Activation syndrome

[[jo...]]

I'm getting worried about what the right thing to do here is. Can anyone who's been in this position give any info? I was expecting there might be start up symptoms but didn't realise they could persist. If I new this was just start up then I could probably see it through but now I dont know what to do. Is it common for start up symptoms to persist with Mirtazapine?

[[jo...]]

My next dose is due soon. My nervous system is contracting and I'm twitching all over. It feels like something building. Weirdly I'm calm though, the restlessness and agitation has calmed down. I cant help feeling I'm in trouble though.

Edited July 20 by [jo...]

[[...]]

2 hours ago, [[j...] said:

I'm getting worried about what the right thing to do here is. Can anyone who's been in this position give any info? I was expecting there might be start up symptoms but didn't realise they could persist. If I new this was just start up then I could probably see it through but now I dont know what to do. Is it common for start up symptoms to persist with Mirtazapine?

Jonwill, hi again. I think nobody can give you info that meets your case for sure. Everyone has been sharing their own experience only and we're all different-+. I think the best way for you is to listen to your body and figure out whether mirt is rather helping or disturbing you. I felt quite soon that whatever side effects, it gave me necessary relief. But this goes to my second time when i changed its dosage more slowly. Some of my start up symptoms lasted for quite a time but the pros of taking mirt were always outweighing. I'm grateful to exactly this ad. This is my experience. 

[[jo...]]

[[...]]

22 minutes ago, [[j...] said:

Thanks Kate. So the first time you took it the effects stayed with you the whole 3 months you were on it? And thats why you tapered and started slower?

First time was pretty difficult. I hurried growing its dosage up and felt really weird. Too much of some outer energy inside. The second time, i didn't feel anything like this almost at all but other side effects, more physical.

[[jo...]]

Ok so I think I made a mistake moving up to fast on the mirt. Currently at 15mg for 15 days was on 7.5 for around 4/5 days. How do I move down safely? I dont want to make things worse but I dont want a long taper either. Any suggestions welcome.

[[Cr...]]

43 minutes ago, [[j...] said:

Ok so I think I made a mistake moving up to fast on the mirt. Currently at 15mg for 15 days was on 7.5 for around 4/5 days. How do I move down safely? I dont want to make things worse but I dont want a long taper either. Any suggestions welcome.

I have no personal experience with mirtazapine, but if I was in your situation of only being on that dose for 2 weeks, and decided not to stick it out, I would probably have returned to my 7.5 mg dose the following day. 

Slow tapers are often dependent on how much dependence/change the medication has caused. If those changes have not occurred you may adapt to an instant drop to 7.5 mgs relatively speaking. If you want to be more cautious you can drop by 3.75 mgs instead.

Fast tapers can be beneficial when your body hasn't acclimated to the medication that much. If you were only on a medication for 3 weeks but decided to do a slow 8 month taper, that amount of time would probably cause you to actually become physically dependent and eventually feel withdrawal symptoms when you otherwise would not have if you withdrew in less than 2 weeks.

Sadly no one here can say how you personally are going to react to a slow or rapid taper. I can only say what I would try in your circumstance, and that would be reducing my dose back to 7.5 mgs to see how I handle it.

[[jo...]]

1 minute ago, [[C...] said:

I have no personal experience with mirtazapine, but if I was in your situation of only being on that dose for 2 weeks, and decided not to stick it out, I would probably have returned to my 7.5 mg dose the following day. 

Slow tapers are often dependent on how much dependence/change the medication has caused. If those changes have not occurred you may adapt to an instant drop to 7.5 mgs relatively speaking. If you want to be more cautious you can drop by 3.75 mgs instead.

Fast tapers can be beneficial when your body hasn't acclimated to the medication that much. If you were only on a medication for 3 weeks but decided to do a slow 8 month taper, that amount of time would probably cause you to actually become physically dependent and eventually feel withdrawal symptoms when you otherwise would not have if you withdrew in less than 2 weeks.

Sadly no one here can say how you personally are going to react to a slow or rapid taper. I can only say what I would try in your circumstance, and that would be reducing my dose back to 7.5 mgs to see how I handle it.

Thanks Crono. Yeah that makes sense to me. I was thinking about halving it and seeing if I'm stable there. 

[[jo...]]

Just now, [[j...] said:

Thanks Crono. Yeah that makes sense to me. I was thinking about halving it and seeing if I'm stable there. 

The thing is I'd like to stick it out but have had people saying it might stay etc. which would be a bad thing. If I can get on a dose and stabalise then work my way slowly which I should of in the first place, mabey thats the thing to do.

[[Cr...]]

1 minute ago, [[j...] said:

The thing is I'd like to stick it out but have had people saying it might stay etc. which would be a bad thing. If I can get on a dose and stabalise then work my way slowly which I should of in the first place, mabey thats the thing to do.

Taking the same route as Kate where you slowly work your way up would definitely be better.

You were on ssri's in the past correct? If so, did it have any positive effect and was it hard to get on?

[[jo...]]

Just now, [[C...] said:

Taking the same route as Kate where you slowly work your way up would definitely be better.

You were on ssri's in the past correct? If so, did it have any positive effect and was it hard to get on?

It was hard to get on but it worked. Took about three weeks if I remember. Thats the thing I might be close to it settling, but if I wait much longer I'll mabey have a long taper.

[[jo...]]

I felt start up with sert from the first pill. Strong. Not the case with this it took a few doses and has gotten worse along the way. Today has been horrific.

Edited July 20 by [jo...]

[[Cr...]]

Just remember that even when you reduce your dose that it may still take a couple days to settle out from the start-up effects that your increase brought on.

[[Bo...]]

I’ve seen this way too many times with these meds, Mirt especially having looked thru tons of posts. 
side effects are your body telling you it doesn’t like it. I’m not anti meds but after this whole four and half year debacle, there are some people who get affected severely and when aka is involved it’s not great news. 
it’s an adverse effect and that is immediately to stop the causation med.

doctors and others commonly mistake it for underlying anxiety instead of calling it what it is , akathisia which is an adverse reaction. Again adverse reactions are not to just stay on something and keep with it but this is just my all the info I’ve learned. Mark Horowitz is a great doctor and researcher who told me you don’t rebuild a burned down house with fire. These meds can be devastating very quickly to people having been there benzo hell and should be the very very very last resort/life on the line trial.

otherwise coping techniques, natural things really are the way out thru the benzo healing process. 
Again, I’m coming from somebody that was clueless and the early stages of this and poly drugged for the various adverse effects and withdrawal effects from being quickly tapered in the beginning off of my Klonopin. The other meds just caused a huge poly drug for me and here we are again with mirtazapine doing the same same thing.
 

It can be miserable, it can be very uncomfortable, but less is more in trying to navigate post benzo use.

The the only thing I’ve seen from many others are the beta blockers that gave some kind of aka relief and don’t require of extremely lengthy taper schedules. 
 

And as we get on and off various psychotropic meds, our bodies have some sort of almost an imprint of previous withdrawals or tapering from medication’s and each one can get more difficult for some people.

Again, why trying to see if your body after 18 to 24 months post (benzos) gets to be more like your original self before trying to add any other medications is helpful bc many people feel more healed and able to navigate life again without needing anything else.

Mentioning this all in detail because I’ve seen too many people go down the same roads and it is heartbreaking…. And a lot of people until they have no idea so it’s good to talk all this through in a lot of details so people can gather information and learn.

You have to choose what you think is best because almost 3 weeks on (mirt) can present strong withdrawals symptoms as you go down at this point so just do the best you can. 

[[jo...]]

8 hours ago, [[B...] said:

I’ve seen this way too many times with these meds, Mirt especially having looked thru tons of posts. 
side effects are your body telling you it doesn’t like it. I’m not anti meds but after this whole four and half year debacle, there are some people who get affected severely and when aka is involved it’s not great news. 
it’s an adverse effect and that is immediately to stop the causation med.

doctors and others commonly mistake it for underlying anxiety instead of calling it what it is , akathisia which is an adverse reaction. Again adverse reactions are not to just stay on something and keep with it but this is just my all the info I’ve learned. Mark Horowitz is a great doctor and researcher who told me you don’t rebuild a burned down house with fire. These meds can be devastating very quickly to people having been there benzo hell and should be the very very very last resort/life on the line trial.

otherwise coping techniques, natural things really are the way out thru the benzo healing process. 
Again, I’m coming from somebody that was clueless and the early stages of this and poly drugged for the various adverse effects and withdrawal effects from being quickly tapered in the beginning off of my Klonopin. The other meds just caused a huge poly drug for me and here we are again with mirtazapine doing the same same thing.
 

It can be miserable, it can be very uncomfortable, but less is more in trying to navigate post benzo use.

The the only thing I’ve seen from many others are the beta blockers that gave some kind of aka relief and don’t require of extremely lengthy taper schedules. 
 

And as we get on and off various psychotropic meds, our bodies have some sort of almost an imprint of previous withdrawals or tapering from medication’s and each one can get more difficult for some people.

Again, why trying to see if your body after 18 to 24 months post (benzos) gets to be more like your original self before trying to add any other medications is helpful bc many people feel more healed and able to navigate life again without needing anything else.

Mentioning this all in detail because I’ve seen too many people go down the same roads and it is heartbreaking…. And a lot of people until they have no idea so it’s good to talk all this through in a lot of details so people can gather information and learn.

You have to choose what you think is best because almost 3 weeks on (mirt) can present strong withdrawals symptoms as you go down at this point so just do the best you can. 

Hi @[Bo...] I am planning on doing 50% cuts from tonight since I am under a month, If I choose to go the AD route after then work it up mich slower. I'd like to get by without meds if possible but it's tough.

[[jo...]]

Haven't had too much agitation and restlessness today. I almost wish I had because now I'm starting to think it might have settled in my system, and mabey I shouldn't taper. I'm thinking I probably will anyway just in case it comes back. Although I'm worried about potential effects from the cut too. Minefield.

[[jo...]]

20 hours ago, [[C...] said:

I have no personal experience with mirtazapine, but if I was in your situation of only being on that dose for 2 weeks, and decided not to stick it out, I would probably have returned to my 7.5 mg dose the following day. 

Slow tapers are often dependent on how much dependence/change the medication has caused. If those changes have not occurred you may adapt to an instant drop to 7.5 mgs relatively speaking. If you want to be more cautious you can drop by 3.75 mgs instead.

Fast tapers can be beneficial when your body hasn't acclimated to the medication that much. If you were only on a medication for 3 weeks but decided to do a slow 8 month taper, that amount of time would probably cause you to actually become physically dependent and eventually feel withdrawal symptoms when you otherwise would not have if you withdrew in less than 2 weeks.

Sadly no one here can say how you personally are going to react to a slow or rapid taper. I can only say what I would try in your circumstance, and that would be reducing my dose back to 7.5 mgs to see how I handle it.

Hi Crono. How long should the whole taper last do you think?

[[So...]]

I think it sounds like you just have no clue what to do, and you are desperately searching for an answer, as many of us have but to which- their unfortunetly isn't one.  We can only share our experiences.

 

My best advice though, to put it simply, is .. well.. you should shit or get off the pot at this point.  The up and down can really really mess w people, so if you put it down, leave it down, if you keep it here, leave it here.  Only you can decide what's best.  I would base it on your baseline before this, if you were just uncomfortable and unable to do everything you'd like, I'd get off, if you were literally in a crisis and wanting to end things, I would maybe stay on.  Also keeping in mind though, please trust those of us who have had it, you really really do not want aka bcuz it will be a whole other level of things.  This isn't a scare tactic at all, but that is the one side effect that should cause great concern and caution & I think everyone who has had it would feel guilty if we did not at least tell you about it as we all haven't had that opportunity to be warned.

 

Psychiatry is guess work and it is really about a cost benefit analysis with your own personal self.

Edited July 22 by [So...]

[[jo...]]

23 minutes ago, [[S...] said:

I think it sounds like you just have no clue what to do, and you are desperately searching for an answer, as many of us have but to which- their unfortunetly isn't one.  We can only share our experiences.

My best advice though, to put it simply, is .. well.. you should shit or get off the pot at this point.  The up and down can really really mess w people, so if you put it down, leave it down, if you keep it here, leave it here.  Only you can decide what's best.  I would base it on your baseline before this, if you were just uncomfortable and unable to do everything you'd like, I'd get off, if you were literally in a crisis and wanting to end things, I would maybe stay on.  Also keeping in mind though, please trust those of us who have had it, you really really do not want aka bcuz it will be a whole other level of things.  This isn't a scare tactic at all, but that is the one side effect that should cause great concern and caution & I think everyone who has had it would feel guilty if we did not at least tell you about it as we all haven't had that opportunity to be warned.

Psychiatry is guess work and it is really about a cost benefit analysis with your own personal self.

Thats why I want to get off. I dont want aka. How would it help to stay on if I was in crisis? surely that would suggest getting off.

[[jo...]]

7 minutes ago, [[j...] said:

Thats why I want to get off. I dont want aka. How would it help to stay on if I was in crisis? surely that would suggest getting off.

I've made a 50% cut. I really dont want aka.

[[jo...]]

Mabey I can move down or off and titrate up very slowly. Possibly on a different AD. As everything I'm hearing about this one is starting to scare the shit out of me.

Edited July 22 by [jo...]

[[jo...]]

12 minutes ago, [[j...] said:

Thats why I want to get off. I dont want aka. How would it help to stay on if I was in crisis? surely that would suggest getting off.

sorry I read your post to fast, I see what you mean. I was in a very bad mental state before but yesterday I was agitated to the point of having very desperate thoughts. I'm not saying I didn't have thoughts like this before but coupled with the sometimes severe agitation is a very bad cocktail.

[[So...]]

Yeah mirtazapine is a very risky antidepressant in benzo wd as is amitriptyline, I'm not saying it's a bad drug, just a risky drug.  It is also very hard to get off of for many people.  So I think getting it out as soon as you can is best if that's what you have decided, after 3 weeks I would keep cutting it in half every week until it's out.  Then you can make a new plan hopefully

[[id...]]

I've had really bad reactions to ADs before (cymbalta was the worst) and I stopped those pretty soon after starting. Mirt did give me agitation at first but then my body adjusted and I regret staying on it for a few years. It didn't fix the problem but my body got used to it and after a few years I stopped feeling anything and was in such a bad shape that I cold turkey'd off of it and even though it was the hardest thing and my CNS is probably still paying for it, I couldn't take another crumb of it at that time and all the months of Mirt withdrawal hell were better than feeling nothing and SI on it.

I did have to take it again later for a few weeks while pregnant because I had such bad nausea that I couldn't eat or drink anything, I was so dehydrated, hooked to many IVs, my life was in danger. Remeron helped me eat some and drink a bit of liquids. I stopped it when my symptoms got better without any problems whatsoever because I wasn't on it very long.

I'm not a doctor but I'd say if you've only been on it for a few weeks and you are clearly reacting to it, it's safer to either stop or fast taper than drag it out.

[[jo...]]

6 minutes ago, [[i...] said:

I've had really bad reactions to ADs before (cymbalta was the worst) and I stopped those pretty soon after starting. Mirt did give me agitation at first but then my body adjusted and I regret staying on it for a few years. It didn't fix the problem but my body got used to it and after a few years I stopped feeling anything and was in such a bad shape that I cold turkey'd off of it and even though it was the hardest thing and my CNS is probably still paying for it, I couldn't take another crumb of it at that time and all the months of Mirt withdrawal hell were better than feeling nothing and SI on it.

I did have to take it again later for a few weeks while pregnant because I had such bad nausea that I couldn't eat or drink anything, I was so dehydrated, hooked to many IVs, my life was in danger. Remeron helped me eat some and drink a bit of liquids. I stopped it when my symptoms got better without any problems whatsoever because I wasn't on it very long.

I'm not a doctor but I'd say if you've only been on it for a few weeks and you are clearly reacting to it, it's safer to either stop or fast taper than drag it out.

Thanks @[id...] I made my first cut tonight. I'm doing 50% cuts over 12 days. Why did you take it first? was it depression? Because it's actually helped mine unless it's a coincidence. It was just replaced by aka which is even worse. Its not full blown marching aka but it's bad enough.

Edited July 22 by [jo...]