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Notw: Researching coming off zyprexa (olanzapine)


Notw

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Hi everyone, I'm pursuing tapering off zyprexa (olanzapine). I'm wondering how important the 10% decrease is? I'm on 2.5mg and it's the only one I'm on. I'm considering using a pill splitter to taper so I would decrease by an eighth (so 12.6%) each time. Here's what I was thinking and I was hoping you all could weigh in. This would obviously be super flexible too depending on how things go and I'm open to suggestions.

 

2.5mg (whole pill)

2.19mg (7/8) stay on 8 weeks

1.88mg (3/4) 8 weeks

1.57mg (5/8) 8 weeks

1.25mg (half) 8 weeks

.94mg (3/8) 8 weeks

.63mg (1/4) 8 weeks

.32mg (1/8) 8 weeks

0

 

I did find a psychiatrist who's willing to help me taper and I haven't asked about compounding it yet but that may be an option. As you can see from my history I went off it cold turkey years ago and didn't really have any problems (trouble sleeping for a few months but that evened out) but then had a psychotic break a year later which I'm realizing may have been akethesia. I'm just hoping to do this the right way this time, a way that helps me get the best outcome.

2010 manic episode. (Was on xanax, wellbuterin, seroquel and other meds before mania). At hospital was put on Olanzapine and tapered to 2.5mg

Jan 2014 went off "cold turkey" (didn't change diet or lifestyle at all. Had trouble sleeping for 3 months but then was fine)

Nov 2014 took one 2.5mg due to lack of sleep due to lots of excitement in life at that time. Had manic episode a few days later. Was put back on olanzapine and tapered down to 2.5mg 

2022 - Researching going off meds again but tapering and adding diet changes and supplementation

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  • Frogie changed the title to Notw: Researching coming off zyprexa (olanzapine)
  • Moderator

Hi @NOTW

 

Welcome to SA. 

 

I'm glad you found a psychiatrist that is willing to help you taper off of Zyprexa. It's very difficult to find one that is willing to work with a patient. You are very lucky.

 

So, you have tapered down to 2.5 mg? How long did it take you to taper down?

 

We don't suggest going any faster than 10% a month.

 

Why taper by 10% of my dosage?

 

 

 

Also, we don't suggest using a pill cutter for tapering as the active ingredient of the tablet is not evenly distributed. We suggest using a scale and weighing your doses. I will give you some information on this.

 

 

This is your page where you will receive information, ask questions and meet member as yourself. We ask that each member only have one page so we can keep all your information in one place.

 

Please reach out to us with any questions you may have after you read the links provided. I'm glad you reached out to us.

PREVIOUS medications and discontinuations: Have been on medications since 1996. 

 Valium, Gabapentin, Lamictal, Prilosec and Zantac from 2000 to 2015 with a fast taper by a psychiatrist.

 Liquid Lexapro Nov, 2016 to 31-March, 2019 Lexapro free!!! (total Lexapro taper was 4 years-started with pill form)

---CURRENT MEDICATIONS:Supplements:Milk Thistle, Metamucil, Magnesium Citrate, Vitamin D3, Levothyroxine 25mcg, Vitamin C, Krill oil.

Xanax 1mg 3x day June, 2000 to 19-September, 2020 Went from .150 grams (average weight of 1 Xanax) 3x day to .003 grams 3x day. April 1, 2021 went back on 1mg a day. Started tapering May 19, 2023. July 28, 2023-approximately .87mg. Dr. fast tapered me at the end and realized he messed up. Prescribe it again and I am doing "slower than a turtle" taper.

19-September, 2020 Xanax free!!! (total Xanax taper was 15-1/2 months-1-June, 2019-19-September, 2020)

I am not a medical professional.

The suggestions I make are based on personal experience.

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  • Moderator Emeritus
On 1/25/2022 at 1:23 AM, NOTW said:

I'm considering using a pill splitter to taper so I would decrease by an eighth (so 12.6%) each time.

 

Hi NOTW

Ultimately how fast you can taper safely comes down to how much time your body needs to process the reductions in the drug dosage.

A few people find they can do a bit over 10%/mo, but we don't recommend trying to increase until you know you can comfortably manage 10% as a starting point.  Many of us have to go more slowly, in fact.

A bigger problem with your draft plan is that these classes of drugs have a hyperbolic effect on our nervous systems' receptors, so rather than reducing 10% of the initial dose each month, you need to base each cut at 10% of the previous month's dose.  I started out with similar thinking to you, but before long always found the relatively larger cuts would reach a point where it was just overwhelming for my body to process.  Frogie's given you a link there on why 10%.  You can also have a look at my tapering graph in my signature here - following my body the whole way down, and a bit of trial and error, you can see a rough fit to a log curve.

I found using a pill cutter was uncomfortably inaccurate below 5mg.  You can weigh powder as Frogie has suggested.  I found making a liquid suspension worked best in my case.

 

Cheers

I am not a health professional - your actions are your own.  

Please do not seek tapering support via private message - "Any reason to hold is a good one"

My taper visualised as a graph   |   My intro thread

Backdrop:  2003 10mg olanzapine | 2004 2-3mg risperidone | end 2014 3wks aripiprazole

2015: olanzapine  10 -> 7½ -> 6⅔ -> 5mg  by crude pill cutter

2018:  Mar 5.00mg -> water titrated taper -> Aug2.5mg tablet and hold

Jan 2019 2.50mg water titration -> Jan 2020 1.214  -> Jan 2021 0.44 -> 2 Oct 0.205 ->3 Oct ZERO🥂

Jun 2023 💉150mg paliperidone "loading" depot shot, 100mg 1wk after Jul 100mg Aug-Dec 75mg/4wks

Jul 2023 2.50mg aripiprazole/day attempt to lower prolactin^

Jan-Feb 2024 cross taper off shots to 1mg risperidone

 

Ask not what you can do for your country, but what your country did to you"  -- KMFDM

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First of all, I love that I'm finally finding a community where I'm not dismissed and am asked really good questions.

 

So the taper down to 2.5mg was by the psychiatrist. I was on I think 15mg in the hospital and then the outpatient psychiatrist tapered me down but as I recall it was pretty quick and big jumps so from 15mg to 10mg to 7.5mg to 5mg and then the second time I was in the hospital I had to ask to be tapered down to 2.5mg because they were going to leave me on 5mg.

 

Could how fast they tapered me way back then affect withdraw now even though that was years ago?

 

Yea, I read on here that zyprexa is insoluble in water so you'd have to make a suspension but that sounds like a lot for me so I'm looking into weighing it if I can't get it compounded but we'll see, I may have to go the suspension route.

2010 manic episode. (Was on xanax, wellbuterin, seroquel and other meds before mania). At hospital was put on Olanzapine and tapered to 2.5mg

Jan 2014 went off "cold turkey" (didn't change diet or lifestyle at all. Had trouble sleeping for 3 months but then was fine)

Nov 2014 took one 2.5mg due to lack of sleep due to lots of excitement in life at that time. Had manic episode a few days later. Was put back on olanzapine and tapered down to 2.5mg 

2022 - Researching going off meds again but tapering and adding diet changes and supplementation

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  • Moderator Emeritus

Hello and welcome from me too.

 

2022 - Researching going off meds again but tapering and adding diet changes and supplementation

 

Q:  What do you mean by "supplementation"?

 

The only supplements which SA recommends are magnesium and omega 3 fish oil.  If you decide to try these, only try a small amount, one at a time, to see how you react to it.  Also, do not make any other changes at the same time, eg a drug reduction, otherwise if things worsen/improve you will not know what caused it.

 

Magnesium

Omega-3 Fish Oil

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

There are many existing topics about various things on SA.  You can use the site search function or use an internet search engine and add site:survivingantidepressants.org to the search term.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Everyone is different, your plan looks good but you may have to adjust as you put it lower.

 

I tapered off zyprexa in 2 weeks from 2.5mg to 0, and only had 1 week after of feeling weird then was fine (was also on prozac at the time), but looking back i got lucky and probably should have gone slower.

 

But it just shows everyone is diff, do what is best for you!

Klonopin Mar 2013 - Feb 2021 - used .000 gram scale to cut pills did very slowly from 2017-2021, had no issues stopping after final dose that was sub .5mg diazepam equivalent (If anyone wants advice for tapering Klonopin with a gram scale, feel free to ask!)

tapered off zyprexa twice over 2 weeks in my 20's, had little issue with that after about 3-4 years of use both times.

Prozac 40MG for 5 years - 2016 - 2021 (Total of 13 years of consecutive use)

(Most recent after last break, been on cumulatively in my life 14 years all times combined, 3 separate on/off occasions, all successful except most recent 3/4)

Recent Issue:  Tapered gradually from 40MG down to 0MG from May 7th - Aug 18th

Felt fine through Oct 5th, slowly started getting depression, panic, and anxiety (Was original thing I was treated for)

Decided to go back on SSRI Nov 1st, reacted very bad to 20mg reinstatement, day 1 was fine, day 2 had ADR. Doctor said to drop dosage.

Took 5mg for 2 weeks, 10mg for 2 weeks, still felt physically sick, could not take 20mg for more than 3 days, looking for advice going forward (ADR)

Not happy about it, but on 1.5mg 3x ativan and temazepam 15mg for sleep

(Was sleeping 2-3 hrs nightly prior to temazepam, was first thing that broke 2-3 hr then wide awake sleep cycle)

Main symptoms: headaches from certain foods and meds, sleep is broken, anxiety and agitation is extremely high, cortisol spike sensitive, bad in morning better at night, panic attacks, concentration is awful, focus is awful, anhedonia is awful, sensitive to light and noise, especially noise, extreme depression, intense bouts of fear, every looks and feels 'scary' at times, stress tolerance extremely low, have bouts of extreme anxiety, and bouts akathesia, and bouts extreme anticipatory anxiety over basic events/tasks. Nervous system is clearly crashed.

No Prozac for 249 days.

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  • Moderator Emeritus
On 1/26/2022 at 4:51 PM, Notw said:

Could how fast they tapered me way back then affect withdraw now even though that was years ago?

 

Your body would likely have processed those changes by now.  Still, with the time you've been on the drug, and that cold turkey - which you've done well to recover from - you can expect to be dealing with a sensitised nervous system now, during the taper, and for some time afterwards.  I would not be expecting a rapid path to zero.

After this many years, and all that, in your shoes when I was ready I would start with a single 10% cut, hold for at least four weeks, journal daily with symptoms, moods, supplements etc, everything relevant.  Then consider the next cut in light of the previous.

 

Since you report psychosis in the past, I would strongly recommend putting a contingency plan in place.  Brief supportive friends and family, and the health professionals you are comfortable working with, and work out what you will do beforehand should trouble arise during your withdrawals.  Just being prepared adds a lot of peace of mind.

If you find a 10% taper too much to deal with, there are gentler tapering options to try after stabilising again.  I found a gentler taper helped a lot.

I am not a health professional - your actions are your own.  

Please do not seek tapering support via private message - "Any reason to hold is a good one"

My taper visualised as a graph   |   My intro thread

Backdrop:  2003 10mg olanzapine | 2004 2-3mg risperidone | end 2014 3wks aripiprazole

2015: olanzapine  10 -> 7½ -> 6⅔ -> 5mg  by crude pill cutter

2018:  Mar 5.00mg -> water titrated taper -> Aug2.5mg tablet and hold

Jan 2019 2.50mg water titration -> Jan 2020 1.214  -> Jan 2021 0.44 -> 2 Oct 0.205 ->3 Oct ZERO🥂

Jun 2023 💉150mg paliperidone "loading" depot shot, 100mg 1wk after Jul 100mg Aug-Dec 75mg/4wks

Jul 2023 2.50mg aripiprazole/day attempt to lower prolactin^

Jan-Feb 2024 cross taper off shots to 1mg risperidone

 

Ask not what you can do for your country, but what your country did to you"  -- KMFDM

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