paws akathisia

My story – severe akathisia, depersonalization and blurred vision after antidepressant changes Hi everyone, I’m hoping to hear from people who have experienced something similar and, especially, from people who eventually recovered. I was stable for many years on 225 mg venlafaxine and 15 mg mirtazapine. I had been taking these medications for a long time and was functioning relatively well. In 2021, my GP advised me to taper. I reduced venlafaxine from 225 mg → 150 mg → 75 mg → 37.5 mg, with approximately 6–8 weeks between reductions. I also reduced mirtazapine from 15 mg to 7.5 mg. Initially, I experienced relatively little withdrawal. I eventually reached zero, but after about three weeks I became so unwell that I restarted medication. I went back to 75 mg venlafaxine and 15 mg mirtazapine and then increased venlafaxine back to 225 mg within about two months. However, I never returned to my previous baseline. Since then I have experienced severe and persistent symptoms, including: * severe akathisia/restlessness * depersonalization and derealization * severe anxiety and hyperarousal * severe depression and anhedonia * racing thoughts * blurred/worsened vision * dizziness * tinnitus * nausea and headaches * sleep problems * extreme fatigue The symptoms fluctuate. I can have windows and waves. Sometimes I feel somewhat better for a while, but then the symptoms can become extremely severe again. Mornings are generally the worst, while things often improve somewhat in the afternoon and evening. At one point I reduced venlafaxine again to 112.5 mg, in three reductions of 37.5 mg. I have been on 112.5 mg for a significant period and at one point had approximately six months of relative stability at this dose. The severe akathisia became particularly noticeable after reducing mirtazapine from 15 mg to 7.5 mg. I later increased mirtazapine back to 15 mg, but paradoxically the akathisia became worse rather than better. I am now reducing mirtazapine very slowly, approximately 0.5 mg per month. I am currently around 12.5 mg. What I am struggling with most is understanding what is happening to my nervous system. Could these symptoms be consistent with protracted antidepressant withdrawal / nervous-system dysregulation, even though I am still taking venlafaxine and mirtazapine? Has anyone experienced severe akathisia + depersonalization/derealization + blurred vision + depression/hyperarousal after changes in antidepressants and then eventually recovered? I am particularly interested in hearing from people who had symptoms for a long time and experienced recovery. I would also like to understand whether people have recovered by stabilizing for a long period and then tapering very slowly, rather than making frequent medication changes. I am feeling extremely unwell and would really appreciate experiences from people who have been through something similar.