Remeron (Mirtazapine) Withdrawal Support Group

[[Ja...]]

I’ve been doing a lot of research as we do when we feel helpless and a little bored. I have come to the conclusion that this is Remeron withdrawal I am experiencing and not residual benzo withdrawal. We spend a lot of time focusing on Remeron as being a powerful antihistamine and assume most of it’s withdrawal effects are related to histamine. This was not explaining a lot of my symptoms though. On top of having diarrhea every single day I could not link these other affects to histamine. This morning and many mornings I have bradycardia, mild nausea akathisia. Diarrhea, bradycardia, nausea and akathisia are the primary symptoms of cholinergic rebound. As with most antihistamines Remeron is also a very powerful anticholinergic. This would be the neurotransmitters that control your heart rate and stomach functions. My vagus nerve has been hyperactive. I have suspected this but I could not link it to Remeron scientifically. When I drink water my heart rate shoots up to 130 while I am swallowing and then immediately drops back down to 70 when I stop. It is a crazy feeling. My resting heart rate is in the 50’s and jumps up quickly upon any slight stimulation. It’s like having incredible vagal tone but it’s too much. Many times my vagus nerve is pushing for too much calm abd my heart rate goes too low and my breathing seems depressed(air hunger) and then my body hits the fail safe - adrenaline. Rinse and repeat. I have no idea how long cholinergic rebound lasts. It is scary and I hope it ends soon. I have been having some improvements with this but it is slow. Today I am back to bradycardia, akathisia and nausea. I tried dao and did not get much relief. No side effects though. I will keep it for high histamine stuff that always bothered me. I ate some hotdogs at a bbq the other night and took the dao and did not get symptoms of histamine which I would have long before all of this so I will use then for that but not much impact on my mirt withdrawal.

[[Ox...]]

This is interesting stuff to keep in mind for my taper, if I go through with it. Tnx for sharing.

[[Ja...]]

I was doing some more deep thinking. Akathisia is considered an extrapyramidal symptom. These symptoms are associated with acetylcholine and not with gaba. I believe after doing this research that many benzo withdrawal symptoms are induced by gaba dysfunction. It is becoming clear to me that many are not. I have maintained that Remeron does not stop healing from benzos and I now believe this is untrue. Remeron should not inhibit the up-regulation of gaba receptors and thus this system should be able to heal while taking Remeron. However, if your biggest symptoms in benzo withdrawal are related to cholinergic rebound then Remeron will stop the healing associated with these symptoms. Yes, benzos are also anticholinergic drugs. My worse symptoms early on were extreme nausea, bradycardia, akathisia and hypermotility(diarreah). The anxiety of benzo withdrawal is gone and I do not have much now in Remeron withdrawal. But the eery symptoms of my early benzo withdrawal are back. The symptoms of cholinergic rebound associated with benzo discontinuation will not heal while you are taking Remeron as they can not due to the fact that the benzo has been replaced by Remeron in this system. There was not reason for my body to reregulate this. So you could say I am still experiencing benzo withdrawal but that is not really fair as this same effect would have been cause by taking an anticholinergic drug like Remeron even without ever having taken a benzo. So now even though my gaba receptors seem to have healed I have to wait for my upregulated acetycholine receptors to downregulate because they are so accustom to doing so much with so little for so long. The opposite of the type of affect benzos have on our gaba receptors.

[[Ox...]]

This is some really good stuff Jack. It sounds plausible.

[Guest [is...]]

Interesting Jack,

 

Everyone is so different , I have none of the symptoms you and others talk, maybe because my cholinergic system was spared ?  I know I have healed while on the remeron. When I stabalize from a cut I have zero sx and feel 100% normal but when I do cut somewhere around the 2-3 week mark benzo mental symptoms come back for a week or so , it seems that each cut gets a little easier.

I don't plan on cutting for a very long time if ever as it is very uncomfortable mentally.

[Guest [Jb...]]

I was doing some more deep thinking. Akathisia is considered an extrapyramidal symptom. These symptoms are associated with acetylcholine and not with gaba. I believe after doing this research that many benzo withdrawal symptoms are induced by gaba dysfunction. It is becoming clear to me that many are not. I have maintained that Remeron does not stop healing from benzos and I now believe this is untrue. Remeron should not inhibit the up-regulation of gaba receptors and thus this system should be able to heal while taking Remeron. However, if your biggest symptoms in benzo withdrawal are related to cholinergic rebound then Remeron will stop the healing associated with these symptoms. Yes, benzos are also anticholinergic drugs. My worse symptoms early on were extreme nausea, bradycardia, akathisia and hypermotility(diarreah). The anxiety of benzo withdrawal is gone and I do not have much now in Remeron withdrawal. But the eery symptoms of my early benzo withdrawal are back. The symptoms of cholinergic rebound associated with benzo discontinuation will not heal while you are taking Remeron as they can not due to the fact that the benzo has been replaced by Remeron in this system. There was not reason for my body to reregulate this. So you could say I am still experiencing benzo withdrawal but that is not really fair as this same effect would have been cause by taking an anticholinergic drug like Remeron even without ever having taken a benzo. So now even though my gaba receptors seem to have healed I have to wait for my upregulated acetycholine receptors to downregulate because they are so accustom to doing so much with so little for so long. The opposite of the type of affect benzos have on our gaba receptors.

 

Mirtazapine has weak or no activity as an anticholinergic or blocker of sodium or calcium channels.

[[30...]]

jack,

do you have a theory as to why during the majority of your benzo taper you were doing okay and when you were at like .3 or so you were doing really well?  is it the low occupancy receptor theory --- kind of like gabapentin - many can go from 600 to 100 no issue but from like 100 or lower down it is a different animal -- there is a high receptor occupancy with low dose?  so when you took that final bit out  all hell broke loose?

 

jen

[[Ja...]]

jack,

do you have a theory as to why during the majority of your benzo taper you were doing okay and when you were at like .3 or so you were doing really well?  is it the low occupancy receptor theory --- kind of like gabapentin - many can go from 600 to 100 no issue but from like 100 or lower down it is a different animal -- there is a high receptor occupancy with low dose?  so when you took that final bit out  all hell broke loose?

 

jen

 

Yes, that is exactly what I think. I also think I could have avoided most of this by going painfully slow at the end. I went to .03 but because of the microtaper I never stabilized before jumping. At the speed I was going at the end I would have hit the wall anyway like I did at 5.1 mg even if it was not jump time.

[[Ja...]]

I have identified another problem today. I am on 60 mg Nexium daily! I used to take 40 but had to increase during withdrawal because the breakthrough acid was so bad. I kept the dose there because I was afraid of having an adverse reaction with how my body was processing Remeron due to shared clearance pathways in the liver. But now I am no longer on Remeron. So, I do not see how I can get my histamine levels under control when I am not digesting my food and letting it ferment in my gut. I think it is time to reintroduce my stomach to it’s old friend hydrochloric acid! I will merely drop to 40 mg and the acid rebound should help digestion considerably. I’ll just take some pepto or gaviscon at night to help me through the process.

[[Ja...]]

Is it too late to reinstate? It’s been 2 months. I’m pacing back and forth around the house with my skin on fire. I was doing well all day. Like an idiot took a 10000 ui vitamin d. Everything feels like acid. I was started to get flushing after meals and the last two nights when I lay down to sleep. This sure feels like Xanax withdrawal. It might just be through the roof histamine levels. Either way, I can’t do this anymore. I had some good days but the bad days are getting scarier.

[Guest [is...]]

Is it too late to reinstate? It’s been 2 months. I’m pacing back and forth around the house with my skin on fire. I was doing well all day. Like an idiot took a 10000 ui vitamin d. Everything feels like acid. I was started to get flushing after meals and the last two nights when I lay down to sleep. This sure feels like Xanax withdrawal. It might just be through the roof histamine levels. Either way, I can’t do this anymore. I had some good days but the bad days are getting scarier.

 

Don't see why it would be too late , this crap isn't like benzo's where kindling or tolerance is a issue.

[Guest [Jb...]]

Is it too late to reinstate? It’s been 2 months. I’m pacing back and forth around the house with my skin on fire. I was doing well all day. Like an idiot took a 10000 ui vitamin d. Everything feels like acid. I was started to get flushing after meals and the last two nights when I lay down to sleep. This sure feels like Xanax withdrawal. It might just be through the roof histamine levels. Either way, I can’t do this anymore. I had some good days but the bad days are getting scarier.

 

Don't see why it would be too late , this crap isn't like benzo's where kindling or tolerance is a issue.

 

Yes, tolerance and kindling do happen.

[Guest [Jb...]]

Is it too late to reinstate? It’s been 2 months. I’m pacing back and forth around the house with my skin on fire. I was doing well all day. Like an idiot took a 10000 ui vitamin d. Everything feels like acid. I was started to get flushing after meals and the last two nights when I lay down to sleep. This sure feels like Xanax withdrawal. It might just be through the roof histamine levels. Either way, I can’t do this anymore. I had some good days but the bad days are getting scarier.

 

What are you eating? Try taking 3,000 to 5,000 of vitamin D. 10,000 is way too much. It's a hormone so it will affect many parts of the body. From my research, Remeron is extremely hard to get off and it doesn't matter if you slow taper or cold turkey you will still get symptoms for the first 4 months at least.

[Guest [is...]]

Day 26 since I cut and today was not too bad , still some weird mental stuff . Jack are you having any mental issues at all ? Or is it just physical?

[[Ja...]]

Day 26 since I cut and today was not too bad , still some weird mental stuff . Jack are you having any mental issues at all ? Or is it just physical?

 

It is mostly physical. But the physical does give me anxiety because of the ptsd of this whole deal. But my anxiety does not feel chemical. It feels real and like a normal response to the stress of the situation. The akathisia I might consider mental. But I have always felt the need to pace when I’m stresses or scared about something. I’m so scared that this is getting worse. This new flushing burning symptom is a symptom I have not had since Xanax CT and it is scaring me to death. I don’t feel like Xanax CT in any other way really but that symptom is terrifying me and has me ready to reinstate.

[Guest [is...]]

If I were you I would just do it and get back to living your life .

[[Ja...]]

If I were you I would just do it and get back to living your life .

 

If it even works. My doctor is out of the office until Monday. I don’t think I have any refills left at the pharmacy. Also I have to make sure he is on board before I reinstate. I don’t want to get stuck without a steady supply.

[Guest [is...]]

Ahh got it , good luck .

[[ja...]]

I am having a similar dilemma, 2 weeks at 5.0 dose and most withdrawal affects have improved considerably however sleep, the reason I was put on mirtazapine, is deteriorating.  Sleep got rocky days 4 to 8 but then started improving and was sleeping ok, getting 5 to 6 hours a night but the past 3 nights in a row it has dropped off to about 3 hours, from 10 to 1, after that I don’t fall back asleep nor do I nap during the day.  Ability to nap during day went away with chemo and never returned.  The last time I tried to taper mirtazapine I made it off but then similarly after 2 weeks things were improving with the exception of sleep which continually declined until 3 weeks later it was 90 minutes a night sleep and after a few nights of that I had to reinstate, life was just not sustainable on 90 minutes sleep a night.  I’m not sure if I should try to hold another week and see if sleep improves or give up and go back to 7.5.  I don’t think I can continue a whole lot longer with only 3 hours of sleep a night but I also hate to go back because some of the side effects of the mirtazapine really bother me, foggy brain, daytime fatigue and muscle pain.  Any ideas?

[[Ja...]]

I am having a similar dilemma, 2 weeks at 5.0 dose and most withdrawal affects have improved considerably however sleep, the reason I was put on mirtazapine, is deteriorating.  Sleep got rocky days 4 to 8 but then started improving and was sleeping ok, getting 5 to 6 hours a night but the past 3 nights in a row it has dropped off to about 3 hours, from 10 to 1, after that I don’t fall back asleep nor do I nap during the day.  Ability to nap during day went away with chemo and never returned.  The last time I tried to taper mirtazapine I made it off but then similarly after 2 weeks things were improving with the exception of sleep which continually declined until 3 weeks later it was 90 minutes a night sleep and after a few nights of that I had to reinstate, life was just not sustainable on 90 minutes sleep a night.  I’m not sure if I should try to hold another week and see if sleep improves or give up and go back to 7.5.  I don’t think I can continue a whole lot longer with only 3 hours of sleep a night but I also hate to go back because some of the side effects of the mirtazapine really bother me, foggy brain, daytime fatigue and muscle pain.  Any ideas?

 

I would be afraid that going back to 7.5 could backfire and possibly bring new symptoms. That is a big updose from 5 back to 7.5 mg. I would updose in small amounts. Go up to 5.1 for a few days and see and then maybe 5.2 if necessary. When you do stabilize I would recommend doing a microtaper like I did. I had a hard time with big cuts like you are doing. You could cut 5 to 4.9 to 4.8 to 4.7 like every week or every few days whatever you feel comfortable with. Then when the symptoms start to build you hold until it settles. That worked way better for me. I just wish I had gone slower near the jump point.

[[Be...]]

Is it too late to reinstate? It’s been 2 months. I’m pacing back and forth around the house with my skin on fire. I was doing well all day. Like an idiot took a 10000 ui vitamin d. Everything feels like acid. I was started to get flushing after meals and the last two nights when I lay down to sleep. This sure feels like Xanax withdrawal. It might just be through the roof histamine levels. Either way, I can’t do this anymore. I had some good days but the bad days are getting scarier.

Sorry Jack for what you are going through. It sounds like the Vit. D made everything worse. Maybe it will calm down in the next day or so. If not I would consider making a small reinstatement.

 

Becky

[[30...]]

hey jack,

I know you have to wait until Monday to speak to the doc -- have things calmed down at all since taking the vitamin D?  I am not sure about the anti-cholinergic piece, its interesting but what I heard is that it is very weak at those receptors --- it sounds like just plain ole withdrawal --- you said you were going too fast at the end --- but you got down to .03 and jumped -- how long did you take to go from .2 (when you started feeling a bit wonky) to .03 where you jumped? 

 

thinking about you buddy

 

[Guest [Ba...]]

Ive tapered off Zopiclone. Thats when things got bad.

I am tapering mirtazapine 15mg of 2 yrs by using uk liquid. Im down to 0.4ml from 1ml .i do 0.1 ml week. Yes ive big digestive problems BIG so much ive had to pay private to see a g.i. who i hoping will help or offer me a scan or tests. The zop started my downward spiral. Some nights my burning all inside going to bed so bad i had to take a zop to put me to sleep. If not what i now eat in the day affects how i get off to sleep with the 0.5 clon im still on and 0.4 ml mirtaz as often they dont work for hours depending what ive eaten. My food doesnt seem to be either leaving my stomach quick or theres a big digestive issue. It sounds crazy but since stopping zop i go high wide awaje by pm if i eat carbs any sugar fruit in day and then the drugs can still knock me out and waking a.m. im sooo tired weak arms weak legs

[[Ja...]]

Is it too late to reinstate? It’s been 2 months. I’m pacing back and forth around the house with my skin on fire. I was doing well all day. Like an idiot took a 10000 ui vitamin d. Everything feels like acid. I was started to get flushing after meals and the last two nights when I lay down to sleep. This sure feels like Xanax withdrawal. It might just be through the roof histamine levels. Either way, I can’t do this anymore. I had some good days but the bad days are getting scarier.

Sorry Jack for what you are going through. It sounds like the Vit. D made everything worse. Maybe it will calm down in the next day or so. If not I would consider making a small reinstatement.

 

Becky

 

It really did. I still can’t believe I did that. I have been pretty much bedridden most of the day today. It’s hard to just lay here because the burning is so intensely uncomfortable. I have realized I have to fight the akathisia though. I am not eating enough to be walking non stop and I think rest is important for stabilization even if rest is hard work.

[[Ja...]]

hey jack,

I know you have to wait until Monday to speak to the doc -- have things calmed down at all since taking the vitamin D?  I am not sure about the anti-cholinergic piece, its interesting but what I heard is that it is very weak at those receptors --- it sounds like just plain ole withdrawal --- you said you were going too fast at the end --- but you got down to .03 and jumped -- how long did you take to go from .2 (when you started feeling a bit wonky) to .03 where you jumped? 

 

thinking about you buddy

 

Thing ramped up even more today or it’s the same. I don’t know. Once the symptoms get severe there is little difference between severe and severer(real word, lol?). Anyway, vitamin d3 has a 50 hour half life from what I read if that even has anything to do with how long it would rev me up for. I hope this isn’t a major setback. It sure feels like one. It was 1 month from .2 to .03 mg.