I'm having a hell of a hard time and experiencing rather weird symptoms. Whether they've anything to do with Mirtazapine (Remeron) is something that I strongly feel but can't quite convince any doctor of. I was put on 15 mg of it in spring 2015 for depression and a severe insomnia - I hadn't slept an hour like since 25 nights back then! The benefits showed immediately within a day and surprised myself and my family. I would sleep well and be in a very happy and cheerful mood. Then however, from summer 2016 I developed some strange food intolerances; caffeine, sugar, fruits containing high amounts of fructose, yoghurt, butter and so on. Eating anything of that would cause me jitteriness and insomnia. I steered clear of those foods. From autumn last year though, a lot of those food intolerances have relented and it changed into intolerance towards medicines and supplements that I was on; the thyroid medicine for hypothyroidism, Vitamin D, Calcium, Vitamin E and could never again tolerate any new medicine or supplement. Symptoms resulting from these are, again, jitters, insomnia and a strange kind of feeling of being struck on the head, like I can't hear anything and the thinking becomes very unclear and blurred. Coupled with this is a weird sensation that if a medicine has any potential side-effect (even physical, such as urine retention), I get it at all costs. So I'm steering clear of the culprits here too. However, avoiding the culprits doesn't end my misery, it just helps in avoiding a whole new set of symptoms, because since autumn 2016 I'm under constant brainfog anyway, have heart palpitations immediately after every meal (but worst after breakfast), have concentration and focus issues, lead a life without any hobbies, wishes or desires. Nothing excites me, nothing interests me and nothing catches my attention. Leave tasks pending for months (the most unlike me habbit), have badly lost my sense of humour. My sense of humour was something that I literally used to pride on, and friends from around the world would call me to fresh up if they were having a dull day. My mind feels numb, although it isn´t as if it´s the sedating effect of the Mirtazapine because 90% percent of the nights I don´t sleep well, and on a lot of nights I feel as if I´m asleep with an awake mind! The GP who put me on it considered it to be just the effects of anxiety and depression and recommended the doubling of the dose to 30 mg. When I contested that, given that I´ve my doubts of a lot of these issues being brought upon by Mirtazapine itself, she referred me to a psychiatrist. He too strongly denies of Mirtazapine having any hand to play on it and instead thinks it´ll be best to combine it with another antidepressant for day-time. He put me on Paroxetine, boom, a flood of side-effects! Then changed to Fluoxetine (Prozac) - third day on it and having weird feelings. The heart poundings are one and is in fact making me very depressed and hopeless!
I started process of switching from Cymbalta to Remeron on March 25, and took my last dose of Cymbalta a few days ago. Other than a few days of extreme irritability, things have been going surprisingly smoothly. Except that I can't sleep. Not really. I'm rapid-cycling between moments of being awake and instantly dreaming as soon as I close my eyes. The waking moments seem precipitated by startling effects in the dream state, that usually have nothing to do with the content of the dream itself. The worst of these is the sudden sensation of being physically attacked by an evil presence. It seems to take me a little bit longer to wake up during these instances. Or at least that's how I perceive it.
How much of this is potentially the residual Cymbalta withdrawal effects, and how much of this is the "strange or unusual dreams" listed as a possible side effect of the Remeron?
And more importantly, how long can I expect this to last? If you experienced disturbed dreams while on Remeron, how long did it last for you, and did it turn out to be a deal breaker?
Please help. Obstructive sleep apnea condition and chronic migraines with insomnia. Also, I am very nocturnal.By SheltieUnderdog
I'll get to the coinciding physical symptoms eventually. I have always had trouble sleeping through most of the night like the majority of people do with ease and very naturally sleep through the majority of the day when most people are awake. I honestly have always preferred not to see the morning (I find it utterly depressing) except I am obligated to get places like doctor's appointments, stores, and restaurants before they close for the day and I would like the be awake and ready to leave my home by the early afternoon on a consistent basis. Since I was 12 years old, my addiction to being nocturnal and having an abnormal or irregular circadian rhythm has gotten progressively worse. So much to the point where I will fall asleep as the sun is rising and wake up when it's setting or it will be dark again by the time I wake up! I am being deprived of too many things, missing doctor's appointments, or not being able to get my car to the auto mechanic before he / she closes for an oil change. I eventually want to get a part-time job (currently living on SSI) and i imagine that my job would take place in the late afternoon or the evening shift but how could I even hold down a job that was a full-blown a graveyard shift under these circumstances!? My insomnia which can be attributed to the fact that I was formerly diagnosed with bipolar 1 with psychotic features and am now diagnosed with schizoaffective disorder, ocd, and add (possibly adhd). Sometimes if I stay awake later than I really want to (preferably between 1 and 3am to be able to wake up by the early afternoon) then I will just remain awake into the next day in order to guarantee that I will make the appointment or obligation and get to it in a state of sheer exhaustion barely able to follow the doctor or specialist as they're explaining things to me. Sometimes I have gone two or even three nights in a row without getting any shuteye because the appearance of it being nighttime awakens me. The only time that my insomnia (but not the sleep apnea or chronic migraines) was under better control was when I was on court ordered injections which were anti-psychotics and along with outright despising the process of getting those injections, I had a plethora of other side effects like akathisia (inability to sit still), lethargy, fatigue, sedation, and severe weight gain at the same time. I've been on Latuda 20mg for a couple of years now with little to no side effects and I plan to stay on it and never be subjected to having to take anti-psychotic injections ever again after my experiences with them when I had to involuntarily take them by court order.
Now I also have some other issues going on in addition to the insomnia and nocturnal sleep cycle. I have ehlers-danlos syndrome type 3. I was diagnosed with severe obstructive sleep apnea after a sleep study ordered by my pulmonologist in the beginning of 2018 shortly after I got off of the anti-psychotic injections and I was 308 pounds (my heaviest ever weight, my height is 5'8). As of December 2019, my weight is 281 and I've been at a weight set-point since the end of 2018 where my weight is no longer fluctuating anymore (cannot easily lose or gain weight). I hated the mask / cpap machine or was cpap intolerant and sent it back to the surgical supply company within a couple of weeks. My ENT is not recommending the oral surgery or UPPP procedure because of how severe the sleep apnea is and I don't want a tracheotomy. He said that I'm too obese to use Inspire. I can't find an oral surgeon who does maxillomandibular advancement surgery. The obstructive sleep apnea and tmj syndrome which I've suffered from for over a decade combined are giving me chronic migraines and still sometimes when I take my prescription strength pain relievers from my rheumatologist. I wake up feeling like I was hit by an 18-wheeler stumbling to the bathroom sink with my eyelids glued together (look up the medical term blepharitis, I get that in my sleep too). Sometimes the migraines are so bad that I will force myself to eat and drink a small amount and take something like Excedrin PM or other types of nighttime pain relievers and fall back asleep and wake up again slightly less messed up because I had more rest even later in the day. Another major problem is that even if I somehow get a better nights sleep one night, the next night I will be so energized once it gets dark that I will do another all-nighter until the sun is coming up and the cycle or revolving door starts all over again.
I used to be prescribed sedatives like Trazadone and Clonazepam but my new psychiatrist (been seeing her for a little over a year) insisted that I come off of them until the sleep apnea was successfully treated because me taking them before going to sleep with that medical condition was too dangerous. I recently found a dental sleep specialist hours away from where I live which designs oral appliances specifically for treating sleep apnea and tmj syndrome and I've been trying to set up an evaluation but they are forcing me to do another sleep study at home because the last one I did at the sleep lab was in March 2018. I recently went to my local CVS and picked up generic Benadryl or diphenhydramine 50mg and I found something recently at 7-Eleven called doxylamine succinate which is labeled as a strong sleep aid. I am sleeping with a wedge pillow and I eventually want to invest in a bed with an adjustable mattress to keep myself on an incline.
If anyone else has any input that you think could be helpful on how I could fend off the insomnia and be less nocturnal on a consistent basis, it would be appreciated.
Is it safe to take regular Quetiapine 800mg all at night? Pdoc prescribed four 200mg tablets at night, but maximum single dose is 400mg. If I want decent sleep I have to take all dose (800mg) as a single dose at night. I'm feeling fine, no overdose symptoms, just little concerns about safety.