Akathisia from mirtazapine

[[Ho...]]

That's such a good question and I only wish we could call up a doctor and ask!  Common sense would say it won't be quite as violent a shock to the system. Dr. Doering didn't say just stop, he said rapid taper so there must be a benefit from a rapid taper vs cold turkey in his eyes. 

Dr. Mark Horowitz even though he lives and practices in Australia does do some kind of telemedicine from Australia to other countries. He's the best. Here's a Facebook site that talks about his methods. I think it's pretty new; I just found it myself.

https://www.facebook.com/profile.php?id=61557053277210

Hugs,

HCHC

[[jo...]]

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

That's such a good question and I only wish we could call up a doctor and ask!  Common sense would say it won't be quite as violent a shock to the system. Dr. Doering didn't say just stop, he said rapid taper so there must be a benefit from a rapid taper vs cold turkey in his eyes. 

Dr. Mark Horowitz even though he lives and practices in Australia does do some kind of telemedicine from Australia to other countries. He's the best. Here's a Facebook site that talks about his methods. I think it's pretty new; I just found it myself.

https://www.facebook.com/profile.php?id=61557053277210

Hugs,

HCHC

Hi @[Ho...] I got my script back! I can go slower.

[[jo...]]

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

Hi @[Ho...] I got my script back! I can go slower.

I didnt even have to get the manual out. I got a different doctor and she kind of gets it. Says I need to go slow. 

[[Fa...]]

@[jo...]  So very happy to hear this.  Job well done!  

[[Li...]]

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

Dr. Mark Horowitz even though he lives and practices in Australia does do some kind of telemedicine from Australia to other countries. He's the best.

Greetings @[Ho...].  Might I offer a clarification? Although Mark does indeed hail from Australia, my understanding is that he currently resides in London. Per a recent bio:

”Dr Mark Horowitz MBBS PhD is Clinical Research Fellow in Psychiatry at North East London NHS Foundation Trust (NELFT), an Honorary Clinical Research Fellow at University College London and a training psychiatrist.”

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

Here's a Facebook site that talks about his methods. I think it's pretty new; I just found it myself.

https://www.facebook.com/profile.php?id=61557053277210

Thanks for the tip about this Facebook page!  It was created in the spring of 2024 when The Maudsley Deprescribing Guidelines (MDG) was released.  It appears to feature the presentations and interviews Mark has been doing to promote MDG as well as posts from Outro Health, a tapering support service for antidepressants co-founded by Mark. (Outro Health was initially launched in two Canadian provinces but was unable to make a go of it; it was recently relaunched in the United States and is currently offering services to residents of California.)

[[Ho...]]

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

I didnt even have to get the manual out. I got a different doctor and she kind of gets it. Says I need to go slow. 

@[jo...] I'm thrilled for you! Whew!! Don't you love it when a doctor gets it? It's so encouraging.

I hope your akathisia is settling down even more. It's easier to titrate down slowly when you know symptoms will subside. Two days ago I lowered my dose by .005. The next day was awful and I thought it couldn't be the mirt because it used to take several days to feel it. But now I think it is the mirt, because I'm feeling better today. When you get low, titrating down has a much bigger impact.

You did so much hard work to navigate through this. You did great!!

Hugs,

HCHC

[[jo...]]

2 minutes ago, [[H...] said:

@[jo...] I'm thrilled for you! Whew!! Don't you love it when a doctor gets it? It's so encouraging.

I hope your akathisia is settling down even more. It's easier to titrate down slowly when you know symptoms will subside. Two days ago I lowered my dose by .005. The next day was awful and I thought it couldn't be the mirt because it used to take several days to feel it. But now I think it is the mirt, because I'm feeling better today. When you get low, titrating down has a much bigger impact.

You did so much hard work to navigate through this. You did great!!

Hugs,

HCHC

High @[Ho...] How low are you?

[[Ho...]]

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

Greetings @[Ho...].  Might I offer a clarification? Although Mark does indeed hail from Australia, my understanding is that he currently resides in London. Per a recent bio:

”Dr Mark Horowitz MBBS PhD is Clinical Research Fellow in Psychiatry at North East London NHS Foundation Trust (NELFT), an Honorary Clinical Research Fellow at University College London and a training psychiatrist.”

Thanks for the tip about this Facebook page!  It was created in the spring of 2024 when The Maudsley Deprescribing Guidelines (MDG) was released.  It appears to feature the presentations and interviews Mark has been doing to promote MDG as well as posts from Outro Health, a tapering support service for antidepressants co-founded by Mark. (Outro Health was initially launched in two Canadian provinces but was unable to make a go of it; it was recently relaunched in the United States and is currently offering services to residents of California.)

Thanks for the clarification—at first I thought he was British but then I realized he was from Australia. My mind, I tell you! I've heard him speak and say the same things in your quote and still it didn't stick.

I did (I think!) come across a portal to contact him, but couldn't find it for @[jo...]. If I come across it again I'll try to send or post it. 

Take care, @[Li...]! Thanks for all your hard work!

HCHC

[[Ho...]]

Hi @[jo...], 

A bit better today. Trying to stay busy so I don't notice 'me' so much! The thing that bothers me the most is the derealization, which started to go before I got this low on the mirt. It will go again! I seem to be stabilizing more quickly after I titrate down. I'm getting a new short list of symptoms; things I never had during benzo recovery. They seem more histamine related. I'm finally understanding that going slower and listening to your body is the best way to ensure feeling as well as possible. Which works for me!!

Is your aka continuing to improve a bit?

[[jo...]]

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

Hi @[jo...], 

A bit better today. Trying to stay busy so I don't notice 'me' so much! The thing that bothers me the most is the derealization, which started to go before I got this low on the mirt. It will go again! I seem to be stabilizing more quickly after I titrate down. I'm getting a new short list of symptoms; things I never had during benzo recovery. They seem more histamine related. I'm finally understanding that going slower and listening to your body is the best way to ensure feeling as well as possible. Which works for me!!

Is your aka continuing to improve a bit?

I haven't been pacing much this week but have still had it. Today has been ok but I didn't sleep last night. There seems to be a connection. How do you taper such small amounts? I doubt I'll be able to do that but I have the time to go slower at least. Not sure how small a dose I'll be able to get from tablets. What dose are you on now? Glad your feeling better. I get dr for a bit when I cut it's horrible but it goes?

[[Li...]]

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

Thanks for the clarification—at first I thought he was British but then I realized he was from Australia. My mind, I tell you! I've heard him speak and say the same things in your quote and still it didn't stick.

I did (I think!) come across a portal to contact him, but couldn't find it for @[jo...]. If I come across it again I'll try to send or post it. 

Take care, @[Li...]! Thanks for all your hard work!

You’re most welcome, @[Ho...].  But all thanks go to you —  your many contributions to our community are much appreciated.  

Might this be the portal you’re thinking about?  It’s a link to Mark’s scheduling page for academic consulting. 

@[jo...] will correct me if I’m mis-remembering, but he has indicated he does not have the funds to pay for Mark’s services.  Happily, there is a Facebook group that uses Mark’s approach he can tap:

Mirtazapine: Peer Support, Withdrawal, Recovery | Facebook

 

[[jo...]]

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

You’re most welcome, @[Ho...].  But all thanks go to you —  your many contributions to our community are much appreciated.  

Might this be the portal you’re thinking about?  It’s a link to Mark’s scheduling page for academic consulting. 

@[jo...] will correct me if I’m mis-remembering, but he has indicated he does not have the funds to pay for Mark’s services.  Happily, there is a Facebook group that uses Mark’s approach he can tap:

Mirtazapine: Peer Support, Withdrawal, Recovery | Facebook

Yeah thanks for that @[Li...] I'll have to sign back up to facebook. BOOO! I hate facebook.

[[in...]]

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

Hi @[Ho...] I got my script back! I can go slower.

This is great news @[jo...]! I'm so happy for you bro!

[[Ho...]]

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

I haven't been pacing much this week but have still had it. Today has been ok but I didn't sleep last night. There seems to be a connection. How do you taper such small amounts? I doubt I'll be able to do that but I have the time to go slower at least. Not sure how small a dose I'll be able to get from tablets. What dose are you on now? Glad your feeling better. I get dr for a bit when I cut it's horrible but it goes?

I did some arm twisting and got a liquid. I'm wishing I'd gone ahead and made my own now, because the prescription is expensive and like you, I'm fearful she'll cut me off before I'm ready. But so far she's been skeptical but mainly okay with it.

I have the same kind of thing; I went down too fast twice and boy did I feel it! I awoke in the dead of night with restless legs and had to get up and walk around for a long time. It made me feel hyper and awake and like my skin was irritated on the inside. Also it put me in an awful, awful mood; I was ready to scream! I want to avoid that. 

I started following more of the Maudsley deprescribing method. Slow and easy and minimize bad feelings and bad days. There is a liquid you can make by yourself. Apparently it's very simple; just ground-up pills and maple syrup. You buy one ml syringes for accuracy. I think it's a good way to go.

I'm on .2 ml. It's not much at all but my receptors scream when I titrate down too quickly. It's recommended that  you titrate all the way down to .001. Then just walk off, hopefully. 

I"m so glad your DR goes away! Mine is in and out. Much worse after cuts. Someday it will be completely gone. Can't wait!

Hugs,

HCHC

[[Ho...]]

@[jo...] I found a screenshot I took last year on why to go down to tiny doses before jumping (not talking about aka!) I was frankly afraid I would get akathisia from going off mirt too quickly. Another reason I'm going slow. The attached screenshot has meant more and more to me as time went on. 

@[Li...] I think the link I found was for patients, not fellow academics. I got there from reading someone's Facebook post. But the point is moot if jonwii isn't in a position to pay, and how many of us are after years of this? The Facebook page is just what will help the most, so a big thumbs up!  It's very hard to scroll through their guides (the sites a bit talky) but the information seems so solid it's worth the effort.

Dr Horowitz seems to have said something about these sites saving his life. I think these sites do that a lot. People like you who volunteer their time and experience, well, words fail. Treasure in heaven!

Warmly,

HCHC

 

[[op...]]

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

@[jo...] I found a screenshot I took last year on why to go down to tiny doses before jumping (not talking about aka!) I was frankly afraid I would get akathisia from going off mirt too quickly. Another reason I'm going slow. The attached screenshot has meant more and more to me as time went on. 

@[Li...] I think the link I found was for patients, not fellow academics. I got there from reading someone's Facebook post. But the point is moot if jonwii isn't in a position to pay, and how many of us are after years of this? The Facebook page is just what will help the most, so a big thumbs up!  It's very hard to scroll through their guides (the sites a bit talky) but the information seems so solid it's worth the effort.

Dr Horowitz seems to have said something about these sites saving his life. I think these sites do that a lot. People like you who volunteer their time and experience, well, words fail. Treasure in heaven!

Warmly,

HCHC

 

@hotcold - are you still tapering mirtazapine, love? 

[[Rh...]]

I tapered off my benzo over 4 years ago and finished my mirt taper 11 months ago.  I got aka from tapering and once I came off.  I do think that some people are more “prone” to it.

I think it’s important to really listen to your body and if you need to hold or slow down your taper I’d suggest doing that.  Mirt is a tricky drug and the cuts can accumulate and catch up later…that is my experience anyways.

Hang in there and just take your time, you’re pretty fresh off your benzo so your CNS is working hard to heal from that. 

[[jo...]]

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

I tapered off my benzo over 4 years ago and finished my mirt taper 11 months ago.  I got aka from tapering and once I came off.  I do think that some people are more “prone” to it.

I think it’s important to really listen to your body and if you need to hold or slow down your taper I’d suggest doing that.  Mirt is a tricky drug and the cuts can accumulate and catch up later…that is my experience anyways.

Hang in there and just take your time, you’re pretty fresh off your benzo so your CNS is working hard to heal from that. 

Thanks @[Rh...] I'm just worried about the whole thing tbh. I'm suffering a lot already and dont think I'll be able to do the micro taper thing even if I wanted. I have been given more time which is good, but it's not going to be that much time. Given the symptoms I have already experienced from going onto the drug and the fact that It gets worse as you get to the lower doses doesn't look good for me. I have actually seen some improvement lately but expect things to get bad again as I start cutting down again from what I have read. It just seems undoable to me the more I think about it. 

[[jo...]]

for example if you look at how many steps are involved in getting off the last 3mg in the post that @[Ho...] left last night its concerning. I wont be able to do it that slow. There just doesn't seem like a safe way off for me.

[[jo...]]

Am I to think that getting off faster at this point is the better option given my time span on the drug? Or commiting to longer and possibly suffering more is the question.

[[Rh...]]

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

Am I to think that getting off faster at this point is the better option given my time span on the drug? Or commiting to longer and possibly suffering more is the question.

I understand your concerns completely. I think everyone struggles with those questions and if they are or aren’t doing it “correctly”.  I think we have to trust that tiny little voice and only you know what it’s telling you.

I will say that as I got lower in my mirt taper I actually felt better, so not everyone will feel worse or have a harder time.  I made some critical mistakes once I was off that lead to setbacks which I believe caused me to be in WD for this long.

I know it seems you can’t accomplish this right now but you’ll find your way, just as we all have before you.  Please know that you can do this and healing is ahead!

[[jo...]]

Thanks @[Rh...] Could you share the mistakes you made? I've made plenty of my own. Taking this crap in the first place being the biggest. 

[[Rh...]]

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

Thanks @[Rh...] Could you share the mistakes you made? I've made plenty of my own. Taking this crap in the first place being the biggest. 

Yes, so I took a migraine med when I was around 5 months off because I’ve been having bad migraines and headaches, then around 7 months I took progesterone and that also messed me up.

Moral of the story, WD sucks and I cannot take much to help it.  

[[jo...]]

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

Yes, so I took a migraine med when I was around 5 months off because I’ve been having bad migraines and headaches, then around 7 months I took progesterone and that also messed me up.

Moral of the story, WD sucks and I cannot take much to help it.  

I'm sorry to here you've had so many problems. 

[[jo...]]

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

I'm sorry to here you've had so many problems. 

Do you still suffer from aka?