I think it is all correct now. I do not have all the data sheets for my doxepin taper early on. I spilled hot coffee on them and they were pretty much toast. I offered my best recollections for those dose reductions. In looking over what I do have it appears I made some cuts to fast. I was going off past history when I tapered doxepin and did it pretty quickly with little problems. This time is VERY DIFFERENT. Ive had both my doxepin doses now for thee day and am not feeling the best.  

I am so sorry pokey that this is so hard for you! Hopefully the stabilizing will help. We think of you!

Thanks @Nemina I hope the small updose settles things down…soon!!!! I’ve decided, for the time being anyway I’m going to target getting to 25mg  

of the Doxepin and once well  stabilized just stay there.  At 76 life’s to short to be struggling with this another 1-2+ years and then I could still not feel that great for a while after getting off. Horowitz thought that was a reasonable thing to consider. 

It’s just to much to deal with!!!!!

I absolutely understand. You need quality of life, you need peace and good sleep. I pray that you will reach a place where you feel better soon. 

Hi @Pokey449 very sorry things are going BAD for you mate. Stability I think is the only one

at the moment mate. From what I see and read, very long holds often resolve the problems, but

when time isn't on our side, it makes this option more difficult. WE just want to be WELL again.

Lack of sleep is horrific, I am regularly doing 20-21 hour days, and they are a killer. I am wishing

you all the best Pokey, all I can say is TAKE THINGS SLOW.

Take care,        B.🙏 

Morning Pokey, here in the UK 🙂

 

I hope you slept ok my friend?

 

Ive just been through your whole SA thread from start to finish to reconstruct your taper history. Ive redone your signature based on this, It is quite long but Im fine with that as it gives us a better history for you.

 

I have a few thoughts:

 

Having started Doxepin 25mg on the 13th January 2025 and very quickly doubling your dose on the 16th January 2025 to 50mg I note that:

 

1. Between the 17 Jan 2025 and the 05 Feb 2025 you did a very fast taper of nearly 65% of your Mirtazapine from 7.5mg to 2.65mg

 

2. On the 06 Feb 2025 you up dosed Mirtazapine to 5.3 mg which is a big RI (100% jump)

 

3. On the 20 March 2025 you then made a further up dose of Mirtazapine back to your original dose of 7.5mg (41.5% increase)

 

4. 24 March 2025 you dropped your Doxepin from 50mg to 45mg whilst I believe suffering from dysregulation from Mirt changes. This would have caused additional kindling and worsened you.

 

5. A few days later on the 04 April you said your sleep had 'gone to hell in a hand basket'......

 

6. On the 07 April 2025 you stated you would try to split your Doxepin dose. I suspect this was to try to combat the sleep issues you were having from the Mirt changes, thinking you were having Inter-dose withdrawal from the Doxepin. As you know sudden shifts in doses whilst not stable are not a good idea and this wouldn't have helped.

 

7. 09 April 2025 you seemed to have stopped splitting your doses and instead moved your entire dose from bedtime to morning. Again more shifts whilst not stable.

 

8. From 14 April to 15 June 2025 you continued to drop whilst not having ever stabilised from your bad Mirt taper/RI.

 

9. I note more attempts during this period to move your Doxepin dose around. Also no crossover undertaken from what I can see just jumping times.

 

10. 08 July 2025 said you took an extra 1/4 tablet of Mirtazapine.

 

11. From here you never seem to be stable (the odd day here and there a bit better but perhaps windows rather than stablisation) and yet keep making drops in-spite of feeling bad. 

 

12. I can see at the start of 2025 you had only been on Doxepin a month and wanted to just stop it. It was a shame you didnt then I think. I think you tried to taper Mirt to 'compensate' for the introduction of Doxepin. I belive this was the start of all your woes bud.

 

13. Having remained on the drug for a few months I think both you and Jane were trying to get you off over a quick period using 25% drops but in a micro taper/BM fashion to avoid further dependence. I believe what you both hadn't spotted is that you were suffering from WD/nervous system dysfunction from all the changes you had made with your Mirt dose in Feb 2025.

 

So in short I think your CNS has NEVER had a chance for the past 12 months to settle down and instead had numerous changes dropped on it causing kindling on an almost bi-weekly basis at points. (You were trying to drop every 10 days at one point from what I read).

 

I don't see an ADR here from Doxepin (you reacted well to your recent up dose) I just see old fashioned WD injury/dysregulation at play. Each time to you take another drop your system gets more angry which makes sense, but you think it is the lowering doses that are causing the problems........

 

@getofflex Could you have a read and see what you think? Appreciate you as ever for helping 🙂 

 

Chippy

@Chippy Holy Moly!!! You went above and beyond Chippy to help me understand what all has transpired. I don’t know how to thank you?!?!  I don’t even remember most of that. I only recall that the original plan, per me and my psych doc was to put me on the Doxepin and taper off the mirtazapine, but for whatever logic/reason that I don’t recall now, the decision was made to reverse that strategy. So I guess that explains the yo-yoing back n forth that was going on. My psych doc, actually he’s a physicians assistant, like most psych docs has no clue about this sort of thing. I do recall early on Jane suggesting I dump the doxepin. I recall being afraid at the time to do that. A big mistake on my part in retrospect. 
So if I’m hearing you correctly all this explains the symptoms and misery I’ve been going through. It’s cumulative. My only option now is to hold until stable between cuts and make small cuts.  I’ve never had to 2 ADs before in my brain at the same time. I think this alone  has added to the deregulation???? So extra carefulness is needed????? There’s no ADR going on, just my brain trying to stabilize to the “chaos”???

Thanks again Chippy. I don’t know how to thank you for what you did. That took a lot of time and effort. I’d have never figured it all out. 🙏🙏🙏🙏🙏🙏🙏

Pokey

 

ps. I got more sleep last night, thankfully, though I continue to wake up 1-3x with very uncomfortable sxs that I’m not sure what’s happening. Feels like I’m not breathing right but I’m unable to pin down a cause/effect relationship. Whatever it is it’s scary and unpleasant that takes time to wear off. I go back to sleep only to awaken later to the same awful symptoms. I think my breathing is being compromised. 🤔

@Nemina @NT1100B B and Nemina thanks for your kind words and support. So wonderful to have kind caring folks like you to offer support. Certainly the doctors and often times our friends and family have no comprehension what we are going through. My wife seems to think a lot of my discomfort is old age aches and pains and is to be expected 😩 She knows tapering is hard but just can’t believe it’s as hard as I say it is. Anyway thanks again. I hope you both are doing as well as can be expected. 
Pokey. 

45 minutes ago, Pokey449 said:

My only option now is to hold until stable between cuts and make small cuts.

I think your only option is to hold indefinitely until you are very stable. IMO. Then you have some decisions to make. If you want to get your drug load down then you would start to taper one of them carefully holding when there’s trouble and either try and get off or hold forever at lower doses. Or honestly if you can get stable just stay put and live your life. 
 

But for the minute you need to not budge an inch in my view. For months now. Just sit tight and ride it out. More changes. More chaos.
 

Getofflex I’m sure will be by at some point to give you her point of view.  
 

Wish there was a magic wand here but time as ever is the answer I think. 
 

I’m glad you slept a bit better. Hopefully slowly but surely this will improve if you sit tight here. These damm drugs honestly. 😡

To add:

 

Id leave the split dose as is, don’t move it further to bed time. Don’t drop back to a single dose. 
 

If your taking 0.6mg extra not 0.5mg dr H suggested leave that as 0.6mg. 
 

I assume you’ve added the 0.6mg to one half of your split? If so leave it like that. 
 

No change in measuring equipment brand/style of drug, nothing just sit exactly as you are! 🙂
 

1 hour ago, Pokey449 said:

Anyway thanks again. I hope you both are doing as well as can be expected. 
Pokey. 

Hey @Pokey449 thanks yourself Bud, it would be much better if we could meet under more normal

circumstances, BUT as you know, NOTHING is normal about these poisonous drugs from hell. WE are

a family, watching each others back until we get back to some normality🤞. I hope you are taking it slow

and easy Bud, we are with you ALL the way.

Take great care,        B.🤞

1 hour ago, Pokey449 said:

@Nemina @NT1100B B and Nemina thanks for your kind words and support. So wonderful to have kind caring folks like you to offer support. Certainly the doctors and often times our friends and family have no comprehension what we are going through. My wife seems to think a lot of my discomfort is old age aches and pains and is to be expected 😩 She knows tapering is hard but just can’t believe it’s as hard as I say it is. Anyway thanks again. I hope you both are doing as well as can be expected. 
Pokey. 

My pleasure.🙂

It’s true, other people cannot understand what we are going through. I try to not burden my husband too much with it and prefer to complain on this forum. Here are people who understand. Chippy has done a wonderful job of sorting your history out. I’m quite impressed and I think his advice is very sound. So we all hope now with and for you that finally not moving anything for a very long time will ease your symptoms.

take good care!

@Chippy Got it!! Not changing a thing until hopefully feeling like a more normal human being again. After reading the breakdown you so unselfishly did of my dosing etc.  its no wonder I'm a mess now.

18 minutes ago, Pokey449 said:

@Chippy Got it!! Not changing a thing until hopefully feeling like a more normal human being again. After reading the breakdown you so unselfishly did of my dosing etc.  its no wonder I'm a mess now.

Thats it! 🙂

 

When you look at it in hindsight it isn’t a surprise really is it! Hope things settle down sooner rather than later mate. 

I can’t account for what the difference is between getting a decent nights sleep as I did Sunday night and a terrible nights sleep as was the case last night. 
Maybe I just have to many complicating factors: WD from tapering, being on CPAP for sleep apnea, mitral valve regurgitation, low back pain. If it’s not one thing it’s another. 
Yesterday I was feeling much better, thinking the 0.5mg up dose was going to smooth things out and “I got this”!!!!
180 degrees difference today 😪🫩 This s**t is exhausting.  But I need to stop whining/venting and do something positive. Later

Pokey 

 

Sorry Pokey. This is the pattern of healing isn’t it. Up and down like a yo yo. Yes go distract yourself with something you like to do. 
 

Chippy

On 2/23/2026 at 9:06 AM, Pokey449 said:

@Chippy Holy Moly!!! You went above and beyond Chippy to help me understand what all has transpired. I don’t know how to thank you?!?!  

@Chippy is a real help! He was really committed to helping you, Pokey, through this. I saw the breakdown above. Is there PTO (paid time off) for you? 

 

Pokey, I hope that the ups and downs even out soon. It is still good to see a better night's rest for you. Here's to another good one 🙏🏼

@namastejen1 fortunately I’m retired and don’t have to worry about  income like B does. That’s a tough spot for him to be in and undoubtedly there are others here in the same boat. I did taper off a benzo when I was still working and thankfully I had a health provider that worked with me and I had virtually no trouble with that taper. 
But this one is kicking my backside. Im tired all the time. Dont feel like doing much. I had to drop out of the orchestra i was playing in as it was to much 😢 and I love playing my horn in an orchestra. I just got back from a long walk & im pooped. Normally something like that makes me feel better. I’ve been pretty active most of my life but I’m like a lump of mashed potatoes some days now with this miserable taper. 
Yes, I can’t tell you how much I appreciate what Chippy did for me. . It was an effort above & beyond on his part. Hope I can repay him somehow. 
 

How are you doing??

Morning friends.  Last night was awful. I feel awful now. Hardly any sleep. Up & down multiple times. Woke several times gasping for breath. Numerous times I’d be just on the edge of falling asleep and wake suddenly gasping for air.  I use a Cpap machine for sleep apnea and ive been having lots of trouble with that, not being able to breathe well and end up not using it which is not good for my health. Then there is the Akathisia that was really terrible. The most god awful creepy crawly feeling that came & went on me in sickening waves coupled with sob. I was up going back n forth between my bed and my living room recliner multiple times in the night trying to find some comfort & sleep, to no avail. 
I still remain worried what I’m dealing with is more than garden variety WD. I still wonder about an ADR between the mirtazapine and doxepin. Serotonin toxicity ????  Then I wonder if my Sob is due to my heart or if the drugs are negatively affecting my heart.  I have mitral valve prolapse with regurgitation that we’ve been watching for years and has been OK. But is the doxepin making it worse now?? 

I get the scary feelings I’m not going to survive what’s going on. This morning at 4 I was sure I’m going to die from what’s happening to me. I feel like I’m slowly spiraling down a dark hole. It’s to much!! And what’s become really scary are the thoughts that I’m not sure I want to survive it. It’s just to F’ing miserable 😢🫩
 

 

 

Oh no, I am so sorry 😢. I wish I could do something for you. I keep you in my prayers.

Oh, @Pokey449, indeed, it is to much, it is unbearable, this suffering cannot be put into words, I completely agree with you. But we don't have any other choice, NO CHOICE, Pokey, we have to hold on.

Svetla

2 hours ago, Pokey449 said:

Morning friends.  Last night was awful. I feel awful now. Hardly any sleep. Up & down multiple times. Woke several times gasping for breath. Numerous times I’d be just on the edge of falling asleep and wake suddenly gasping for air.  I use a Cpap machine for sleep apnea and ive been having lots of trouble with that, not being able to breathe well and end up not using it which is not good for my health. Then there is the Akathisia that was really terrible. The most god awful creepy crawly feeling that came & went on me in sickening waves coupled with sob. I was up going back n forth between my bed and my living room recliner multiple times in the night trying to find some comfort & sleep, to no avail. 
I still remain worried what I’m dealing with is more than garden variety WD. I still wonder about an ADR between the mirtazapine and doxepin. Serotonin toxicity ????  Then I wonder if my Sob is due to my heart or if the drugs are negatively affecting my heart.  I have mitral valve prolapse with regurgitation that we’ve been watching for years and has been OK. But is the doxepin making it worse now?? 

I get the scary feelings I’m not going to survive what’s going on. This morning at 4 I was sure I’m going to die from what’s happening to me. I feel like I’m slowly spiraling down a dark hole. It’s to much!! And what’s become really scary are the thoughts that I’m not sure I want to survive it. It’s just to F’ing miserable 😢🫩

Morning Mate

 

Im very sorry you are suffering so. My heart goes out my friend.

 

Im not saying you are not having other interacting issues but with everything you have been through you need a good looooong hold here to see the benefit of what we talked about a couple of days ago, no magic fixes here.

 

Its only been a couple of days since your updose and as much as your wave brain wants to take you to all the unexplained possible options your mind can come up with, try to remember that what you are going through is very typical of someone who's nervous system has had so much happen to it in the last 12 months.

 

I know that wont make this any easier but perhaps it might settle your mind from catastrophizing about things.

 

I am very much hoping things get better sooner rather than later mate.

 

Chippy

Thanks @Chippy I hear what you are saying and I do acknowledge that my anxiety may be/likely is getting the better of me at times like last night.  But then I go and wonder what am I to do with hard facts like my SPO2 going below 95% often and I’m  waking with SOB while knowing I have a leaky mitral valve. Facts get mixed in with the anxiety & exhaustion and it becomes hard to sort potential real possibilities from an exhausted catastrophizing anxious mind. 
I can’t imagine feeling any worse than I do today. I’m nothing but a couch potato and feel like doing absolutely nothing, but that means I’m missing out on life today 🫩
Good thing I’m retired I guess. 

@namastejen1 @Nemina @skamen thanks for your kind words. I think it’s really important and helpful to support each other. Everyone else in our individual lives really doesn’t understand what we are going through. 

@Chippy  is there any information on SA or here about when to take your daily dose(s) in relation to meals. It just dawned on me. I ask because I take my 1st 1/2 of my doxepin dose at 8am which is 2hrs to 30 minutes after my breakfast, depending on when I get up. I take my 2nd 1/2 dose at noon which is near my lunch time. I’m just wondering if food is affecting the absorption of my doxepin doses, thus WD symptoms.