You may need to pay attention to the "brand"

Dear All,

 

I hope this post find you all doing netter than I am.

 

The point of this post is to tell you something I discovered.  Some of you may notice that small changes can  make a big difference.  On January 1, my insurance company changed its preferred pharmacy, and I received different brands of the 2 meds I take, diazepam and mirtazapine.  It made me have an extra crappy January and early February until I figured it out.

 

These medications have been around for a long time, and so there are many "generic" manufacturers available.  Your pharmacy is not obligated to provide you the same manufacturer, and neither they nor your doctors will admit it, but I promise you there are differences among the manufacturers.  I am not "endorsing" one brand of anything over another.  I am simply pointing out that you might need to pay attention.  Consistency is probably more important than whether you use brand "X" or  "Y." 

 

The pharmacy will tell you what brand they are providing if you ask, and if you find you do better on one than another, you can ask a pharmacy what brand they will provide before you fill your scrips.

 

Hope that helped someone.

 

Be well and good luck,

 

Ramcon1

Hi Ram  , your correct thers been quite a few warnings about the differnce in  brands over the few year's I've been on the forum  Sorry to see your still not  doing good  How much Diazepam did you reinstate by and how much are you presently taking? My best to you 

 

 

Love Nova xxx  :smitten:

This is something I have been wondering over the past few days because I am also on Diazepam and Mirtazapine and have had changes in brands with both recently. I thought it because I was thinking that stability and consistency are so important, that anything you can keep the same, such as brands, you should!

Johnnyboi,

 

Brand is important, but med and tapering technique are even more so.  We cannot give medical advice so "IF I WERE YOU, and PS this is what I am doing myself now:

 

You tapered off diazepam by just breaking up 2 mg pills.  Do that again.  I am doing that now.  I need to cut from 12 mg.  10%/week or 2 until I am done.  While I do that I am holding mirt and will hold mirt until I am 6 months off diazepam.  Then I would buy this scale (I have it):

 

https://www.amazon.com/American-Weigh-GEMINI-20-Portable-MilliGram/dp/B0012TDNAM/ref=sr_1_4?ie=UTF8&qid=1519167949&sr=8-4&keywords=milligram+scale&dpID=41YcbMS0XFL&preST=_SX300_QL70_&dpSrc=srch.  \

 

The scale is accurate to about +/- 3 mg, and you should reset it often as it drifts, but its cheap.

 

Then you can do the 10% by cutting the mirtazapine pills with a razor blade going from 30 to 27 to 24 etc.  You will need to use some algebra but it is really easy algebra as 15 mg pills weigh 150 mg, so to cut to 27 you take one 15 mg pill and cut the other to 120 mg +/- 3 mg you get 12 mg.

 

Be well and good luck,

 

Ramcon1

Johnnyboi,

 

Brand is important, but med and tapering technique are even more so.  We cannot give medical advice so "IF I WERE YOU, and PS this is what I am doing myself now:

 

You tapered off diazepam by just breaking up 2 mg pills.  Do that again.  I am doing that now.  I need to cut from 12 mg.  10%/week or 2 until I am done.  While I do that I am holding mirt and will hold mirt until I am 6 months off diazepam.  Then I would buy this scale (I have it):

 

https://www.amazon.com/American-Weigh-GEMINI-20-Portable-MilliGram/dp/B0012TDNAM/ref=sr_1_4?ie=UTF8&qid=1519167949&sr=8-4&keywords=milligram+scale&dpID=41YcbMS0XFL&preST=_SX300_QL70_&dpSrc=srch.  \

 

The scale is accurate to about +/- 3 mg, and you should reset it often as it drifts, but its cheap.

 

Then you can do the 10% by cutting the mirtazapine pills with a razor blade going from 30 to 27 to 24 etc.  You will need to use some algebra but it is really easy algebra as 15 mg pills weigh 150 mg, so to cut to 27 you take one 15 mg pill and cut the other to 120 mg +/- 3 mg you get 12 mg.

 

Be well and good luck,

 

Ramcon1

 

Hi Ramcon1,

 

Thanks for the advice! We're on a similar journey here. I haven't come across many people as of yet who are going through same as me. I am currently in the stage of trying to stabalize again on Mirt, sleep is the only thing effected. I can now see how much Mirt was helping me in the past when I'd come of benzos. I just got way to eager to get off all meds but should have waited 6 months before doing the mirt withdrawal!!

 

I'm doing what you've mentioned, although I am currently doing a liquid taper to get more accuracy but I am getting off the Diazepam at the same rate as you. Then I plan to wait 6 months before beginning a slow mirt withdrawal. I got close though man! If I never messed with the mirt after jumping from Diazepam end of last year, I'd be 4 months free now, only 2 more months and I'd be beginning my mirt taper!

 

It can be done! 

Jonny,

 

Your and my journeys could not be more different, but if you found what I posted useful, then I did my job.

 

Here is where we are similar, and I think all humans are: there is a point beyond which we cannot bear.  For you it was insomnia.  I have that too, and it was well managed by mirt and melatonin.  Where I gave in was anxiety and panic.  I quit smoking.  I did not want to.  I had to.  My IBS was sooooo brutal, and every cigarette was a violent laxative that inflated me with gas, so they had to go.  After about 1 month, I started to get really bad anxiety and panic.  I tried to tough it out for about 3 months.  After 4 months cig free and STILL literally bouncing off the walls like a lunatic for hours at a time I said F@CKKKKKKKKK THISSSSSSSS!!!!!!!!!!!!!!! and reinstated on valium.

 

After a 4 month honeymoon on valium, 2 years off cigs, I still have some very high anxiety days and still get the damn attacks.  Not as often, but I now have 1000 triggers I did not used to have, and I am 99% those triggers are from reinstating, but oh well.

 

I will taper, but I need to find SOMETHING that works for anxiety and panic that will not make my gastro worse, because like any human, there is only so much I can bear.

 

Long story short, I have not yet found anything that will solve my issue.  If mirt solved your issue, stick with it until benzos are a long way in your rear view.  Then you can taper, and if necessary switch to something less toxic like melatonin or benadryl.

 

Hope that helped too.

 

ramcon1

Jonny,

 

PS AS FAR AS I KNOW, mirtazapine/remeron does not dissolve in anything (water, milk, nontoxic organic solvents) so you might need the scale for that.

 

Others please chime in if you know differently.

 

Be well and good luck,

 

Ramcon1

I guess you're right, no two journey's are the same, too many variables 

 

I gave up nicotine after being hit with the insomnia in Dec, I just couldn't link the insomnia concretely to the Mirt withdrawal at the time, so I removed as many triggers for insomnia as possible. Whatever withdrawals I would have suffered certainly got buffered by the Diazepam reinstatement for me, so at least I'm over the nic withdrawal.

 

I think you are right about our limits. Mine are heart symptoms, palps and racing heart etc, they have always been the thing that has been the most difficult and they've only gotten worse over time. The insomnia would be my other for sure, simply because it amplifies every other symptom. I always found my IBS worse during the low end of the taper and the first month after jumping. IBS was non existent for me until last half of 2017, so it's definitely something that has taken time to develop during benzo usage. I even went to the docs and got diagnosed with it before eventually realising it was the benzos.

 

Also, I've had so many panic attacks at this point, by far the most prevalent symptom, that I often find myself having a panic attack whilst talking with people and just braving it through. I now know the panic attacks are a clear sign for me of going too quick, in the past I'd go two hours having a panic attack and it would pass. These days I try to prevent them with a proper taper. Fingers crossed.

 

I have melatonin and Diphenhydramine but have not tried them yet.

Also, just in case anyone reads this and is planning on withdrawing from Mirt, I did come up with this plan. Note, I am most likely going to get a scale now and do it the way you mention ramcon1, just for accuracy but you could theoretically cut the pills up as follows:

 

30mg

28.125mg (-6.25%) (15mg + 7.5mg + 3.75mg + 1.875mg)

26.25mg (-6.66%) (15mg + 7.5mg + 3.75mg)

24.375mg (-7.14%) (15mg + 7.5mg + 1.875mg)

22.5mg (-7.7%) (15mg + 7.5mg OR half 45mg tablets)

20.6mg (-9%) (15mg + 3.75mg + 1.875mg)

18.75mg (-9%) (15mg + 3.75mg)

16.875mg (-10%) (15mg + 1.875mg)

15mg (-11%)

 

Hopefully the maths is accurate. That above just gives an idea of how you could cut the pills up with a pill cutter. Half of 7.5mg would be 3.75mg and half of 3.75mg would be 1.875mg. You could then place the pieces in capsules and not have to be chopping pills every night and messing around with the little bits. It would be difficult with some brands of Mirt but the ones I used for most of my treatment (Activas) are quite big. A scale would make things more accurate but it could be done without and you would stay close to the 5-10% harm reduction method.

 

Also, during my research on it, I have come across people who have used water and maple syrup and they were people who suffered a lot until they began to taper properly. Also, here in the UK, the oral solution of Mirt is available. I plan on DEMANDING (lol) that once I got down to 15mg. Who knows though, I am not even starting until benzos are six months behind me 

 

PS, anyone reading this, please do you own research and take it slow. I don't want to suggest things I haven't even tried yet 

Johnny,

 

Also do not downplay the role tobacco could have in panic attacks, heart palpitations IBS and other things even several months after your last use.  Some members bit my head off when I pointed out the similarities of benzo wd with tobacco, but the science minded ones like me get it.  Both tobacco and benzos manipulate GABA and Glutamate so it makes sense.  And also, (where they REALLY bite my head off) is with both benzos and tobacco a significant percentage walk away without ANY symptoms, a more significant percentage have a tough time for a few months, and then there are the poor unfortunate few who still feel awful after over a year from their last cig or dip.

 

Note that I wrote "tobacco" and not nicotine.  Nicotine is completely different.  In most people, it is much more stimulating, much less relaxing, and much less addictive.  It is the other things in tobacco that when combined with nicotine make it so addictive.  Tobacco is actually an MAOI and an antihistamine too.  No wonder people love it.  I know I did.

 

 

Three last recommendations: 

1. Do not look so far ahead.  Get through the diazepam. 

2. When you get to mirt/Rem, buy the scale.  For $30-ish it's worth it.  I checked.  Mirt/Rem is insoluble.  Even a pharmacy-bought liquid will say "shake before dispensing" because it is just powder suspended in fluid, and is therefore in accurate. And if you get liquid, you will be changing brand too!

3.  When you get low on mirt, if insomnia creeps in I like your ideas of melatinin and diphenhydramine.  I am paradoxical for diphen (pure speed to me) but many find it helpful.

 

Good luck in your pursuit of health.

 

Ramcon1

Yeah, I had a bad night last night but I'm still keeping faith I will stabilise on Mirt again. I haven't given it enough time yet, something will give eventually if I stay on the same dose religiously. It might just take longer than expected.

 

One thing I thought of the other day and wanted to mention was I suddenly thought, wouldn't it be easier to crush the Mirtazapine pills into powder and then fill capsules with the correct amount?

 

I mean if you get the maths right with how much everything should weigh, it would be possible right. Be much easier than taking a razor blade to the pills.

Johnny,

 

You are still looking too far ahead.  Get through the diazepam.  When you get there, for what it is worth I find the razor blade very easy as the pills invariably have markings of some kind stamped in them, and when you cut straight down at the same point on a pill you get within +/- 5 mg on a pill you check with the scale, which is +/- 0.5 mg of drug which is close enough even for sensitive people like us.

 

Ramcon1