CmonAussie: polydrugged

[CmonAussie]

Hi everyone,

 

This year has been a tough one for me and I’ve never reacted to drugs in this way. Since having covid my central nervous system has been affected and I need some advice please. 
I had been on Prozac in the past with no issues, I cold turkeyed it last year in October. Then had covid in Jan this year and felt extremely anxious so decided to reinstate. Once I did it immediately zapped my anxiety and emotions and I haven’t felt them since (with the exception of some small windows). 
I have been on a number of antidepressants since:

Seroquel 25 mg PRN (2020 - 2022) 

Mirtazapine 15mg (February to March 2022 -cold turkeyed and took a few doses intermittently - bad rebound insomnia)

Cymbalta 30 mg (5 days in February)

Parnate 10mg (4 days in March)

Domperidone (February to March 2022)

Hospitalised on 5mg Olanzapine and Mirtazapine 15mg reinstated which was upped to 30 mg for a week. 
 

Down to 22.5mg Mirtazapine and 2.5mg Olanzapine currently, still feeling emotionally numb but haven’t been able to drop the Olanzapine because of insomnia. 
 

I know it’s quite a complicated history but I wasn’t aware it was the drugs causing the issue for a while, because I had covid and thought it was that. 

 

I have a very supportive psychiatrist who does want to help me taper slowly, probably not slow enough though so I’d just like some advice please to taper off the Mirtazapine and Olanzapine and just hoping one day I’ll feel like myself again. Do you think it’s possible for me to heal? 

Thanks for all your help! 

 

 

[CmonAussie]

I should also mention I tried dropping the Olanzapine in hospital and got down to 1.25mg but couldn’t go lower because of insomnia. Not sure what to do because I lack motivation and will have to go back to work soon. 

[Onmyway]

Hi @CmonAussie

welcome to SA.  I am having a hard time figuring out your drug history. Can you please list it in chronological order and include the dates where possible with the months and the years? 

 How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

Jan 2020 - Oct 2022 Prozac

...

May 2022 

 

You are probably having withdrawal from prozac which we often see interact with Covid symptoms as well. If you give us a clearer drug history we may be able to advise on reinstatement or tapering and such. 

Also, do you want to come off of your drugs or are you asking for advice on what drugs to take. We can't help with the latter unfortunately but can advise you on tapering if that is what you are seeking. 

OMW

 

Edited May 24, 2022 by Onmyway

[CmonAussie]

On 5/22/2022 at 3:41 PM, CmonAussie said:

Hi Onmyway, thank you so much for replying. 
 

Please see drug history below:

-Prozac 20mg (Jan 2020 - Oct 2022) Cold turkey in Oct 2022

 

-Prozac 10mg (Jan 2022 to Jan 2022 for 2 weeks)

-Seroquel 25 mg PRN (2020 - 2022) 

-Mirtazapine 15mg (Feb 2022 to Mar 2022) -cold turkeyed and took a few doses intermittently - bad rebound insomnia)

-Cymbalta 30 mg (5 days in Feb 2022)

-Parnate 10mg (4 days in Mar 2022)

-Domperidone (Feb to Mar 2022)

 

Hospitalised in May 2022 on 5mg Olanzapine and Mirtazapine 15mg reinstated, which was upped to 30 mg for a week. 

Current: 22.5mg Mirtazapine and 2.5mg Olanzapine

 

On 5/22/2022 at 3:41 PM, CmonAussie said:

I’m looking for advice please on how to taper off Mirtazapine and Olanzapine. Olanzapine has been added to help me sleep but I’m feeling so demotivated on it and even more like a zombie. 
Do you think it’s ok if I taper off Olanzapine first before Mirtazapine? 
 

thank you
 

 

[CmonAussie]

Apologies, I’ll update my drug history now

[CmonAussie]

@Onmyway I have been on 2.5mg Olanzapine and Mirtazapine 22.5mg for a month now. 
I’m looking to taper off these, the compounding pharmacy has made my mirtazapine into a liquid and said they can do the same for the Olanzapine when I need it. Olanzapine has caused me to be even more demotivated and emotionally flat than I already was. Which one do you think I should taper off first? 

[Onmyway]

Hi @CmonAussie, 

how long have you been on the olanzapine? If you have taken a drug for a short time it may be possible to taper faster than the 10% rate every month that we recommend. Olanzapine is an antipsychotic and as such has more severe side effects, so would make sense to taper first and to taper fast. However, why were you prescribed olanzapine? Did you have psychosis? Withdrawal from olanzapine can worsen those. You said you tried to lower it to 1.25 but couldn't go lower but your signature says you are on 2.5, did you have to increase it? 

 

Mirtazapine may need to stay to help keep sleep during withdrawal. You will have to taper it very slowly once you stabilize. 

 

What does your insomnia look like? Do you have trouble going to sleep or do you wake up early in panic? The early morning panic and terror wakings are part of withdrawal. I would not recommend to treat them with olanzapine. Have you seen this thread - it has links to insomnia help. 

Important topics about symptoms, including sleep problems - Symptoms and self-care - Surviving Antidepressants

 

You have had a lot of drug changes in recent times so your nervous system has been thrown into chaos. With stability (and no more changes) it will recover slowly. In the meantime, your system will be sensitive to the introduction of new drugs and supplements (incl. alcohol, pot, street drugs, some vitamins etc.) We recommend magnesium and Omega-3 as calming and sustaining healing. Try them one at a time and at a low dose because not everyone's system reacts positively to them either. 

 

Here is our best guess at what is happening in your brain. 

 

The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants

What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants

 

You will get better albeit slowly! 
Hope you see a respite soon, 

OMW

[CmonAussie]

Hi @Onmyway 
Thanks for your prompt response, I really appreciate it.

 

Yes sorry I know it’s confusing, I was put on Olanzapine due to insomnia caused by cold turkey off Mirtazapine. In hospital I said to my psych I’d like to come off it, I was coming off Olanzapine (I have been on it now in total a bit over a month) and got as low as 1.25mg, then one night didn’t take it at all and had insomnia so reinstated back up to 2.5 mg. 
 

I understand my nervous system has been through way too many changes lately, thanks for those links.

 

I take magnesium and fish oil at 8pm every night before bed. 
I would like to come off both of these drugs but properly this time, lately I’ve had some twitching and tinnitus which I think might be caused by the instability, it’s slowly going away now as I have stayed on a consistent dose the past few days. 
 

What do you think about coming off Olanzapine first? I just want my emotions to come back and feel this medicine isn’t helping, but it is helping with sleep at the moment. Do you think if I do a slow 10% taper my sleep will eventually regulate once I’m off it? 

 

Thank you very much for your suggestions.

kind regards

A

 

[CmonAussie]

My insomnia is trouble getting to sleep, I’ve had a few nights without it. My anxiety is still gone along with my emotions, I would actually love for my anxiety to come back (sounds silly) but think that might happen being off all drugs. 
Thanks 

[CmonAussie]

Also it seems Olanzapine is just masking my Mirtazapine withdrawals. Olanzapine also was most likely causing the twitching and tinnitus. 
 

Because of this, would it be the right decision to come off Olanzapine at 10% per month and deal with any insomnia that occurs? 

[Onmyway]

Hi @CmonAussie, 

have you tried melatonin instead? 

Your sleep will be restored as you come off of the olanzapine, but it will take a long time - a 10% of your previous dose a month tapering is a long one though if you have been on the drug for longer than a month that is what we recommend. 

It's useful to accept insomnia as part of withdrawal and not be scared by it. Insomnia is not dangerous though it is unpleasant. 

You probably have withdrawals from the prozac, because it is metabolized very slowly, so hits people weeks and months later. 

 

How are your symptoms now? Do you feel stable enough to commence tapering? We recommend some stability before starting tapering after a history of lots of changes. 

 

OMW

[CmonAussie]

Thank you @Onmyway

Also just wanted to say hi to @Altostrata, I messaged you on Facebook about a month ago.

I just checked and tomorrow actually marks a month on Olanzapine. I wouldn’t want to be on Olanzapine for over a year and would prefer to taper off this if it is masking my previous withdrawals. 
 

Either way I figure I will have to face the withdrawal insomnia at some point once reducing/coming completely off Olanzapine.  

I have tried melatonin and find it does help a bit. 

I feel I am starting to stabilise. Do you think I should stabilise on these doses a bit longer before making a reduction? 

[Altostrata]

Hello!

 

9 hours ago, CmonAussie said:

Also it seems Olanzapine is just masking my Mirtazapine withdrawals. Olanzapine also was most likely causing the twitching and tinnitus. 
 

Because of this, would it be the right decision to come off Olanzapine at 10% per month and deal with any insomnia that occurs? 

 

"Masking" withdrawal symptoms is what drug treatment is supposed to do. It's possible that you'll be able to sleep on only mirtazapine; it's also possible that olanzapine's "masking" is enabling you to sleep. 

 

We don't know which it is because you were put on both simultaneously in the hospital, and you are taking the 2 drugs together at night. If you go off olanzapine quickly, you may not be able to sleep, either because of withdrawal from the olanzapine or the underlying withdrawal from mirtazapine. We cannot predict this.

 

You might decrease olanzapine by 10% and see what happens. Please let us know how you're doing.

[CmonAussie]

Thanks @Altostrata

Do you think I can come off Olanzapine quick given it’s only been a month? By halving the tablet then quartering.
Or is it now the best idea to reduce by 10% each month?

[CmonAussie]

Also just wanted to say a big thank you to all mods for all the help you’ve provided to so many! @Altostrata

@Onmyway you’re both amazing people. 

I see from your message earlier that my nervous system needs a slow taper this time around. 

I should hold for another week on 2.5 so at least for 2 weeks I will have been on that dose before making any further reductions. 

I have a psych who is on board with slow tapering so I can request liquid Olanzapine and come off it in ml increments. I was thinking every 3 weeks if I feel ok to continue to reduce by 10%. I need to come off this drug because it’s making me even more demotivated/zombie like and my sleep last night on it wasn’t the best anyway

[Onmyway]

@CmonAussie, 

did the zombie-like feeling come from the olanzapine or was it there before the drug. 

You have made lots of changes recently and it is hard to say what is from what. If that was from the prozac earlier tapering before stabilization can worsen some of these symptoms. In WD the body craves stability. 

 

It may be wise to listen to your body before you make cuts. We recommend waiting 4 weeks or stabilization before making 10% cuts. If after a couple of such cuts you don't have withdrawal symptoms you can speed up your tapering by cutting every 3 weeks. Sometimes you may not feel withdrawal symptoms for a while and they catch up to you. Given what your nervous system has been through recently, I'd advise lots of caution. We see that people suffer when they make lots of changes in quick succession which throw the nervous system into disarray and make it more sensitive to more changes. 

 

Please proceed with caution. 
OMW

[CmonAussie]

Hi @Onmywayyes the Zombie feeling was already there since Prozac. I do get slight glimpses of emotion every now and then.

I agree though, too many changes in such a short amount of time. I’ll stabilise on the doses I’m on before making the 10% cut to not confuse my system any more. 
Do you find people can recover from this once off all drugs? 
 

 

[Onmyway]

@CmonAussie, 

yes, people recover - you can see progress yourself as time goes as well. 

Some of the people who recover never come back but a few write their success stories to encourage others. 

Have you seen them? 

 

Success stories: Recovery from psychiatric drug withdrawal - Surviving Antidepressants

[CmonAussie]

Thank you @Onmyway That’s really helpful. 
My psych is happy for 10% from the previous dose in reductions. 
I’m just hopeful my brain will go back to normal after tapering off these drugs properly. 

Is it possible to heal even on the drugs also? 

[Onmyway]

The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants

What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants

[Carmie]

Hi CmonAussie, 

 

How have you been doing in the last month? Are you still in a wave or do you feel like you’re slowly stabilising?

 

Hope you have a nice day🤗

[CmonAussie]

Hey @Carmie

 

Thanks so much for checking in. I’m unfortunately in hospital at the moment but telling them to take me off these slowly. They were going a bit quick at first and I’ve now told them to hold and am now stabilising. I’ve had a few windows of emotions while on the hold, though when I was going quick suffered massive headaches and felt even more emotionally numb. 
 

I just can’t believe that knowledgeable psychs are so few and far between. It’s absolutely gobsmacking and just goes to show how much of a lifesaver this site is. They even wanted to put me on something else because of my “depression”, which is actually drug induced emotional anaesthesia. 
 

But apart from that I’m doing okay thanks, how are you going? 
 

 

[Carmie]

19 hours ago, CmonAussie said:

Hey @Carmie

 

Thanks so much for checking in. I’m unfortunately in hospital at the moment but telling them to take me off these slowly. They were going a bit quick at first and I’ve now told them to hold and am now stabilising. I’ve had a few windows of emotions while on the hold, though when I was going quick suffered massive headaches and felt even more emotionally numb. 
 

I just can’t believe that knowledgeable psychs are so few and far between. It’s absolutely gobsmacking and just goes to show how much of a lifesaver this site is. They even wanted to put me on something else because of my “depression”, which is actually drug induced emotional anaesthesia. 
 

But apart from that I’m doing okay thanks, how are you going? 
 

 

Sorry you’re in hospital CmonAussie, I’m glad you’ve stabilised though. I’m glad you’re holding, please taper by no more than 10% a month when you start tapering again. My body is so hypersensitive that I can only taper by just over 1% at the moment. 

 

Yes, it’s sad that there aren’t many knowledgeable psychs, I guess they only know what they’ve been taught. They put people on meds, but don’t know much about withdrawals and how the more meds we are put on and off the more our brains become destabilised and hypersensitive. You’ve made a clever decision about not adding any more of these meds. Adding more of these psych meds doesn’t solve the problem, it just makes our poor brains more confused than ever and then we have added things we have to taper off. 
 

I’ve been put on and off so many things, I don’t even remember what they all were. This downhill spiral started because of chronic pain. I have to taper extremely slowly, but ever small drop is a step in the right direction.

 

Take care🧡

[CmonAussie]

Thanks heaps @Carmie I know I need to slow down now. I somehow thought believing in and listening to this doctor could make me better, given I’m not coping on these drugs.
 

But I’ve now learnt going off them quick is not the answer either. It’s just hard being in this position with little support from medical professionals, I had no idea anything like this could happen and am thinking of each and every person on this site, hoping they recover soon. Luckily there are a few doctors out there who recognise this, we’re lucky to at least have them. 
 

I’m so sorry you’ve been put on so many things for pain, sounds like you have a good plan in place to come off them.

 

I see you’re from sunny Queensland 🙂 it’s so nice there. Bit gloomy here in Sydney at the moment, lots of rain! Hoping for some sun soon.

 

Hugs 

[Carmie]

On 7/6/2022 at 1:55 PM, CmonAussie said:

Thanks heaps @Carmie I know I need to slow down now. I somehow thought believing in and listening to this doctor could make me better, given I’m not coping on these drugs.
 

But I’ve now learnt going off them quick is not the answer either. It’s just hard being in this position with little support from medical professionals, I had no idea anything like this could happen and am thinking of each and every person on this site, hoping they recover soon. Luckily there are a few doctors out there who recognise this, we’re lucky to at least have them. 
 

I’m so sorry you’ve been put on so many things for pain, sounds like you have a good plan in place to come off them.

 

I see you’re from sunny Queensland 🙂 it’s so nice there. Bit gloomy here in Sydney at the moment, lots of rain! Hoping for some sun soon.

 

Hugs 

Good on you for slowing down CmonAussie, 

 

If we all had this site before we were put on and off all these meds we wouldn’t be in the predicament we are today. Most of us just did whatever the doctors said, big mistake. I really don’t trust doctors now, I research everything. 
 

Yes, I’m from sunny Queensland, I live in Brisbane. You’ve been getting heaps of rain lately down south, you poor things. We had flooding this year too, some of my friends had to evacuate their homes. I live not far from a small creek and it turned into a raging river. The creek came all the way up the embankment, but it would have to come up a hill to get to my place so I never get flooded. I’d loved having a river out back, but minus the flooding. I sat in the rain with and just watched the water.

 

 Sending hugs back to you too🤗

[Carmie]

How are you doing @CmonAussie ?

 

Are you still in hospital? Hope you’re having a good day🧡

[CmonAussie]

Hi @Carmie

I’m doing okay thanks, still in hospital and having brief glimpses of emotion every now and then. My meds are stable and at the same doses, the dr has ordered a gene test Cytochrome P450 and I’ll let you know what comes out of it.

Also had an MRI but I doubt it will show anything.

 

How are you going? 

[Carmie]

On 7/12/2022 at 9:26 PM, CmonAussie said:

Hi @Carmie

I’m doing okay thanks, still in hospital and having brief glimpses of emotion every now and then. My meds are stable and at the same doses, the dr has ordered a gene test Cytochrome P450 and I’ll let you know what comes out of it.

Also had an MRI but I doubt it will show anything.

 

How are you going? 

Glad you’re continuing to do fine CmonAussie, 

 

My last taper is going okay, thanks for asking, keep us updated 🤗

[CmonAussie]

Hi @Altostrata

My Mri is showing Subcortical white matter lesions. Does this contribute to the lack of emotions and do drugs cause this? 
 

I’ve tapered from 5mg to 0.75mg Olanzapine in the past 3 months which I know is quick. 
 

if drugs do cause these lesions I’d want to be off them asap.

 

thank you

[Altostrata]

16 minutes ago, CmonAussie said:

My Mri is showing Subcortical white matter lesions. Does this contribute to the lack of emotions and do drugs cause this? 

 

I have no idea what this MRI means. It could be benign or meaningless. Please talk to your neurologist. 

 

Taking psychiatric drugs may cause emotional blunting, but it's unlikely you got these lesions from 3 months of olanzapine and mirtazapine, regardless of tapering. Tapering would not cause these lesions.

[CmonAussie]

Thank you @Altostrata

i am seeing a neurologist soon.

 

I just read about how Olanzapine causes changes in the brain so I wanted to come off it quickly. 

Can my emotions still come back even though I got these lesions?

[Altostrata]

I do not know what the lesions mean.

 

You might continue to feel emotional blunting as long as you're taking a psychiatric drug. It can take a while to recover from this when you go off.

 

When was the last time you reduced olanzapine? From what dose to what dose? What happened after that?

[CmonAussie]

Thanks @Altostrata

 

A month ago I was on 2mg of Olanzapine and I’m now on 0.75mg. So a very quick taper. I did have some feelings some back briefly in this time but they have gone again.

 

 

[Altostrata]

Did you experience any odd feelings while you were reducing olanzapine? What are your current most prominent symptoms?

[CmonAussie]

Yes, @AltostrataI had weird brain vibrations/pins and needles, headaches and a bit of insomnia. I do feel like Olanzapine is damaging parts of my brain and my most prominent symptom is the emotional numbing. 

I just hope this drug isn’t causing permanent damage, so I do want to go off it quickly. 

 

[Altostrata]

Those were withdrawal symptoms. What are your current most prominent symptoms?