce the risks of a bad outcome and to maximise the prospects of success.   You are choosing to define a good outcome in terms of positive functioning, wellbeing and health rather than having met an abstract deadline.   In other words you are doing a great job.   Enjoy the long hold.   I am confident this will behind you at some point and that you will be in a good place because you girded your loins and played the long game

 

Dalsaan x

[LLiz]

Thank you, ChessieCat and Dalsaan, for your replies!

 

I felt especially cheered up by the way you expressed your support, Dalsaan. I will keep reminding myself of what you wrote. I am not finding it easy to accept this situation, but your positive reframing will help, and I will do it somehow!

 

All the best to both of you!

 

LLiz

[AliG]

Sending Support & encouragement, . You will get through this.    

Ali

[LLiz]

Thank you, thank you, Ali!!

 

So will you!

 

LLiz

[LLiz]

A question:

 

It was necessary for me to change mirtazapine tablets three days ago. The brand and size are the same, but my old tablets were several years older, from a supply saved for me awhile back. For the last three days, I have felt increasingly different. The first day, I felt a little spacey and a little hyper, the second day was worse, and now on day three I feel very uptight and wired, am having trouble concentrating, and am getting a headache in addition. These are not withdrawal symptoms I have had before. I am thinking that the new pills are effectively stronger.

 

I would like to try a small drop tonight to see what happens. My current dose is 0.12 mg and I would try a drop of about 10% to 0.11 mg. I am still very much wanting to hold my dose, but am trying to figure out how to do that with the new pills. I had been continuing to improve on my hold, and don't want to sabotage that! Anyone else experience this or have any ideas?

 

LLiz

[Altostrata]

Your old tablets might have degraded, your new tablets are likely stronger.

 

You may wish to reduce your dosage slightly to compensate.

[LLiz]

Thank you, Altostrata, for your reply. I will try that.

 

Thank you, also, for starting and running this site!! I do not want to even think about what would have happened to me and many others without the help that is found here.

 

I hope that you have recovered from your Paxil withdrawal by now!

[LLiz]

Hello,

 

Things have not been the same since I was changed to the newer tablets at the end of January. I am having difficulty finding a level that I can remain at for a long hold without problems. At the time I changed, I was taking 0.12 mg. Now I am at 0.08 mg. I keep dropping 0.01 mg at a time and have minimal new withdrawal symptoms, but after I hold for 6 days to about 2 weeks, I suddenly start feeling new symptoms: I get spacey, restless, irritable, unable to concentrate, and start having headaches again. Then I drop and things improve immediately.

 

My usual withdrawal stuff is not worsening--hallucinations, nausea, muscle spasms, fasciculations, paresthesias, and nerve pain are at a low level now. Yay!! Sleep sometimes gets worse after drops, but then improves again after a few days. I still have trouble with weakness, low energy, and tiredness, especially in the morning (cortisol?), but eating more salt helps that somewhat. I still have cognitive problems and tinnitus, too. My doctor did a bunch of blood tests, and everything is normal.

 

Do I have another problem going on unrelated to withdrawal? Is this windows and waves and dropping just appears to help? Is it from a long term sleep debt? Can things just get really strange when you are at very low doses? Am I expecting things to be too logical and linear? Is this some adverse effect? I am trying to decide what to do--maybe I should just try holding in spite of the new symptoms if they happen again? Anyone else experience this? Thank you for reading this!

[Altostrata]

That's a difficult question. It sounds like you are getting adverse effects from the mirtazapine along with withdrawal symptoms (fortunately, temporary) when you reduce the dosage.

 

Are you taking fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

[LLiz]

Thank you for your reply, Altostrata!

 

I will tentatively assume that there is an adverse effect going on, too, and try making a small drop if it happens again. I will try fish oil a second time also, since I can eat better now. I will also work more on good self-management in attitude and behavior, to at least not make it harder for my body to finish this withdrawal and post-withdrawal. This partly means for me, not spending time wishing that I could be doing things that I can't. I am getting even more hopeful again, since the last drops seem to have actually gone okay, even if they were just an adjustment of the new tablets to the level of the old, probably degraded tablets. It is impressive, how hard these last hundredths of milligrams are to stop taking. It is also impressive, how resilient the human body is.

[AliG]

Liz.  The body is always heading towards healing .  As you get lower , it gets more tricky.

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

[LLiz]

Wow, AliG, that shows why it is so much harder to drop as you go down! And another link within that one explains why drugs seem to change actions at different doses, and both links show why more drug is not more effective at doing what it does. I could actually read it now--less brain fog! Thank you for your reply!

 

I am experimenting more now with salt. Eating more spread out in six doses throughout the day seems to be making me way more functional, at least for the last few days.

 

LLiz

[LLiz]

Update:

 

On March 20, I took my last dose of mirtazapine. I decided to try stopping for two reasons. After starting the new tablets, I could not stabilize for any significant length of time. Also, one of my original adverse effects had returned and was continuing to worsen.

 

I dropped 0.01 mg a day for the seven drops before the final hop from 0.01 mg, and nausea, nerve pain, hot flashes, itching, burning, and muscle fasciculations gradually increased. I developed balance issues, was extremely fatigued, had increased memory problems, and felt dizzy and anxious.

 

Meanwhile, my ability to concentrate has improved, the hallucinations completely disappeared, the nighttime sickness waves stopped, and I stopped getting muscle spasms extremely easily. My very symptomatic low blood pressure is now improving, and I am probably getting enough sleep, although it happens at odd times some days. All of the withdrawal symptoms that appeared since stopping mirtazapine have lessened greatly even though the time frame is so short.

 

Maybe this will be the beginning of the end, and I can finally continue the transition to life after withdrawal. I am almost afraid to hope that this will actually succeed. I really think the holds helped a lot! I was doing so poorly just before this last series of drops, that I do not see reinstatement as a reasonable option. I remember that things usually heal in waves and windows and I understand how important it is to take good care of myself now to maximize my chances of healing well.

 

My plan is to update my thread a few more times even if this final drop actually succeeds. I really appreciated reading such updates that others of you have written. Even though our stories and situations are different, it has still helped me enormously with discouragement.

 

LLiz

[marie123]

Hi LLiz. Congratulations for finishing your taper. I've been following your posts for a while since I have to taper Remeron also. Yes good care of yourself and ride out any remaining symptoms. I wish you continued healing and good luck!

 

Marie

[brassmonkey]

Hi LLiz--  It's wonderful to hear that you've been able to make the final jump, congratulations. I wish you the best of luck as you continue to heal from this horrendous experience.  Please drop in from time to time and let us know how you are getting on.

[AmyK]

Congratulations Lliz, you have been so patient. I am so happy to read that a lot of your symptoms lessened. You are an inspiration and I wish you all the best. Sending healing thoughts your way!

[LLiz]

Thank you so much, Marie, brassmonkey, and AmyK for your well wishes!! It means a lot to me that you wrote!!

 

LLiz

[Hibari]

Congratulations LLiz!  So great to hear you are off Mirtazpine and that it can be done!   I am working my way down from a dose of 41.25 of Mirtazapine, along with Lamictal, and as you know it's a strong medication to withdraw from.  It's inspiring to me every time I see someone come off of Mirt and I appreciate you posting. 

 

Wishing you the best as you continue to heal.

 

Hibari.

[LLiz]

Hibari, thank you so much for your note!! Yes, it can be done! I hope you are doing well with your hold.

 

LLiz

[Hibari]

Hibari, thank you so much for your note!! Yes, it can be done! I hope you are doing well with your hold.

 

LLiz

I am doing really on my hold right now.  i have moved into a stable place-since Friday and my mood today is just great!  This was after a brutal two days at the top of the week when my peak wd symptoms hit.  I am going to hold here till for the next 2 weeks or so and then do some micro drops.  Having a day like today and hearing about successes makes me feel so happy.

[LLiz]

Update:

 

Well, it has been almost two months since I stopped mirtazapine. Most withdrawal symptoms are very much decreased or gone. I still have some tinnitus, a bit of nausea, and occasional mild hallucinations. Sleeping is still somewhat of a problem, too, but the worst one is the tendency to have very painful muscle spasms, which mean pain at night and day, and drastically reduced ability to exercise. I am not sure that those are fully withdrawal related. Part of the problem may be that I spent so much time in bed for months because my blood pressure was too low. I think I probably got very deconditioned. Unfortunately, I am still back in bed part time from muscle pain and so I am pretty housebound, but I plan to recondition slowly and carefully now instead of rushing ahead and getting hurt over and over again like I was before.

 

Problems that seem resolved are: low blood pressure, memory, concentration, learning ability, extreme fatigue, most nerve pain, and paresthesias. I haven't noticed any new allergies for awhile, either.

 

Things that have helped me the most include acupuncture, massage, going outside and paying attention to little beautiful things like bugs and baby leaves, learning to be calmer about life, that there is a spiritual meaning to all this, and avoiding rehashing in my mind how terrible the withdrawal was and how much I missed out on. It helps that I am noticing and really enjoying the many small kind acts from people I come into contact with. I am seeing how important it is that I not stress about much--symptoms seem to return for a bit when I do. I also think of the kind messages so many of you have written and am thankful for the information on this forum. I don't know how I would have managed without it!

 

I hope to stay hopeful and positive as much of the time as possible, although I do get discouraged sometimes when sleep is too little and pain is too much.

 

I wish the all of you the best! Yes, it is possible to stop mirtazapine, although it may take a long time and be very difficult!

 

LLiz

[Hibari]

Thank you so much for sharing LLiz and congratulations for getting off the Mirt train.  As I get closer to the end, it's so nice to hear that it can be done and that despite some on going issues, you are feel well.

 

The muscles ache stuff is very interesting.  I don't know where your spasms are but leg aches and restless legs are many of the symptoms I have read on different sites while people go on or off Mirt.

 

I'm wishing you even more healing!

[Hopefull]

Great news Lliz,

Wishing you all the best in the future.

[LLiz]

Thank you so much for your notes, Hibari and Hopefull!! I felt really encouraged when I read and reread them!

 

I have now been off mirtazapine for three months.

 

Most of my symptoms are at a lower level now except for the muscle spasms, which are often severe. A physical therapist I just started working with thinks that they are primarily from neurological imbalance. I still get acupuncture and massage several times a week for them as well, which are definitely helpful.

 

Sleeping problems, vivid dreams, nerve pain, fasciculations, itching, skin pain, and tinnitus are current issues. I also went through a period of anxiety for several weeks, probably mostly because of having difficulty dealing with so much muscle pain.

 

After some earlier negative experiences, I was happy that the last three medical care providers that I saw did not have a problem dealing with antidepressant withdrawal. They believed me, considered my symptoms carefully, and came up with ideas to try to help my body to heal.

 

I am getting better at asking for help, practicing acceptance, and reminding myself of things I am thankful for. I am learning to not mind most symptoms, most of the time. And I am not being hard on myself when I fail. For me, these practices seem crucial to getting through this.

 

We can do this!

[Hibari]

So glad to hear you are still going strong!  3 months off, that's fantastic LLiz!

 

I too am a big fan of acupuncture and I am glad it's helping you along with the massage.

 

I really like how you said "I am getting better at asking for help, practicing acceptance, and reminding myself of things I am thankful for".    That is slowly happening more and more for me.  

 

Quick question-did you gain weight on Mirtazapine and if you did, did it come off once you were off?  

 

Keep posting your progress! 

[LLiz]

Thanks, Hibari!

 

Yes, I gained weight on mirtazapine. During one phase of the withdrawal (at a low dose), the nausea was so intense for several months that I lost it all then. I gained a little back when that cleared up, probably because I went through many months unable to exercise significantly. The mirtazapine hunger is definitely gone now, so I expect that when I can take long walks again, my weight will normalize. The excessive hunger didn't really fully disappear for me until I was completely off the drug.

 

All the best, Hibari!