rage!

you may of just hit the nail on the head! I stopped citalopram 2 weeks ago after titrating onto mirtazipine. I took both for my first two weeks on mirt. Then stopped cit completely. Now you got me thinking. ..This could be withdrawal from cit still!

Hope your irritability passes quickly ♥ I now feel better as I think you may be right. Not sure why the gp want to give me yet another AD without taking that into consideration! Xx

Do not add any more new meds into your system as it is highly sensitized right now and any more changes can really cause the wheels to come off the bus!  The docs don't have a clue about any of this, throw people on meds updosing too quickly, stopping and switching to other meds without proper tapers, and have people taper much too quickly in general when they want to stop.  This all sets the paitent up for failure with a re-emergence of anxiety and depression, withdrawal symptoms, that are deemed relapse and off we go onto meds again, or different meds, etc.  I've seen some real tragedies from these tactics, so please be careful!  Not to scare you but it is scary business.  This stuff isn't just a drug floating around likle asprin that goes away when we quit taking it; if causes brain remodeling in an effort to restore balance, and when drugs are stopped, changed, added, it just causes the nervous system even more confusion in an effort to adapt.  You actually have to grow a new brain that takes the drug's actions into account; when you change things up suddenly, you have to grow a new brain again and it doesn't happen quickly.  Danged doctors just don't have a clue what they are doing to us!

Anger is not listed as a side effect of mirt and I've never seen anyone say as much.  The literature states:

Mirtazapine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

drowsiness

dizziness

anxiousness

confusion

increased weight and appetite

dry mouth

constipation

nausea

vomiting

Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS section, call your doctor immediately or get emergency medical treatment:

flu-like symptoms, fever, chills, sore throat, mouth sores, or other signs of infection

chest pain

fast heartbeat

seizures

I was on 40mg of cit and had been on citalopram for six months. I came off it as I was still depressed and spent my time in bed! No appetite, not my own head etc. My gp told me to directly halve to 20 each day for two weeks and then 10 the 3rd week along with mirt 15 then at the end of forth week stop cit completely. I'm now believing you all here it could be wd. I had tremors / slight dizziness last week + a couple of rages. This week worse rages and sweating badly! I have made an appointment 14th with my doc that's the earliest I could get! In the meantime I will continue taking mirt and not start ven until I see her. It was a locum doc yesterday who told me to stop mirt and start ven. I think my own gp will share the views shared here! Hopefully ♥

Thank you so much for your help xx

You were on lit long enough to definitely have brain remodeling and now your system is trying to build a new brain in the absence of Cit.  It is a slow process, though. All the symptoms you listed are definitely withdrawal symptoms from coming off an SSRI too quickly.

Many find fish oil, 2 g a day, and magnesium beneficial.  There is nothing that can speed withdrawal and get it over with.  The good news is, at only two weeks out, you are still the window where reinstatement can work and relieve your symptoms.  Then you can do a very slow taper off of cit.  

What was the dose you were at when you added the mirt?  You could add that back, and then do the slow taper from there when you feel stable. Of course, that dose may be too low since you did taper to that point before adding the mirt.  The tapering folks recommend a 10% per month reduction, of the previous dose.  See the topic for the 10% taper in this thread:

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

This is a far more conservative taper schedule than most docs recommend, ironically!  You'd think doctors would be more conservative!  But it is a harm-reduction method, keeping you comfortable as your brain adjusts to the small changes.  Small changes mean small adjustments and less instense withdrawal symptoms.  You may still experience WD symptoms with this method but they should be quite tolerable  If not, a 5% taper might be more appropriate.

The four weeks is because it takes a week or so for the brain to register the imbalance and start remodeling, then up to a week of symptoms if there are any, and then back to balance.  It's important to let stability set in for a bit before challenging the brain with another cut.  Of course, there are receptors all over the body, which is why you have the physical symptoms as well as the emotional.

Just curious, how did you feel on the combo when you added the mirt?

hope you are having a good day.

My whole withdrawal from 40 cit was over and done in 4 weeks. 2 weeks out of the 4 weeks I was taking 15 mirt. I took 10 cit and 15 mirt for one week. The other week (last week) I took 5mg cit and 15 mirt. Then finished cit completely. My doc said to go up to 30 mirt but that made me go to bed for 3 days nursing diazepam to get through the day! Doc then said the dose too strong and pull back to 15 mirt. On a good note...no rages today and have been my old self!

It has been a taxing time!

Thanks for your support and great advice ♥

God bless x

forgot to mention I felt great when taking 10 cit and 15 mirt ♥

I just read an intro from a guy on SA who actually did a fairly slow taper off 75 mg Effexor over 9 months, thought it was going well, but two months off he had a three day panic attack and ended in the hospital and back up to 150 mg Effexor!  Now he has to start all over.

It's a tricky time because the longer you wait to reinstate, the more likely it won't work.  I got lucky that it did work 10 months out, but generally they say after 3 months it's really more risky. 

You might want to go back to 10 cit and 15 mirt, just my suggestion :-)  Sounds like your doc really didn't know what he was doing, whipped you up high on the mirt way too fast!

I'm always blown away reading stories on Patient by people who are put on these meds and are complaining about horrid side effects; more often than not their doctors have them up the dosage before their systems ever had a chance to get used to going on the med to begin with!  The body has to get used to the action of the drug the same as it has to get used to the cessation of the drug!  

I'm glad you are feeling less rage-y today!

When I see my doctor on the 14th , I will go through your suggestions with her. Don't laugh but i have saved all your responses as they make perfect logical sense to me. So on the 14th I will raise all of the points suggested! She won't know what's hit her lol!

Heaps of appreciation betsy ♥ god bless x