Brief Answer: Hello Detailed Answer: Welcome to XXXXXXX You have been taking treatment of depression and are taking Xanax and Nardil since 1985. Xanax is a benzodiazepine drug and this is a drug with effectiveness in anxiety and sleep problems associated with depression. Nardil is a anti-depressant drug which is a older drug. Continuous use for about 28 years has made you dependent and this is the main reason for withdrawal syndrome. Nardil is an older drug and there has been improvement in drugs and you has been given Mirtazepine which is a newer and safe drug. The drug is safer as compared to Nardil and is also more effective. If you are able to tolerate the symptoms then there is no need to consult the psychiatrist again but if the symptoms are really bothersome then you should take help from your psychiatrist. Mirtazepine will cover the depleted amounts of serotonin and dopamine so this will prevent severe withdrawal. Most likely the withdrawal symptoms you are having are due to Xanax withdrawal because beizodiazepine withdrawal lasts for long. Best thing in such case is to gradually taper the doses of drug over 4-6 weeks and this will prevent the symptoms. Over all the symptoms will decrease in severity in coming 8-10 days by own. There is no need to worry, however minor symptoms may persist for some months but they can be tolerated easily. If possible please mention the symptoms you are exactly having in withdrawal so that I can comment better. Thanks, you can mention your symptoms in follow up if you want to get more questions.

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Brief Answer: Hello Detailed Answer: Welcome to again Abrupt stoppage of benzodiazepine usually result in severe withdrawal. 4 mg dose in not a low dose and continuous use for 28 years has resulted in development of tolerance. Gradual tapering of doses is usually advisable. You can consult your doctor again and can ask of gradual tapering of doses. You have been off Xanax since last one month, so there is no need to take replacement drug as the acute severe withdrawal time has passed already. Try relaxation exercises like Progressive Muscle Relaxation Exercises, Breathing Exercises for relaxation. Though these modalities will not provide acute relief but they will improve the symptoms with time. Although Mirtazepine increases serotonin levels but this drug increases serotonin by a different mechanism than conventional anti-depressants so this drug will not cause severe side effects. Even MAOIs cause increase in the levels of serotonin along with other neurotransmitters so there is no need to fear because of this drug. Mirtazepine is a drug that improves sleep along with antidepressant action. This drug is also free of sexual side effects and even improves such condition. Even it improves hallucinations or severe panic like situation. Apart from that you can take Omega 3 Fatty Acid Soft gels which improves anxiety and depression. These are nutritional supplements and have proved potency. Thanks, hope this helps you. If you have more questions you can ask again.

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