I’m new here and I feel like a total idiot.  You’ll see in my signature that previously I started and stopped several ADs with no problems, until 2022 when I tried to stop mirtazipine.  That was rough and I was also prescribed Pristiq to help with the withdrawal (before I knew any better). The mirtazipine taper was successful last year and last October/November I was impatient to get off the Pristiq too.
 

I started off too quickly, since I had previously not had issues stopping Pristiq and I also figured I could go faster at the very top of the hyperbolic curve.  I also felt pretty good for the first couple months of tapering which made me over-confident.  Then I made a drop in early January, below 25mg and got hit with a bad wave. In hindsight this was predictable, and that’s why I feel like an idiot. I was so eager to get off all these drugs that I took additional risks.

 

I have been holding my dose for about 7 weeks. The good news is that I get some windows where I feel “ok”.  The bad news is that these are followed by bad waves, and the windows seem to be getting shorter.  I am Experiencing a number of symptoms, the worst ones are insomnia and extreme anxiety. The anxiety wakes me up at night.  I also know to be careful of supplements, but a few days ago in desperation I tried a low dose of an herbal sleep remedy I had in the cupboard (by cutting up a capsule).  It actually helped with sleep but then I realized it also contains a bit of GABA and 5 HTP so I am thinking of stopping that.

 

My main question is regarding updosing. I am considering updosing to see if it helps. Is it too late to updose after my 7 week hold? Should I start with a small increase first? Part of me just wants to go back to the full dose and try to let my nervous system fully settle before trying again.

 

 

Hi @Treeguy

 

 

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

 

11 hours ago, Treeguy said:

I’m new here and I feel like a total idiot.  You’ll see in my signature that previously I started and stopped several ADs with no problems, until 2022 when I tried to stop mirtazipine.  That was rough and I was also prescribed Pristiq to help with the withdrawal (before I knew any better). The mirtazipine taper was successful last year and last October/November I was impatient to get off the Pristiq too.
 

This is very common. I had the same experience. Its is dangerous as it gives you a false sense of security. My drug was Sertraline, On and off several times fast tapers no problems. Same again I got prescribed Mirtazapine and thats when things went very wrong for me.

 

Sorry they stacked another drug into the mix for you to now deal with. 😞 

 

11 hours ago, Treeguy said:

I started off too quickly, since I had previously not had issues stopping Pristiq and I also figured I could go faster at the very top of the hyperbolic curve.  I also felt pretty good for the first couple months of tapering which made me over-confident.  Then I made a drop in early January, below 25mg and got hit with a bad wave. In hindsight this was predictable, and that’s why I feel like an idiot. I was so eager to get off all these drugs that I took additional risks.

This is the false sense of security I was talking about. Each drug cant be seen in isolation. You have to think about your nervous systems condition as a whole. Once you were sensitised it was completely likely that stopping Pristiq would have been much harder this time. But how were you to know!

 

11 hours ago, Treeguy said:

I have been holding my dose for about 7 weeks. The good news is that I get some windows where I feel “ok”.  The bad news is that these are followed by bad waves, and the windows seem to be getting shorter.  I am Experiencing a number of symptoms, the worst ones are insomnia and extreme anxiety. The anxiety wakes me up at night.  I also know to be careful of supplements, but a few days ago in desperation I tried a low dose of an herbal sleep remedy I had in the cupboard (by cutting up a capsule).  It actually helped with sleep but then I realized it also contains a bit of GABA and 5 HTP so I am thinking of stopping that.

It's good you have experienced windows and both windows and waves during a period of stabilisation is completely normal including a worsening of symptoms. 

 

I would not take the supplements at all. They will likely make this all worse for you IMO. 

 

11 hours ago, Treeguy said:

My main question is regarding updosing. I am considering updosing to see if it helps. Is it too late to updose after my 7 week hold? Should I start with a small increase first? Part of me just wants to go back to the full dose and try to let my nervous system fully settle before trying again.

This is completely up to you. It is best to increase your dose within a couple of weeks of a hold but I think you are within a sensible time frame personally to try.

 

I would do just as you said and go for a small increase and hold there and see how you react.

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

How long does it take to stabilize after reinstating or updosing?

 

Hypersensitivity and kindling

 

How are you making your reductions? It's really important to make them accurately. 

 

Preparing Doses for Tapering - Weighing & DIY Liquids

 

Cutting Calculator

 

Using Manufactured Liquid Antidepressants

 

Could you update your signature to look like this? Would help us understand your history clearly and also how much you should try if you choose to updose:

01 January 2022 Mirtazapine 15mg

01 January 2023 Pristiq 25mg

01 February 2023 Mirtazapine 7.5mg

and so on....

 

Condense a taper like this to save space:

01 January 2024 Started Mirtazapine Taper 14mg, 01 Feb 24 13mg, 01 March 24 12mg and so on......

 

Alternatively you could just keep holding and wait to stabilise. This can take a long time and is often measured in months rather than weeks Im afraid.

 

I will add that the supplements might be be the reason you are feeling a bit worse recently, changes are not good for your nervous system. So you might be better off holding for a couple of weeks and letting your system settle to no supplements and reassessing then.

 

The choice is completely yours and there isnt a right or wrong one.

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

 

Chippy