Nicjk: my introduction

[Nicjk]

1 hour ago, ChessieCat said:

I've moved your question to your own Intro.

 

how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators

 

I like this one.  Note the instructions.  And that there are 3 tabs for different types of taper.

 

 

Thanks so much ChessieCat. Very useful spreadsheets! Question - is there a way you guys can change the title of my intro? I find "insomnia from Lexapro" really triggering because my biggest regret is getting back on Lexapro. It is what got me into this mess, now stuck on Olanzapine and Nortriptyline. 

[ChessieCat]

28 minutes ago, Nicjk said:

I find "insomnia from Lexapro" really triggering because my biggest regret is getting back on Lexapro.

 

Generally the title is not changed because the staff do not have time to spend on that type of thing.  However in this instance I will do it for you.

[ChessieCat]

I can see from your drug signature that you were taking Pericyazine (Neulactil).

 

May I ask how many doses of it you were taking a day?  There is another member robynne who is currently taking 2.5mg and it would appear that she is experiencing interdose withdrawal because she is only taking it once a day and from the information I have found it has a half life of 6-7 hours and the patient information sheet that I found for NZ states to divide the dose and take it twice daily.

 

Thank you in advance.

 

 

 

[Nicjk]

3 minutes ago, ChessieCat said:

However in this instance I will do it for you.

I so appreciate that ChessieCat! I completely understand why you don’t usually do it, so I’m thankful that you made an exception on this occasion. I will be relying on SA a lot during my Olanzapine taper. 
 

In terms of your question about Neulactil - I was only on it once per day. So horrible that Robynne is experiencing interdose withdrawals. I didn’t experience that

 

[Nicjk]

Hi everyone,

 

I have been on 5mg Olanzapine for 3.5 years. A year and a half ago I attempted to switch to an Olanzapine wafer dissolved in water so that I could start my taper and I had insomnia for 2 weeks so had to go back on the solid tablet. This is because the liquid version is metabolised differently to the solid pill, so some people can't tolerate the liquid. Since then I have been sensitive to even tiny fluctuations of the drug in my system.

 

Three nights ago I made a 3% reduction and I have started waking up really early (around 3am). The first night I couldn't fall back to sleep but the night after I was able to. Do you think I will just need to tolerate the insomnia and wait until it passes each time I reduce? I would have insomnia even if I made a 1% reduction so the only way I can see me getting off this drug is if I wait out the insomnia each time. Thanks for reading 

[Intense]

On 1/3/2024 at 9:47 PM, Nicjk said:

Hi everyone, I am about to begin my olanzapine taper and I will be reducing by 5% per month because I am super sensitive to reductions (I attempted to reduce in the past). I will be having capsules compounded because I can’t tolerate liquid olanzapine. I’m on 5mg now and I meant to ask my psychiatrist if he could prescribe me 5mg capsules so that my brain could get used to metabolising the capsules instead of a solid tablet, before I make my first reduction, but I forgot. So I will be going straight to 4.75mg in capsules. Am I likely to run into issues because I’m not letting my brain get used to capsules first? 

What hayduke said is true. Stay on the solid form as long as possible until you feel comfortable and stable. Don't feel like you have to rush to taper. After holding, then you can taper. Also, if you can't tolerate the liquid form, I think that's probably because your body isn't fully adjusted to the 5mg yet, so you might need more time on 5mg. When you’re ready to taper, you can put a 5mg olanzapine tablet in 50ml water in a small brown glass jar, and you leave it in the fridge for at least 30 minutes. You'll need a 60ml syringe and a 30ml syringe when you get to 3mg and below. If I put a 5mg olanzapine tablet in 50ml water, 10ml will equal 1mg. Take it out of the fridge and stir it with a straw or the syringe. You'll notice white particles in the middle of the water or just sunk to the bottom. So take a plastic straw or the syringe and just stir it. You'll notice everything is now evenly distributed. So you just use the syringe and measure out your dose. Some people are also sensitive to medication taken in liquid form, so that may be the case for you.

[Nicjk]

46 minutes ago, Intense said:

What hayduke said is true. Stay on the solid form as long as possible until you feel comfortable and stable. Don't feel like you have to rush to taper. After holding, then you can taper. Also, if you can't tolerate the liquid form, I think that's probably because your body isn't fully adjusted to the 5mg yet, so you might need more time on 5mg. When you’re ready to taper, you can put a 5mg olanzapine tablet in 50ml water in a small brown glass jar, and you leave it in the fridge for at least 30 minutes. You'll need a 60ml syringe and a 30ml syringe when you get to 3mg and below. If I put a 5mg olanzapine tablet in 50ml water, 10ml will equal 1mg. Take it out of the fridge and stir it with a straw or the syringe. You'll notice white particles in the middle of the water or just sunk to the bottom. So take a plastic straw or the syringe and just stir it. You'll notice everything is now evenly distributed. So you just use the syringe and measure out your dose. Some people are also sensitive to medication taken in liquid form, so that may be the case for you.

I waited 1.5 years since trying to switch to the liquid version, do you really think I should spend more years on this drug? I don’t think more time on the drug will fix my sensitivity 

[Intense]

22 minutes ago, Nicjk said:

I waited 1.5 years since trying to switch to the liquid version, do you really think I should spend more years on this drug? I don’t think more time on the drug will fix my sensitivity 

I didn't say you need to stay on it for years in order to fix your sensitivity. It shouldn't take years for that. Probably more like 3-4 weeks or as long as 2-3 months, sometimes longer than that depending on how long you were off the solid version of olanzapine. But what I'm trying to say is don't try to rush to get off of olanzapine and don't try to do big sharp drops in order to try to get off of it quicker because it's only going to lead to more problems down the road, including the inability to fall asleep. I've been doing the 2.5% brassmonkey slide taper where you do a 2.5% drop every week for 4 weeks and on the last reduction hold it for an additional 2 weeks (or basically holding the last reduction for 3 weeks). Now I'm at 1.12mg and I'm still able to go to sleep and still stable. Why? Because I started with 5mg, my body was already dependent on the 5mg dose, so then I switched over to the water taper, started doing a very slow taper and it's been working out well for me. You're gonna have to work out the sensitivity issues before you start tapering. Otherwise, it's just gonna lead to more issues down the road.

[Nicjk]

41 minutes ago, Intense said:

I didn't say you need to stay on it for years in order to fix your sensitivity. It shouldn't take years for that. Probably more like 3-4 weeks or as long as 2-3 months, sometimes longer than that depending on how long you were off the solid version of olanzapine. But what I'm trying to say is don't try to rush to get off of olanzapine and don't try to do big sharp drops in order to try to get off of it quicker because it's only going to lead to more problems down the road, including the inability to fall asleep. I've been doing the 2.5% brassmonkey slide taper where you do a 2.5% drop every week for 4 weeks and on the last reduction hold it for an additional 2 weeks (or basically holding the last reduction for 3 weeks). Now I'm at 1.12mg and I'm still able to go to sleep and still stable. Why? Because I started with 5mg, my body was already dependent on the 5mg dose, so then I switched over to the water taper, started doing a very slow taper and it's been working out well for me. You're gonna have to work out the sensitivity issues before you start tapering. Otherwise, it's just gonna lead to more issues down the road.

I tried to switch to the wafer a year and a half ago. I have stabilised on 5mg for a full year and a half- do you really think that my sensitivity will sort itself out if I hold for another few months?

[Intense]

1 hour ago, Nicjk said:

I tried to switch to the wafer a year and a half ago. I have stabilised on 5mg for a full year and a half- do you really think that my sensitivity will sort itself out if I hold for another few months?

Ok you've stabilized, but you're saying you still can't tolerate taking the liquid version of the olanzapine? Can you at least try the 2.5% brassmonkey slide taper and try the water taper method I mentioned? You're saying your sensitivity hasn't been fully restored, but I think maybe you just need to do a smaller drop so the drop isn't as severe. Or use pharmacy compounded capsules. Whichever you wanna do.

[Nicjk]

15 minutes ago, Intense said:

Ok you've stabilized, but you're saying you still can't tolerate taking the liquid version of the olanzapine? Can you at least try the 2.5% brassmonkey slide taper and try the water taper method I mentioned? You're saying your sensitivity hasn't been fully restored, but I think maybe you just need to do a smaller drop so the drop isn't as severe. Or use pharmacy compounded capsules. Whichever you wanna do.

That’s right I can’t tolerate the liquid version because it is metabolised differently to a solid tablet. The 3% drop I did was with compounded capsules. If I’ve got insomnia with dropping 3% don’t you think I’ll have the same issue with 2.5%? 

[Intense]

26 minutes ago, Nicjk said:

That’s right I can’t tolerate the liquid version because it is metabolised differently to a solid tablet. The 3% drop I did was with compounded capsules. If I’ve got insomnia with dropping 3% don’t you think I’ll have the same issue with 2.5%? 

Are you sure about that? I don't think you even tried the method I described. I put a 5mg olanzapine tablet in 50ml water in a small brown jar, put it in the fridge for at least 30 minutes and take it out. You can leave it in there longer if you like, but I usually leave it in there no more than 9 hours. Now before, you will have noticed white particles that were in the middle of the water or sunk to the bottom, which is just filler and isn't important. Then I take a plastic straw or the syringe and stir it. You'll notice that everything is now evenly distributed. Then take the syringe and measure out and take your dose. If you're saying you have sensitivity issues to the olanzapine, at least try this method and try taking just 5mg, hold on that for a while, and see how you react to it. If you react positively to it, like you're able to go to sleep, then that's a good sign. Then I would just hold on 5mg for maybe 1-2 weeks, then I'd start the taper. If you can't even handle 5mg in liquid form, then I'd say sure go ahead. Go to a compounding pharmacy and have them make compounded capsules.

[hayduke]

nicjk, have you reviewed this topic?

 

 

[hayduke]

On 1/21/2024 at 9:10 AM, Nicjk said:

Hi everyone,

 

I have been on 5mg Olanzapine for 3.5 years. A year and a half ago I attempted to switch to an Olanzapine wafer dissolved in water so that I could start my taper and I had insomnia for 2 weeks so had to go back on the solid tablet. This is because the liquid version is metabolised differently to the solid pill, so some people can't tolerate the liquid. Since then I have been sensitive to even tiny fluctuations of the drug in my system.

 

Three nights ago I made a 3% reduction and I have started waking up really early (around 3am). The first night I couldn't fall back to sleep but the night after I was able to. Do you think I will just need to tolerate the insomnia and wait until it passes each time I reduce? I would have insomnia even if I made a 1% reduction so the only way I can see me getting off this drug is if I wait out the insomnia each time. Thanks for reading 

 

Insomnia is very common during withdrawals.  You might find some ways to deal with it as covered in the thread I linked above.  Often it can be waited out.  This can be one of the 'brakes' on withdrawing as fast as we might wish.

 

There is nothing wrong with making even smaller cuts, seeing how your body recovers and making the next cut based on that.  10%/mo is still too fast for many of us.

 

I don't think I'd agree that your body metabolises the drug differently in a liquid, it's the same amount of the same molecule after all, but it may happen at different rates than a solid tablet.  You might find that using a smaller amount of liquid to make the suspension improves your experience as it will be more 'dense' and your body might react to it more like it would a tablet.

[Nicjk]

Hello @Altostrata I'm hoping you can help me. I am looking to begin tapering off Nortriptyline at 10% per month but I only have 25mg tablets. I am currently on 125mg, so I take 5 x 25mg tablets. I am unable to tolerate liquid versions of medication (I have tried them in the past and I can't sleep). How would I go about tapering off the firm 25mg tablets? 

[Nicjk]

Hi everyone, I have been on Nortriptyline and Olanzapine for 3.5 years. Can anyone guide me as to which drug I should taper first? I’m guessing it wouldn’t be a good idea to taper both at the same time? @ChessieCat you might be the beat person to answer this question

[FireflyFyte]

10 hours ago, Nicjk said:

Hi everyone, I have been on Nortriptyline and Olanzapine for 3.5 years. Can anyone guide me as to which drug I should taper first? I’m guessing it wouldn’t be a good idea to taper both at the same time? @ChessieCat you might be the beat person to answer this question

 

I have moved your post here as we ask that you keep any questions related to your tapering journey in your introductory thread.

Given that Olanzapine is a very powerful medication, you may want to consider tapering that one first. We do recommend only tapering one medication at a time so that any withdrawals can be attributed to the correct medication and adjustments made if needed.

[Nicjk]

17 hours ago, FireflyFyte said:

 

I have moved your post here as we ask that you keep any questions related to your tapering journey in your introductory thread.

Given that Olanzapine is a very powerful medication, you may want to consider tapering that one first. We do recommend only tapering one medication at a time so that any withdrawals can be attributed to the correct medication and adjustments made if needed.

Thank you for your advice. It will take me approximately 16 months to come off Nortriptyline and up to 7 years to come off olanzapine. Doesn’t it make sense to get rid of nortriptyline first? 

[FireflyFyte]

4 hours ago, Nicjk said:

It will take me approximately 16 months to come off Nortriptyline and up to 7 years to come off olanzapine. Doesn’t it make sense to get rid of nortriptyline first? 

 

This is up to you to decide. You could also take some time to lower your Olanzapine dose, hold, and then taper the Nortriptyline.

[Nicjk]

21 hours ago, FireflyFyte said:

 

This is up to you to decide. You could also take some time to lower your Olanzapine dose, hold, and then taper the Nortriptyline.

That's a great idea. I appreciate your input 

[Nicjk]

Hi mods, I haven’t had a chance to update my signature but I have a fairly urgent question. I went through a rocky period so went into hospital and my psychiatrist increased my Nortriptyline from 125mg to 150mg. After 5 nights I couldn’t stand the side effects (dry mouth and eyes) so I went back down to 125mg. It’s now 2 weeks later and I have been hit with horrible withdrawals from the drop back down to 125mg. I am considering updosing to 130mg to see if it helps to relieve the withdrawals (a 5mg updose). Do you think it’s a bad idea? I have been back on 125mg since the 6th of March. Thanks so much. @Altostrata if you’re free to answer this question I’d be so grateful 

[Nicjk]

Hi everyone, I posted this on my intro thread but haven’t received a response and it’s now urgent. On the 1st of March I increased Nortriptyline from 125mg to 150mg because my psychiatrist thought I was having a resurgence of depression. I had too many negative side effects so I only lasted 5 days on the higher dose before I dropped down again. Two weeks after I reduced back down I started having horrible withdrawals and it has now been 18 days since I reduced back down to 125mg. Would it be safe for me to do a small updose to alleviate the withdrawals? I am thinking of going up to 130mg which is only a 4% increase. Thanks so much

[Emonda]

Hi Nicjk,

I've moved your new post back to your own thread. It is best for everything relating to yourself to be in the one spot so that those trying to assist can see what you've been told before.

 

On 3/22/2024 at 8:05 PM, Nicjk said:

I haven’t had a chance to update my signature but I have a fairly urgent question.

 

Please update your signature, and someone will try to assist.

 

FYI: Alto has stepped back from day-to-day involvement here, so best not to tag her moving forward. If you post in your thread, one of us will do our best to assist.

 

Please note that the volunteer team is very small.

 

As to your question, consistency of dose (amount, time you take it, and manufacturer) is so important.

 

Regards