Slow taper doesn't work for some

"What symptoms are you having"

This isn't all of it but close enough...

Physical:

-Hot flashes

-Temperature control problems

- Loss of sensation in face

- Sense of taste and touch decreased

- Dizzy

- Migraine

- Head feels flu-y. Like it's under water or a hot hair balloo.

- Throbbing or pulsing inside head. It's like I can feel my brain moving.

- Plugged ears that won't pop

- Voice sounds like it's in a tunnel

- Neck pain and very stiff neck and shoulders.

- Hot shooting pain down neck and back.

- Increased muscle weakness

- Pain or numbness in arm. Sometimes tingling.

- Dry mouth

- Trouble swallowing. Throat feel swollen.

- Vision loss

- Blurry wavy vision. Vision worse is bright light. Have trouble telling where anything is or focus on anything. Like everything is in magic mirrors. Can't see fine details very well at all.

- Tunnel vision. Loss of peripheral vision

- Body feels like it's moving when it's not

- Walking feels like being on a on treadmill or carousel

-Cliche movie scene of hallway getting longer

- Walking into things or physically feeling like I will . Have to be very careful.

- Ground and objects seems further away than usual

- Sometimes really hard to move

- Dexterity much worse

-Trouble with motor skills and poor proprioception

-Depth perception off and sense of where things are and where I am in relation to them.

Mentally

- Sleep disturbances

- Extremely vivid and odd dreams

- Cognitive disturbances / Mentally disorientated

- Concentration problems

- Confused easily

- Difficulty processing information or forming new memories

- Short term memory loss

- Extreme brain fog

-Can not talk properly

-Can not write properly

- Can't understand people as well

-Losing track of time. No sense of time. Minutes can feel like hours or hours can feel like minutes.

- Feels like being in a dream

- Dissociation

- Derealization

- Depersonalization

- Extreme anxiety

-Feels 'high'. Everything seems surreal.

-Zoning or blanking out for extended periods of time.

-Images seem to move a little or 'breathe'.

These are all anxiety symptoms

These are all anxiety symptoms

Yeah that's what the 5 different doctors I saw said. Never had any of these issue before I tried decreasing my dose. I missed two weeks of work because I was like... literally high out of my mind. No kidding. And I'm from the West Coast of BC  Canada so um yeah.. marijuana central.   

Dunno if my last post went through... I guess they have an issue with me talking about pot. ANYWAY... Yeah that's what the 5 doctors I saw said. Never had these issue before mirtazapine. I went on it for insomnia! And it only helped me get to sleep for the first two weeks!

My gp told me to just stop. She said there was no way I'd get withdrawals only being on it two months. Well according to studies that is more than enough time. She refused to prescribe any more. Said if I had any issues it was me and not mirtazapine. I KNOW it's not me. So I had to go elsewhere. She would have sooner committed me to a metal institution than believed she was wrong.

With mirt is suppose to be 10% a month ,I was told to drop from 45 to 30 in two weeks the withdrawal symptons were similar to anxeity buy 100% worse.

With sertraline 75mg I was told I could come off that without any tapering

Medication really is a minefield

Best speak to your doc again

Thanks Calmer. See my symptoms passed after about three weeks. At first they would come and go and then I had them non-stop for a whole week. I've felt fairly 'normal' the past week. I'm at least about to get out of the house and go to work. 

I'm in Canada so I can't get the liquid. I tried making my own. I'm kind of iffy about wasting tablets though. Would it be better to cut them and use a scale to measure and then make liquids out of the pieces? 

To clarify I went back up to 15mg then my symptoms passed after a few weeks. I am currently on 15.

Hi Nyx, have a read of this and get the equipment together, make a plan, and go as slow as you like.   This I have to give credit to Evergreen  for as she got off Mirt' this way.  If anyone struggles, is sensitive to the drops this can be very helpful.  

Here is the pill to liquid instruction for anyone who might want to taper slowly.

You will need a 15 ml syringe and also a 1ml syringe with markings on at 0.1ml intervals

A pill crusher (available from Amazon)

A clean medicine bottle or small jar

A small accurate measuring jug or medicine cup with measure on. 

-------------------------------------------------------------------------------------------

• Crush up 2 x 15mg (or 1 x 30mg) Mirtazapine pills until they are a fine powder (although the outer coating does not grind up as fine as the white Mirt’ powder that is inside, but that's fine. So long as the white Mirt’ is a fine powder.

• Then measure 30ml of half water and half maple syrup (or something else to your taste) and pour into the medicine bottle.

• Then pour in the powder and shake it vigorously. So 1ml of the liquid equals 1mg of Mirtazapine. N.B. Mirtazapine is not soluble in water and so you must shake it vigorously every time you take out a dose to ensure you are getting an accurate measure of Mirtazapine.

• Also you should store it in the fridge. It is recommended to keep it no longer than four days, but a reliable source kept (her) each batch for two weeks without a problem.

So from the 30 mg / 30 ml draw up the syringe what you require. 

1 ml of the liquid = 1 mg.

This has been tried and tested and works very well. Just make sure you shake it very well before drawing up the syringe.

I visited BC, through the Rockies from Vancouver & on to Calgary, nice trip ! 

I don't think you can benefit by cutting the tablets and measuring, some have tried using a jewellers scale, but it can be a wide inacuracy I've read.  

Ah yes, I see it took 3 weeks for your symptoms to pass, that right?  So you may need to wait for this each time, see how it goes Nyx ?  

Best wishes.

Thanks. I have seen that. I just put 2 15mg sol tabs in 30ml of water (in a 30ml amber glass bottle.It's dark blue) and they disolve. It has to be shaken up each time. I don't like using sweetener plus the sol tabs are sweet aleady. I looked in multiple places and could only find up to a 10ml syringe. I guess I could order online if I absolutely had to. But I just do 10 and then 5. I have a 1ml dropper with markings as well. 

I think my problem might be that I went straight from 15mg tabs to 13.5ml solution. In a few weeks I'm going to switch to 15ml solution then work down from there. Thanks again. 

I tried to go faster than Calmer suggests and have ended up with severe depression and anxiety. I went from 30mg to 0mg in 2 weeks and by day 6 was feeling very low and by the time I got to zero I was suicidal, crying unable to sleeps and the worst anxiety I've ever experienced. I'm now stable on 15 mg and at some point in the future will try to cut down but that will now be months away and it will be the 5 % every 2-3 weeks. No quicker.

Oh bless you Staz, you've been hit really hard with the quick wd, this is what I mean when I say "lose confidence to try to withdraw again" because it knocks folk for six, and there's nothing you can do to ease it quickly.  15 mg's not a bad place to be though, at least you're half way down now.

I know there is a very small percentage of people who can do a quick taper, but any that I have read about on the various web sites come back weeks or months later with the same story of sheer torture.  Or rebound insomnia, anxiety, depression.  Stick with us Staz, when you're ready you can prepare your plan, feather the Mirt' WD bed, get everything together.  I can assure you it's doable at a slow rate.

xx

Hi Nyx

10 + 5 is ok though, not as if you have to do repeatedly with a 1 ml syringe.  There is something called Ora-Plus suspension liquid, which keeps the Mirt suspended long enough to dose accurately.  (Thanks to Betsy for this advice).  Apparently tastes nasty mind you but what the heck!

Yes it sounds like you must have felt the difference from tablets to the Sol tabs, people have warmed of updosing slightly believe it or not, by +1mg, so youu have experienced this.  How long have you been at 13.5mg from 15 mg ??  

Hope you're having a good day.  

 

I'm still suffering Calmer as the mirt hasn't built back up in my body enough to be effective as yet. The weekend was bad again but today a slight improvement. I now look forward to taking my mirt in the evening as yesterday after taking it I was fine, actually managed to watch some TV and have a ham sandwich. My GP gave me a small amout of diazepam which I use in emergencies but I guess it will take a few weeks to recover fully. I've a review of my meds with the NHS Crisis Team doc on Wednesday and it may be a case of back up to 30mg or withdrawl and another AD. TBH I think it would take me all all 6 months to get off of the mirt. Thanks for your support and well done in supporting other members. Your experience is invaluable.

xx

Can you get a liquid form from the pharmacy?

Hi Staz,

How many days now since you reinstated?  If you can hang on 2 weeks at 15 mg this may well help you, but I guess you will be advised by the Crisis team ... it would be hard to swap AD's now because you would still have to taper off Mirt', no other AD can cover the symptoms of Mirt WD, hmmm lets hope you can settle on Mirt' for now.  15 mg carries quite a sedative effect, I've read your previous post and it was when you were switched to 30mg that the insomnia happened.  So 15 could be right for you?  Or when the 2 weeks is up try 22.5, but I don't think the 30mg did you any favours did it?  

6 months to get off Mirt' isn't too slow, I've been tapering since end of September and still have a way to go ... ugh !

xx

Hope you get on ok withh the team tomorrow.  

ps ... meant to say, you could try taking your Mirt' a little earlier in the evening to get some relief, but only about an hour or so ?

Hi Tonia,

Liquid Mirt' is available in UK, and yes on prescription from the doc',   Are you tapering?

No, but my doc wanted me to start taking it and I saw the withdrawal symptoms and also it tends to stop working with a lot of people. I'm already going through that now with Paxil. My heart palpitations and anxiety are unbearable almost on a daily basis. The only place I go are to doc appointments and I freak out then.

Sorry to hear that Tonia, Mirt' wd symptoms can be bad if rushed, yes.  

Are youu following the 10% rule to wd from Paxil though?  Youu might be ok if you slow it down?  Click on my name and follow the link for an informed choice on a 10% taper.

There is life after wd Tonia, its waiting just around the corner for you, thinking of you.

Best wishes x

I haven't started a taper on Paxil. I'm too unstable right now. My doc said they'll have to add something to it. Probably an antipsychotic at a low dose. They call it an add on or a mood stabilizer. I don't like the side effects of those drugs. Plus I'm sure they are very hard to come off of because they act on so many receptors.

M

Too right Tonia, anti psycotics will take control over you, have you had them before?  I would have thought a strong Benzo whilst going through any involuntary WD wp;d be the answer, not another strong mind blower that is even harder to come off.  

Poop out is a big problem, yes it can happen with Mirt' too but usually after a lengthy period of time I think.  But WD from one AD cannot be covered by another AD.  I know the lady you spoke about above (Evergreen), found Inositol really helped her with the anxiety of involuntary WD, 1.5 - 2 teaspoons in her tea morning and night, watch out for your stomach, see if it helps maybe?  

I already have gastritis. What does inositol do to your stomach?

Did the gastritis start alongside the other problems with the AD?  

Inositol was ok for me, just about, but I knew I had to be near a loo after breakfast if you know what I mean.  I took it when I felt really low during my wd from Mirt' at about 7.5 mg ... since then I've been ok really.  

Wouldn't be so good if you're in the middle of no where, or driving long distance ... ugh !   It is Vitamin B, folk have said how beneficial it is to take a combo' of B vitamins during wd, our system gets depleted of these whilst taking AD's I understand.

Yes, the gastritis started from all the acid build up from my anxiety. The only thing is I'm wondering if the B vitamins I took at one time didn't cause more anxiety. Some people they have a tendency to give you energy and they can make you nervous. I have problems with not being able to go to the bathroom so it may help me or it can cause diarrhea. Can you take inositol with clonazepam?

Hi Tonia

Yes, Inositol is a vitamin, Vitamin B8, i'll inbox you the link, it can be taken with anything. You could google vitamin B and just make sure your diet is covering the foods, watch your Magnesium too as this is essential for our nervous system also.  There is a lot of talk about magnesium deficiency for us AD sudderers, I take Mag supplements and also cover is with my nutribullet type smoothie (I just use a normal blender !).  

 

What form of magnesium do you take? I have seen that magnesium Taurate was good for anxiety and a newer one magnesium threonate. I was going to a natural/reg Med doc and she told me L theanine was good for anxiety at 200 mg. I had to quit going because she didn't take my insurance and her visits were anywhere from $100-$250. I just can't afford that. Plus she wanted me to up my Paxil from 50 mg to 60 and I've seen 2 psychiatrist since her and and they said no. Actually the other 2 were not psychiatrists they were a PA and nurse practitioner. I'd rather have a full fledged psych doc. They both had said and done some things I knew myself wasn't accurate. I've had this OCD since 21 and I'm 45 now and I'm a major researcher. I've found out some things these doctors don't even know. I had one doc at UNC ask me was I a nurse? I found out a medication I was being given was interacting with my clonazepam and causing the levels of the Med to raise in my system. I had severe anemia from the medicine so I quit taking it and went I to withdrawal because when I stopped the medication my clonazepam levels dropped and the pharmacist didn't even know it. I found out by research.

Hi Tonia

My I didn't realise there were so many Magnesiums to be honest - you are very well read, I joined a Magnesium Advocacy on facebook but I have little time to read it all and find it quite complicated.  

I take a so called high potency by Viridian 300mg daily (100 mg is the capsule !!) contains Mag as oxide, citrate and bisglycinate) - I'm hoping for the best !!  To say Mag supports fatigue it's a good job I take it during wd as this is my main symptom.

The fb advises to get youur levels checked firstly, but again I didn't, maybe I should go along with that.  

Sorry I didn't notice your message. I was only on 13.5 for a few days. I've been taking 15 until I get stable. I feel like I'm probably just about ready. 

I looked up the suspension liquid. With shipping and conversion the cheapest from Amazon .com is $55. Amazon .ca has it... for $136! That's what they do when they are low in stock. Kind of more than I'd like to spend. 

Wow thats expensive, sorry, maybe ask your local pharmacy?  Other than that, I'll ask around, see what others use and get back to you, if I forget give me a nudge maybe?

x

I'll try that. Thanks. 

You're taking magnesium for withdrawal? What kind of withdrawal?

 I'll rephrase  ~ Mirt' taper, instead of withdrawal, or sometimes discontinuation, which ever  

 

 

Does the magnesium help any with anxiety? What meds are you on?

The people at my local health food store recommended a high dose of vitamin c. I got New Roots Vitamin C8 powder which has 1165 vitamin c and 20mg of magnesium. Plus a bunch of other stuff like zinc, calcium, managanese, selenium, potassium etc. I take one teaspoon in water a day (usually when I start work because that's when it's the worst). Someone else also recommended L-Theanine but that makes me sleepy. 

I have L theanine. So you don't take any psychiatric medications?

Does the supplement help?

Does the supplement help any?

Only mirtazapine. I'm not sure if L-Theanine helps anxiety but it does help me sleep. Taking it during the day would make me too tired. I already have chronic fatigue. 

Do you have any suggestions for a good syringe? The markings on all the ones I find in stores rub off. Also how do you take the .25 in 14.25. I tried it today but I'm pretty sureI was off. There are 4 little lines between each big line of my syringe. I also have a 1 ml dropper which has 4 little lines then .0.5 then 2 more little lines under that. 

Hi Nyx

Oh I know, the syringes are rubbish; I think the trick is to not rub them at all, just rinse gently.  

Hmmmm yes, yo must be using a 20ml syringe, it is a bit of a guessing game isn't it 

on the 1 ml syringe 0.25 is a quarter of a mg/ 0.25 mg ... might need your strongest glasses on lol (not funny I know, especially at 10.30 at night when all you want to do is crash out in bed) 

I take it you're dissolving the same amount of mg as ml of water.  Good shakes every time.  Some say it keeps in the fridge 4 days, is that what your following?

I've bought syringes from the vets, chemist and Sainsburys, they're all pretty much the same quality, not meant to late  ggrrrr

x

My mom gave me a few she got from the vet and they work well. No rubbing off or anything.

I'm wondering since I've only been on mirtazapine 4 and a half months and not like years if  I could try going faster like 5%-10% a week? I'm getting really tired of the fat it's put on my stomach (which before was completely flat) and pelvic area. And the bloating. I seriously looked like I was 4 months pregnant one day it was so bad. Ive been reading that it gives you this layer of fat that is impossible to get rid of no matter how much you diet and exercise (which I'm doing). It can also cause urinary retention which I find upsetting since before I went on mirtazapine I was given an ultrasound for that exact problem. Plus I've been dealing with bladder infections for years. I should have never been prescribed this drug if knew it could cause that.

Hi Nyx

What mg are you on now?  You could of course try the 5% each week, I know you said at the top of the page that you were very sensitive & in your words "had issues just going from 15mg to 13.5", which was actually a 10% cut, some are ok with this, but always best to hold for 3-4 weeks.  

See how you go, see what reactions you get, there's no knowing what is right for everyone.  I wouldn't do a 10% weekly though, you might suffer with that.  You're using the Sol Tabs still?

Yes the belly fat is pretty awful; I don't know if you ever read Evergreens posts, she was very informative about losing weight whilst on Mirt, I think she figured she had to eat less than 1500 calories a day, and exercise everryday especially CV.  But she said it was unsustainable, and lets face it, it seems most people who don't eat enough, whether due to ill health or because they just can't eat, really seem to suffer the most with anxiety.

Anyways, watch out for any interactions if you have antibiotics for any uti's, you will have to google that one.

Best wishes Nyx 

Calmer I'm titrating off of Prozac from 10 to 5mg. How long should I wait to completely stop? I'm also at 45mg of Paxil. I was at 50 mg. I have been at this amount for 2 weeks. I have been on Paxil for 15 years and it stopped working. This Paxil is so hard to come off of. I am I really bad shape. Nausea, headaches feel bad, gastritis. Any ideas? I had a natural/reg medication psychiatrist I was going to and she told me I could use L theanine for anxiety. I've been going through this since July of 2015 because my shakes were so bad I couldn't sit still. So I knew there was no way I could try to come off of Paxil then.

I'm not so familiar with Paxil, but know it is hard to wd from.  I would deal with one at a time, not the two together.  I've heard from others that Prozac can be useful whilst coming off other AD's, so maybe hang on to that one and get off the Paxil very slowly.

The 10% every 4 weeks applies to ALL AD's, so I would follow that rule, or even 5% every 2 weeks; although I don't think Prozac wd is too bad, I wouldn't worry about that one too much.  

Did you look at the method on S.A. at all ?? I think there is some fantastic advice for withdrawing there, you have to sign up, but its a very active forum:

For advice on tapering Mirtazapine slowly at the recommended rate of no more than 10% every 3 or 4 weeks, please see the following which is within this forum, 

https://patient.info/forums/discuss/depression-resources-298570

and then click on the link "REDUCING AD'S USING 10% WITHDRAWAL METHOD".  

Hope this helps a little

I'm on 13.5 right now. I had to go back up to 15 and work my way down. I was on 14.25 for 3 weeks and now I've been on 13.5 for a week. I think my issue might have been going straight from 15mg tab to 13.5ml liquid before.It seemed easier when I switched to 15ml liquid then worked down from there. I had no issues the 3 weeks I was on 14.25. I don't really want to jinx myself but I really want this to be over as soon as possible.

I've just been using a glass to mix one sol tab in 15ml of distilled water and taking my dose with syringes from there. It takes a minute or two but seems easier right now than mixing more in a containiner and leaving it. That way I know it's fresh too. 

  I definitely eat less than 1500 calories (most days). Before I had to eat a bunch just to keep weight on (I was about 15 pounds underweight before I started mirtazapine). I got an app called Myfitnesspal which counts them for me. I exercise daily too. Not strenious though I do move. I also walk an average of 3000-4000 steps during my shifts at work. I'm buying an elliptical/stair stepper/tredmill hybrid today or tomorrow too. Also getting into some weight lifting. If I don't lose the belly fat until after I'm off mirtazapine then at least other parts of my body will look good lol. And I'll be so used to exercising by then it will be easier to get my flat stomach bad. 

Yeah I'm on a very high dose of probiotics right now (Custom Probtioics 11 Strain Probiotic Powder which cost me over $200 so better be worth it!) so hopefully I won't be getting any... Knock on wood. I hate antibiotics because everytime I go on them I get yeast infections.

*back not bad. 

Their forum on Surviving Antidepressants is much different than this one. I can't figure out how to navigate through it. I was taking 10 mg of Prozac to replace Paxil but the anxiety etc was bad and I didn't know if it would stay eventually stop or could start back. Have you ever heard of anyone going on Prozac and having the anxiety to stay or all of a sudden come back? The first time I took it years ago I had no problems.

if I get withdrawal symptoms from cutting back 5% a week do I go straight back to 15ml then start over or just back to the last dose I was stable at? i.e 13.5. 

I would say, as you were on 13.5mg, start the liquid at 13.5mg for a few days or so, making a total of 2 weeks before any further taper.

On a 5% taper, you won't be feeling like you need to updose.  

For anyone needing to updose, youu always go back to the previous dosage.

How are you feeling?

So I got myself down to 10 ml but I haven't been good at remembering to take it so I've missed a day or two quite a bit. I got a cold and wasn't feeling well so I missed about 4 or 5 days or so. I didn't have any effects. I started feeling dizzy when grocery shopping three days ago. Which could have been the cold but then I realized I hadn't taken mirt for a bit. My friend who has a lot of experience with antidepressants told me to take it. So I did and I felt like 3 times worse the next day. So I didn't take it the following night and felt way better the next day. Not totally normal but better. I'm feeling so so now but it's only the beginning of the day and I haven't gone to work yet so I'll see. I've kind of put myself in a place where I can't take any though so if things get worse there isn't much I can do. 

Hi Nyx

When tapering, I think when folk skip doses it sensitises the nervous system, sometimes causing havoc and difficult to put right, where Mirt' is concerned.

Do you mean you are on 10mg/10ml?  That is a steep amount to CT from, I wouldn't advise doing that.  A few days here and there of missing doses, and you saying you feel so so, remember - wd/discontinuation syndrome sometimes kicks in fully after 2 weeks.  Its up to you, but personally I'd get back on the 10 mg and make a plan to do a slower taper from hereonin, but then you knew I'd say that lol.

Whatever you decide, I hope you stay well, let us know how you get on.

Best wishes.  

When I go back on it I feel much worse so I'm not really interested in doing that. There is literally no one to cover my shifts at work until next week.

Hi Nyx

You might be one of the lucky ones, fingers crossed for you  

By advice of ppl at survivingantidepressants I reinstated at 1ml. I was told to stay on it for a month before making any changes.

Most of the people there seem to have been on anti depressants for years so I'm not sure if their guidelines apply to me but I guess I'll try to follow them as closely as possible.

Yes I'm familiar with the strategy 'some' of the moderators at S.A. advise, see how you go, it could be all you need, some say it is cruel to keep at a low reinstatement if its not working after a week/10 days ... I totally get it, but there are options, and only you can decide.

Am I right in thinking the 1 ml is 1mg, are we talking 0.1 ml/1mg?  

Some of the nausea might be eased by taking an antihistamine (non drowsy daytime) because Mirt' has a huge histamine block and when its whipped away it reacts by increased upset stomach/nausea/itching ??

I hope you get some relief Nyx, hey you're lower on the doses than me now  I've got some catching up to do lol.  No not funny, just typing out loud!!  

Oh yes, did you try Benadryl tablets (drowsy) to help you sleep at all ??

Best wishes x

Yeah it's hard to know exactly what to do when the only advice out there is from other people whose situations may be entirely different from yours and they are going off of personal experience. My doctor's advice as just to take a tablet every second day for a few days then stop. She said if I have any issues it's not withdrawal but an 'underlining condition' (that I suddenly developed? Uh come on...). There is no good professional medical advice online either. 

I mean 1 ml. As in a full 1 ml syringe. I was told to treat it like I would a 10 ml and go very slowly. Like down to .9 after a month... Ugh. 

I haven't been noticing nausea and my sleep has been ok but I've been taking anihistamines for my cold haha. So maybe that's why.

Thanks again for your help. 

Calmer,can I ask where are you now with your tapering mirtazapine? Are you completley off? And if so how long have you been off?and any withdrawels now?and if not how long until all withdrawels went completley?