Activation syndrome

[[Ho...]]

I was on 15 mg for several months. Tried to go up but it made me feel worse; less relaxed and even more upset and jittery. Yet on 15 mg I was relaxed.

When I started getting off I went from 15 to 7.5 mg in a heartbeat and didn't notice a thing. Then I dropped to 3.75 quickly and still was pretty ok. From then I've had to go incredibly slowly. I've been titrating down using liquid form, for months now. I'm on 2.5 mg. It's a tiny dose but I don't want to go faster, because there is blowback when I drop just a little.

If I were you I'd get off this before the four week mark. I'm no doctor, just a patient, but when mirt makes you worse right away, I don't think you get any better. It's not a standard antidepressant. It was created for seniors who would have dementia and forget to eat. At higher doses, it gives you an insane appetite.

They found that at low doses it's very sedating, and found too that it has some antidepressant properties at 15 mg or less. It's not having the standard sedating effect on you. You just may feel better off of it.

Hope that helps!

HCHC

Edited July 22 by [Ho...]

[[jo...]]

Thanks HCHC do you think cutting 50% every 2/3 days is ok? I'm a bit worried about jumping from 3.5. But only been on a couple of weeks. Might be ok.

[[jo...]]

What symptoms do you experience from the lower cuts?

[[So...]]

I wouldn't worry about our symptoms tbh @[jo...] it will just scare you & I don't think you need to worry since you have only been on 3 weeks.  If you get symptoms come back & well reassess.  

 

I wanted to also add in my last comment, aka doesn't have to be pacing.  At least in my book, some debate this. I consider the symptoms of aka to be agitation, mental restlessness/ocd, dysphoria, terror, vocal tics, feeling desperate, trapped, and hopeless, physical restlessness, rocking back and forth, pacing, pressure/crunching in the spine stomach or chest (don't really know a better way to describe that one but it's weird).  I don't even think everyone who paces has akathisia, and some who don't pace do have it.  If you have it tho, you are very miserable if it's bad and it's sort of existing second by second and hijacks you.  Not saying this to upset you, I can't say whether you personally have it or not, just saying there are different levels of it and it's a little different for everyone.  Some people can work during it, some can't leave their bed, some pace all day, etc.

Edited July 22 by [So...]

[[So...]]

I can see you're really struggling though, so if you ever need anyone you can dm me and I'd be happy to chat with you

[[jo...]]

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

I wouldn't worry about our symptoms tbh @[jo...] it will just scare you & I don't think you need to worry since you have only been on 3 weeks.  If you get symptoms come back & well reassess.  

I wanted to also add in my last comment, aka doesn't have to be pacing.  At least in my book, some debate this. I consider the symptoms of aka to be agitation, mental restlessness/ocd, dysphoria, terror, physical restlessness, rocking back and forth, pacing, pressure/crunching in the spine stomach or chest (don't really know a better way to describe that one but it's weird).  I don't even think everyone who paces has akathisia, and some who don't pace do have it.  If you have it tho, you are very miserable if it's bad and it's sort of existing second by second and hijacks you.  Not saying this to upset you, I can't say whether you personally have it or not, just saying there are different levels of it and it's a little different for everyone.  Some people can work during it, some can't leave their bed, some pace all day, etc.

What I experience is restlessness and agitation to the point were I am sometimes pacing around, not because I have to, but because I want to. To try and relieve some of that horrible energy in my muscles. SI, screaming things like c@*t into a pillow, quick building despair and irrational thinking etc.

[[So...]]

Yes that does sound like it to me, I'm very sorry but it will eventually go away.  I'm here for you and you can do this.

 

I will say too if you truly need an antidepressant, I would honestly try a different one.  None of them are completely safe but mirt is like a 4 in 1 drug.

Edited July 22 by [So...]

[[id...]]

By aka you mean akathisia? I had that and it's torture! I feel for you.

Originally I took Mirt for postpartum depression after my first child was born. My meds history is more complicated than that but that's the short story of the time I took Mirt for 3 years.

What dose are you on? The way Mirt works slower doses are actually more sedating than high doses (I think high doses rev you up enough and it's not offset by anti-histamine action). So you might see improvement in akathisia but feel more tired or hung over in the morning. 

[[jo...]]

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

By aka you mean akathisia? I had that and it's torture! I feel for you.

Originally I took Mirt for postpartum depression after my first child was born. My meds history is more complicated than that but that's the short story of the time I took Mirt for 3 years.

What dose are you on? The way Mirt works slower doses are actually more sedating than high doses (I think high doses rev you up enough and it's not offset by anti-histamine action). So you might see improvement in akathisia but feel more tired or hung over in the morning. 

I just cut from 15 to 7.5

[[Ho...]]

 

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

Thanks HCHC do you think cutting 50% every 2/3 days is ok? I'm a bit worried about jumping from 3.5. But only been on a couple of weeks. Might be ok.

Hi @[jo...], no one knows exactly how it will be for you, I'm so sorry to say! However, quick on quick off seems to be the consensus. My side effects from dropping down are usually depression (never as bad as it was, happy to say), inner restlessness/feeling upset, more than usual burning. It's different for everyone, but my burning is usually inside my skin, from my mouth and down my legs. 

I have a treadmill that I walk on when I feel too restless. I just hop down to the basement, read benzobuddies or watch a show for 20 minutes and that helps me for a while. There are days when I do it 2-3 times a day, but often I don't have to go on at all.

So many people can name their symptoms. I'm not good at that. I spend more of my energy trying not to notice symptoms and ride on top of them. It helps me get through the days but it doesn't help me identify my symptoms well and I wish right now I could do it better so I could say to you that I have x, y and z symptoms. I honestly don't know if I feel badly from dropping down on the mirt or if it's just the regular stuff.

You'll do fine. You've already gone to .375 mg. You're doing great! You're in a position where you can stop taking it and if you decide later to take some, you can do that too. Staying on it too long is the issue, and you're not there. You can choose to go on and off at will.

Thinking about you and counting on things going well for you!

Warmly,

HCHC 

[[Cr...]]

@[jo...] so you had your first night back at 7.5 mg? Hopefully things should level out in a few days.

Lets not forget that you are also going through benzo withdrawal, so if you notice an uptick in mental symptoms or physical symptoms in the next few days that is not necessarily indicative of mirtazapine withdrawal.

And yes, if depression is too much to bear then you can definitely look into other less risky options later on. For now just focus on coming off the mirt (assuming that is the choice you made).

[[Cr...]]

10 hours ago, [[S...] said:

Yes that does sound like it to me, I'm very sorry but it will eventually go away.  I'm here for you and you can do this.

I will say too if you truly need an antidepressant, I would honestly try a different one.  None of them are completely safe but mirt is like a 4 in 1 drug.

I agree. While every AD carries risks, I think it is safer to assume that ones that target multiple receptors are more likely to causes unwanted side effects and a harsher withdrawal. I believe this is how the types of ADs are ordered by # of receptors/systems they affect.

Ssris => Snris=> Tricyclics => Tetracyclics (mirt) => MAOIs

MAOIs affect so many things that you literally have to be on a special diet and exclude a vast swath of other medications. 

Relatively speaking (side effects), ssri's may be the better option, unless your depression is a type that doesn't respond to increased serotonin. Sadly with these types of medications people have to invest at least 4 to 8 weeks to find relief. That can feel like quite a long time for someone desperate for relief.

 

[[jo...]]

I cant take this it's just not stopping. made a cut last night and worse.

[[jo...]]

I'm gonna go back up tonight it was more tolorable than this

[[jo...]]

If I hold will this get better? I'm in a bit of trouble here. Making that cut has made me a lot worse I think. 

[[...]]

@[jo...], hi. I won't give you any advice. You seem to have already had more than enough. I'd be confused by all our inputs too and i'd be scared no end on reading the thread. I am a bit scared actually... Although i quit mirt completely exactly a month ago.

Just remember you're still going through benzo withdrawal and i'm sure all of your worst goes to it. Whatever you feel,it's manageable and i'm sure you'll cope with it too. Peace and healing to you.

[[jo...]]

If I go back to 15mg after only 1 day at 7.5 is that a bad idea? I'm not sure how it works

Edited July 22 by [jo...]

[[...]]

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

If I go back to 15mg after only 1 day at 7.5 is that a bad idea? I'm not sure hoe it works

I personally think there will be nothing awful about it but the more often you jump up and down, the worse. Just make up your mind and stick to it.

[[So...]]

Yeah and everyone should keep in mind sometimes getting on and off isn't bad for people- you are probably on of those people @[...] so I wouldn't be scared tbh

[[...]]

 @[So...], i didn't get you to the full. Sorry, English isn't my mother tongue. If you mean it's ok for me to start and stop psychotropic medications a few times within a short period of time, then, no, on the contrary, it was a disaster. The more often, the worse. I think, first of all, our brain needs stability, something monotonous, especially after being affected by benzo. The fewer changes we have while healing, the better, allowing our brain to be readjusting consequently without being confused a few more times.

Anyway, thank you for reassurance Seem to need it too. I really felt uncomfortable while reading others experience with mirt. Just wondering if a month off is enough to call it a success and happily breath out...

 

[[jo...]]

I cant cope. I'm thinking about just CTing the mirt. I'm to bad and don't know if I will stabalise.

[[Cr...]]

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

I cant cope. I'm thinking about just CTing the mirt. I'm to bad and don't know if I will stabalise.

While CTing is never the best option, if you feel the med has turned on you then do what you feel would be best. If you want off asap, a rapid taper may be better than just stopping. Not saying just stopping can't c/t work, as I did it twice in my past. Once was after 4 weeks on Lexapro, 2nd time was after 8 weeks on Celexa. I don't recall any debilitating issues, but those are different types than Mirt.

It is highly likely that due to your short term use, most of these uncomfortable AD wd symptoms will be short-lived (a few days to a week). If you were not in benzo withdrawal it would probably feel more tolerable.

Hang in there Jon. These symptoms, and the uncertainty that comes with them, seem quite frightful.. but they will pass. You can get through it. 

[[jo...]]

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

It is highly likely that due to your short term use, most of these uncomfortable AD symptoms will be short-lived (a few days to a week). If you were not in benzo withdrawal it would probably feel more tolerable.

hi Crono. Is that If I stay on do you mean.

[[Cr...]]

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

hi Crono. Is that If I stay on do you mean.

I just edited it to add "wd" to my statement, but I suppose it could be applied both ways..holding at 7.5 mg for a while or doing a Cold turkey/rapid taper.

If being on this med is going to frighten you then coming off is probably the better option. Just remember that doing it quickly (CT/RT) may result in some unpleasant symptoms. Based on your usage, they likely won't last long. 

 

[[Cr...]]

Right now fear is going to be a big factor in how you feel. It can make all your symptoms feel a lot worse than what they truly are. Just remind yourself why these symptoms are present, that they are just sensations, and they will subside.

Fear can make our thoughts run a mile a minute, causing a false impression that we are going crazy or having a mental breakdown. Panic feeds the symptoms, the increased symptoms feed back into panic and it becomes a horrible cycle.

You made it this far into benzo recovery, so you have it in you to feel off for a few days. Just "expect" to feel off for awhile to help reduce any fear caused by being caught off guard.