apollyon: Starting Olanzapine Taper Tomorrow

[apollyon]

I've been on 10mg of Olanzapine (zyprexa) for over a year now. I didn't take the time to research this drug when I was prescribed it and thought it was a miracle. It ended my drug-inducded psychosis immediately and provided me with sleep for what felt like the first time in my life. It no longer provides me with the ability to sleep. It's not that I feel like I've lost these things, I actually have lost them: I've lost my intellect, my creativity, my ability to learn and retain new information, my ability to play music, my libido, the list is endless. I'm afraid the damage is permanent. I am 100% physically dependent on this substance. If I don't take it I feel anxiety immediately and can't sleep (not that I'm sleeping well as is); I've never missed a dose for longer than 24 hours. I am incredibly frustrated with myself for enabling my addictive personality to take this drug without thinking about the consequences I now face. I really thought I was "cured". But now I know I'm looking at likely worsening symptoms and possibly return to psychosis on top of withdrawal, increase in insomnia, anxiety, and depression. And who knows what other physical or mental side effects will persist or appear or worsen as I start to get off this drug. I'm going to try to jump from 10 to 7.5mg.

 

I have an appointment tomorrow and I'm going to discuss tapering immediately. I can't seem to find [m]any success stories of people getting off this soul-destroying drug and I fear I've basically ruined the rest of my life by starting this drug. I am 100 percent positive I will relapse on alcohol either as I taper or when full withdrawal hits and I quit entirely. I really don't even care if I do, I just want to get off this bullsh*t. I may even drink my way through a rapid taper. I'd rather drink for a few months and withdraw from alcohol with a librium taper than continue on this med. I mean, thats how I feel, I can't say with any certainty what I will or won't do. Either way, I need to get off this poison before it robs me of any more of who I am.

 

I've just read it literally decreases the size of our brains after 36 weeks by over 1% and up to 10%, which is far more than the average human loses in their entire lifetime. I'm upset, scared, feeling hopeless. Feel like I face an insurmountable task. Like I've ruined my mind, my spirit, my body. Just incredibly disappointed in myself. I mean I'm already incredibly anxious and depressed, I can't imagine things getting much worse, but here I am. Any hope, insight, success stories, etc...would be greatly appreciated because I feel like I'm ruined. Also a taper schedule would be nice. Ideally I can just do it in 2.5mg drops as I'd rather not deal with a syringe or micro-dosing. Thanks.

[hayduke]

Hi @apollyon and welcome to SA

Sorry to hear you have been kept on this major tranquiliser for much longer than it would seem to have benefitted you.  Thanks for setting up your drug history in your signature.

Who is your appointment with tomorrow?  I would generally expect prescribers to be unsupportive of tapers, and incapable of providing sound advice on how to.  If you find an exception, you would be rather fortunate.

I was able to blunder down from 10mg to 5mg over a year without much bother, but below 5mg it becomes more important to take care with your footwork.  It's unlikely that you would have a good time going from 7.5->5->2.5->0.  If you withstood jumping from 5mg to 2.5 (most couldn't), cold turkey from 2.5mg especially would be inviting a lot of trouble.  A rapid taper is like thinking "Hey if I jump down this 30 foot high ravine instead of a 20 minute walk down via the bridge I'll be 2 minutes from my house in no time!"  Except you basically scotch your journey at the bottom of the ravine.  I was raised a drinker but six months after reaching zero have never been such a lightweight with alcohol.  It typically won't help, and is basically self medicating for the anxiety and whatever else that you will have to face and process anyway to heal.  You don't want to flare up again and be put on a second round of psychiatric drugs, by all reports it's even harder then.

It isn't very difficult to titrate your dosage after you've done it a few times, it becomes more like brushing your teeth before bed, nothing like the washing up most nights!
 

 

[apollyon]

On 3/31/2022 at 11:04 PM, hayduke said:

Hi @apollyon and welcome to SA

Sorry to hear you have been kept on this major tranquiliser for much longer than it would seem to have benefitted you.  Thanks for setting up your drug history in your signature.

Who is your appointment with tomorrow?  I would generally expect prescribers to be unsupportive of tapers, and incapable of providing sound advice on how to.  If you find an exception, you would be rather fortunate.

I was able to blunder down from 10mg to 5mg over a year without much bother, but below 5mg it becomes more important to take care with your footwork.  It's unlikely that you would have a good time going from 7.5->5->2.5->0.  If you withstood jumping from 5mg to 2.5 (most couldn't), cold turkey from 2.5mg especially would be inviting a lot of trouble.  A rapid taper is like thinking "Hey if I jump down this 30 foot high ravine instead of a 20 minute walk down via the bridge I'll be 2 minutes from my house in no time!"  Except you basically scotch your journey at the bottom of the ravine.  I was raised a drinker but six months after reaching zero have never been such a lightweight with alcohol.  It typically won't help, and is basically self medicating for the anxiety and whatever else that you will have to face and process anyway to heal.  You don't want to flare up again and be put on a second round of psychiatric drugs, by all reports it's even harder then.

It isn't very difficult to titrate your dosage after you've done it a few times, it becomes more like brushing your teeth before bed, nothing like the washing up most nights!
 

 

Thanks for the reply @hayduke. My doctor is open to me tapering, though she is under the impression that doing so in 2.5mg chunks is the only way. She says she's done this with prior patients but part of me does not believe her. Well, most of me doesn't believe her at all. I honestly don't think I'll have trouble with the first 10 to 7.5 decrease except a week or two of light insomnia. By my next appointment on the 18th I should know how I'm faring at 7.5mg. She brushed me off when I suggested 2.5mg dose prescription so I could cut by lower, I even mentioned 10 percent decrease and she said this was unnecessary. Yet another psychiatric nurse I've been talking to is convinced I will have zero trouble getting off the zyprexa. So, their confidence goes against all the crap I was reading that was scaring me the other day when I made this post. And I honestly am terrible about overthinking and thinking my way into panic, so I'm guessing it will actually be best for me to stay away from obsessing about the taper and just update here every few weeks. I don't want it to become an obsession, wondering "am I feeling withdrawal" "what do I feel now" "i won't be able to sleep" etc...shooting myself in the foot. I don't really care if I need to go on a different psych med, I just feel like this med in particular is awful to be on long term. The cognitive decline is real with this one. 

 

Anyways my doctors plan is a 4 month taper minimum. Which seems like a fair starting point. And we can adjust as needed as I get further along in the taper. It's only day 2 so its hard to tell anything by now outside of last night had some difficulty falling asleep due to anxiety about being able to fall asleep, and I think that will be a major issue if I continue to obsess over it and scour the internet for stories. 

[apollyon]

@haydukeoh and as for the drinking, i'm going to try not to worry about that right now either. i hope i can make it through this without relapsing, but if I do, I do. And i know how to stop that with librium that my doctor would be open to prescribing. I've done that 100 times before and know how that process looks. but yeah im also aware that drinking generally makes bad situations worse. so thanks for looking out

[hayduke]

It's important to understand that the 10% guideline is based on each previous dose, not from the starting dose.  Your receptors and nervous system do not react to drug dosage in a linear fashion.  Frustratingly, it is more of a log curve.  If you look at the link in my signature, you can see a rough log curve emerges in the graph I made of my taper.

You may find it helpful to show your doctor the Horowitz paper covered here https://www.survivingantidepressants.org/topic/19996-horowitz-2019-tapering-of-ssri-treatment-to-mitigate-withdrawal-symptoms/

If they are pushing you to make reductions before you are feeling steady, it's very important to be clear that you're not ready and hold your ground.  It's your body.  I really think a 7.5 straight to 5mg cut is asking for trouble.  If you feel the reductions are too large within something like 4-7 days, I would consider reinstating the previous dose or close to it, stabilise again, and try a much smaller cut when you are ready.

 

If you let them push you in this situation, what usually happens is that your withdrawal effects will be diagnosed as a 'relapse' of what got you drugged in the first place and it's back to square one or worse.

Re drinking I'm not saying it's always the worst thing you can do, but withdrawal from these psychiatric drugs typically sensitises one's nervous system.  The effect of alcohol is amplified which can be especially destabilising, especially at the tail end of the taper.  I couldn't tell you how long that takes to resolve, I'm six months out and still get dizzy after a couple of beers.  Best to steer clear.

 

Cheers

[hayduke]

Here is a great explanation https://www.madinamerica.com/2019/03/peer-support-groups-right-official-guidelines-wrong-dr-mark-horowitz-tapering-off-antidepressants/