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Dr. Bob is Robert Hsiung, MD,
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Posted by 49er on September 21, 2008, at 11:28:24
In reply to Re: mirtazapine/remeron updates?, posted by Anxiety123 on September 11, 2008, at 12:06:56
> All these ADs work like that. Drs say they are not addictive but they are. You have to wean really slow, especially when you get to lower doses. I would recommend cutting no more than 1 to 2 mgs a month and even slower as you get lower. Maybe 1 to 2 mgs every other month. The chemicals in our brains are completely altered when taking these drugs and it takes awhile for the brain to know how to function properly without it. It is better to slowly wean so your brain can adjust as you get lower on the dose and finally off. Hope this helps some.
Anxiety,
That has definitely been my experience. I am now down to around 2.7mg. Even though the last few cuts I have made are 5% of the current dose with an average of 4 weeks between cuts, the withdrawal symptoms have been tough. I have been mainly dealing with insomnia and pseudoanxiety meaning I am anxious for no reason.
It seems as I have gotten lower that the withdrawal symptoms have increased in spite of my slow tapering. It is like this drug is saying that it is going to make it as tough as possible for me to get rid of it.
BUT I WILL PREVAIL COME HECK OR HIGH WATER!
Anyway, I know I sound like a broken record but this drug (or any psych med) needs to be tapered very slowly. A cold turkey or a fast taper is usually very dangerous.
49er
Posted by 49er on September 21, 2008, at 11:34:09
In reply to Re: mirtazapine/remeron updates?, posted by brazilnut on July 25, 2008, at 3:30:16
>
> Leo,
>
> Maybe cutting half is still too much. The recommended rate is about 10% each 10 days, 5% after arriving at 50% down.
>
> Good luck!
> Roberto
>
Roberto,This post may be too late as I haven't read the followups. But I wanted to post it for other people's benefit.
You're right to mention that dropping the dose of 3.25mg may be too much. However, I think your suggested tapering rate may still be too fast.
The Paxil Progress Boards, which is run by an RN who almost lost her son to a Paxil induced suicide/homicide while on on an MD advised taper, suggests 10% of the current dose every 3 to 6 weeks. With Remeron, as I have gone below 5mg, I have had to go even slower.
I think because it takes a minimum of two weeks for withdrawal symptoms to show up, that is the minimum amount of time you should wait.
49er
Posted by brazilnut on September 28, 2008, at 20:27:48
In reply to Re: mirtazapine/remeron updates? » brazilnut, posted by 49er on September 21, 2008, at 11:34:09
> Roberto,
>
> This post may be too late as I haven't read the followups. But I wanted to post it for other people's benefit.
>
> You're right to mention that dropping the dose of 3.25mg may be too much. However, I think your suggested tapering rate may still be too fast.
>
> The Paxil Progress Boards, which is run by an RN who almost lost her son to a Paxil induced suicide/homicide while on on an MD advised taper, suggests 10% of the current dose every 3 to 6 weeks. With Remeron, as I have gone below 5mg, I have had to go even slower.
>
> I think because it takes a minimum of two weeks for withdrawal symptoms to show up, that is the minimum amount of time you should wait.
>
> 49er
>Hi, 49er!
Youre right, its better to be on the safe side. The recommendation I mentioned is not mine, it is in Doctor Ashleys publication on withdrawal. Shes a British scientist who studied benzo (mainly) and A/D withdrawal for 12 years. It is stated as an average, but each person is different and nobody knows beforehand how one will react. I quitted mirtazapine at a 2% per week rate, and had no problems. However, Im suffering for 2 years after that to quit other stuff (next week Ill finish Inderal). And I have at home a good example on how people are different: my wife took Rivotril for 8 years, every night, stopped cold turkey, and nothing happened.
Thanks for your comment!
Roberto
Posted by AnitaDean on December 29, 2008, at 15:37:05
In reply to Re: mirtazapine/remeron updates?, posted by Car Gal on September 11, 2008, at 20:08:09
Is anyone still out there on this REmeron discussion? I just went from 1/2 to 3/8 of a 15mg. pill and WOW am I in a state of withdrawal. The insomnia has gotten better but it seems the anxiety doesn't want to go away. I went down 9 days ago and expected to feel normal about 4 days ago. Will my "withdrawal" get worse? I have only been on Remeron since July. I started at 15mg. then slowly cut down to 3/8 as of Dec. 20 (2008). Will my withdrawal be less severe b/c I haven't been on it for so long? I am SUPER SUPER sensitive, too, so these things tend to hit me harder.
I was planning on going down another 1/8th next week but that doesn't seem like a good idea now.
Please help!
Anita
Posted by Kangaroo_on_spaghett on December 29, 2008, at 23:10:19
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 29, 2008, at 15:37:05
Hi,
No. i have no idea. I am out here though and did manage to get off the drug OK>
Jess.
Posted by Maritza on December 30, 2008, at 8:27:42
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 29, 2008, at 15:37:05
Ho w are you measuring 3/8 of a 15 mg pill? I'm on 1/2 of 15mg now and would like to wean down but I don't know how to measure smaller doses acurately.
Thanks
Posted by AnitaDean on December 30, 2008, at 11:05:38
In reply to Re: mirtazapine/remeron updates? » AnitaDean, posted by Maritza on December 30, 2008, at 8:27:42
I cut it into quarters then cut the quarters into 1/8ths.
Posted by AnitaDean on December 30, 2008, at 11:31:31
In reply to Re: mirtazapine/remeron updates?, posted by Kangaroo_on_spaghett on December 29, 2008, at 23:10:19
Can you tell me how you weaned off? Did you have any "withdrawal" at all? Did you wean slower as your dose got smaller?
Posted by Anxiety123 on December 30, 2008, at 18:59:10
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 30, 2008, at 11:31:31
I haven't weaned off completely yet. I am weaning now. I was taking 30 mgs and am down to about 20 mgs. It has taken me a year to get to that amount. I am going very slow because I know if I don't I will have withdrawals. I am water tapering my dosage to get the tiny cuts. That way your brain has time to heal as you get lower on the amt. Cutting pills is too hard on the brain so you have withdrawals. It is because the ADs alter the chemicals your body makes and your brain basically has to relearn how to make the chemicals again.
Posted by Anxiety123 on December 30, 2008, at 19:01:57
In reply to Re: mirtazapine/remeron updates?, posted by Anxiety123 on December 30, 2008, at 18:59:10
I also forgot to mention if you go to paxilprogress.com you will learn a lot about how to get off ADs safely. Even though it was started as a paxil message board, there are people weaning off all kinds of ADs.
Posted by AnitaDean on December 30, 2008, at 19:02:24
In reply to Re: mirtazapine/remeron updates?, posted by Anxiety123 on December 30, 2008, at 18:59:10
Can you explain what "water tapering" means? I have been cutting and I have withdrawal, though not bad enough to make me want to go back up. It took you a year to go down 10mgs??? Wow. I have 5.625 mg to go.
Posted by Maritza on December 30, 2008, at 20:16:36
In reply to Re: mirtazapine/remeron updates?, posted by Kangaroo_on_spaghett on December 29, 2008, at 23:10:19
> Hi,
>
> No. i have no idea. I am out here though and did manage to get off the drug OK>
>
> Jess.HI, would you mind sharing how you did it. How did you measure lowere doses acurately if you weaned. if you went "cold turkey" did you experience any withdrawl? Thanks,
Maritza
Posted by Kangaroo_on_spaghett on December 30, 2008, at 20:23:14
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 30, 2008, at 11:31:31
Sorry, not really. My doctor said that 15mg was hardly a dose anyway and it wouldn't matter if I stopped taking it. I'm a cold turkey kind of person so I did that but I think we were wrong.
Anyway I had a lot of trouble eating and with nausea for about a month. I was really off food and I usually eat like a horse. I was depressed and I had trouble sleeping but both are normal for me in June so I didn't really blame the med withdrawal.
Sorry not to be of more help. I think my eating had returned to normal well and truly after five weeks.
Jess.
Posted by Maritza on December 30, 2008, at 20:43:23
In reply to Re: mirtazapine/remeron updates? » brazilnut, posted by 49er on September 21, 2008, at 11:34:09
> >
> > Leo,
> >
> > Maybe cutting half is still too much. The recommended rate is about 10% each 10 days, 5% after arriving at 50% down.
> >
> > Good luck!
> > Roberto
Hi How are you? I'm wondering how to acurately measure 10% and 5% cuts in weaning off of remeron. Also, I've recently been diagnosed as hypothyroid and have been on thyroid meds for about 6 months. I really believe it's related to remeron. I've read it as a possible side-effect. I think that because it effect the adrenals, this screws up other hormones, including the thyroid. I was wondering if anyone has heard or experienced this also. I'm also concerned that with weaning there may be a flood of adrenaline. This combined with thyroid meds may be excessively stimulating. Add to that withdrawl symptoms and I'm probably looking at a nervous break down. My medical doctor seems to ignore my beliefs about this and thinks I need to get my thyroid levels under control first. I think I need to come off of remeron, safely, then see if I still have a thyroid problem. He agrees remeron can cause many problems but is doing nothing to help me get off. Can anyone identify with these concerns?
> >
> Roberto,
>
> This post may be too late as I haven't read the followups. But I wanted to post it for other people's benefit.
>
> You're right to mention that dropping the dose of 3.25mg may be too much. However, I think your suggested tapering rate may still be too fast.
>
> The Paxil Progress Boards, which is run by an RN who almost lost her son to a Paxil induced suicide/homicide while on on an MD advised taper, suggests 10% of the current dose every 3 to 6 weeks. With Remeron, as I have gone below 5mg, I have had to go even slower.
>
> I think because it takes a minimum of two weeks for withdrawal symptoms to show up, that is the minimum amount of time you should wait.
>
> 49er
>
Posted by Anxiety123 on December 30, 2008, at 20:46:36
In reply to Re: mirtazapine/remeron updates?, posted by Kangaroo_on_spaghett on December 30, 2008, at 20:23:14
If you will join paxilprogress.com and let me know what your screen name is, I will send you my e-mail address and explain to you how to water taper. My screen name is Anxiety123 on paxilprogress.com. I don't want to post my address out here but on the paxil board we can send private messages. I will be glad to help you. I am very sensitive and that is why it is taking me a long time. But the general rule of thumb is not to cut more than 10% of your current dose.
Hope this helps.
Posted by AnitaDean on December 30, 2008, at 21:33:09
In reply to Re: mirtazapine/remeron updates?, posted by Anxiety123 on December 30, 2008, at 20:46:36
Ok will do. Whoops my last cut was 25%! 10% every month or so? I guess the only way to do 10% is by water tapering right? Am I screwed b/c I cut my last dose by 25%? Thanks will get back to you on the paxilprogress.com
Posted by Anxiety123 on December 30, 2008, at 21:41:48
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 30, 2008, at 21:33:09
Sorry, I gave you the wrong website. It is paxilprogress.org.
25% is a very large cut. If you feel really bad you could consider going back up some on the dose and stabilize before you make another cut. Everyone is different on how long they wait between cuts. It takes some longer to stabilize and you never want to make a cut until you feel you are stable and not having wd symptoms.
Posted by Maritza on December 30, 2008, at 22:43:45
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 30, 2008, at 21:33:09
Hi, so I registered on Paxilprogress.com. My user name is the same as here, Maritza. I am currently in a waiting mode with them . My registration needs to undergo moderation before my forum is activated. I still don't get how to tirate doses down. It's not possible to cut the pill in 10% increments. What does water tapering mean. I think alot of people would appreciate this explanation.
Thanks
Maritza
Posted by 49er on December 31, 2008, at 5:15:42
In reply to Re: mirtazapine/remeron updates?, posted by Maritza on December 30, 2008, at 22:43:45
> Hi, so I registered on Paxilprogress.com. My user name is the same as here, Maritza. I am currently in a waiting mode with them . My registration needs to undergo moderation before my forum is activated. I still don't get how to tirate doses down. It's not possible to cut the pill in 10% increments. What does water tapering mean. I think alot of people would appreciate this explanation.
> Thanks
> MaritzaHi,
I am tapering Remeron by 10% and here are the steps. I don't use water titration as that is just too messy and confusing for me.
1, Buy a digital scale on EBay that can measure .001g. They range in price from $15 to $30.
2. Buy empty gelatin capsules. I bought a whole container of 1000 for $10 from vitacost.
3. Buy pill crusher
4. Count out the amount of Remeron you are currently using. For example, if it is a 15mg pill, crush it and then pour it into the emply capsule.
5. Weigh it on the digital scale and note the measurement.
6. Use that measurement to subtract the 10% amount from. For example, if the measurement is .215g, your new dose will be .194.
Fire away with any questions.
49er
Posted by AnitaDean on December 31, 2008, at 10:49:33
In reply to Re: mirtazapine/remeron updates? » Maritza, posted by 49er on December 31, 2008, at 5:15:42
Thank you for this. HOw often do you decrease by 10%? I started w/15mg in July and am now down to 3/8 pill. SHould I start decreasing by 5%? Or can I still go down by 10%? My last decrease was 25% (11 days ago) and the one prior to that was 20%.
Posted by Anxiety123 on December 31, 2008, at 12:34:20
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 31, 2008, at 10:49:33
Maritza. I agree 100% with using the scales also. The only reason I use water is because I was water tapering klonopin before I started the remeron. I didn't know about the scales then and was taught by a lady on a benzo withdrawal board how to water taper. Once you get on the paxil board you will find there are a lot of people weaning using the scales. There is even a thread that explains it in detail. There is a guy on the board that goes by screen name Palm and he is tapering remeron using the scales. You can post to him or do a search and read some of his posts.
Posted by AnitaDean on December 31, 2008, at 14:51:40
In reply to Re: mirtazapine/remeron updates?, posted by Anxiety123 on December 31, 2008, at 12:34:20
So what is easier, the scales or water tapering? Sounds like the scales to me?
Posted by AnitaDean on December 31, 2008, at 15:15:31
In reply to Re: mirtazapine/remeron updates?, posted by Anxiety123 on December 30, 2008, at 21:41:48
Hi I registered on PaxilProgress as AnitaDean. Can you send me the water tapering info?
Posted by Anxiety123 on January 1, 2009, at 13:44:34
In reply to Re: mirtazapine/remeron updates?, posted by AnitaDean on December 31, 2008, at 15:15:31
I think the scales are easier. I only do the water because I tapered off a benzo using water and that is what I got used to. That was before I knew about the scale method. With the water, you have to order alot of the equipment such as a small blender and measuring devices. Then you have to do all the math to make accurate cuts. With the scales, you can find them for pretty cheap on e-bay or amazon. There is alot of info posted on the paxil board about what kind of scales to use and how to use them, also how to calcuate the math. Depending on what AD you are weaning off of also can make a difference. Some of them such as paxil and lexapro come in a prescription liquid and that makes them easy to cut without any special equipment. If they are a capsule, you can't put them in water so the scales work well. I don't have all my info on the water taper at home. It is all on my computer at work and I am off on vacation until Jan 12. If you still want me to send it to you, I can when I get back to work. Just put a post out here or send me a private message to Anxiety123 on the paxil board with your e-mail so I can send it all to you.
Posted by Maritza on January 1, 2009, at 22:01:36
In reply to Re: mirtazapine/remeron updates? » Maritza, posted by 49er on December 31, 2008, at 5:15:42
> > Hi, so I registered on Paxilprogress.com. My user name is the same as here, Maritza. I am currently in a waiting mode with them . My registration needs to undergo moderation before my forum is activated. I still don't get how to tirate doses down. It's not possible to cut the pill in 10% increments. What does water tapering mean. I think alot of people would appreciate this explanation.
> > Thanks
> > Maritza
>
> Hi,
>
> I am tapering Remeron by 10% and here are the steps. I don't use water titration as that is just too messy and confusing for me.
>
> 1, Buy a digital scale on EBay that can measure .001g. They range in price from $15 to $30.
>
> 2. Buy empty gelatin capsules. I bought a whole container of 1000 for $10 from vitacost.
>
> 3. Buy pill crusher
>
> 4. Count out the amount of Remeron you are currently using. For example, if it is a 15mg pill, crush it and then pour it into the emply capsule.
>
> 5. Weigh it on the digital scale and note the measurement.
>
> 6. Use that measurement to subtract the 10% amount from. For example, if the measurement is .215g, your new dose will be .194.
>
> Fire away with any questions.
>
> 49er
> Thanks, I appreciate this info. Only one question, does this effect the rate of absorbtion?
>
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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