4 weeks off the Mirtazapine, things still rough.

Treatment and medication
1

Hi all. First a bit of background. I have been on many anti-depressants in the last 4 years since a botched op left me in severe non stop daily chronic pain. I haven't adjusted at all well to being jobless/lifeless/in pain and generally watching my world die around me whilst I'm still here to watch it. I have PTSD surrounding the event and am severely depressed.

I decided to come off anti-depressants after reading a great deal of critical papers based on their success and upon who is actually funding/producing the research for their data. And yep. It's the profit making companies that make it?!?

My other main reason is (that for me) anti-depressants have caused me SO much more problems than not being on them. They have nearly killed me with regards to suicidal thoughts and intention so enough is enough.

As a final point my GP (NHS drug dealer) has absolutely no (and I mean zero) understanding of correct titration methods and if this is the person I am entrusting my health and life to then......well that's not great is it.

So, I titrated from 30mgs at 2mgs a week. I did this to try and avoid withdrawal, sadly even this didn't. I bought some micro scales on Amazon and simply cut the pills.

My last dose of 4mgs of mirtazapine was 28 days ago now. The first week-10 days was easy, no withdrawal at all, I congratulated myself on beating this drug then boom...... INSOMNIA, and I don't mean I don't sleep great, I mean I don't sleep, max is 1-3 hours. Nausea, headaches, vomiting, hot flushes that come on in a second. Suicidal thoughts non stop and agitation like you wouldn't believe. My chronic pain symptoms have also been massively exacerbated by the stopping of the drug.

Lots of people say the patch between week 3-5 is the worst and I can 100% attest to this. I am just hoping I don't have to be like this for months as my mental and physical health from my chronic pain means I already have VERY low resilience to continue.

I have upped my magnesium, cut out ALL stimulants, am using piriton to help sleep as well as zopiclone 7.5mgs (will be detoxing this in the new year) and eating very clean.

I see lots of ppl on forums saying 'always consult your GP......or........your GP knows best; well in my 4 years of navigating the system (and having worked as a mental health professional before my botched operation I can clarify that certainly 80-90% of GP's in fact know nothing about correct Z-drug, benzo, anti-dep, SSRI or opiate withdrawals. Whatever they tell you to do, I would recommend adding 10 times the amount of time they recommend. Seriously. Dr's are rushed, highly stressed, often utterly incompetent and very often suffering from very sad, grandeous ego complex's. Take what they say with a MOUNTAIN of salt.

Anyway, I will update as my journey continues and let you know when this ■■■■ abates.

Jack

2

HI friend...

I am so sorry to read all the sufferings you have been through and I somehow can relate to your situation both mentally and spiritually. I hope all of this will end some day soon for you and you will earn your happy and normal life.

In my opinion you have gone a bit tooo fast with your taper plan. 2Mg per week when we talk from 15 to 4 Mg is itoo fast. Normally people advice 10% of your current dose every 3-4 weeks. The jumping figure of 4MG is again too high there are poeple around who prefer jumping at around 0.3 MG or even lower if you are able to measure.  I think you are still on time to stabilise. Maybe reinstating at a lower dose could help... like 2 Mg.... and then taper later after you are a bit stable by using 10% rule. IN order to measure such small doses you do not need to use a micro scale... just mix the Remeron with water on a 1mg to 1ml density and then draw what you need with a syringe after you shake it well to ensure the equal distribution of particles. I am using this method and i have gone since 4th of July up to now at 8.1Mg. Of course i am not having a beautiful time but at least it is liveable... and I am working full time. 

My topic is below and there is a lot of info there so you can read in case you have any question buddy. 

https://patient.info/forums/discuss/weaning-off-mirtazapine-531188

Of course it is the option that as you are 28 days out to wait it out and it might work but from the stories i have read the time might take even longer. This is your decision buddy and do not take my word as an advice. I AM NOT A DOCTOR but just a fellow SUFERER from this bloody meds.

All the best buddy.

3

Great post Jackweds, so true that docs, p'docs, most docs' just do not know about the slow taper, or the necessity to remodel the brain slowly to avoid withdrawal,

after change in chemistry of the brain (from AD's) letting it adjust its chemistry and structure to try to return to homeostasis.  So very sorry for all your suffering, and you being a mental health professional have seen another side.

4 mg is a high jump in mho, I plan to go right down to 0.1 mg ... yes it takes time, but I am very aware that insomnia may strike otherwise and then a return to anxiety ugh ...

4 weeks out from stopping, you might be better, as Toni suggests, to go back to a low dose, I would say 3mg and stabilise before considering your next move.  Yes the golden rule seems to be no more than 10% every 4 weeks, you can read about it for a full informed choice, click on my name and follow the link/s under my status.

I have read of people stopping Mirt' at a higher dose, such as yours, and getting away with it,  maybe 5% of folk.  But I think those that suffer within 2 weeks, it can be a long haul to stay cold turkey, but we're all different, and it depends how much the individual can take.  

In my research, the best advice I found before the 10% was by Joseph Glenmullen, but even he recommends 25% drop each time, so out of date for many of us.

I hope you find some relief, just knowing that it will pass, and as you have been on a painful journey I hope yo have learnt that those 'S' thoughts are a symptom and not a need, empowering ourselves with this knowledge is vital to take control of our thoughts and not letting our thoughts control us due to a med' - or wd from it.

Best wishes Jackweds, be strong, I can read you are, stick with us.

4

Jack

I feel your pain and relate absolutely to all you have said especially our GP's knowledge. I am on a very slow tapering journey and can agree with others that even your jump from 4mg to zero is too quick - even though 4mg seems such a low dose. When I was at 4mg my doc said that's only a homeopathic amount you can stop straight away. If only !.  I have recently dropped from 3mg to 2mg because I was doing fine. However  the old symptoms returned after a week and I have had to go back to 3mg and will just follow the 10% rule over a long period of time. I had to insist on getting liquid mirt from my GP to do the slow withdrawal. It's nonsense to try to cut up tablets to give a steady dose. Stick with us and let us know how things progress.

5

Hi all. Thank you for your compassionate and extremely wise comments so far.

The main point I am picking up on is that even 4mg's seems to be too much of a dose to give up on.

I genuinely thought that a 2mg drop a week from 30mg would be fine. (To clarify my GP advised 7 days at 15mgs then stop!!)

I know this may sound like I am crazy but I am going to continue with the total withdrawal. Mainly because I have done a month and the symptoms today (nausea, irritability, suicidal thoughts) have decreased a little. I am however sad to say that my insomnia is still terrible.

I will update this feed every other day to let people know how I am getting on. I know it is often valuable for people to compare their progress with others (although crucial to remember that everyone's progress is different and our environments and epigenetic will affect us all in differing ways.

To clarify to those who it is relevant to:-

I titrated from 30mgs down to 4mgs. I did this over a very long period of time and reduced 2mg's a week. At 4mgs I (very probably wrongly) decided I was on a low enough dose to stop.

That was now 29 days ago, first week-10 days where a breeze. Since then, nausea, insomnia, stress, suicidal thoughts, irritability, deep catastrophising and a feeling of total doom.

I am absolutely determined not to use Mirtazapine again, the thought of putting (even a tiny dose) back in to my system makes me feel terrible. I am a very strong individual and am truly determined to stay off this drug. Although my updates may make depressing reading over the coming weeks; I am already looking forward to posting that I am symptom and mirtrazapine free.

As a side note I am not going to be taking any other anti-depressant medication in future. I am trying to use healthy nutrition, exercise, visualisation, positivity, self compassion and natural pain relieving techniques and therapists.

I remain on codeine (approx max of 240mgs a day) for my chronic pain and zopiclone 7.5mg for sleep. My intention in the new year is to titrate and stop using both of these drugs also. I am particukatly worried about zopiclone as I haven't slept drug free since 2012..........but that is a future worry and not something I should focus on now. Let's sort out the mirt withdrawal first!!!!

Thanks again for your kind words. And isn't it fascinating to see such intelligence being shared in the comments I have received. Sad this kind of compassionate, reasoned dialogue cannot seem to make its way into the GP surgery?!

I will update soon. Many thanks, Jack,

6

Thanks so much Toni for your reply, I have done a general reply to all. Many thanks, I really appreciate it, : )

7

Thanks for your reply, I have done a general reply: thank you : )

8

Many thanks for your reply. I have done a general reply below. Thank you : )

9

Hi Jack. I am on my way back from work and while waiting on the semaphore thought to answer back. As far as the sleep is concerned you can try Linden and Chamomile mixed tea. I have used it successfully on my very bad days. Do not touch zopiclone for the moment...your CNS is already sensitized and fighting it's way back to homeostasis... Let it heal... If you decide not to reinstate that is your choice but as Calmer is saying do not take the depressive thoughts seriously. Try to live with those waves and consider them an indicator of healing. Build up a routine and follow it. Exercise and walking are the perfect medicine.

10

Hi all.

Day 30 off the Mirt, nausea is a lot better and my headache is less which is great.

The bad news is my insomnia is terrible. I manage to get to sleep by using 7.5mgs and piriton, but I only manage to stay asleep for a few hours before waking, then the problem starts, once I wake it is impossible to get back to sleep, no matter how sick with exhaustion I am. As a side note I am a type 1 diabetic so my sleep is terrible anyway due to frequent urination/hypoglycaemia.

Agitation is bad and I think mainly due to my pain/lack of sleep I am still having a lot of suicidal thoughts, although no intention to carry out the act.

Anyway, I will update again in time; I am going to try and get up tomorrow at a set time and set some serious sleep hygiene goals.

Jack

11

Is Piriton the same as Benadryl, or the same amount of drowsiness can be earnt from them?  Some people use Phenergen, maybe look into this, but check with your doctor if you have any allergies/heart/breathing difficulties.  All for sleep aid.

I wonder can you take the Zopiclone before you go to sleep and the Piriton/Benadryl/Phenergen when you wake after a few hours?  

Symptoms of insomnia are just about the worst WD symptom, very common, and very difficult.  Have you tried listening to some meditation or maybe check out the Honest Guys on You Tube for those difficult middle of the night times which are so awful.

 

12

That is a good point about the piriton, I will try 7.5 zopiclone and not the piriton tonight. I am not sure about the comparison to Benadryl but I know that stuff does make me drowsy.

Yep insomnia is the absolute worst, I am sitting here in agony with my chronic pain and wired/feeling so sick with my exhaustion. It is very very hard to cope with this level of discomfort.

I hope you are well. Jack

13

Thank you Jack, I am fine, my tapert plan is taking longer than I imagined but hey ho, slow I go.  

How did your night go?  Yes, don't feel bad about taking the Mrt' again if insomnia is too bad, no no no ... don't suffer unnecessarily.  No medics that I've ever heard of have discussed the rewiring of the brains neurons, but after being altered by AD's, they cannot just click into place and sleep be normal, the "trellis" (drugs) have been whipped away abruptly without time for the necessary alteration, it takes time, that's why so many of us are doing the slow taper.  

That wired feeling is awful, he more tired we get the more wired the more we are unable to sleep ugh ... some take a Benzo for a month or two when desperate, would you consider this?  Maybe discuss with your doc?

 

14

Hey Jackweds..

For me in the cases of terrible insomnia and anxiety Linden and Chamomire does the trick. I wake up around 2-3 am if I can not sleep and make this tea. After i put some sleep hypnosis video on my cell phone and go back to sleep. Most of the time i get like 3-4 hours extra sleep until the time to wake up.

You can try for yourself and see... Maybe it works for you as well.

Good Luck.

15

Hi Jack, suicidal response is a very common response to constant chronic pain, the feeling of lifelessness you are experiencing is most likely from the antidepressants, the idea is that they cut off all the low feelings but at the same time they cut off the highs. The clean diet will help but honestly in your case the best person to see about your need for antidepressants is a psychiatrist, you are corrent in that a regular GP will have no idea in the case of a combination of meds there are pain specialists out there that can help. In terms of detoxing, dont cut all stimulants as this can throw off the sleep cycle and make rest impossible. I recomend a regular coffee in the morning so your body can find a kind of cycle to fall into. Like you are telling it when to be awake. Finally keep up the surgars as you will burn more on less sleep and this can leave you feeling aweful if you get critically sugar low. See a psychiatrist and see if you can find a pain specialist GPs arent trained for cases like yours.

16

Hey, just a quick check in. Now been six weeks since my last dose.

Last week was terrible, suicidal thoughts plagued me and I consider myself lucky to still be alive.

3-4 days ago things started to improve. Feel a lot better now.

Of course I still have severe chronic pain but now I am off the mirt I feel more more in control and far less.....well mashed and controlled by a drug.

Those titrating keep going.