Akathisia from mirtazapine

[[Ho...]]

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

@hotcold - are you still tapering mirtazapine, love? 

Yes, I sure am! It's not so easy. I wasn't expecting another face plant but at least going slow lightens the load a bit. 

[[Fa...]]

@[jo...] How is the Mirt taper going?  

[[jo...]]

Hi @[Fa...] I'm holding at 3.75 and trying to work out how best to approach it. I'm not very stable and haven't been the whole time on it so not sure wether to hold longer or make a move.

[[jo...]]

The last thing I want to do is make things worse and I dont have a clue how to micro taper or even if my doctor will support that so need a taper plan. I'm thinking of dry cutting 10% a month atm. See how that goes.

[[Fa...]]

@[jo...]  Out of a scale of 1-10 with 10 being the worst, what would you say your average day is...or, do they vary a lot from day-to-day?  May I ask what your day of AKA looks like?

[[jo...]]

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

@[jo...]  Out of a scale of 1-10 with 10 being the worst, what would you say your average day is...or, do they vary a lot from day-to-day?  May I ask what your day of AKA looks like?

Days vary. An aka day is torture. Up to 16 hours of pacing isn't unheard of. Some days there is no pacing but mental stuff like today. So better but still pretty bad. Some days if I haven't slept then the next day is better so not sure what the connection is there but there is onne clearly. So yeah it tends to alternate atm. All in all I'm much worse off than before going on. Huge error on my part thinking this could help. 

[[Fa...]]

I was the same.  I began my taper while in it.  And, there is a connection between little sleep and the next day not being as bad.  However, we won't know why that is, but it is.  I've heard others say the same thing.  I experienced it.

How long have you been holding at 3.75mg?

[[jo...]]

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

I was the same.  I began my taper while in it.  And, there is a connection between little sleep and the next day not being as bad.  However, we won't know why that is, but it is.  I've heard others say the same thing.  I experienced it.

How long have you been holding at 3.75mg?

Quite a while I'd have to check. Maybe 6 weeks or so.

[[Fa...]]

I know it's scary to think about reducing when you are like this.  I felt the same.  I made the decision to start tapering very slowly.  As I did, my symptoms did not get worse...but, I was reducing slowly.

Do you think that you would feel a sense of relief by knowing that you were taking steps to reduce your dose.  There is a psychological factor at play here when we feel as though we are stuck.  We aren't stuck...remember that.  What about a trial reduction of less than 10% to see how it goes?  

[[jo...]]

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

I know it's scary to think about reducing when you are like this.  I felt the same.  I made the decision to start tapering very slowly.  As I did, my symptoms did not get worse...but, I was reducing slowly.

Do you think that you would feel a sense of relief by knowing that you were taking steps to reduce your dose.  There is a psychological factor at play here when we feel as though we are stuck.  We aren't stuck...remember that.  What about a trial reduction of less than 10% to see how it goes?  

I was thinking that but don't really trust my scale for the finer margins. It seems to jump around a bit. How much would you suggest trying to cut?

[[Fa...]]

If it were me, I would try maybe 3%.  I know it's ultimately up to you, but I'm sharing what I did in order to test the waters.  I think I had even tried 2% at the beginning.  It's in my history.  But, seeing that it was the Mirt that caused the AKA, I'm not sure that holding longer is going to produce a different result.  I know it's a crap shoot...but, there are only two choices.  A small reduction is a good way for you to see how you react after the hold you have done.  What does your gut tell you?  When you think about holding, how does your body feel?  When you think about reducing, how does your body feel?  

 

[[jo...]]

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

If it were me, I would try maybe 3%.  I know it's ultimately up to you, but I'm sharing what I did in order to test the waters.  I think I had even tried 2% at the beginning.  It's in my history.  But, seeing that it was the Mirt that caused the AKA, I'm not sure that holding longer is going to produce a different result.  I know it's a crap shoot...but, there are only two choices.  A small reduction is a good way for you to see how you react after the hold you have done.  What does your gut tell you?  When you think about holding, how does your body feel?  When you think about reducing, how does your body feel?  

I want to reduce definitely. No doubt about it. I was thinking of going a lot faster than that though. Mabey I'm being hasty. I've only made 2 cuts so far both 50%. Obviously I'm not going to go that big now but was thinking of mabey taking it down to 3mg. Is that crazy?

[[jo...]]

I'm not sure how long I'm going to have this prescription for I really don't trust my doctors so it's making me want to go faster maybe.

[[Fa...]]

Did the AKA get worse after your first big reduction?

[[jo...]]

I dont remember it getting particularly worse or better. There was a lot of other stuff though DR, Depression, feeling generally messed up etc. That stuff passed though. The aka didnt. If I think about it, the aka is maybe less intense now unless I've just gotten somewhat used to it. It's still bad though. I really dont want it getting worse obviously. 

[[jo...]]

I think this might be as stable as I'm going to get at this dose. I'mean, the DR etc has gone so that might be my stabalisation.

[[Fa...]]

I think I agree with that based on how I experience things.

So, if you have a number in your head, if you're like me, it won't matter what anyone says, you'll end up going with that number.  It really is intuitive.  If you go from 3.75mg to 3mg, that is 20%.

[[Fa...]]

10% is approx. 3.40mg.

[[jo...]]

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

I think I agree with that based on how I experience things.

So, if you have a number in your head, if you're like me, it won't matter what anyone says, you'll end up going with that number.  It really is intuitive.  If you go from 3.75mg to 3mg, that is 20%.

Yeah it's maybe a bit big. I don't know though it's just what I been thinking

[[jo...]]

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

Yeah it's maybe a bit big. I don't know though it's just what I been thinking

I managed to survive 2 50% cuts but I'm getting to the lower doses now which is harder. Maybe I'll try it and it'll be a good gauge as to what I can handle. The thought of tapering for a year or more feeling like this is scary

[[Fa...]]

Or, you could do one cut of 10% for a test run, and then increase if you want after?

I rounded up...so, technically, 10% of 3.75 is clearly 3.375.

I know you'll make the right decision. 

[[jo...]]

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

Or, you could do one cut of 10% for a test run, and then increase if you want after?

I rounded up...so, technically, 10% of 3.75 is clearly 3.375.

I know you'll make the right decision. 

Yeah thats probably a better idea. My scale wont measure the 5 though. I may have to round things down when I cut. For example I now weigh 0.037. Thats how my scale works. do you think that will cause problems as I go down?

[[Fa...]]

No.  I don't think that will create a problem.  Many people round up or down.  Just make sure you always round up all the time or down all the time.

Just make sure you are taking the percentage off the current dose...that is important.

[[jo...]]

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

No.  I don't think that will create a problem.  Many people round up or down.  Just make sure you always round up all the time or down all the time.

Just make sure you are taking the percentage off the current dose...that is important.

Will do. Thanks again for all your help! it really is much appreciated.

[[Fa...]]

You're welcome.  I think the 10% first go is a good decision.  Be brave!  I think you will feel proactive by taking this step.  It will give you a good indication of where you're at.