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[SADnomore]

Thank you Gem! Back at ya, girl! If you can remember, how long were you on mirtazapine before you felt able to step down to the 3.75 zopiclone? Was it a couple of weeks, or more like a month? Just trying to figure on how many more to get prescribed. xx
Marie

[Gemical]

Hi Marie,

As far as I can remember this is how it worked for me, though it may be a little or a lot different for you but I hope this helps....

So I started both meds at the same time

Week one - Mirt 7.5mg, Zopiclone 7.5mg
Week two -Mirt 15mg, Zopiclone 7.5mg
Week three - Mirt 22.5. Zopiclone 7.5mg
Week four -Mirt 30mg, Zopiclone 7.5mg
Week five - Mirt 37.5mg, Zopiclone 7.5mg
Week six - Mirt 45mg, Zopiclone 7.5mg

I stayed at Mirt 45mg and Zopiclone 7.5mg for about another 6 weeks then I started to feel a bit more confident that Mirt was really helping me with sleep. So then I reduced Zopiclone to 3.75mg and spent about another 2 months like this. Then I started having half of a 3.75mg tab (about 1.875mg I guess) and again stayed like this for another 2 months. Then after that I stopped taking it altogether so all in all the whole process did take a good few months but it worked. And I still have some tabs left over so I know if I really need one or am having a particularly tough night they are there which is a good safety net for me.

If you haven't already got one then I highly reccommend getting a pill cutter, that way you can half and quarter the pills really accurately. It may be an idea for you to keep ordering the 7.5mg Zopiclone and use a pill cutter to halve it to make a 3.75mg tab. That way if you try it but you don't feel ready to reduce you can go back up to taking one whole 7.5mg and try again in a week or so. Or, you could even drop down from 7.5mg and use your pill cutter to make one half and a quarter so you can make an even more gradual reduction from 7.5mg to 5.625mg and to then 3.75 mg and so on and psychologically knowing you still have the option of going back up to 7.5mg might make it feel less daunting.

So my advice would be settle on the Mirt for a little while first - a couple of months or so before starting to lower sleeping tab. But you never know you might find that you feel you are able to start reducing sooner than this??

Iv'e got crazy a crazy clenched jaw from the Venlafaxine at the moment - its like my top and bottom teeth are glued together and Iv'e been feeling real tense and I think all the tension is what causes my headaches - been taking Diazepam to see if it will help me relax a little and am taking on board what Aprilmoon so wisely said about being kind to myself. My partner has taken my boy out for a few hours so I am just gonna rest in bed with a hot water bottle, drink lots of water and watch something silly. Do you think the jaw clenching and muscle tension wears off over time?

I am so pleased I have found you and Aprilmoon. Honestly it has really helped me so very much. All my love and , Gem x

[SADnomore]

Gem, hunni, I hope you got some good rest in! Yes, the jaw clenching is normal, I had it too. Chewing gum helps to work the pain out. I kept a pack on me for awhile, can't remember when I no longer felt the need, but it did go away! The physical tension is called muscle tonus and is a side effect that I got too. It was the very last to leave, somewhere between weeks 4 and 5. Both of my arms and legs and my abdomen (knots in the stomach) were involved and yes I hated it; long, slow breath in through the nose to the count of 4, hold a couple of ticks, then slowly breath out through the nose to a count of 6. Repeat several times. It seems to stop it temporarily. Do it again when you notice it building. I felt a kind of weakness at the same time, which drove me nuts, lol! It does seem to go away at bedtime every night, thank the Lord! Hang in there, it is just a side effect and it will go away. I thought of it as the smooth muscle in the gut (which is where 90% of our serotonin receptors are!) being activated as the SSRI's "reuptake inhibition" took effect. The tension being from all the "little doors" being slammed shut in these receptors there and elsewhere in the body, ha ha! The serotonin would keep trying to get (back) in, and the doors were held firmly shut until it gave up each day. Made perfect sense to me and it helped me wait it out. The tension would let go for a bit longer each day towards the middle of that 4th week, and finally by the end of that week it quit altogether. Hallelujah!

As for any anxiety, I think Rossthekid's explanation is the best! SSRI stands for Selective Serotonin Reuptake Inhibitor. That's the first function of venlaxafine and it continues, it doesn't stop at the higher doses. We want this, as it keeps the serotonin in our synapses (space between nerve cells) longer, which means we feel better! But not right away ... Ross says:

"SSRIs cause your serotonin levels to drop when you first start taking them.

(This is because a small part of the serotonin cell called an autoreceptor senses when the serotonin is not being reuptaked, (doors are slammed) and so it tells its cell not to release more.)

Your serotonin levels will not rise until the autoreceptors in your brain have stopped working (become desensitised). (That is, until they give up and the cell releases serotonin again. That's why you feel anxious, your symptoms spike, etc. during this period).

This takes time. For some people it could be a couple of week, for others a month or more."

I got through the lag and the side effects and am so glad I stuck it out! It has the effect of steering my mind away from negative thoughts, it helps me to remember and to think more clearly, and my carb cravings are gone at last. I don't get all anxious and fretful, and I haven't dissolved in tears for weeks and weeks. The effects are subtle at first, and it takes a good while, but it really does work!

You've been ramped up really quickly, so I imagine your doc decided this was war on your depression and it was time to be aggressive, no holds barred. Let's get your serotonin, your noradrenalin and at least some dopamine going asap so you feel better faster! But, if dealing with the side effects til then gets to be really too much, do speak to him. Certainly you can try propanolol, which is a beta blocker lots of us take for physical symptoms of anxiety. (I'm going to ask my doc tomorrow for it to take along with my next increase, so the side effects aren't so acute.) And if you still feel overwhelmed, then he may titrate the venlaxafine down for a bit.
Hang in there, sweetheart, hopefully you can ride it out with the diazepam and maybe some propanolol. Fingers crossed, but if you need to take it down then he should be open to discussion.

Thank you so much for all your advice on the zopiclone. I don't think many people realize how stuck we get with it and how long we need to plan for withdrawal. I wouldn't have known to give it as long as you did, and probably would have had wicked rebound insomnia, bad news for sure! Now I feel better already not being in a rush. I know it'll work out All my love to you too, Gem! Myself and I know, aprilmoon are both here for you always!

Marie

[loreen]

Marie, that is so interesting.

I am just so happy venlafaxine is working for me, I have not really questioned how it works !!! Having tried many SSRI s I do wonder why they did not help, and ven really has ? I gave it at least 3 months on each, but had no luck. I know venlafaxine is a SSNR so maybe that is the subtle difference.

Still got the constipation, but am managing it. Its a small price to pay for feeling human again,and not a tearful wreck....

keep posting xxxx

[Gemical]

I second that Loreen! Very interesting indeed. Thanks Marie! I had no idea that there were any serotonin receptors in the gut, let alone 90%! Wowzers! Really useful info about how the meds work and it all explains a great deal in terms of how sometimes people can feel worse before feeling better.

Good call about the chewing gum too! Ive been forcing myself to yawn which seems to be helping a little but it's good to know these side effects will most likely wear off over time...feel like my arms and legs and stomach muscles are permanently engaged.

I am glad the Zopiclone rundown helped a little. Like I say, you may sense that you can reduce it a bit quicker than I did but definitely no rush

Loreen so good to hear again how much the Ven has helped you after trying all the other meds.

And I checked out that thread you recommended Marie, about good stories - Venlafaxine. Some much needed encouraging posts and experiences for sure. Thanks for the tip!

Loads a love and , Gem X

[loreen]

Hi Gem

How are you doing today ? Hope the ven starts to work on you very soon.

My anxiety is a bit high today, but its probably because it is a wet half term ! I am at home trying to entertain my 10 year old ( who is autistic ). My eldest (19) has gone on her first holiday abroad without us,so i am panicking about all the things that could happen. She is a sensible girl, but it doesn't stop me worrying !!

Even my cat looks stressed today!!

Take care

Loreen xx

[Gemical]

Hey Loreen,

School holidays can feel really tough sometimes eh? Especially when it is so wet. I totally empathise with you. At times it is hard enough when you feel your best and the sun is shining but at least it's easier to get out and there are more opportunities to entertain the wee ones. I am imagining (though I don't know) that it is even harder when the world isn't set up for children with autism, further compounding the isolation and stress most parents feel at some point or another. So it's no wonder you are feeling more anxiety today - and your cat too! Cats always know the score. I am sure your daughter will be fine - but it's easy for me to say and again I can totally understand your worry. Will you get any time later tonight to do something nice for yourself?

I felt a little teeny, weeny bit brighter yesterday and today. I don't know if it's because I don't feel as alone now that I have joined this forum or whether the Ven is kicking in a little bit? Most of me still feels pretty bad though and I feel scared that if I say I feel a tiny bit better my mind will start talking me down again (already has) so I'm trying not to get too attached to feeling a fraction better as it feels too good to be true that it could be the start of something - probably isn't. I do hope the Ven starts to really kick in soon though! I've really had my fill of feeling this despair and darkness now!

I hope you get a chance to nuture yourself at some point this evening. Maybe you and your cat can give each other some TLC.

Sending love and , Gem x