how can i help Mum, am worried sick

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I have been looking on this forum to try and help my mum who seems to be having the most awful time on mirtazapine. She has been on it for 6 mths at 45mg and was prescribed it for Anxiety after my dad suddenly became very ill. She said she hasn't felt good on it and has an awful shake now in her body but the last 6 weeks she has been suffering from chronic diarrhea and bleeding.  She saw the gp who said she didn't think it was the tablets so she left her on them. It is only last week when mum went back and said she still had the problem that the gp said she would take her off of them. She tapered them quickly from 45 then dropping to 30 four days later and then nothing, Mum is now feeling worse than ever, she is sweating profusely and feels awful. She still has the diarrhea and is losing huge clots of blood when she goes. She is exhausted and pale and unable to eat. 

I am so worried that she has been taken off these far too quickly and now is in the most horrible withdrawal. How long will it take for her to start to get them out of her system and feel better. I have told her to contact her gp again on Monday as she is feeling so ill. I am very cross that she has been taken off them so quickly, almost like going cold turkey. I am also furious that she has been given such an evil drug for anxiety, it sounds truly awful. 

I don't live near mum and I don't know what I can do to help her through this. Is the bleeding normal do you think. She has been bleeding for 6 weeks now and it is getting worse.  I am terrified that something else sinister is going on.

Can anyone give me any advice that might help Mum.

Thanks for reading.

lori

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  • Posted

    Hi Lori,

    I'm really sorry to hear of your mum's suffering.

    I'm concerned about her symptoms. Has she been referred to or seen a gastroenterologist recently? Her symptoms may well be nothing serious but I don't think mirtazapine would cause them.

    Diarreah yes but passing blood clots and loss of appetite are worrying. I'm not a doctor but I think she needs a colonoscopy done if it's red blood. If it's dark/black then the bleed is higher up and may need an endoscopy.

    Everyone reacts differently when coming off, some have little to no withdrawals and some like myself have many. I had stomach spasms, anxiety and diarreah but I never passed blood and my appetite was ok.

    It would be recommended to reduce slowly and gradually. Coming off the could take 6-12 months. Whilst it may seem like an evil drug mirtazapine does and can help many people. It just doesn't agree with everyone.

    Considering it's your mother, then with her age, I really think it's best she gets examined. It may be nothing serious but best to get checked out. The mirtazapine alone shouldn't be causing loss of blood and it also increases appetite

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    • Posted

      HI,

      Thank you so much for taking the time to reply to me. I too am extremely worried about the bleeding but she says the gp says it's nothing to worry about. She felt up and said she couldn't feel anything but I said to mum that this doesn't rule something out as she would need a colonoscopy to make sure everything is ok. The blood is bright red and the clotting has just recently started. I have read that diarreah is a side effect of the drug but I can't find anything on bleeding. But mum says they don't seem to be taking much notice of her at the surgery. In fact when the gp took her off the mirtazapine she told her to come back in 3 weeks! Even though she has been bleeding constantly for 6 weeks.

      My siblings and I are beside ourselves with worry.

      I will tell her she has to go to the gp next week and demand a proper test, do you think?

      Many thanks

      Lori

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    • Posted

      She needs to see a different GP- or just go to the A&E at the weekend. My partner also had similar symptoms and I was beside myself with worry but colonoscopy showed everything was normal and it was just a functional issue. But the doctor still referred her to a gastroenterologist who did the colonoscopy just to be safe.

      The fact that it's been 6 weeks means it's not getting better on its own. She may be anaemic if she's passing that much blood.

      It's sad to say but many doctors don't know a lot about mirtazapine. They know the basics but when it comes to withdrawal symptoms they aren't all knowledgeable. I had the worst stomach pains I've ever had in my life going down from 15 - 7.5 - 3.75 in the space of 3 weeks. I'm now back on 7.5 which I think I'll stick too till after xmas then drop to 3.75 and hope to come off it completely in March 17

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  • Posted

    I think Paul's reply is excellent and I can add very little except to say she must not delay in getting advice on the bleeding even if it means going to a&e over the w/e. But the docs advice on mirt withdrawal in going from 30mg to zero seems crazy knowing the problems so many people on this forum have had in dropping quickly. Like Paul and others I'm on a slow taper taking many many months - it's the only way for me. If it were me I would re-instate 30mg this evening and review the situation tomorrow morning being prepared to go to a&e or if feeling a bit better see a gp on Monday without fail

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  • Posted

    I must say I am surprised the GP is not taking the gastrointestinal symptoms more seriously, chronic diarrhoea with fresh blood and clots needs further investigation and your mother needs to go back and tell him/her she wants some tests - scans or colonoscopy.i do hope she can get the help she needs, if only to set her mind at rest. She must be so worried, on top of the original anxiety.
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  • Posted

    Hi Lori,

    Am sorry to hear what a tough time your mum has been having, it sounds really awful.

    I'm afraid I don't know anything about the bleeding, but it sounds like if she had it while on the tablets and also since stopping then it's unlikely this is a side-effect of the medication? Like you say her GP really needs to investigate further if it persists. Having said that I think stomach related issues are a common problem with Mirtazepine though.

    I'm not an expert but from my own experience with withdrawal, I suspect the taper was too fast. I tapered slowly and still had terrible withdrawal including anxiety, insomnia, profuse sweating, nausea, heartburn, lack of appetite, stomach pains, aching, and shivering. The worst symptoms lasted about two weeks and I would say it was around six weeks before I felt back to normal. From the research I did at the time I think it is quite common for people to feel awful, and start to worry about something more sinister going on. Just know that it will pass.

    It seems a lot of GPs just don't appreciate how severe the symptoms of withdrawal can be with this drug. I had no warnings that I might have any physical symptoms, but was as least told that it needed to be stopped slowly.

    I hope your mum starts to feel better very soon, and that this all is proven to be a side effect of the drug/stopping the drug. Try not to worry, as hard as it is!

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  • Posted

    Tell her to ring 111 and decribe her symptoms i dont believe the mitraz has caused the bleeding an clots bit it does warrent further investigation 111 can arrange for an appt to b seen at a and e by a duty go tell her to ring now
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    • Posted

      I should also add find out ur mums gp name and call the practice manager and complain explain ur far away and ur not happy regarding her treatment bet they act then
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  • Posted

    I echo what others have said. Your mum should have been put into the fast track system to be seen within 2 weeks with those symptoms. Please insist that she is. Her GP sounds like a total incompetent.
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  • Posted

    Hi Lozzie

    There are a couple of points that stand out to me.

    The higher dose can exacerbate anxiety, I was on 30 for several years, I had an episode of stress due to my work, GP increased my Mirtazapine to 45mg. My anxiety didn't go away, it did come and go but eventually I realised it was becoming more constant. So I changed jobs to a much less stressful area. But the anxiety persisted. I won't bore you with an account of everything but eventually I decided to research mirtazapine because I was also putting on loads of weight. When I read accounts here I realised that my anxiety may be due to being on the higher dose of Mirtazapine. So I started to reduce it. I'm reducing by 7.5mg at an interval of 3 weeks for each reduction. After about a week on a lower dose my symptoms of anxiety subsided substantially. I'm now on 22.5mg. I've decided to remain on this dose for longer as I have an exam in 2 weeks and my husband is due to have a quadruple bypass in the next couple of weeks. Despite these events I'm so much calmer and nicer than I was 4 months ago.

    Your mum's anxiety may have been made worse by the dose being hiked up to full dose so quickly. In addition the dose was reduced far too quickly. Even though your mum was on them for only 6 months her body became used to the drug.

    The problem I've encountered is that GPS aren't experts. They go on the BNF which is far too generalised. I've read many accounts on here and the things that stand out are:

    Higher doses can make anxiety worse.

    Withdrawal must be done slowly and in small steps otherwise people may experience 'cold turkey'.

    Has the GP considered counselling to help your mum deal with your dad's illness?

    I hope some of this helps. I'm sure you'll get lots of replies. I hope your mum starts to feel better soon.

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  • Posted

    Hi Lozzie, I concentrated on the withdrawal, I didn't mention the GI symptoms.

    To reassure you these symptoms can be caused by stress. Yes they could be a sign of something more suspicious, but stress definitely causes some people to have diarrhoea and with extreme diarrhoea there could be some bleeding. However, I agree with the other replies that the GP should at least consider investigating this further if only to put all your minds at rest. There are minor tests such as stool sampling and non-invasive tests like ultrasound that could shed some light.

    I agree try a different GP.

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  • Posted

    This taper is way too fast.  I was recommended to reduce to 30 mg, stay on that for two weeks then come down to 15mg and this was still too fast.  I am on it for depression so that may make a difference.  However, I was still struggling after the two weeks with side effects, so cut a 30mg and 15 mg tab in half and took those instead.  I am now down to 15 mg, but am having real problems with sleep. The blood clots sound like something else though.
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  • Posted

    Hi,

    Just an update, spoke to mum yesterday and she said she would try and get an appointment for today. I have now been informed that she has been admitted to hospital as she is so weak and they have said she may need a blood transfusion and go on a drip whilst they try to find out what is wrong with her. I do know she has completely stopped the tablets within the space of 5 days which was really stupid of the gp to do to her.

    I am so relieved that at least she will be looked after properly now.

    Lori

    X

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    • Posted

      I second Paul's message, I do hope your mother can get the help she needs. I was worried about her, and you. Something has gone badly amiss if she has got to the stage of needing a blood transfusion.

      I will be thinking of you

      Liz

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