7 minutes ago, Pokey449 said:

@NT1100B @ChippyWell after hearing what Sminismoni explained to me yesterday it’s appears I may have spent the last 10 months tapering Doxepin to no avail. The pattern of my symptoms and how they have progressed fits like a glove with his explanation of the situation. The lower I go on the doxepin in combination with the stable low dose of mirtazapine that I’m on my symptoms seem to be getting worse & worse. My sleep and apnea have worsened. Last night I could not use my BIPAP hardly at all. I awoke twice with obvious shortness of breath, headache, pain  and malaise. My breathing was definitely OFF!! Hard to sleep if you can’t breathe. 
I’m not going to change anything until I run this by Horowitz but it’s looking like my only solution is to reinstate doxepin to my original dose and then taper off the mirtazapine which I should have probably done in the first place. My current psych provider has no clue about any of this, despite being a nice caring guy. 
My sleep doc wants to do a repeat sleep study because of all the troubles I’ve been having with my BIPAP but I think that’s likely a waste of time until I can correct the current situation.  What a F’ing mess!!!!!!!😤

Hey Pokey

 

Argh so sorry Pokey what a mess this is for you. 

 

Yes I agree leave it all as it is till you’ve spoken to dr H. I wouldn’t recommend jumping your doxepin dose like that. See what he says and then go from there mate. Remember stability not lots of changes and certainly not big swings. 
 

Chippy

Hi @Pokey449, I am tapering Mirtazapine, and I am now at .3 mg. What I noticed is more I go down of this hellish drug more I experience shortness of breath. This awful state becomes worse the evening and the night. We have to eliminate this poison from our brain., Pokey.

Svetla

1 hour ago, Pokey449 said:

My sleep doc wants to do a repeat sleep study because of all the troubles I’ve been having with my BIPAP but I think that’s likely a waste of time until I can correct the current situation.  What a F’ing mess!!!!!!!😤

Oh dear @Pokey449 Yes indeed, F**K me these doctors are worse than useless. Hells bells I don't know

where to start Pokey, yes without breathing we are dead. A very tricky one, hopefully Horowitz will instruct

you what to do safely. I would have thought the doxepin should be GONE. But I know nothing about it Pokey.

 

See what he says, just take things easy, and if you can, distract the thoughts any way you can. The more you

worry about it the worse it will be. Take things slow my good man, we are with you all the way. The danger we

are put in with these bloody things is scandalous.

Take care,       B.🤞

Dear @Pokey449 I am very very sorry for your very difficult situation. 
I just wanted to throw in one thought, that might be helpful and might not be helpful for you at all, that is only for you to decide: here in this forum, everybody’s goal is going to zero. But sometimes that might not be a helpful goal for everyone, especially for elderly folks.
 I have a friend who tapered Venlafaxin(slowly, but obviously still  too fast) , she was 75 or 76 years old at that time, and after three months being on zero, she had terrible withdrawal. She ended up in a psychic ward, where they reinstated a high dose, as far as I remember, it was even the full dose she had been on in the beginning. In her case, the reinstatement worked and she felt her old self after a couple weeks. ( I think she was very lucky, this is not something I would necessarily recommend, it’s just a situation that I’ve witnessed.) She has decided to stay on the Venlafaxin for the rest of her life, because of her age. In the last five years till now she has been healthy and stable. This might not be a possible route for you, I understand that your case is complicated because you have two drugs to juggle. And of course her story is very different from your situation. I just wanted to tell it, because she was also an elderly person and I can understand very well of her decision to give up tapering and for her it has worked.

considering your age it may be an idea to try to find a dose of both your medications where you have the highest possible quality of life and then stay there and enjoy a peaceful old age instead of being focused on going to zero. I have read a bit in your thread, but not everything, so this might not be a possibility for you because of other complications. But I just thought I might throw that thought in, because on this forum here we are so much focused on getting rid of the meds completely.

 

I so much hope you will find a good solution for you! You are in my prayers.

 

@Nemina @NT1100B @Chippy @skamen

Thanks a bunch for your posts in response to my dilemma. I’m now sure @Sminismoni is correct: that my breathing is being affected by two meds ( both my doctor & I were so stupid for allowing this to happen) that are more sedating at lower doses that affect respiratory drive & putting my brain into a fight or flight state waking me up in distress. 
I awoke twice last night feeling starved for air with my whole body aching from, I guess, oxygen deprivation. After I was awake for a while the extreme discomfort dissipated. Common WD sxs dont just evaporate like that. The first time I awoke I was using my cpap, but even it was not enough to compensate for what was happening. I got up for a bit, peed and went back to bed, fell asleep w/o my cpap and awoke at 530!with the same scary sxs. Got up, fixed a coffee and all the sxs vanished. I feel ok currently. 
I think my breathing at night is being seriously compromised. It’s certainly not good for my health and I’m worried it may be life threatening AND I don’t know what to do about it. I don’t confer with Horowitz until Thursday. 
Logic tells me I will need to go back up with my Doxepin dose back to 50mg where it will lose its more sedating affect.. Hold it there & then taper the mirtazapine.  I’m afraid to do anything until I hear from Horowitz BUT I’m afraid to stay where I’m at given how my breathing is being affected. 
@Nemina I hear what you are saying about being at my age and just staying put on a single med at a “comfortable” dose like the lady you referenced. At 76 life is too short now to be putting up with all this misery day in & day out. It’s really hard on old bodies 😢

Pokey 
 

2 minutes ago, Pokey449 said:

@Nemina @NT1100B @Chippy @skamen

Thanks a bunch for your posts in response to my dilemma. I’m now sure @Sminismoni is correct: that my breathing is being affected by two meds ( both my doctor & I were so stupid for allowing this to happen) that are more sedating at lower doses that affect respiratory drive & putting my brain into a fight or flight state waking me up in distress. 
I awoke twice last night feeling starved for air with my whole body aching from, I guess, oxygen deprivation. After I was awake for a while the extreme discomfort dissipated. Common WD sxs dont just evaporate like that. The first time I awoke I was using my cpap, but even it was not enough to compensate for what was happening. I got up for a bit, peed and went back to bed, fell asleep w/o my cpap and awoke at 530!with the same scary sxs. Got up, fixed a coffee and all the sxs vanished. I feel ok currently. 
I think my breathing at night is being seriously compromised. It’s certainly not good for my health and I’m worried it may be life threatening AND I don’t know what to do about it. I don’t confer with Horowitz until Thursday. 
Logic tells me I will need to go back up with my Doxepin dose back to 50mg where it will lose its more sedating affect.. Hold it there & then taper the mirtazapine.  I’m afraid to do anything until I hear from Horowitz BUT I’m afraid to stay where I’m at given how my breathing is being affected. 
@Nemina I hear what you are saying about being at my age and just staying put on a single med at a “comfortable” dose like the lady you referenced. At 76 life is too short now to be putting up with all this misery day in & day out. It’s really hard on old bodies 😢

Pokey 
 

We are with Pokey. I’m sorry I wish I had more to say mate other than you are right to want to wait to speak to Dr Horowitz and then make some choices. Just a couple more days now and you’ve been waiting so long already. I wish I had a magic wand. 😞

14 hours ago, Nemina said:

have a friend who tapered Venlafaxin(slowly, but obviously still  too fast) , she was 75 or 76 years old

I completely agree @Nemina I have a mother in law on an antidepressant and I would never dream of suggesting she stop it. She’s stable on it and who needs to be in wd at her age. X

On 12/30/2025 at 7:20 PM, Pokey449 said:

Hi Everyone. I’m just in the process of crossing over from SA. Will be back later to post.

 

You can find my journey so far in my SA blog here; https://www.survivingantidepressants.org/forums/topic/32119-pokey449-doxepin-mirtazapine-nightmare/

i was prescriped doxepin for sleep at one point if i remember correctly but i never took it. i did take mirtazapine very briefly for sleep though a few years ago but stopped as it gave me horrible panic attacks. im now on melatonin and it works just fine for me. i was also on quetiapine a few years ago for sleep and it worked for that but it did make me very groggy in the mornings and the tiredness i got from it was more of that akin to feeling very disoriented and sluggish, it didint really give me that natural kind of tiredness as melatonin does but it knocked me the fuck out. im not taking it anymore though as i feel incredibly iffy nowadays about taking psychiatric drugs for sleep.

 

Edited February 16Feb 16 by Some0n3

4 hours ago, Pokey449 said:

At 76 life is too short now to be putting up with all this misery day in & day out. It’s really hard on old bodies 😢

Pokey 

My heart goes out to you @Pokey449 Not an easy one to answer, I would just stay put until you have

heard what Horowitz says about it. Now if you CTd Doxepin that could kill you, the problem as you say is

BOTH drugs at lower doses make you even sleepier, so yes I get your point in raising the dose. SEE what

your man says.🤞

Take great care though Bud.....WE are with you all the way.      B.

@NT1100B B I wont CT anything. Yes, that’s a no brainer to NOT do……I sent a note to my sleep doc who wanted to do a repeat sleep study because I’ve been having so much trouble with my sleep. He just focuses on sleep apnea. But my sleep issues are beyond garden variety sleep apnea. I figured I should let him know why I think a sleep study now would be a waste of $$ and time. That I need to get my sleep back to being “normally abnormal” if you get my drift. 

@NT1100B @Chippy @Nemina Morning ( here at least) everyone. Another awful night. I’m on a 1 now feeling rotten.  I think I’m progressively getting worse. Well I know I am when looking ffom the beginning of my taper to now. It’s bend a slow gradual decline.I knew something wasn’t right about this taper as I neared the dose I’m at now. Couldn’t put my finger on it. Maybe will never know for sure but now im pretty sure what’s happening based on what Sminismoni explained to me. It seems the sedating affects of the doxepin at the dose I’m at now in combination with the sedating affects of the mirtazapine are impacting my brains control of my respiration which in turn triggers a fight or flight response. I just know I wake up SOB  and very anxious. I feel like it’s slowly getting worse. And it’s scary. I fear it’s impacting my brain, heart and other functions. Honestly I’m afraid of dying in my sleep. 

I don’t know what the solution is?? I have a 10 minute session with Horowitz on Thursday. It’s what is called a 10 minute email/voice memo session. I send him a question and he responds with a voice memo. I think im going to email his secretary this morning and ask if he’s had a cancellation for one of his zoom sessions. A 10 email/voice memo just doesn’t seem adequate for discussing what I’m dealing with. I know my local psych provider wouldn’t have a clue or understanding of what I’m dealing with or how to address it. 
Now I’m at the beginning of dragging through a very long day. I don’t feel like doing anything. Im just a llmp lump in my recliner. I need to get some exercise but I just don’t think I can muster the energy to do it today 🥲
 

 

 

33 minutes ago, Pokey449 said:

@NT1100B @Chippy @Nemina Morning ( here at least) everyone. Another awful night. I’m on a 1 now feeling rotten.  I think I’m progressively getting worse. Well I know I am when looking ffom the beginning of my taper to now. It’s bend a slow gradual decline.I knew something wasn’t right about this taper as I neared the dose I’m at now. Couldn’t put my finger on it. Maybe will never know for sure but now im pretty sure what’s happening based on what Sminismoni explained to me. It seems the sedating affects of the doxepin at the dose I’m at now in combination with the sedating affects of the mirtazapine are impacting my brains control of my respiration which in turn triggers a fight or flight response. I just know I wake up SOB  and very anxious. I feel like it’s slowly getting worse. And it’s scary. I fear it’s impacting my brain, heart and other functions. Honestly I’m afraid of dying in my sleep. 

Morning @Pokey449 Sorry you are having such a bad day again. It's hard to know what to suggest. Your situation is very unique. Obviously you have been slowly moving your dose across and I don't think you have been feeling any better as a result currently. I do wonder if the move is not helping things. The brain likes consistency and obviously splitting your dose isn't that. Perhaps its worth pausing your transition for the minute as you are feeling so bad.

 

33 minutes ago, Pokey449 said:

I don’t know what the solution is?? I have a 10 minute session with Horowitz on Thursday. It’s what is called a 10 minute email/voice memo session. I send him a question and he responds with a voice memo. I think im going to email his secretary this morning and ask if he’s had a cancellation for one of his zoom sessions. A 10 email/voice memo just doesn’t seem adequate for discussing what I’m dealing with. I know my local psych provider wouldn’t have a clue or understanding of what I’m dealing with or how to address it. 
Now I’m at the beginning of dragging through a very long day. I don’t feel like doing anything. Im just a llmp lump in my recliner. I need to get some exercise but I just don’t think I can muster the energy to do it today 🥲

Are you able to get a full session with Dr H soon and have a good chat with him?

 

There are situations where continuing to hold isn't for the best. For example is you are having a ADR to a drug.

Generally though as you reduce your dose an ADR would improve not worsen. I know you are also concerned about getting more issues the lower you go with sedation.

 

Wish I could say more mate, I just hope you can get a better sleep tonight and feel easier in the morning. 

 

Chippy

Hi @Chippy  I’ve been holding my doxepin dose, not moving it forward. In fact I moved it back an hour. Maybe I shouldn’t have done that but I don’t think that’s the issue. 
According to the psychiatrist, Sminismoni,  who responded to my posts the other day it sounds like from what he described I am having essentially an ADR.  Both Doxepin & mirtazapine are more sedating in the lower dose ranges where I’m at now.  They have a strong histamine blockade affect which he says affects the part of your brain that controls respiration, which is why I’m waking with SOB. Which in turn triggerd a fight or flight response aka anxiety. He also said reducing the Doxepin even more will not stop this response as it’s a function of the drug at low doses, not a WD affect. So I’m F****d in that regard. I think about the only thing I can do which I need to run by Horowitz is to go back up on the doxepin. Stabilize and then think about tapering off the mirtazapine. I feel so rotten now I don’t know if I’ll even make it to try that. 

24 minutes ago, Pokey449 said:

Hi @Chippy  I’ve been holding my doxepin dose, not moving it forward. In fact I moved it back an hour. Maybe I shouldn’t have done that but I don’t think that’s the issue. 

Oh ok with you. No I think you should stay where you are now. I don't think you should have moved it but it is what it is now. Your system has had a lot of changes and I don't think this helps matters. But maybe that isnt the issue as you say.

 

24 minutes ago, Pokey449 said:

According to the psychiatrist, Sminismoni,  who responded to my posts the other day it sounds like from what he described I am having essentially an ADR.  Both Doxepin & mirtazapine are more sedating in the lower dose ranges where I’m at now.  They have a strong histamine blockade affect which he says affects the part of your brain that controls respiration, which is why I’m waking with SOB. Which in turn triggerd a fight or flight response aka anxiety. He also said reducing the Doxepin even more will not stop this response as it’s a function of the drug at low doses, not a WD affect.

 

Im not sure what to say that about her assessment as its beyond my experience mate. 

 

24 minutes ago, Pokey449 said:

I think about the only thing I can do which I need to run by Horowitz is to go back up on the doxepin. Stabilize and then think about tapering off the mirtazapine. I feel so rotten now I don’t know if I’ll even make it to try that. 

As you said here. Present your thoughts to Dr H and see what he says. If only the doctors knew about this stuff. You shouldn't have to figure all this out on your own!

 

Chippy

@Chippy I found a 25 minute slot for a Zoom with Horowitz on Thursday. He will be getting tired of me as this will be my 3rd session with him.  It’s another $275 which this is starting to get pricey.  
I need to figure this out as my tired old body has tried to fall asleep twice while drafting this message to U. I’m absolutely useless today when I should be out walking a couple mile. 

5 minutes ago, Pokey449 said:

@Chippy I found a 25 minute slot for a Zoom with Horowitz on Thursday. He will be getting tired of me as this will be my 3rd session with him.  It’s another $275 which this is starting to get pricey.  
I need to figure this out as my tired old body has tried to fall asleep twice while drafting this message to U. I’m absolutely useless today when I should be out walking a couple mile. 

That’s a good plan. You’re worth the money mate. I really hope you find a solution to all this soon. You’ve been struggling a long time now it’s not fair. 

Dear @Pokey449 what terrible situation you’re in! I’m so sorry for you. It is very wise to invest the money in your health, this is such a tricky situation. You really need a professional.  There’s not much right now We can do here for you, but I wanted to let you know that here are people thinking of you. 

Thanks @Nemina  I appreciate your thoughtfulness. I appreciate everyone here for that matter. In a real way we are a forgotten population, an ignored one by a majority of the psychiatry profession. 

Evening @Pokey449

 

Just thought I’d drop by and say I’m so sorry to hear you’re struggling so much. I see you have a zoom appointment with Dr Horowitz on Thursday? Hopefully he can shed some light on your situation and decide which drug to taper first. At least then it will give you some guidance and a direction to move in along with a little reassurance. 
I hope things pick up for you soon. 
 

Thinking of you 

 

Nick 

I’m sending prayers your way@Pokey449. It’s sometimes difficult for me to be active on here. But I wanted to drop by and give some support. I remember you from SA and hope that you can get everything sorted out so that you’re breathing better and can sleep better as a result. 
 

Try to remain positive with all of this even though it feels really sh!tty. Stressful thoughts on top of stressful thoughts creates more of the same. Let us know your next steps after you meet with Mark. 🙏

 

Be well, my friend. 

@namastejen1 @NBJ71 Thanks for kind words and support. Really means a lot. I’ve been really scared with what’s been going with my situation. It’s a lonely thing we all are going through, especially in the dark silence of the night when waking up to the drug demons. It’s helps to know I’m not alone and that we all are either praying for or cheering each other on. Best to both of you 

Pokey 

2 hours ago, Pokey449 said:

@namastejen1 @NBJ71 Thanks for kind words and support. Really means a lot. I’ve been really scared with what’s been going with my situation. It’s a lonely thing we all are going through, especially in the dark silence of the night when waking up to the drug demons. It’s helps to know I’m not alone and that we all are either praying for or cheering each other on. Best to both of you 

Pokey 

You are not alone Pokey we are all here for you just wish we could say more. 

How was last night, @Pokey449? What question do you want to address tomorrow to Horowitz?

Svetla

Hi Svetla & Chippy. Yes I’m having my 3rd session with Horowitz tomorrow. It’s starting to get $$$ but he’s the only doc I’ve talked with in some time that seems to know what’s going on with this taper business and these meds. My psych doc, while being a kind & caring person admits he “doesn’t know what else to do for me” and my primary care doctor is clueless about how to get off these poisons. I told him I belonged to SA,ADR and he considers us all to be a group of “outliers” is the term he used. That it’s “typically easy to get off an AD in a few weeks” 😤 Needless to say I don’t share anything with him regarding my taper. 
 

Svetla as for what I’m going ask Horowitz I’m going to share the theory of what’s going on offered to me by @Sminismoni although he just PM’d me yesterday offering that he may be incorrect in his assessment of what’s going with me. But I still think it’s worth asking. I’m going to ask about the risk of over sedation as I go lower in dose with the doxepin. It paradoxically becomes more sedating as the dose decreases. So does mirtazapine. I’m going to ask if the miserable sxs I’m having in the wee hours are more a function of being an adverse reaction as opposed to a WD sxs? I tend to think that’s what’s going on. I think the doxepin is making my sleep apnea worse. I should have NEVER been put on doxepin as it is known to make sleep apnea worse and should not be given to people with a history of AFIB. Which I have both. Another example of docs handing these drugs out like candy.  
So I’ll have a prepared list of questions so I’m optimizing my time with Horowitz. He’s a personable guy, I think very smart and knows the subject matter well. If you can afford it I think a session with Jim Svetla would be worth your $$ and time 

Pokey

Morning folks. Last night was another night of waking in the wee hours with very uncomfortable sxs.  I tend to think I’m having symptoms from an adverse drug reaction(s) to the doxepin in combination with the mirtazapine. I think it’s making my sleep apnea worse for one in some way. Perhaps suppressing my respiration. Other sxs include headaches, nausea,?what I call Akathisia  and pain. But after I get up and have breakfast & move around a bit the sxs dissipates. I don’t think WD sxs would go away that easily??? Will be interested in how Horowitz sees that. Most interested in his advice as to what to do next. I don’t think I can keep this misery up. It’s killing me