I have had such a long, epic relationship with Remeron, generic for the anti-anxiety medication Mirtazipane, that I had to look through old blog entries to reconstruct my timeline. I am about to wean off it again and could not for the life of me remember if this would be the third or fourth attempt.

It’s the fourth.

I am going to blatantly plagiarize my blog post from April 2019 to reconstruct my timeline:

• I started taking Remeron in July 2013 when I was first diagnosed with postpartum depression. I took it at bedtime and it definitely helped me sleep. I wrote all about it in my memoir, Adventures with Postpartum Depression.
• My first psychiatrist yanked me off Remeron and Zoloft in February 2015 when I learned I was pregnant with my second child.
• When Julian was born in November 2015, I started taking Zoloft again. My new psychiatrist and I decided that I could wait on the Remeron.
• Three months after Julian was born, I started experiencing increased anxiety and insomnia. I tried to tough it out then realized I was being a martyr for no good reason. I called my psychiatrist and we decided to (1) bump my dose of Zoloft from 100 mg to 150 and (2) put me back on 15 mg of Remeron at bedtime.
• I took Remeron for a year or so and then my psychiatrist and I decided I was ready to wean off Zoloft and Remeron.
• I weaned off Remeron and was off it for several months but then, early 2017, when I made some dietary changes (quitting sugar, reducing carbs), I noticed a surge in anxiety at bedtime. Along with the anxiety came insomnia.
• I realized that I had been numbing some unaddressed anxiety with food, so I went back on Remeron for the rest of 2017. I did a lot of journaling to work through the anxiety and food issues.
• About six or seven months ago, in Fall 2018, I started weaning off Remeron for the third time. By the end of 2018, I was sleeping beautifully sans mirtazipane and assumed I did not need the drug anymore.

Whew. So that brings us through December 2018 and what I thought was the end of my relationship with Remeron. But my old friend insomnia returned in mid-January 2019. It took me about two months to realize I had insomnia. Let me recap:

• First, my shoulder went out on January 13, 2019 the day after I turned 40. The timing felt like a cosmic joke. I started having trouble getting enough sleep. I blamed my sleep issues on my shoulder pain.
• Then I had a cold. I took Tylenol PM and Nyquil and got enough sleep.
• Shoulder pain and insomnia continued. When the cold was over, I blamed the latter on the former.
• Shoulder pain was brought under control, but I was still having trouble getting enough sleep. I would fall asleep easily enough but wake up and stay awake for hours and hours. Some nights, I’d be up from 2-5 a.m. Some nights, I was just up until it was time to start my day.
• I decided I needed to wean off caffeine. I always sleep better when I’m off caffeine.
• Another cold. More Nyquil.
• Finally, by mid-March 2019 I was fully off caffeine.
• But still, I was not getting enough sleep.
• I realized I needed to go back on Remeron.

I have been back on Remeron since mid-March 2019, and though I have only been taking it for seven months, I feel ready to wean again. A couple months ago, I started taking a magnesium supplement called Calm at bedtime. My primary physician recommended I take it when I told her that I fall asleep fine but have trouble getting back to sleep if I wake up during the night. Apparently, for a woman, this type of sleep issue can be related to a magnesium deficiency. An hour before bedtime, I stir a quarter teaspoon of the powder supplement into an ounce or two of hot water. I drink it like its tea, and I have noticed a remarkable improvement in my quality of sleep since adding the supplement to my bedtime routine.

So. Deep breath. It is time for me to wean off Remeron for the fourth time. We shall see what happens this time around. As I have told myself before, I will take the medications I need to take in order to feel like my best self, stigma be damned. But I do not want to take medications if I can make lifestyle changes to manage my symptoms.

I feel like I am at the beginning of a transformation. I quit soda. I started hot yoga. And I found the Calm supplement. Maybe this time I will wean myself off Remeron and stay off it for more than few months. Who knows? This might be the last time I ever wean off Remeron.

Here’s the weaning plan:

• I alternate between a full dose of 7.5 mg and a half dose of 3.75 for two weeks.
• Then, I’ll take the half dose every night for two weeks.
• Then I’ll take a half dose every other night for two weeks. On the off nights, I will just take the Calm supplement. (I will take the Calm supplement every night regardless.)
• Then. I’m done.

We shall see what happens next! I have not scheduled a follow-up appointment with my psychiatrist. She suggested we leave it open and I can get in touch with her if I feel the need. I love her faith and trust in my ability to monitor my health. I love that I trust myself to do this as well!  

p.s. I drafted this post on Halloween, an hour after my appointment with my psychiatrist. This is being posted a bit later though because hey, Halloween + Mom Life.