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#181 mimi10

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Posted 15 July 2021 - 11:32 AM

It is now day 16 off mirtazapine and I don’t know what to think at this point.  Things just do not seem to be improving, still nausea, headaches, tinnitus, anxiety and insomnia.  No sweats the past few days though.  I have had to use trazodone to sleep the past three nights, I have fallen asleep on my own about 930 but wake up at about 1030, so only sleep about an hour, then I just lay there and can’t sleep.  I do not feel anything other than comfortable, tired and relaxed at that time but simply do not sleep, so at about midnight I give in and take 50mg trazodone.  I then usually fall asleep about 1230 but wake up for good about 3.  Again I feel ok at 3, in fact, not even tired anymore at that time.  But most days the anxiety starts around 9am and continues for a few hours and nothing alleviates it.  I don’t know if this is still mirtazapine withdrawal or the trazodone is causing it, or some of both.  I have also developed bad hip pain when lying on my right side and that’s the side I normally sleep on, so it’s pretty difficult to sleep much at all.

I saw my pcp yesterday and he said he thinks my hip is bursitis so I have an appointment with an orthopedic next Friday, the past two nights however pain has not been as bad.  He also said mirtazapine doesn’t have much of a withdrawal and it should be over at two weeks off and suggested perhaps trying another antidepressant, which I declined.  So he left it with I should let him know when I’m ready to try something else, he thinks it’s anxiety even though I told him prior to going on cymbalta I didn’t feel anxious.  Said something about don’t have to feel anxiety to have anxiety.  What did that mean?  In the meantime I have had a first visit with an acupuncturist who says she has had success with drug withdrawals and insomnia.  Only issue is she wants to see me twice a week for the first six weeks and it’s private pay because Medicare and my insurance don’t cover acupuncture.  First visit was 145 and all subsequent visits are 80, husband is not real happy about it but I willing to let me give it a try. 
I just don’t understand where this anxiety is coming from, I did not feel anxious or any of these various things, nausea, dizziness, headaches and such,  prior to withdrawing from the cymbalta and now even more so since I have stopped the mirtazapine.  I don’t really want to medicate the withdrawal, if that’s what it is, with another drug that will require another withdrawal.  I am so confused at this point I don’t know which way to turn.  Sorry to ramble so much, hope this makes sense and hat if you could weigh in here I’d much appreciate it.


#182 fishinghat

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Posted 15 July 2021 - 12:12 PM

Beleive it or not I still think this is the mirtazapine withdrawal.

 

I had a discussion with my psychiatrist yesterday about withdrawals and she told me That it seems to her that the more psych meds you are on the worse the withdrawal and the longer it lasts. This pretty much matches what I have seen here. I would say that you should be seeing some slight improvement soon, say 2 weeks (educated guess). Hang  in there!!


#183 mimi10

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Posted 16 July 2021 - 08:43 AM

Last night, still not good.  My brother brought me a couple of 1mg clonazepam pills which he takes for parkinsons and sleep, wanted me to try them and see if they worked better than trazodone.  I fell asleep taking nothing at 9 from exhaustion but woke up at 930 and could not get back to sleep.  finally at midnight i decided to try the clonazepam but I had cut them in half per his advice and took .5.  I dont feel like it did anything, I fell asleep about 130 and woke back up at 3 and been up since then.  I didnt want to take trazodone after i took the clonazepam, wasnt sure about mixing them.  guess we will see what tonight brings.  thanks for being there, as you always are,


#184 fishinghat

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Posted 16 July 2021 - 02:50 PM

Clonazepam is one of the strongest benzos there is and if it didn't do anything for you then benzos are out. 


#185 Mxpro32

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Posted 16 July 2021 - 03:22 PM

I do not recommend benzos at all. I took clonazepam for a few weeks and it stopped working. My body adjusted to it, then I tapered off over slowly and experienced terrible anxiety during the process. I still have periods of anxiety now that I'm off, but for the most part my anxiety is pretty low. Steer clear of benzos.

#186 mimi10

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Posted 17 July 2021 - 05:39 AM

Thanks guys for the input.  I totally agree.  I have danced with that devil before during chemo and it was a beast to get off of.  Out of desperation for some sleep I gave it a try but it did nothing so I agree with you hat, it’s out.  


#187 mimi10

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Posted 18 July 2021 - 03:02 PM

Almost 3 weeks off mirtazapine, not sure how much longer I can hang in there, past 2 nights only hour and a half sleep each night.  Falling asleep about 930 then up at 11, don’t sleep during day.  Tried taking a trazodone last night about midnight, usually gets me another 2 hours but nothing at all last night.  This is brutal.  This is the way my insomnia was which got me put on mirtazapine so makes me wonder if it’s return to that.  We are taking the kids and grandkids to a beach about 8 hours away for a week the first week in august, we’ve been doing this since the grandkids were born and made the reservation months ago.  I’m going to have to find something to help by then even if it means I have to reinstate the mirtazapine.  


#188 mimi10

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Posted 20 July 2021 - 11:16 AM

Now 3 weeks off mirtazapine, some things are improving, headaches only occasional now, nausea comes and goes, hasn’t been much anxiety lately.  The past few nights I have been experiencing what seem like tightness and vibrations throughout my torso, hip, low back and also chest, feel like tremors, not painful just really annoying and impossible to sleep through.  And the big beast is the insomnia.  The past 2 nights I’ve still only slept about 90 minutes.  2 nights ago fell asleep about 930 from exhaustion and woke up at 11.  Last night got even worse, fell asleep a little after 9 but woke up at 930, finally took a trazodone about 11 and slept 1130 to 1.  I really want to wait this out if it is withdrawal but this is just how sleep was for the entire month of January when I saw my doc for help.  I just don’t know how long to try to wait this out, most recovery center sites I’ve seen say withdrawal should only last about one month.  Any thoughts would be gratefully accepted.


#189 fishinghat

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Posted 20 July 2021 - 01:33 PM

If some of your less severe symptoms are beginning to fade then the insomnia should start reducing in the near future. 


#190 mimi10

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Posted 21 July 2021 - 09:30 AM

I have failed, still awake last night at 10, up over 24 hours, still not being able to fall asleep, so I caved in and took 7.5 mirtazapine.  I fell asleep about 11 and slept through til 430, best I have slept these last three weeks.  Today anxiety is really up there, don’t know if it’s still withdrawal or if the dose of mirtazapine caused it.  I didn’t have anything like that before when I started taking it, it was actually very easy to get on.  So I guess my questions is, have I done irreparable damage to trying to get off mirtazapine.  Can I just start skipping it again if I can manage some sleep on my own or do I need to restart the taper.  As much as I would like to get off this drug, I do need to sleep. 


#191 fishinghat

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Posted 21 July 2021 - 12:00 PM

No irreparable damage. Is the mirtazapine a capsule or a tablet?


#192 mimi10

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Posted 21 July 2021 - 12:03 PM

It’s a very small round tablet.


#193 fishinghat

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Posted 22 July 2021 - 08:20 AM

The reason I ask is that you might want to take say 3 milligrams as soon as withdrawal symptoms begin to increase. Then next time that wears off take about  2 mg and so forth until you have weaned off. You would need a good set of scales to do the weighting.


#194 mimi10

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Posted 22 July 2021 - 03:09 PM

Thanks for the help, hat.  I don’t have a scale but I can cut the tablet into quarters, 3/4 would be 3.75 and 1/4 would be 1.875.  I will keep that in mind.  I slept ok last night taking nothing but I think it may have just been carryover from the 7.5 I took the evening before.  Today has been a decent day.  The insomnia is mostly what I’m dealing with now and unfortunately mirtazapine is the only thing I’ve found that lets me sleep at least 5 hours.   Hold some good thoughts for me for tonight and we will see what happens.


#195 frog

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Posted 22 July 2021 - 08:36 PM

Sorry Mimi :( 

I'm guessing it's the sedating effect that is helping you, as my doc gave mirtrazapine to me as an option (I'm starting an SSRI to deal with all the bad anxiety I have post withdrawal) and said it's sedating so can help with my trouble with sleeping. I don't want to be sedated as I am not a high energy person to begin with so I decided against it. I'm wondering if there's another sedating medication that you could try that is not so habituating??


#196 mimi10

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Posted 23 July 2021 - 07:40 AM

Frog, how I wish there were something to help me sleep.  Last night around 845, husband and I were watching a movie on tv, told him I was going to bed, felt like I could hardly keep my eyes open any longer.  Went up to bed and fell asleep about 855 but then woke up at 905, how can I be that exhausted and yet only sleep ten minutes.  I couldn’t fall back asleep so about 10 I tried the melatonin again, took a few drops of the sublingual which hat recommended to me and also a 2mg slow release.  I did manage to fall asleep about 1030 but woke up again about midnight.  Then at 1am I was still lying there awake so took 50mg trazodone and fell asleep again around 130 and slept til 3 and then that was it.  I have been getting these weird type of internal vibrations or tremors, not painful, but annoying and can’t sleep,when they’re going on.  Seems like they start in the early morning hours, like 3 or 4. Usually feel them in my hip, lower back and chest, not even sure what’s causing them but I’m thinking withdrawal because I’ve not had them before getting off the mirtazapine.  I hope you find something that works for you in coping with your anxiety.  I’ve not had luck with any of them except the mirtazapine and that’s been the most difficult one for me to get off of.  


#197 frog

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Posted 23 July 2021 - 11:21 AM

Sorry Mimi. That's so rough. I think you had said that you had gone to sleep specialists and it was unhelpful which is SO frustrating


#198 mimi10

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Posted 23 July 2021 - 03:47 PM

Yes the first sleep specialist I saw was no help at all, actually he was pretty much a jerk.  He told me to take lexapro and I filled the prescription and came home and took one dose and just one dose gave me terrible vertigo, couldn’t even stand up, nausea like crazy, crawling to bathroom to vomit.  I called his office and told him I could not handle the lexapro and what was happening and he said If you don’t take the drug I can’t help you and that was the end of it.  I never took another dose and never saw or heard from him again.  The second sleep doc I saw tried me on ambien, then ambien cr, then lunesta started and lastly sonata.  None of those meds ever really helped me.  Ambien cr knocked me out but I’d wake up 3 hours later and it was not a refreshing sleep at all.  When all of those drugs failed he just gave up, didn’t know where else to turn since nothing helped.The psych I saw for insomnia just loaded me up on anything she could think of that was sedating to try to get me to sleep, never took me off any and never decreased doses even when they weren’t working.  She had me on so mich at the same time it took me a year to get off,  she was also a cbt psych so tried a few tricks like sleep restriction and that was a miserable failure as well.  Sleep eventually reestablished itself after I had been of everything for about a year and I was doing well until last December when it all came back again after my bouts of illness.  The strange things is that I simply can’t sleep, I don’t feel anxious or that my mind is racing , I am relaxed and comfortable and tired and just don’t sleep, then I get to a point where I can’t hold my eyes open and fall asleep only to wake up less than an hour later and unable to get back to sleep.
unfortunately I am feeling more and more each day that I’m just going to have to go back on the mirtazapine and try to adjust to the daytime fatigue it was causing me.  My pcp has already tried Zoloft and the cymbalta and I couldn’t really tolerate either and both made the insomnia worse.  I was on the mirtazapine for about three months and sleep in the beginning was definitely better than the sleep near the end, at first I think I was sleeping 6+ hours but it gradually fell back to about 4+.


#199 mimi10

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Posted 26 July 2021 - 06:51 AM

Well I could not take it any longer, the insomnia was back to premirtazapine days, absolutely horrible.  I reinstated mirtazapine 3 nights ago.  Cut the 7.5 in half and tried 3.75 but did not help sleep at all so after lying there awake til midnight took the other half.  Past 2 nights taking the 7.5.  I am hoping to stabilize on this and start sleeping better.  Will see doc next week and see what he has to say but I’m thinking I just going to stay on the mirtazapine for a few more months before attempting another taper off.  I feel awful that I could not get off this drug but the no sleep for such a prolonged time I simply couldn’t deal with anymore. 


#200 fishinghat

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Posted 26 July 2021 - 07:48 AM

Reasonable. You have to take care of yourself mimi. What ever it takes.


#201 mimi10

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Posted 03 August 2021 - 03:12 PM

Saw my doc today and he felt going back on the mirtazapine was the thing to do, said if other withdrawal effects were improving but sleep was deteriorating 3 weeks after stopping it was most likely a return of the insomnia.  Wants me to try 15mg and see if that helps at all but for the next few weeks he told me to stay the course and don’t do it yet as we are going away with the kids and grandkids next week and when we come back I have a spinal cord stimulator test scheduled and that will take a week.  So for right now it’s 7.5 mirtazapine and sleep has been decent.  Might try 15 in a few weeks though.  Hope everybody is well.


#202 mimi10

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Posted 30 August 2021 - 12:23 PM

I am back, I’ve missed you guys.  I am about to try the mirtazapine taper again, maybe smaller and slower this time around.  I have been on 7.5 since I reinstated until 2 nights ago when I cut the pills as best as I could and am taking close to 3/4 pill or a dose of around 5.9mg.  I plan on staying on that for a while before cutting some more.  I have ordered a scale and some empty capsules from Amazon and they are supposed to arrive Saturday.  When I get the scale I will weigh a 7.5 pill and try to figure things out from there.  I will probably be back to get help with my math, not my strong suit.  Hat, IUN, and frog, I hope you are all doing well and hope to hear from you all soon.


#203 frog

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Posted 30 August 2021 - 12:31 PM

Mimi I hope this one does the trick but hopefully you're able to sleep too. I had an unpleasant bout of insomnia when I recently started Lexapro but things have calmed down so much now. I do feel super groggy in the mornings though which stinks but I'll take it over not sleeping


#204 fishinghat

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Posted 30 August 2021 - 01:15 PM

mimi, stay strong and patient. Let us know how we can help.


#205 mimi10

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Posted 01 September 2021 - 06:40 AM

Day 4 at reduced dose of mirtazapine and headache, tinnitus and nausea have started, also did not sleep well last night, maybe 3 or 4 hours.  Anxiety starting, went for a walk inside the local target store to settle it some.  Going to try to hold at the 3/4 pill dose and try to see if things settle down over the next week or so.  Amazon now says scale should arrive tomorrow and I’m sure I will have many questions then.  


#206 mimi10

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Posted 01 September 2021 - 05:01 PM

I think I need a little help here, scale arrived today from Amazon.  I calibrated the scale and weighed 3 of my 7.5 pills and the average weight is .83 so I am just filing enough off the pill to make it weigh .62 which I think is about equal to the 3/4 pill I have been taking for the past few nights.  I multiplied .83 by .75 to get that weight.  Did I do that correctly?  And moving forward I am thinking that it doesn’t matter what the dose is but I should just keep reducing the weight of the pill by another 10 percent and make about 3 weeks of pills at that dose.  So the first few weeks of pills should weigh .62 and then the second set of pills for the following few weeks should weigh .56.  Am I on the right track here?  Also I got some empty gel capsules, should I put the pieces of pill into the capsules or just take the pieces, is there a difference.  Thanks in advance for any help you can provide.


#207 fishinghat

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Posted 02 September 2021 - 07:45 AM

Your math is perfect!!  Good job. 

 

Using the capsules sounds like a good plan but I am a little concerned you may be dropping too fast given your previous experience. Just something to think about.


#208 mimi10

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Posted 02 September 2021 - 09:41 AM

Hat, do you think drops are too big or 3 weeks is too fast.  I had already cut my dose to 3/4 pill for 4 nights before scale arrived so I figured I would just keep that as a first cut.  I have made up 3 weeks of that dose, if things, mainly sleep, are not stable at that point I could make more at that same .62 dose.  Most of the withdrawal effects I was dealing with, but the insomnia caused me to crash and burn on the last taper, which is why I was going to try to let sleep be my guide this time.  The insomnia started getting really bad at about the 2 week mark which is why I was thinking of staying at this dose for 3 weeks.  Well for now I will stay with the .62 dose and I’m counting on my friends here for advice along the way as to how to proceed.  Last night was a decent night as far as sleep went and today things have also been a little easier so far.  Hat, I want to thank you for being there and making yourself available to help me, as well as others, along this process.  Your input is so valued and so appreciated, it’s wonderful to have you to help me through this difficult journey.  Many, many heartfelt thanks.

Also a shout out to IUN and frog for all they share as well. 


#209 fishinghat

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Posted 02 September 2021 - 01:02 PM

A drop every three weeks may be fine but be prepared to go slower if necessary. You seem to be sensative to withdrawing from this med.


#210 mimi10

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Posted 04 September 2021 - 12:21 PM

One week at reduced dose, but the scale is driving me nuts.  I got it out this morning and recalibrated it again and this time the average weight iof the pills is .75 not .83 that I got earlier this week.  So I redid this weeks pills to weigh .57 and surprisingly most were at that weight.  I have no idea what’s going on with the scale, I’m going to reweigh the pills again later today and see what’s happening.  I have found that even when I weigh the crumbs of pills I still have to recalibrate the scale every few weighs because suddenly it won’t be at zero anymore.

on the other hand, withdrawal has been tough, headache, tinnitus, nausea and anxiety seem to roll in every morning around 8 and usually by early afternoon things have settled considerably and I feel very close to normal.  Sleep has been rocky, getting about 5 or 6 broken hours of sleep and again am being bothered by these internal vibrations or tremors in my low back, hips and rib cage during the night which while not painful are very annoying and impossible to sleep through.  My plan right now is to hold onto my dose of .57 and try to ride this out.  Just curious as to why the withdrawal is so rough between morning and early afternoon and then seems to disappear until the following morning.  I usually take my dose between 9 and 930 each evening.





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