19 replies to this topic

[penisbreath]

I was taking a low dose of Mirtazapine to sleep for 2 weeks. I stopped it cold-turkey (I was down to about 3mg) and, after a few days, became very restless, felt a disconcerting stiffness in my face/jaw, and overadrenalized basically. My mind feels blank/locked and it can be hard to think clearly.. I've had similar cognitive symptoms when a stimulant dose is too high.

6 weeks later, I've tried:

1. Antihistamines (Doxylamine, Cyproheptadine), which fix the inner restlessness, but wire me more. Reinstating the Mirtazapine just wires me.

2. clonidine, which helps the restlessness too, but makes me depressed/anxious.

3. Benzos, which I can't take due to paradoxical reactions.

4. Propranolol, which helps slightly, but makes me feel sick and hypoglycemic.

5. Opiates -- codeine, and a low-dose of some buprenorphine I was saving for depression -- which are great for mood and everything, but actually stimulate me too, rather than sedate. The buprenorphine, which I only took once, made me vomit heavily and I grew more irritable eventually .. so if that's a sign the dose was simply too high to start with (0.25mg of a sublingual strip), I would try it again.

I've been to emergency twice, because I was growing suicidal, and told there was nothing they could do; I couldn't get to see a psychiatrist or neurologist. The first time, the nurse laughed because she said such a low-dose of Mirtazapine could never do this. The second time, the doctor I saw said Mirtazapine can produce vicious withdrawals and I tend to be extremely sensitive to medication anyway.

Currently trying Niacin (3g a day) and Manganese (20mg-30mg of chelate a day), with some very slight results possibly.

I took 25mg of Lithium Orotate out of desperation last night and it helped a lot of the physical anxiety and let me sleep, but made the restless legs worse.

Other clue: Melatonin pretty much fixes the issue when taken at night (though I ran out).

On top of everything else that sucks in my life, I get to miss New Years now because I'm too restless to leave the house. I can watch 5-10 minute clips on youtube, but nothing else.

My own GP said he has no ideas either, and is a 45 minute drive away ..

I thought about Lyrica.. ?

Edited by lucky.pierre, 31 December 2013 - 05:22 AM.

[formergenius]

How does Kava sit with you?

[penisbreath]

Never tried it .. I assumed it worked similarly to benzos, so thought it would just make things worse?

Oh, and NMDA antagonists are also out, due to increased anxiety, including magnesium. (I know, the level of sensitivity is ridiculous).

[formergenius]

Hmm I binged on Kava for over 2 weeks.. When I ran out, nothing in particular happened. Unless you mean that benzos make your situation worse acutely, I'd say it's worth a shot.

[penisbreath]

No, the mechanism of benzos seems to result in more agitation/anxiety. Alcohol makes me hyperactive too, and I've been told there's a link.

That said, I know a guy with bipolar who gets paradoxical reactions to benzos but can tolerate Kava, so it might be worth a try.

[Tom_]

Mirtazapine isn't the cause, I'm sure of that. The dose is simply way to low and you weren't on it for long enought.

Pregabalin is certainly worth a trial.

[penisbreath]

Based on the recommendation of someone, I think I'm going to ask to try a mood-stabilizer. Pregabalin's withdrawals sound kinda nasty.

[Tom_]

Pregabalin tends not to have a withdrawal, just like the majority of the mood stabilizing antiepeleptics.

[Tom_]

The reason I'd suggest pregabalin over a mood stabilizer is its more likely to be effective for anxiety.

[penisbreath]

Okay, thanks Tom. I'll see if I can convince my doctor.

[penisbreath]

Is Lyrica different enough to Neurontin that if I find Neurontin energizing, Lyrica still might be calming?

[Tom_]

Significantly. Of course it could still be energizing but its something I doubt.

[socialpiranha]

It's not impossible that the mirtazepine messed something up, it binds to lots of strange receptors that we don't really understand. Never underestimate the power of a drug to upset the finely tuned balance of neurochemicals. It almost sounds like a cholinergic issue with the jaw and face tightness etc. Anyway full circle try lamictal or topomax. Kava's worth a try too but i don't recommend it if you dont react well to weed, kava contains cannabinoids closer in pharmacology to thc than cbd. i have noticed poeple who get anxiety relief from weed also benefit from kava and people who get anxogenic effects from weed also get them from kava.

[penisbreath]

Thanks, man. I have no doubt it's the Mirtazapine .. it feels like some combination of over- and underexcitation. Herbs that target COMT and MAOI help the core restlessness, for example, but then create a different kind of overstimulation and agitation.

I've only smoked weed once, but it wasn't really anxiolytic or anxiogenic .. it made me very hyperactive and disinhibited and I just felt strange overall (though not paranoid or anxious per se).

I think Lamictal might take too long to kick in? I'm pretty much surviving minute-to-minute. I called my GP and he said he's fine with trying Lyrica and has some samples at his office .. I just hope it doesn't do the paradoxical thing like benzos.

[socialpiranha]

well good luck with it friend

[penisbreath]

Thanks...! I think a mood-stabilizer (low-dose?) might be a good idea in general, since all the good stuff tends to induce overexcitation in me. So will keep Topamax/Trileptal as a back-up option, and might switch over once everything's settled.

[penisbreath]

hopefully someone's around to answer this .. I got some Lyrica samples from my doctor, but they're 75mg in powder. Since it's expensive and I wanted to start on a low dose, I was going to dissolve it in water.

I've never dissolved a med in water before .. what temp. should I use and is it necessary to store it in the fridge?

[penisbreath]

Also Tom (or whoever), my GP gave me 28 x 75mg caps. I don't want to use them up too quickly (since it's pretty expensive here), but if I'm desperate for relief and also sensitive to meds what dose should I start on, and how long should I wait to see results?

I took 25mg 2 hours to begin with and feel slightly sedated, but don't notice anything else.

[penisbreath]

Taking 50mg b.i.d. of Lyrica. Not really anxiolytic .. I get sedated/depressed on it, but still feel mentally tense .. easier to sit still though.

However, RLS are worse and I have this weird tic where I lose control of my right pinky finger .. when I'm typing, it'll just jump underneath my hand .. very weird. It first appeared on Riluzole.

GP has given me a script for Requip (prior to the tic appearing), though I'm a little wary of the Parkinson's dopamine agonists. Wondering if I should try it, or wait to get evaluated by a psychiatrist/neurologist.

Edited by lucky.pierre, 05 January 2014 - 12:32 PM.

[Tom_]

I don't think you should be spliting the dose, they are capsulated for a reason and it can mess with how quickly they are absorbed. Try 1 or 2 days of 75mg in the morning or when ever anxiety is normally worse for you. You could always try at night as well since it may help you sleep.

I know our problems are quite different but I've had a lot of success with 40mg Tranylcypromine and 30mg Pericyazine (you may not be able to find that exact drug in your country) but a very low dose of a typical neuroleptic might be worth a try if the pregabalin doesn't do the trick.