I am sensitive to medication so I need some advice. Thanks!

[erik1979]

I am sensitive to medication so I need some advice.


After taking 7.5mg for 7 weeks due to sleep problems I tapered of in 4 weeks. The reason that in slept poorly was due to stress and physical complaints due to illness. I am not yet cured and it remains unclear when this will happen.


So after 6-7 weeks, I felt good. This dose helpt me a lot with sleeping but it also improved my mood.


I tapered off in 4 weeks like mentioned above and then stopped. My tapering schedule looked like this: 7.5, 5.0, 3.75, 2.0, 1.0, 0,0.


On the first reduction, I suffered muscle twitching and slight dizziness during the day. And when I finally stopped completely, I started having heat attacks at night, muscle twitching and flu-like symptoms for about 8 days straight. Lack of sleep made me very emotional and low in energy during the day so I decided to reinstate at 1.0.


Unfortunately, this dose did not help me to sleep so I eventually went back to the original dose of 7.5mg 1 week ago.
Since then, I sleep well again and all side effects like the muscle twitching have disappeared.


Despite realising that this medication has brought me a lot, I would prefer to be on as low a dose as possible so that I can eventually taper more easily.


My idea is to stick with 7.5 at least for 1 month and then taper very slowly to avoid as many side effects as possible.
I was thinking about 20% reduction per month so 7.5, 6.0, 5.0, 4.0, 3.2, 2.5 and so on.


Personally, I think the 1-month period each reduction is a bit long. Can this also be done every 3 weeks, for example?


And what do you think of my tapering schedule given my situation and past history? Any other tips or advise?
Thanks a lot!

[panic_down_under]

After taking 7.5mg for 7 weeks due to sleep problems I tapered of in 4 weeks. The reason that in slept poorly was due to stress and physical complaints due to illness. I am not yet cured and it remains unclear when this will happen.

As I understand it you are being treated by a psychologist for the stress. How long have you been seeing the psychologist? What does he/she have you working on to help you better manage your stress levels and do you think this is working?

So after 6-7 weeks, I felt good. This dose helpt me a lot with sleeping but it also improved my mood.

Mirtazapine is a sedative which dampens stress by sedation and helps you to sleep both of which can improve mood. I suspect you gained the most from sleeping better.

Despite realising that this medication has brought me a lot, I would prefer to be on as low a dose as possible so that I can eventually taper more easily.

As per above, I think the main assistance you're getting from the med is the improvement in sleep.

It is usually no more difficult to taper from a high dose than a smaller one. Withdrawal symptoms are typically at their worst when tapering off the last few milligrams, not at the high end cuts.

My idea is to stick with 7.5 at least for 1 month and then taper very slowly to avoid as many side effects as possible.

I suspect that no matter how slowly you taper off you will soon be back to where you were a week ago. Your problem isn't that you tapered off the med too quickly, or incorrectly, but that nothing has really changed in the underlying condition and as soon as you have a sleepless night you'll be right back where you started.

[erik1979]

[QUOTE=panic_down_under;2058824]


As I understand it you are being treated by a psychologist for the stress. How long have you been seeing the psychologist? What does he/she have you working on to help you better manage your stress levels and do you think this is working?
[/ QUOTE]


That's right. I have now had 3 talks so have just started. I still find it hard to say whether it is helping me. Time will tell I guess.


[QUOTE=panic_down_under;2058824]
Mirtazapine is a sedative which dampens stress by sedation and helps you to sleep both of which can improve mood. I suspect you gained the most from sleeping better.


As per above, I think the main assistance you're getting from the med is the improvement in sleep.
[/ QUOTE]


I think you are right.


[QUOTE=panic_down_under;2058824]
It is usually no more difficult to taper from a high dose than a smaller one. Withdrawal symptoms are typically at their worst when tapering off the last few milligrams, not at the high end cuts.
[/ QUOTE]


Clear. I also realise I shouldn't stop anytime soon but I would like to reduce the dose, even if it's just for my own state of mind. What do you think of my suggestion to take 7.5 for a month and then reduce 20% per month? Then what dose will I stay on for now since it only helps me sleep? As soon as there is improvement in my situation, I can taper off from that dose.


Thanks!

[erik1979]

As I understand it you are being treated by a psychologist for the stress. How long have you been seeing the psychologist? What does he/she have you working on to help you better manage your stress levels and do you think this is working?



Mirtazapine is a sedative which dampens stress by sedation and helps you to sleep both of which can improve mood. I suspect you gained the most from sleeping better.



As per above, I think the main assistance you're getting from the med is the improvement in sleep.

It is usually no more difficult to taper from a high dose than a smaller one. Withdrawal symptoms are typically at their worst when tapering off the last few milligrams, not at the high end cuts.



I suspect that no matter how slowly you taper off you will soon be back to where you were a week ago. Your problem isn't that you tapered off the med too quickly, or incorrectly, but that nothing has really changed in the underlying condition and as soon as you have a sleepless night you'll be right back where you started.

something went wrong quoting. See my post above thanks

[panic_down_under]

That's right. I have now had 3 talks so have just started. I still find it hard to say whether it is helping me. Time will tell I guess.

Talks? Does the psychologist have you working on ways of dealing with the stress and insomnia and how to challenge negative thinking, or are you just talking about life and the past?

I also realise I shouldn't stop anytime soon but I would like to reduce the dose, even if it's just for my own state of mind.

What worries you about taking 7.5mg which is already a very low dose?

What do you think of my suggestion to take 7.5 for a month and then reduce 20% per month? Then what dose will I stay on for now since it only helps me sleep? As soon as there is improvement in my situation, I can taper off from that dose.

This is up to you. If all you want is to ensure you sleep then a lower dose may be enough. The thing to be aware of is that if you drop below the dose needed to keep insomnia at bay this may not become apparent for some days. Also tolerance can build over time and you may need to increase the dose to maintain the same level of control.

[erik1979]

Talks? Does the psychologist have you working on ways of dealing with the stress and insomnia and how to challenge negative thinking, or are you just talking about life and the past?



What worries you about taking 7.5mg which is already a very low dose?



This is up to you. If all you want is to ensure you sleep then a lower dose may be enough. The thing to be aware of is that if you drop below the dose needed to keep insomnia at bay this may not become apparent for some days. Also tolerance can build over time and you may need to increase the dose to maintain the same level of control.

The psychologist is helping me with the negative thoughts and accepting the situation.


Somehow, I am appalled by the fact that I need medication to sleep well. This bothers me tremendously. Despite it is helping me…


I also dread the idea of eventually tapering off, especially as this can take months. Hence the idea of slowly taper to a lower dose already. Maybe not lower than 5 or 3.75.

[panic_down_under]

Somehow, I am appalled by the fact that I need medication to sleep well. This bothers me tremendously. Despite it is helping me…

I wonder if your concerns about the med was and continues to be a large part of the problems you had tapered off and afterward. Psychology is at least as important in withdrawal and recovery as chemistry and can be the most significant factor for some.

I also dread the idea of eventually tapering off, especially as this can take months.

I doesn't have to take months. That is something you are choosing to do.

[erik1979]

I wonder if your concerns about the med was and continues to be a large part of the problems you had tapered off and afterward. Psychology is at least as important in withdrawal and recovery as chemistry and can be the most significant factor for some.



I doesn't have to take months. That is something you are choosing to do.

Thanks. I was definitely anxious during and after tapering off. Especially afraid that I wouldn't be able to sleep again due to physical discomfort. I think this will remain the case for now....

How would you suggest to taper? 20% every 2 weeks or so?

[panic_down_under]

Thanks. I was definitely anxious during and after tapering off. Especially afraid that I wouldn't be able to sleep again due to physical discomfort.

Then the insomnia will likely return when you quit if the anxiety isn't under control. Your main issue is the anxiety.

How would you suggest to taper? 20% every 2 weeks or so?

You can probably do it by taking half the 7.5mg for a week and then stopping...once the anxiety is under control.