Kem2022: olanzapine and insomnia - withdrawal?

[Kem2022]

Hello All,

 

I am brand new to this forum - first post. I just wanted to get some feedback/suggestions on what I have been going through.

 

My story is this; I have suffered on and off from insomnia for the last 5 years. Up until October last year (2021) I could manage my occasional sleeplessness with an over the counter sleeping aid or half an antihistamine tablet. However, a psychiatrist prescribed me 2.5mg Olanzapine to help with the occasional insomnia and anxiety. He told me that it was non-addictive and that I could take it sporadically. I had started a new job in October, so wanted to ensure that I had a good night sleep for the first few weeks while I settled in. I took half a tablet (1.25mg) 4-5 times per week, some times a bit less, for around 3 x weeks. After this, I noticed that I was no longer able to find sleep naturally. I tried everything, and despite being exhausted I just couldn't sleep. So over the next few weeks I would avoid taking the Olanzapine, only to become completely exhausted by day 5 of little to no sleep that I ended up caving and taking some. Eventually I needed to increase from half a tablet to a full one, then to 1.5 tablets, and sometimes closer to 2. This cycle continued for about 6-7 months. Olanzapine helped me sleep, but made me feel horrific and irritable the next day. I ended up finding some scary (and similar) stories to mine online, and decided to quit for good. But since then, I have not been able to sleep naturally, or very rarely if I do. Additionally, none of the over the counter sleep aids work anymore - this is what scares me the most as I have very few options now, and I'm not sure why this is the case. Further, my GP put me on Mirtazapine at my request as I had been on this previously around 10 years ago and I recall it being highly sedating and helped my anxiety a lot. Upon starting the medication, my sleep improved greatly - I felt amazing. Then after 4 weeks it started losing its effect. Doubled the dose at 4 weeks, which helped for another 4 weeks, then again it lost its effect. I seem to be resistant to most medication that normally helps you sleep. My GP has now prescribed temazepam until I see a sleep specialist later this week. I'm hoping to god that the sleep specialist can help because I do not want to become reliant on a benzo in addition to everything else!

 

So my question is, if the Olanzapine has caused/contributed to these sleep issues - are there any options to help mitigate this kind of insomnia until my brain (hopefully) recovers? Just wanting to hear other peoples stories. It has been about 4 x months since I've touched Olanzapine yet I am still having great difficulties and it is ruining my life. I feel suicidal and anxious a lot of the time, am having trouble managing work, and am just at a complete loss as to what to do. Has anyone else experienced this?

 

Thanks in advance  

 

   

[Shep]

Hi, Kem.

 

Welcome to Surviving Antidepressants.

 

It looks like you've been trapped into the merry-go-round cycle of sleeping drugs. Getting on a consistent dosing schedule and then doing a slow and careful taper can free you from this cycle. 

 

You mentioned being on mirtazapine 10 years ago, in addition to various sleep drugs taken more recently. It will help us to have a signature with your drug history. Please see the first post here for how to set up your signature: 

 

How to List Drug History in Signature

 

This link will go directly to your own signature. Account Settings – Create or Edit a signature.

 

Please include your drugs and any supplements you're taking. 

 

Once we have your signature, we can help you set up a consistent dosing schedule and give you the information for a proper taper. 

 

In the meantime, please have a read of these helpful links:

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

Non-drug techniques to cope with emotional symptoms

 

If you know what led to your insomnia prior to drugs, such as intrusive thoughts or worrying, you may want to target your non-drug coping skills to things such as mindfulness, gentle yoga, learning the "change the channel" technique and not going into emotional spirals. These skills will help you get through the withdrawal-induced insomnia, as well as prepare you to sleep naturally at night after you're completely off these drugs. Guided sleep meditations can also be helpful. You can find thousands of them on YouTube. The non-drug coping techniques thread lists these and more ideas. 

 

Please continue to use this thread to document your taper and to ask questions. 

 

[Kem2022]

Hi @Shep

Thanks for your reply. Indeed I have! It’s horrible. I have updated my signature now. Hopefully it looks ok?

I saw a sleep specialist yesterday who told me my insomnia was like due to conditioning and that CBTi will work. I feel like this is a fob off and that my symptoms are biochemical. And he said scientifically no, that’s not the case. That’s what all the doctors say. I’m willing to try it but I’m very skeptical which isn’t ideal. Trying to keep an open mind but it’s hard.

This is a tad personal, but unfortunately I found out that I am pregnant. The issue is that my insomnia is so bad that when I don’t sleep (which is basically all the time) I feel very ill and emotionally unstable. Quite often I feel suicidal. The doctors told me I’m not allowed to stay on my antidepressants and to come off them immediately (GP and psychiatrist). I told them I’m scared because I’m not feeling well and need something to help manage my sleep and insomnia, to which they told me I simply can’t take any medication and to try CBTi - this is despite being at risk of suicide and therefore harming self and baby. I was left with no choice but to make the decision to terminate the pregnancy. I am feeling very hopeless and traumatised. It is sad that women have very limited options when pregnant. I can’t be the first person to experience this. Anyway, thanks for listening. Advice welcome

[Shep]

@Kem2022 Thanks, Kem. Your signature looks great. 

 

You're right to be skeptical. CBT is unlikely to do a lot for insomnia, although it's good to keep a positive outlook and tell yourself that you're going to be fine. Withdrawal is a long, heavy road to travel for many of us, but it is temporary. So those kind of thoughts can be helpful to carry around in your head.

 

I'm sorry for the loss of your pregnancy. Please do as much self care as you can. No, you're not the first person to experience this. Psychiatry is brutal and causes a lot of harm to so many people. 

 

I'm going to leave you some information on tapering mirtazapine.

 

Tips for tapering off mirtazapine (Remeron)

Why taper by 10% of my dosage?

 

The Brassmonkey Slide Method of Micro-tapering

The Windows and Waves Pattern of Stabilization

 

On 8/7/2022 at 11:12 PM, Kem2022 said:

My GP has now prescribed temazepam until I see a sleep specialist later this week.

 

Please note you can become dependent on a benzodiazepine in as little as 2 - 4 weeks, even with periodic use. 

 

Please let us know more about your mirtazapine taper. Perhaps there's a way to adjust that drug so you don't need to continue on with the benzo. 

 

How fast are you tapering mirtazapine? What were your doses over the past several months?  When did your sleep get so bad you needed to add in a benzo? 

[Kem2022]

Hi @Shep

 

Thanks for your reply. 
 

The chronic insomnia started 3 weeks after taking olanzapine, which was October/November 2021. Since then my sleep has been terrible. I only started using a benzo for sleep 2 weeks ago but not because I didn’t need it sooner, it’s just my GP wouldn’t prescribe it until just recently. This is why I was going back and forth with olanzapine for so long, because nothing else would help me sleep. And this is also the reason for starting mirtazapine- primarily to help me sleep, but I had some depression too.
 

I have tried adjusting the mirtazapine dose and my body just keeps developing a tolerance to it, all it’s doing for me at this stage is keeping me reliant on it for no good reason. So I’m tapering off to try something else. I have been on mirtazapine since May, worked well for sleep initially then at 4 weeks it’s effects started wearing off. I doubled the dose to 30mg, and again, it helped me sleep for another 4 weeks, and then the effects started wearing off. I went back down to 15mg for 1.5 weeks, and then alternated 7.5mg and 15mg tabs every second night. Last 2 nights have taken 7.5mg, not noticing any withdrawal symptoms but sleep is still no good. Lots of people say lower dose of mirtazapine is more sedating, but this has not been my experience. Anyway will stay on 7.mg for a couple of weeks and then probably take 1 pill every second night. I have only been on mirtazapine for 3 months so tapering shouldn’t take as long as last time hopefully 🙏 

[ChessieCat]

14 minutes ago, Kem2022 said:

Anyway will stay on 7.mg for a couple of weeks and then probably take 1 pill every second night.

 

Please see this topic:

 

NEVER SKIP DOSES TO TAPER

 

Post #1 of this topic explains how to get non standard doses:

 

Tips for tapering off mirtazapine (Remeron)

[Kem2022]

Thanks @ChessieCat that’s good to know. I will avoid skipping doses

[Shep]

15 hours ago, Kem2022 said:

So I’m tapering off to try something else.

 

Please note we're a site for people tapering off psychiatric drugs and using non-drug methods for coping. We can't help you taper your current drug for you to go on another drug or drug cocktail. We're not medical professionals here. You'll need to work with your doctor for that. 

 

All psychiatric drugs effect sleep, so the long-term outcome of relying on drugs to sleep are not good. Mindfulness, guided sleep meditations, good sleep hygiene, gentle exercise, a healthy diet with limited caffeine and sugar, avoiding alcohol, and avoiding screens at bedtime (cell phones, computers, television) can all be helpful for the long term goal of being able to sleep well at night. 

[Kem2022]

Hi @Shep

 

Apologies, I didn’t realise that I wasn’t allowed to use any other forms of medications after tapering for my sleep issues in order to use this site. This surprises me. I would much prefer to be on an antidepressant or medicine  that I’ve used before to help mitigate the symptoms of severe insomnia (caused by inappropriately prescribed medication) which is causing suicidal ideation, rather than be on nothing at all? I’m not asking for advice on managing these medications either, just said I was going to try something else. But if that means that I cant be a member, well so be it I suppose. Thanks anyway