I was Just looking for some more advice.

I am currently on 45mg of mirtazapine and 100mg of sertriline. I am also on 70mg of quetiapine which I have tapered down from 300mg since November gone.

Before I was put on these last June the doctor took me escitralapam I he’d been taking for many years and switched me to the sertriline and mirtazapine. She also gave me 15mg of diazapam for 6 months that she took me off in 5 weeks.

I am still not stabilised at all and was wondering if I should continue tapering or hold until I stabilise and if so how long it could take.

Thanks in advance

Tony

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.

Please use the format outline here Preferred signature/drug history format

As above could you update your signature to include your complete history and as much information as you can on your taper with dates and doses etc....? Thanks :)

2 hours ago, TonyA said:

Before I was put on these last June the doctor took me escitralapam I he’d been taking for many years and switched me to the sertriline and mirtazapine.

Can I ask why your doctor switched you? Did you suddenly start to have symptoms? This could be down to tolerance/poop out of the drug. Doctors often try to deal with this by changing drugs. This often worsens folk. In this situation it is seen that actually tapering can 'outrun' the tolerance and force the brain to 'catch up' and stablise.

2 hours ago, TonyA said:

I am currently on 45mg of mirtazapine and 100mg of sertriline. I am also on 70mg of quetiapine which I have tapered down from 300mg since November gone.

Thats a lot of drugs to get given especially here in the UK. We are generally a little more cautious than the US. Are you having sleep issues, looking at the Seroquel and Mirt? Sleep in WD

 

2 hours ago, TonyA said:

I am still not stabilised at all and was wondering if I should continue tapering or hold until I stabilise and if so how long it could take.

Thanks in advance

We only suggest tapering in most cases, (Tolerance and severe ADR asides) whilst stable and at no more than 10% of your last dose. Tapering Information

I have seen quite a few people in this postion where they are switched to another drug/s from the orginal drug, that destablises them and then they try tapering off as they 'never feel stable'. Personally I think a really long hold would be best rather than pushing on with any further reductions. This can often need to be many months to find your WD Normal Baseline, which we would suggest to be a prolonged period of symptoms you can rate to be 1-3/10 in severity. (1 being mild, 10 being severe). From here you will have the platform needed to support a gradual taper off each drug rather than making things worse with further reductions. Hypersensitivity and kindling

Have a good read of our coping skills section, I believe these are fundamental in helping us cope with WD. Acceptance is the most imoportant of skills. Acceptance is key - Why does acceptance feel impossible?

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.

1 hour ago, Chippy said:

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.

Please use the format outline here Preferred signature/drug history format

As above could you update your signature to include your complete history and as much information as you can on your taper with dates and doses etc....? Thanks :)

Can I ask why your doctor switched you? Did you suddenly start to have symptoms? This could be down to tolerance/poop out of the drug. Doctors often try to deal with this by changing drugs. This often worsens folk. In this situation it is seen that actually tapering can 'outrun' the tolerance and force the brain to 'catch up' and stablise.

Thats a lot of drugs to get given especially here in the UK. We are generally a little more cautious than the US. Are you having sleep issues, looking at the Seroquel and Mirt? Sleep in WD

 

We only suggest tapering in most cases, (Tolerance and severe ADR asides) whilst stable and at no more than 10% of your last dose. Tapering Information

I have seen quite a few people in this postion where they are switched to another drug/s from the orginal drug, that destablises them and then they try tapering off as they 'never feel stable'. Personally I think a really long hold would be best rather than pushing on with any further reductions. This can often need to be many months to find your WD Normal Baseline, which we would suggest to be a prolonged period of symptoms you can rate to be 1-3/10 in severity. (1 being mild, 10 being severe). From here you will have the platform needed to support a gradual taper off each drug rather than making things worse with further reductions. Hypersensitivity and kindling

Have a good read of our coping skills section, I believe these are fundamental in helping us cope with WD. Acceptance is the most imoportant of skills. Acceptance is key - Why does acceptance feel impossible?

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.

Hi chippy

Thank you for responding and having me here.

The doctor took me off the escitralapam in march 25 in one saying they went working.

She put on sertriline and upped that to 200mg before bringing me back down to 50mg in the mean time she took me off diazapam I had been taking for 6 month at 15mg a day in 5 weeks. As I got worse she gave me mirtazapine on top at 30mg.

As I furtdeclined I got sent to the mental health team were the psychiatrist put me on quetiapine in September last year and titrated me up to 300mg and upped the mirtazapine to 45mg. In this time I started looking into things myself but by then it was to late.

I am now doe to 70mg or quetiapine.

I have never really stabilised and just feel so hopeless now.

In summary I am on 70mg of quetiapine 45mg of mirtazapine and 100mg of sertriline.

I don’t know if I should hold or keep going.

I feel like the worst case ever and fear I will never get better. This has been going on for 18 months. I really need some guidance.

Many thanks

Tony

Can anyone else help with this please.

27 minutes ago, TonyA said:

I feel like the worst case ever and fear I will never get better. This has been going on for 18 months. I really need some guidance.

do you feel you have adverse reactions or you are just still destabilized ? have you seen any progress in the last 18 months ?

Assuming you are truly destabilized, and you are slowly improving, holding would be the best options, this road isn't a short one, especially with a big drug history, but you will improve and heal.

You may still decide to taper, but you might consider going even slower than 10% again due to you being switched out with a lot of drugs (you are on high doses so the first reductions could be bigger as on highest doses there isn't much receptor occupancy change, but after that you go slower.)

If you decide to taper and not continue holding, you need to decide which drug is the worst for you in terms of effects, maybe one drug is over stimulating you so you want to reduce the dose of one drug for a period before moving to another one of the drugs.

again there is a good chance you will see you can't handle tapering with you being destabilized, which means you probably need to hold for longer.

31 minutes ago, TonyA said:

Hi chippy

Thank you for responding and having me here.

Pleasure and you are very welcome.

31 minutes ago, TonyA said:

The doctor took me off the escitralapam in march 25 in one saying they went working.

She put on sertriline and upped that to 200mg before bringing me back down to 50mg in the mean time she took me off diazapam I had been taking for 6 month at 15mg a day in 5 weeks. As I got worse she gave me mirtazapine on top at 30mg.

As I furtdeclined I got sent to the mental health team were the psychiatrist put me on quetiapine in September last year and titrated me up to 300mg and upped the mirtazapine to 45mg. In this time I started looking into things myself but by then it was to late.

This makes sense. GPs in the uk don’t usually offer so many drugs. I’m sorry it’s so common for psychiatrists to just keep adding pills and shifting doses hoping something works. They have nothing else to offer.

33 minutes ago, TonyA said:

In summary I am on 70mg of quetiapine 45mg of mirtazapine and 100mg of sertriline.

I don’t know if I should hold or keep going.

I feel like the worst case ever and fear I will never get better. This has been going on for 18 months. I really need some guidance.

As I said in my intro post I think your best bet is to not move doses any more and hold till things ease.

I’ve heard so many people say that they are the worse case ever and won’t get better. This can’t be true for everyone and it isn’t for you. Will arent the worse case ever and, you not alone. You will get better.

Ultimately you have to decide what is best for you based on what you have learned. I’d make the choice to stay put and commit to it for as long as it takes for things to be more stable. If you keep tapering now I think you’ll make yourself worse and worse until eventually you’ll be off the drugs but have a long recovery ahead. If you can get stable you can live whilst you taper off and your nervous system will be in a better place once off.

12 minutes ago, Lighty said:

do you feel you have adverse reactions or you are just still destabilized ? have you seen any progress in the last 18 months ?

Assuming you are truly destabilized, and you are slowly improving, holding would be the best options, this road isn't a short one, especially with a big drug history, but you will improve and heal.

You may still decide to taper, but you might consider going even slower than 10% again due to you being switched out with a lot of drugs (you are on high doses so the first reductions could be bigger as on highest doses there isn't much receptor occupancy change, but after that you go slower.)

If you decide to taper and not continue holding, you need to decide which drug is the worst for you in terms of effects, maybe one drug is over stimulating you so you want to reduce the dose of one drug for a period before moving to another one of the drugs.

again there is a good chance you will see you can't handle tapering with you being destabilized, which means you probably need to hold for longer.

Hi Lightly

Thank you for your reply.

I do feel like I have got better there has been times I have managed to get back to work but then just been crushed. I dropped on the quetiapine from 100mg to 75 mg and had three good weeks and then I hit a wall again.

I held at 75mg for 12 weeks and still felt the same so went down to 70mg about 5 weeks ago.

I don’t know weather I will ever get better or would it be better to do a long hold.

Thank you so much.

16 minutes ago, Chippy said:

Pleasure and you are very welcome.

This makes sense. GPs in the uk don’t usually offer so many drugs. I’m sorry it’s so common for psychiatrists to just keep adding pills and shifting doses hoping something works. They have nothing else to offer.

As I said in my intro post I think your best bet is to not move doses any more and hold till things ease.

I’ve heard so many people say that they are the worse case ever and won’t get better. This can’t be true for everyone and it isn’t for you. Will arent the worse case ever and, you not alone. You will get better.

Ultimately you have to decide what is best for you based on what you have learned. I’d make the choice to stay put and commit to it for as long as it takes for things to be more stable. If you keep tapering now I think you’ll make yourself worse and worse until eventually you’ll be off the drugs but have a long recovery ahead. If you can get stable you can live whilst you taper off and your nervous system will be in a better place once off.

Hi Chippy

Again thankyou

I held at 75mg of quetiapine for 3 months and did not seem to get any better so I dropped any5mmg to 70 about 5 weeks ago.

Should I do a long hold.

I feel like nothing is going to work and I won’t get better.

Thanks for your support

Tony

1 hour ago, TonyA said:

Hi Chippy

Again thankyou

I held at 75mg of quetiapine for 3 months and did not seem to get any better so I dropped any5mmg to 70 about 5 weeks ago.

Should I do a long hold.

I feel like nothing is going to work and I won’t get better.

Thanks for your support

Tony

I can imagine how disappointing it must have felt to held for that time and still not get any better.

Long holds sometimes need to be for 12+ months.

Do you react to any of your doses? As in does actually taking a dose worsen you in any way?

Hi Chippy

Thanks again for your help.

I don’t react that I’m aware of but my brain fog has seemed to got worse since I we nt down 5mg.

Tony

14 minutes ago, TonyA said:

Hi Chippy

Thanks again for your help.

I don’t react that I’m aware of but my brain fog has seemed to got worse since I we nt down 5mg.

Tony

That is good to hear you don’t seem react to the dose.

You could try updosing and see if it helps. I think Id opt to hold though personally. If you wanted to try I’d only go up 2mg (2.5% ish of your current dose) to be safe as it’s been 5 weeks. As with RI there is always a chance it may worsen you.

Either way I think you’ll need to long hold before tapering imo. Wish there was a quick solution, there often isn’t in wd unfortunately.

L I C

Thank you so much. I will take your valued opinion and hold.

I held for 3 months at 75mg and did not seem to get better that’s why I dropped agin.

What is a long hold and can I stabilise on the meds I’m on.

Again thankyou for your help it is really appreciated.

Tony

10 minutes ago, TonyA said:

L I C

Thank you so much. I will take your valued opinion and hold.

I held for 3 months at 75mg and did not seem to get better that’s why I dropped agin.

What is a long hold and can I stabilise on the meds I’m on.

Again thankyou for your help it is really appreciated.

Tony

A long hold can be many months even 12-18.

There are no certainties in any of this unfortunately but I believe you can stabilize given enough time, the body is amazing.

1 hour ago, TonyA said:

L I C

Thank you so much. I will take your valued opinion and hold.

I held for 3 months at 75mg and did not seem to get better that’s why I dropped agin.

What is a long hold and can I stabilise on the meds I’m on.

Again thankyou for your help it is really appreciated.

Tony

Hey @TonyA as Chippy said, long holds can be even a year. You are experiencing withdrawal from the escitalopram and the Benzo. The doctors poly drugged you to try to cover up the withdrawal. This can take some time to reach any stability

It would be great if you could add exact dates and doses to your signature including the escitalopram. When you started etc . Thanks.

According to you, the brain fog got worse with your last drop. I encourage you to hold till this improves significantly. ❤️🙏

Thank you so much L I C your help is appreciated

Will I function in this time.

Tony

56 minutes ago, TonyA said:

Thank you so much L I C your help is appreciated

Will I function in this time.

Tony

Yes, time will bring healing.

What are your symptoms? I am sorry you are suffering. Treat yourself with kindness, understanding and patience. You did nothing wrong. The doctors don't understand and Big Pharma has lied about these drugs. Your body wants to heal. Eat healthy, try gentle walks, stay hydrated. Avoid alcohol, nicotine, caffeine, too much sugar, artificial sweeteners. Eat while healthy foods.

We are here for you. ❤️🙏

L I C you are very kind for helping me and welcoming me. I will add all the dates soon.

Thanks again.

Tony

My symptoms are brain fog, apathy and fear. X

47 minutes ago, TonyA said:

My symptoms are brain fog, apathy and fear. X

Those are all common symptoms unfortunately....they will get better. There are CBT materials on line that can help with the fear. Remember thoughts and feelings aren't facts. I know it's hard, I too am dealing with this at present. ❤️🙏

https://www.cci.health.wa.gov.au/resources/looking-after-yourself

Cognitive Behavioral Therapy Los Angeles

Free Online CBT Workbook - Learn CBT Skills Online

A free online CBT workbook from doctoral psychologists: 8 parts covering goals, automatic thoughts, restructuring, and exposure. Start any chapter.

Edited August 1Aug 1 by LostinCanada

Hi L I C

I am sorry to hear you are tlo dealing with this. I thought you were better.

Do you get anxiety in the mornings too.

I wake up and it is awful.

I hope you are feeling better soon. ❤️

5 minutes ago, TonyA said:

Hi L I C

I am sorry to hear you are tlo dealing with this. I thought you were better.

Do you get anxiety in the mornings too.

I wake up and it is awful.

I hope you are feeling better soon. ❤️

Hi @TonyA a lot of us are dealing with this. You are far from alone ❤️

Anxiety is worse in the mornings because of natural cortisol spikes that help wake us up - to a sensitive nervous system its like throwing water onto a pan fire. It's very common.

Ways to help it is to not fight it and flow as much as you can. Think "oh there's my body over reacting while it heals."

Our bodies are always working towards healing. 💪

Hi @cherrysquid

Thank you for your reply. It’s so hard in the mornings. All as I want to do is get up and get back to normal. I feel bad all the time and just want to get back to the life I had. Back to work and doing the things I used to do.

Thanks for your support ❤️

Tony

10 minutes ago, TonyA said:

Hi @cherrysquid

Thank you for your reply. It’s so hard in the mornings. All as I want to do is get up and get back to normal. I feel bad all the time and just want to get back to the life I had. Back to work and doing the things I used to do.

Thanks for your support ❤️

Tony

I understand that feeling well. The amount of thinking and wishing I did earlier in my journey was unreal, but it doesn't help anything.

Have a look at some of our coping strategies we have:

Being human and dealing with emotions in WD

Acceptance is Key

Resilience Building: Self love & Worth

I don't think any of us will be our old selves again. When we recover - and we will - we will be a newer, better, stronger version of our old selves. Like shedding an old skin.

Hi C S

Thank you for this.

Will I stabilise on the meds I’m on.

Thanks

Tony

6 minutes ago, TonyA said:

Hi C S

Thank you for this.

Will I stabilise on the meds I’m on.

Thanks

Tony

I believe with consistency and time, yes.

It's an umbrella format, I would say, of recovering.

You need to show your nervous system routine and safety.

Listen to your body; you know it best. Hold as long as you need to. Do not taper too quickly. Take your meds at the same time every day. Look after yourself.