My experiences with GAD and PTSD, Paxil, benzos, and quitting Mirtazapine cold-turkey

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Please forgive me if I type too much, I just don't want to forget anything that someone might find helpful.

In 1996, my closest childhood friend killed himself, then a few months later my dad was diagnosed with a brain tumor and he died within a month, in a hospice bed, in our dining room. A few months later I found out my girlfriend of 3 years was messing around with another guy, and that's when I felt the anxiety switch turn on. I physically felt something change in my and it felt like I had been punched. The feeling never went away, and just got worse, and in no time at all I had my first panic attack while driving on a busy freeway in Chicago. I began to get tunnel vision and my hearing became muffled and I thought I was going to lose consciousness, and my friend in the passenger seat had to take the wheel and drive us off to an exit ramp. It was terrifying. 

So I went to see the family doctor I had known since I was a child, and he diagnosed me with GAD and PTSD, putting me on Paxil right away. Paxil made me even worse for the first two weeks or so. I couldn't sleep, I didn't want to eat, I would grind my teeth like I was on speed, and my emotions were all over the place. It finally stopped and I felt better, but Paxil's side effects were awful, the worst being no orgasms. For nearly two years, orgasms were impossible. It was depressing. Long story short, I left my old doctor for insisting on getting me on Paxil, and then Ativan, which I became addicted to. He insisted I stop taking Paxil without a taper, so I felt like I was going insane. I started having panic attacks every single day, which is when he put me on Ativan and told me to take as needed, so that's exactly what I did, because he never told me it was addictive. (I just trusted my doctors back then.) 

I found a new doctor who helped me immediately. He weaned me off Ativan with a longer-lasting benzo, diazepam, to make it easier to taper. It still took me nearly an entire year. That was hellish. I hadn't slept well in months, and the new doctor told me that the first night I took mirtazapine I would sleep like a baby, and I remember saying, Sure buddy you're crazy. But he was right. Mirtazapine started working on my anxiety the very first day. (Unlike SSRIs which take WEEKS.)

So since I've gone through all that, I wasn't as frightened to quit mirtazapine. Plus I'd done a lot of research on respected websites, not AD forums or anything, because those are usually full of people that go on and on about how the drug they're currently on is awful and "the devil" and they can't believe it's not banned, etc. When in fact, some drugs work for some people, others, not so much. You have to try different ones until you find a good match.

I think some of these forums do more harm than good: they're filled with people that are hurting and have nobody else to turn to, so they unload all of their problems, suspicions, fears and junk science, which scares the newer members and makes them worry that THEY'RE going to have a hard time starting or quitting a med. When you have anxiety, at least when I do, your expect the worst possible outcome, and you worry about everything. And that worry and pessimism feeds on itself and makes the anxiety worse and more difficult to treat. So I think it's important to take a lot of what people complain about with a grain of salt. That doesn't mean these people are not being truthful, but just because that was THEIR experience that doesn't mean it's going to be YOUR experience, too.

I was always unmotivated and tired on mirtazapine. I slept well and it really helped my anxiety, but I never wanted to do anything, and most of the time mirtazapine caused intense brain fog so I couldn't think clearly. It affected my work and my relationships with friends and family. When I stopped taking it last week, I immediately had a rush of energy that I hadn't experienced in years. That brought some anxiety too, but I was determined to get through it, and I'm so glad I kept going. This is a huge step for me because I really didn't think I could do it, but I had to try. I was sick of the brain fog and weight gain and lack of energy so I had to see if my condition would improve off the meds.

So of course I would recommend stopping it cold turkey and just getting it over with, instead of dragging it on and on and being miserable for months. I would not suggest this with benzos or SSRIs, Mirtazapine is a tetracyclic and it affects your brain's receptors differently, so it's not as big of a shock to your system when you stop taking it. Don't get me wrong, it made me feel some de-realization, where you feel really weird like everything is not quite real, but probably only 15% of the intensity that I felt when tapering benzos. And I've been nervous, and the brain fog comes and goes, but overall I have more energy and the aches and pains are beginning to subside.

So now, all I'm really feeling is a general sense of feeling "off", just slightly weird, along with almost-constant, low-grade anxiety, but that improves every day. I haven't had taken any mirtazapine in 7 days, now, and I feel good. I'm currently completely med-free.

I take 150mg of Suntheanine L-theanine on an empty stomach in the morning, which calms more morning anxiety. I’ve cut out all caffeine and vitamins, because both just make my anxiety worse. I take 400mg of magnesium glycinate about two hours before bed, with food. I then take 1-2mg of melatonin about an hour before bed. L-theanine calms the brain without making you tired. It REALLY helps. Magnesium calms me and makes me a little tired, so that's better around bedtime. I usually have a glass or two of red wine in the evenings, which calms my mind a bit as well. (It’s so nice to be able to enjoy wine without feeling exhausted and foggy after the first few sips, like it did when I was on mirtazapine!)

Hope this helps and sorry this was so long guys! 

1 like, 16 replies

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16 Replies

  • Posted

    I am fully in agreement with you about forum streams tending to concentrate on the problems, because those you are doing well on a medication have no need to write. I also agree with you about different drugs suiting different people. However on the subject of mirtazapine withdrawal I would just sound a note of caution. If it is only one week since you stopped it, you might, and I stress MIGHT, have more withdrawal symptoms to come. When I reduced my dosage just a little, I was hit by disabling brain zaps 2 weeks later. I actually decided to go back to my usual dosage, since it was suiting me and helping me to get on with my life, with minimal side effects. I simply wanted to try reducing the mirtazapine so I could feel like I was moving on.
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    • Posted

      I agree. It's only been one week. But when I tapered Paxil I immediately got those zaps, along with debilitating anxiety and crushing panic attacks. We’ll see how I feel next week.

      But I do wish people would stop using the word “withdrawal.” Because true withdrawal only happens with physically addictive drugs, and mirtazapine is not addictive and you don’t build a tolerance to it. “Withdrawal” is such an intense, loaded word, that makes people fearful and pessimistic, in my opinion. It conjures up images of heroin addicts vomiting and thrashing around screaming for a fix.

      If people think they’re going to go through that kind of withdrawal, then they’re more likely to expect the worst, and then their underlying depression or anxiety takes over and makes the whole situation 1,000 times worse than it has to be.

      I think the official language used to describe feelings associated with cessation of non-addictive ADs os “discontinuation syndrome.” Which certainly doesn’t roll of the tongue or sound as urgent as “withdrawal” but it is more accurate.

      May I ask, were you taking any other meds at the time when you started tapering your dosage? And what were your diagnoses? I ask that because I was never diagnosed with depression, per se, just anxiety. (Although having to deal with that anxiety 24/7 sure made me feel depressed and hopeless, for a long time!) 

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    • Posted

      I was diagnosed with depression and anxiety, 6 years ago, and taking mirtazapine and venlafaxine. I also take a low dose of haloperidol to combat panic attacks. These started after major emergency surgery 4 years ago. I am successfully gradually reducing the venlafaxine and haloperidol.
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    • Posted

      Pixie, I ran those 3 drugs through an onlne interaction checker, and found two major interactions. Have you spoken to your doctor about taking these drugs together?

      Also, have you considered that there's a good possibility that the reason you had such a hard time reducing your dose of mirtazapine was becuase you were also taking these other drugs concurrently? I was only taking mirtazapine, and it's been much easier for me. 

      The zaps we talked about, that seems to be related to seratonin, and mirtazapine does not affect seratonin li

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    • Posted

      I forgot to mention that I attached a screenshot of those drug interactions in my last reply.
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    • Posted

      Hi! Thanks for the information. I actually had an appointment with my doctor this morning to discuss other matters, so I mentioned drug interactions to her. She said that since I'd been on the mirtazapine/venlafaxine combination for over 6 years without any problems, and they were prescribed by the psychiatrist, she didn't think there was likely to be a problem. I've seen through this forum site that the combination is fairly common, and the psychiatrist said last week that I should continue. I have regular ECGs, because venlafaxine can have a side effect on the heart. As to the venlafaxine/ haloperidol interaction, i've done some internet research and found that the lowest recommended dose of haloperidol for various uses is 0.5mg two or three times a day, and I am on less than 0.5mg once a day. So all in all, my mind has been set at rest about it, and I'm not going to worry - because that would cause anxiety and be counterproductive!
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  • Posted

    Yes found it.

    You have been going trough hell and back i think.

    What a story.

    I also agreewith you what you say about forums, it is very difficult to see what is right about people saying.

    For my self i know that i have read to much about "withdrawal" and have felt what other people told.

    That is why your post catched my eyes because it is a different story.

    I was diagnosed first with anxiety and then with depression, i think she was not right with the depression, my husband says also, you are not depressed, it is anxiety.

    Quote: I was always unmotivated and tired on mirtazapine. I slept well and it really helped my anxiety, but I never wanted to do anything, and most of the time mirtazapine caused intense brain fog so I couldn't think clearly. It affected my work and my relationships with friends and family.

    So am i and i hate it, before Mirt we where walking miles in the woods and now i am sitting at home and feeling depressed because of the Mirt. I can not walk very long, to tired and tingling in arms, foggy head, the world looks darker now, the leaves are not so green as before the Mirt.

    I love to go out in nature and feel that Mirt that has taken from me.

    I am afraid when i stop taking Mirt that the anxiety will come back and you know how that feels.

    So i do not know what to do.

    I will thank you very much for your long story, i appriciate it very, your so open, thanks.

    I will follow your condition.

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    • Posted

      You are so welcome Karin. The same thing happened to me with mirtazapine: at first it was such a relief to be free of panic, but after a few years it started to hurt more than it helped. Now, that could be because I no longer needed it, and so it was increasing chemicals in my brain that didn't need to be increased, which could explain the brain fog and lack of motivation and aches and pains.

      The problem is, when people like us stop taking meds, you will, at least temporarily, experience some increase in anxiety while your brain adjusts. This is normal. But often you don't know if it's just a temporary thing, or if its your regular anxiety coming back, so people get discouraged and give up. Really, at least with mirtazapine, it takes a few weeks to know for sure.

      I would suggest speaking to your doctor and requesting a small prescription of a benzo like xanax to have on hand while quitting mirtazapine, so if your discontinuation symptoms become too bothersome, you can pop a low dose xanax and get some releif. But, of course, you can't do that too often or for too long or you'll have to withdrawl from xanax, and that is something I wouldn't wish on my worst enemy. 

      Are you taking other meds besides mirtazapine?

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    • Posted

      It was also for me a relief that the anxiety was gone. I first got Lexapro, i was going high as a kite. After a week i got Sertraline five weeks, the panic was quite extreme.

      Then the doctor has prescribed me 30mg Mirtazapine and I could only sit and a lot of panic, have used this five weeks using Seroquel to help plus Oxazepam, it did not work.

      Then went to 15 mg Mirtazapine and that was much better but I was lost myself in the meantime, sometimes a good day.

      Then I went up and down with the dose, not very clever of me and then for 5 weeks 7.5 mg mirtazapine, slowly reduced to a quarter, 3.75 mg for 1 week and then 2 mg for about 4 days en then quit.

      That was last August.

      The unrest came back and i was sometimes depressed and very tired.

      I was to busy, a lot of stress with everything and started again in December 2015 with 7.5 mg for five weeks and then increased to 15 mg, then again I was more stressed, hyper.

      Have done this for 6 weeks and was again to busy, so it was not going well. Then i went down on the dose to 11.25 mg and 7.5 mg for 4 weeks, to tired on this dose. So stupid to go up and down again!

      I think also that I have the 15 mg not give the chance to work. Now i try since 12 days 15 mg and hold it for 5 or 6 weeks without doing something stupid and see how that goes, i think i really must give it a good chance.

      I think my nervous system is not quit well through all the up and downs.

      Other medications I am on since 1996 are Oxazepam and Diazepam. This after a long relationship in a sect, and when I stepped out i lost myself and it took years before I was meself a litlle bit more.

      This caused so much stress that i got benzo's till now. I never got the right help.

      I have never tapperd the benzo´s, now i take every day Oxa 1, 2 or 3 Diazepam 5 mg, so i am pretty addicted to.

      I never swallowed Xanax.

      That is the short story.

      So I want to try 15mg for 5 or 6 weeks but it is hard, the feelings are rare and my body does rare but i try to stick it out. I sit at home and see no other people, can not have people around me now.

      I am also in menopause so the hormones are also confused.

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  • Posted

    Hi Mud93433

    You certainly have been through a lot.  I had a very similar experience, my husband and I split up he didnt tell me he had stopped paying the mortgage so we ended up losing our home, my son lost was devastatetd, I then had to find somewhere to live and make my son feel safe again, then his dad met someone else and made my son feel so insecure as he didnt really bother with him for a while (thankfully its back on track now) so had to deal with my son's broken heart.   Then i got made redundant and had to find another job so scary!!  then my mum was diagnosed with cancer and then my boyfriend left me and went off with someone else and then I got made redundant again.  I too nearly fainted and was told it was depression which it definitely was, its reactive depression which means you only feel this way due to lifes' unfortunate dealings, aparently this is the best depression to have as it will also disappear too.   Anyway sorry to babble on, I have been off of Mirtz for 4 weeks now and feel so much better very tearful but I can cope with that, what I cant deal with is the lack of sleep.  Did you suffer with this and if so did you find anything to combat it ?  Would love to hear from you, thanks

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    • Posted

      Reactive depression sounds accurate for myself as well. Every person has their breaking point, and I reached mine. 

      It actually got worse, later. My mom was diagnosed with Alzheimer's in 2004 and in 2010 left my career to have my mom live with me so I could become her sole caregiver. I'm an only child so it was just me. It was the hardest thing I'll ever have to do. She did so well until the last 5 years, then it went downhill fast. We were so close, she was without a doubt my best friend. I kept her out of a nursing home and kept her laughing every day, that was my job. The thought of dumping her in a home where she knew nobody all while she was suffering from severe dementia—there’s just no way I could go to work every day knowing that she was suffering and completely alone. She just died in late February. I'm still devastated. It was so hard to watch her slowly be eaten alive by that horrible disease. I need some serious therapy after that, for sure. But now I have to try to go without my meds to see if I can handle this. If I can't I'll go back on them.

      Yes, the first couple nights without mirtazapine were a little rough, then I was better for a few days, and now last night I woke up after sleeping only 6 hours and i'm exhausted. I just woke up so nervous with my mind racing and I couldn't even lie still. I used to laugh about Restless Leg Syndrome but it's a real thing, at least in the context of AD cessation. Although, I went out to dinner with an old friend and we celebrated with a bit too much wine, so I know that didn’t help. (But I had some much-needed fun!) We'll see how I sleep tonight.

      There are a couple things that really help. Magnesium Glycinate, 400mg, with a little food, a couple hours before sleep. That calms me down. It really works. I've also been taking low dose melatonin which has helped as well, but that's not something you'd want to do long term. And a helpful non-prescription anti-anxiety supplement called Kava Kava takes the edge off quite a bit. I've tried the pills and they didn't do much. My favorite Kava is called Kava Candy, available on Amazon. They are lozenges that you let dissolve in your mouth. They taste like orange and numb your mouth a bit, and calm you down similar to a benzo—you can feel it working. I only take those if my anxiety is unbearable. 

      Hope you can get some sleep!ccurate for myself as well. Every person has their breaking point, and I reached mine. 

      It actually got worse, later. My mom was siagnosed with Alzheimer's in 2004 and I left my career to have my mom live with me so I could ber sol caregiver.I'm an only child so it was just me. It was the hardest thing I'll ever have to do. She did so well until about 2010 then it went downhill fast. We were so close, she was without a doubt my best friend. I kept her out of a nursing home and kepy her laughing every day, that was my job. She just died in late February. I'm still devestated. But I have to try to go without my meds to see if I can handle this. If I can't I'll go back on them.

      Yes, the first couple nights without mirtazpaine were a little rough, then I was better for a few days, and now last night I woke up after sleeping only 6 hours and i'm exhausted. I just woke up so nervous with my mind racing and I couldn't even lie still. RI used to laugh about Restless Leg Syndrome but it's a real thing, at least in the context of AD cessation. Although, I went out to dinner with an old friend and we celebrated with a bit too much wine, so I know that doesn't help. We'll see how I sleep tonight.

      There are a couple things that really help. Magnesium Glycinate, 400mg, with food a couple hours before sleep. That calms me down. It really works. I've also been taking low dose melatonin which has helped as well, but that's not something you'd want to do long term. And a helpful non-prescription anti-anxiety supplement called Kava Kava takes the edge off quite a bit. I've tried the pills and they didn't do much. My favorite Kava is called Kava Candy, available on Amazon. They are lozenges that you let dissolve in your mouth. They taste like orange and numb your mouth a bit, and clm you down similar to a benzo. I only take those if my anxiety is unbearable. 

      Hope you can get some sleep!

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    • Posted

      Sorry about that, I pasted my post and I must've accidentally did it twice. It's supposed to end with "Hope you can get some sleep!"

      I wish we could edit our posts.

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    • Posted

      No wonder you cracked, thats so much to handle and sad to deal with, hope you are getting more happy days than sad now.  Well I think I am going to be tested to the limit now,  Its been 5 weeks since I came off of Mirtz and had the most devastating news on Wednesday.  My best friend from the age of 11 (I am 43 now) has just been diagnosed with seondary breast cancer it has gone to her lungs and they cant do anything about it so I have not stopped crying and cant believe she wont be here by side anymore its heartbreaking.   i am so worried the depression will come back with such force, however at the moment I am trying to stay strong and not let it back in, I have to be the strong one for my friend and i owe her that so when those deep dark clouds start to hover over my head again I will tell them to DO ONE youre not allowed in, wish me luck.  Thank you for your advice on meds I think its more important now to stay focussed so I will probably stay clear from anything right now, just a sleeping tablet would be good.  Thank you for listening and remember life is for living and very short indeed so go out put your dancing shoes on and have a bucket full of wine  x
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    • Posted

      Mud i was thinking about you.

      How does it go?

      And are you back on Mirt?

      I hope you are in a better place.

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