Safe to reduce dose again?

Doctors & the NHS aaaahhhhhhhhhhhhhhhhhhhhhhhhhhhhh !!!  At least you got yourself some 15 mg now.  You know don't go missing a trick here, remembering that the lower doses are more sedating, you may very well find that the 15 mg help you to sleep, now there's something to look forward to, once you are settled on it that is, couple of weeks probably.

Your doctors surgery must be quite remote to say the least to have such poor continuity, is there another practice you could consider?  couldn't be worse than that one perhaps.

 

That should say (doen from two weeks on 22.5mg from 30mg).

All sounds good so far, is it the tamazepam glueing you're the bed when the alarm went off or maybe the lower Mirt dose being more sedating I wonder.

Hope my doc will give me Tamazepam if I need it later into my WD - us it just for sleep or s tranquiliser?

No it is just tiredness or possibly the mirt. Temazepam is a fab sleep aid because it doesn't ever make me feel heavy or hung over. I can take it at 3 am and still get up at 7 am without feelinng drugged. I had it for years and never got addicted as it was easy for me to stop when I was put on mirtazapine. No withdrawals whatsoever. However, I know that many people do have the most terrible withdrawals from benzos.

Sorry about those typo errors, I was on a coach when I wrote that, the Mirt' eyes didn't help either!

Did you discuss the liquid with your doc?  I have a chart if you want a copy, conversion from mg / ml.  1 ml = 15 mg - you won't need it for

15 mg of course, tablet is easier - I miss the tablet form actually, far easier ... messing about with a syringe & drawing up at bedtime is no fun, scared of knocking the liquid gold Mirt' bottle over!

 

No, I didn't talk about the liquid because the doc was so determined I was to stay on 15mg until after Christmas and then said I should see a doctor before cutting down further. I have at least found out the the vibration in my chest was nothing to do with my heart because although there were a couple of anomolies on the ecg, they did not coincide with the time I indicated I was getting the vibrations. I now think these vibrations were mirt side effects because tremor and frequent urination are listed. I actually feel better since I dropped the dose to 15mg. The only withdrawal (if it is a withdrawal) is diarrohea. As it isn't painful, I can live with that. I have also seen a huge reduction in my carb cravings. Despite what the doctor said, I intend to cut my dose again by a quarter in ten day's time. Then go from there. How are you feeling on your current dose of mirtazapine?

Yes I think I have slightly less cravings for carbs ... not enough though!  

I would say the lower dose is more sedating, even going from 15 to 9.75 which I'm at now ... so slow but hey ... don't want to kick start any sleep problems basically if I'm honest.

The 3.5 drop is the hardest ... everyone says this is the one that you feel the most.  Can you remember David who cold turkey'd - he had to go back to 3.5 after 8 months of WD hell - and it sorted him out straight away.  Some may find that hard to believe really, but so true.

 

I can completely believe it. If I was still sleeping okay on my dose then I would be taking it much more slowly too, but I have nothing to lose sleep-wise. Having said that, I have only needed half a temazepam the past two nights and so I am going to try without tonight because I don't have to fetch my son from work late until next Wednesday. I still have to be up at the crack of dawn for the horses though. My intention is to reduce by 3.75 mg the next time and see how it goes. Still no withdrawals on day five of reducing to 15mg, but I know it will be much harder the closer I get to zero and I may have to go and ask for the liquid form. David jumped off at 7.5mg, I believe? As the doctor told me, mirtazapine is a very powerful drug and so even the smallest amounts have a big effect.

Just a word of caution:  temazapam is a benzo very addicting.  Just a couple of weeks of regular use can have you hooked, so that would be another one to taper when ready.  Benzo withdrawal is no picnic and must be done very carefully.  I get it with regards to needing to sleep, since nothing goes well when short on sleep, so I'm not trying to take the tem away from you, but just be aware of this :-)

Thanks, Betsy. Yes, I have used temazepam on and off for fifteen years. I managed to get off them no problem when I started on mirtazapine, but don't think it will be so easy without the mirt. On nights when I have alcohol, I don't take one, and I also use benadryl occasionally, although this leaves me feeling hungover for most of the following day. So I do try not to take the temazepam every night, and when I do take it, I always try half a 10mg tablet first. Just wish I could sleep like a normal person. I have been an insomniac my entire life until I found mirtazapine, and then it pooped out on me after working really well for almost four years.

I'm sorry you are in this conundrum! 

There is an article in the paper today re chronic insomnia, talks about specialised sleep clinics and various sleep strategies,- this is UK so you might want to look along these lines or at least read about it.  And yet again, CBT is a therapy not to be sniffed at it says for sleep problems!  Did you ever read that book I recommend "Say Goodnight to Insomnia - Dr Greg Jacobs" ... I bought it and its helping me at the mo.  

And also ... there is a plan of WD for Temazepam, there's a plan for everything !   There are withdrawal indications of course from Benzo's including inappropriate secretion of adrenalin so there is catch 22 - the nights you try to do without the wonderful Temazepam it makes secretions for you !!!!  Is it any wonder you can't sleep with this running in the background.

The answer CITA states is to convert to Diazepam, at a rate of 

1mg Benzo to 0.75 mg Diazepam - there is not a lot written but I'm happy to copy it to you.

Of course the right thing to do, as you well know, is exactly what you are doing - Mirt' WD first, then the Benzo, if desired (!) with the help of Diazepam.  Or help of CBT, or Sleep Clinic - whatever floats your boat ... take your time, think and research   And then there's Phenergen ... 

x

Thanks, Calmer. Is phenergen different to benadryl? Is it better fir sleep?

Not sure how they compare ... maybe ask your pharmacy or try to see if you feel doped when youu wake - I know quyite a few who swear by Phenergen.  

Glad your wd is going so smoothly, amazing not to have any anx'  -  Happy days  

I'm sure the inositol is helping me. Also I have had the same 'pattern' happen to me each time I have reduced my mirt. First two days - nothing, then day three and four - euphoria, followed by one day of axiety/low mood and then normal again. I guess we are all different. I am hoping this pattern continues until the end because I love the euphoria days!

Oh yes, I could use some of the euphoria !!

I can't remember - did you say Inositol was from the doctor or is it a supplement?  

 

It's a supplement (vitamin B8).  I take a really big heaped teaspoon in my morning tea and if I feel low, I take another in the afternoon. It's really helped my husband with work stress too. He says it's really given him a lift. 

Thanks Evergreen, sure sounds like a good supplement !