Mirtazapine to Dothiepin

[Long Meg]

My poor husband is suffering.He went to Dr's 2nd March because he hadn't slept for literally 4 nights and was generally very anxious.He had been taking 2x MIRTAZAPINE (sorry can't remember dose) since October 09.He was prescribed BUSPIRONE 5mg x 6 and PROPANANOL 40mg x 3. and told to cut MIRTAZAPINE to 1;stopping them on Sunday 7th.He was also given DIAZEPAM 5MG X 3 IF NEEDED. He started DOTHIEPIN 25mg on Mon 8th, increasing these by 25mg daily up to 150mg(by Sat 13th).
By Wed 10th he was having severe tremors/shakes,very anxious and aggitated,couldn't get breathe,hearing voices,loss of appitite,nausea,dizzy,falling ove-everything really. I rang GP and was told to give him 2 DIAZEPAM. This worked for an hour. Rang again Thurs. Told to stop BUSPIRONE. He was like this all weekend. I rang emergency dr on Sun 14 afternoon. They came out and said it was beyond them and spoke to a physc, dr at local hospital, who said to increase DIAZEPAM to 6 a day. At this stage the tremors were constant and full body. They stopped at night so he could sleep. All Mon 15th he had powerful shakes and was very distressed.So was I. I rang 999 in the evening when he fell, yet again. 2 hours later we were discharged from casualty having been told to take 8 DIAZEPAM AND 4 PROPANAOL( plus his 6 DOTHIEPIN). All the drs we have seen say it is the crossing over of pills and the quick build up of DOTHIEPIN and it should stop by 7=10 days.
The past few days the tremors have not been constant, but they are still full body and alarming. He has lost weight. He is sleeping nearly all day and all night. It is so frightening. we did not know what to expect. He is signed off for 6 weeks. I am off 2 weeks, so far, without pay, which is hard. Has anyone had this situation, coming off something so quick and starting a new one quickly? he was on DOTHIEPIN for 15 years until last Oct when he stopped sleeping and his anxiety returned, hence the introduction of MIRTAZAPINE. We are at gp's on Tues so we will see what this week brings.
Sorry for this confussing waffle, but I was so happy when I found this site. I am house bound cos I daren't leave him in case he falls, so I have time to search and try and learn things! he is sleeping now, so I am not sure what he will think if he knows i have typed his trauma on the internet!

[pollyanna]

Hi Long meg and

i havent had any experience that you have written about ,of changing over meds like that, but just wanted to welcome you to the site.
It must be very distressing and frightening for both of you what is happening right now, you say you have a gp appointment on tuesady, i hope they can help him a bit more and things settle down for him soon, let us know how it goes.

tc

P x

[Long Meg]

Thank you Pollyanna. Support it so vital in these situations. This is so new to us and it hit so quickly. Plus it has only been a short time that we have had to deal with it. Close friends and family are supportive, but there are times when we have just felt alone. So far he hasn't had the tremors today,just the can't get breathe feeling. He is sleeping so much which is good. I know we will get through this but time goes so slowly sometimes. Once again thank you.

[JT69]

Hi Meg,

OHG, I so feel for your husband. I am no doctor but cannot believe how he has been messed around!!!

It is a shame that the mirtazipine did not help him sleep as this usually has that benefit but maybe the dose wasn't correct for him.

I feel the tapering of mirtazipine to dotheipin was far too quick and probably caused the awful side effects he has been experiencing. This will settle but the transition sounds horrendous!! I really feel for him and for you seeing him like this.

Hopefully now the GP has put him back onto dothiepin he will settle again, if sleeping is a problem then zopicone is good to help temporarily.

A situation like this just clarifys the fact that GP's do not know enough about the anti-deppressants and that it is best to be reffered to a physcitarist who are more knowledgable, but again its all down to budgets etc and then people like us have to suffer!!! The National Health at times fails us!!!

I do hope your husband feels the benefit soon and starts to feel better, very destressing for both of you.

Take care and let us know how you get on on Tuesday.

Jo.xx

[ElizabethJane]

Dear LongMeg well done for being brave and posting your story on the net. i can empathise entirely about your husbands situation. I was also taking dothiepin for sixteen years and came off them in October. I'm sorry that the mirtazapine did not suit your husband. It can have some nasy withdrawal effects as I know all too well. I did not hear voices but I was hallucinating. It can be very frightening. If he does not already have one your GP must refer your husband to a psychiatrist urgently so that your husband is on the correct medication and dosage. This is really one for the psychiatrists. I was also given valium to cope with the withrawals. If he is no better tomorrow then he needs an urgent referral from your GP. You both should not be suffering like this and we will try to support you as best we can. EJ.

[Long Meg]

Thank you every one for your kind words.
Well, today, the second time in less than a week, Hubby was taken away in an ambulance, 20 miles to the hospital. I rang NHS Direct to get advise about his chest/heart pain and difficulty in getting breathe. The adviser spoke to hubby. He advised getting ambulance. Once in casualty, all tests,blood,x ray,etc proved ok. the pain in his heart had gone, within an hour. He wasn't struggling for breathe either.He was let out and told the same as before;it is the transition causing all this. On way home, he felt faint and woosey. He had a bacon butty and a banana, which is the first thing he had eaten all day (me too!), took all his pills and went off to bed at 7.30.
We will compile a list of questions tomorrow ready to throw at the gp on Tuesday. As the lovely dr in A & E said, when I said I wish we had been warned of all the possible side effects, that not everyone has problems. Some people will get frightened by being told what could happen and not go through with treatment. I understand that.
I impressed drs with my list of events of the last 3 weeks, dates, drugs given etc. It is very important to keep a written account to hand as we cannot remember the whole sequence of events.
I will certainly suggest a psychiatrist to the gp on Tues and see what response we get.
xx

[ElizabethJane]

Just wondering how you both are today and whether your husband is feeling any better?

[Long Meg]

After Tues visit to gp he has to cut diazepam down from 8 x 5mg daily to 7 x 5mg and reduce by 5mg a week. This will taken forever - I didn't thing it would take so long when he has only been taking them for 2 weeks. The gp also suggested C.B.T. hubby seemed interested. Anyway, he was in a state yesterday , big tremors again, struggling for breathe, falling over etc. Hubby wanted to go to psyciatric ward. I rang gp, who said she would arrange emergency referral to mental health team. They rang 5 hours later and said they would come to our house the following day(today). This wasn't what hubby wanted to hear, but he was a bit calmer by this point so said ok.
Today at 4pm a psyciatric nurse and a social worker visited us at home. They asked a lot of questions and said C.B.T is perhaps the best route to take, to try and get to the bottom of why he needs anti dep. He seems to be ok with that idea, but doesn't really feel it will help him. As long as he gets the pills sorted; to feel well; that is his main concern. And mine. They are coming to see us again on saturday at 11.30. Should be interesting. He seems to be calmer this evening, fingers crossed.
xx

[JaneC]

Hi Meg,

Just wanted to give you a and say what a caring wife you are. I hope you get things sorted out and your husband gets better soon. I had a bad experience coming off another AD too quickly last year, felt like I was losing my mind, and it was only through NMP that I understood what was going on. All the very best to you both x

[JT69]

Hi Meg,

I do hope they sort something out quickly for you, its absolutely unacceptable how they just expect you to cope when your poor hubby is going through all of this, they should be visiting you daily!!! I hope he soon starts to feel easier, it must be dreadful for you both. Take care and remember to post and let us know how you are both doing. Sending you a big hugJO.xx