Hi Gilda. Despite the nagging symptoms, it sounds like you're making progress. Recovery comes in small steps. The muscle aches and pains may be from your heightened anxiety, which is common. Try to take it one day at a time--you are recovering!

@Pokey449 @mstimc60 @Chippy The pharmacy called me. They said they contacted the company that produces SyrSpend, which is the solution used to make mirtazapine suspensions. The company told them that it can only be prepared starting from regular tablets. The pharmacy also told me that, for the preparation, they add 10% extra to compensate for losses. That’s why it doesn’t work for me. I bought SyrSpend myself and I would like to prepare it at home.

They explained that they use a “geometric dilution” procedure to make the preparation. I tried to understand how it works, but I can’t find anything online. Does anyone know what it is?

I would also like to understand how I could switch from my orally disintegrating tablets to the liquid solution that would be prepared using regular tablets from another brand. I know that between an original brand and a generic equivalent there can be a variation of plus or minus 10%. But the manufacturer of my orally disintegrating tablets in Italy does not distribute regular tablets.

Would it make more sense for me to take part of the orally disintegrating tablet, as I do now, and part of the liquid prepared with regular tablets from another manufacturer?

I also read that the liquid form acts immediately in the stomach. Could you give me some information on how to proceed? Thank you.

@mstimc60 Thank you so much, you are always so kind and reassuring. You are always there, and that means a lot to me. You always have kind words for me. @Chippy I know that you are not feeling well either, and I thank you for the time you dedicate to me. You try to look for solutions together with me, and that makes me feel less alone.

Right now I am having a very strong headache. I feel so disabled. I could understand the classic withdrawal symptoms, but I cannot explain what I feel in my head. It is confusion, heaviness. Sometimes it feels as if it were detached from the rest of my neck. I also have muffled ears and these tinnitus sounds that are horrible noises.

Thank you truly for being there for me.

20 hours ago, Luke said:

Purtroppo, devi scegliere tra continuare con questa riduzione e sperare che i sintomi si attenuino col tempo (ma nessuno può dire quanto tempo ci vorrà), oppure tornare a 7,5 mg e mantenerla, sperando di stabilizzare la situazione, se quella dose era più gestibile e la tolleravi meglio. Sembra proprio che la riduzione del dosaggio abbia causato un significativo peggioramento dei sintomi.

Qualunque sia la tua scelta, ti consiglio di mantenerla per un po'.

@Luke Thank you. I’m sorry that you are unwell too. I decided to stay at 6.8 mg. I realized that dose changes make me feel worse, so it’s better that I don’t increase the dose. I hope to stabilize. I also wish for you to recover. It seems to me that you are making some progress.

16 minutes ago, Gilda said:

Right now I am having a very strong headache. I feel so disabled. I could understand the classic withdrawal symptoms, but I cannot explain what I feel in my head. It is confusion, heaviness.

Hey Gilda. Head pressure and headaches are very common symptoms of wd and wd injury. We do have a new thread about it. It’s so new there isn’t too much discussion there at the moment. But I assure you, you are not alone in this one either.

https://antidepressantrecovery.org/topic/401-brainhead-symptoms/

28 minutes ago, Gilda said:

Would it make more sense for me to take part of the orally disintegrating tablet, as I do now, and part of the liquid prepared with regular tablets from another manufacturer?

Yes this is what we recommend. You start by taking 25% of your dose in the new form for 4-7 days, then increase it to 50%, the 75%, the take all your dose in the new form.

It is very easy to make a liquid from a standard tablet. We have a guide about it or we can talk you through it.

You also don’t need to make a liquid and can cut the standard tablet on your scales. But the same crossover procedure is recommended.

https://antidepressantrecovery.org/topic/240-preparing-doses-for-tapering-weighing-diy-liquids/

33 minutes ago, Gilda said:

They explained that they use a “geometric dilution” procedure to make the preparation. I tried to understand how it works, but I can’t find anything online. Does anyone know what it is?

I would worry about this Gilda.

1 hour ago, Gilda said:

@Luke Thank you. I’m sorry that you are unwell too. I decided to stay at 6.8 mg. I realized that dose changes make me feel worse, so it’s better that I don’t increase the dose. I hope to stabilize. I also wish for you to recover. It seems to me that you are making some progress.

I see.

I hope that in a relatively short time, you stabilise.

You do not need to concern yourself with this yet, but if you are able to stabilise, you may wish to consider smaller drops in the future as these might be much more manageable for you. However, this is something we can discuss and that you can think about later on, once you have stabilised.

For now, take care of yourself as best you can.

Hi, the day before yesterday and yesterday I felt extremely unwell. Today I have a deep visceral anguish. I think my problem is kindling. If I keep oscillating with the dose, I will always feel sick. Unfortunately, I made a mistake by going down to 5 mg, then back up to 7.5 mg, and then down again to 6.8 mg. Since then I’ve been feeling bad. Before doing this down-up-down pattern, even though I was splitting my orally disintegrating tablet inaccurately, I wasn’t feeling like this.

Anyway, I have a question. I have a scale and I’m measuring the hard capsules. They have different weights. What does that mean? Also, unfortunately, sometimes the scale gives me one weight, and the next time a different weight for the same capsule. I would like to know whether the active ingredient inside the capsules is always the same. I would like to dissolve a hard capsule in water and start doing 20% liquid and 80% orally disintegrating tablet. But I haven’t understood whether every capsule, even if it weighs differently from another, contains the same amount of active ingredient.

Unfortunately, I also find myself making two different transitions: from one brand to another, and from orally disintegrating tablets to liquid. Do you think this can be done?

Hey Gilda

Tablets often weigh differently to each other.

We always suggest weighing 10 tablets and dividing that weight by 10 give you an average tablet weight. Use this weight as the weight for a full dose going forward. The amount of active ingredient to fillers is proportional so heavier tablets have more drug in them.

What scales do you have and how many decimal places to they go to? I would suggest trying to use one of the calibration weights on the scale at the same time as your pill to load the scales into their operating range. I find this makes them more consistent in their reading.

If it was me I would just move to hard tablets and not move to liquid as yet. Less changes the better.

Hi, I’m going through hell. What I’m experiencing is not withdrawal. I’m having unbearable tinnitus in my head, at an extremely high volume. There are many strange sounds. My ears feel blocked, my head feels strange, I’m depressed, I have a large lump in my mouth, and swollen lymph nodes in my neck. I had an ultrasound and they said the lymph nodes are reactive. Large yellow bumps appeared under my eyes. I have restless legs. Subjective akathisia with anguish in my stomach, pain everywhere. And I’m still using the orally disintegrating tablets that I split by hand. Unfortunately I’m in kindling and brutal withdrawal, and I’m trapped taking a medication that is harming me. For 22 days I’ve been trying to take 6.8 mg. I say “trying” because there is no precision when splitting an orally disintegrating tablet. I truly don’t know what to do. I’m stuck. I’m afraid to change brand or method in my current kindled state. I don’t know how I could act. I’ve always suffered from tinnitus after stopping Rivotril and I was already very ill because of it. But what I’m hearing now is not normal tinnitus. These are deafening noises. They are in my head and in my ears. I hear different sounds in each ear. I’m truly desperate that I might stay like this. I’m forced to go to the office. At the office it’s worse. I hear the tinnitus more and my head feels stranger. I’m afraid I won’t stabilize because of all these ups and downs with mirtazapine. Before all this up and down, I didn’t have these screaming tinnitus noises or this strange feeling in my head.

I’m So sorry!

It sounds as if you are feeling the effects of fast tapered discontinuation of clonazepam on top of everything else

It can be very brutal.

Have you visited the benzo buddies site/forum?

@Finni Before taking antidepressants, I wasn't like this; I had dizziness and felt agitated. Then, the psychiatrists told me it was somatized anxiety and prescribed me medications. Unfortunately, I then suffered from kindling because I stopped taking them after just a few days.

Then, unfortunately, I came across mirtazapine. This is hurting me, and I can't even taper off it. So many of my problems are due to kindling. The noises in my head are killing me. I cry every day. A human being cannot live with these deafening noises. On top of that, I am trapped with an unstable dose of mirtazapine. Mirtazapine is what caused these noises in my head. I am suffering from so many things, and now these deafening noises on top of everything else.

@Gilda Im in a similar situation, and I know it is hell!

Were you advised not to dissolve your disintegrating Mirtazapine tablets in water?

Edited May 18May 18 by Finni

@Finni Yes, but my orally disintegrating tablets are made of pellets that contain the medication. These pellets do not dissolve in water. I know that other orally disintegrating tablets have pellets that do dissolve and disperse the medication instead. I am trapped. I cannot change brands because it would make me feel worse

15 minutes ago, Gilda said:

@Finni Yes, but my orally disintegrating tablets are made of pellets that contain the medication. These pellets do not dissolve in water. I know that other orally disintegrating tablets have pellets that do dissolve and disperse the medication instead. I am trapped. I cannot change brands because it would make me feel worse

Did @Emsy chime in?

I came back to edit this because I just got caught up with what Emsy said about her tablet and how they’re different from yours.

I’m still getting caught up on your situation

Sorry about that

Edited May 18May 18 by Finni

1 hour ago, Gilda said:

I’m forced to go to the office. At the office it’s worse. I

Does your office have fluorescent Lighting. My withdrawal symptoms increase in that lighting.

https://antidepressantrecovery.org/topic/273-fluorescent-lights-anxiety-sleep-issues-visual-problems/?do=getNewComment

@LostinCanada Hi, I don’t know. Maybe.

Today I worked from home and it went better. The biggest problem are these noises in my head: it’s a very loud ringing and I hear impossible sounds in my ears. I hope they decrease.

Two different psychiatrists don’t believe me about the sensitivity of my nervous system. They want me to take benzodiazepines and I don’t know what to do. I’m not sure if it’s the right choice. I could have a paradoxical reaction. And then I would have another addiction, and if they don’t work I wouldn’t be able to stop them.

I feel so stuck. I don’t know what to do, but at the same time I can’t stay like this.

I’m also afraid of changing my mirtazapine, which I take as a suspension made with a different brand in hard tablet form. I’m afraid of the change because of how sensitive I am. But at the moment I’m not sure I’m taking the same dose every day.

Give me advice. What would you do about benzodiazepines and about the medication issue?

Unfortunately my orosoluble tablets cannot be dissolved in water because they have microbeads that don’t break down in water, only in stomach acid, and the drug is all inside those beads, so they don’t disperse in water and it’s difficult to prepare a suspension. They also stick to the sides of the glass.

Thank you to anyone who replies.

8 minutes ago, Gilda said:

afraid of changing my mirtazapine, which I take as a suspension made with a different brand in hard tablet form. I’m afraid of the change because of how sensitive I am. But at the moment I’m not sure I’m taking the same dose every day.

So you are now using regular tablets to make a liquid? If this is correct, when did you start doing that?

9 minutes ago, Gilda said:

What would you do about benzodiazepines

Avoid absolutely.

10 minutes ago, Gilda said:

about the medication issue?

This change to hard tablet/liquid is new...it takes time to stabilize...this is a long process and adding more drugs will not help your CNS settle down.

Hi, I still haven’t started the liquid taper. I don’t understand why they’re telling me to take Rivotril (clonazepam). I’m in severe kindling and I’m afraid of switching from the orally disintegrating tablet to a liquid made from a hard tablet of a different brand. I don’t know what to do.

43 minutes ago, Gilda said:

I don’t understand why they’re telling me to take Rivotril (clonazepam).

They are trying to treat your symptoms with a benzo. We don’t suggest this. It’s like fuel onto the fire.

44 minutes ago, Gilda said:

I’m afraid of switching from the orally disintegrating tablet to a liquid made from a hard tablet of a different brand. I don’t know what to do.

It is your choice. You could do it slowly and see if you react to the switch. So try 25% of your dose in liquid and see if you tolerate it. Hold that for a few days and then try 50%. And so on.

Hi everyone,

I wanted to give you an update because I was doing really, really badly on Remeron (mirtazapine). In the end, I was hospitalized, and they took me off it completely, using En (delorazepam) injections to help me through the first three days. Then, they started me on lithium, Rivotril (clonazepam) drops, and Levopraid (levosulpiride).

On the first day, I had vomiting and diarrhea, followed by awful stomach pain that lasted for a week. Today, 17 days later, I am doing well. I was in the hospital for 15 days, and now I am being followed by a psychiatrist at the community mental health center connected to the hospital. They set up the appointment for me; she will be taking care of my treatment from now on and is already having me taper off Levopraid (levosulpiride) very slowly.

Finally, I found someone who actually understands how drug dependence works. Regarding Levopraid (levosulpiride), she explained that it’s not like benzodiazepines: I can drop one drop every two days, and if I start feeling bad, I just need to go back to the previous dose. [1]

I am finally no longer anxious, my panic attacks are gone, and above all, that horrible feeling in my head has disappeared. The tinnitus is still there, but the constant buzzing in my head is gone. I still have some pain and itching, but I feel a thousand times better than before. Remeron (mirtazapine) was destroying me, plus I had tapered off Rivotril (clonazepam) way too fast in the past.

Lithium has completely turned my life around from day one. I feel like I've come back to life: I want to do things, go out, and I don't cry every single second anymore—in fact, I don't cry at all. Sadly, the tinnitus is still horrible, and I still have nightmares because of a trauma I experienced, but I will be starting psychotherapy soon to work through that.

In the hospital, they completely figured out what was wrong. I was so lucky, because before this, no psychiatrist believed me, but in that ward, they actually listened to me and believed me.

I hope you are all doing well. I will keep you updated. Thank you so much to everyone for the support you've given me!

---

@Gilda so good to hear you'e in a better place and have a supportive doc.

Hi @Gilda

Im glad you have been getting some support from professionals who understand and believe you and that things have been going better for you.

I do wonder if you were in benzo WD and RI Clonazepam has helped this for you. I think you have been lucky that adding in additional drugs has helped you, more often than not when our nervous systems are destablised additional drugs is like fuel on the fire.

So happy you are off Mirtazapine it is an awful drug.

I'd be very careful with your changes now and consider holding all your doses steady for a while so your system can stablise, then taper off carefully.

2 hours ago, Gilda said:

I still have nightmares because of a trauma I experienced, but I will be starting psychotherapy soon to work through that.

This could be due to the drug damage, sleep issues are common in WD, you may find the therapy helps and it can't hurt, but if you still have problems be aware that it may well not be your mental health that is making the nightmares happen.

Look forward to hearing some more positive updates from you.

10 hours ago, Gilda said:

Hi everyone,

I wanted to give you an update because I was doing really, really badly on Remeron (mirtazapine). In the end, I was hospitalized, and they took me off it completely, using En (delorazepam) injections to help me through the first three days. Then, they started me on lithium, Rivotril (clonazepam) drops, and Levopraid (levosulpiride).

On the first day, I had vomiting and diarrhea, followed by awful stomach pain that lasted for a week. Today, 17 days later, I am doing well. I was in the hospital for 15 days, and now I am being followed by a psychiatrist at the community mental health center connected to the hospital. They set up the appointment for me; she will be taking care of my treatment from now on and is already having me taper off Levopraid (levosulpiride) very slowly.

Finally, I found someone who actually understands how drug dependence works. Regarding Levopraid (levosulpiride), she explained that it’s not like benzodiazepines: I can drop one drop every two days, and if I start feeling bad, I just need to go back to the previous dose. [1]

I am finally no longer anxious, my panic attacks are gone, and above all, that horrible feeling in my head has disappeared. The tinnitus is still there, but the constant buzzing in my head is gone. I still have some pain and itching, but I feel a thousand times better than before. Remeron (mirtazapine) was destroying me, plus I had tapered off Rivotril (clonazepam) way too fast in the past.

Lithium has completely turned my life around from day one. I feel like I've come back to life: I want to do things, go out, and I don't cry every single second anymore—in fact, I don't cry at all. Sadly, the tinnitus is still horrible, and I still have nightmares because of a trauma I experienced, but I will be starting psychotherapy soon to work through that.

In the hospital, they completely figured out what was wrong. I was so lucky, because before this, no psychiatrist believed me, but in that ward, they actually listened to me and believed me.

I hope you are all doing well. I will keep you updated. Thank you so much to everyone for the support you've given me!

---

I’m so glad to hear you’re doing better!!