Mental Health I have used benzos on and off for anxiety and sleep, and Mirtazapine is no longer effective for sleep. What could come next?

[Bleaney]

Has anyone else been using Mirtazapine/ Remeron 'off label' for sleep only to find that it becomes ineffective as tolerance builds over time?

What did you switch to next, if anything?

Most of us probably have some 'complicating factors' going on too, and one of those for me is that I have also used benzos for my social anxiety and poor sleep caused by my recently diagnosed Autism (recently diagnosed but I have always had it.)

Benzos make getting on in this world like day and night for me, in terms of how things go and feel with and without them. I have already experienced increasing tolerance / higher doses /dependence / and addiction issues from benzos first time round a few years ago. When I reached the end of that road, I tapered down and abstained for 6 months to get myself out of that mess. I eventually went back to benzos because for me life is SO MUCH easier and better on them than not. Having found a med that solves many of my problems I think I would me mad and foolish not to use it for the benefits it gives me.

I am aware of the problems of benzo use. And one of the big ones is the potential for tolerance, dependency and addiction. So this time round I have been fairly determined not to let my benzo use and tolerance escalate too far into taking ever increasing doses leading to more and more severe dependency and addiction.

I can only think of one way of achieving this, and that means having days off where I don't take any benzos. The main problem then is that sleep is extremely difficult on the non-benzo days due to the rebound insomnia. THe Mirtazapine that did help me out on these days no longer works, unless I combine it with increasing amounts of whisky. I don't really want to be doing that long term though.

I typically have one weekend day and one mid week day where I abstain from benzos and where sleep is a bitch. I know I could just 'suck it up' / 'tough it out' on those days, and it may have to come to that.

Otherwise, does anyone know of any medications / substances / drugs / herbal remedies / anything at all that could take the place of Mirtzapine and help me with my sleep?

(I have tried Valerian root, Phenergan/Promethazine, Hydroxyzine, Diphendrydramine, CBD, amongst many other things that I cant think of right now. Without exeption none of these things work for very long due to rapid build up of tolerance.

EDIT: added later - I have also tried Zopiclone etc, and I see the Z-drugs as basically the same thing as a benzo, only that they've been tweaked for sleeping. They both work on the GABA receptors in the brain in a similar way, and I believe that the Z-drugs and benzos are cross tolerant with each other.

Ideally I'm looking for something that isn't similar to benzos / Z-drugs or anything that works on the GABA receptors, so that I can give these a rest on my off days and try to keep my GABA tolerance as low as possible for as long as possible.)

 

[SuperPsych]

I'm in a similar boat. I've struggled with insomnia since I was a kid and have tried everything. Benzos worked best for me but the addiction issues are no fun to deal with. Have you tried Zopiclone? I've found it to be a pretty effective sleep med. I'd still be worried about addiction issues, but the addiction issues shouldnt be as severe as benzos I dont think

 

[Specified]

I've tried zopiclone...after bout week it gives me nightmares. But everyone's different. Have you tried seroquel? It's an an anti psychotic but don't let that scare ya...won't have any side effects if you're not psychotic

 

[Bleaney]

I'm in a similar boat. I've struggled with insomnia since I was a kid and have tried everything. Benzos worked best for me but the addiction issues are no fun to deal with. Have you tried Zopiclone? I've found it to be a pretty effective sleep med. I'd still be worried about addiction issues, but the addiction issues shouldnt be as severe as benzos I dont think

I see Zopiclone as basically the same thing as a benzo, only that it's been tweaked for sleeping. They both work on the GABA receptors in the brain in a similar way, and I believe that the Z-drugs and benzos are cross tolerant with each other.

Ideally I'm looking for something that isn't similar to benzos / Z-drugs or anything that works on the GABA receptors, so that I can give these a rest on my off days and try to keep my GABA tolerance as low as possible for as long as possible.

I've tried zopiclone...after bout week it gives me nightmares. But everyone's different. Have you tried seroquel? It's an an anti psychotic but don't let that scare ya...won't have any side effects if you're not psychotic

Ive not looked into or tried Seroquel, but I will follow up on that, thanks.

 

[Bleaney]

From Wikepedia - Seroquel "Despite being widely used as a sleep aid due to its sedating effect, the benefits of such use do not appear to generally outweigh the side effects.......The use of low doses of quetiapine for insomnia, while common, is not recommended; there is little evidence of benefit and concerns regarding adverse effects"

Doesn't sound too great. Does anyone in the UK know if Quitepine is prescribed over here for insomnia, and how have you got on with it if so?

 

[Anxiety Girl]

Yeah mirtazapine stopped working for sleep and I got depressed on it and had serotonin syndrome, tolerance definitely builds just like it does on everything for most people

I have a valium addiction now, I'm tapering, as it turned out they make your mental health worse, my story is on a thread I made couple of day's ago, I have needed to take pills for insomina for years and tried almost everything apart from antipsychotics, so yeah don't think you can take benzos occasionally as that's how it started for me, but your brain then wants it every night, you can't sleep as your brain is waiting for the drug it knows helps sleep, I know you've been addicted before, so have I and came off them, they helped before, this time round they did, untill they didn't, what may of worked for you before might not next time, and every time you go on benzos then try and come off it's worse, it's called the kindling effect

You can try trazodone, it's a sedating antidepressant, but on low dose can help sleep, it don't really work as an antidepressant at low dosages though hence why it's off label for insomnia

Another is 400mg capsules of l theanine, it's what's in green tea, but obviously a much higher dose, helps anxiety too, you can get it off ebay etc, but that works on gaba receptors but not the same gaba receptors as benzos, I've tried it, but it gave me nightmares but everything gives me nightmares

 

[Bleaney]

Yeah mirtazapine stopped working for sleep and I got depressed on it and had serotonin syndrome, tolerance definitely builds just like it does on everything for most people

I have a valium addiction now, I'm tapering, as it turned out they make your mental health worse, my story is on a thread I made couple of day's ago, I have needed to take pills for insomina for years and tried almost everything apart from antipsychotics, so yeah don't think you can take benzos occasionally as that's how it started for me, but your brain then wants it every night, you can't sleep as your brain is waiting for the drug it knows helps sleep, I know you've been addicted before, so have I and came off them, they helped before, this time round they did, untill they didn't, what may of worked for you before might not next time, and every time you go on benzos then try and come off it's worse, it's called the kindling effect

You can try trazodone, it's a sedating antidepressant, but on low dose can help sleep, it don't really work as an antidepressant at low dosages though hence why it's off label for insomnia

Another is 400mg capsules of l theanine, it's what's in green tea, but obviously a much higher dose, helps anxiety too, you can get it off ebay etc, but that works on gaba receptors but not the same gaba receptors as benzos, I've tried it, but it gave me nightmares but everything gives me nightmares

Thanks for your reply.

I agree with some of what you have said, but not all of it.

I can take benzos occasionally. At least I have done for the last 5 years or so. And will hopefully continue to do so. One way or another, and no matter how difficult things may get. Even if it means regulary getting no sleep, or very little sleep on the off days. I know it is difficult and not what normally happens. But individual people can be exceptions to generalities. (If I can't find anything to replace Mirtazapine, I'm not sure right now if I'm kidding myself or not as to whether I will be able to resist taking Benzos on long sleepless nights, time will tell on that.)

I can't see any other alternative to taking days off benzos. At the moment it feels like life without them is not an option (I would not be able to continue doing my current job without them and would have to leave due to the anxiety straight off.) Taking them all the time and getting re-addicted to spiraling doses is not an option either. I absolutely do not want to repeat that again. So it really feels like there is no other option other than to take them occasionally. If this means that facing the rebound anxiety and insomnia on the off days is the price to pay then so be it.

I was kind of playing benzos and Mirtazapine off against each other to achieve this dosing pattern over the last 5 years or so. But now my tolerance to Mirtazapine is finally rendering this tactic ineffective, in as much as it no longer works without consuming more and more whisky with my Mirtazapine. I know this is very bad for my health, and it's no fun waking up with a bad head most times this happens either.

You're dead right that the brain comes to rely on benzos and / or things like Mirtazapine in order to sleep. It can take weeks or months of abstinence to reverse this effect.

I also agree that benzos can make your anxiety feel even worse. I believe that this is a rebound effect though and that equilibrium gets restored in time. But everyone is different, and everyone's reactions and wiring and chemistry and all the rest of it means that what works for one person may not work for another, and vice versa.

I have tried l theanine. Unfortunately I couldn't feel a thing off it, in terms of anxiety relief.

This kindling effect sounds pretty scary. I need to look this up. And Trazadone, I don't know anything about that..

 

[Anxiety Girl]

I was kind of playing benzos and Mirtazapine off against each other

At first I was taking benzos for a while couple of months maybe, then stopping and taking mirtazapine for a month or so, then move onto zopiclone, then promethazine alternating so my brain didn't get used to one lol, but it got obviously got used to sedatives in general, I'd take anything if I knew or thought it would help me sleep

I'm not sure l theanine worked for my anxiety, I only took it for a short amount of time when I started this valium taper, I've not tried it on it's own I've just read alot of good things about it, weird thing is at lower dosages it apparently gives you energy

Whisky every night is worse than benzos though I think, so if you can do them when you really need them and not every night then that's good, remember the very long half life of valium though, even taking 2-3 times a week, they don't have a chance to leave your system on the days off, hence why when people stop their taper completely the worse effects start at around 2 weeks, then it takes even longer to piss clean, around 6 weeks it can show up in your piss for as it builds up in your system, in your muscles and tissues etc

 

[Bleaney]

At first I was taking benzos for a while couple of months maybe, then stopping and taking mirtazapine for a month or so, then move onto zopiclone, then promethazine alternating so my brain didn't get used to one lol, but it got obviously got used to sedatives in general, I'd take anything if I knew or thought it would help me sleep

I'm not sure l theanine worked for my anxiety, I only took it for a short amount of time when I started this valium taper, I've not tried it on it's own I've just read alot of good things about it, weird thing is at lower dosages it apparently gives you energy

Whisky every night is worse than benzos though I think, so if you can do them when you really need them and not every night then that's good, remember the very long half life of valium though, even taking 2-3 times a week, they don't have a chance to leave your system on the days off, hence why when people stop their taper completely the worse effects start at around 2 weeks, then it takes even longer to piss clean, around 6 weeks it can show up in your piss for as it builds up in your system, in your muscles and tissues etc

I've cycled through a whole range of downers too.

Right now I could really do with another 4 months off work on furlough pay in order to do a big reset off everything. I don't think that's going to happen though so I'll have to figure something out.

I've found that short acting benzos like Etizolam and Xanax work better for me. It's more that that they seem better for anxiety that's the important thing for me at the moment. But if you're tapering down and off then a long acting benzo like Valium will be best for that, as I'm sure you know.

If I could get a job where I could work from home more often I'd be able to have more days off benzos and that would help change the balance of things more in my favour.

 

[Anxiety Girl]

I've found that short acting benzos like Etizolam and Xanax work better for me. It's more that that they seem better for anxiety

I used to love xanax back when I was first trying them but they was loose bars so could of been mixed with RCs lol, then I'd buy legit pharma grade ones but they wore off quick and I'd get rebound anxiety

I tried etizalam it made me really fucking angry at nothing, I was fuming mad and I kept taking more every hour I'd take another and another, even ordered more, but before they arrived I thought nope, not taking them again so I sold them, I'd been off every drug for 4 months before I took those, and here I am again lol

Yeah valium is the best one for tapering, brings the levels of it in your body down gradually helping the gaba a receptors to adjust better than shocking them by trying to use a short acting benzo, still fucking scarred to get off though that's for sure

 

[Bleaney]

I used to love xanax back when I was first trying them but they was loose bars so could of been mixed with RCs lol, then I'd buy legit pharma grade ones but they wore off quick and I'd get rebound anxiety

I tried etizalam it made me really fucking angry at nothing, I was fuming mad and I kept taking more every hour I'd take another and another, even ordered more, but before they arrived I thought nope, not taking them again so I sold them, I'd been off every drug for 4 months before I took those, and here I am again lol

Yeah valium is the best one for tapering, brings the levels of it in your body down gradually helping the gaba a receptors to adjust better than shocking them by trying to use a short acting benzo, still fucking scarred to get off though that's for sure

It sounds like Etiz really did not agree with you if you had a bit of 'benzo rage' going on. I used to get that sometimes after taking too much Phenazepam, that really was not good.

It's the right thing for most people to do, to get off benzos, and to find other ways of dealing with the anxiety.

Once you do get off them the rebound anxiety and insomnia will pass and then hopefully you'll be in a better position to start over again with a different approach.

If you've already been through all this before that will help as you know that you can do it.

 

[Anxiety Girl]

If you've already been through all this before that will help as you know that you can do it

I have but I wasn't on them this long and it's been every night, when I came off them before I'd go onto something else, have breaks from the valium, yeah been on and off 6 or 7 years, mainly on I know but the breaks made me think I can come off, but I'd end up back on, this time I don't want back on them when I get off, another reason is my vendor could get busted anytime, he's the only trusted person I buy off, fuck being forced into cold turkey eh

Thanks though, I know it's the right thing to do, know I need to find other ways to deal with anxiety and everything else my loony brain is lol

 

[paranoid android]

Trimipramine is a old tricyclic that is pretty good for sleep. So is amitriptyline

 

[Jerry Atrick]

From Wikepedia - Seroquel "Despite being widely used as a sleep aid due to its sedating effect, the benefits of such use do not appear to generally outweigh the side effects.......The use of low doses of quetiapine for insomnia, while common, is not recommended; there is little evidence of benefit and concerns regarding adverse effects"

Doesn't sound too great. Does anyone in the UK know if Quitepine is prescribed over here for insomnia, and how have you got on with it if so?

Seroquel is overprescribed. Yes, it is common at least in the US for docs to prescribe it for insomnia but I do not recommend it. I'm not a doctor but prescribing a powerful anti-psychotic for insomnia is considered off label use. I would say to trust your gut instinct on what Wikipedia has to say about it.

Also, I can no longer find it but I read a journal article several years ago that linked Seroquel being prescribed for insomnia as causing Parkinson's-like symptoms in patients. The only articles I can find now relate to Seroquel being prescribed to Parkinson's patients for psychosis. But if you know what Parkinson's is, I would never take a medication that can outright cause it. May not happen to you but why roll the dice?

 

[pf100]

When it stopped working for sleep, I switched from mirtazapine to amitryptiline which I hate, but whatever. I tried seroquel but that stuff is incredibly nasty to me so I stopped that.
I slept okay the last couple of years without anything but lately I have insomnia so taking about 1mg, yes 1mg, of mirtazapine at night.
Mirtazapine is the best for sleep for me. I like taking the least amount that works because it has a 20 to 40 hour half life and too much makes me sleepy the next day.

 

[Dreamflyer]

I've done both, and unfortunately I build up a tolerance to medications very quickly. I don't mean to be discouraging, but I want to share my personal experiences with you.

Mirtazapine knocked me out for about my first month on it, but now it only works on my depression.
Benzos can help me fall asleep sometimes, but it's not quality sleep and I feel even more tired in the morning.
I've tried the natural approach (melatonin, valerian, chamomile, etc.), but they do nothing for me.
Ambien scares me because I don't want to go out sleep-driving.
Benadryl gives me horrible restless leg syndrome.

I've known people who tried things like Seroquel and Trazodone, but they had bad reactions to them so I've never tried them.

Everyone's chemistry is different though, so don't give up.

I sleep better as I get older, and I also require less sleep to feel rested. This probably didn't help you much, but I know how insomnia feels and it sucks. You're not alone.

Feel better,
Dreamflyer

 

[SpiralusSancti]

Mirtazapine (like just about any sleep-aid for me) worked fine a few day and than I would need to increase dosage so I didn’t continue to use. But for my ex it seemed to continue working fine as sleep-aid even after a long use.

Maybe check out thread I made - https://bluelight.org/xf/threads/me...st-other-options-so-you-don’t-have-to.930000/

 

[Dreamflyer]

Mirtazapine (like just about any sleep-aid for me) worked fine a few day and than I would need to increase dosage so I didn’t continue to use. But for my ex it seemed to continue working fine as sleep-aid even after a long use.

Mirtazapine is unique in the sense that lower doses are more sedating, while higher doses can become stimulating. Years ago, I thought that increasing the dosage would help me sleep better, when in fact it was having the opposite effect.

As an unrelated but interesting side note, nicotine seems to be the other way around. Low doses are stimulating but high doses are sedating. Who would've known?