Mirtazapine withdrawal

[[ev...]]

It is now Saturday down here in Australia. I have been through hell this week. Awful burning sensations in my body. It is so difficult to cope when one has no idea when this will end. The psychiatrist has me on 20mgs of Endep and 7.5mgs of Zopiclone. In despair I phoned him yesterday. In addition to the aching I had gastric problems. His response was to tell me to increase the Endep and the Zopiclone by 50%. The night before I had woken early and thought maybe I was in need of more drugs in order to sleep. I resisted the temptation to increase either of them and was rewarded by a fairly good night's sleep. I am deeply worried about the Endep for reasons Data_Guy presents in an earlier post.

 

Psychologically this is so incredibly difficult because I know it should not have happened. I should never have allowed myself to be put on such a massive dose. On reflection, I realise that I was in danger every day I took such a huge amount of the drug. And I am infuriated that I was not warned about the dangers of missing a dose or cutting the drug the way I did.

 

It seems as if I can manage for a little while and then I start crying again. Yesterday I had two long bouts of crying and today I have had one. This kind of pain is utterly unacceptable. But I know that the psychiatrist will continue as if he had done nothing wrong; in his mind he probably thinks he has acted totally in my best interests by prescribing all the drugs he has. I am concerned that on Monday he will want to give me even more.

 

I am in such a vulnerable situation because of my history of severe depression. I really would like to get off all drugs entirely. That is why I am seeking the help of a psychologist whose father is a psychiatrist. I have met her before and maybe she can give me strategies to get through what I fear is going to be an extended period of pain.

 

And Data_Guy I am sorry I was unable to take your advice vis-a-vis the Endep and the Zopiclone. I desperately need sleep to survive this and these drugs seem to be the only way. But I am going to try very hard to keep the levels as low as possible.

 

I will give the psychiatrist your post on Monday. He has already said he does not think that Endep will prevent me from recovering from the withdrawal. Sadly, I no longer believe him. He has prescribed so many drugs over the last eighteen months which have given me appalling side effects so why would I trust him now.

 

Bye for now,

 

Ivan.

 

[[ev...]]

I am putting this on here as I am desperate. Pain management on this scale with no end in sight is a monumental challenge. I do manage for a while but then the aching appears to ramp up and my spirits crash to the floor again and I wonder how I will get through the rest of the day. What makes this immensely difficult is that there is no end date and I may even be making things worse by taking Endep which does assist with sleep. I try to motivate myself every minute of every day but I just can't do it all the time. I am seeing a psychologist on Tuesday. I really want her to help me. The psychiatrist will see me tomorrow. I have decided to confront him politely with my concerns about how this all happened. As Data_Guy has made clear 90mgs of Mirtazapine is a huge dose. And I wasn't warned of the possible consequences of reducing the dosage. And I will present him with Data_Guy's post about the problem with taking a similar drug to Mirtazapine in withdrawal.

 

Thanks for reading this,

 

Ivan.

[[ev...]]

Could someone give me some advice? I presented the psychiatrist with Data_Guy's concerns about Endep possibly interfering with my withdrawal from Mirtazapine. His response was to prescribe .5mgs of Clonazepam. Equivalency tables tell me that this is equivalent to 10mgs of Valium. Add the Zopiclone tablet and I am up to 15mgs of Valium equivalent. I am very uncomfortable with this. It does seem as if now I am in a Catch 22 situation where thanks to the overprescribing of an anti-depressant and the resulting withdrawal I am now doomed to benzodiazepine addiction. I just don't want to allow this to happen. But somehow I have to have sleep.

[[ev...]]

in regards to my last post, I have done some research online into Clonazepam aka Klonopin or Rivotril. As I am sure many members on this site know from their own experience, Clonazepam is highly addictive. In fact, it is probably the most potent benzodiazepine per mg on the market. So I have absolutely decided that there is no way I am taking it. I am taking one tablet of Zopiclone per night along with two tablets of Endep. These are relatively small doses of drugs and that is the way I want to keep it. The psychiatrist did not dismiss the claim that Endep interferes with Mirtazapine withdrawal but my GP did. He also asserted that I am now on considerably less psychiatric medication than I was on. And today I am starting to feel as if things are turning ever so slowly in my withdrawal. I just want to avoid swapping one nightmare for another.

 

So if it is a choice between a low dose of Endep which may or may not be affecting my withdrawal as opposed to Rivotril which will almost certainly result in addiction and a nasty withdrawal, I am going with the Endep. But it must be said that in the long run my aim is to get off all psychiatric drugs. My GP has said he would like me to get off the Endep too and I hope I will be able to.

 

Data_Guy if you read this I would like to thank you very very much. Your thoughtful analysis of Endep and Mirtazapine made the psychiatrist think and it resulted in his prescribing Clonazepam. As a consequence, my doubts about his prescribing have been clarified. I simply do not have any faith in him and will question everything he does and will push back when I think it is right to do as I have done today.

[[Da...]]

I'm glad to hear that Ivan. Clonazepam, which I unfortunately have some experience with, is indeed very physically addictive. I struggled to get off it for 10 years and the harm it did was pretty incalculable. It is the most potent benzo with quite a long half life, so it puts your system under pressure to adapt to it 24 hours per day. I'm glad you did the smart thing and declined to take it. I think you are very capable of making your own decisions and analyzing whether any treatment is right for you, even in this state of severe withdrawal. I hope you can take some comfort in that and build on it. There is a tendency to become dependent on doctors to solve our problems, but it can be a shock to wake up to the fact that their solutions are often terrible and are not in our best interests. Once you go through a bad withdrawal and see that the doctor really has no good solutions or explanations for it, it's a bit easier to see that the emperor has no clothes.

 

I'd be happy to help if you have any questions about your treatment, but I think you are making the right decision in choosing the lesser of the two evils to help you through the withdrawal. Endep should be easier to get off of than Clonazepam (much easier), and you can probably minimize harm by tapering very slowly (10% cuts or less every 2 weeks). I hope you have good luck with the psychologist.

 

You may be able to find a psychiatrist who does talk therapy (they do still exist, although they're sparse). They are usually a bit more skeptical of medication, but still have training in how to use it. Not sure whether that helps or not. Psychiatrists are covered here, but not psychologists. A bit of a travesty IMO.

 

Cheers.

[[ev...]]

I made a list of  reasons why I should avoid Rivotril. I will present this to the psychiatrist next Monday. The most significant is that I have taken it before and for some time. I have had much trouble getting off benzodiazepines especially Ativan last year. So I am not going down that road again. I confronted the psychiatrist this morning by telling him that I struggled to understand why he saw fit to prescribe two antidepressants at the same time. Mirtazapine at twice the maximum dose and Lexapro at the maximum dose. I got off the Lexapro with no side effects. So I drew the conclusion that Mirtazapine would be easy to get off too. At the very least he could have warned me but he failed to do that. I told him that he should have done that.

 

I don’t doubt that he acted from what he sees as the best of intentions. However, he is so incredibly complacent about the effects of the drugs he prescribes.

 

I believe if and when I get better that I had a fortunate escape with the Mirtazapine as down the track I may have needed an operation or something else could have occurred which meant I would not have taken the drug for a couple of days. Then a truly terrible withdrawal could have occurred.

 

 

[[ev...]]

Hi Data_Guy if you are reading this,

 

I have written to my psychiatriatrist. I explained why I behaved the way I did yesterday at our consultation. I also listed six reasons why I was not prepared to take the Clonazepam but preferred at this stage to take the small dose of Endep and the Zopiclone (7.5mg). I noted that Zopiclone is clearly highly addictive as with each night it has less and less impact on my sleep. Here are the reasons:

 

Six reasons for refusing to take Clonazepam

1. Addiction – I have taken this drug before as Rivotril. It was part of an addiction to benzodiazepines that took me months to recover from.

2. Rivotril is the most potent drug per mg on the benzodiazepine equivalency list provided by the South Australian Government. In effect .5mg is equivalent to 10mg of Valium. If the dose was increased to 2mg, that would be 40mg of Valium. I am already on 7.5mg of Zopiclone which is equal to 5mg of Valium. I want to keep the Zopiclone at this level as I can see that it is highly addictive. The 5mg Valium equivalent is having less and less impact on my sleep each night.

3. Endep at this low level of 20mg is helping with sleep – something I need desperately to manage the withdrawal symptoms. This drug appears to have no obvious side effects at this dose.

4. Both you and Dr Piez stated clearly that the Endep dose is so low that it is very unlikely to interfere with the withdrawal process. I prefer to take this into account rather than committing myself to a highly addictive drug such as Rivotril.

5. Stopping Endep suddenly even at this low dose could cause another withdrawal.

6. At one point I thought that you were considering Endep as an anti-depressant once (if and when) these withdrawal symptoms have gone away.

 

Today the aching continues but I think it is gradually getting less severe but given what I have been told on the survingantidepressants.com site I am not expecting miracles. Such a huge dose reduction over such a short time has set me up for a very nasty and most probably prolonged withdrawal.

 

Thanks again for your input. And best of luck to anyone who reads this.

 

Best wishes,

 

Ivan.

[[ev...]]

It is another day into my withdrawal and recovery from 90mg of Mirtazapine. The symptoms have dissipated somewhat over the last 48 hours. This means that I can function a lot better and go out with more confidence. I am also starting see that it is possible for this thing to end.

 

I do want to get off psychiatric drugs altogether for a while but there are still two obstacles in my way - 20mg of Endep and 7.5mg of Zopiclone. These drugs have helped me sleep during this ordeal but the Zopiclone is so highly addictive that I chose to take an extra 3.75mg at 4am which did provide me with extra sleep. It would appear that it is the Zopiclone which is giving me sleep and the Endep could have no purpose at all. What I am proposing to do is start weaning myself off both drugs by firstly ensuring that I do not go above 7.5mg of Zopiclone again by cutting a tablet into three and taking each bit at bedtime, 1am and 4am (if necessary). I will reduce the Endep which I have only taken a total of 380gm over a period of maybe 21 days. My plan is to cut by 1/4 of one 10mg tablet each week for 8 weeks. This plan does mean I will stay on Zopiclone for that period of time which I am not keen on doing because it is so addictive.

 

My willingness to cut more is going to depend to some extent on how quickly my withdrawal symptoms dissipate.

 

One other problem with Endep is that I think is what is causing wind and an uncomfortable stomach from time to time. Obviously I don't want to be dependent on a drug with this sort of side effect.

 

If anyone has any ideas or could give me pointers about how to go about this, I would appreciate your input.

 

I guess as everyone is an individual there is no right answer.

 

All of this does leave me with a dilemma. I was alienated by psychiatric drugs particularly benzodiazepines in the past. And I chose to get off all psychiatric drugs but then terrible depression descended on me out of the blue. The psychiatrist maintains that I should be on antidepressants for the rest of my life to avoid a recurrence. But sadly it seems as if every antidepressant I have tried has given me unpleasant side effects - except for one which is Mirtazapine, the drug I cut and had to withdraw from.

 

I think that there is a strong possibility that the psychiatrist and I may part ways next Monday before his month long trip to France so that he can attend a conference. I have completely lost faith in him after his latest thought bubble that I should take Clonazepam.

 

Moreover, I am about to type up a list with the title "Psychiatric Drugs, Psychiatry and Me" in which I lay out many of the side effects and withdrawals that I have experienced over the years from these drugs. And much of it will be about the drugs he prescribed for me. When he sees that I am betting he will suggest I find someone else.

 

He presents himself as an oracle of wisdom whilst I regard him as a conjuror with a box of tricks many of which don't work and make people sick. I don't think anyone has ever challenged him the way I have.

 

I will post the list later today Eastern Australian time.

 

Bye for now,

 

Ivan.

 

 

[[ev...]]

Dear Dr,

 

I am writing to express my concerns about the treatment I have received whilst under the care of psychiatrists in a period which spans more than a decade. It should be noted that ECT did get me out of depression in 2013 and your prescription of Ativan appeared to lift me out of deep depression in the middle of last year. Moreover, the prescription of Endep and Zopiclone provided me with sleep when I was in a desperate state during this withdrawal from Mirtazapine. But they were only necessary because of a withdrawal inflicted on me as a consequence of taking a huge dose of Mirtazapine. So here are my thoughts. If as a result of this, you feel that you no longer wish to have me as one of your patients I will accept that and move on. However, given the dire straits I have been in over the last three months I would anticipate that you would like to see me through this.

 

Best wishes,

 

Ivan

Psychiatric Drugs, Psychiatry and Me

 

Here is a list of some of the many ways psychiatry and psychiatric drugs have a deleterious impact on my life. As a consequence of that I have endured as a result of my time under the care of psychiatrists, I am wondering if it would not be better to simply get off drugs and try to find other ways of warding off depression. It should be noted that almost every psychiatric drug I have taken has either had significant side effects or presented me with withdrawal symptoms. In the case of benzodiazepines in particular I have had both side effects and painful withdrawals.

 

◾Addiction to benzodiazepines three times. I took Clonazepam, Valium and most likely Temazepam during early bouts of depression. On each occasion I had painful and prolonged withdrawals. The worst was last year when I withdrew from Ativan and Mogadon. I only took Lorazepam for five weeks. Yet it took me three and a half months to recover from the aching and shaking it which affected me whilst I was taking it and during my gradual recovery.

 

 

◾Many drugs were thrown at me while I was under the care of a psychiatrist in the Victorian public system. However, I hardly remember their impact on me because I was given 56 ECT treatments which wiped many years from my memory – something that has been an enormous challenge for me. What makes it worse is that nothing much came out of all those treatments and eventually the psychiatrist gave up on me and discharged me with a list of three psychiatrists.

 

 

◾I do remember that Olanzapine (an anti-psychotic) was prescribed for me by a psychiatrist in the public system. It gave me the shakes. Seroquel which you prescribed led me to bounce up and down all day.

 

 

◾A combination of Valium and Temazepam prescribed year last year by my GP led me to be drowsy all day. At one point I slipped and fell through the front window.

 

 

◾Mogadon wreaked havoc on my digestive system so much so that I endured a nightmare during which I was defecating on average 14 times a day. I was always led to believe this was a result of depression and only discovered that Mogadon was the culprit when I took it for one night a couple of weeks ago.

 

 

◾Lexapro on the TGA maximum recommended dose which I was prescribed last year resulted in stomach upsets and flatulence. I withdrew from this drug easily which indirectly led to the nightmare I have been going through over the last three months.

 

 

◾It is true that I did not have any obvious side effects from Epilim but I was never clear about why I was taking it. And Propanolol did not present me with any problems but then I only took it to help me handle the shaking from the withdrawal from Ativan.

 

 

◾And now we come to Mirtazapine. This is the only antidepressant I took which did not give me significant side effects. I got off 30mg of it at the end of 2017 with no withdrawal symptoms. (I was then put on Nardil. Indeed, I stayed three weeks in hospital to ensure it was not deleteriously affecting me. Then you took me off stating that Lexapro is a "more modern drug”.)

 

 

◾There was one side effect which came with the 90mg dose and that was a difficulty getting to sleep which I found to be a side effect of a high dose. So then I made my mistake and cut the drug to 45mg for three nights leading to the truly awful withdrawal I have been experiencing.

 

 

◾Zopiclone is clearly a highly addictive drug. Its effect is getting weaker and weaker as each day passes. Indeed, to get a decent amount of sleep last night I took an extra half tablet at 4am.

 

 

◾Finally there is Endep. I am not sure if it is having any effect on my sleep but it is certainly giving me flatulence and I want to get off it as soon as possible as I don’t want to develop a dependency on it.

 

 

[[ev...]]

Here is another update on my situation. Over the last few days since Sunday my symptoms have eased off. They are by no means gone but I feel much more positive about the future. I was becoming really frightened last week as the aching seemed to be increasing five weeks after I had stopped the drug so quickly. In total I had endured nearly three months of intense withdrawal symptoms for nearly three months and I guess I have still some way to go. My outlook was really negative because of the feedback I got from the administrators and moderators on the survivingantidepressants.com site which indicated given the amount I was on and the speed at which I had withdrawn I was in for a very long time of pain. They also told me to reinstate a small dose of Mirtazapine something I was unable and unwilling to do. As a consequence I was officially warned and banned from the site if I did not indicate I was intent on following their advice. Moreover, my psychiatrist talked in terms of months before things started to improve.

 

His prescription of Clonazepam on Monday and his track record of prescribing lots of psychiatric drugs at high doses have meant I am not likely to continue to be his patient after next Monday.

 

I do still have an issue with drugs prescribed to help sleep. I am now taking one and a half 7.5mg tablets of Zopiclone and I am down to one 10mg tablet of Endep. I think I should be able to get off the Endep easily as the total amount I have taken equates to only four days of the drug prescribed for depression which 100mg. I have only been on the drug for less than three weeks. It is the Zopiclone which is the problem. I will talk to both the psychiatrist and my GP about strategies to contain its use and reduce it. I am going to take only one tablet tonight and wear the lack of sleep that may lead to. It must be borne in mind I have taken a total of only 35 and a half tablets over less than a month.

 

Data_Guy if you are reading this, thanks again for all your encouragement. It has been really appreciated.

 

Best wishes,

 

Ivan.

 

 

[[Da...]]

Thanks Ivan. I'm glad you feel I helped. I've read all your updates with interest, even if I haven't had time to respond to all of them. I hope you continue to improve and find something that helps your depression that is less harmful than the current pharmacological options. I know you've likely tried many other methods, but there is a large variety of tools that are less toxic than medicine's best options. I know psychotherapy is usually cited as equal in efficacy to the drugs (not really encouraging if you know the actual efficacy of the drugs, but I assume they refer to the exaggerated claims and not the true efficacy). But joining groups of people by playing sports, going to church, engaging in social activism etc. I think are pretty underrated in lifting people out of depression. There is one interpretation of emotional anguish that suggests it stems from feeling we are being/may be expelled from "the tribe", which during much of evolutionary history would have meant certain death, but now mostly results in loneliness, which can lead to poor health and a host of other poor outcomes. I think this is often ignored by health professionals because they can do little other than make suggestions, and people often have difficulty or are unwilling to change their behaviour. I know from experience it can be difficult. I often go days without talking to friends or family, which is usually the result of intense insomnia, exhaustion and irritability that I've had since my withdrawal from Clonazepam. But I do generally feel better when I get out with friends or family. If I've read correctly, it seems like you are fairly well supported, so maybe it's a moot point, but I'm sure there are plenty of options that have yet to be tried with varying degrees of intensity.

 

The last piece of advice I'd give, which might not be welcome, is to challenge the notion that you are naturally prone to depression. Even if this is true, it is likely triggered by some stressor or other life event, rather than simply appearing out of the blue for no reason. I'm not a denialist of the fact that depression is a biological illness, but I think the idea that many people have a chronic, recurrent depression that appears out of the blue for no reason is greatly exaggerated. I think that is a pernicious, false idea meant to justify large scale drug prescribing. A diagnosis of depression was fairly rare before the current cornucopia of drugs to treat it appeared on the market. Once this happened, companies "marketed" the illness, which, as often with pharma, involved a lot of disinformation and exaggeration. I'm not saying you are a victim of marketing or anything, but I suspect many on this forum are and were misled as to the true benefits and risks of the drugs they were taking, as well as the actual implications of the diagnosis they were given. Regardless of whether you or anyone has a chronically occurring depression, it doesn't follow that drug treatment is absolutely necessary, especially given the very limited efficacy and hidden (and often unquantifiable) harm these drugs can cause. I'm glad you've committed to attempting a drug free period. The notion that "a biological illness requires a biological treatment" is a canard which actually seems to have increased the rate of disability from mental illness rather than decreased it. Again, I think that is due to the fact these drugs are more dangerous and less effective than recognized. But I don't categorically oppose drugs either. I know there are some people who benefit greatly from them, and that is a victory, but I do oppose medicating something like 20% of the population with psychotropic drugs for questionable diagnoses. The last I checked, rates of mental illness have had no significant increase, despite constant claims by the media and mental health industry. The psychiatrist Alan Frances - who directed the task force for DSM IV - has suggested that given the new information about the efficacy and safety of antidepressants (observational data suggests they increase the suicide rate), they should only be prescribed to those with severe depression, otherwise the risk /benefit tradeoff makes no sense. He has a few books that are very good, like "Saving Normal", where he argues against overdiagnosis, overprescribing and their harmful effects. I think if you arm yourself with some knowledge, you would be less inclined to submit to a questionable recommendation, like the one this psychiatrist made. If a treatment has questionable empirical support, it is pretty unlikely to be effective, other than as a placebo. In drug trials, it is only something like 1 out of 1000 bioplausible compounds that actually succeed in reaching the market, and even some of these are of pretty questionable utility (Remeron being one, it actually increases the suicide rate more than most ADs and has limited efficacy. You can see here, if you click on table 2 on page 6, the hazard ratio for Mirtazapine is substantially elevated  ) https://www.bmj.com/content/350/bmj.h517.

 

If you do become depressed again and need pharmacotherapy, that is no failure on your part. I only think you should test and challenge the ideas that 1) you are fated to become depressed again for some reason. 2) you need drug therapy as a result. Again, if it turns out that both ideas survive your tests, it's no failure. All you can do is try.

 

Good luck.

[[ev...]]

Thanks for your thoughts, Data_Guy. In relation to the three depressions , they resulted from my overreaction to a sore back or to problems with sleep. I think I have learnt to live with difficulties successfully and have demonstrated this to myself as a consequence of getting through two periods of severe withdrawal from two different psychiatric drugs. I tell myself if I get depressed again, the two approaches utilised by psychiatrists won’t work or will do me harm. These are drugs and ECT. And it seems as if almost any drug gives me nasty side effects. So I am entering the next few weeks with an open mind. My first objective is to see the withdrawal through. It looks as if I can stop taking Endep in the next day or two without any side effects. Zopiclone is a different matter altogether. I will probably need to keep taking it until the withdrawal symptoms have gone away. Thankfully I have a very good GP who is a lot more cautious when he prescribes drugs. If he is willing to see me through, I may opt to seek him regularly without going to see a psychiatrist.

 

My experience of psychiatrists especially the latest one has made me very wary. I talked with my friend today about his psychiatrist. She appears to have a much different approach to mine. He focuses almost entirely on drugs whereas she is interested in Cognitive Behavioural Therapy. Someone like her maybe a better option for me.

 

But it must be in my mind that each episode of depression was extremely severe and I have to bear this in mind.

 

In regards to activities which take me out of the house, I have maintained a number of them in spite of the withdrawal symptoms I have experienced twice in the last year. Indeed, I have been absolutely determined to keep leading classes at the University of the Third Age and helping people to improve their English as a volunteer at the local library. This contact with other people helped me to keep going.

 

This week has been one of the most surprising of my life because I have from being desperately pessimistic about the future to looking forward to what life has offer.

 

I am meeting the psychiatrist on Monday. I will report on what he has to say.

[[ev...]]

Now the challenge is to get off the sleeping tablet, Zopiclone. I have been taking it for around a month. In total 36 7.5mg tablets. I was also taking Endep (10-20mg). I reduced it down to 5mg last night and will stop taking it tonight. Last night I took 1 1/4 tablets of Zopiclone. I want to get off it as soon as possible because it is clearly a highly addictive drug. Tonight I will try to go down to 3/4 of a tablet and keep dropping it. I am prepared for some insomnia but it is worth it as I just don't have any desire to be on benzos or Z drugs.

 

And if my psychiatrist had had his way I would now be on 2mg of Clonazepa as well.This would have set up a nightmare second withdrawal this year. I doubt if I will continue as his patient after our Monday meeting. Please don't take my observations in the set of posts as a condemnation of psychiatry. It is just that this one who is extremely experienced in my experience has prescribed lots of drugs in high doses over the last eighteen months.

[[ev...]]

Here is a copy of the email I have just sent to the psychiatrist who has been treating me for the last eighteen months. I have decided that if I am going to work with a psychiatrist and it is agreed that I have to take drugs, there will be limits placed on the amount. Indeed, I will be looking for someone who doses more than focus almost entirely on prescribing drugs.

 

Dear Dr,

I am writing to let you know that over the past week there has been a marked improvement in my symptoms. As a consequence, I have been thinking about what should happen next and I have come to the conclusion that it is not in my best interests to continue in your care.

My reason for deciding this is that you are committed in your practice to prescribing numerous drugs some at very high levels. It is clear that you subscribe to the chemical imbalance theory of depression which has led you to have me on 45mg of Lexapro whilst at the same time taking Mirtazapine at twice the TGA recommended maximum dose.

 

The reaction I had to cutting the Mirtazapine for only three nights is one example of the potentially dangerous consequences of this approach to the treatment of depression. Indeed, I believe I have had a fortunate escape from something much worse further down the track when events may have conspired to cause me not to take the drug for a short period of time.

 

Over the last eighteen months I have been experienced side-effects from anti-psychotics, anti-depressants and benzodiazepines. It is true that I came out of a severe depression the week you prescribed Ativan for me. However, it should be noted that this drug is not an anti-depressant. Indeed, when I look back my three experiences of depression, I cannot think of an occasion when taking anti-depressants actually helped me in any way. I took them over the last year because I had placed my trust in your judgement and accepted your proposition that these drugs would “protect” me from another onset of depression.

 

As it turned out the huge dose of Mirtazapine you prescribed for me almost precipitated the very thing I was taking it to prevent. My experience over the last three months has been truly horrific. The kind of aching I experienced was at times almost unendurable.

 

It is not only your prescribing of anti-depressants that has concerned me. I was never clear why I was taking 100mg of Epilim each day - a drug devised to counter the impact of Epilepsy.

 

However, it is your approach to the prescribing of benzodiazepines and Z drugs which made me make up my mind that I should seek someone else’s assistance. The advice to medical practitioners is that these drugs should be taken for no longer than four weeks. Yet you had me on 10mg Mogadon for a number of months and then added Ativan on top of that. Given my previous experiences of withdrawal from benzodiazepines I made it clear I wanted to get off these drugs as soon as possible. You went along with this and after a period of painful withdrawal I got better. My suspicion is that you would have kept me on these drugs if I had not been so insistent that I get off them.

 

Then last Monday you came up with the suggestion that I take .5mg of Clonazepam with a view to increasing the dosage to 2mg later in the week. When I realised just how much Valium equivalent dosage that is, my faith in your approach to psychiatry came to an end.

 

At the time I came out of a severe depression, I was prepared to go along with your approach to the use of drugs. But it should be noted that I was constantly questioning you about the number and amount of drugs you were prescribing. This should have led you at the very least to warn me of the dangers of cutting high doses of antidepressants without your supervision. You have told me yourself that many of patients mess around with their dosages.

 

As I said, I regard this dreadful experience of Mirtazapine withdrawal as a lucky escape. Now thanks to that withdrawal I still have to get off the highly addictive Z drug, Zopiclone. So, to cut a long story short, I am simply not prepared to take massive doses of antidepressants again – given that the theory which has led to their use is actually rather dubious.

 

In conclusion, I want you to understand that I believe you acted in my best interests throughout; it is just that I can no longer commit myself to the drugs you are likely to prescribe for me in the future especially as they almost inevitably will come with side effects or much worse.

 

Yours sincerely,

 

Ivan.

 

 

 

 

[[ev...]]

It is now Sunday in Australia. I did reduce the Zopiclone to 3/4 of a 7.5mg tablet from 1 1/4. The result was a second night of limited, interrupted sleep and I am now dog tired. Another consequence is that the aching from the withdrawal is more pronounced today probably thanks to the lack of sleep. I fear that I am becoming too fixated with the dangers of addiction to this drug. I have now taken 38 tablets. Clearly, after 3 to 4 weeks of taking it, I have to take more to get the same effect. So it does seem as if sometime I am going to have to wear the sleeplessness which comes with withdrawal from Z drugs and benzodiazepines. I plan to reinstate the drug to a higher level tonight as I find it hard to function properly without enough sleep. This is a very tricky situation. At least I can tell myself that I was fortunate enough to be aware of the dangers of taking a potent benzo such as Clonazepam and avoided the risk of really serious addiction. I will post this on another section of the Benzobuddies site as well to see if anyone has any ideas. I am committed to getting off Zopiclone; the question confronting me is when is the right time. I am no longer on Endep because it didn't seem to be assisting my sleep and it was giving me an uncomfortable stomach.

[[ev...]]

I had a big think about my email to the psychiatrist. The reality for me is that I have a history of severe depression. I decided to cut myself off from psychiatrists and psychiatric drugs in 2013 and three years later I fell into deep depression for no obvious reason while I was on holiday in Japan. So I have to accept that I must stay in contact with a psychiatrist even if there is absolutely no doubt in my mind that they have done much harm to me. And at the moment thanks to the psychiatrist I need sleeping medication or else I can't sleep. This is an issue because I am becoming addicted to it but without it I would not be able to cope. The plan is to attempt to keep this drug at a really low dose and sometime in the future I am going to have to wear withdrawal from it. I did try taking 10mg of Endep again last night and that seemed to help. I got maybe six hours sleep and only had to take 7.5mg of Zopiclone.

 

I do feel as if the aching is dissipating but ever so slowly. I think back to the  brutal intensity two weeks ago and it is certainly less severe than that. It is now seven weeks since I took my last dose of Mirtazapine.

 

So I have decided I am going to stick with the psychiatrist. We talked it through yesterday. He understands that I will not just accept every drug he prescribes and that I am determined not to allow myself to take high doses of anti-depressants. Moreover, he did not contest my refusal to take Clonazepam. And I know that if I won't take something I know he will not cast me aside as I am sure some psychiatrists would. He is going to France to a conference and a holiday so I won't see him until late October in any case.

 

Over the next month I will be seeing my GP once a week. He is really easy to talk to and understands the reservations I have about psychiatric drugs and psychiatry in general. Now all I have to do is get better which I suspect is going to take some time.

 

Bye for now,

 

Ivan.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[[ev...]]

Here's an update four days on from my last post. The aching continues. If I were to be asked, "Has it improved?", my answer would be yes. Compared to the brutal savagery of the aching two weeks ago, it is less painful. But it is still very much evident and imposes itself on my thoughts every minute I am awake.

 

I have been trying really hard to keep the addictive drug Zopiclone as low as I possibly can; last night I got a reasonable amount of sleep with one tablet of 7.5mg and a 10mg tablet of Endep. I find if I take a higher dose of the antidepressant, I get a really uncomfortable stomach. I am just hoping that this drug holds my sleep together so that I don't need any more Zopiclone other than the two half tablets I take in the night. I have to take it this way because the drug is so short acting.

 

If you were to say to me: "How long do you think this withdrawal will take to end?", I would say at least three months and that is probably being optimistic. After three months of these sensations and seven and a half weeks since I took the drug at all, I feel as if this aching has become a part of me. It seems at times as if it will never go away.

 

All my plans for the future are on hold; my job is to survive by keeping as active and as fit as I can. I have already lost out on a trip overseas. My wife is going with her sister.

 

And I can't help feeling angry and frustrated with the psychiatrist who prescribed a ludicrously high dose of 90mg Mirtazapine each day. And I still blame myself for not contesting this and not finding out about the dangers that come with high doses of antidepressants.

 

At least I can now say to myself that I am no longer on such a high dose and that I will never allow myself to be on a dose like this again. It is also important for me to find ways to keep control of my life so that I don't get into a position once again when psychiatrists are free to do what they like with me.

 

I know they believe they are acting in their patients' best interests but the sad thing is - as I can attest from bitter experience - that they frequently get it wrong and inflict harm on those they are trying to help.

 

Best wishes,

 

Ivan.

[[ev...]]

I think this would be my last post for a while. The main difficulty I have at the moment in addition to surviving the symptoms is that I am incredibly angry about what is happened and I just can’t put it aside. It is now three months since I started having these withdrawal symptoms and eight weeks since I stopped taking the drug. The aching has dissipated a little bit but surviving this from day today is incredibly difficult. So I expect I will just have to live from day today and hope that some point in the future it will all go away. What I do about warding off depression is something I will have to give a great deal of thought as I’m sure a lot of you have had to do too.

 

Okay bye for now,

 

Ivan.

[[ev...]]

One last thing:

 

Today after my second attempt to reduce the Endep down to zero I am absolutely dog tired. I have no idea how the Endep is working to give me better sleep in addition the one 7.5mg tablet of Zopiclone but it appears as if it does. Even though I get an uncomfortable stomach, I am going to return to 20mg Endep. The one major advantage I see from doing this is that I have been able to hold the dose of Zopiclone to 7.5mg which is equivalent to 5mg Valium. Without the Endep to structure my sleep better I fear I will be tempted to take more and more of the Zopiclone.

 

Withdrawal from 90mg Mirtazapine is a truly terrible thing to have to endure and sleep is absolutely essential in the face of it. Once these symptoms of constant aching relent, I will do everything I can to get off the two drugs which now sadly are essential to keeping me doing things. Getting out and about is so important in the face of this.

 

And I am able to tell myself that to reach an equivalent of 90mg Mirtazapine I would have to take Endep for ten and a half days.

 

I am so sorry if I am not following a set of strict guidelines but withdrawal from huge doses of Mirtazapine after taking it for ten months really is in uncharted territory.

 

My challenge - if I do recover from this - is to decide whether I will take antidepressants again. At this point in spite of taking a low dose of Endep my inclination once I get off it is to avoid antidepressants. I have no doubt that they do work for some people but I cannot think of one that has worked for me or hasn't given side effects or withdrawal.

 

That's all for now.

 

 

Bye,

 

[[ev...]]

Data_Guy if you are reading my ramblings, I hope you agree that my best option is to do everything to get sleep and everything to avoid getting too addicted to Zopiclone. I really wish I did not take these drugs but for the time being it looks as if I will have to.

 

If anyone has read these posts the two messages to come out from them is make sure you know what a psychiatrist or GP is actually getting you to take before you swallow it and don't play around with dosages of antidepressants unless YOU know what the possible consequences are.

[[ev...]]

Here is another update. I have now been off Mirtazapine for nine weeks. There has been some improvement and for a few brief moments I thought the aching would fade away. However, then the aching comes back again as it has done today. I am now getting worried about the length of time i have been taking Zopiclone. It is about six weeks. At first it seemed as if I was going to keep raising the dose but it would appear that a small dose of the anti-depressant Endep has stabilised my sleep so that I have kept the dose down to 1 and a quarter of 7.5mg tablets of Zopiclone which translates into 6.25mg Valium.

 

The amazing thing about this withdrawal is that throughout it I have remained able to walk flat out for forty minutes. People tell me I look well. And I am able to run classes at the U3A and the library as a volunteer. What I do is I focus out when I am with people even if I turn my attention to my body I feel the aches. But the brutality is no longer there and there have been times when I have not been forced to concentrate on my aching. The psychiatrist said it would be like this with good moments and then a return of the symptoms and eventually it will gradually fade away.

 

It is sad though when my hopes are raised only to be dashed again. I was on the surviving antidepressants site and was told there that I had to reinstate the drug and come down slowly. They also told me that I should be ready to be prepared for a long period of withdrawal symptoms  I was not able to go back on the Mirtazapine because the psychiatrist would not prescribe any more of it. I do not know whether or not their approach would have worked. All I do know is once withdrawal set in it didn't matter what dose I was on the aching remained and according the psychiatrist this was most unusual. He said in all his previous cases restoring the original dose brought the symptoms to a close.

 

By the way, I do not have a great deal of regard for those who run survivingantidepressants.org. I feel that the administrators and moderators are inflexible; if you don't do it their way, they warn you and won't allow you back on the site unless you tow their line. This attitude is sort of dictatorial. Once I got the warning I never posted on the site again.

 

By posting this I am looking for reassurance. I don't expect that anyone else had the experience of coming of such a high dose as 90mg of Mirtazapine in a very short time. But there must be people who have experienced withdrawal and come through it. Is my gradual improvement with nasty bumps on the road typical of withdrawal? I cannot wait for it to be over as I can resume living my life rather than putting everything on hold and I also want to get on with getting off the Zopiclone asap.

 

Best wishes and good luck to anyone who reads this.

 

 

Ivan.

 

 

[[ev...]]

The UK daily Mail has been successful in its campaign to address the over-prescribing of a number of psychiatric drugs. If you are interested, here is the link:

 

https://www.dailymail.co.uk/news/article-7445657/One-four-people-hooked-prescription-drugs-official-review-calls-national-helpline.html

 

You can Google The daily mail prescription drugs and you will find the article.

 

Ivan.

[[ev...]]

Here is an update on my progress. I have been experiencing the trauma of Mirtazapine withdrawal since May 27th. I had to come off this drug over 8 days before July 9th because the psychiatrist could not arrest the symptoms by stabilising me on higher doses. He said that coming off so quickly went against the textbooks but it had to be done. It is also true that 90mg a day went against the textbooks too and was twice the amount allowed to be prescribed by psychiatrists in the Australian public system.

 

So you can see it is many weeks since I stopped taking Mirtazapine. Yet I still have one withdrawal symptom which is paraesthesia (aching throughout the body). It has got significantly less, however.

 

I have become reliant on Zopiclone for sleep but I did manage to keep the dose low and I have reduced it without losing a lot of sleep down to half a 7.5mg tablet plus a tiny fragment if I am awake in the middle of the night. I also take a small dose of the tricyclic anti-depressant, Endep, off label for sleep. I have managed to halve that from 20mg to 10mg. I think this drug did help me avoid going up to higher doses of Zopiclone. Moreover, I don't envisage coming off this to be a problem.

 

All the experiences I have had of psychiatry have made me very unwilling to take psychiatric drugs again especially not that I know how devastating "discontinuation" from anti-depressants can be. I have decided I will not be seeing the psychiatrist who prescribed the massive dose of Mirtazapine along with other psychiatric drugs without explaining to me the risks involved.

 

Yesterday I did look at some YouTube clips in which Dr Peter Breggin outlines why he believes that psychiatric drugs and ECT are dangerous and should be banned. He completely debunks the theories behind their increasing use. He also warns of the dangers down the track of heart disease, stroke and dementia if people stay on these drugs for long periods of time.

 

Like many other patients I walked out of the psychiatrist's office thinking he was helping me only, in my case, to discover he was putting me in great danger. If my experience of his treatment is an example then many of his patients are on benzodiazepines, anti-psychotics, anti-depressants and anticonvulsants - with the risks of side-effects and withdrawal that come with them - all of which he had me on towards the end of last year.

 

I do wish I could be a success story on here but there has been an improvement which gives me some hope especially after the fears I had when I started this period of withdrawal four months ago.

 

Best wishes to everyone who reads this and good luck.

 

Ivan. 

 

 

[[ev...]]

I don’t know how people feel on this site. For me anger is something I really feel strongly. Anger at allowing myself to fall into the hands of psychiatrists over and over again. It is now 12 weeks since I stopped taking this awful drug and I still have aching all over my body. I do hope one day that it goes away. But now I know that I just have to hang on because I do not want to fall into the grip of these people again.

 

Bye,

 

Best of luck.

 

Ivan.

[[ev...]]

Here is another update. My withdrawal symptoms from Mirtazapine come and go now rather than always intruding on my thoughts like they did for the last four months.

 

I saw my GP yesterday after I had been down to 1/4 of a 7.5mg tablet of Zopiclone for three nights. I have also been taking 10mg of Amitriptyline for sleep. He told me that at such a low dose I might as well come off the Zopiclone. So I didn't take it last night and got some sleep. I am tired today and aching but I am going to stay off the drug and get off the Amitriptyline as soon as I can which will probably be in the next couple of days. And then I will be free of psychiatric drugs though sadly not yet free of their effects.

 

We discussed the advantages and disadvantages of taking psychiatric drugs. The GP came to the conclusion that if I am mentally ok it is best to stay off these drugs given that their side effects and withdrawal symptoms have played havoc with my body over the last twelve years. He also felt that Cognitive Behavioural Therapy is the way to go for me. It is such a relief that at long last I don't have to have my body interfered with any more by these potent drugs.