Confused by meds and symptoms (escitalopram and Mirtazipine)

Mental health
1

Hi. A bit of background. I was on escitalopram since 2011 and it worked great. Last year my anxiety hit a high and I was put on pregabalin low dose (50mg) with the escitalopram and it got me through. But when my anxiety got bad again  we tried to increase the pregabalin and I couldn't go beyond 100mg without anxiety going through the roof.

So doc decided to introduce Mirtazipine 15mg. Almost instantly my anxiety felt better.

Then early June I came off the 100mg pregabalin quite quickly (about a week) and late June stopped the escitalopram (after going to 10mg every other night for 2-3 weeks) as doc thought it'd be good if I was just on Mirtazipine.

In hindsight I can see I was started to get anxiety symptoms (including some OCD stuff) through June and then a week after stopping the escitalopram and three weeks after the pregabalin,  my anxiety went through the roof again. Doc said double Mirtazipine to 30mg. Things got worse. Nightmares, couldn't eat, permanently agitated, severe anxiety, couldn't cope. Ended up using diazepam through the day.

I stuck this for three weeks and couldn't cope any longer so gp said go back to 15mg Mirtazipine and reintroduce Escitalopram 10mg. Which is where I am now. I've been on this for two and a half weeks and it's still very rough.

I'm taking Zopiclone 3.75 to get sleep as wasn't getting much at all. I take 2mg diazepam a couple of times a day but I could take more as I feel severely anxious, restless, agitated all day. My mind won't let me shut off and rest or concentrate on much at all.

I'm exhausted but can't rest. I need rest as I have ME/CFS as well.

I was getting little moments of less anxiety towards the end of last week and was feeling hopeful. I even found I could focus on a few things I'd not been able to since June.

This week has been full on with my head not stopping. Ocd stuff too. When I close my eyes, I get strange dreamlike images (this has been the case all along since I was on 30mg Mirtazipine) but I'm not asleep and can't sleep in the day although I need to.

I've got an appt in two weeks to review what I need (therapies etc) but just feeling this daily slog isn't going to improve.

I do breathing and listen to relaxing music but can't do meditation as it makes me worse, it's never suited me. 

Why am I not adjusting back to those meds I was on? Could it be pregabalin withdrawal? I stopped it quickly early June.

I can't believe how bad I'm feeling still everyday. 

Especially as I thought I was getting glimmers of improvement a few days ago.

I'm not expecting perfection but this head to toe restlessness, anxiety, and racing thoughts has been full on!

Any insights appreciated. Thanks. 

2

Hi Nikki,

I've been reading up on Pregabalin withdrawal symptoms and a lot of what you are suffering appears to be related.

The withdrawal on top of a new regime could be why you are feeling like you do.

I've only just realised in the past few weeks that when I was at my worst it was actually withdrawal symptoms from going cold turkey from Trazadone and then withdrawing from Mirtazapine.

A 

Someone who knows about withdrawal actually said to me at the time they thought I was suffering withdrawal but I didn't realise.

I really hope things settle soon as you've been suffering badly.

Hugs 🤗 

3

Hi Karen

Thank you. Yes I read up on it too and it fits. Thank you for reading up on it. I wish I'd known and had tapered properly. Doc said it probably wasn't doing much so just stop. 

I had another rotten night. I think the Zopiclone has stopped helping like it was. Been on it three weeks now at 3.75 dose.

I'm going to ask for Quetiapine but I'm worried I'll get withdrawal from Zopiclone now too as gp said just to replace it with the Quetiapine.

Feeling rough. So anxious. But have to be able to function.

My dog is poorly and I need to get her to the vets. 

Don't know what to do first! 

How was your night? X

4

Oh Nikki bless you ❤️

I think we can probably say that when we both suffered ( your still suffering) from is withdrawal, absolutely horrendous, they don't tell us about this and don't taper us slow enough!

Give the Quetiapine a go, you may not get withdrawal from the Zopiclone if you replace it with Quetiapine.

As soon as I read all those withdrawal symptoms I knew that's what I had suffered and it was a damn rough ride!

It's a shame your GP didn't suggest Quetiapine twice a day, as I think you would find some benefit from it during the day too, and 25mg is a very low dose, apparently some take hundreds of mgs  a day!

Is the GP ringing you today or do you have to ring them?

My night wasn't too bad thank you, still up early, but never mind!

Hope you get something sorted and feel calmer as the day goes on.

Hugs 🤗 

5

Hi Karen

The GP is phoning me this morning as I've called and asked for a follow up on yesterday's call. Unfortunately now I'm having to take me dog to the vets for 11.15 as she's having problems and I'm worried I'll miss the gp as I'll be busy there!

Is Quetiapine a longer term med?

I will ask her about taking two doses. 

Yes I think this is definitely withdrawal as I'm now on the same meds I was on anyway just minus the pregabalin. Plus of course regular diazepam and sleeping tablets! Blimey. I keep feeling it's a tangled mess that'll never get sorted out but it won't always be this way will it?!

Must try to eat something as have to go to vets and don't want to be weak n wobbly there!

It seems like although you're still having difficult nights, you're managing better?

X

6

Hi Nikki,

Fingers crossed you don't miss the call !

Hope your dog is ok too.

I think Quetiapine is not a 'forever' medication but more for as long as you need it, I'm not really sure?!

As although it does work within 45minutes re sleep etc it also says takes a few weeks to build up in the system?

It should improve your appetite though!

I go sleep no problem, but just can't get past this waking up early gggrr!

Will see what Dr says tomorrow.

Let us know how you get on at the vets and with the GP.

Hugs 🤗 

7

Hi Nikki I am not surprised you are highly agitated etc.There have been far too many drug changes in a very short space of time.Pregabalin should have been withdrawn slowly over a period of time.Also time should have been allowed to pass before withdrawing your antidepressant.Also add in the side effects of the other drugs you are on.l would advise you have to give it time to settle l know it is horrible but it will pass.Try not to stay on zopiclone or diazepam long term as they cause a lot of problems with long term use.

8

Thank you Marleen.

It is truly horrible!

I keep telling myself it will pass, one day there'll be some real improvements.

I'm worried about taking the zopiclone but without it I'd not have any sleep at the moment. 

Hoping I can taper it once I'm doing better in the daytime.

X

9

I know it will pass.Don't change anything now allow your brain to settle down as it has been through so much.Let everything settle down and it will.l started feeling really agitated increasingly so over the last 3 or 4 years.l thought nothing is helping l was getting worse however l worked out for myself l was in withdrawal from diazepam which l was taking for sleep for 10 years.l wasn't abusing it in any way.So l started to reduce it very slowly and as awful as l feel at times the agitation has definitely decreased.l know l will get there in the end and so will you.

10

Do you think my agitation is to do with diazepam? I'm keeping it to one or two 2mg a day. I don't like taking it. It's been 6 or so weeks now I've been using it. 

I'm panicking now that it's that causing me problems?! X

11

Do not panic l think the pregabalin withdrawal that is causing your agitation.Diazepam has a side effect of agitation however l don't know if that is the cause.Use it only when absolutely necessary.Just take it one day at a time and don't expect too much too soon.Trust me it will settle down.l know you feel despair however it will not last.l find when l felt agitated l took the dogs out for walks a lot of time l didn't want to leave the house however it was the best medicine.

12

Just reading here.Please don't add quetiapine into the mix the last thing you need are more side effects.

13

Thank you Marleen.

I don't know how I'm keeping going, one step at a time it feels.

X 

14

I'm not going to. Not changing anything although I'd like to not be on Zopiclone and diazepam!

Thanks Marleen x

15

You will get through this we are all facing battles and we all have to realise we are stronger than we think.We can cope keep telling yourself that.

16

It sounds like you have your battle coming off the diazepam. Wishing you well. Thank you for your words of encouragement, experience and strength Marleen x 

17

Same to you Nikki you can get through this and the other side will be much brighter.

18

That will be wonderful Marleen X

19

Don't give up hope l know ànxiety robs us of our belief in ourselves but trust me Nikki it is still there you just have to believe in yourself.Let me know how you get on.