Akathisia from mirtazapine

[[Ta...]]

Jonwil,

I detoxed off of mirt, and suffered from akathisia. I got help from INCREASING NITRIC OXIDE. There's a breathing exercise where you 1) hum thru your nose for at least 5 seconds. 2) Then you breath in deeply thru your nose, 3) and then exhale making a small "o" with your mouth. Nitric oxide is created in your sinuses.

Unsweetened cranberry juice, pomegranate juice, tart cherry juice, and organic blueberries increase nitric oxide. It can be very calming. This saved me. Seriously! You can look up nitric oxide on Benzo Buddies or Google it.

Wishing you health and wholeness,

Eileen

[[Bo...]]

The main mirt group is really the most in the know about mirtazapine. Not as many here bc it’s benzos primarily.

I’ve read prob everything I could read at this point on almost all psychotropic meds and spoken to every coach, Nicole Lamberson who runs BIC, Dr Mark Horowitz who wrote the deprescribing manual online everyone should have a copy of before tapering their med or better yet every Dr should have too….

its impossible to predict how a person will do but their current state gives some indication usually. If your nervous system is unstable, changes usually can have an uptick in symptoms. I changed brands and forms of mirt 3x after 4 weeks on and it was rocky but I stuck out the liquid and thankful I did bc it allows me to decrease in small amounts more often which my body needs as it has been so sensitized these last few years. I can’t do a cut and hold each month, I micro taper .01mg a day usually and hold here and there when things kick up. 
i was having very very severe adverse reactions to mirt after dosing every night for the first 6mo so I tried to do a blind taper 4mo in and 11% in two weeks crashed me so I knew I couldn’t handle trying to come off quickly based on that. I also was only a few months off K and didn’t want to jeopardize my benzo withdrawal bc it was so early and throw my body into further chaos which can always happens and have to updosd mirt to insane levels to try to stabilize...my aka experience has been life threatening so I had to try to not keep making rapid changes and see if I could stabilize and the adverse stuff go down which it did. 
s good way to gauge is did you have adverse reactions an hour it two after dosing from the first couple days on Or did the adverse stuff and aka start with changing dosing around etc? If it started immediately then you know it’s truly adverse where the latter is your body likely just disrupted and throwing tantrums bc it got destabilized after dose changes rapidly- which up and down does that and then it feels like we are adverse to the meds. Peoples bodies do settle from this but it can be a couple /few months…. Especially if people panic snd make more rapid changes. It always feels like we must do somenrjmh bc our bodies are in such chaos when much of the time unless it came on immediately with first dose or two, holding still and doing nothing is what stabilizes us with good ol time. 

many people in the mirt Facebook group have been in the same situation, adverse reactions, akathisia hell, benzo prior which contributed to harder case on mirt- research by the group has shown, etc etc ….. everyone had had to find their way and make the best decision they can based on the info they have and what their body is telling them. Most have said the slower tsper and their body finally stablilizing (stable doesn’t mean feeling good) is what got them off successfully. Some can go at 10% a month and that would prob be a year at your amount. Usually 10% a month is the upper end of what people can manage.

I would message your Dr to have that option in the event your want to do a slower taper …. It does nothing but give you leverage and is no bother to them if you’re saying you want to try and stay on and even out. It really is a patients right to be able to take the time they need to come off a med. it should never be a Dr dictating.

And once you’re off and in the event you need to reinstate, you’re going to need that Dr to prescribe again anyway and they can’t deny you that. And be aware of reinstatement for mirt ahead of time- very very small amount can stabilize you like under 1mg. Don’t make the mistake if you ever have to reinstate (key is to do this in the first month) to go back to 3.75mg. it can make things worse going high as you saw with updose to 15mg early in this for you and drs don’t know this and usually us patients don’t know til we already made the mistake. 

There is no reason to not try to tell your Dr you want to stay on the med and tell them you  are ‘better’ to just get what you need.
for those that do the  rapid taper polls from the groups former members shows the 12-24mo deal like benzos is what  their healing time frames things started turning around.

just want you to have all the info upfront….. it can take awhile for changes to settle our systems especially after having tapered a benzo and we just have to do our best to navigate and make the best choices we can moving forward. I thought I was set to shve to slow taper in severe aka mania screaming in car and pillows throwing things etc non stop, plus the adverse after dosing keeping me up all night …. And thankfully  my body stabilized once it got used to the liquid and slowing down making no changes.

You’ll find your way as you go and see what you can manage …. Just don’t be afraid to get the med from your Dr thigh and ideally staying on the same brand is a good thing during this. Like faith said any changes is usually a disruption and our bodies need consistency / it’s paramount in all this and our brains crave it.

 

Edited August 27 by [Bo...]

[[Ho...]]

@[Bo...], you nailed it!! 

@[jo...] I saw that you messaged Rebecca29. Boges11's input is probably better for you since she knows mirt and aka. Rebecca29 knows aka, but from a different source.

I thought @[Bo...] explained it very well: How to tell if your aka is an adverse med reaction or a withdrawal effect. I think that's key for you! If you can parse out when your aka started—right after beginning mirt or a bit later—then you can reasonably deduce what is causing the aka.

OH man. You've gotta get better. 

Hugs,

HCHC

 

[[jo...]]

Thanks for your detailed reply @[Bo...] The thing is the agitation did start early on and at the first dose 7.5. Does that make it an adverse reaction? I was a few doses in before I noticed I think but was told it's start up effects and should subside. It happened before I changed dose. And if an adverse reaction, then dose that mean I slow taper or get off fast. As stated I may have to come off fast. Thanks again for your time it's much appreciated.

[[Fa...]]

@[jo...]  You keep saying 'you may have to come off fast'.  Does that mean that it is not an absolute?  

@[Bo...] has really answered all of the questions including that about switching brands.  And, what she said is true, which completely escaped my mind.  We are talking about an AD rather than a benzo.  So, responses to posts in Tapering Strategies may be thin due to this...not because you are not being heard.  I hope that brings you some insight.  You've connected with those on the site who have experience with Mirt, and a lot of experience and knowledge.  It's time to make decisions...do whatever you can to secure a script to allow you to continue to tapering (if that is what you want to do), or move forward as best as you can in using what you have left to rapid taper.  Changing brands feels like it may disrupt your nervous system even more.  We want black and white, but we get grey.  Decisions are made in the grey.  You can do this for yourself, one way or the other.

 

 

[[jo...]]

Hi @[Fa...]My doctors don't beleive this stuff and are cutting me off. I doubt I can convince them otherwise. I tried. I was just trying to work out if having an adverse reaction puts me in a better or worse situation for a fast taper it's not really clear to me. You say knowing where the aka comes from can help but help how.? thats what I'm trying to understand.

Edited August 27 by [jo...]

[[Fa...]]

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

I was just trying to work out if having an adverse reaction puts me in a better or worse situation for a fast taper it's not really clear to me.

No one can answer that.  We don't move forward in this with a lot of clarity...we move forward while feeling uncertain, but we move forward anyway.  You won't find anyone who will be able to answer this for you.  As always, there are too many factors of which many we don't even understand.  

[[Fa...]]

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

I doubt I can convince them otherwise.

I feel you need to try.

[[jo...]]

13 minutes ago, [[F...] said:

I feel you need to try.

I have tried, they completely don't get the situation. It's just the typical "it's underlying issues" etc This is impossible.

[[in...]]

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

I have tried, they completely don't get the situation. It's just the typical "it's underlying issues" etc This is impossible.

I know about the "underlying"-story. I can't say on here what we would like to do to those doctors 😅 You know the story though 😎 I really hope your situation will improve soon!

[[Li...]]

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

I have tried, they completely don't get the situation. It's just the typical "it's underlying issues" etc

At this point, might I suggest that your goal is not to educate your doctors but rather to obtain a continuing prescription of mirtazapine to buy youself more time to figure things out.  

If your doctors have told you ‘it’s underlying issues’ they should be fine with continuing your prescription.  In your shoes, I’d simply agree with them that you need to continue the medication to deal with those ‘underlying issues.’

[[jo...]]

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

At this point, might I suggest that your goal is not to educate your doctors but rather to obtain a continuing prescription of mirtazapine to buy youself more time to figure things out.  

If your doctors have told you ‘it’s underlying issues’ they should be fine with continuing your prescription.  In your shoes, I’d simply agree with them that you need to continue the medication to deal with those ‘underlying issues.’

They are already cutting me off because they think it's a sub thereputic dose and isn't doing anything for me and there won't be any withdrawl. Plus I have been complaining about side effects. There's not much chance in convincing them they really don't understand and just think it's general mental health issues.

[[Re...]]

On 26/08/2024 at 08:56, [[L...] said:

Yes. You can view her posts at:

Rebecca29's Content

Hi @[Li...], I post from time to time. And yes, once I got off of the offending drug exacerbating it, things gradually started to improve. I am at about 14 months off now  (I think) and can say the spikes have been minimal as of recently. I do not and will not take any other prescriptions or anything that could cause or exacerbate it again.

[[Li...]]

Hello @[Re...]!  Good to hear from you — I think of you often and the many challenges you have faced and continue to face. Thank you for sharing your experience with @[jo...].  I’m sure he appreciates it as do I. 

[[Ho...]]

Ho @[jo...],

You could tell them that you want to try the higher dose to see if that makes the side effects calm down. Just saying, "I've been thinking about this and I'm starting to wonder if going up to a more therapeutic dose will help. I'd like to try that," might change their minds. 

Honestly I don't think I've ever advised anyone to fib and I'm feeling guilty about that and about your conundrum. All these voices! All the advice!

You'll figure it out. You'll get where you need to be. Sounds like you're ready to just taper down to zero because you think it's most likely your best bet to recover from the akathisia. 

Whatever you decide, we're here for you!

Hugs,

HCHC

[[jo...]]

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

Ho @[jo...],

You could tell them that you want to try the higher dose to see if that makes the side effects calm down. Just saying, "I've been thinking about this and I'm starting to wonder if going up to a more therapeutic dose will help. I'd like to try that," might change their minds. 

Honestly I don't think I've ever advised anyone to fib and I'm feeling guilty about that and about your conundrum. All these voices! All the advice!

You'll figure it out. You'll get where you need to be. Sounds like you're ready to just taper down to zero because you think it's most likely your best bet to recover from the akathisia. 

Whatever you decide, we're here for you!

Hugs,

HCHC

Hi @[Ho...] I already disscussed that I want off the drug but stupidly thought they'd let me do it my way. I might just have to come off quick. I can try talking to them again but their not very receptive.

[[PE...]]

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

Hi @[Ho...] I already disscussed that I want off the drug but stupidly thought they'd let me do it my way. I might just have to come off quick. I can try talking to them again but their not very receptive.

Yeah say you changed your mind 😊

[[jo...]]

I still have aka but have been able to not pace so much lately, is that a sign of stabalising? I still feel it strongly internally. 

[[jo...]]

.

Edited August 28 by [jo...]

[[Re...]]

23 hours ago, [[L...] said:

Hello @[Re...]!  Good to hear from you — I think of you often and the many challenges you have faced and continue to face. Thank you for sharing your experience with @[jo...].  I’m sure he appreciates it as do I. 

@[Li...]Thank you for caring. @[jo...], I am here for you.

Edited August 28 by [Re...]

[[jo...]]

On 27/08/2024 at 04:39, [[B...] said:

The main mirt group is really the most in the know about mirtazapine. Not as many here bc it’s benzos primarily.

I’ve read prob everything I could read at this point on almost all psychotropic meds and spoken to every coach, Nicole Lamberson who runs BIC, Dr Mark Horowitz who wrote the deprescribing manual online everyone should have a copy of before tapering their med or better yet every Dr should have too….

its impossible to predict how a person will do but their current state gives some indication usually. If your nervous system is unstable, changes usually can have an uptick in symptoms. I changed brands and forms of mirt 3x after 4 weeks on and it was rocky but I stuck out the liquid and thankful I did bc it allows me to decrease in small amounts more often which my body needs as it has been so sensitized these last few years. I can’t do a cut and hold each month, I micro taper .01mg a day usually and hold here and there when things kick up. 
i was having very very severe adverse reactions to mirt after dosing every night for the first 6mo so I tried to do a blind taper 4mo in and 11% in two weeks crashed me so I knew I couldn’t handle trying to come off quickly based on that. I also was only a few months off K and didn’t want to jeopardize my benzo withdrawal bc it was so early and throw my body into further chaos which can always happens and have to updosd mirt to insane levels to try to stabilize...my aka experience has been life threatening so I had to try to not keep making rapid changes and see if I could stabilize and the adverse stuff go down which it did. 
s good way to gauge is did you have adverse reactions an hour it two after dosing from the first couple days on Or did the adverse stuff and aka start with changing dosing around etc? If it started immediately then you know it’s truly adverse where the latter is your body likely just disrupted and throwing tantrums bc it got destabilized after dose changes rapidly- which up and down does that and then it feels like we are adverse to the meds. Peoples bodies do settle from this but it can be a couple /few months…. Especially if people panic snd make more rapid changes. It always feels like we must do somenrjmh bc our bodies are in such chaos when much of the time unless it came on immediately with first dose or two, holding still and doing nothing is what stabilizes us with good ol time. 

many people in the mirt Facebook group have been in the same situation, adverse reactions, akathisia hell, benzo prior which contributed to harder case on mirt- research by the group has shown, etc etc ….. everyone had had to find their way and make the best decision they can based on the info they have and what their body is telling them. Most have said the slower tsper and their body finally stablilizing (stable doesn’t mean feeling good) is what got them off successfully. Some can go at 10% a month and that would prob be a year at your amount. Usually 10% a month is the upper end of what people can manage.

I would message your Dr to have that option in the event your want to do a slower taper …. It does nothing but give you leverage and is no bother to them if you’re saying you want to try and stay on and even out. It really is a patients right to be able to take the time they need to come off a med. it should never be a Dr dictating.

And once you’re off and in the event you need to reinstate, you’re going to need that Dr to prescribe again anyway and they can’t deny you that. And be aware of reinstatement for mirt ahead of time- very very small amount can stabilize you like under 1mg. Don’t make the mistake if you ever have to reinstate (key is to do this in the first month) to go back to 3.75mg. it can make things worse going high as you saw with updose to 15mg early in this for you and drs don’t know this and usually us patients don’t know til we already made the mistake. 

There is no reason to not try to tell your Dr you want to stay on the med and tell them you  are ‘better’ to just get what you need.
for those that do the  rapid taper polls from the groups former members shows the 12-24mo deal like benzos is what  their healing time frames things started turning around.

just want you to have all the info upfront….. it can take awhile for changes to settle our systems especially after having tapered a benzo and we just have to do our best to navigate and make the best choices we can moving forward. I thought I was set to shve to slow taper in severe aka mania screaming in car and pillows throwing things etc non stop, plus the adverse after dosing keeping me up all night …. And thankfully  my body stabilized once it got used to the liquid and slowing down making no changes.

You’ll find your way as you go and see what you can manage …. Just don’t be afraid to get the med from your Dr thigh and ideally staying on the same brand is a good thing during this. Like faith said any changes is usually a disruption and our bodies need consistency / it’s paramount in all this and our brains crave it.

Hi @[Bo...] How do you know when you've stabalised? 

[[fa...]]

On 27/08/2024 at 10:35, [[j...] said:

They are already cutting me off because they think it's a sub thereputic dose and isn't doing anything for me and there won't be any withdrawl. Plus I have been complaining about side effects. There's not much chance in convincing them they really don't understand and just think it's general mental health issues.

Can you get it online thru the Hims website 

[[Ho...]]

@[jo...] I was just watching a video; Dr. Josef Witt-doering actually addressed what you're going though. It wasn't much, but he stated that if a med was causing an adverse reaction, then one would taper much more quickly than a normal hyperbolic taper.

Common sense! But it was just nice to hear a doctor say it. 

Warmly,

HCHC

[[jo...]]

5 hours ago, [[H...] said:

@[jo...] I was just watching a video; Dr. Josef Witt-doering actually addressed what you're going though. It wasn't much, but he stated that if a med was causing an adverse reaction, then one would taper much more quickly than a normal hyperbolic taper.

Common sense! But it was just nice to hear a doctor say it. 

Warmly,

HCHC

Thats good to hear as I'm extreamly worried. I don't seem to be pacing as much now although I am still suffering a lot with the adverse affects of agitation mental aka. And can still feel a lot of physical agitation. Maybe I'm just becoming acustom to it and forcing myself not to pace as much or maybe the dose is settling a bit I'm not sure. I've been cut off but can always try talking to them again. But not sure how best to taper from here even if I am put back on. or maybe like I've said it's going to be a fast taper and hope for the best.

[[jo...]]

Should I just stop? this is getting to be a lot to deal with. Whats the difference between a fast taper and just stopping?