Switching from mirtazapine to amitriptyline

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Been on mirt for 1 year didnt like it not helping me went from 30 to 15 to 7.5 now on 25mg ami im really struggling sleep issues suicidal thoughts nausea i feel ive hit rock bottom and see no way out also been prescribed sertraline but to scared to take them thought id try the ami on its own my anxiety is through the roof,got problems at work also im hating life whish i wasnt here if i had the bottle to commit suicide i would my doctor is no help he just gave me crisis number to call need help no where to turn

Advice needed please

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14 Replies

  • Posted

    I feel for you, I've been there ... a few times.   The last really bad one was when I quit Mirt.   Realised I am, unfortunately, just one of those who cannot live without a working drug solution sad    Currently on 3 x 100mg Pregabalin and 1 x 150mg Trazadone and I sleep like a baby smile smile.   I would say I'm feeling the best I have since ''getting'' severe depression and very severe anxiety, that's 20 years.   Hang in, try and see a Psychiatrist for drugs if you can, the GP's are clueless.   It gets better,  you just need to find the right combination of medicine.

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  • Posted

    Justin, this is clearly withdrawal symptoms from the Mirtazapine.  You don't say how quickly you went down the doses, how long did you hold at each of those doses?  

    This can be put right and get you back on an even stabilisation.  All those symptoms including the 'S' word that no one wants to address, are all WD effects from coming off Mirt too quickly.

    Neither the Amitryp or Sert will cover the physical WD, the only thing to do is to take Mirt' once again - do you have any left?  

    Can you write here how long you were on each dose please. How long on 30mg, 15mg & the 7.5 - I presume you stopped at 7.5 ?  And how long ago was it since you stopped all together ... it's important to know this to see what might be the best dose to reinstate at.

    I'm not medical, I don't have any formal training, your doctor has formal training and is throwing 2 other AD's your way which won't help.

    I was on Mirt for 2 years, I did a very slow tapering programme to avoid those symptoms you describe.  I did have a little wobble once off Mirt, and I can only offer advice from the research I have done for myself.  My doctor didn't know or understand the discontinuation symptoms either - she even stated that they were my old symptoms returning, which was not true.

    Wishing you well, it may be tough right now, but it will get better, let us know how you are, here to help you.

     

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    • Posted

      Very true about the taper Calmer, I came off ''too fast'' initially - I was only on 7.5 for 2 weeks then stopped.  The side effects were horrendous - I had to go back on, and I think it was about a month then, but my GP had put me on venlafaxine, which was useless and a month later was in a right mess, so I was put on Pregabalin as an ''emergency drug''.   But your post has me interested... was this ''right mess'' still side effects of coming off - obviously in your opinion - and maybe I should have e.g. been on 7.5 for 6 months??

       

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    • Posted

      Thank you for your reply was prescribed 30 mg mirt last june after a bad break up i was previously on citalopram and amitriptyline for 12 years i got it into my head they weren't working so thats why i went docs who changed me to mirt initially was ok vivid dreams etc but then got all sorts of side effects blocked nose ,swollen eyes,bit of weight gain so yold doctor i wanted back on cit and ami he did i lasted 4 days on these as i went cold turkey on mirt i felt awful so went back docs and he put me back on mirt 15mg (i feel ashamed writing this) i also bought zopiclone of internet and was taking 3.5 with the mirt was doing okish,id been of work in this time for a back operation now recovered went back to work 4 weeks ago couldn't sleep went 3 days without so upped my dose back to 30 on the mirt yhis made me worse cronic insomnia so went back to 15 on the mirt with a full dose of zopiclone 7.5 this worked ok for a week ,but then my anxiety went through the roof with work stress so i went docs he said try sertraline and amitriptyline so thought id taper of the mirt went down to 7.5 and 7.5 zop my method in my thinking is now cut down the zopi and up the amitriptyline to 50mg eventually and just be on the amitriptyline just dont want to be on the mirt but your right im getting bad withdrawal symtoms from the mirt im sorry this is long winded but im just being truthful and honest thanks justin

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    • Posted

      I haven't took the sertraline as yet he gave me 50mg i wanted to get the mirt out my system also quite afraid to take it as ive read horror stories i just want to be normal and have a life,all this started with isomnia 25 years ago its cost me relationships in the past and to lose friends ive never been as low in all my life im 47 btw thanks for your reply earlier ian

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    • Posted

      When did you drop from 30 mg of Mirt Justin?  Are you saying it was 4 weeks ago?  

      Did you then drop to 7.5 mg of Mirt?  

      Upping and downing Mirt' can confuse the Central Nervous System and I read of folk having a bad time like yourself.    And a high percentage get worse going from 15 mg to 30 mg, seems to make any anxiety worse.  

      Lets not rule out that Zopiclone carries its own withdrawal after 10 days or so, so a tapering is required for that also - just stopping brings on anxiety ... it can get confusing when taking more than one drug.  

      Well, I think your best option is to go back to Mirt, do you think you could do this?  Reinstate and WAIT for stabilisation.  It might take a while, but having cold turkeyed it may well take a lot longer to stabilise.  You could search this site for Cold Turkey's and see what is written.  Of even google Mirtazapine cold turkey and I think you will be lead back to this site.

      Hope a little bit of this helps. 

       

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    • Posted

      Hurrendous symptoms after only 2 weeks ..... ugh, how awful sad  

      Well its hard to say wether you would have been better to stay on Mirt' for 6 months, most doctors say this is the minimum time for prescribing AD's don't they - whilst you sort out what the underlying factor is that causes us/you to be anxious/depressed/insomnia whatever in the first place.  I would have thought reinstating back to 7.5mg of Mirt (before trying another AD) would have stabilised you - doctors don't go along with AD's causing withdrawal, its just sad that they can't specialise in everything.

      So are you still on Mirt 7.5 & Ven & Preg?

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    • Posted

      Sorry Justin, I meant to say reinstate to 7,5 mg and WAIT, no other AD's.  

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    • Posted

      I stayed on the Mirt7.5 and Pregabalin 3 x 100, ven I threw out the window.   Then finally (after 20 years) managed to see a Psychiatrist (1.5 hours!), he put me on Trazadone, stop the mirt dead (I was fine) and slow (weekly) cut down on the Pregabalin.   That was hard, and just 2 weeks after stopping Preg was close to S.  Emergency app with GP and she put me back on the 3 x 100 Preg.   Now I'm ''fine''.   Want to get off everything but therapy unavailable .... NHS cuts, damn tories...

       

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    • Posted

      Yeah roughly 3-4 weeks ago then did a week of 15 then a week of 7.5 i really dont think i can go back to mirt ive been 1 day on amitriptyline and 3.5 zopicloe going to do same tonight i know i will have to tape of zopiclone also just want the mirt out my system i really just want to be on amitriptyline,but idealy nothing at all but have had terrible insomnia for years,just feel really sick at mo stomach cramps dizziness muscle ache like you said it will be wd from mirt i really appreciate you getting back to me
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    • Posted

      Hi Ian, I'm sorry you are going through such a rough patch.  These drugs initially seem like the way to go to deal with difficulties, insomnia, depression, anxiety, etc. but they don't give benefit for free - there's always a cost with drugs and eventually the costs outweigh the benefit.  Then, the docs start trying this and that, because honestly it is really a guessing game, see what sticks.

      So, if you want to get off everything, the first thing to do is get stable for a good month after any changes of meds.  Need the nervous system to get as calmed down as possible.  Changes in drugs and dosages means manipulating neurotransmitter levels which causes big swings.  Everything needs to calm down, sort of like swinging a ball on a rope, waiting for it to stop moving.  Then you can very gradually taper.  When working with more than one drug, it is best to only begin tapering one at a time so that you know what withdrawal symptoms are caused by which drug.  If you drop them all at the same time, you won't know which one is causing the problems.  The recommended taper rate is 10% of the previous dose per month.  So, if I were taking 15 mg of mirtazapine, the next month would be 13.5, then the next month would be 10% off of 13.5 (remove 1.35 mg) etc.  You could toggle the drugs, reducing one this way for a few months, and then holding on that one and working on another one.

      I'm reducing two meds, venlafaxine and mirtazapine.  Now that I have a feel for what wd feels like for each one, I have been co-tapering, but 5% of each one, or maybe 8% of one and 2% the other.  It's work. Having had a failed cessation of venlafaxine with protracted withdrawal and then reinstatement, my nervous system is pretty touchy, and I'd rather stay comfortable and functional as I come off.  Think turtle, not hare.

      There's a link within this thread that discusses the 10% method:

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

      Follow it and it will take you to a site that has information about HOW to measure these dosages.

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    • Posted

      Hi Calmer.  My doc wants me to start Cymbalta while I'm still taking 30 mgs. of Mirt.  He said to call him in a week and we will "take it from there."  I won't do it.  I've been on Mirt for at least 20 years.  I think it has stopped working but I can't be sure.  I'm calling him tomorrow to say that I want to wean off of the Mirt (at least get down to about 5 mgs) over maybe 3 months.  My doc is a psychiatrist and I've been seeing him for years.  I am surprised by his giving me an antidepressant on top of an antidepressant.  Maybe he has a good reason but he didn't take the time to tell me.  I did the research on Cymbalta over this weekend.  I know the advise given here to listen to your body is wise.  I'll be checking back to let you know how I'm progressing.  I wish you all well.  Thanx again. 

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  • Posted

    Hi Justin, i have been on mirt for six months and decided to change. The sleep factor is always the selling point on mirt. Anyhow  I phased it out quickly and that has left me at Rock bottom like yourself. I have started on Citalopram for a week but has not kicked in yet. I am using diazepam small amounts to try and get me through . My doctor is not a supporter of pill therapy!.

    Throughout many posts on the topic of Mirt, the theme seems to be that it is more dangerous than other antidepressants and withdrawal can be catastrophic. I would never recommend it to anyone.

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  • Posted

    Hi Justin.Read your email and wanted to give you some support.I started on Mirt 41/2 months ago (15mg) upping to 30mg about 2 1/2 months ago for IBS/anxiety/depression(take 15 am,15 pm).Also was put on Gabapetin starting about 4+ months ago at 200 upping in 200 mg increments to 600mg 1 month ago for IBS/nerve pain.At the same time I was being weaned off of Paxil which I took for 20 years(20mg twice a day).It's been rough because between the IBS,anxiety/depression and my body/mind getting used to all the meds I'm having good and bad periods.What has really kept me going is my faith in God and Jesus and prayer and friends and family.I have a good counselor/psychologist I see but as fate would have it she had knee replacement surgery in April and won't be seeing people again until end of June beginning of July.My psychatrist who prescribes the meds is good and responsive but really doesn't do as much on the"having someone to talk to"side of things.As for your meds,unfortunately tapering is the only really good way and when they are mixing other meds it can really mess your mind up.Talk to your psy/doc and push them to help figure out your meds.But having someone to talk to is HUGE! I'm praying for you and even though I'm in the U.S. let me know what I can do to help.DO NOT GIVE IN OR UP!! God Bless You,Bob

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