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#121 frog

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Posted 12 May 2021 - 06:27 PM

Hi Mimi,

I don't know if this is helpful as far as your concern over tapering your meds, but when I was taking imodium and only wanted to take half a pill I was having a hard time because it's a softer tablet so those normal pill cutters with the razor blade would just crush it. I was getting really frustrated and then I ordered this on Amazon. It's a little scissors that's shaped so you can put a pill in there. It works much better for cutting small or weird pills plus you get to decide how much you want to cut off. 

 

https://www.amazon.c...1?ie=UTF8&psc=1

 

Anyway I'm sorry you're having insomnia issues. I can definitely relate. I've been on Seroquel since over a year ago for insomnia that developed from the withdrawal. Started out on 50mg, now I've been on 25mg for quite some time. I've gone through phases where it worked really well then it wasn't and I was having trouble falling and staying asleep. Ultimately while it works well my goal is to not take any meds for sleep. All sleep meds result in poorer sleep quality and often fatigue or hangover the next day, Seroquel included. I've been doing CBT for insomnia for about a month now and now I fall asleep pretty fast and sleep for 7 hours pretty much every night. But my biggest problem is that I can't fall asleep so I will be tackling that next. Hoping it works, I know you said CBT for insomnia did not work for you, but maybe a combination of the CBT-I skills + medication will help you get back on track. Happy to try to provide a refresh on what the doc taught me if that would be helpful at all :(


#122 fishinghat

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Posted 13 May 2021 - 07:59 AM

Well, internet down all day yesterday. Urgg!!  Running off and on so far this morning. They have been out 4 times and "fixed" it. Technology. Back to work on  the sleep issue.


#123 fishinghat

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Posted 13 May 2021 - 08:49 AM

These are sort of the typical posts about drinking red wine. Just my observation but it seems like if you drink more than 1/4 cup it can cause more issues than help. I would recommend to start low and give it a try. If you are very tolerant of alcohol it might be necessary to ty 1/4 cup or even slightly more. 


#124 fishinghat

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Posted 13 May 2021 - 08:59 AM

These are just some of the posts about L-Theanine and sleep. L-theanine has been a staple on this site for years in helping with sleep and withdrawal. Be sure to buy a product that is pure suntheanine as this is the pure form of L-theanine. Also be sure the product is caffiene free. Many L-theanine supplements contain caffiene. 
 
Posted by invalidusername on 20 February 2019 - 03:38 PM in Medical Support 
Suntheanine can indeed make you drowsy/sleepy. But if you take yours at night, and with it having a half-life of around 8 hours, it shouldn't impede much on your waking life. It is possible that the compounding of them every day might, but this is something that only time will tell. Two weeks is sufficient to tell whether or not they are working on a daily basis. Some use theanine on an as-needed basis, but I am of the school of thought that it is much easier to prevent a fire than to put a fire out. 
 
Posted by FiveNotions on 08 March 2014 - 09:46 AM in What are you feeling? 
theanine increases alpha waves in the brain, which promote calmness and deep sleep....
 
Posted by johanna7272 on 11 March 2013 - 01:21 PM in What are you feeling? 
The Jarrow Formulas Theanine 200mg works very well on sleep...actually too much. I have been sleeping more than usual.
 
Posted by DonMH on 24 September 2012 - 01:48 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta 
The L-Theanine will help relax you and help you to sleep.
 
Posted by Cam on 14 July 2010 - 01:46 PM in What are you feeling? 
At night I take
250 mg of Theanine (helps you relax and sleep)

#125 fishinghat

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Posted 13 May 2021 - 09:25 AM

General guidelines for sleeping better.

 

How to Sleep Better
 
Tips for Getting a Good Night’s Sleep
 
Tip 1: Keep a regular sleep schedule
Getting back in sync with your body’s natural sleep–wake cycle—your circadian rhythm (daily rhythm)—is one of the most important strategies for achieving good sleep. If you keep a regular sleep schedule, going to bed and getting up at the same time each day, you will feel much more refreshed and energized than if you sleep the same number of hours at different times. This holds true even if you alter your sleep schedule by only an hour or two. Consistency is important.
Set a regular bedtime. Go to bed at the same time every night. Try not to break this routine on weekends when it may be tempting to stay up late. No more than 15 minutes earlier or later each day. 
Wake up at the same time every day. If you’re getting enough sleep, you should wake up naturally without an alarm. If you need an alarm clock to wake up on time, you may need to set an earlier bedtime. As with your bedtime, try to maintain your regular wake–time even on weekends. 
Nap to make up for lost sleep. If you need to make up for a few lost hours, use a daytime nap rather than sleeping late. DO NOT NAP MORE THAN 1 HOUR PER DAY as it may affect your evenings sleep. DO NOT NAP AFTER 5 PM. The best time to nap is early afternoon.
 
Fight after–dinner drowsiness. If you find yourself getting sleepy way before your bedtime, get off the couch and do something mildly stimulating to avoid falling asleep, such as washing the dishes, calling a friend, or getting clothes ready for the next day. If you give in to the drowsiness, you may will usually wake up later in the night and have trouble getting back to sleep. 
 
Tip 2: Naturally regulate your sleep-wake cycle
Melatonin is your naturally produced hormone that regulates your sleep. Melatonin production is controlled by light exposure. Your brain will secrete more in the evening, as it becomes darker, Conversely, during the day your brain detects increasing light levels and begins producing serotonin, which causes one to wake and be alert.
Spending long days in an office away from natural light, for example, can impact your daytime wakefulness and make your brain sleepy. Then bright lights at night—especially from hours spent in front of the TV or computer screen—can suppress your body’s production of melatonin and make it harder to sleep. However, there are ways for you to naturally regulate your sleep-wake cycle, boost your body’s production of melatonin, and keep your brain on a healthy schedule.
Increase light exposure during the day
Remove your sunglasses in the morning and let light onto your face. 
Spend more time outside during daylight. Try to take your work breaks outside in sunlight, exercise outside, or walk your dog during the day instead of at night. 
Let as much light into your home/workspace as possible. Keep curtains and blinds open during the day. 
Boost melatonin production at night
Turn off your television and computer. Many people use the television to fall asleep or relax at the end of the day. Not only does the light suppress melatonin production, but television can actually stimulate the mind, rather than relaxing it. Try listening to music or audio books instead, or practicing relaxation. If your favorite TV show is on late at night, record it for viewing earlier in the day. 
Don’t read from a backlit device at night (such as an iPad). If you use a portable electronic device to read, use an eReader that is not backlit, i.e. one that requires an additional light source such as a bedside lamp. 
Change your light bulbs. Avoid bright lights before bed, after 7 PM do not use a light greater than 25 watts. Reduce light exposure by significantly reducing the brightness on your TV or electronic device.
When it’s time to sleep, make sure the room is dark. The darker it is, the better you’ll sleep. Cover electrical displays, use heavy curtains or shades to block light from windows, or try an eye mask to cover your eyes. Most patients with chronic problems blacken their bedrooms entirely. Do not use nightlights if it can be done safely. Block all windows in the bedroom so light can not enter.
Tip 3: Create a relaxing bedtime routine
If you make a consistent effort to relax and unwind before bed, you will sleep easier and more deeply. A peaceful bedtime routine sends a powerful signal to your brain that it’s time to wind down and let go of the day’s stresses.
Keep noise down. If you can’t avoid or eliminate noise from barking dogs, loud neighbors, city traffic, or other people in your household, try masking it with a fan, recordings of soothing sounds, or white noise. You can buy a special sound machine or generate your own white noise by setting your radio between stations. Earplugs may also help. Sound machines can be purchased at local department stores.
 
Keep your room cool. The temperature of your bedroom also affects sleep. Most people sleep best in a slightly cool room. A bedroom that is too hot or too cold can interfere with quality sleep. 
 
Make sure your bed is comfortable. You should have enough room to stretch and turn comfortably. If you often wake up with a sore back or an aching neck, you may need to invest in a new mattress or a try a different pillow. Experiment with different levels of mattress firmness, foam or egg crate toppers, and pillows that provide more support. 
Relaxing bedtime rituals to try
Read a book or magazine by a soft light 
Take a warm bath 
Listen to soft music 
Do some easy stretches 
Wind down with a favorite hobby 
Listen to books on tape 
Make simple preparations for the next day 
DO NOT exercise or do any significant physical activity after 6 PM. Anything considered work (laundry, dishes, etc) must be avoided after 6 PM.
Tip 4: Eat right and get regular exercise
Your daytime eating and exercise habits play a role in how well you sleep. It’s particularly important to watch what you put in your body in the hours leading up to your bedtime.
Stay away from big meals at night. Try to make dinnertime earlier in the evening, and avoid heavy, rich foods within two hours of bed. Fatty foods take a lot of work for your stomach to digest and may keep you up. Also be cautious when it comes to spicy or acidic foods in the evening, as they can cause stomach trouble and heartburn. 
Avoid alcohol before bed. Many people think that a nightcap before bed will help them sleep. While it may make you fall asleep faster, alcohol reduces your sleep quality, waking you up later in the night. To avoid this effect, so stay away from alcohol in the hours before bed. 
Eliminate caffeine. You might be surprised to know that caffeine can cause sleep problems up to ten to twelve hours after drinking it! No chocolate, most teas, coffee.
Avoid drinking too many liquids in the evening. Drinking lots of water, juice, tea, or other fluids may result in frequent bathroom trips throughout the night. Caffeinated drinks, which act as diuretics, only make things worse. 
Quit smoking. Smoking causes sleep troubles in numerous ways. Nicotine is a stimulant, which disrupts sleep. Additionally, smokers actually experience nicotine withdrawal as the night progresses, making it hard to sleep. 
Eliminate stimulants. No sugars, salty food or MSG. Sugar is a stimulant which can increase blood pressure and pulse. It can take significant time to process this material and slow down your metabolism. Salts like table salt and MSG provide sodium which is used by the body to help carry electrical system in our bodies. This can also increase heart rates and metabolism for several hours.

#126 fishinghat

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Posted 13 May 2021 - 09:29 AM

How to sleep better (page 2)
 
If you’re hungry at bedtime
For some people, a light snack before bed can help promote sleep. When you pair tryptophan–containing foods with carbohydrates, it may help calm the brain and allow you to sleep better. For others, eating before bed can lead to indigestion and make sleeping more difficult. Experiment with your food habits to determine your optimum evening meals and snacks. If you need a bedtime snack, try:
A small bowl of whole–grain, low–sugar cereal 
Granola with low–fat milk or yogurt 
A banana (not sugary fruits)
You’ll also sleep more deeply if you exercise regularly. As little as twenty to thirty minutes of daily activity helps. And you don’t need to do all thirty minutes in one session. You can break it up into five minutes here, ten minutes there, and still get the benefits. Try a brisk walk, a bicycle ride, or even gardening or housework.  Serious exercise, even small amounts, must be done before 6 PM.
Some people prefer to schedule exercise in the morning or early afternoon as exercising too late in the day can stimulate the body, raising its temperature. 
 
Tip 5: Get anxiety and stress in check 
Do you find yourself unable to sleep or waking up night after night? Residual stress, worry, and anger from your day can make it very difficult to sleep well. When you wake up or can’t get to sleep, take note of what seems to be the recurring theme. That will help you figure out what you need to do to get your stress and anger under control during the day:
If you can’t stop yourself from worrying, especially about things outside your control, you need to learn how to manage your thoughts. When trying to go to sleep it is essential not to think about work, money, your family’s problems or other stressful subjects. These are very detrimental to sleep. Do not think about exciting subjects (a vacation, your favorite hobbies, etc.). Instead pick something mundane (boring). Pick a subject like weeding you garden, cleaning your car, etc. It will be difficult to stay focused on these boring subjects at first but it will become easier with time and practice.
If the stress of managing work, family, or school is keeping you awake, you need help with stress management. By learning how to manage your time effectively, handle stress in a productive way, and maintain a calm, positive outlook, you’ll be able to sleep better at night. 
Relaxation techniques for better sleep
Deep breathing. Close your eyes—and try taking deep, slow breaths—making each breath even deeper than the last. 
Progressive muscle relaxation. Starting at your toes, tense all the muscles as tightly as you can, then completely relax. Work your way up from your feet to the top of your head. 
Visualizing a peaceful, restful place. Close your eyes and imagine a place or activity that is calming and peaceful for you. Concentrate on how relaxed this place or activity makes you feel. 
Tip 6: Ways to get back to sleep
It’s normal to wake briefly during the night. In fact, a good sleeper won’t even remember it. But if you’re waking up during the night and having trouble falling back asleep, the following tips may help.
Stay out of your head. Hard as it may be, try not to stress over the fact that you’re awake or your inability to fall asleep again, because that very stress and anxiety encourages your body to stay awake. 
Make relaxation your goal, not sleep. If you are finding it hard to fall back asleep, try a  relaxation technique such as visualization (focus your eyes on something in the room), deep breathing, or meditation, which can be done without even getting out of bed. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body. 
Stretching. If you wake during the night do NOT fight it or panic. If you can not go to sleep in 10 to 15 minutes, get up, wake 20 or 30 feet, stretch (touch your toes or stretch your arms), walk back to bed and lay back down again. Each time you stretch and lay down your body will produce a small amount of endorphins which help the body relax.  
Postpone worrying and brainstorming. If you wake during the night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when you are fresh and it will be easier to resolve. Similarly, if a brainstorm or great idea is keeping you awake, make a note of it on paper and fall back to sleep knowing you’ll be much more productive and creative after a good night’s rest. 
 
FN - Sound machine/radio - I pick out which of the sounds (often I have high and low pitch, hissing, humming, and whirring all at the same time) I find most pleasing ... and somehow that helps me drift off to sleep ... It helps cover up outside noises.

#127 fishinghat

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Posted 14 May 2021 - 03:28 PM

mimi

 

How did the melatonin work out?


#128 mimi10

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Posted 16 May 2021 - 06:59 AM

Lots to catch up on.  Allergic to kids, that’s a good one.  Things have been quite busy lately and I haven’t had the time to fully participate on the forum.  My husband had an appt with his cardio on Wednesday and things did not go real well.  He had six bypass surgery in 2015, then in 2019 had to get three stents.  Now it appears he has a very leaky mitral valve that needs either repair or replacement which means another open heart surgery.  He has another test, a TEE, to be done this coming Thursday and we will no more then.  It also appears he may need a pacemaker but the valve surgery would have to be done first.  I am very concerned.

frog, thanks for the info on the scissors, I’ll be checking them out.  Any information you have to share is always welcomed and appreciated.

hat, looks like you’ve been very busy putting all the sleep information together for me and I appreciate it.  My sleep hygiene has always been pretty good.  I had never had any issues with sleep, in fact, was a very good sleeper until middle of chemo.  It had been improving the last few years, not back to where it was originally, but I could get a decent nights sleep that left me ready to take on the day.  Now sleep is just so erratic.  I have been taking 7.5 mirtazapine every night and the past few nights had been decent but last night I woke up around 1 and couldn’t really get back to sleep after that, just dozed a few minutes here and there.  I have tried the melatonin but I’m not sure it helps.  I took it Wednesday and Thursday nights and sleep was okay but not really improved.  It seemed like the melatonin gave me a headache and the following mornings I felt some light anxiety for a few hours.  I skipped the melatonin Friday and slept well, no headache, no following morning anxiety.  Last night I used 3 drops at about 130 because I wasn’t falling back asleep, and I never really fell back asleep at all until about 4 and that’s was when I dozed off for a few minutes here and there for a couple hours.  So I guess I’m still unsure of the melatonin’s benefit or not at this point.

today is my daughters 40th bday, she and her husband are coming to my house for bday cake and presents after their dinner.  They are doing carry out from one of their favorite restaurants because we are still not doing any dine in at this point.

I hope everyone is doing well and I thank everyone for their help.


#129 fishinghat

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Posted 16 May 2021 - 07:04 AM

Well if it is not a significant positive effect then the melatonin is out. 

 

My deepest sympathies on your husbands heart issues. With all that and family business as well sleep may be compromised as well. I will continue to work on the sleep options. Take one day at a time and enjoy all that you can with your family.


#130 mimi10

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Posted 16 May 2021 - 08:03 AM

Thanks hat.  Please keep your fingers crossed and say a prayer for us.  I am worried.  My husband and I have been together since I was 17, not sure how I’d manage without him.


#131 fishinghat

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Posted 17 May 2021 - 11:31 AM

Hi mimi. How is your husband doing?  My prayers and best wishes.

 

Well, considering that the melatonin didn't work ou I guess the next thing I would recommend is 200 to 250 mg of suntheanine before bed. Very low risk of any side effects and can be very beneficial. 

 

More sleep recommendations soon.


#132 fishinghat

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Posted 17 May 2021 - 12:00 PM

Magnesium deficiency.
Magnesium deficiency showed  important disorders of sleep organization, agitated sleep with frequent periods of nocturnal awakenings, increase of the durations and percentages of light sleep, a decrease of duration and percentage of deep sleep, a decrease of duration and percentage of REM sleep caused by magnesium deficiency with the disappearance in the REM sleep in some.
 
Magnesium deficiency and excess are frequent problems for members. Both conditions are intimately involved with sleep. A simple blood test can tell if these conditions are present.
 
OK, so the last three to try is a small amount of red wine, suntheanine and check your blood serum levels. Again, I would start with the suntheanine and maybe tryt the small dose of red wine before bed while you wait for the suntheanine to come in. I wish I had more options but anything else I could find had some issues of concern and more problems is not what you need now.

#133 fishinghat

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Posted 17 May 2021 - 12:03 PM

I just noticed that you had tried taking magnesium before with no success. I would still go ahead and get a blood test for magnesium as high magnesium can cause some significant sleep issues and is common in most withdrawals. 


#134 fishinghat

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Posted 17 May 2021 - 12:06 PM

I also found this...

 

Acute treatment of mirtazapine impaired road-tracking performance and increased sleepiness, but sedative effects disappeared under repeated administrations. Trazodone did not affect driving performance or cognitive function under acute or repeated administrations. 
 
So, you build up resistance to it and it stops working for you.

#135 fishinghat

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Posted 17 May 2021 - 12:10 PM

I also did not see any reference to clonidine. It is a medicine that can have very beneficial success in extending the sleep cycle. It is by prescription only. Many drs do not know about its benfits to sleep and controlling adrenaline/norepinephrine. They only know about its blood pressure controlling effects.

 

That is all I can think of for now.


#136 mimi10

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Posted 21 May 2021 - 07:10 AM

Sorry I haven’t been around as much but things have been a bit hectic. Husband is ok, thankfully he will not require open heart surgery at this point but he does have to have a pacemaker implanted.  The surgery will be in about 2 weeks. 
I thought sleep was getting better because I had slept ok for a few nights straight but then again last night I was laying there staring at the ceiling until about 1 am and then finally fell asleep but woke up at 4, so erratic.

Been busy grandkids baseball and softball and senior center is getting ready to reopen next week so we volunteers had to go for an orientation and training session to prepare or the new way things will be done

i have now been off cymbalta about 2 months and things seem to be going smoothly from that.

I hope you are all doing well and hat I thank you from the bottom of my heart for all the support you have given me as well as the illuminating and intensive research you have shared with me.  I see my primary in early June and will be discussing with him maybe getting off mirtazapine y using a compound pharmacy to lower the dose.  I have been on 7.5mg pretty consistently now for coming up on 3 months and I’m not sure if it’s really doing anything at this point with the exception of avoiding the withdrawal from it.


#137 fishinghat

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Posted 21 May 2021 - 08:41 AM

Good luck mimi and hang in there. Always a pleasure to help where I can.


#138 mimi10

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Posted 04 June 2021 - 04:48 PM

I saw my primary doc this morning and I told him about  daytime fatigue and fogginess from the mirtazapine.  He said we had 2 options, increase the dose to 15mg because some of his patients have felt that improved things or get off mirtazapine.  He felt the best choice was to try to get off the mirtazapine and if insomnia is still an issue to go back on 7.5 for a week and then increase to 15mg.  The part I didn’t like was when he said just stop taking it because I’ve only been on a low dose of 7.5 for 3 months and mirtazapine doesn’t have much of a withdrawal.  When I explained to him that I didn’t agree with that he agreed to write a script for 30 7.5mg pills and told me to cut them in half for 2 weeks and then just stop.  I have been struggling to cut those little pills in half and then I cut some of the halves in half again, they are very difficult to cut, they cut very irregularly and tend to want to crumble.  My plan is to try to do 3/4 of a pill for 2 weeks, then 1/2 pill for 2 weeks then 1/4 pill for 2 weeks and then off.  I am hoping that sleep will be better and I’ll be able to get off entirely but I guess only time will tell.  
I hope everyone is finding some relief from their withdrawals and healing and wish everyone well.


#139 fishinghat

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Posted 05 June 2021 - 06:36 AM

Sounds like a sound plan. 


#140 mimi10

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Posted 05 June 2021 - 07:07 AM

Thanks hat, you’re a great person to run these ideas by.  Started last night going to 3/4 pill and I know that cut should not have any affect  yet but last night I had trouble getting to sleep, finally fell asleep about 11 but woke up at 4 with a headache and couldn’t get back to sleep.  Sleep had been much better the previous few weeks.  Going to stick with the 3/4 tonight and see what happens.  Again, thanks for your input hat, it is much valued and appreciated.


#141 frog

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Posted 07 June 2021 - 11:37 AM

Good luck mimi!

 

Sleep can be so subjective that just the knowledge that you've changed something can keep you from sleeping. I'm tapering my tiny pill of Seroquel. Similar to yours I'm reducing by a quarter a week just to make for a gentle reduction even though the doctor said it wasn't necessary. It's really all mental because I'm taking such a tiny amount that it's unlikely that it's actually doing much at all. It's just a habit I'm accustomed to now. I was falling asleep fine before starting the reduction and the night I reduced I could barely fall asleep. But Sure enough nearly every day since then I've fallen asleep ok (with the help of all the tips and tricks from my CBT doc) even the night I reduced from the 3/4 to 1/2. I'm sure you already know this but I wouldn't put much stock into one night's sleep. Hopefully you've been sleeping better since that night


#142 mimi10

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Posted 07 June 2021 - 01:52 PM

Thanks frog, I totally agree with you, I think just thinking about the cut I had made made me have a little trouble getting to sleep.   Last night was closer to normal for me.  The mirtazapine is such a tiny little pill with almost a plastic feeling coating on it but when I try to cut it I get crumbles.  I tried the scissors you recommended from Amazon and even they don’t work for this pill.  I have taken 3/4 pill for the past 3 nights.  I’m not sure when to expect the withdrawal from the cut in dose to start, I’ve seen people say anywhere from 2 days to 3 weeks before you feel the cut.  I was thinking about waiting 2 weeks but I thinking that if things go smoothly maybe I’ll try dropping to half a pill after 10 days.   I’ll keep posting as to how things are going, thanks again.


#143 frog

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Posted 07 June 2021 - 02:51 PM

Darn sorry the scissors didn't work. They worked well for all the tricky pills I've tried. 

 

Hopefully you have no withdrawal and can drop easily :) I don't know anything about this drug in particular but it says it has a half life of about 20-40 hours so I think if you were to notice anything it would be in a week or so. Maybe do 2 weeks for your first drop and if no issues you can do shorter for the rest. 


#144 mimi10

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Posted 10 June 2021 - 07:39 AM

I’ve stayed at 3/4 pill or about a 5.8mg dose for 6 nights now and I guess I’ve found out when withdrawal starts for me with mirtazapine.  Today I woke up very early, have a headache and a light jittery feeling, so far it is uncomfortable but tolerable, we will see how this unfolds.

Hat, question for you, pharmacist said plasma half life and cns half life are 2 different things, I didn’t fully understand what he was telling me, could you explain it to me in laymen terms please.  


#145 fishinghat

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Posted 10 June 2021 - 08:51 AM

plasma half life - The length of time it takes a drug to decrease in strength by 50% in the blood.

 

Example - Cymbalta has a serum (plasma) half life of 12 hours. Therefore 12 hours of taking a dose your blood levels of Cymbalta drop in half.

 

cns half life - The length of time it takes a drug to lose 50% of its effectiveness on the nervous system. This term is not often used except by special medical researchers.

 

So, more simply, Plasma half life is the time it takes 50% of a drug to be flushed out of the blood....while the CNS half life is the amount of time it takes a drug to lose 50% of its effects on the nervous system.

 

I hope this helps.


#146 mimi10

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Posted 10 June 2021 - 10:01 AM

Hat, got it, thanks for simplifying that info for me, now do you know how I would calculate cns half life for the mirtazapine.  I know the plasma half life is the 20 to 40 hour one, but  it seemed the pharmacist was implying that the cns half life kicks up most of the withdrawal.  I am trying to be patient with my cuts but the day after fatigue that it gives is wearing me down.  This 3/4 dose is just as bad as the 7.5 I had been taking.  I’m hoping when I go to 3.75 things won’t be as bad and that I will still be able to sleep.


#147 fishinghat

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Posted 10 June 2021 - 12:35 PM

Very few drugs have had their CNS half life studied. I can tell you that the drug must enter the plasma in order to effect the nervous system. As the blood level increases so typically does the effect BUT not directly proportional. So if the amount in the blood stream doubles that does not mean the effect on nerves double. It will rise b ut not at the same rate. This can not be calculated but must be determined by direct measurement. A second factor is does the drug cross the blood brain barrier (the membrane around the brain) or not. Its ability to effect the brain is very much determined by this absorption factor across this membrane.


#148 mimi10

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Posted 16 June 2021 - 06:38 AM

I stayed at 3/4 of a dose, about 5.8mg, for 8 nights, things were stable so I tried going to half a pill, a 3.75 dose.  I have taken the half dose of mirtazapine for 3 nights now and things were stable until last night when the insomnia came back again, asleep at 10 but up at 130 and no sleep after that.  I am hoping this is withdrawal and will correct itself and not a return of the insomnia that was the reason I went on this drug.  I do find that I am less fatigued during the day and clearer headed on the lower dose.  Going to give it a few more nights and see what happens, don’t know what else to do at this point.  I have been trying to find a mirtazapine group online similar to this one but no luck.  Thought I found one but the last post to it was a few months ago so I don’t think they are very active and another group more or less told me that’s what I get for tapering cymbalta too quickly and that they help people get off drugs and not take drugs to aid in withdrawal from another one.  I told them I was put on it for insomnia and it was a replacement for cymbalta now due to cymbalta withdrawal but I got no response so I guess I’m just being ignored by them now.  I realize I probably don’t belong here anymore since I am no longer on cymbalta but you guys are such a source of support and encouragement and I find it a safe place to get support and advice.  I appreciate you all, especially hat, so very much.


#149 frog

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Posted 16 June 2021 - 03:34 PM

I haven't been on Cymbalta for over 1.5 years but still here :) You are welcome here Mimi!

 

I think you already said that it didn't work for you, but you tried CBT for your insomnia right? I learned some helpful tips for calming anxiety if I wake up in the night and start to get worried about sleeping. Sometimes it works, sometimes it doesn't but it's way better than lying there progressively getting more anxious about the fact that I'm not falling back asleep.  

 

I think your sleep will get better. You already had 3 decent nights with the half dose. Sleep is so fickle there are so many things that can affect it. I know right now because you're reducing your medication you're likely really vigilant about your sleep and how you feel during the night and ironically that can make your sleep worse. So this is a reminder that you're doing great, that your body and mind want to sleep but maybe you're experiencing some anxiety which is telling your brain that being awake and alert is important, so just keep doing your best to stay calm and relaxed and sleep will come :)


#150 mimi10

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Posted 17 June 2021 - 06:48 AM

Frog, thanks so much for your kind and encouraging words, I think they’re exactly what I needed to hear.  I realize that things, including sleep, are going to be rocky for a little bit while withdrawal is going on, I can’t let it have control.  I need to accept that this may be the way things are until I get off entirely and my body has a chance to heal.  I still use some of the cbt-I like the breathing techniques and the progressive muscle relaxing, sometimes it helps and sometimes nothing helps, guess that’s just the way it is.  Pain also affects my sleep and I will see my pain doc again tomorrow and we are thinking of trying a spinal cord stimulator and if it helps having it permanently implanted, running out of options on that front as meds didn’t work, nerve blocks have been very temporary with what little relief they do give and physical therapy hasn’t been helping either.  So, frog, thanks again, so much, for sharing your thoughts with me, your timing was perfect as I was feeling pretty down with this whole withdrawal thing and your words were very encouraging.





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