Slow taper doesn't work for some
Posted , 9 users are following.
Ive been reading a lot of tapering and I read that even a very slow taper doesn't prevent withdrawal symptoms for some people. Has anyone experienced this? I have a very sensitive system (I always had issues with medications as a child and I thought as an adult I would be different, but no) so I'm thinking I MIGHT be one of those types. I had issues just going from 15mg to 13.5,
1 like, 63 replies
Nyx001
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tonia_2003 Nyx001
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Nyx001 tonia_2003
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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'.
lynne82155 Nyx001
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lynne82155 Nyx001
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Nyx001 lynne82155
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Nyx001 lynne82155
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lynne82155 Nyx001
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The last 15mg Im having real difficulty
At my last appointment with my psych he wants me to come off what Im on now 150mg of sertroline in a week and 15mg of mirt in two weeks!!!!!
That scares me
Nyx001 lynne82155
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lynne82155 Nyx001
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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
Calmer Nyx001
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But now, some people, me included have been following an even kinder method of 5% every 2 weeks, and waiting for the body/mind symptoms/sensations to pass before tapering lower, so listening to YOUR own body because we are all different is key.
So yes, I can speak personally of this very slow method, I get a little faster sometimes, going to 7-8% every 2 weeks if I feel strong ... how sensitive we are depends of many things afterall right? Apparently our brains need an extra 2 weeks more than our physical bodies to rewire the brains neurons, or repair from the Mirt' at each taper.
My symptoms have been mainly fatigue around day 4-7, and around day 10-12 I feel low, but then these pass and I have a few good days and I rethink the next titration. So all in all not so bad.
So you going from 15 to 13.5 was a 10% cut, you may have to decide if this was confortable, bearable, doable before your next drop, you could do a 5% see how that feels for you next time, you may get confident and try another 10% but I wouldn't go faster than that as you say you are sensitive. I take it your symptoms or issues passed after a few weeks, or havn't you gone that long?
The lady who has posted her taper programme was Evergreen, her chart is faster than I mention.
So from 15 I went 14.25, 13.5, 12.75, 12.00, 11.25, 10.5 etc, and I plan to go to 0.4, 0.3, 0.2, 0.1 ... then I will be in a place to find out if I get any wd after that !!
Liquid Mirt' is available on prescription in the UK only, it is expensive and you will be lucky to get it, may have to beg (!) or maybe offer to pay for a private prescription. There is a method to make it, its not 100% accurate but it is listed within this forum.
I'm at 4.2 mg at the mo, so still getting there, I'll be around for a while yet, and will let you know how it all ends up, fingers crossed.
Nyx001 Calmer
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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?
Nyx001
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Calmer Nyx001
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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.
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• 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.
Nyx001 Calmer
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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.
Staz Calmer
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Calmer Staz
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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
Calmer Nyx001
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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.
Staz Calmer
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xx
tonia_2003 Calmer
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Calmer Staz
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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.
Calmer
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Calmer tonia_2003
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Liquid Mirt' is available in UK, and yes on prescription from the doc', Are you tapering?
tonia_2003 Calmer
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Calmer tonia_2003
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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
tonia_2003 Calmer
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M
Calmer tonia_2003
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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?
tonia_2003 Calmer
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Calmer tonia_2003
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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.
tonia_2003 Calmer
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Calmer tonia_2003
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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 !).
tonia_2003 Calmer
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Calmer tonia_2003
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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.
Nyx001 Calmer
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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.
Calmer Nyx001
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x
Nyx001 Calmer
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tonia_2003 Calmer
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Calmer tonia_2003
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tonia_2003 Calmer
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Nyx001 tonia_2003
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tonia_2003 Nyx001
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tonia_2003
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tonia_2003
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Nyx001 tonia_2003
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Nyx001 Calmer
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Calmer Nyx001
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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
Nyx001 Calmer
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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.
Calmer Nyx001
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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
tonia_2003 Calmer
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Calmer tonia_2003
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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
Nyx001 Calmer
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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.
Nyx001
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tonia_2003 Calmer
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Nyx001 Calmer
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Calmer Nyx001
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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?
Nyx001 Calmer
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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.
Calmer Nyx001
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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.
Nyx001 Calmer
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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.
Calmer Nyx001
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Hi Nyx
You might be one of the lucky ones, fingers crossed for you
Nyx001 Calmer
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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.
Calmer Nyx001
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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
Nyx001 Calmer
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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.
Guest Calmer
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