View Full Version : Another withdrawal thread
Hello. I am posting my progress on my withdrawal from Mirtazapine with the aim being to share my experience and also hopefully to get some advice and support along my journey. I have been on Mirtazapine for 7 months mainly on 30mg for depression but did have a brief 4 week attempt on 45mg which was too much for me introducing anxiety for the first time. I have had nausea every day for 22 months now and after my physical tests were 'normal' the conclusion of my GP was nervous system related illness which now 9 months later feels like a convenient diagnosis. I have never had any relief of nausea from taking AD medication and actually now feel worse with growing fatigue and nausea. Took the decision to come off Mirtazapine last week and try and let my body find equilibrium again.
Plan is to taper down 7.5mg at each drop with intervals of 1-2 weeks between drops. Now on 22.5mg since 5th June.
Day 1 - early morning felt awful with extreme fatigue, headache and nausea. Expected this. Determined to push through it. Afternoon symptoms eased
Day 2 - same symptoms as previous day but less pronounced. Feel encouraged. Eating very well
Day 3 - awful fatigue and nausea again. Although I was expecting this the severity of my symptoms is awful. Spent all day on my sofa. Still managing to eat. No anxiety or depression feelings as yet but do feel down.
Wish me luck. Going to be a rough 4-6 weeks but need to try something new.
Day 4 - slightly better day but same symptoms of nausea,fatigue and headaches. Also morning pain in and around my rib cage or lungs. This clears after a few hours but is present every morning. Possibly linked to flu like symptoms?
Day 5 - slightly better again but still unwell with nausea growing through the day. Was tempted to drop down again to 15mg tonight but resisted after reading stories on the Remeron withdrawal article and comments on mentalhealthdaily.com
Day 6 - same feelings and symptoms today. Had dizziness also. Realisation that I have a long road ahead coming off Mirtazapine. Anybody else had pain in and around the upper rib cage when withdrawing from this AD or any other?
Revised plan to drop down to 15mg from 22.5mg when I feel ready rather than setting a target although I am determined to come off this drug ASAP
Any advice and / or encouragement are welcomed.
Aw hope you will be ok. I was ok after about 3 weeks but those weeks were hell. I used to have my head down the toilet most of the day and felt as if I had been on heroin or something. It was horrible and made me ill taking it. A total suicidal mess but WD was 3 weeks for me, also that length for my vf's ex gf. Good luck xxxx
Thank you for your reply Karen. What dose were you on and for how long? I have read that a good percentage taper is 10% of dose per month which would mean 10 months at 3mg reduction each month! Not something that I want to consider as I would rather go through 3-4 weeks of hell and then 4-6 weeks of withdrawal symptoms than many months of slowly diminishing symptoms over 10 months. I have been on Mirtazapine for 7 months and do not want to be on it for a day longer than I need to be. Frustrated that whilst I am withdrawing from it, I am still extending my time on it. Very tempting to simply stop and take the consequences.
Day 7 - continuing nausea, fatigue and headaches. Slight improvement from yesterday. Lung / rib pain is easing also. Looking For reassurance that I am following a recommended withdrawal. My local mental health team have not provided any guidance after making the first request for help 7 days ago. My local service is appalling for adults.
Day 8 - same symptoms but slightly better again. Finally spoke with a mental health nurse who suggested a 4 week withdrawal which is the maudsley guidance. Seems a very short withdrawal for me. Will take my time and listen to my body and decrease to 15 from 22.5 as soon as my symptoms have settled. Most severe symptoms are usually experienced after coming off Mirtazapine completely according to the nurse so I have a rocky road ahead.
Seems I am very sensitive to AD medication which I think is linked to a general sensitivity to any stimulant that I have including caffeine, alcohol, acidic food and even cold drinking water.
Any thoughts?
Week 2 day 9 to 12 remain on 22.5 until I have had endocrinology appointment. Withdrawal symptoms have decreased although fatigue is noticeable. Any physical or mental activity results in fatigue and malaise. Determined to come off Mirtazapine.
Day 13- dropped down from 22.5 to 15 last night. Feel the same as I did when first dropping down from 30. I have read that Mirtazapine has a long half life of between 20 to 40 hours so the effect of reducing dosage does not take effect immediately so expect withdrawal to show tomorrow.
Feeling determined to be drug free and try and heal my body and mind naturally. That's the plan anyway
Week 2 days 14-16. As expected withdrawal symptoms kicked in 2 days after dropping down to 15mg. Strong nausea, head zaps, dizziness and low mood. Plan is to drop down to 7.5 in week 3 but only when withdrawal symptoms have settled down. Must balance my urgency to come off mirt with the need to allow the body to adjust. The faster I drop down the harder it will be when I stop taking the drug so patience is important. No significant change in mood just got to keep remembering that awful symptoms are due to the drug.
Hi Hipha,
Good luck with the withdrawal, but listen to your body - it will tell you the optimum speed, not your mind.
Thank you for your wise words Hanshan.
Day 18 - Tough day again today and my mood is low after nausea grows after eating lunch. Also brain zaps and sedated feeling after eating. Food and nutrients entering the blood stream seem to have a real impact on my symptoms. Having a blood sugar test soon where my blood is measured before and after eating a typical lunch and at hourly intervals thereafter. Not sure what the endocrinologist is looking for but assume looking for dips and / or spikes in blood sugar levels?
Days 19 to 22 - symptoms becoming less noticeable. Sleep continues to be good as it has been for as long as I can remember. Slight drop in mood with some feelings of hopelessness creeping in on a morning. Found it difficult to decide whether to drop down again to 7.5mg from 15mg at the start of the 4th week. Decided to take e plunge and have been on 7.5 for 2 days. Surprisingly no bad withdrawal symptoms so far although this seems to be the pattern with 2-3 food days after dropping down followed by 2-3 bad days and then gradual improvement. Experience so far has been surprisingly good. I realise that this may change when I stop taking mirt hopefully in 5 days. One thing I have been reminded is that no two withdrawals are the same. Feeling determined and slightly hopeful for the future.
Week 4 - definitely finding withdrawal symptoms are stronger this week. Been on 7.5mg for 7 days and so I am due to stop taking Mirtazapine from today. Not sure that I am ready. Been feeling anxious in last 2 days which is more of a symptom feeling than being a worry about any forthcoming event or situation. Is this common when withdrawing from any anti depressants generally and specifically for Mirtazapine ? Still sleeping ok despite being on 1/4 of my dose although still on pregabalin 200mg at night as withdrawing from that at same time as Mirtazapine would be too much. Tried not taking my usual 100mg dose of pregabalin and felt really sickly. Feeling determined to come off all medication. I want to be me again and if that means still feeling sick well so be it.
Week 5 - took my last dose of Mirtazapine at end of week 4. Been off it for 4 days so far. Decided to take the plunge as I felt I was putting off the inevitable. Same pattern of withdrawal symptoms with first 2 days after drop being ok but then strong nausea, headaches and fatigue kicking in. Last 3 days have been tough although not as bad so far as I had feared. Slight improvement today although anxiety symptoms appeared this morning and mood is quite low although no worse than when on 30mg. Feel positive that I have done the right thing. How long did your withdrawal symptoms last after stopping completely.
Interesting post. Hope side effects disperse quickly for you. Now youre free of the ads.
Wishing you well x
Week 6 - 1 week off mirtazapine. Week 6 started off as week 5 ended with strong nausea and brain zaps all day and night. Difficult to maintain belief and hope that the withdrawal symptoms will eventually disappear. Can't resist looking for comfort in forum posts and nausea seems to be one of many withdrawal symptoms that can last for many weeks after stopping. No anxiety or depression symptoms which is a relief ( so far ). Determined to be free of mirtazapine. Trying to eat healthily, drink plenty of filtered water and am taking Omega/3 capsules.
Wow just when I thought it could not get worse it did. My withdrawal journey from Mirtazapine is now nearing the end of week 6 and this is day 13 since I stopped taking it. Nausea has intensified in the last 3 days and for the first time I feel like I could actually be sick. Unsurprisingly my appetite for food is low so weight loss is inevitable. Couple nausea with fatigue and headaches and I am feeling awful. Can't help the feelings of doubt that are creeping in. Did I do the right thing coming off Mirtazapine and will this withdrawal ever end? Who knows this might just be the beginning of this awful experience. Any stories and experience of withdrawal and nausea to help me through this would be greatly appreciated.
SmilingAlbert
13-07-15, 17:21
hi Hipha,
Sorry to hear this -
I thought you were feeling nauseous in the first place (before taking mirt etc.)? It could be that you are encountering your original problem, rather than anything to do with withdrawing from Mirt?
Albert
Hello smilingalbert. I have felt nauseous throughout the last 2 years including all of my time when on Mirtazapine especially after eating. This nausea is different in that it is much more intense and with me throughout the day whereas previously it was in spells. This situation is what I was hoping to avoid when withdrawing in that I am having withdrawal symptoms which are similar to my original symptoms putting doubts in my mind. Bottom line is that I was not getting any better when on Mirtazapine and am no nearer to returning to work and normality so why continue with a strong AD that is not helping me whilst growing my physiological reliance on it. Having said all of that doubts are creeping in and maybe the last 6-7 months is as good as I can be, with Mirtazapine helping in the background and smoothing out my symptoms. One thing is for sure for some people withdrawing from AD medication is prolonged and very difficult. I felt similar to this when withdrawing from Trazadone and at that time gladly accepted a diagnosis of depression and prescription for Mirtazapine. I understand my body a lot better now at least and know that a diagnosis of depression and anxiety is too simplistic. There is something else going on possibly CFS/ME. Time will tell
SmilingAlbert
13-07-15, 20:54
Sorry to hear all this Hipha. Feeling nauseous all the time is awful, I know I've been there. But it is not normal - have you got a good doctor? After 2 years, it might be time to get a new one, and/or a referral to a (new) specialist.
Best wishes for your recovery
Thank you for your kind words smilingalbert. My GP is supportive but completely passive when it comes to my treatment. I feel like I should sit in her seat during consultations. To be fair if psychiatrists do not know what these drugs do and the impact they have on an individual's physiology then what chance does a GP have? I managed to get referred to an endocrinologist recently and just had all results back which are all 'normal' which is like a slap in the face. I am heading towards an 'unexplained illness' with depression and / or anxiety as the only remaining diagnosis. I have no idea whether I am depressed and whether the nausea is due to depression and nobody else can tell me. My mood is remarkably good considering how I have felt for the last 2 years. Mirtazapine does seem to help some people but I am not sure what it has done for me. Returning to it would feel like I was giving in to the withdrawal symptoms and returning to a life of poor (but not bad) health. Will keep hoping that this nausea will ease soon.
SmilingAlbert
14-07-15, 11:22
I think you need to find a good psychiatrist asap. If you can afford it, go private if need be; I would suggest that spending money on this is perhaps the best thing you could do with it right now, given your situation.
Not sure what another psychiatrist would do without understanding why I have persistent nausea. It could be due to slow gut motility (gastroparesis) which would require a different medication approach than if the root cause was related to anxiety or depression. Any psychiatrist would be guessing as to which medication to try next and to be fair Mirtazapine would be the first choice given my symptoms. Worth a try I suppose in the future but at the moment I have decided to try a novel approach of no drugs to see what happens to me. Not going well at the moment but still early days (day 14). Thanks for your concern and interest.
SmilingAlbert
15-07-15, 20:33
Have you had an endoscopy? That can prove gastroparesis one way or another, and find any other physical possibility - e.g. gastritis.
Hello. Yes had an endoscopy 18 months ago. It was normal although as I had not eaten for over 12 hours there would be nothing in my stomach. Not sure whether there are any other indications for gastroparesis apart from feeling of fullness when eating which I don't have. Running out of possibilities. Medics that I have spoken to have not come across anybody who has had nausea every day for 2 years without any diagnosis. I attend a depression anxiety support group and I took the opportunity to ask my fellow attendees whether they had any physical symptoms esp nausea and none out of 14 others had any nausea apart from fleeting mild events. This does not in itself explain anything but further reinforces my feeling of being out of the ordinary. Was hoping that Mirtazapine and Pregablin would sort this but has only smoothed out my nausea slightly. Will keep hoping something turns up of me.
SmilingAlbert
15-07-15, 22:23
OK - thanks - I was told by my gastroman that gastroparesis does show up on scopes, but there is also a gastric emptying test you can do to make sure which is fairly simple and non-invasive (I had the test - a doddle). It mostly comes as a side-effect of diabetes.
I had constant nausea for around 7 months, and after a legion of tests turned up nothing I finally realised that it was stress and anxiety, which I had suspected all along.
GI problems from stress and anxiety are extremely common; I read a history of the bombing campaign during WW2 recently, and a vast amount of people in the countries involved felt very sick a lot of the time: not especially surprising when you consider that they feared, sometimes all too correctly, that a bomb could fall on their home one night and blow them up along with their families.
If you google 'anxiety' and 'nausea' it returns over 20m results. I remember when I was a child feeling very sick before exams; it is, in a weird way, normal. Your body is in fight or flight mode; when we were cavemen, it was a signal to be on our guard, and even empty our stomachs to enable us to run faster than the woolly mammoth chasing us.
I am in no way belittling your situation; as I said before, I have been there, and I know how awful it is. But I would be amazed if your nausea had a physical cause: if it was a serious life-threatening issue I think a lot of other symptoms would have appeared by now, after such a long time.
I fear your symptoms are feeding upon each other (I know, I've been there too), and you probably have health anxiety on top of your existing anxiety.
That is a lot to deal with, and your body is complaining. That's how they work sometimes, and not for nothing is the gut described by some as a 'second brain' - you can google that and find 2.7m items on that subject too.
I suspect that your solution is to deal with your stress and anxiety; intensive CBT and other therapy, a strong exercise regime, and yes, finding the medicine out there that could help you: there's a lot out there.
Best wishes for your recovery, which WILL come.
Albert
Hi Hipha,
Sorry to hear about the continuance of these symptoms.
I don't think depression is a common cause of anxiety, but I'm surprised to hear of a group of people with anxiety who haven't experienced nausea - I'd imagine it's one of the most common anxiety symptoms.
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I meant to say "I don't think depression is a common cause of nausea". Sorry if that caused any confusion. Nevertheless, you have researched it and found that it is, so I will go with that. The main thing is to beat the nausea, whatever the cause.
Thank you both for your replies and views.
I have looked into anxiety and depression extensively and both do have nausea as a common symptom. However it is almost always intermittent and is triggered by events or thoughts causing depression and/or anxiety. My situation is weird in that I have had nausea every day without a break for 2 years and for much of that time I have not felt anxious or depressed although a low mood is inevitable. I agree that it is highly unlikely that I have a disease or functional problem as Something would have shown in the extensive tests that I have had. However I cannot agree that this is not due to something physical as every illness is physical if you view the mind and body as one. I cannot deny that I am hanging on for a diagnosis that would 'let me off the hook' and I know this will not come. From my perspective and those close to me a diagnosis of depression and /or anxiety does not stack up and is backed up by the fact that nobody suggested either of these illnesses for the first year of my illness. I feel that I am closer to knowing myself through this illness and feel that this is fatigue related as it first appeared when I was exhausted after a very long drive and no sleep and now gets worse when I push myself too hard. Depression and fatigue are closely related. My plan is to avoid or lessen medication as much as possible to see if my body 'bounces back' as I believe the less stimulation the better for me. However if I fallback I will not hesitate in restarting my search for the right drug for me. Feeling slightly better today so hopefully I am heading in the right direction.
Update
End of week 7 withdrawal - day 20 off mirtazapine. Withdrawal symptoms continue with strong nausea with me most days. Just when I think that I am over the worse, withdrawal symptoms return with a vengeance. Today has been awful with diarrhoea, stomach cramps, nausea, strong fatigue, aches and pains, low mood and anxiety. Symptoms today felt unusual and new to me especially the diarrhoea. All this after a good day yesterday with only mild nausea. Can't help but have doubts that these symptoms are not withdrawal but are 'how I am now' which is frightening. Determined to keep on this path and review progress in 4 weeks time where I will consider trying a new medication if these symptoms persist. If they get much worse then I will have little choice but to try something new. Any advice or encouragement would be appreciated.
At three weeks, you should be somewhere in the tail end of withdrawal from mirtazapine. Remember that it does make changes in the brain that take some time to stabilize, even when it has been fully cleared from the body. The four week withdrawal may have been on the fast side for your body to fully adjust to each reduction in the taper.
Thank you Hanshan
I agree that my withdrawal from 30mg over 4 weeks was too steep and was influenced by my urgency to not have this drug in my body a day longer than I had to. However the main reason for this 4 week plan was due to my local mental health service recommending 4 weeks. They quoted maudsley hospital guidance for this plan so who was I to disagree? So 7 weeks on and 3 weeks off Mirtazapine I feel depressed, sick, fatigued and now have diarrhoea although this has eased today. Realise that my brain and body is trying to readjust to life without a strong drug being pumped in every day. Just hope that my body can readjust and symptoms ease without me having to resort to trying another AD medication which would be a desperate move. For the people who get real benefit from AD drugs I can understand why they would continue to take them. For people like me who have not gained any benefit; we are left with a brave decision to withdraw from these powerful drugs or to continue to desperately try the many drugs available in the hope that something will help. I wonder if anybody knows what impact taking these drugs has on our individual brains and the levels of addiction that occurs. Will keep on this course and will continue to record my journey
My impression is that the people who study these meds are all about start-up effects, first-response time, and response level, etc. If they look at withdrawals, it's mostly after a short trial of around 4 - 8 weeks, and everyone withdraws easily. It's much harder to study withdrawal of people who have been taking an AD long-term, since they are not easily collected into a homogeneous group, all starting at the same time, and so on.
Do keep posting and give it time to settle. You may need several weeks before you know what the next step should be. Best of luck.
Thank you Hanshan
That makes sense. The drug companies do perform rigorous tests on these drugs but as you say it is very difficult for them to recreate real world situations of withdrawal as I am sure that they are not able to use people who are already depressed in their trials as this would be too risky so they are never going to see a true picture of how a drug is tolerated or how withdrawal is managed. People like us who have existing mental health issues will be more prone to difficulties when taking these powerful drugs as our physiology is already sensitive and has lost balance.
Having a roller coaster journey with withdrawal and today I feel quite nervous and depressed. I know and recognise depression immediately and it has only shown itself when I have been withdrawing from an AD medication. If this depressive mood continues it will take a lot of courage from myself (and understanding and patience from those around me) to avoid commencing a new AD. Thanks again for your support
Week 8 of withdrawal completed - 4 weeks off Mirtazapine completely after tapering down from 30mg over 4 weeks. Had an awful week especially in last 2 days with strong nausea and horrific gastro issues. Did not expect this and thought that I had seen off the worst of the withdrawal. Symptoms are: nausea, constipation followed by diarrhoea, loss of appetite, strong fatigue and low mood and slight anxiety. Feel helpless and hopeless. Have read other peoples experiences on forums where withdrawal lasted for several months with similar symptoms to me but feel that is extreme and many people come off Mirtazapine in weeks with only mild symptoms. Maybe I am one of the unlucky people. I do think that my persistent nausea and intolerance to alcohol, caffeine and basically any stimulant is a link / clue to why I suffer when starting a new drug and especially when withdrawing. Will keep battling against this cruel illness. Would I feel better if I started on the next drug suggested by my GP which is fluoxetine? Who knows but feeling the inevitability of trying this drug creeping up on me.
Just reading your post and I'm on the same boat as you except I tapered down from 15MG to 7.5 MG. I tried stopping this medication cold-turkey and switching to Sertraline (Doctors orders) and experienced the worst withdrawal of my life. Ended up going back on it and haven't felt right since restarting it, when I was off it cold-turkey, for two days I felt fine until day three when I experienced;
Derealization
Panic attacks.
Full blown anxiety.
Nausea.
Diarrhea.
Headaches.
Dizziness.
Depression.
Crying spells.
Shaking.
Vomiting.
And more...
This all went on for two weeks until I finally went back on 15MG but the only symptoms that remained were panic attacks, anxiety and depression. Nausea would come and go. Anyway, I did not have anxiety before this medication, as it was prescribed to me for depression and to help with my sleep. And since restarting the 15MG, I have not felt right so I have gone down to 7.5MG and I feel back to my old self for three days. No anxiety or depression except feeling low in little spouts but it quickly goes away. No panic attacks either. I also feel the way you do - will I feel like this forever now? I should probably research people who have came off this medication long-term (I was on it for two years) and find out if they ever felt themselves again. Anyway, I would advise you to either stick it out or go back on a very low dose to ease the symptoms.
Keep posting, my friend.
Thank you Virtuoso. I have been very critical of Mirtazapine mainly due to the horrendous withdrawal symptoms I have had and the failure of it to resolve my ongoing nausea. One fact I have learned since coming off it is that it was helping me in so far I was stable mentally with no depression and low anxiety. However I did not feel that I was improving any further after 7 months on 30mg and I was no closer to returning to work. I therefore took the decision to withdraw and see how I felt. I will admit that I am tempted to return to Mirtazapine as I do feel depressed, the nausea is worse and my appetite has gone. After 4.5 weeks off this drug I am hoping that I am still experiencing withdrawal and that I will see an improvement soon. I have a family holiday soon and I am dreading it as I do not want to spoil their holiday. I do empathise with you and we have both found that Mirtazapine can increase anxiety which I have read is due to it increasing levels of noradrenaline. I can't help but think that AD medication has a huge impact on an individuals physiology and none more so than after withdrawing. My body is in a state of shock I think and is scrambling to try and regain homeostasis. I will follow your progress via your thread with interest and will keep the hope that my symptoms will improve soon. Good luck friend
Hi, Hipha.
Thanks for your reply. I'm sorry you're finding difficulty with depression and feeling nauseous, I can inform you that it is most definitely withdrawal symptoms as I had the same when I quit cold-turkey for those two weeks. It disappeared soon after I restarted it so clearly it's the medication. I agree with you about the whole thing with regards to your body scrambling - my GP even said that stopping & starting these medications takes havoc on your brain/body because the brain has been given this pill consistently for a period of time and now that it no longer has it, it's expecting to be fed and when it doesn't get fed, it goes into a state of shock.
I'm going to remain on 7.5MG until I feel content enough to cut the pill again in a lower dose. It's all about letting your body get used to the lower doses, there is no rush whatsoever, because I know for sure my body will adjust slowly but surely until there is no medication left in my body. I think slowly is the best way to go forward. I read from someone else who had successfully came off this medication that his withdrawal symptoms lasted six months but he felt back to himself after six months exactly. I'm sure that because your brain isn't getting fed the pill it's expecting - that too will put a damper on your mood. I kind of regret coming on this medication and not going to therapy sooner for my original problem - depression. To be quite honest, my depression back then I was able to cope with to a degree and I took the shortest, easiest route to try fix my depression and that was obviously popping medication into my mouth.
Please keep us posted on your symptoms and how you're feeling - it's good to write it all out sometimes instead of being alone and thinking about it constantly. Hang in there - and if you need to go back to taking your medication don't beat yourself up over it. Do what is best for your body and your health.
Hi Virtuoso - Good to hear that you have mostly stabilised on 7.5 mg. Just take it easy from here.
Hipha - Have you tried any probiotics / prebiotics? Lots of research is currently going on into gut flora and how they affect mood.
MyNameIsTerry
02-08-15, 10:39
There a few "second brain" style threads on the Natural Remedies board that I have seen. I think probiotics are something to look into and even NICE & the NHS are coming around to them although they remain at arms length on the issue given the lack of research for them.
Are there any useful studies you know of, hanshan? I've seen one in the BBC Science magazine but it was conducted by one of the manufacturers so I'm a bit dubious about them until more come out. That was based on mood.
I read some interesting research on rats and anxiety recently. They determined that the signal for anxiety it sent from brain to gut and gut to brain. They severed the channel for the brain to create the anxiety signal and observed the gut sending the anxiety signal to the brain. That seems to make a case for gut flora too.
Virtuoso - I am not convinced that my symptoms are solely withdrawal based. It is difficult to unpick these symptoms and identify those that have been around pre medication and those that have appeared whilst taking AD meds and finally those that have appeared whilst withdrawing. I can identify depression as a symptom that first appeared when I withdrew from Trazadone and has now reappeared during withdrawal from Mirtazapine. Depression can however manifest itself in many ways I think and could be the basis and cause of my long running nausea symptoms. I suspect that if ten healthy middle aged men took Mirtazapine for 7 months and then withdrew over 8 weeks that they would not have any significant withdrawal symptoms and would not become depressed. Does the fact that I have depression now after 5 weeks off mean that I have an underlying depressive illness? Sure that my psychiatrist would say yes.
Hanshan - yes I did briefly try probiotics (biokult) 18 months ago on the advice of a nutritionalist and had an increase in my nausea symptoms so stopped. I was however also taking a range of other supplements at the same time so who knows whether the biotics were entirely or partly to blame. My mother had anxiety and depression which included nausea symptoms and was prescribed fluoxetine which initially made her illness and symptoms worse. After 3-4 weeks she started taking a probiotic and at week 5 the nausea disappeared and her mood lifted. We may never know what resolved her nausea.
Mynameisterry - interesting research although what does it prove for humans? If this theory is true for humans then it widens the focus of anti depressant and anti anxiety treatments to include the gut. All the articles that I have read regarding treatment focus on the brain and the gut is rarely mentioned in terms of treatment although there is wide acceptance of the brain gut axis. Hope treatment options improves rapidly as there is only so much that therapy and existing drug options can do for people like me.
You can find a review here:
http://www.biomedcentral.com/content/pdf/1757-4749-5-3.pdf
http://www.biomedcentral.com/content/pdf/1757-4749-5-4.pdf
Probiotics don't have to be sold as such - they can be naturally fermented foods like natural yoghurt, kimchee (though strong on the chili), sauerkraut or miso.
MyNameIsTerry
02-08-15, 12:02
They use rats as they are quite close to humans. When they studied many areas such as amydala response, pre-frontal cortex stimulation, etc in trying to understand how things like CBT can work they used rats or mice.
I guess to us at this moment is means we can look towards the things we probably already know, how food can make us worse or how certain foods can be a trigger for some people. But also how we need to work on good gut health alongside what we are doing. It makes sense anyway given the many IBS, GERD types issues we tend to experience and flora pay a big role any the whole process from mouth to the other hole :blush:
At the end of the day, without the gut being optimal, you don't get enough neurotransmitters created and for that you need things like these flora. These SSRI/SNRI's only restrict us leaking the neurotransmitters so I find it very strange how doctors don't tell us what to eat to maximise the benegit of them.
Have you seen anything on Glutamine? It plays a bit role in GABA and can easily be purchases from even supermarkets. I know there are some drugs out there looking to incorporate this system. I remember a few mentioned on NoPoet's drug research initiative thread.
I am quite keen to see what comes of probiotics.
Some years ago NIMH were performing research on Transcranial Magnetic Stimulation (TMS) but it just seems to have died off. We've got these devices around like Alphastim but they don't seem the same and the NHS use a form of stimulation for migraines only. I wish they would follow up on things like this too because the meds are simply a minefield and can be very tough to even get benefits from.
Hipha,
do you suffer from clinical depression? Depression is found to be a common withdrawal symptom from what I read - and I know it's probably difficult to tell which is from withdrawal and which is from just yourself whilst you're in the middle of discontinuing medication, only time can tell, though. However, by your theory, if the depression is just you then surely the medication has not worked because it is still there when you take away the medication and therefore you will need to be on medication for a long period of time?
The reason I knew that my depression was from withdrawal was because it would come in spouts and sometimes I'd feel back to my old self, sometimes I wouldn't but mood swings are part of withdrawal. Also, if you think your depression is not because of the medication withdrawal, then wouldn't it be a better idea to go back on the medication to help with your depression? I would worry that your depression may get worse if not properly treated.
Good luck, friend.
Hello
I was diagnosed with moderate depression back in November 2014 but at that time I was withdrawing from Trazadone and was having a terrible experience worse than this withdrawal from mirtazapine. Make no mistake I was depressed at that time and gladly accepted the diagnosis and the prescription for mirtazapine. The depression this time feels similar in nature and symptoms like nausea, fatigue and loss of appetite. Last time it took 6-8 weeks for the depression to lift and perhaps that was due to mirtazapine. I do think that we must all recognise that our individual illnesses do not stand still; they move and morph into different conditions, feelings and symptoms so I must accept the possibility that whilst I did not have depression back in 2014, I have it now and it might not be due to withdrawal. I will monitor my symptoms and if I feel that I am heading in a dangerous direction I will go see my GP although as I have said many times: I have hold of the steering wheel which is scary. Thank you for your kind words. I do hope that you find peace again with or without medication. We are in the same boat so it's good to share thoughts.
I'm glad you say you have a hold of the steering wheel - which means you are in control. That is a huge plus, friend. Please make sure you stay in that position and do not lose control. There is always light at the end of the tunnel, so maybe when you have a spark of feeling good it would be worth noting so you can always remember it when you're feeling low or about to give in.
My steering wheel analogy was aimed at showing that I have control of direction of travel but actually I have no idea where I am heading as I have no experience or knowledge of these drugs and am not a psychiatrist or psychologist. Nobody else seems to have any interest in taking hold of the wheel or even suggesting a direction. Terrifying times for me.
Hipha,
have you ever had therapy before? Therapy can help sometimes.
Hello. I have had some therapy yes. Psychoanalysis for 8 short sessions over 8 weeks which was difficult as many upsetting subjects were discussed which made me feel worse. What I found was that if conclusions are made by myself or the therapist it is then up to me whether I believe it is the reason behind my illness. I also acknowledge that there are some real issues with my family and my relationships and that change is needed. I also had a brief spell of counselling via the NHS which was useful in that it is good to talk but I gained nothing more than having a chat with a friendly person. I am booked on to a 5 day mindfulness course which starts early September. I think that I would gain benefit from therapy and Mindfulness if I did not feel so physically ill with nausea. I do ruminate quite a bit looking for the answer to my illness and trying to explain to myself and comfort myself that it is not my fault. Learning to reduce this constant thinking as it does not help me and contributes to my illness. Vicious circle of physical symptoms and damaging thoughts needs to be broken but there is no magic key and will never be a eureka moment.
I'm sorry you've went through therapy which hasn't really made a huge impact on you. Perhaps it's been the wrong kind? I think of therapists like I think of medication, each one is different and sometimes it takes a while to find the right therapist. For example, some of the therapists have different ways of coaching people and giving them exercises to try at home, some just talk to you, some just don't help at all etc. People benefit differently from each one and it's tricky to find an actual good one that suits you and your needs, so maybe that's where your problem lays. I had been to a therapist in school who was absolutely useless and did nothing for me, I felt like a child with her exercises and never went back after two days.
The therapist I am seeing currently is a lot better and gives me homework for home. She warned me that in order for me to get better, most of the work has to come from me but she will be there to guide me through it. I think that is something you need, a guidance and support for your depression. I am very interested in your story and want to see you overcome your battle with depression and hopefully you are rid of these terrible withdrawal symptoms soon.
That is a good way of looking at it. So far I have not found a med that works (makes me feel 70% better) or a therapist who can tune into my illness. I did not have any issues with any of the therapists personally just did not gain much benefit. Also there is the cost factor which at £50 per 50 minute session means I feel overly keen to get my money's worth rather than relaxing and accepting the course the therapist takes me. I am considering revisiting therapy although would rather receive a recommendation. Also I would prefer a therapist to be able to take an holistic view of me and recommend and pursue the best form of treatment. Many therapists specialise in one type of therapy such as psychotherapy rather than fitting the therapy type to the patient and perhaps using more than one approach as needed. Thank you for your interest in my illness and recovery. The feeling is mutual
---------- Post added at 16:40 ---------- Previous post was at 16:18 ----------
Week 9 - in summary quite an horrific week to begin with due to awful gastro symptoms along with the usual nausea. Doubts on whether I have done the right thing in withdrawing as I do feel worse now physically than when on the drug. Mentally I feel mildly depressed and anxious whereas when on the drug I felt anxious but not depressed. Last 2 days have seen an improvement with gastro issues clearing up and slightly better mood. Pressure from my family to return to medication if no improvement soon as I need to be stable to take therapy. I have no idea whether my symptoms are withdrawal or not or combination with underlying illness. It's amazing to me that after only 5 weeks my view of Mirtazapine has changed from 'evil drug' to a drug that was giving some benefit but not resolving my nausea. As I have said this is not a typical withdrawal if there is such a thing. But one thing is for sure; withdrawal from Mirtazapine can be very difficult especially if used long term regardless of what the medical community say. Will review my position in 2 weeks and if symptoms are no better or worse them will consider trying fluoxetine as my mother has gained huge benefit from it. Desperately searching for something that will relieve my nausea which would, I think, see me recover quickly.
Week 10 complete - 6 weeks off mirtazapine. Symptoms have settled down slightly although left with depression, constipation and of course my old friend nausea. Feel hopeless and helpless and although I did not feel much better on mirtazapine at least I did not feel so depressed on a morning. Fatigue is also a big issue for me at the moment which appears the day after doing something strenuous like driving 200 miles which has floored me physically and mentally. This could be how I am now without medication. Withdrawal may be complete. One thing for sure is that I did not have depression before starting AD medication 12 months ago. That is what I am hanging on to and maybe I need to let that go as the fact is I am depressed now. Awful feeling along with anxiety. I will keep posting although maybe my withdrawal is complete. The inevitability of starting a new medication is moving closer every day.
I am still taking pregabalin 200mg before bed and 100mg early morning. Suddenly occurred to me that pregabalin may be contributing to my depressive mood as this is a known side effect. Realise that I feel depressed after 12 hours has passed which is the full life of pregabalin. So perhaps my body is starting to crave the next dose when I wake? Plan has always been to stop pregabalin once off mirtazapine. I feel no benefit from pregabalin apart from it may relax me at night helping me to sleep. I would stop now but if I am 2 hour late taking my dose I get terrible sickness and fatigue so sm forced to continue taking it. Here we go again!!
Week 11 complete - 7 weeks without Mirtazapine. Not much to report apart from continuation of depressive feeling and symptoms of nausea, constipation and growing fatigue. Any strenuous activity seems to floor me but strangely fatigue sets in the day after. I am not sure whether there are any lingering withdrawal symptoms from Mirtazapine or whether this is how I am now. Depression is accompanied by a mild sense of anxiety and not having the confidence to do anything. I do not regret coming off Mirtazapine as it was not giving me relief from nausea. What I do regret is not trying to split my dose taking 15mg in morning and same at night instead of all 30mg at night. My nausea is / was worse on the afternoon when Mirtazapine was possibly losing its effect after 14 hours since last dose. I do not have anybody guiding me with my local mental health trust in disarray with no funds to recruit staff. So I will continue withdrawing from Pregabalin and consider my position next week with the likelihood that sertraline or fluoxetine will be the next candidate. I never thought I would say this but I would also consider returning to Mirtazapine as at least it helped improve my depressive mood. Any encouragement or advice is welcomed.
Week 13 - 9 weeks off Mirtazapine. Feel that I have stripped back most of the symptoms some of which were caused by the meds and can see a clearer view of what my illness looks and feels like. This was my intention from the start as I felt I had lost sight of what my illness looked like in the midst of trying 3 medications each with there own side effects. What I see is an anxious man and the anxiety has found its way out through nausea. Seems obvious doesn't it but lack of any anxiety feelings for the first 12 months of my illness meant that I have spent the last 12 months in denial looking for a diagnosis of a physical illness with a name. 24 months on and I know and accept my illness. In terms of withdrawal well although it is difficult it is possible. Take your time and listen to your body. Find a balance which reflects your length of time on the drug and your eagerness to get off it. Everybody is different but I am inclined to take as steep a withdrawal as you can handle as a long withdrawal means you are on the drug longer. Be brave but not foolish in your withdrawal plan. So fluoxetine for me starting tomorrow. This drug has helped my mother and her panic and low mood immensely. Wish me luck.
Hi Hipha,
Best of luck with the fluoxetine.
There seems to be a variety of over-the-counter remedies for nausea - mostly antihistamines like diphenhydramine and various oils like ginger, lemon or peppermint. Have you tried any of these?
SmilingAlbert
03-09-15, 13:31
I think you have made the right call Hipha. The nausea is just a symptom, not a cause in itself.
There seems to be a variety of over-the-counter remedies for nausea - mostly antihistamines like diphenhydramine and various oils like ginger, lemon or peppermint. Have you tried any of these?
All of these will be more or less useless - I know, as I've been there and tried them all.
All of the above are of some limited use when nausea has an organic cause; e.g. when you've eaten or drunk something that upsets your stomach. However, when your brain is sending your stomach signals to be nervous & anxious, those blot out everything.
When you conquer your anxiety, your nausea will be quickly cured; good luck with the Prozac - many people are helped by this, though it may be difficult in the early stages.
Albert
Thank you Hanshan and smilingalbert
I have tried drinking ginger and peppermint tea but both irritate something inside me and results in increasing nausea rather than easing it. Tea and coffee are both very irritating to my gut although not sure whether it is due to caffeine or the acidity of both. I have read that tea and coffee both increase stomach acid which will irritate an already sore stomach. I am trying camomile tea with a spoon of honey which is ok (but is not the same as a Starbucks !!)
I agree Albert. No OTT counter products help with nausea which is due to anxiety. I feel like my condition is rare in that the anxious thoughts and feelings did not appear until recently almost like the symptom appeared and the thoughts decided to catch up later. Is there such a condition as an anxious stomach but calm mind??
Just taken first dose of fluoxetine....here we go again
Last post on this thread from me. I tried fluoxetine but after 4 weeks on 10mg I was forced to stop due to growing flu like symptoms including painful legs and arms and overall body pain and nausea. This has at least confirmed that I am intolerant to AD medication especially SSRIs. Stopped cold turkey after only 4 weeks and withdrawal has been and is difficult with heavy flu like symptoms. Resorting to diazepam to ease the pain in my limbs and to stop my hands and body shaking. In comparison mirtazapine was successful! Doc has said that I am very unlucky and that I need to accept that I need to recover without medication. Thanks for your support on this thread.
Sorry to hear that the meds were unsuccessful. Best wishes for your ongoing recovery, and feel free to drop a line at any time.
SmilingAlbert
07-10-15, 21:01
Good luck Hipha; you will recover, I promise you.
Thank you hanshan and smilingalbert for your kind words. It means a lot to me. I am sure that we will exchange views soon on this forum and hopefully I will join you one day in your individual paths to recovery.
I was mainly on 30mg but had gone up to 45mg at one point. I came off complately within three weeks and was the same, flu like symptoms and was sick each day with the terrible anxiety. But it was all over very fast coming off so fast! I am back on again now and wen tup from 15mg to 30mg about a week ago but have been really weepy and anxious so cut back down to 15mg last night, still feel terrible but kind of numb too. I have no idea which dose works best for anxiety! I don't suffer with depression as a rule. But feel really fed up. I also take Amitriptyline 30m. How are you getting on with your wd darl?
Hello Karenp
Sorry to hear that you are struggling. From what you describe it does not seem to me that you have had any success with mirt for relieving anxiety. Is this correct? If so why continue with it? Mirt does not seem to resolve anxiety by itself with other drugs like pregabalin introduced alongside sometimes to counteract the anxiety brought on by mirt! That was the case for me and a friend of mine who is now on 30mg of mirt and 600mg of pregabalin to counteract anxiety. There are very few long term meds for anxiety. Diazepam does help take the edge off for me but not worth risks of long term use. I withdrew from mirt over 2 months and have been off it for nearly 5 months. I am also trying to withdraw from pregabalin and down to 50mg per day from 300mg. I am suffering from awful gastric issues, fatigue, dizziness and occasional anxiety. Not sure whether I am still suffering from mirt withdrawal along with pregabalin withdrawal. Feel like the last 14 months trying various AD meds has caused a chemical storm in my body and brain which will take many more months to settle down (hopefully). Be interested to hear your story
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