Withdrawing from mirtazapine

[pulisa]

Hipha, good luck with your journey too. I made the same decision 6 months ago and don't regret it-neither does my liver. I still have agitation but it's no different to when I was on meds.

[A63]

Hello Sandie, Pulisa and Hipha,

I can empathise with what you have experienced on 30 and 40 mgs of Mirt.

Like Sandie, I have slept about three hours a night since my doc upped my dose to 30 mgs of Mirt: this strikes me as too much of a coincidence. Tonight will be my second night on 15 mgs. I think it will probably take two or three days for the levels of Mirt to reduce, which is probably why Sandie only got three hours sleep last night.

Everyone is different, and I know from this forum that some people do really well on 30 or 45 mgs of Mirt. In my own case, I think six weeks is long enough: if it isn't going to work now, then there is probably no point in continuing at 30 mgs.

I empathise with Sandie's description of her doctor being unwilling to prescribe sleeping meds. Most doctors now seem full of the horrors of 'addiction'. Yes, no-one wants to get addicted to benzos or 'Z-drugs', but I really feel that it is often better to get a few hours rest from a couple of tablets than it is to spend most of the night tossing and turning. When you feel a bit more 'normal' mentally, then you can reduce your reliance upon benzos or Z-drugs: they need to be used as they were intended to be used, I would say; they are not 'evil' per se.

[sandie]

Hipha - may I ask how long you were on Mirt and at what dosages ? How has your withdrawal been thus far ?

[sandie]

So I have seen my GP today and told him that I am weaning off. I told him that I had dropped from 30mg to 22.5mg, and that I intended to stay on this does for 8-10 days, and then drop to 15mg, where I will remain for another 8-10 days. From here to 7.5 mgs for around 8-10 days and then take 7.5 mgs on alternate days for maybe a week or two.

I want it to be gradual and in as small increments as possible in the hope that it will cause me less side effects.

BUT, GP seems to think it is not necessary to be this slow and gradual, and suggests, drop by half straight to 15mg, for 2 weeks, and then continue 15 mgs on alternate days for another 2 weeks before stopping altogether.

His reasons ? The drug companies make the tablets in 15mg, 30mg and 45 mg tablets. Therefore he can only prescribe increases or reductions in these dosages, ie, he cannot condone splitting a pill (which is what I am doing with the 45 mg tablets I was given but never used, in order to drop from 30 mg to 22.5 mgs.) It is also the reason why he started me at 15 mg, even though one of my issues is lack of sleep - I barely manage 2-3 hours a night - and research/evidence points to 7,5 mg being the very best dosage of Mirt for promoting restful sleep.

I like my GP and I think I could trust him with all things physical, but however experienced a GP might be, he is not a mental health professional.

I still believe that the young and inexperienced GP who started me on ADs back in September should not have done so as speedily as was the case without having given me some breathing space. Yes I was anxious because all sorts of things were happening in my life over which I had no control and I was struggling, but I think she felt - and in some ways led me to believe, that ADs were a magic bullet and they most certainly are not.

[Istherehope?]

Gosh my heart goes out to everyone on this thread...this is so so tough isn't it? A63 I can relate so much, I am often feeling that I don't want to carry on too...

I've wondered about the Mirt introducing more fears for me Sandie. I've become fairly convinced that we can't cope financially as a family, which is (hopefully) irrational and wasn't something I was worried about before the meds...its just so hard to know what is meds and what is the illness, it does my head in.

Anyway, I've no real answers but want to give hugs to everyone here xx

[Hipha]

Hipha - may I ask how long you were on Mirt and at what dosages ? How has your withdrawal been thus far ?

Hello Sandie. I was on mirt from November 2014 through to July 2015 including 10 weeks withdrawal. 3 weeks on 15mg, increased to 30mg which was ok but still did not give relief for persistent nausea, increased to 45mg for 3 weeks but was too much and introduced panic so dropped back down to 30mg and mild anxiety emerged. Decided to withdraw after recognising that I was feeling no better on mirt than before taking. Withdrawal was tough and I dropped quickly but it was bearable for me... Over 4 months off mirt and as I am currently withdrawing from lyrica I am not sure whether I am suffering any lingering withdrawal from mirt.

[MyNameIsTerry]

One question for any Mirt users out there. Did any of you develop phobias while on the Mirt or did any of you become agoraphobic ? Certainly in the 3 months since I have been on meds (4 weeks sertraline and 8 weeks Mirt), my anxiety has worsened and I have developed some almost manic behaviour with certain things.

Whilst I haven't been on Mirt, I have been on Citalopram and Duloxetine. Both made me agoraphobic. I've always said that it wasn't true agoraphobia though, more increased anxiety of my GAD manifesting this way as months of getting out sorted this and I don't think that does justice to how a true agoraphobic has to battle out of their disorder.

---------- Post added at 07:52 ---------- Previous post was at 07:33 ----------

I want it to be gradual and in as small increments as possible in the hope that it will cause me less side effects.

BUT, GP seems to think it is not necessary to be this slow and gradual, and suggests, drop by half straight to 15mg, for 2 weeks, and then continue 15 mgs on alternate days for another 2 weeks before stopping altogether.

His reasons ? The drug companies make the tablets in 15mg, 30mg and 45 mg tablets. Therefore he can only prescribe increases or reductions in these dosages, ie, he cannot condone splitting a pill (which is what I am doing with the 45 mg tablets I was given but never used, in order to drop from 30 mg to 22.5 mgs.) It is also the reason why he started me at 15 mg, even though one of my issues is lack of sleep - I barely manage 2-3 hours a night - and research/evidence points to 7,5 mg being the very best dosage of Mirt for promoting restful sleep.

I think this is a big problem with these GP's, the based dosage on a manufacturing unit size. The unit size should be there to provide them with the ability to do what they want, it shouldn't dictate treatment. Drug companies don't make them with withdrawl in mind anyway.

If we go by this GP's advice then we can't ever follow what MIND have reseached or what the Royal College of Psychiatrists say. The latter being the very people GP's refer more complex issues to when they are out of their depth. To put it in terms of physical illness, who's advice would you follow - your cardiologist or your GP when it comes to your heart?

[sandie]

I think you have summed it up perfectly Terry.

I also believe that my GAD / Health Anxiety has been exacerbated by the meds, and this has increased my sense of agoraphobia, which because I then spend more time indoors, along with my thoughts, then worsens my general anxiety.

Now if all of this happens during the dark, grey, gloomy and wet months of winter - is it any surprise that the depression / anxiety often deepens.

By the way Terry, I have hopefully sent you the attachment about withdrawing from ADs, etc via PM - hopefully it has worked.

[sandie]

So last night I reduced my Mirt dosage - from 22.5 to 15 mg. I slept well for the first time in a long while, but put this down to the fact that the previous night was very badly disturbed, my husband is home and this is a huge comfort and relief to me. I have also been taking a small dose of Melatonin. I only started this on Saturday night (hubby bought me some back for the US), and it may be having a compound effect.

I plan to drop to 7.5 mg in a week or so's time and then perhaps stop the Melatonin, to see if the 7.5 dosage helps my sleep.

My GP started me on 15 mg of Mirt - which never helped with my sleep. Perhaps had he started me on 7.5 I might not have had all the issues I have experienced with this awful AD.

---------- Post added at 10:14 ---------- Previous post was at 09:43 ----------

Thought I should add that even though I got a decent night's sleep, and despite this morning being very mild, I am jittery and anxious and shivering; I suspect this is withdrawal and hope that I will be over the worse by Christmas Day. I shall reduce down to 7.5 mg, probably on Boxing Day night - this will be 11 days on 15 mg, which should be a slow enough taper

[MyNameIsTerry]

Thats good to hear, sandie. It must have been a relief to have a decent nights sleep for once.

My GP gave me a month of Zopiclone but didn't tell me how to take it properly, according to the crisis team who he called in who advised to restrore my sleep, so I had to wean off that after becomng tolerant to it. It took over a week of using a "night on, night off" protocol which the nurses said should have been how I was taking it. I knew nothing and was given no advice so just tried this and I couldn't sleep hardly at all on the nights without it but it steadily got a bit more and after about a week & a half I was getting 5 hours or so. It took months beyond that though but it took months before the Citalopram that caused it all started to help me anyway so it could have been a bit of both.

So, maybe you will get some alternating good & bad nights? But as long as it's restoring overall, thats an improvement. No doubt the dosages will affect you in different ways anyway given what other users say about the right dosages for different treatments.

Melatonin eh? A prescription drug overhere so it's also illegal to import it or bring it back BUT I've seen a letter from the MHRA a few years ago saying they didn't even care about personal use quantities as long as they weren't counterfeit. They may change their policy though and Customs are free to seize it but if you know where to look, there are companies that have postal offices in the UK but dispatch banned products like this from the US where it is legal. The thing is though, you can buy it anywhere in the US, it's not a prescription drug, so my view of this is that we have a very advanced medical system saying it's fine to use and we should be fine with that. I also know that some of the banned substances in the UK only made it on there because of the athletic scandals (DHEA) or the date rape media pressure (GBH caused GABA to be banned). There was NO science behind that, it was political. The US have a very advanced medical system and if they believe these things are fine, why don't ours?