Stopping mirtazapine

[Benjammin69]

It sounds to me like your anxiety has ramped up and your mind is overstimulated. Are you finding it really hard to concentrate? Are your thoughts racing? This can be very tiring if so.

You are getting intrusive thoughts and these are always more intense and more frequent when overall anxiety levels go up. I've spoken to many OCDers who say this and also say the opposite is true in that as those levels subside the thoughts decrease.

Whilst these thoughts can be very scary, they are literally just the subconscious blurting stuff out that normally would be catered for by some other process or ignored because they are meaningless. So, try not to panic as they come and don't analyse them negatively i.e. obsess over what they mean, because they mean nothing, its just a hyperactive self protection system. Try to acknowledge them as simply thoughts, no more important than a thought popping in to buy some milk when walking around the supermarket.

With this being a drug withdrawal issue, I don't know if that will be possible and it may mean riding this out first but if so, it's something to try.

Try to calm your nervous system with anything relaxing, an exercise or activity, breathing work, etc. Again, this may not work for you right now but it may help with adrenaline levels. Too much adrenaline ramps up these thoughts too so a bit of gentle exercise or breathing work can help with this.

If you can, resist any urges to protect yourself from these scenarios in the thoughts e.g. don't hide knives or lock the bleach away, because as you already know this is not something you would do and reacting this way can keep them going.

It's good to know you have your family to support you. When things are really bad, feeling some safety from their presence can be very important.

Hi Mate, thanks for your reply it is really appreciated!

I am finding it hard to concentrate and just live life at the moment, my mind is racing and locks on to any thought which is distressing. At the moment my mind won’t let me continue to progress as it cannot function fully it is literally just scanning and locking in to one thing. I had this before when I had MDD mixed with anxiety.

My psych has said I can use benzos when it gets to bad but I am avoiding those as don’t want to rely on them to have a peaceful mind also I don’t find they work with anxiety caused by depression.

I was absolutely fine and fully functional 3 weeks ago before my psych pulled me off the mirtazapine so re-instating I thought would work quicker than it has done.

It’s really hard not to focus on these thoughts, I have been in therapy for the last 12 months and last week I couldn’t attend face to face as I felt that awful.

I’m hoping this will calm down soon mate I really do! I literally am living day by day at the moment

As always thanks for your views and response

[MyNameIsTerry]

No worries, just wish something helped because when it's this bad each day is a massive uphill climb and then you wake up and do it all over again. I hated it.

When I went on Duloxetine it reduced me a wreck. Those first 10 or so days were the worst and all I told myself was that tomorrow it will break and I just held on teeth gritted. Nothing was going to help me then, I was so agitated the first few hours of the day I would stand in the kitchen as I just couldn't sit down.

The last two mornings I gave in on the Diazepam I had resisted and it did help. Those couple of hours where it calmed the symptoms of adrenaline down a bit helped with not only the symptoms of my chest feeling the pressure and me wanting to run a 30 second mile screaming (think the lift scene in the film Crank ) but also the thoughts of despair that I was going through yet again today.

If they can help, you know tons about managing them so you won't get tolerant. But sometimes you just need a few hours or that one less awful day and you get a little boost from that respite. If you can find that somehow, any how, it will do you good.

I hope something helps. Hang in there. You went through it before and kicked it's backside so you will again. Mirt is supposed to kick in quicker for those it works for so fingers crossed and I agree with you that your body has been used to it before so it should get into it sooner this time, it's perhaps the major imbalance of the shock of the withdrawal that needs to abate a bit first and then things will seem a bit easier to cope with.

Given the thoughts have come from the withdrawal, once you get stable again I would expect they will either go or greatly reduce. Some people have intrusive thoughts starting antidepressants and they often seem to go once they get through the side effects window.

[Benjammin69]

No worries, just wish something helped because when it's this bad each day is a massive uphill climb and then you wake up and do it all over again. I hated it.

When I went on Duloxetine it reduced me a wreck. Those first 10 or so days were the worst and all I told myself was that tomorrow it will break and I just held on teeth gritted. Nothing was going to help me then, I was so agitated the first few hours of the day I would stand in the kitchen as I just couldn't sit down.

The last two mornings I gave in on the Diazepam I had resisted and it did help. Those couple of hours where it calmed the symptoms of adrenaline down a bit helped with not only the symptoms of my chest feeling the pressure and me wanting to run a 30 second mile screaming (think the lift scene in the film Crank ) but also the thoughts of despair that I was going through yet again today.

If they can help, you know tons about managing them so you won't get tolerant. But sometimes you just need a few hours or that one less awful day and you get a little boost from that respite. If you can find that somehow, any how, it will do you good.

I hope something helps. Hang in there. You went through it before and kicked it's backside so you will again. Mirt is supposed to kick in quicker for those it works for so fingers crossed and I agree with you that your body has been used to it before so it should get into it sooner this time, it's perhaps the major imbalance of the shock of the withdrawal that needs to abate a bit first and then things will seem a bit easier to cope with.

Given the thoughts have come from the withdrawal, once you get stable again I would expect they will either go or greatly reduce. Some people have intrusive thoughts starting antidepressants and they often seem to go once they get through the side effects window.

Cheers mate -thank you. You know what it’s like when you feel like you can’t escape your own mind and the thoughts go round like a hamster wheel! It’s awful and because I’ve reduced mirt, added Wellbutrin then re added mirtazapine I think my CNS is just over stimulated. I hate that everything takes 4-6 weeks to kick in as someone who is anxious and depressed count them days down like chalk on the wall in the film castaway!

Yeah I’m so stupid as I save benzo’s for a bad day... then I have a bad day and don’t take one lol.. it’s not funny really but what is a bad day?!?

Once these thoughts and rumination calms down I can move on with life and focus on wellbeing... just a matter of time I think


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[MyNameIsTerry]

Yeah I often do that with things I save up. I try to push through without. Especially with benzos and z meds worrying about running out later when I may need them. It's part of my anxiety I think, trying to be more of a boy scout for later. I've done it with money ever since getting into debt early on in my working life with credit cards.

That 4-6 week thing is something I think we all say on here but whether it's true is debatable. I think its a worst case for starting meds thing. When I started Cit in week 4 it started getting easier and by the end of week 5 the side effects had cleared. Then starting Duloxetine it hit me like a train for about 10 days when I went up to the standard therapeutic dosage and after that it did decrease (just carried on at a lower level for ages but I think my GP should have switched me and I knew nothing about this stuff back then so trusted him).

So, whilst it possibly could be x weeks that doesn't have to mean at the same intensity. And you started back up fairly soon so if any changes were still happening to cause the withdrawal you would have started reducing or eliminating that effect by reintroducing the drug I would have thought.

In a switch between same class meds there is a dip as we changeover and I doubt that causes a complete backing out of the down regulation effect, it wouldn't make sense. So, it seems plausible the Mirt binding effect could have been in the process of unpicking itself to return to the pre Mirt state and reinstating the dose has interrupted that. I don't know much about the binding though but it's not like these meds work fast like benzos.

How long have you been on the Wellbutrin? I wonder if part of this is start up side effects too?

Yeah, mental agitation is horrible. A few of us on here have mentioned it being one we've found hard to deal with. It makes you feel like you're going mad...but no drawing a face on a football and talking to it like in Castaway

[Benjammin69]

Yeah I often do that with things I save up. I try to push through without. Especially with benzos and z meds worrying about running out later when I may need them. It's part of my anxiety I think, trying to be more of a boy scout for later. I've done it with money ever since getting into debt early on in my working life with credit cards.

That 4-6 week thing is something I think we all say on here but whether it's true is debatable. I think its a worst case for starting meds thing. When I started Cit in week 4 it started getting easier and by the end of week 5 the side effects had cleared. Then starting Duloxetine it hit me like a train for about 10 days when I went up to the standard therapeutic dosage and after that it did decrease (just carried on at a lower level for ages but I think my GP should have switched me and I knew nothing about this stuff back then so trusted him).

So, whilst it possibly could be x weeks that doesn't have to mean at the same intensity. And you started back up fairly soon so if any changes were still happening to cause the withdrawal you would have started reducing or eliminating that effect by reintroducing the drug I would have thought.

In a switch between same class meds there is a dip as we changeover and I doubt that causes a complete backing out of the down regulation effect, it wouldn't make sense. So, it seems plausible the Mirt binding effect could have been in the process of unpicking itself to return to the pre Mirt state and reinstating the dose has interrupted that. I don't know much about the binding though but it's not like these meds work fast like benzos.

How long have you been on the Wellbutrin? I wonder if part of this is start up side effects too?

Yeah, mental agitation is horrible. A few of us on here have mentioned it being one we've found hard to deal with. It makes you feel like you're going mad...but no drawing a face on a football and talking to it like in Castaway

Hi Mate,

Started on the Wellbutrin 27 days ago lol so on 28 days that’s 4 weeks so I should be fixed tomorrow ..

My mind does seem quieter today but it is still early doors. I think it has got to be a combination of both which is makes things even harder as I was managing situational anxiety before where now I am managing the symptoms of depression - re the energy, not wanting to do anything etc

The meds are meant to give you some respite to work on the things that will truly help re: exercise. Therapy and staying active... so I am waiting for that to start to take hold.

I find that my brain can only really focus on one of the beasts at anyone time so I’m either not depressed but extremely anxious or not anxious and severely depressed....

I am holding on to the fact that I messed with my meds rather than thinking it is a relapse of depression. I am still thinking I will get better within a few days...

I’m the same as you. I have loads of benzos in my bathroom cabinet which I end up just storing and fighting through this mess with sheer willpower. My therapist suggested against that and to use the meds to reduce my symptoms etc - I even had expired diazepam and had to swap them at the doctors

[MyNameIsTerry]

Noticed you saying you are getting one or two normal days on James thread. Glad to hear it mate, perhaps the med is kicking back in to stabilise the mess the sharp withdrawal caused?

I bet it's quite a relief?!!!

[Benjammin69]

Noticed you saying you are getting one or two normal days on James thread. Glad to hear it mate, perhaps the med is kicking back in to stabilise the mess the sharp withdrawal caused?

I bet it's quite a relief?!!!

Yeah had a good window on Monday and Tuesday, yesterday was a car crash but it’s obvious the recovery is going to come in windows and waves. It’s been an awful journey! Pretty intense.

Thanks for your help mate much appreciated

[Benjammin69]

I’ve had my consultation with my psych and instead of introducing a new drug we are going to increase the mirtazapine to 45mg augment that with my usual quetiapine. He also wrote me a script for cl9nazepam PRN....

How quick will 45mg increase take to work for anxiety and depression...

I’ve stopped the Wellbutrin now as it was too activating!

[Mindprison]

Hi Benjammin

I'm only on 30mg but was on 45 briefly before I went on Pregabalin. I take both now but I dropped the mirt to 30 because I liked the minor sedation it gave me at night for sleeping.

When I put the dosage up to 45mg it took a few days for my body to adjust and I started seeing some benefit after a week or two. I would say that if it's going to make a marked improvement, it will do so within 3 weeks.

Sometimes it can take a while for it to build up in your body to that theraputic level.

[Benjammin69]

Hi Benjammin

I'm only on 30mg but was on 45 briefly before I went on Pregabalin. I take both now but I dropped the mirt to 30 because I liked the minor sedation it gave me at night for sleeping.

When I put the dosage up to 45mg it took a few days for my body to adjust and I started seeing some benefit after a week or two. I would say that if it's going to make a marked improvement, it will do so within 3 weeks.

Sometimes it can take a while for it to build up in your body to that theraputic level.

Hi mate

Thanks. I tried pregabalin and it didn’t work for me . I went all the way up to 450mg and it just didn’t work. At the moment Ive been through most SSRI, most SNRI and most anti anxiety meds too... so at the moment just trying to stabilise on mirtazapine as it has worked before.

I have benzo to help but don’t want to rely on those.

Cheers


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