Addition of antidepressant

[[Ka...]]

Seems often when taking benzos we  are offered an antidepressant if tapering a benzo, or when depression is a feature. 
Last night, through another helpful post, I’ve unraveled a personal experience with mirtazapine:

1. I was taking lorazepam & advised to add mirtazapine 15mg. I wasn’t depressed but very anxious 
2. After some months, was advised to reduce lorazepam (quite fast) then mirtazapine was shifted to 30mg. What I wasn’t told by prescriber was that 30mg affects you differently & that a lower dose is more sedating. I was barely functional and didn’t actually google it. 
3. The combination of fast lorazepam reduction and upping mirtazapine to 30mg caused problems. This worsened as I was advised initially to alternate mirtazapine 15mg with 30mg.

4. Lorazepam was changed after 8 months to diazepam with intention to reduce/stop
5. Several months later, 30mg mirtazapine was changed to 45mg. 
6. In intervening time, venlafaxine was added without explanation - and then later doubled

When faced with or considering addition of an anti depressant info shared by others here is so invaluable. I should have done some serious homework! Suffice to say in my case the chemical soup didn’t really help me in the short or longer term. 
I’m not anti medication per se but we need clear advice when embarking on new meds. I think for me this was a case of a ‘need to know’ basis. I did ‘need to know’ so that I understood back then an appropriate medication plan to weigh up pros as well as cons. Learning retrospectively the difference in mirtazapine 15/30/45mg is annoying. We deserve to have information so we can give informed consent to those prescribing. 

 

Edited February 23 by [Ka...]

[[Rh...]]

I fell into the antidepressant loop when I was at the tail end of my benzo taper over 4 years ago.  My doctor said adding Mirtazepine would “help” me ease off my benzo and then I could just come off the Mirtazepine as it “isn’t dependent forming like the benzo was”.  I should have listened to that little voice inside my head that was telling me to just wait it out and not add anything, but the fear and PTSD I experienced from my valium taper left me worrying I might not survive when I made the final jump off valium.

I then added Mirtazepine (3.75 mg’s) and it did help ease the withdrawals of coming off valium and also helped me sleep and gain weight (unfortunately too much weight).  I stayed on 3.75 mg’s for over a year and then went cold turkey off because it was “such a low dose” per my dr.  big mistake!  I ended up reinstating to 1.75 mg’s which took me over 3 years to taper off of. I completed my taper to zero  almost 9 months ago and am in acute withdrawals.

I stupidly thought I would avoid acute WD as I tapered with compounded liquid over years and jumped off at zero!  But as my luck would have it I feel I’m paying for both drug withdrawals now.

Im hopeful in healing but the not knowing when is the hardest part.  I 100% agree with you in that informed consent is needed and also an explanation of how different doses might affect us.  You are right in that the lower doses of mirt are more sedating and higher doses more activating.  I found even 15 mg’s was WAY too much for me and reduced to 3.75.  
 

i hope your able to taper off all that you want when your ready and the effects are minimal!  Hang in there!!!

[[Ka...]]

Hello @[Rh...] the AD loop is a conundrum. 

It’s interesting that you took 3.75mg mirtazapine (& lower) - in UK it is usually just 15, 30 or 45mg. Was never given advice to break up 15mg smaller & was so compliant back then I didn’t even consider it! The benefit of hindsight. 

I got in a real fix & decided to take control. But brain fog did cloud my thought process somewhat. My profile documents what I decided to do. Faced with a poly drug scenario I took myself off all meds except a benzo. That was kept at low dose for years. Not ideal. Finally free since January. It’s very early days. 
I wish you well on your navigation through the benzo/AD maze & hopefully out the other side. BB is amazing for support, comparing stories & sharing our experiences. Here’s to healing. 
 

Edited April 3 by [Ka...]

[[Bu...]]

Hello @[Ka...] and @[Rh...],

Just wanted to say thanks for this thread. It's helping me to untangle some things that have been very, very confusing.

I took mirtazapine during my first round of withdrawal about 14 years ago.  I didn't even know it was withdrawal.  My provider put me on 30 milligrams.  It did help with the depression, but gave me weird head sensations at night, like something was crawling in my brain.  After about 6 months of this misery, I told her I wanted off.  She tapered me by cutting to 15, then 7.5 then off.  At 15 mg, I felt so much better.  I remember thinking "I wish I just been taking this the whole time and why on earth hadn't that been an option from the provider?!?"  She also said that, since I tapered it, I couldn't possibly being having any withdrawal from it...  

Anyway, it didn't even occur to me how this probably played into my symptoms and subsequently being reinstated on the clonazepam.  So yes, we definitely need more info to make an informed decision.  Though in my case, I doubt the provider knew anything more.  She was a N.P in a small clinic in a G.P. office.  Hindsight is indeed 20/20.  I guess this also applies to doing some research regarding the person who is prescribing.  Probably should have gone with a mental health provider for that.  😕

[[re...]]

Mirtazapine caused me severe upper head issues and tingling and itching from only a couple times use. It was so nasty that stuff. I am so scarred from all doctors have done to me in regards to meds and their approach to it when it turns on you. 

[[Ka...]]

I had a rotten time on mirtazapine. I did not have depression & didn’t want to take it. Got pressured into it. I was anxious & WD symptoms from ativan for anxiety were mistaken for depression. If I could go back in a time machine I would not have taken either. I’m sorry you’ve had such problems.