Hello everyone,

 

I decided to continue my story from Surviving Antidepressants here. I'm still very much in the thick of it, but clinging on to hope of improvement!

First of all, echoing others, a big thank you to Luke and everyone who participated in creating this forum - you are keeping a community alive, and helping to provide some light among the darkness.

 

Background:

No obvious mental health issues before end of 2022, but subsequent reflection and diagnosis of C-PTSD have made me realise there was a lot going on, with some of the T's rather more full on than I had given credit.

 

2019-2022 = chronic stress with a LOT of big stuff, including betrayals, scary traumatic events and parenthood that opened up all the previously locked away 'stuff'.

 

Jan 2023 - First panic attack...things gradually got a bit worse over the year and in Feb 2024, I made the mistake of finally relenting to the umpteenth suggestion of trying Sertraline. 

Feb/Mar 24 - A laundry list of side effects that didn't subside with reduced dose, and when GP CT'd me, everything fell apart. After 3 weeks as a weeping howling mess, I ended up with the crisis team who put me on Mirtazapine as short term intervention (I'd also lost 1.5 stones in 3 weeks...). 

 

May 24 was discharged to community mental health team, who after an initial meeting refused to give me a medication review for 7 months, (or indeed do anything else). They did, however order the GP to up my Mirtazapine to 45mg, which I refused and started to taper back to 22.5 off my own bat, which sat with me reasonably well until...

 

Aug 24 - Saw a consulting pharmacist who told me I should never have been put on Mirtazapine, came up with a plan to cross taper to Escitalopram (I was uneasy about this), but then she promptly got sick and no-one picked up my case. I then got a freak mild concussion from my toddler, which further sensitized my nevous system.

 

Nov/Dec 24 - Finally saw another doc who agreed I should come off mirt. As usual suggested a far too fast taper - a theme - but I bought myself pill cutters/scales and all my kit to taper with liquid....and then my life fell apart with what appears to be pretty sudden onset autonomic dysfunction (possibly hyper-POTS) that seemed to be triggered by another high stress/traumatic situation. 

 

BY Jan 24 I couldn't even walk to the shops and eventually even aroudn my flat, as HR & BP would both sky rocket, and at the end of that month was put on Bisoprolol by GP, which although helping the autonomic symptoms, seems to have played havoc with my nervous system, especially with dosage changes due to side effects, it lowering my BP too low or me getting mad BP rebounds if the dosage was reduced too much.

 

Feb-June: With agreement of GP slow tapered Mirtazapine from 22.5mg to 15mg. No immediate or during ill effects, but things have got worse since stabilisng at 15. Hard to tell if down to Mirt, Bisoprolol, Autonomic dysfunction or all of the above.

 

Docs have kind of abandoned me - the consulting pharmacist wanted to cross taper me again, but again has totally disappeared from the scene,  and only other 2 docs have either told me to CT (idiot) or hold in the hope of stability. So currently at 15mg, but with my physical and mental health continuting to deteriorate.

 

Have also found out I have very unexpected levels of coronary artery disease, 90th percentile for my age(47), despite never smoking or taking drugs, rarely drinking and mostly being pretty active. SHock of this has probably contributed to mental state. 

 

In the PLUS column, I'm finally getting the medical tests I've been fighting all year to access, that may provide some clarity or even a diagnosis, and accordingly could open up treatment options more apt than the ill fitting sticking plaster that is Bisoprolol. Also in January, I will be starting my twice postponed trauma therapy that again has taken me 20 months to fight the medical system for. I just hope I will be physically capable of attending.

 

Am due another medication review in late Jan, and with my medical results also coming up soon, I'll have to make decisions re when and how to get off these medications, particularly as anecdotal evidence suggests Mirtazapine may be a factor in my autonomic dysfunction.

 

Accordingly I'll be very grateful to tap in the wisdom of others during the next stage of my journey, which hopefully will be one of recovery rather than deteriotation.

 

Here's my thread on SA for those who would like to read my journey so far: https://www.survivingantidepressants.org/forums/topic/31979-lomekian-my-intro-and-mirtazapine-journey/#comment-714596

Welcome to the forum, lomekian.

 

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Hi Lomekian

 

Welcome to the Forum!

 

Im very sorry to read your awful experience over the last couple of years. We are similar ages (45) and both males from the uk with young children so I empathise. I also had no previous experience with mental health drugs until later in life. I'm very much regretting ever getting involved with them.

 

You obviously had an AR to Sertraline again I think I may have had the same to Mirtazapine off the back of two fast but successful tapers off Sertraline a couple of years before. I'll never know what has caused everything that has happened to me, but I am certain it is a combination of these different drugs and fast tapers and CTs that has got me here. Once your CNS is sensitised I believe any further medication or changes is fuel onto the fire.

 

I think you are doing the right thing imo to get stable on 15mgs and sit there for a second until you're happy to make the choices of what you do next. As you're well aware the best option would to then taper slowly off listening to your body as you go. I understand you're worried about the effect Mirtazapine may be having on you, Ive seen a few people in a similar boat.

 

I really hope that things settle down for you at 15mg and the tests you've waited so long for shed some light on some of your current condition.

 

Again welcome mate, I hope this community can grow so we can gain from the mass of knowledge embedded in it and help each other through these challenging times.

 

Speak soon

 

Chippy

Thank you for joining.

 

I wouldn't discount the role of sertraline withdrawal and Mirtazapine in the autonomic dysfunction.

 

I certainly had extremely bad autonomic dysfunction purely from Mirtazapine withdrawal.

 

The question is, what to do about this?

 

You may want to request referral to the tapering clinic set up within the NHS that Mark Horowitz is involved in, if you're engaging with NHS care: National Psychiatric Drug Deprescribing Clinic (PDC) | NELFT NHS Foundation Trust

 

My understanding is that wait times can be quite long, so it might be worth asking your GP to make the referral before your review.

 

Just a suggestion.