MindDrift: olanzapine / Zyprexa withdrawal, then Citalopram withdrawal

[MindDrift]

1 hour ago, hayduke said:

Hi @MindDrift

 

I would suggest holding until you've felt ok for a week or so.  Next cut not inside a fortnight of your current 5% cut.

 

Have you looked at the Brassmonkey slide taper?  I found this easiest on the system.  Basically a set of four 2.5% cuts, one each week, then a two week hold before resuming.  Obviously, holding longer at any time that makes sense, as always.

 

 

 

 

@hayduke

 

Thanks for your message & the info.

 

This looks very interesting, I'm going to consider it but first I'm going to hold for a month & see where I'm at then.

 

As I mentioned, I prepare my dose by dissolving the Citalopram in water & administer using an oral syringe. If I'm using the Brass Monkey Slide then how will I get such precise doses using this method?

 

Thanks! x

 

 

[MindDrift]

@Altostrata

 

EDIT:

 

I figured out most of what I asked in my last post by looking at tapering threads.

 

The only thing I still wanted to ask is what is "basic normal withdrawal pattern please?"

 

Thanks! x

 

 

[MindDrift]

@hayduke

 

So, three days after my 5% cut & I seem to be in a waves & windows pattern, but not like any other period I can remember: Yesterday 7am, woke feeling absolutely terrible. Three hours later felt exactly as I did before the cut. Two hours later, felt terrible again. Three hours later, felt much better, clearer & more positive than I have done in a really long time. 

 

Today I seem to be back in the same cycle.

 

Not sure quite what's going on but hopefully it's a good sign.

 

What do you think?

 

x

[hayduke]

23 minutes ago, MindDrift said:

@hayduke

 

So, three days after my 5% cut & I seem to be in a waves & windows pattern, but not like any other period I can remember: Yesterday 7am, woke feeling absolutely terrible. Three hours later felt exactly as I did before the cut. Two hours later, felt terrible again. Three hours later, felt much better, clearer & more positive than I have done in a really long time. 

 

Today I seem to be back in the same cycle.

 

Not sure quite what's going on but hopefully it's a good sign.

 

What do you think?

 

x

Sounds fairly typical while you hold and let your nervous system catch up.  How's your self care?

 

As Alto mentioned, you're showing signs of a sensitised nervous system (can relate).  Making the next cut 2.5% when you're ready is probably better than 5%, but as you've observed, no rush.

 

Even though it's been over a year, your body is probably still adapting to all the changes.  I was still very dopamine sensitive 18 months after a long taper off olanzapine.

[MindDrift]

@hayduke

 

Thanks for your reply!

 

My self care is pretty good thanks. I try to eat healthily, drink plenty of water, get exercise, meditate etc. I'm trying to sleep 8 hours instead of my usual 7-7 1/2 per night now.

 

As you can probably see from my sig I've been in this process since 2020, first with Olanzapine which I successfully got off, then with Citalopram, which I drastically damaged my CNS after coming off too quick. Been having waves of PAWS for two & a half years and it can still be pretty challenging now. I'm not surprised that my CNS is a bit all over the place.

 

It's interesting that you mention dopamine: Yesterday when I had that really feeling good period it felt like a sort of dopamine hit. had similar earlier on today for a brief spell too. Would that be right? 

 

I'm going to consider the Brass Monkey Slide method but going to wait a month & see where I'm at then.

 

Anything else you'd suggest?

 

Thanks for your support!

 

x

[hayduke]

Yeah, I'm suggesting you might still be sensitised from your previous olanzapine taper.

 

Are you taking magnesium and fish oil?  I couldn't have got 1/4 as far as I did without epsom salt baths, even daily at times.  Meditation is great, yoga is also amazing at settling down your CNS in the right classes, and time in nature is invaluable too.

[Altostrata]

@MindDrift this oscillation pattern is one of stabilization. Keep notes of how you feel from day to day, you might be able to anticipate your withdrawal pattern.

 

Did you move your dose later in the day?

 

Are you able to get prescription liquid citalopram?

[MindDrift]

21 hours ago, hayduke said:

Yeah, I'm suggesting you might still be sensitised from your previous olanzapine taper.

 

Are you taking magnesium and fish oil?  I couldn't have got 1/4 as far as I did without epsom salt baths, even daily at times.  Meditation is great, yoga is also amazing at settling down your CNS in the right classes, and time in nature is invaluable too.

@hayduke

 

Agreed, though I'm sensing my CNS probably took much more of a bashing from the too quick Citalopram taper & subsequent reinstatement a couple of years ago. 

 

I do take Omega 3, magnesium, vit d & vit e too. I take various Indian herbs that are a part of my Ayurvedic lifestyle too. I also try to commune with nature every day which I really love!

 

I slept ok last night & feel reasonably good this morning. Hopefully I'm starting to even out after the cut on Monday.

 

Epsom Salt baths might be tricky as I've only got a walk in shower! : ) x

 

 

[MindDrift]

10 hours ago, Altostrata said:

@MindDrift this oscillation pattern is one of stabilization. Keep notes of how you feel from day to day, you might be able to anticipate your withdrawal pattern.

 

Did you move your dose later in the day?

 

Are you able to get prescription liquid citalopram?

@Altostrata

 

Hi Alto!

 

I didn't change the dosage time. Maybe I should? Though, it suits me to take it first thing & means I don't forget.

 

My Doctor is not at all knowledgeable about tapering or withdrawal. He's got that dangerous belief that if you're encountering any withdrawal after two weeks then it's a return of symptoms. He's also not very supportive of me in this regard so getting liquid Citalopram probably is not an option.

 

Measuring the dose seems to be ok atm. I dissolve & administer in a 3ml oral syringe. Is there anything you could suggest for greater precision of measuring the dose?

 

Thanks! x

[MindDrift]

@hayduke

 

So, five days after my cut I feel almost back to where I was before.

 

With that in mind, and seeing as it was only a 5% reduction, would you suggest staying where I am for the next three weeks or maybe trying another 5% cut in a weeks time? So that would have been 2 x 5% cuts in a month. What do you think?

 

Thanks! x

 

 

[Altostrata]

On 9/21/2023 at 1:58 AM, MindDrift said:

Measuring the dose seems to be ok atm. I dissolve & administer in a 3ml oral syringe. Is there anything you could suggest for greater precision of measuring the dose?

 

If your dose will fit into it, there are smaller 2mL and 1mL oral syringes.

[hayduke]

5 hours ago, MindDrift said:

@hayduke

 

So, five days after my cut I feel almost back to where I was before.

 

With that in mind, and seeing as it was only a 5% reduction, would you suggest staying where I am for the next three weeks or maybe trying another 5% cut in a weeks time? So that would have been 2 x 5% cuts in a month. What do you think?

 

Thanks! x

 

 

That's good.  This is a pretty typical pattern, as Alto observed.  Why not wait another week and see how it evens out?  It's helpful to get used to observing how you are feeling after cuts, and developing a sense of when you need to hold, and when it's good to try a another reduction.

Re Epsom salts, my last place didn't have a bath either.  I got a suitably sized tub and used to just soak my feet in it - this is still a very effective method of taking on magnesium.

[MindDrift]

7 hours ago, hayduke said:

That's good.  This is a pretty typical pattern, as Alto observed.  Why not wait another week and see how it evens out?  It's helpful to get used to observing how you are feeling after cuts, and developing a sense of when you need to hold, and when it's good to try a another reduction.

Re Epsom salts, my last place didn't have a bath either.  I got a suitably sized tub and used to just soak my feet in it - this is still a very effective method of taking on magnesium.

@hayduke

 

Thanks, yeah, it's much more encouraging than how I felt the day after the cut! Even before the cut I was still encountering some uncomfortable waves of PAWS so still expecting more of them at some stage, though hopefully they'll not be any worse than before.

 

I'm going to re-evaluate where I'm at on October 9th.

 

I take 300mg magnesium every morning; do you think taking on kore could be a benefit for me? 

 

Thanks! x

[hayduke]

8 minutes ago, MindDrift said:

@hayduke

 

Thanks, yeah, it's much more encouraging than how I felt the day after the cut! Even before the cut I was still encountering some uncomfortable waves of PAWS so still expecting more of them at some stage, though hopefully they'll not be any worse than before.

 

I'm going to re-evaluate where I'm at on October 9th.

 

I take 300mg magnesium every morning; do you think taking on kore could be a benefit for me? 

 

Thanks! x

 

You can't go too wrong holding whenever you feel wobbles, until you don't, I reckon. 

 

Oral magnesium isn't bad, some are better than others.  Though I share the common view that Mg is best absorbed through the skin.  There is a spray-on form too which I might use in between baths.  It's just not as effective though it does help.

For some reason my body has an enormous appetite for Mg, so I am very conscious of how to best feed it!

[MindDrift]

2 minutes ago, hayduke said:

 

You can't go too wrong holding whenever you feel wobbles, until you don't, I reckon. 

 

Oral magnesium isn't bad, some are better than others.  Though I share the common view that Mg is best absorbed through the skin.  There is a spray-on form too which I might use in between baths.  It's just not as effective though it does help.

For some reason my body has an enormous appetite for Mg, so I am very conscious of how to best feed it!

@hayduke

 

Thanks!

 

I've got some Magnesium spray/ lotion, maybe I should start using more of it again?

 

How do you know when you need more of it? Also, in what way does it help with the WD? Makes you feel better?

 

 

[hayduke]

1 minute ago, MindDrift said:

@hayduke

 

Thanks!

 

I've got some Magnesium spray/ lotion, maybe I should start using more of it again?

 

How do you know when you need more of it? Also, in what way does it help with the WD? Makes you feel better?

 

 

 

The nervous system is electrochemical, and it helps with that balance (salt, batteries etc).  It's also really good at stopping muscle cramps.  My first yoga instructor picked this up a long time ago ("eat more spinach" also good advice from her).

 

It settles the nerves, simply.  Very calming, and for the right reasons.  I've been known to visit friends just to use their baths for a soak in it.  Best thing to do is try it one evening after your chores, you might not get too much done after 🙂

[MindDrift]

@hayduke

 

Hello!

 

After feeling settled for about 10 days, after my less than 5% cut, I made another 1ml reduction yesterday morning. 
 

So far it’s been playing out the same as last time: Restless sleep last night & feeling the same kind of terrible as I did when I made the last cut. 
 

Expecting a changeable day tomorrow then hopefully start to feel a bit better on day 4. 
 

Wish me luck! x 😀

[hayduke]

That's the way @MindDrift.  Learning to identify the patterns and 'wd normal'.

[MindDrift]

@hayduke

 

Hello!

 

Three days in & it's similar but not quite as intense as the last cut I made. Not sure why that is?

 

Today was a bit of a struggle though because I couldn't sleep last night. Went to bed at 11pm, laid there till 1.30am then got up & watched a film. Went back to sleep at 3.30 & got up at 9.30am. I had to work so that's what I did. Whenever I don't get enough sleep it always magnifies everything, and that's how it felt today. It's almost 9pm here so I'm going to bed in about an hour. Need some proper rest. When I did my last cut, day four was a real turning point so I'm hoping for an element of that tomorrow. 

 

I was on 2.5ml & now down to 2.3 so that's less than a 10% reduction all told. So, now I hold till November 1st then make another cut? 

 

Is there any evidence to suggest that leaving less than a month between cuts can be a safe and effective way to taper down?

 

Thanks! x

 

 

[Altostrata]

1 hour ago, MindDrift said:

Is there any evidence to suggest that leaving less than a month between cuts can be a safe and effective way to taper down?

 

Hello, @MindDrift Seems you understand your own withdrawal pattern.

 

The recommendation of monthly intervals is an estimate. If withdrawal symptoms from your prior decrease had completely gone away for a couple of weeks, you might cautiously try another reduction.

 

Given your withdrawal pattern, it seems you need about 3 weeks minimum to recover from a decrease.

 

I must say, that citalopram has a hold on you!

[MindDrift]

Hi @Altostrata!

 

It actually took me about a week to get back on solid ground after a less than 5% cut (2.4 from 2.5ml.) Hopefully it'll take about the same time to recover from this most recent 1ml cut.

 

How important is it to wait once I feel ok? Could I try a 1ml cut every two weeks or is there value in holding for longer periods even if I feel ok?

 

Thanks! x

 

 

[Altostrata]

5 minutes ago, MindDrift said:

How important is it to wait once I feel ok?

 

It's important. Not feeling okay is your nervous system saying it needs a rest from drug changes.

[MindDrift]

Thanks @Altostrata!

 

What I meant was that once I feel ok, which with these last two cuts has been about a week, would it be ok to make another cut right away? 

 

Or would it be wise to still have additional hold time between cuts?

 

Thanks! x

 

 

[hayduke]

1 hour ago, MindDrift said:

Thanks @Altostrata!

 

What I meant was that once I feel ok, which with these last two cuts has been about a week, would it be ok to make another cut right away? 

 

Or would it be wise to still have additional hold time between cuts?

 

Thanks! x

 

 

 

Best to keep it at or under 10%/mo.  The extra week when you feel ok is still healing time for your body.

 

After a while at 10%/mo you might get a sense if you are one of the lucky few with more wiggle room.  I wouldn't play with that part of the envelope until you've established a comfy 10%/mo descent rate, and remember many of us have to go slower.

[Altostrata]

On 10/4/2023 at 2:42 PM, MindDrift said:

Could I try a 1ml cut every two weeks or is there value in holding for longer periods even if I feel ok?

 

I think you mean a 0.10mg cut? You could try that every 2 weeks, it would be within 10% per month until your dose got below 2.0mg.

[MindDrift]

Thanks @Altostrata!

 

Yeah, sorry, typo. It is 0.1 that I meant.

 

So, most recent cut pretty much followed the same pattern as the first but nowhere near as intense. Not sure why that is? Day five & I'm almost back to normal.

 

I'm going to wait another nine days then make another 0.1 ml cut & carry on this way.

 

So, am I right in thinking that the WD symptoms will most get likely more intense as I get to lower doses?

 

Thanks! x

 

 

 

 

 

 

[hayduke]

1 hour ago, MindDrift said:

am I right in thinking that the WD symptoms will most get likely more intense as I get to lower doses?

This is why we base our 10% (5%, 2.5%, w/e) reduction on the previous dose, and not from the original amount.  The curve you want to follow is approximately hyperbolic with a longer tail as you approach zero.  The reason for this is that our nervous systems respond to drug dosages in that manner, which is to say non-linear.

 

The take away from that is that since the reductions get smaller, you try and keep things even for your nervous system as you go.  If you were to just take the same physical amount off (say 0.1ml) each cut, our nervous systems react by seeing the cuts as bigger each time.

 

Our bodies are the ultimate judges of whether we are tapering too fast.  Keeping wd symptoms minimal and manageable all the way through the taper is the way to go.

[Altostrata]

8 hours ago, MindDrift said:

So, am I right in thinking that the WD symptoms will most get likely more intense as I get to lower doses?

 

Not necessarily, as long as you stay within 10% reduction per month. After you get below 2.0mg, you may wish to change to 0.05mg reductions.

[MindDrift]

23 hours ago, hayduke said:

This is why we base our 10% (5%, 2.5%, w/e) reduction on the previous dose, and not from the original amount.  The curve you want to follow is approximately hyperbolic with a longer tail as you approach zero.  The reason for this is that our nervous systems respond to drug dosages in that manner, which is to say non-linear.

 

The take away from that is that since the reductions get smaller, you try and keep things even for your nervous system as you go.  If you were to just take the same physical amount off (say 0.1ml) each cut, our nervous systems react by seeing the cuts as bigger each time.

 

Our bodies are the ultimate judges of whether we are tapering too fast.  Keeping wd symptoms minimal and manageable all the way through the taper is the way to go.

@hayduke

 

Thanks Hayduke!

 

x

[MindDrift]

16 hours ago, Altostrata said:

 

Not necessarily, as long as you stay within 10% reduction per month. After you get below 2.0mg, you may wish to change to 0.05mg reductions.

@Altostrata

 

Thank you! x

[MindDrift]

@hayduke

 

It's 9 days after my last 0.1ml cut and the last couple of days have been difficult.

 

Yesterday was more emotional than anything else but had a dull headache simmering most of the evening. Felt real emotional fragility & what felt like a bit of a wave of numbness & depression.

 

Today has been really difficult. Woke up with a headache & feeling so tired. It's 2pm now & I've felt terrible with classic WDs most of the day. Got aching limbs, headache & that feeling of being spaced out & disconnected. It's all the same stuff I've been experiencing to differing degrees for the last three years or so. 

 

Even before I started tapering again, I was still getting waves of WDs, but was rarely experiencing the intensity that I'm feeling today so hopefully it's going to pass.

 

I'm sensing that this is just another non linear wave that's being magnified by the most recent tapering?

 

Would I be right in thinking that future waves will probably be like this, or even more troublesome as I get down to lower doses?

 

Thanks in advance!

 

x

 

 

 

 

 

 

[hayduke]

22 hours ago, MindDrift said:

@hayduke

 

It's 9 days after my last 0.1ml cut and the last couple of days have been difficult.

 

Yesterday was more emotional than anything else but had a dull headache simmering most of the evening. Felt real emotional fragility & what felt like a bit of a wave of numbness & depression.

 

Today has been really difficult. Woke up with a headache & feeling so tired. It's 2pm now & I've felt terrible with classic WDs most of the day. Got aching limbs, headache & that feeling of being spaced out & disconnected. It's all the same stuff I've been experiencing to differing degrees for the last three years or so. 

 

Even before I started tapering again, I was still getting waves of WDs, but was rarely experiencing the intensity that I'm feeling today so hopefully it's going to pass.

 

I'm sensing that this is just another non linear wave that's being magnified by the most recent tapering?

 

Would I be right in thinking that future waves will probably be like this, or even more troublesome as I get down to lower doses?

 

Thanks in advance!

 

x

 

 

 

 

 

 

I would hold until you feel better.  This sounds pretty normal for wds, at times.  There isn't always obvious rhyme or reason to how you feel, but you still have to work with it.

 

Also noting that after your total 10% cut, if you were doing 4x2.5% cuts on the brassmonkey schedule, you'd be due for a two week hold.

 

Cheers

[MindDrift]

@hayduke

 

Hello!

 

It's 15 days since my last 0.1ml cut and after feeling almost back to normal I had a massively stressful emotional event, three days ago, that triggered a pretty bad wave of symptoms. I'm really struggling to eat because I just don't feel hungry. Sleep is pretty poor too & it's magnified everything. Been bursting out crying & having loads of old stuff from childhood, around loss & abandonment etc coming up again. It's 6pm here & I've got leg pains, headache, anxiety, a head that feels like a big marshmallow & just generally feel physically unwell.

 

Based on the way I was feeling before the aforementioned stressful event, I'm hoping that this is just stress related & not going to be a precedent for a load more uncomfortable waves  of symptoms.

 

Any feedback you've got would be greatly appreciated! x

[hayduke]

19 hours ago, MindDrift said:

@hayduke

 

Hello!

 

It's 15 days since my last 0.1ml cut and after feeling almost back to normal I had a massively stressful emotional event, three days ago, that triggered a pretty bad wave of symptoms. I'm really struggling to eat because I just don't feel hungry. Sleep is pretty poor too & it's magnified everything. Been bursting out crying & having loads of old stuff from childhood, around loss & abandonment etc coming up again. It's 6pm here & I've got leg pains, headache, anxiety, a head that feels like a big marshmallow & just generally feel physically unwell.

 

Based on the way I was feeling before the aforementioned stressful event, I'm hoping that this is just stress related & not going to be a precedent for a load more uncomfortable waves  of symptoms.

 

Any feedback you've got would be greatly appreciated! x

That all sounds pretty "wd normal" to me.  Life stresses can be amplified during wds, and while advice to minimise them can be trite given we're not always in much control of them, learning to weather them is part of the road.  Holding is generally a good move in the face of these.

 

The emotional releases sound very familiar, the drug masks a lot of that sort of thing and it's pretty normal for them to come up amplified.  "Neuro-emotions" is one lens to look at it through, and can definitely be a factor.  I tend to think there's plenty to have a good cry about in a lifetime!

Sounds like you're doing pretty well.

 

Cheers

[MindDrift]

@hayduke

@Altostrata

 

I'm feeling truly awful again. Got such massive feelings of abandonment, loss & a sense that I'd rather not be here anymore. I've been going through this for over three years and am back to feeling about as bad as I ever have done. I can't take too much more of this. I'm still at 2.3ml but was thinking about going back up to where I was to try to alleviate the symptoms. If I did this is it going to get better or worse as a result of kindling? I need to do something cos this feels like the waves I had 3 years ago & I don't see this getting any better any time soon. Any suggestions or guidance please? x

[Altostrata]

@MindDrift could these be feelings coming back now that your dosage is lower? Is there anything about it that indicates this is a withdrawal symptom?