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In a terrible state, what should I do?

Posted , 7 users are following.

andy46832
andy46832

Hi,

I really hope someone out there can help.I was prescribed mirtazapine in november 2015 due to a complete breakdown. By March 2016 I had made some changes in my life and decided I wanted to come off. I was not sure what to do but did what I thought was ok and took roughly 4-6 weeks and came off. Unfortnately I had spectacular withdrawal symptoms so reinstated and decided, from advice on this and other forums, to do a much slower taper. Last week I eventually came off again, following a 30% reduction every 4 weeks. I had got down to 0.35mg, which I thought was a more than conservatively low amount at which to stop. Unfortunately yet again I have had some terrible withdrawl symptoms.  Everything was ok till day 6. I am really loathed to re-instate but don't know what to do? Any advice would be greatly received.

Also would any-one recommend getting some other drug from the doc to help come off. Or is that a bad idea?

Thanks

0 likes, 33 replies

33 Replies

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  • my_cloud
    my_cloud andy46832

    Posted

    Andy

    Based on my experience I would go back to 0.35mg and stay on it until you feel ready for a very slow reduction. I too thought that stopping on such a very low dose after tapering would be no problem. Other people appear to have no problem but not me. I went onto liquid Mirt and following advice from Calmer on this forum I dropped very slowly 10% per month to a tiny dose 0.05mg in Jan before I slowly stopped. Even then some anxiety and insomnia has returned which varies day to day but am pleased to be off this powerful drug.

    • andy46832
      andy46832 my_cloud

      Posted

      Thanks my cloud. I guess I had not heard many people going much further than 0.35mg before. Thought that would be more than low enough. But perhaps from what you say and what calmer has said it isn't low enough. Makes you wander what on earth is in this drug?

    • my_cloud
      my_cloud andy46832

      Posted

      Andy

      I know other people drop from 7.5mg with few problems and I found it very diffficult to accept why a drop from 0.5mg which I had been on for a couple of weeks caused me so many problems especially when my doc said just stop at 7.5mg. Anyway I went back on 0.5mg stabilised and did this very slow taper.. If I could do it I'm sure you can. Good luck

    • andy46832
      andy46832 my_cloud

      Posted

      Thanks for all your comments and support my cloud.
    • Calmer
      Calmer andy46832

      Posted

      I am sorry to err on the side of caution here, no other AD can cover WD symtoms of another AD, Prozac will not take away any symptoms left by Mirt.  And I would recommend you stay on Mirt right down to 0.1 mg & beyond (as above).

      Prozac is one of the few AD's that can be taken with Mirt, I think it could support you whilst going off, but not replace.  Chances are you won't need anything else, I didn't, but we're all unique.  

      Benzo's are even harder to come off than Mirt', ugh ...

       

    • UKSteve
      UKSteve Calmer

      Posted

      The switch to Prozac is not to substitute it is to support coming off another SSRI.

      It is a well known method that works for some who have found it unbearable to come off their existing antidepressant but like everything but doesn't work for everybody

      no size fits all.

      I have given the advice that Andy should consult his doctor because he is having severe withdrawals.

      He should not be taking advice from anybody on here as a substitute for professional medical opinion

    • andy46832
      andy46832 Calmer

      Posted

      Out of interest how do you measure such small amounts? I have a 1ml syringe but markings are so tiny.
    • my_cloud
      my_cloud UKSteve

      Posted

      UKsteve

      I wish I had your confidence in taking professional medical opinion over coming off Mirt. As I said above my doc said it would be no problem once I had tapered down to 7.5mg - I could stop altogether. How wrong he was and frankly without  the vast experience of the wonderful people on here who have been taking Mirt (compared with zero for my doc) and their sound advice   I don't yhink I would have coped. 

    • Calmer
      Calmer my_cloud

      Posted

      Here here Mycloud smile .  Unfortunately doctors, P.docs even, just do not seem to have the knowledge that is required to taper from this or other AD's, including Prozac ~ same rules apply for Prozac, not to taper more than 10% every 3-4 weeks, never heard of using it for a week then stopping.

      Also Mirtazapine is not an SSRI, it is a tetracyclic piperazinoazepine, which has a different structure from any other currently used antidepressant.

      When you said "Switching over to Prozac" and "transferring over" - I got the impression you meant to swap UKSteve, sorry if I misunderstood.  

      Also it must be remembered that it is not a matter of AD's building up the the blood stream" ~ far from it.  AD's alter the brains neurotransmitters, and a slow taper from the current AD should always be done with great care and very slowly to enable them to restructure, not "take Prozac for a week then stop the Mirt" as you quoted.

       

    • Calmer
      Calmer UKSteve

      Posted

      UK Steve, I am addressing you personally now.  

      I am not "bashing" anyone, I am here to support folk who are trying to taper, or who are having difficulty withdrawing from Mirtazapine.  

      I have seen "qualified doctors" during my spell of taking Mirtazapine, but mostly, with regards to coming off AD's, they do not know how to do it well even those who claim to have experience. They are generally not trained in discontinuation and seem to misread the signs. A lot of withdrawal issues are misdiagnosed to be psychiatric problems.  I got more help and expert advice from fellow sufferers on this forum and am simply repaying the good.

      Anyway, my doctor was mainly out to lunch when I tried to see her.  I got more help from my daughter who is a doctor and has helped me more than any GP.

      It is OK to give my well researched opinions, if they differ from yours that is not my problem.

    • my_cloud
      my_cloud UKSteve

      Posted

      I'm sorry you feel the need to reply in this way. Of course any member is free to comment and give their own views. I along with many others have found Calmers advice on tapering and too quick a withdrawal to be spot on.  You were quite dogmatic about recommending a prozac bridge - let me tell you that was the worst advice I had from my doc - all it did for me was insomnia and my withdrawal became worse. Going on to Prozac as you recommend  may well be valuable for others but my solution came from Calmers advice to taper much more slowly than I had been doing. So lets share our experience of using and withdrawing from Mirt rather than criticise someone who has been so helpful to many of us.

    • eva28308
      eva28308 Calmer

      Posted

      Hi Calmer, thank you all the advise and help what you do on this forum. We all appreciate it very much. I try to go on your side to open and see how to make liquid solution from Mirtazapine but I could not open.

      would you tell me how to do liquid Mirtazapine and how you went donwn to 0.1 mg . I m 2.8 right now and holding on because I have sevire anxiety all day and my body can't take anymore cut,but for the future I would like to know. 

      Thank you very much

  • andy46832
    andy46832

    Posted

    Thank-you to everyone's comments so far. It seems that the safest option for me. Is to reinstate @ 0.35 and reduce to a much lower dose and then try coming off again.

    General opinion is, to reduce as slow as possible. I have managed generally throughout my taper to reduce by 30%, not 10% as recommnded. I have not always been great but I have managed.

    Should I continue to reduce by 30% if my body can deal with it or should I follow the 10%? Could the 30% reduction possibly be why I have suffered so badly after coming off or is it perhaps i just came off too early.

    Any thoughts welocme...

    • my_cloud
      my_cloud andy46832

      Posted

      Andy

      I can only give you my experience. I found it much easier to come down to about 1.5mg than I did to get from there to zero. I used a 1ml syringe with 100 graduations so the lowest I was taking was 0.15mg and I got there from 1.5mg over many weeks.  I still find it hard to accept that 0.15mg was still having an effect on me- ok maybe it was a placebo type effect but I know when I stopped altogether sleeping beceme more difficult.  But we are all different and Iam particularly sensitive to medication. 

    • Calmer
      Calmer andy46832

      Posted

      Yes I would say so Andy, you are right reinstate to 0.35 mg and take that dose for at least 2 weeks, or better still wait until you feel stabilised again and wait another 2 weeks, in mho.  Let your doc know what you are doing and be sure to tell him you have had bad WD and need to reinstate.  

      I would go slowly, certainly not 30%, try 5% firstly, increase to 7%, it won't take much longer.

      Yes so many people on here suffering badly, just wish there was a way to promote the slow taper to an audience before they even start to taper smile  

       

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