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LiaJ

LiaJ: Overwhelmed by the deluge of information but no real answers

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LiaJ

I joined this forum last June before I began an unsuccessful taper from Celexa, however, this is my first post. I honestly had no idea until then how horrific untethering from these substances is, and how devastating it can be long term. What I really need is some good news. Is there any good news in the midst of this real-life horror story?

 

Right now I feel completely alone. I haven't found a medical practitioner to forge a partnership for helping me discontinue successfully--or even reach the psych NP who prescribed my meds for a change when things went really wrong. So, there is no "discussing anything with a trusted healthcare practitioner". All I have is you all. So, I'm sort of pleading with you for guidance.

 

I am still not sleeping well. I slept fine, for years on Celexa, then weaned off and threw everything out of balance. To be fair, the year prior to my discontinuation was incredibly stressful.

I abruptly ended Trintellix this week (because I ran out and can't get anymore) and am taking approximately 10mg of Prozac (approximately because I'm splitting 20mg of powder roughly in half) as of today. The Prozac instantly quelled my WD symptoms from the Trintellix within the hour, and my plan is to either formulate a liquid suspension of this drug or find a doctor who will prescribe one. 

 

I have exhaustively researched how to overcome this problem. I'm an athlete, so I've stacked as many cards in my favor with diet, lifestyle and nutrition as well as I possibly can. But I can't seem to find a way through this, or make a plan that makes sense, and I'm scared I'll never be okay.

 

 

 

 

Edited by Altostrata
added screen name to title

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Altostrata

Welcome, LiaJ.

 

Those knowledgeable medical practitioners are few and far between.

 

Good to hear the Prozac stopped the Trintellix withdrawal symptoms. Yes, you should be measuring out a more consistent dose. This topic will explain how to make a liquid  Tips for tapering off Prozac (fluoxetine) as well as a gradual tapering plan.

 

How are you sleeping?

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LiaJ
13 hours ago, Altostrata said:

Welcome, LiaJ.

 

Those knowledgeable medical practitioners are few and far between.

 

Good to hear the Prozac stopped the Trintellix withdrawal symptoms. Yes, you should be measuring out a more consistent dose. This topic will explain how to make a liquid  Tips for tapering off Prozac (fluoxetine) as well as a gradual tapering plan.

 

How are you sleeping?

I forgot to add in my initial post--I have to take Remeron to fall asleep. I didn't use to have to take anything to fall asleep, but now I take 7.5mg of Remeron every few nights, usually, to sleep. I haven't slept well since August. Most nights 4-5 hours. Six to seven hours on nights I take Remeron. I would like to stop the Remeron ASAP, but am not sure how to taper.

 

May I ask how you became so knowledgeable about this issue?

 

Thanks 😊

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Gridley

Hello, LiaJ and welcome from me too.

 

We ask all of our members to fill out a signature so that all of your information can be read at a glance.  This helps moderators determine you current situation and we would ask that you follow the instructions at the link below. Please include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

  • Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • This is a direct link to your signature:  Account Settings – Create or Edit a signature.
At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
 
Why taper by 10% of my dosage?
  
To get you started and familiarized with the protocols followed by SA, I am linking to a few topics so that you have a better understanding of what is recommended here. 

 

 
Since you are on Prozac and also wish to go off the Remeron, please keep in mind that we generally recommend tapering only one drug at a time.  This link explains why and which to taper first:
 

 

Edited by Gridley

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nz11

Well done on doing the drug sig

wow that is a lot more colorful than I had imagined.

You haven't put in when you started taking the remeron. Although at a guess is it: from 1 Oct 2017, 7.5 mg every three days. 

Help us out here what is your definition of 'every couple of days or so' ?....once a week?  

 

Oh yeah sorry forgot to say welcome to sa.

nz11

 

 

 

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LiaJ

Hi NZ!

I started the Remeron in the hospital on October 31, 2017. Initially, it was powerfully sedating; a 7.5mg dose would suffice for two or three days. So, I'd take it one night, and be able to sleep that night, and the next two nights before needing to take it again. Now I'm finding I have to take it more often.

 

You've successfully weaned off Paxil? I've heard that drug is notoriously difficult. What was your recovery plan?

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nz11
22 minutes ago, LiaJ said:

What was your recovery plan?

I determined to remain vertical and ventilating but often ended up horizontal and ventilating...as you do!

Basically I just held on. Wouldn't say in hindsight I weaned. 

I notice doctors are now using this word 'wean' no doubt another attempt to dodge the cognitive dissonance triggered when they use the word taper as that would infer addiction. And they couldn't possibly have given someone an addictive drug.

 

Please don't assume that if it comes from a doctor it is safe. 

Did the doctor inform you that a wdl symptom of remeron is insomnia and nightmares. 

 

 

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LiaJ

This week I just began taking Prozac (10mg) and abruptly ended Trintellix (5mg), and have been taking Remeron as needed (15 or 7.5 mg) for sleep. I’m now experiencing anxiety, akathesia and restlessness, and can’t sleep (even though I took the Remeron). How can I know which med is causing these symptoms? I really want to stop taking both immediately. I know this is ill advised—I don’t want to see a doctor about it, but am not sure what to do.

Edited by scallywag
update title with member's username

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nz11
1 hour ago, LiaJ said:

This week I just began taking Prozac (10mg) and abruptly ended Trintellix (5mg), and have been taking Remeron as needed (15 or 7.5 mg) for sleep. I’m now experiencing anxiety, akathesia and restlessness, and can’t sleep (even though I took the Remeron). How can I know which med is causing these symptoms? I really want to stop taking both immediately. I know this is ill advised—I don’t want to see a doctor about it, but am not sure what to do.

 

Just a gentle reminder sa has a rule only one introduction thread per person.

It keeps things all in one place...good idea eh. This way its easy to following a persons journey.

 

So sorry things have suddenly destabilized.

I'm a bit confused in the drug sig are you able to clarify a few things

you say you reinstated trintellix yet nowhere prior do you mention trinitellix. Id like to know for how long you had been taking it. 

Are you able to give the start date for trintellix and the dosage and the taper down changes if any. I can see you jumped off at 5mg.

You say in one place you stopped T because you 'ran out and couldn't get anymore' then in another you say you stopped it due to being too aggravating. Which is it?

If as you say  the T was too aggravating why did you think that.

What may I ask is your understanding of akathisia?

If you can answer these questions they will help the moderators get a clearer picture.

 

The reason sa advocates only changing one drug at a time when poly drugged is because if things turn sour to whom do we point the finger. As you have now found out. 

Taking any psych drug as needed is to play with fire. You should be taking the same dose every day. Else you are playing ping pong with your brain. These are not aspirins but potent dependence inducing brain altering chemicals. 

 

Prozac has a 'major ' interaction with the remeron. 

Please make clear in your drug sig when you have taken the remeron in the last few days. 

You have only taken prozac at 10 mg for 2 days right? 

 

nz11

 

 

 

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LiaJ

I started taking the Trintellix in the hospital oct 31 2017. I was on it for six weeks, but had restlessness and agitation. I also cannot afford it. It’s a new drug and costs a lot of money. I saw a new psych doctor who put me on Prozac. I stopped the Trintellix this week and started taking 10 mg of Prozac. I’m also taking Remeron. Technically the Remeron interacts with several drugs. I don’t want to be on it anymore. I hate it.

Edited by scallywag
merged from second introduction started

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Staz
29 minutes ago, LiaJ said:

started taking the Trintellix in the hospital oct 31 2017. I was on it for six weeks, but had restlessness and agitation. I also cannot afford it. It’s a new drug and costs a lot of money. I saw a new psych doctor who put me on Prozac. I stopped the Trintellix this week and started taking 10 mg of Prozac. I’m also taking Remeron. Technically the Remeron interacts with several drugs. I don’t want to be on it anymore. I hate it.

I had a major reaction to prozac when I was in 15mg or Remeron. I was started at 20mg of Prozac and felt anxiety and agitation like I've never known before so my local Crisis Team put me on diazepam to calm me down. Addiction and poly drugging then followed. with the knowledge I now have I think it caused me seratonin syndrome and I ended up on a psych ward after 3 weeks. The rest is history.

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LiaJ
24 minutes ago, Staz said:

I had a major reaction to prozac when I was in 15mg or Remeron. I was started at 20mg of Prozac and felt anxiety and agitation like I've never known before so my local Crisis Team put me on diazepam to calm me down. Addiction and poly drugging then followed. with the knowledge I now have I think it caused me seratonin syndrome and I ended up on a psych ward after 3 weeks. The rest is history.

I am sorry to hear this. How did you stabilize?

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joy2730

Hi

 

I am following your journey if that is alright with you.  I have a few questions, but do not feel you have to answered them, if you are uncomfortable with them.

 

How old are you, just roughly in decades is a guideline and how is your functioning regarding work and relationships.

 

It is just good to have a solid background to the struggle.  Do you have a lot of support from friends and/or family?

 

I can assure you that many people do get out of being polydrugged with different combinations and some people find it relatively easy to get off antidepressants, but others do struggle.

 

You must not lose hope by reading this site, as people without problems probably would not join this site.  I think it confuses the doctors that some have no trouble and others do.

 

It seems to be quite common that people can get off the drug but then have a set back a few months out that involves insomnia or panic.

 

You will find lots of good advice and support here but sadly no quick answers.  When antidepressant withdrawal has been investigated by different governments and the medical profession a new way forward may be found.  It is being worked on but it is early days.

 

Joy

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Staz
2 hours ago, LiaJ said:

I am sorry to hear this. How did you stabilize?

I didn't and have been tried on many drugs and the Crisis Team got me addicted to benzos. I've not been stable at all for 20 months and my psychiatrist has told me I have treatment resistant depression. The only thing I can now try is to get off of Valium and hope I improve but it's going to take me a long time to come off 12mg safely.

I live in a constantly suicidal state of mind.

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scallywag

LiaJ -- Welcome to Surviving Antidepressants (SA).

 

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us. Thank you for taking time to post a VERY detailed history in your signature.

 

You've been taking two anti-depressants and recently switched one of them.  It's very common for a person to react to that kind of change.  Your 2-3 month rapid taper off Celexa probably set you up for the insomnia, a very common withdrawal symptom.  Your restlessness and the return of insomnia may well be to the discontinuation of vortioxetine (Trintellix). 

 

Tips to help sleep.

 

Please continue taking both medications. In other words, DO NOT STOP TAKING THEM.   Stopping is almost certain to worsen your symptoms not ease them.

 

A few questions for you:

  1. Why was your medication switched to fluoxetine (Prozac)?
  2. At what time of day do you take mirtazapine (Remeron)?
  3. At what time of day do you take fluoxetine (Prozac)?

Some relevant informational topics for you:

Before you begin tapering -- what you need to know.

Why taper by 10% of my dosage?.

Tips for tapering off Remeron (mirtazapine)

Tips for tapering off Prozac (fluoxetine)

 

These links have helpful descriptions and analogies to explain why the CNS (central nervous system) reacts to dose decreases of neuroactive drugs such as SSRI antidepressants:

How your brain responds to psychiatric drugs - aka "Brain remodeling"

Youtube video, 4 minutes: Healing from antidepressants

 

You may way want to follow this topic so that you get notifications when someone posts in your thread.  Click the white Follow this topic" button near the top right of the page. A dialog box appears:  select one of the notify options, then click follow this topic in the dialog box.

 

Please take a moment to answer the questions and let us know how you're doing.

Edited by scallywag
merged from second introduction started

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LiaJ

Today I feel like I'm about to walk into the darkest time of my life. I requested last week that I stop the Trintellix because it was too agitating. I felt slightly manic, and of course, panicked because I've never felt that way before. I attribute this change to the Trintellix. I had taken Celexa for years with no such adverse effects. In fact, I probably would have been fine to remain on such a low dose permanently. I am mad at myself for weaning off and causing what has proven to be 5 months of absolute hell. I have a lot of health related anxiety, so this has been particularly challenging for me. To be perfectly honest, reading this forum has caused a lot of anxiety that never existed prior to finding it. Now I'm desperate for answers and am very thankful for the assistance you are willing to offer. 

 

Anyhow, I requested a change be made, so the psych NP suggested Paxil. I said hell no. Then he suggested Prozac, so I said sure, as I am aware that it's commonly used as a "bridge", and makes for a less agonizing taper. However, there are issues weaning off Trintellix:

 

1. Psych NP said it isn't necessary, and wouldn't prescribe more

2. I didn't have any more Trintellix so I had no choice but to quit and begin the Prozac. 

 

The first day I was taking the Prozac was fine. Then the extreme restlessness, agitation, heart palpitations, and sleeplessness set in. The Remeron provided no relief, by the way, which I thought was strange, since it had an anti-cortisol function that worked beautifully for me in the hospital back in October. I'm going to take it tonight, and every night, until I've properly tapered.

 

I usually take the Remeron either at 10 or 11 at night, or if I wake up in the middle of the night and can't go back to sleep. This is typically around 3 am. I was taking the Prozac in the morning (though I was instructed to take it at night). I've never been good at taking pills at precisely the same time. Ever. I always took the Trintellix after I ate breakfast.

 

I went to my psych's office today and told them it was imperative that I see my psych NP as soon as possible. They are able to get me in on Monday evening (It's Friday evening, January 5, 2018). I asked the DNP what she suggested I do over the weekend. I have precisely TWO doses of Trintellix, and my Prozac. She agreed it wasn't good to do a lot of med hopping, so she advised me that I take nothing but the Remeron until I can see my psych. 

 

I am not at all trusting of doctors. I also don't want my life to fall apart, and I feel like it's on the precipice. I am afraid he's going to throw an anti-psychotic med on top of all of this, and I don't want to do it. I just don't.

 

Despite the commonly accepted advice here that a gradual taper is absolutely necessary, I am afraid that I'm going to have two options: immediate and painful withdrawal or poly-pharmacological merry-go-round.

 

Help.

Edited by scallywag
deleted quote of immediately previous post for readability

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nz11

Lia just wanted to say you did a great job on the drug sig.

 

1 hour ago, LiaJ said:

weaning off Trintellix:

 

1. Psych NP said it isn't necessary, and wouldn't prescribe more

This is just so wrong. 

These people are dangerous if I were you I wouldn't go back to them. 

Trintellix has a black box warning that it can cause suicide. That makes it dangerous to start but like all these ads even more  dangerous to stop. As the FDA warned in 2004 abrupt changes of an ad can cause suicidal reactions. Because of that reason it must be tapered very slowly. 

 

2 hours ago, LiaJ said:

I didn't have any more Trintellix so I had no choice but to quit

Could you have gone to your doctor or another doctor ...

You don't need a psych doc to get a prescription.

 

1 hour ago, LiaJ said:

.....and makes for a less agonizing taper

This is not a fact.

 

2 hours ago, LiaJ said:

I requested last week that I stop the Trintellix because it was too agitating. I felt slightly manic, and of course, panicked because I've never felt that way before. I attribute this change to the Trintellix

You say that the T was too agitating, I'm not saying it wasn't  but I think this  may have been the wdl symptoms off celexa which the T was not completely  masking.

A two/three month taper (? skipping doses?) was far far too fast,, following sa's recommendation you would have needed nearly two years to taper from 5mg to 0.5 mg of celexa.

Can you see the timeframes these drugs have covertly dealt us. Its an eye opener isn't it. Sadly the medical profession are still blind to it. So you pretty much CT it. 

 

 

1 hour ago, LiaJ said:

She agreed it wasn't good to do a lot of med hopping, so she advised me that I take nothing but the Remeron until I can see my psych. 

 

okay ...In other words just wait until Monday to restart the med hopping again.

I think you are very accurate in your prediction they will throw an antipsychotic (Seroquel) at you. Guaranteed if you tell them you have ongoing sleep issues. 

 

2 hours ago, LiaJ said:

The first day I was taking the Prozac was fine. Then the extreme restlessness, agitation, heart palpitations, and sleeplessness set in

 

3 hours ago, LiaJ said:

so she advised me that I take nothing but the Remeron until I can see my psych

 

So they told you to stop the Prozac

What do you think about that?

 

You may now be exposed without any potential buffer to T wdl and imo celexa wdl.

imo you are going to need to take something to relieve the wdl symptoms else you may end up in hospital (again).

If you don't take the Prozac I'm wondering if its worth going back to the trintellix or a low dose of celexa (essentially you are a celexa addict with what looks like 7 years use that will be a difficult habit to break) maybe 1-2 mg.

Do you have any celexa left?

(If T is equiv in potency to Lexapro then 5mg T = 10mg of Prozac so it does seem a reasonable equivalence ).

It seems to me there is no remeron friendly (no major interactions) ad. They are all 'major'. 

 

You don't need to go to the psych doc for prescriptions (or prescription refusals) or intelligence insulting comments or labels you can get them from a doctor.

Well you know what I mean ....you can get prescriptions from any doctor.

 

It would be really good to hear from the moderating team...before Monday.

SW ?

Alto are you there?  

 

 

2 hours ago, LiaJ said:

I am afraid that I'm going to have two options: immediate and painful withdrawal or poly-pharmacological merry-go-round.

 

Not necessarily you can try to stabilize on a current drug and then taper slowly as per sa guidelines.

It may take years. (No kamakazi 3/4 month tapering), but you will be stable and have a life in the mean time.

You can do it. You are going to be okay. 

 

nz11

 

 

 

 

 

 

 

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LiaJ
14 hours ago, nz11 said:

Lia just wanted to say you did a great job on the drug sig.

 

...

Not necessarily you can try to stabilize on a current drug and then taper slowly as per sa guidelines.

It may take years. (No kamakazi 3/4 month tapering), but you will be stable and have a life in the mean time.

You can do it. You are going to be okay. 

 

nz11

 

34

 

Thank you for your input. I understand now how critical those final percentages are (when tapering). I don't have any Celexa left. I thought about resuming the Celexa, but I can't take it simultaneously with the Remeron (the pharmacy won't dispense the two given the interactions), and now I'm being told that I shouldn't ever discontinue a drug abruptly for any reason. So now I feel like I'm stuck with the Remeron and the Trintellix. 

 

I am wondering if the best way to get the Trintellix is to go voluntarily admit myself to the hospital? Seems extreme, but if Monday comes and they don't refill the script...

Edited by scallywag
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LiaJ
17 hours ago, joy2730 said:

Hi

 

I am following your journey if that is alright with you.  I have a few questions, but do not feel you have to answered them, if you are uncomfortable with them.

 

How old are you, just roughly in decades is a guideline and how is your functioning regarding work and relationships.

 

It is just good to have a solid background to the struggle.  Do you have a lot of support from friends and/or family?

 

I can assure you that many people do get out of being polydrugged with different combinations and some people find it relatively easy to get off antidepressants, but others do struggle.

 

You must not lose hope by reading this site, as people without problems probably would not join this site.  I think it confuses the doctors that some have no trouble and others do.

 

It seems to be quite common that people can get off the drug but then have a set back a few months out that involves insomnia or panic.

 

You will find lots of good advice and support here but sadly no quick answers.  When antidepressant withdrawal has been investigated by different governments and the medical profession a new way forward may be found.  It is being worked on but it is early days.

 

Joy

Hi Joy,

 

I'd love it if you'd follow my journey! Thank you for reaching out. I am about to turn 35 next month, and I've been pharma-drugged consistently for a little over ten years. Personally, this illness and the subsequent drug therapies have made it challenging to maintain relationships. When I quit drinking (age 27) I started to socially withdraw. I would love to be married and have a family, and hope that this will still happen one day. Professionally, this illness has been devastating. I haven't been able to hold a full-time job longer than 6-8 months. I do think this would be different if I found work that was meaningful to me, which hasn't happened yet. I am planning on starting graduate school (I graduated from college in 2012) for counseling (go figure!!) because I want to help people address their mental health challenges without reaching for drugs first. This is what keeps me motivated to keep going, through the dark times. 

 

I am living with my grandparents. I just moved back in with them when I was hospitalized last October. They are supportive but don't exactly understand what this all is. They're from a generation, too, where they simply just trusted doctors. If you had a problem, you'd go to your doctor, and faithfully follow whatever advice they offered. I've tried to live alone, but without a consistent income in today's world, it's difficult. I have my sister and a couple of friends here that are supportive. I am reaching out to NAMI support groups here, as well as a holistic mental health network I located.

 

Please tell me more about your experience as well. How has your life been affected? Where are you in your journey?

 

Lia

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nz11
46 minutes ago, LiaJ said:

I thought about resuming the Celexa, but I can't take it simultaneously with the Remeron (the pharmacy won't dispense the two given the interactions

 

Well I ran all your doubles through  interactions.  So why did  they  dispense the P and R or the T and R then.

And why in  past they  dispense B and C when that had a 'major' interaction as well. 

Maybe because the C and R interactions are four  lines longer I guess.

Well that means maybe you carry on with the P or the T 

 

 

Interactions between your selected drugs

Major

mirtazapine citalopram

Applies to: Remeron (mirtazapine), Celexa (citalopram)

Using citalopram together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms during treatment. In addition, combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

Interactions between your selected drugs

Major

fluoxetine mirtazapine

Applies to: Prozac (fluoxetine), Remeron (mirtazapine)

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

 

 

Interactions between your selected drugs

Major

mirtazapine vortioxetine

Applies to: Remeron (mirtazapine), vortioxetine

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

 

Interactions between your selected drugs

Major

buspirone citalopram

Applies to: BuSpar (buspirone), citalopram

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

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joy2730

Well you are still young and haven't been polydrugged for all that long, so you should do well.

 

I am 59 now and have been on psychiatric drugs since I was 18 or 19 (I don't know which cos I was too ill to know my age!) but have got off antipsychotic, antidepressants, mood stabilisers, tranquillisers and sleeping pills, but am stuck with 18 mg citalopram, but nothing else.

 

I took drugs all the time except for 6 months in my first pregnancy.  It is not recommended but other than premature birth all went well and I know loads of women who have taken SSRIs while pregnant.  I wasn't able to breastfeed though, which has been a big regret.

 

This has affected the whole of my life, my career, marriages and everything.  I now wish I had got off these meds sooner in life but in those days we lacked the knowledge and confidence to go against doctors.

 

My regrets are enormous but I am still alive with whatever I have now, but am so glad I got off all the drugs I did get off.  They were not working anyway!

 

In the future I hope to get off the citalopram but I work hard now and get a lot of satisfaction from my work, and my GP thinks it is probably more important to me that I continue working.   So do I.

 

I recommend anyone to try to get off them, I did after decades of use and against all medical advice.  I nearly didn't work trying to get off diazepam as everyone said I was too old at 48, but that was not true either, and I managed it.

 

You must take heart that it is entirely possible, but you mustn't miss your chance to have a child just because you are on drugs.

 

I saw a video youtube clip of a woman trying to get off Paxil to have a pregnancy but couldn't manage it and had to go back on.  She had worked so hard at trying to get off it, but even though my babies were born prematurely and I couldn't breastfeed I am still glad I chanced having them.

 

Take good care you are so young to be doing this, some say it is harder when you are female, but who really knows?

 

Joy

 

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LiaJ
9 hours ago, nz11 said:

 

Well I ran all your doubles through  interactions.  So why did  they  dispense the P and R or the T and R then.

And why in  past they  dispense B and C when that had a 'major' interaction as well. 

Maybe because the C and R interactions are four  lines longer I guess.

Well that means maybe you carry on with the P or the T

Interactions between your selected drugs

Major: mirtazapine citalopram
 
Major: fluoxetine mirtazapine
 
Major: mirtazapine vortioxetine
 
Major: busipirone citalopram

...

 

Serotonin syndrome can occur when taking supplements with SSRIs as well. I think it's something that must be monitored. Interesting, the symptoms of serotonin syndrome are nearly identical to withdrawal. The fact is, there is a possibility for an adverse reaction occurring when you mix ANY drug, or supplement, for that matter. One size fits nobody, you know? 

Edited by scallywag
trimmed quote to relevant portions

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LiaJ
5 hours ago, joy2730 said:

Well you are still young and haven't been polydrugged for all that long, so you should do well.

 

I am 59 now and have been on psychiatric drugs since I was 18 or 19 (I don't know which cos I was too ill to know my age!) but have got off antipsychotic, antidepressants, mood stabilisers, tranquillisers and sleeping pills, but am stuck with 18 mg citalopram, but nothing else.

 

I took drugs all the time except for 6 months in my first pregnancy.  It is not recommended but other than premature birth all went well and I know loads of women who have taken SSRIs while pregnant.  I wasn't able to breastfeed though, which has been a big regret.

 

This has affected the whole of my life, my career, marriages and everything.  I now wish I had got off these meds sooner in life but in those days we lacked the knowledge and confidence to go against doctors.

 

My regrets are enormous but I am still alive with whatever I have now, but am so glad I got off all the drugs I did get off.  They were not working anyway!

 

In the future I hope to get off the citalopram but I work hard now and get a lot of satisfaction from my work, and my GP thinks it is probably more important to me that I continue working.   So do I.

 

I recommend anyone to try to get off them, I did after decades of use and against all medical advice.  I nearly didn't work trying to get off diazepam as everyone said I was too old at 48, but that was not true either, and I managed it.

 

You must take heart that it is entirely possible, but you mustn't miss your chance to have a child just because you are on drugs.

 

I saw a video youtube clip of a woman trying to get off Paxil to have a pregnancy but couldn't manage it and had to go back on.  She had worked so hard at trying to get off it, but even though my babies were born prematurely and I couldn't breastfeed I am still glad I chanced having them.

 

Take good care you are so young to be doing this, some say it is harder when you are female, but who really knows?

 

Joy

 

5

I think that what you've been able to accomplish, coming off the drugs you have successfully, is an amazing success story! Sometimes we need to look back if only to see how far we've come. :)  Have you ever read Eckhart Tolle's "A New Earth?" Are you familiar with him? I highly recommend the read. It has helped me tremendously.

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LiaJ
14 hours ago, nz11 said:

...

Could you have gone to your doctor or another doctor ...

You don't need a psych doc to get a prescription.

...

Unfortunately I don't have a primary care doc at the moment. I'm looking for one, of course. So, I suppose the plan is to reinstate the Trintellix and keep taking the Remeron, tapering the Trintellix first before the Remeron?

Edited by scallywag
trimmed quote to relevant portion

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scallywag

Medical professionals ALMOST ALWAYS prescribe additional or different medications in response to reported symptom changes. This rarely truly helps a person.  Typically the symptoms will go away only because they're suppressed by significant doses of the new medication(s)/dose(s) and eventually new symptoms arise which "require" -- you guessed it -- new medications or increased dosage. Far too many people get medication-induced and medication-reinforced symptoms and then caught in an awful and miserable tangle.

 

It usually takes at least several weeks to get therapeutic effect from SSRI medications.  Are you willing to give yourself another 1-2 weeks on the prozac? Can you find ways to manage using non-drug techniques to deal with your symptoms?

Non-drug techniques to cope with emotional symptoms.

 

Lia, one of the first things I learned here at SA was that stable medication and stable doses are the most likely path to stable symptoms. Then once symptoms are stable, not necessarily absent but with no dramatic swings day-to-day, it's time to consider a small dose reduction of one medication.  I hope you'll consider obtaining stability a worthy interim goal.  Do what you can to take your doses at the same time each day. Some people set an alarm, usually on their phone, to remind them to take the medication at the scheduled time.

 

Am I understanding correctly that you are now taking 7.5 mg mirtazapine (brandname: Remeron) some frequency that isn't  every day?  If so, please consider taking 7.5 mg every day or a portion of the tablet, say ¾ which would be 5.625 mg. Irregular dosing of neuro-psycho-active medications with a short half life creates symptoms for many many people.

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LiaJ
21 hours ago, scallywag said:

It usually takes at least several weeks to get therapeutic effect from SSRI medications.  Are you willing to give yourself another 1-2 weeks on the prozac? Can you find ways to manage using non-drug techniques to deal with your symptoms?

Non-drug techniques to cope with emotional symptoms.

4

 

If I switched to Prozac I would have to continue on Trintellix, and I don't know if that would help at this point. My plan was to stabilize on Trintellix since it was such a low dose and begin tapering that drug first.

Edited by scallywag
move reply out of quote box

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LiaJ
Just now, LiaJ said:

 

SW,

I'm not sure if switching to Prozac would help at this point, since I'd have to remain on the Trintellix simultaneously, then taper off that. Is that advisable?

 

I'm all over the place with Remeron. Two nights ago I took 15 mg, (7.5mg at 8pm, another 7.5mg when I woke at 1 am) Last night I took 7.5mg but slept very poorly. I have a feeling your suggestion is to take 15 mg of Remeron until stable and then ween off the activating SSRI (Trintellix) first?

 

Thank you :)

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LiaJ

So, a 5 mg pill of Trintellix weighs .155 grams on a milligram scale. 

 

I'm better with words than mathematical calculations. Can someone help me through making the calculations for a 10% reduction? 

 

My plan is not to create a liquid suspension but to crush the pills, and add the powder to a capsule, or to water and drink it. 

 

Many thanks!

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LiaJ

Can anyone speak or advise upon whether 5HTP or Tryptophan can be used during the withdrawal process and at what point should they be applied?

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scallywag

Lia, thanks for clarifying.  I got the trintellix/prozac wrong -- I didn't see that you stopped prozac and reinstated trintellix.  Would you modify your signature so that it reflects what you are currently taking? 

 

Remeron: I'm suggesting that you find a stable dose that you take every day.  A couple of options:

- 1½ tablets (7.5 + 3.75 mg) at 8 pm each day; or

- 7.5 mg at 8 pm and 3.75 mg at 10:30 or 11 pm (bedtime)

What do you think about trying one of those plans for 2 weeks?   

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scallywag

Weighing pills:  You'll probably find the discussion in this topic helpful, Using a digital scale to measure doses.

 

5HTP and Tryptophan: We don't recommend either -- the results vary too much from one person to the next. More information in this topic, 5-HTP and L-tryptophan

 

A couple of tips for using this site:

  1. People will see your questions sooner if you post them in your introduction topic.
  2. Very many, almost every possible,  symptom and supplement have been discussed. You can find them by using the site search tool or by doing a web search (google, bing, duck-duck-go) using the keyword,  e.g. 5-HTP or tryptophan, and this expression, site:survivingantidepressants.org.  Including the site will force pages from this site to be at the top of the results.
Edited by scallywag
add 5htp info and tips

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nz11
5 hours ago, LiaJ said:

Can someone help me through making the calculations for a 10% reduction

 

 

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LiaJ

Hello!

 

I've read the info about supplementing with Seriphos. I would like to try this, but my question is this:

 

Can I take this while I'm still on Mirtazapine? I'm taking roughly 5 mg at night. Mirtazapine also lowers cortisol.

 

Thanks 😊

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ChessieCat

For what symptom are you wanting to supplement with Seriphos?

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ChessieCat
7 hours ago, LiaJ said:

while I'm still on Mirtazapine

 

The last mention of Remeron is 4th January 2018.  Please update your signature so it remains current and we can see your drug history at a glance.  Thank you.  Click on this link to go straight to your signature:  Account Settings – Create or Edit a signature

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LiaJ
On 2/17/2018 at 5:51 PM, ChessieCat said:

For what symptom are you wanting to supplement with Seriphos?

Sleeplessness due to cortisol surges at night. I have been weighing shards of dissolvable Remeron tablets, so my calculations are by weight and not milligrams. About a week ago I dropped from .071 to. 065 and I'm having anxiety at night and disturbed sleep. 

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