Coming off Remeron. Withdrawal? Or Rebound Anxiety?

[cnote]

What's up guys! Sold my house, bought a new one. Lots of change! All good though! However, i don't do good with even good change sometimes. haha.

My Dr. and I thought it would be a smart idea for me to start Mirtazapine/Remeron 15mg for about a month, then ween off when I felt ready after moving into my new house.

I have been off of it for about 4 or 5 days now. The 1st day was not bad at all, I was still sleeping good at night. The 2nd night, I remember having a few strange feelings during the day which felt to me like panic attacks. Almost the feeling as if I was not even real, or in a real world for about 5 seconds. Strangest feeling. But it was quick and gone.

Yesterday my anxiety was up a little bit, and last night I did not sleep AT ALL, it felt like. I HATE THAT.

I know Mirtazapine is a sedative when taken at night, basically a giant antihistamine. I'm hoping I don't go through insomnia forever.

I really want to get a way from taking Mirtazapine, or anything. It's a good med for me when times of high stress. It helps with insomnia and appetite too. But it makes me eat like CRAP. Makes me crave sweets etc. Even if I don't eat a lot of crap, I still seem to gain atleast 5 - 10 lbs every time I start this medication.

So I'm going to see how long I can go without it. Or if I get bad again, I'll try another antidepressant. SSRI's used to make me worse though back in the day.

And I wont' do benzos ever again.

So, that being said. I'm trying to figure out if this insomnia last night is from remeron withdrawal? I hope it doesnt happen again tonight.

Will my sleep eventually come back? How long can you go without sleeping very well? Thanks so much! :) Anxiety is actually quite low today.

[CCtrauma]

I have started with the vitamins and need to start with exercise.  I try to tune the world out, but unfortunately, it is part of my job and I can only take it in small doses I guess.  I am news free for for the rest of the week until I stable out. On valium for now and pray this goes back to normal soon.

[Gjhollow]

OK so 1st off. I am in Michigan and so sorry about what happened in Orlando. Everything. Absolutely upsetting evend up here. But I see someone is suffering like me. Have you tried a good health food store and vitamins. I am on B3, B6, C, D, and Gaba with B6. I see that vitamin deficiency is the world's culprit because our foods are so processed and we are afraid of these fruits and vegetables because of GMO and all. I am leaving sugar alone too and using raw honey. Exercise along with it all and I am getting myself off of all meds. Trying to get a good regular exercise regimen because I have back problems and learned that Xanax is terrible for back issues and can make them worse. Not to mention cause the body to break down. I am doing a niacin flush and detoxification after my wedding in a few weeks. Lifestyle changes on the horizon too. We must tune out the television and especially politics. Limit time on Facebook and work on something creative. I'm writing a screenplay. I hope that you can find what works for you. I just may have to  cope with Xanax and clonopin just for a few more weeks but donlove the tried results of lifestyle changes but still have to look these stresses in the face with a resting ***** face mind and attitude For now.

[CCtrauma]

With my PTSD and associated Anxiety, the events in Orlando kicked off my anxiety I guess.  I have worked many mass casualties and these always put me in a dark place.  This is why I make the 15mg jump.  I should have left well enough alone and stuck with the 30mg.  I just had no idea a 15mg jump would end so poorly... any advice or experience would be greatly appreciated.

[CCtrauma]

I hope someone here can please help me.  I was on 30 of Remeron and feeling better than I have for years, a real rock star! (I am an Emergency Manager in Texas) so even the stresses of the recent flooding was no issue.  I started to have a slight bit of anxiety over the weekend and saw that my phyDr said I could go up to 45 so I did.  The next day was horrible and now its wednesday and I feel like crap and missed work today.  I just talked with my dr and she said it would take up to 4-5 days for the extra dose to get out of my system and get me back to how I was feeling before.  I love this med and I hate to think of getting off of it, great energy, appatite and sleep.   Has anyone else felt this bad from bumping up 15mg?  Desperate for answers.  

[tgirlbaum]

How are you doing now?

[cnote]

Adrenal surges/breathing difficulties started last night again. I'm down to 3.75mg. Have been on that for 7 nights now.

I think Mirtazapine/Remeron has a LONG half life, b/c it seems as if I don't feel the cuts til a few days later.

Last night, I felt VERY relaxed in bed, went to sleep, and then BOOM. I started having those dang adrenal surges again! Lasted almost all night long!

I'm SO tired today.

I want off this **** so bad! I feel calm today. And I kept calm in bed. It's just  little freaky when your breathing feels like it wants to stop while you are having these adrenal surges.

It HAS to be the Remeron/Mirtazapine. B/c they suppress the adrenals. Now my adrenals are FLOODING from what I understand.

I still have to cut down more for a while. Like 1.75mg for a week... then practically dust... hopefully it's not that bad.

I CAN DO IT!!!

[cnote]

You guys are so awesome. I truly DO believe it is a CRUTCH. I truly believe taking SOMETHING at night before bed is a CRUTCH.

You see, this ALL started last year. Maybe even closer to a year and a half ago. I started experiencing insomnia slowly out of the blue.

So I started taking Remeron to help, b/c instantly Remeron DOES in fact work the first night for sleep because of it's antihistamine effects. After weening off in the past, I'd have rebound insomnia, which led to me taking/alternating zyrtec and benedryl just to sleep at night. I'd take those in moderation for months.

Then I'd jump back on Remeron, ween off, back to zyrtec/benedryl... the cycle seems to continue.

So, I don't know If I'm mentally addicting MYSELF with these CRUTCHES to feel safe at night... to feel like I need SOMETHING to relax/sleep.

So, there could be some real anxiety at night if I don't take anything. It could be possible.

But, what I'm deciding to do is... since I weened off Remeron SLOWLY... did fine for 4 nights without it, maybe I'll take Remeron every 3 days or so. That should do me no harm. Then maybe go every 6 days without it, until I just either forget about it, or just feel like I don't need it at all anymore.

I know It won't work TRULY as an antidepressant that way, but I have heard of people taking Remeron as PRN.

We shall see how that works. I have a follow up appointment next week with my Dr.

He will almost positively agree that last night was just ALL anxiety and THAT'S IT. Even with the scary strange new feelings.

I know things will be fine. I'm fine today! It's this night time sleep anxiety crap I can't seem to get myself out of.

Atleast I didnt allow myself to go through crap last night. At least I was man enough to say, "to heck with it, I'm going to take 7.5mg of Remeron and get some sleep." Because in the past, I would think it was better for me not to take anything and NOT sleep at ALL... which in reality makes things 10X worse for me.

Thanks again for writing! You guys ROCK! :)

[nursegirl6572]

Sounds like a panic attack.

I don't think you were on the Remeron long enough to be experiencing "withdrawls" per se, plus you said you tapered down.  In MY opinion, the Remeron was curbing your anxiety, and coming off of it is causing that anxiety to resurface...in other words, rebound anxiety.

As for the worries about being subconsciously addicted?  I think more than anything in addition to you having some rebound anxiety, you're convincing yourself that everything you're feeling is related to you coming off the Remeron.  That's probably why you felt better after taking it.  Like a placebo effect, you know?

You've got lots of experience dealing with anxiety, start reemploying your coping mechanisms, and give it some time.  If you've tapered down low enough, it may be better to just jump off the Remeron all together at this point, to minimize that "mental" part of it, and continue to worry about you "needing" it.

Keep us posted!

[cnote]

Thanks guys so much. The scariest thing just happened. Its 1:23am here. Even though I didn't get any sleep last night, surprisingly I have felt pretty good all day. Well, I crawled into bed and read a little bit, started getting tired. My eyes were rolling back like I was getting ready to drift off to sleep. So I put my book down, closed my eyes and started relaxing. I started to drift off to sleep when all of a sudden, my body got flushed with adrenaline it felt like. My heart rate shot up, and I felt out of breath for a 2nd or felt like I quit breathing for a quick second. Then I got up to go pee, and while looking down at the toilet I felt odd... and my head felt light and it almost felt like I was swaying left and right for a second. I got back into bed, tried some deep breathing. I got tired again. And the SAME thing happened! Felt all those feelings, then I started shaking. Finally at that point I knew I wasn't going to sleep tonight. Son I broke down and took 7.5 mg of remeron. I just figured its not worth it to feel like such utter crap. I have all these thoughts like: is this just who I am? Am I subconsciously addicted to remeron? Or going through a physical w/d? Or is this anxiety at a whole new level? Will I ever sleep again? My muscles are twitching like crazy too. This *****.This stinks.

[Paxiled]

Because melatonin is naturally found in the body, the body will flush out what it doesn't need.  If it doesn't work, it can be either because you just don't need it, or you're taking the wrong dosage.  As I said, most people take too much.  The early studies used too high of dosages and didn't work very well.  But it isn't like taking an antidepressant, which is totally foreign to the body.  The body can handle things it normally makes.  But my thinking with you is, you should come back pretty quickly, since you weren't on the medication that long.  So I don't think you'll need melatonin that long.  If that doesn't work for you at any dosage, try a homeopathic remedy called Calms Forte.  Since there are no active ingredients, it can't harm you.  It helps me fall asleep, though it doesn't help me, unfortunately, stay asleep.

[nursegirl6572]

Hey there my friend!

I would guess it's rebound anxiety and rebound insomnia, coupled with the life changes.  Give it some time, try the suggestions Paxiled mentioned.  Here are some tips to help you with the sleep.  A lot of people don't realize just how lousy their sleeping habits are...and if some real effort is put into changing those bad habits and working toward consistency at bedtime, improvements are seen!

Here are some tips to help with your sleep:

1.  Avoid any and all stimulants (caffeine, nicotine, energy drinks, etc) as much as possible, especially within 4+ hours of bedtime.

2.  Exercise is a great way to induce sleep, as it releases natural endorphins.  Even a brisk evening walk will help.  Your exercise should be an hour or more before your bedtime..you don't want to exercise right before bed.

3.  Try to avoid eating a heavy meal close to bedtime.  If you're hungry, stick to a light snack an hour or more before bed.  Avoid ALL fluids 3 (or more if you can) hours before bed.  Nothing worse than finally getting to bed and have mother nature wake you up!

4.  Stick to a consistent bedtime and a consistent bedtime routine.  Even on days when you don't FEEL tired at your bedtime, try to stick to your routine...that conditions your body and brain.  Pick a reasonable time.  If you work 3-11:30 and get home at 12, a reasonable time isn't 12:30, as you would need time to unwind after getting home.

5.  Create an environment conducive to sleep and relaxation.  Your bedroom and bed should be an inviting place that you look forward to retiring to.  Keep the room clean and clutter free, keep dust levels down.  Keep your bedding washed with clean or fresh smelling scents.  Choose comfy, non-binding clean smelling PJs.  ALL of our 5 senses affect our mood, and also our sleep.  If you have a quiet room, but your sheets smell like feet (lol), that won't be very relaxing.  Keep the room DARK.  Keep weather in mind.  In the summer, you would only need a light sheet or blanket, in the winter, heavier blankets are necessary to keep you comfy.  

Again, back to the senses...if you create a bed that keeps you too hot or too cold, that will interfere with your sleep.  Keep a glass or bottle of water at your bedside, in case you awaken with that dry mouth and need for a drink.  This way you don't have to get out of bed to get something to drink.  Light soothing music or white noise machines for LOW (not blaring) background noise can be helpful.  Try to avoid using TV as a background noise, as our brains are still working while asleep, and the things you hear from the TV could affect your anxiety levels and even dreams.  Basically, sleeping with sounds of "The Chainsaw Massacre" in the background won't lead to happy thoughts.  ;0)  A warm bath or shower is great before bed...dry your hair.  Never go to bed with wet hair.  NOT comfy!

6.  Ignore the urge to get out of bed.  Even when you're feeling frustrated, try to remain in bed, reposition yourself, adjust your sheets, read a book if you are not falling asleep, but the more up and down you do, the harder it is to get and stay asleep it is.  The same goes for nighttime awakening.  If you DO fall asleep and wake up in the middle of the night, ignore the urge to get out of bed...again, reposition yourself, adjust the sheets, and try to go back to sleep.  When you get up out of bed, you're waking yourself more.  If you stay lying in bed, you are not as awake.  If nature calls...go to the BR, and get right back to bed..no snacking, no smoke breaks (I'm bad at this...lol).  Those things are murder for sleep.  Get up...go potty, right back to bed.

7.  When you DO manage to finally start on a consistent routine, you'll find things that help and hurt your sleep.  Take note of them and adjust your regimen as needed.  Sleep patterns will change, and life happens, so sometimes, adjustments need to be made. Consistency is TRULY the key..I cannot stress that enough.

8.  Listen to your body.  For a while, while your sleep is lousy, you will feel tired at odd times of the day.  Your body is telling you it needs rest, so heed the wanring...take a nap.  Lie down on the sofa, and catch a 1 hour (or less) nap.  Don't nap for hours at a time, that will interfere with your nighttime sleep.  An hour is the perfect amount of time for a refresher.  Also, don't nap in bed.  Once you're conditioned, your bed should be for nighttime sleeping only.  

Hope these tips help some...I know these are the things I do that help me get some decent sleep.  It's not always foolproof, but it works pretty well.  Please be patient for a while too...your body is getting back to normal, and that takes some time.  If you are going days without any sleep, definitely see your doctor.  Sleep deprivation is a whole other ballgame, it can be dangerous.

Best to you...sweet dreams!

[cnote]

Paxiled, thanks for replying. Do you think my sleep cylce will eventually come back regardless? I have meletonin tabs at home. But they usually don't work well for me.

And if I did start taking meletonin tabs, how long do you take those for beofre they don't work? lol. Then does your body quit producing meletonin eventually b/c you are feeding it meletonin?

Thanks so much! I'll try the magnesium supplement!

[Paxiled]

It might be from anxiety, might be from some medication.  I don't know the cause, but what might help is magnesium supplements.  Magnesium relaxes the muscles, and both anxiety and medication for it interferes sometimes with its absorption (besides which most Americans often get too much calcium which leaches magnesium out of the body, usually by drinking milk instead of getting calcium and magnesium in balance from deep green vegetables).  Might help you sleep as well.  You might try taking some melatonin for the sleep problem -- antidepressants tend to affect serotonin, and serotonin produces melatonin, which sets our sleep cycles, so in adapting back to being without the drug you might have the melatonin cycle out of whack.  Small doses work better than large -- 1mg is a good place to start.  You know, I thought about taking remeron, but my psychiatrist won't prescribe it for anyone except geriatric patients who have stopped eating -- she says even these patients eat a lot on this med.  

[cnote]

Oh! My muscles seem to be twitching a lot too. I have had this problem though for about a year or more. But when I took Mirtazapine/Remeron it settled down. So I wonder if that is from anxiety?