FireflyFyte: Latuda withdrawal

[FireflyFyte]

I started taking 20mg of Latuda near the end of May 2022 for treatment-resistant depression and anxiety. I started taking the drug as recommended, with at least 350 calories of food, until sometime in July where I got annoyed with feeling exhausted after dinner and started taking it right before bed without food. I did not realize that this meant I probably only absorbed 50-75% of those doses.

 

By early to mid August, I began experiencing withdrawal symptoms (unbeknownst to me) including severe anxiety, racing thoughts, SI, fast heart beat, and a lack of appetite.

 

I spoke to my psych about what was happening but she could not determine whether my symptoms were from the drug itself or a withdrawal but later suggested that I "taper" off of the medication. 

 

I started taking 10mg of Latuda, with food, from September 19th to September 26th and then went cold turkey.

 

Since I have stopped the Latuda, my anxiety is seemingly getting worse, I have bouts of insomnia, I still have no appetite, my heart rate is regularly raised, and have had some GI concerns as well.

 

I am 2 1/2 weeks off of Latuda and wondering if I should re-instate and, if so, at what dose? Have I passed the point of no return?

 

My psych does not believe that what I am experiencing is withdrawal but rather a return of symptoms and wants me to try another anti-psychotic. I have an appointment with a different psych on Tuesday to discuss.

 

I have been out of work on FMLA to handle the anxiety from this and terrified that I am months away from being anywhere close to who I was before this all started.

 

 

[FireflyFyte]

Had my best sleep in weeks last night (my FitBit rated it an 87) and woke up with noticeably less anxiety. I did take 50mg of hydroxyzine around an hour before bed.

 

Anxiety has been simmering all morning but no intense spikes yet to report. Edit: had some chest pain around 10:30 AM but it seems to have relaxed some.

 

Had a really bad anxiety spike/panic attack on Wednesday (October 5) in the afternoon and am more than annoyed that I can't determine if it is due to withdrawal or caused by the Buspar that my psych added on September 28 as it is known to raise anxiety in the first few weeks of taking the medication. I told my psych multiple times that I was worried about trying another medication but she persisted so we added Buspar to handle the anxiety and now she wants to add another AP into the mix as well.

 

My psych also prescribed a two-week course of Ativan (0.5mg) and did take one yesterday as I was panicked and considering trying to get into inpatient. It did help bring my anxiety down but know Ativan is not a long-term solution for my issue.

 

Have an appointment next Tuesday, October 11, with a different psych but imagine he will also brush off my anxiety as withdrawal and claim it's my symptoms resurfacing and that it requires another medication.

 

I am coming up on three weeks fully off Latuda and am worried that re-instating won't help and have no idea what dose to try and re-instate on if that's even an option. I am supposed to be back to work October 17th and some days I feel I could manage but the bad days are extreme and can't just take off a day or two every week but I live alone, own my own house, and have animals to support so not sure of my options at the moment. I know these concerns are contributing to my anxiety levels.

[FireflyFyte]

Have gotten better dates around my journey with Latuda -

 

April 27, 2022: Started Latuda (20mg with 350+ calorie meal)

Mid to End of July: Stopped taking Latuda (20 mg) with food so probably only absorbing 50-70%

August 11, 2022: Withdrawal started (high anxiety, SI, no appetite)

Sept 17 - 18, 2022: Reinstated Latuda (20mg with 350+ calorie meal)

Sept 19 - 26, 2022: Tapered with Latuda (10mg with 350+ calorie meal)

 

I also made a log for yesterday of symptoms, medication, etc. 

 

• FitBit Sleep Score: 87
• 7 AM - Woke up with less anxiety than usual
• 8:15 AM - Ate breakfast (Chobani yogurt and a decaf coffee) and took the following medication: Propranolol (20mg), Vyvanse (40mg), and Buspar (5mg)
• 10:30 AM - Intrusive thoughts and burning chest
• 12:30 PM - Severe ruminating/intrusive thoughts
• 12:45 PM - Ativan (.5mg)
• 1 PM - Ate lunch (Smart Ones Fettuccini Alfredo)
• 1:45 PM - Buspar (5mg)
• 4 PM - Propranolol (10mg) and felt pressure in my head
• 5:45 PM - Ate dinner (sushi)
• 6:15 PM - Buspar (5mg)
• 9:30 PM - Hydroxyzine (50mg) and got into bed
• 9:45 PM - Meditated
• 10 PM - Fell asleep
• 1 - 6 AM - On and off sleeping

 

[FireflyFyte]

I am having a rough time and am convinced that I need inpatient care. I doubt there is anything they can do to help but am struggling every moment of the day and worried that I can't care for my animals or myself, honestly.

 

Made a log for yesterday -

 

October 8, 2022

• FitBit Sleep Score: 85
• 7 AM - Anxiety, hot flashes, high heart rate, and racing thoughts (5/10)
• 8 AM - Ate breakfast (Think bar) and took Buspar (5mg), Propranolol (20mg), and Ativan (.5mg)
• 9 AM - Took Vyvanse (40mg)
• 11:30 AM - Head pressure (2/10)
• 11:50 AM - Tinnitus (1/10)
• 12:45 PM - Lunch (sushi)
• 1:15 PM - Buspar (5mg)
• 3:30 PM - Tightness in chest (2/10) after reading these forums
• 4 PM - Propranolol (10mg)
• 6:15 PM - Dinner (chicken, rice pilaf, and salad)
• 6:25 PM - Buspar (5mg)
• 7:15 PM - Crying
• 9:30 PM - Hydrxyzine (50mg) and went to bed
• 9:45 PM - Meditate
• 10 PM - Fell asleep
• 3:30 AM - Woke up with headache. Back and forth with sleeping. 

[manymoretodays]

Hi FireflyFyte and welcome aboard,

Thank you so much for attending to your signature!

Would you add in the Ativan as well please.  Date started, dose, if using regularly or prn(as needed).

 

So you started with psychoactive drugs in 2019 and with Adderall I see.  Why did you beging the Adderall?

You mention "treatment resistant depression and anxiety" in your first post.......did these symptoms then arise secondary to your Adderall use?

And I don't mean to overly probe you right now......I know you are having a hard time.  It's just that sometimes, the drugs themselves are responsible for so much of what gets diagnosed as mental illness.  Something that I'm sure you have discovered with your use of Latuda.

 

We are a site for harm reduction tapering and are staffed by those who have tapered off, or are in the process of doing so.  Peers who have been through it.

We don't do medical management or medication management per se, that should be your prescribing doctors job.  Unfortunately, although things are changing slowly.......there just are not enough doctors doing harm reduction deprescribing at present......and so we continue to exist.

 

And wow, quite the whirlwind of prescriptions since you came off the Latuda and/or changes in your stimulant dose too(adderall and then Vyvanse).

How did you feel after upping the adderall?  How did you feel after the switch to Vyvanse, and then after the increased dosage?

 

How did you taper from the 10 mg of Latuda Sept. 19-26th?

 

This is our harm reduction tapering strategy:

*Why taper by 10% of my dosage?

and this applies to most all of the psychoactive drugs we see used here.  Generally, a physiological dependency, will set in with most of the AD's and AP's(antipsychotic), in as little as one months time.  And so tapering by 10% or less of each successive dose is recommended.  It sets in with the benzo's, like your Ativan in even less time, often around 2 weeks only of continued usage.  If you do decide to continue with your psychiatrists(I assume) you may want to even share parts of that post with them, so they may help you with further and future tapers.

*Tips for tapering off lurasidone(Latuda)

more about Latuda ^, including how to get some of the non-standard dosages that you might need for tapering or reinstatement

 

I'm a little concerned about the many drugs you have tried, since coming off Latuda, and also the Adderall to Vyvanse switch(back in May) and if any of these drugs might be working together in a not good way.

So.......would you please go to Drugs.com and put all of your current drugs into the interactions checker.

You might as well put the Latuda in there too......just to see.

Then link us to the results in a reply or copy and paste them in a reply.

Do look at the results too and let us know what you think about them.

To check more than 3 medications you will need to register at Drugs.com, and pick a user name.  They don't scam you, or bother you with emails or promos though and are a great site for always checking medications before taking, as well as checking for potential and current drug interactions.

 

And okay, here is what we have on reinstatement:

 

About reinstating and stabilizing to reduce withdrawal symptoms

And you will see as you read through that a reinstatement of Latuda would best be done at a much lower dose than the dose you last took.  We recommend that to avoid any kindling reactions.......that sometimes can occur.

Hypersensitivity and Kindling

 

If it was me, and I decided to try a reinstatement of Latuda, I don't think I would attempt doing more than 1-2 mg and then I would carefully observe, and keep objective NOTES, going while trying the reinstatement.

Recording drug schedule and symptoms to track patterns and progress

And I do see that you have already done some in your last post.  Good job!

 

And okay, longest approval/starting post ever.......but I feel like I should give you more eneral information around WD(withdrawal) now too.

So bear with me.  You'll have it to reference and look over when you can.  Do always go to the first post in the links given to start.

 

Brain Remodelling

What is Withdrawal Syndrome?

 

*The Windows and Waves pattern of Stabilization

 

*Dr.Glenmullen’s withdrawal symptom list.

do have a look at the downloadable  PDF symptom checklist there, and see if you identify with any of the WD symptoms noted there

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal. 

 

We don't recommend a lot of supplements or medications to treat WD on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system.  

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

Okay FF, I'll get you approved and started today.  Welcome again.

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, communicate with others here, as well as keep a record of your journey.

 

Best, Love, peace, healing, and growth,

manymoretodays(mmt)

Edited October 10, 2022 by manymoretodays
more ?'s, around the adderall and then Vyvanse

[FireflyFyte]

Thank you for your response.

 

I am currently in the ER so can’t update my signature. I have really struggled with thoughts of self-harm in the last week so admitted myself yesterday.

 

My medication journey began before the Adderall. Have been on Wellbutrin, Lexapro, Zoloft, and Citalopram but couldn’t remember the dates but will try to update when I can.

 

Of course, everyone I have spoken to at the ER doesn’t think I am dealing with withdrawal so am at a loss at the moment. Maybe I am not and am just broken beyond repair at this point. 

[manymoretodays]

Oooh.

Well, I went ahead and got the interactions done.

Drug Interaction Report

I just put in everything presently taken, and put the Latuda in there too, just to see. 

Interactions between your drugs

Moderate

propranolol

busPIRone

Applies to: propranolol, BuSpar (buspirone)

Propranolol and busPIRone may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

LORazepam

busPIRone

Applies to: Ativan (lorazepam), BuSpar (buspirone)

Using LORazepam together with busPIRone may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

propranolol

hydrOXYzine

Applies to: propranolol, hydroxyzine

Propranolol and hydrOXYzine may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

LORazepam

hydrOXYzine

Applies to: Ativan (lorazepam), hydroxyzine

Using LORazepam together with hydrOXYzine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

Moderate

busPIRone

hydrOXYzine

Applies to: BuSpar (buspirone), hydroxyzine

Using busPIRone together with hydrOXYzine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

propranolol

lurasidone

Applies to: propranolol, Latuda (lurasidone)

Lurasidone and propranolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

LORazepam

lurasidone

Applies to: Ativan (lorazepam), Latuda (lurasidone)

Using LORazepam together with lurasidone may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

busPIRone

lurasidone

Applies to: BuSpar (buspirone), Latuda (lurasidone)

Using busPIRone together with lurasidone may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

hydrOXYzine

lurasidone

Applies to: hydroxyzine, Latuda (lurasidone)

Using hydrOXYzine together with lurasidone may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Minor

propranolol

LORazepam

Applies to: propranolol, Ativan (lorazepam)

Information for this minor interaction is available on the professional version.

No other interactions were found between your selected drugs. However, this does not necessarily mean no other interactions exist. Always consult your healthcare provider.

Drug and food interactions

Major

lurasidone

food

Applies to: Latuda (lurasidone)

Avoid consuming grapefruit or grapefruit juice during treatment with lurasidone, as it may increase blood levels of the medication. This can increase the risk of side effects such as Parkinson-like symptoms, abnormal muscle movements, seizures, high blood sugar, diabetes, high cholesterol, weight gain, sex hormone irregularities, and heat-related disorders such as heat intolerance or heat stroke. In addition, you may be more likely to experience side effects associated with low blood pressure such as dizziness, lightheadedness, headache, flushing, fainting, and heart palpitations. You should also avoid the use of alcohol while being treated with lurasidone. Alcohol can increase the nervous system and blood-pressure lowering effects of lurasidone. You may experience increased drowsiness, dizziness, difficulty concentrating, and impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns. Lurasidone should be taken with food consisting of at least 350 calories. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position.

Switch to professional interaction data

Moderate

propranolol

food

Applies to: propranolol

Food can enhance the levels of propranolol in your body. You shoud take propranolol at the same time each day, preferably with or immediately following meals. This will make it easier for your body to absorb the medication. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking propranolol. Propranolol is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Switch to professional interaction data

Moderate

LORazepam

food

Applies to: Ativan (lorazepam)

Alcohol can increase the nervous system side effects of LORazepam such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with LORazepam. Do not use more than the recommended dose of LORazepam, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

busPIRone

food

Applies to: BuSpar (buspirone)

You should avoid the use of alcohol while being treated with busPIRone. Alcohol can increase the nervous system side effects of busPIRone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Patients receiving busPIRone should preferably avoid the consumption of large amounts of grapefruits and grapefruit juice. If this is not possible, the busPIRone dose should be taken at least 2 hours before or 8 hours after grapefruit or grapefruit juice. Large amounts of grapefruit and grapefruit juice may cause increased levels of busPIRone in your body. This can lead to increased adverse effects such as drowsiness. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

hydrOXYzine

food

Applies to: hydroxyzine

Alcohol can increase the nervous system side effects of hydrOXYzine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with hydrOXYzine. Do not use more than the recommended dose of hydrOXYzine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Central Nervous System (CNS) Drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'Central Nervous System (CNS) Drugs' category:

• BuSpar (buspirone)
• Ativan (lorazepam)
• Latuda (lurasidone)
• hydroxyzine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Psychotropic agents

Therapeutic duplication

The recommended maximum number of medicines in the 'psychotropic agents' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'psychotropic agents' category:

• BuSpar (buspirone)
• Ativan (lorazepam)
• Latuda (lurasidone)
• hydroxyzine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Tranquilizers

Therapeutic duplication

The recommended maximum number of medicines in the 'tranquilizers' category to be taken concurrently is usually one. Your list includes three medicines belonging to the 'tranquilizers' category:

• BuSpar (buspirone)
• Ativan (lorazepam)
• hydroxyzine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

---

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major	Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate	Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor	Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown	No interaction information available.

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• Propranolol uses and side effects
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• Latuda uses and side effects
• Hydroxyzine uses and side effects

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And yay! it copied over here.

 

FireflyFyte, you are not broken beyond repair at this point.  Very likely WD has kicked in from the Latuda.

And there may be more going on.  Possibly too much on the stimulant and/or paradoxical effects from drugs you are on in addition to WD.  Paradoxical meaning sometimes we can get the opposite of the intended effect from a drug or drug(s).  You are taking a lot right now in attempts to dampen your sensorium down too.

And again, I'm no doctor or pharmacologist but we see this stuff all the time here.

 

Good job I say on keeping yourself safe, while having intense self harm thoughts.  Do what you need to do in that regard.  I'm hoping you are able to get home again and don't need inpatient.  Me, I would ask that they have the pharmacy do a review on your present drugs.  Too much on the CNS being dampened right now in my humble opinion.....and again, just a lay person who has been through it.  Be thinking of who you could call to support you at home, someone to stay with you short term, and support you, give comfort,  and help you with basic functioning for a little bit.

 

Okay and hugs.  Rooting for you.  You can do it.  Just today.  Just this next hour and then the next.  This too, will pass.  I hope that is not sounding too trite at the moment.

 

L, P, H, and G,

mmt

Edited October 10, 2022 by manymoretodays
did a little color coding on interactions

[FireflyFyte]

Sadly, I am being moved to inpatient. I am not in a safe state at the moment.

 

So far, I have only taken six doses (once a day) of the Ativan (.5mg) and have felt the best I have in weeks after the doses but know it is not a sustainable option but will see if I can sleep without the hydroxyzine to take that off of the table. 
 

Talked to the Nurse Practitioner here and discovered that they don’t dispense stimulants, and neither does inpatient, so appears I am going cold turkey off of my Vyvanse which is especially terrifying when my CNS is already in shambles. I was considering getting off of it but wanted to taper, safely. 
 

I am really in a sad game of “is this withdrawal and/or side effects of new medication” and would like it to end.

[manymoretodays]

I know. There, there.  Take a break from the outside world if you can while there.  My fingers are crossed or I am hoping you are at a good enough place for now. 

 

You know how to look any new medications up now, and can give input into your care when you see the psychiatrist or nurse practitioner.  Your plan sounded good.  If the Ativan helped that is a good thing for now.

 

Don't worry.  Self care now.....the best you can.  💜

 

Let us know when you are home again, if you would like further assistance with tapering.

 

It can get awfully difficult if we try to help while you are inpatient at the same time..... and being managed by the doctors, nurse practitioners, and other staff.  Just know you have a voice.  Use it.  Hugs.

 

Best, L, P, H, and G,

mmt

Edited October 10, 2022 by manymoretodays

[FireflyFyte]

On 10/10/2022 at 6:19 PM, manymoretodays said:

 

 

Let us know when you are home again, if you would like further assistance with tapering.

 

 

I got home yesterday from inpatient care and it has been a whirlwind as far as drug changes.

 

They stopped my Vyvanse (40mg), my Buspar (5mg 3x a day), and my Propranolol (10mg 2x a day). They added Prozac (20mg), Zyprexa (2.5mg), and added an evening dose of Ativan (.5mg).

 

I spoke to my psychiatrist today and asked to stop the Zyprexa as I do not want to be on another anti-psychotic and it has been less than two weeks since I started. She agreed so my last dose will be the one I took last night so my current medical regime is as follows -

 

8:30 AM - Prozac (20mg) and Ativan (.5mg)

9:00 PM - Ativan (.5mg)

 

My psychiatrist wants to keep me on the Ativan for at least another month to give the Prozac time to build in my system and, hopefully, help with anxiety. If that's the case, we will start tapering down the Ativan. Her taper schedule was to stop the evening dose for a month, assess how I am doing, and if stable remove the morning dose. I am not comfortable with this schedule since I would have been on Ativan for around 7 weeks at this time so am going to need assistance on how to slowly, and more safely, come off of the Ativan.

 

Eventually, will want to get off Prozac as well but not in any rush. 

[manymoretodays]

Thanks Fireflyfyte,

On 10/25/2022 at 12:06 PM, FireflyFyte said:

They stopped my Vyvanse (40mg), my Buspar (5mg 3x a day), and my Propranolol (10mg 2x a day). They added Prozac (20mg), Zyprexa (2.5mg), and added an evening dose of Ativan (.5mg).

 

I spoke to my psychiatrist today and asked to stop the Zyprexa as I do not want to be on another anti-psychotic and it has been less than two weeks since I started. She agreed so my last dose will be the one I took last night so my current medical regime is as follows -

 

8:30 AM - Prozac (20mg) and Ativan (.5mg)

9:00 PM - Ativan (.5mg)

 

Wow, that's a lot of abrupt changes.

 

By the way, how are you feeling, what kind of symptoms are you having right now?

 

On 10/25/2022 at 12:06 PM, FireflyFyte said:

My psychiatrist wants to keep me on the Ativan for at least another month to give the Prozac time to build in my system and, hopefully, help with anxiety. If that's the case, we will start tapering down the Ativan. Her taper schedule was to stop the evening dose for a month, assess how I am doing, and if stable remove the morning dose. I am not comfortable with this schedule since I would have been on Ativan for around 7 weeks at this time so am going to need assistance on how to slowly, and more safely, come off of the Ativan.

 

Heck no, I'm not comfortable with that kind of taper plan either.  Doubtful that the Prozac will relieve the anxiety, but here's hoping it will help somewhat......  If I were you, I would use the psychiatrist for your prescriptions mainly.  And after a stabilization period, and a time where you are not making abrupt changes for at least a month or so........you can think about tapering again.

 

Did they start you right up on Prozac at 20 mg and Ativan at 1 mg(per day)?

Are you feeling at all like that is too much benzo or Ativan now?  Are you depressed, blah, sleeping too much or feeling too zombie like?

 

We often taper the benzo after tapering the AD(Prozac), as it can often provide a buffer or "brake" effect for WD symptoms like anxiety and panic. 

 

Thank you so much for coming back and updating FF.  Ooof.  Take it slow now for sure.  Hang in.

 

L, P, H, and G,

mmt

 

 

[FireflyFyte]

14 hours ago, manymoretodays said:

Thanks Fireflyfyte,

 

Wow, that's a lot of abrupt changes.

 

By the way, how are you feeling, what kind of symptoms are you having right now?

 

 

I am really struggling right now - heightened anxiety, fast heart rate, racing thoughts, low appetite, exhaustion throughout the morning even after a decent sleep, SI, and deep periods of depression/hopelessness. Part of me really wants to return to in-patient where I felt quite a bit better.

 

14 hours ago, manymoretodays said:

Heck no, I'm not comfortable with that kind of taper plan either.  Doubtful that the Prozac will relieve the anxiety, but here's hoping it will help somewhat......  If I were you, I would use the psychiatrist for your prescriptions mainly.  And after a stabilization period, and a time where you are not making abrupt changes for at least a month or so........you can think about tapering again.

 

Did they start you right up on Prozac at 20 mg and Ativan at 1 mg(per day)?

Are you feeling at all like that is too much benzo or Ativan now?  Are you depressed, blah, sleeping too much or feeling too zombie like?

 

We often taper the benzo after tapering the AD(Prozac), as it can often provide a buffer or "brake" effect for WD symptoms like anxiety and panic. 

 

 

I was started at 20mg of Prozac and was originally on .5mg of Ativan once a day (in the morning) and a second dose was added (in the evening) about a week later.

 

The Ativan was originally helping with the anxiety but doesn't seem to have much effect currently aside from helping me sleep and possibly contributing to feeling exhausted in the morning.

 

I have had a few people recommend that I stop the Ativan now since I have only been on it for three weeks (tomorrow) instead of staying on for another month and having to do a long taper but it seems like you think I should stabilize on my current meds for a month before trying to taper anything?

[manymoretodays]

9 hours ago, FireflyFyte said:

I am really struggling right now - heightened anxiety, fast heart rate, racing thoughts, low appetite, exhaustion throughout the morning even after a decent sleep, SI, and deep periods of depression/hopelessness. Part of me really wants to return to in-patient where I felt quite a bit better.

 

Oh FirelyFyte,

It does sound tough.  Do you have some support on the ground, and can you take it easy right now?.......even while physically getting hit with the symptoms.  I'm hoping you don't have to immediately resume any responsibilities and have caring and supportive people to call upon, when needed.  Don't despair if you don't.  Members often support other members on each others Introductions and via PM's.  You'll see the little envelope icon at the top of your screen.

 

Good sleep is a good thing.

 

9 hours ago, FireflyFyte said:

I have had a few people recommend that I stop the Ativan now since I have only been on it for three weeks (tomorrow) instead of staying on for another month and having to do a long taper but it seems like you think I should stabilize on my current meds for a month before trying to taper anything?

 

Yes, I'm wondering about your current Ativan dosage, if possibly it's too much, or needs to be split into 3 doses......the current daily total.  Let me confer.  And get someone a bit more savvy with the benzo's to peak on in and advise you.

 

On 10/25/2022 at 12:06 PM, FireflyFyte said:

8:30 AM - Prozac (20mg) and Ativan (.5mg)

9:00 PM - Ativan (.5mg)

 

This is good information ^.  Give a try at NOTES.  Put in the times on the left and then on the right, do note your drugs by name and dosage, keep going with times, and then also on the right note symptoms as they occur throughout the day and night.  You can summarize the night, if you sleep through, or just have a few brief awakenings in the morning. 

-recording-drug-schedule-and-symptoms-to-track-patterns-and-progress/#comment-567765

And then I'll pull out the sample note-example, and other that you can use.  Just do it on paper, or however you prefer, and then post here, in a reply when you have 24 hours done.

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day:

 

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:

DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

And oh, you did NOTES before.  So this will be familiar.

 

Okay.  It's definitely time to utilize any non-drug coping skills you may already have, and to learn new ones, and practice them.  Anything that you've found that helps with symptoms outside of medications/drugs?
And then, Here is our Symptoms and Self Care forum

Look at some of the topped pinned topics that apply.

and then there are links to many helpful topics indexed in the first post in this topic:  Non-drug techniques to cope with emotional symptoms

L, P, H, and G,  Best.  And rest.  Relax as much as possible, while you begin to stabilize.

mmt

 

[FindRest]

FireflyFyte, sounds like you’ve been through some very tough stuff lately. I imagine many of your current symptoms are a result of all the switching they did while you were inpatient. It’s common for the aftereffects of those switches to not show up for several weeks, which may be why you’re feeling worse now than when you were inpatient.

 

14 hours ago, FireflyFyte said:

I am really struggling right now - heightened anxiety, fast heart rate, racing thoughts, low appetite, exhaustion throughout the morning even after a decent sleep, SI, and deep periods of depression/hopelessness. Part of me really wants to return to in-patient where I felt quite a bit better.

I felt most of these symptoms after my dr CT’d me off of Effexor a few years ago. It was terrible, and I too wondered if I needed to go inpatient and I doubted whether or not I could survive.  I started charting my symptoms and rating each of them daily. Any slight improvement from day to day in any symptom gave me strength and hope that I was improving. 
 

It also gave me hope every time I posted my 24-hour symptoms here and got feedback from the moderators. I knew I wasn’t alone in this scary phase and I trusted their experience and advice. 
 

You will get through this. Giving you a big hug of encouragement right now. 
 

 

[manymoretodays]

Update when you can FireflyFyte.

We're rooting for you!

 

L, P, H, and G,

mmt

[Thorin]

You can get through this FireflyFyte. I’m coming off Latuda and not long ago I thought I couldn’t live with it. Out of nowhere, after a few particularly bad days I’ve had a few ok days and an actual good day. It seems to be about: just getting through one day at a time, trust you will improve (difficult), doing things that make your system healthier and more resilient and patience! Good luck!

[FireflyFyte]

Apologies for a delayed response - I did end up going back inpatient as I wasn't safe at home.

 

At in-patient, the following happened -

• Upped my Prozac to 40mg
• Stopped the Ativan (my decision and they agreed)
• Restarted Zyprexa at 2.5mg
• Started Gabapentin at 300mg three times a day

Due to having a lot of concerns around withdrawal, I stopped the Zyprexa a few days after leaving inpatient but five days after that my withdrawal symptoms returned - waking up in a panic, feeling hot/overheated, lack of appetite, etc. so re-instated the Zyprexa and after 5/6 days have felt more "normal".

 

The timeline is as follows -

• October 27: Stopped the Ativan
• October 31: Gabapentin and Zyprexa started
• November 1: Prozac upped to 40mg
• November 10: Stopped Zyprexa
• November 15: Re-instated the Zyprexa

I am well aware that I am heavily poly-drugged but my current plan is to stabilize on my current cocktail for at least 1-2 months and then I will start a slow taper (5% every two weeks, if tolerated) of the Zyprexa and will try to taper off from the Gabapentin after that. I have not restarted my medication for ADHD and don't have plans to at this time - don't need to add more drugs to the mix.

[FireflyFyte]

I am thinking of using the water method for tapering Zyprexa, when I am ready, but should I slowly convert over to dissolving my tablet in water before I start the tapering process?

[FireflyFyte]

My current plan is to stay on my current cocktail until at least after Christmas but am leaning towards stabilizing even longer, maybe until early February, and then beginning my taper of the Zyprexa.

 

I have a few questions regarding the taper if anyone can provide insight -

• I am planning on a water titration so should I stabilize on my current dose (2.5mg) dissolved in water for some time (a few weeks?) before I begin to taper down
• My thought is to put the 2.5mg pill in 25ml of water so that 10ml of water = 1mg of pill. When I am calculating the drop should I do 5% of the 25ml bringing it to 23.75ml?
• For those who have done the BrassMonkey slide, are the four 2.5% drops calculated from the original dosage or dependent on each other? Meaning, would you drop 2.4 -> 2.37 -> 2.31 -> 2.25 or would it be 2.4 -> 2.34 -> 2.28 -> 2.22?

@hayduke - Hope you don't mind the tag but know that you tapered Zyprexa using the BrassMonkey method so would really appreciate getting your insight here. Reading your story has me a little less nervous about starting this process when I am ready.

[manymoretodays]

Hi FireflyFyte,  Sounds good.  HOLDING for the holidays!  And yes you should most definitely do a crossover to liquid gradually with your Zyprexa while making no other changes, additions, or tapering.  I'll get you the link to that topic when back at my desktop.  Or....using your main browser.....type in survivingantidepressants.org crossover.  You should also look at the Zyprexa tapering topic.  When you updosed, did you all the way back to 2.5mg of Zyprexa(olanzapine)?  Would you get your new cocktail/medications into the interaction checker and then post here: copy or link is fine.  And...when do you take each of your drugs now?  Just do a list.  Time: drug: dose.  Thanks.  With the brassmonkey slide I think going with the total 10% off, each previous dose/ month works fine.  And then an additional 2 week hold after the 4th 2.5%.  I'll get some topics here for your Introduction library when back to my desktop.  Good planning FFF.  How are you?  Home?  Hoping we'll enough.  L, P, H, and G.  mmt

Edited December 1, 2022 by manymoretodays

[FireflyFyte]

14 minutes ago, manymoretodays said:

When you updosed, did you all the way back to 2.5mg of Zyprexa(olanzapine)?  

 

Yes, when I up-dosed I went back to the full 2.5mg of Zyprexa. Thankfully, the re-instatement has gone well.

 

15 minutes ago, manymoretodays said:

Would you get your new cocktail/medications into the interaction checker and then post here: copy or link is fine.  And...when do you take each of your drugs now.

 

Here is the interaction list: 

1. Drug Interactions Checker
2. Search
3. Report

Print

Drug Interaction Report

6 potential interactions found for the following 3 drugs:

• gabapentin
• Prozac (fluoxetine)
• Zyprexa (olanzapine)
• Add another drug

• Consumer
• Professional

Major (0)

Moderate (3)

Minor (0)

Food (3)

Therapeutic Duplication (0)

Interactions between your drugs

Moderate

FLUoxetine  gabapentin

Applies to: Prozac (fluoxetine), gabapentin

Treatment with FLUoxetine may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with some anticonvulsants can increase that risk. In addition, FLUoxetine can cause seizures in susceptible patients, which may reduce the effectiveness of medications that are used to control seizures such as gabapentin. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Also let your doctor know if you develop seizures or experience an increase in seizures during treatment with FLUoxetine. Additionally, because these medications may cause dizziness, drowsiness, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

FLUoxetine  OLANZapine

Applies to: Prozac (fluoxetine), Zyprexa (olanzapine)

Using OLANZapine together with FLUoxetine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

gabapentin  OLANZapine

Applies to: gabapentin, Zyprexa (olanzapine)

Using gabapentin together with OLANZapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

No other interactions were found between your selected drugs. However, this does not necessarily mean no other interactions exist. Always consult your healthcare provider.

Drug and food interactions

Moderate

FLUoxetine  food

Applies to: Prozac (fluoxetine)

Alcohol can increase the nervous system side effects of FLUoxetine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with FLUoxetine. Do not use more than the recommended dose of FLUoxetine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.Switch to professional interactiondata

Moderate

gabapentin  food

Applies to: gabapentin

Alcohol can increase the nervous system side effects of gabapentin such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with gabapentin. Do not use more than the recommended dose of gabapentin, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate

OLANZapine  food

Applies to: Zyprexa (olanzapine)

Alcohol can increase the nervous system side effects of OLANZapine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with OLANZapine. Do not use more than the recommended dose of OLANZapine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

 

16 minutes ago, manymoretodays said:

And...when do you take each of your drugs now.  Just do a list.  Time: drug: dose.  Thanks.  

 

• 8:00 AM: Prozac (40mg) and Gabapentin (300mg)
• 3:00 PM: Gabapentin (300mg)
• 9:00 PM: Gabapentin (300mg) and Zyprexa (2.5mg)

18 minutes ago, manymoretodays said:

 How are you?  Home?  Hoping we'll enough.  L, P, H, and G.  mmt

I am doing well, thank you so much for asking. I've been home since November 6th and returned to work a few days later. Still have some lingering anxiety but a lot of it is around the medication and the taper(s) so am trying to remind myself that getting stable and doing a slow, and steady, taper is my safest route to getting off of these drugs. I am also doing an IOP (Intensive Outpatient Program) so three nights a week I am in guided group therapy for approximately 3 hours learning DBT skills and other coping mechanisms. Trying to focus on caring for myself so try to journal regularly, do a guided mediation before bed, walk the dogs daily (weather permitting), and started a meal delivery service so I can have more consistent and healthier meals. 

[manymoretodays]

Thanks, good job FFF.

 

I might split the Zyprexa off from the Gabapentin with your 9 pm dosing by 2 hours.  You could move it by one hour at a time, until it is spaced 2 hours from the Gabapentin.  That should help prevent potential interactions between those 2, hopefully.

 

Tips for tapering off Zyprexa(olanzapine)

 

Cross Over: Changing form(eg tablet to liquid) of drug OR changing brand of same drug

 

The brassmonkey slide method of micro-tapering

[FireflyFyte]

15 hours ago, manymoretodays said:

I might split the Zyprexa off from the Gabapentin with your 9 pm dosing by 2 hours.  You could move it by one hour at a time, until it is spaced 2 hours from the Gabapentin.  That should help prevent potential interactions between those 2, hopefully.

 

I'll start this tonight and move the Gabapentin to 8 PM.

 

Also, question, I am going to hold on my current cocktail until after the holidays, and potentially until the beginning of February but should I start tapering the Zyprexa or the Gabapentin first? I am thinking the Gabapentin might help with the Zyprexa withdrawals but I know that Gabapentin withdrawals can be a beast in their own right so am worried that being on them for a year plus while I taper the Zyprexa might lead to problems down the road. Being poly-drugged is so much fun 🙄

[manymoretodays]

Hi FFF,

Yes.  The Gabapentin is new too, or newer for you.  At least a new class of drug.

Here is that topic:

Tips for tapering off Neurotin(gabapentin)

The tapering topics are also a good place to start to get familiar with your drug too

I think I gave you the Zyprexa tapering topic above.

Also Drugs.com will inform on just single drugs too, with how they work, what class drug they are, and side effects, so it is a good resource.

 

I was okay with you starting with Zyprexa mainly because I have a real aversion to that drug.  I mean it is one nasty AP(antipsychotic)/neuroleptic that often gets misused or mis-prescribed in my humble opinion.  It can have some adversities.

 

Taking multiple psych drugs? Which drug to taper first?

something to mull over ^ and read and decide

 

For right now, for yourself try to get a feel for how each of your drugs effects you.  You've likely seen me ask others for NOTES??  Just do some observations, on paper is helpful, for yourself right now, to get an idea of any effects both before and after each drug is taken.  And then ultimately, it will help decide which to start with, when you taper.  It's always nice to be able to just lower dosages whenever possible too, less chance of side effects with that.  And as we've learned here.......there really is no rhyme or reason to so called "therapeutic doses".

 

Good question, and something we can decide before you begin tapering.

You doing okay?

 

L, P, H, and G,

mmt

[FireflyFyte]

1 hour ago, manymoretodays said:

I was okay with you starting with Zyprexa mainly because I have a real aversion to that drug.  I mean it is one nasty AP(antipsychotic)/neuroleptic that often gets misused or mis-prescribed in my humble opinion.  It can have some adversities.

 

I am still leaning towards starting the Zyprexa first knowing how many receptors it affects in the brain and the real risk of gaining weight and/or developing diabetes.

 

1 hour ago, manymoretodays said:

For right now, for yourself try to get a feel for how each of your drugs effects you.  You've likely seen me ask others for NOTES??  Just do some observations, on paper is helpful, for yourself right now, to get an idea of any effects both before and after each drug is taken. 

 

I was doing a daily tracker but haven't as of late. I'll start doing that again so I can get a better idea of how I might be responding to the medication.

1 hour ago, manymoretodays said:

You doing okay?

 

Yes, thank you for asking. I woke up to my phone being dead so that was stressful but was able to get it started and not spiral with anxiety too much which is a positive for me - I can spiral quickly. I do find myself spending way too much of my time, and mental effort, worrying about these medications and the withdrawals so need to work on "changing the channel" on my thoughts and finding something else to occupy my time. I might order myself a new coloring book as I find coloring to work as a calm distraction.

[hayduke]

On 12/2/2022 at 2:12 AM, FireflyFyte said:

@hayduke - Hope you don't mind the tag but know that you tapered Zyprexa using the BrassMonkey method so would really appreciate getting your insight here. Reading your story has me a little less nervous about starting this process when I am ready.

 

Hi there.  Yes, I found his taper the gentlest and steadiest way to come off olanzapine.  It was the best template of any I tried, including plain 10%/mo cuts and daily micro tapers.  The hold every few weeks is something you would come to appreciate, I think.

I don't know if you're going to want to try and get to zero on olanzapine while still taking prozac.  I have not taken ADs myself, but hear prozac can be activating or even mania inducing, and as the olanzapine wears off, you will want to be as gentle on your nerves as you can be.  I even tapered off coffee along the way, which took a year and was hard, but worth it.  I wouldn't start it again now.

So I would suggest maybe alternating rounds of tapering olanzapine for a while, holding, tapering off some prozac, another hold, another round of olanzapine taper, etc.  If you are listening to your body I think you would have a fair idea of when to hold one and work back towards tapering the other.

No idea what's going on with the gabapentin in all that, sorry.  Others could advise.

Edited December 2, 2022 by hayduke
typo

[hayduke]

On 12/2/2022 at 2:12 AM, FireflyFyte said:

• I am planning on a water titration so should I stabilize on my current dose (2.5mg) dissolved in water for some time (a few weeks?) before I begin to taper down
• My thought is to put the 2.5mg pill in 25ml of water so that 10ml of water = 1mg of pill. When I am calculating the drop should I do 5% of the 25ml bringing it to 23.75ml?
• For those who have done the BrassMonkey slide, are the four 2.5% drops calculated from the original dosage or dependent on each other? Meaning, would you drop 2.4 -> 2.37 -> 2.31 -> 2.25 or would it be 2.4 -> 2.34 -> 2.28 -> 2.22?

 

1) Yep getting used to the liquid first at the same dose is a good idea.  It does feel a bit different, and some people struggle with it.  I didn't, it just felt like any other dosage adjustment.  If you do struggle with sleep, nerves etc after a couple of days, let us know.
2) That's the general idea
3) I did each four cuts in the cycle as constant amounts, so it would add up to 10% of the starting dose of the previous cycle.  I only recalculate from the preceding dose once, at the start of each cycle

For 2) and 3), if you can drive a spreadsheet, you can plan ahead and consider options as you go.  There are some examples people have shared around the site. 

 

[FireflyFyte]

15 hours ago, hayduke said:

Hi there.  Yes, I found his taper the gentlest and steadiest way to come off olanzapine.  It was the best template of any I tried, including plain 10%/mo cuts and daily micro tapers.  The hold every few weeks is something you would come to appreciate, I think.

 

Thank you. I am leaning towards this method especially given that I need to work and live alone (with two dogs and three cats to care for) because I have to be mostly functional.

 

15 hours ago, hayduke said:

I don't know if you're going to want to try and get to zero on olanzapine while still taking prozac.  I have not taken ADs myself, but hear prozac can be activating or even mania inducing, and as the olanzapine wears off, you will want to be as gentle on your nerves as you can be.  I even tapered off coffee along the way, which took a year and was hard, but worth it.  I wouldn't start it again now.

So I would suggest maybe alternating rounds of tapering olanzapine for a while, holding, tapering off some prozac, another hold, another round of olanzapine taper, etc.  If you are listening to your body I think you would have a fair idea of when to hold one and work back towards tapering the other.

 

I wasn't planning on tapering off the Prozac but it is something that I will consider. I currently only have one coffee in the morning with breakfast but can start switching over to decaf which I have done in the past.

10 hours ago, hayduke said:

1) Yep getting used to the liquid first at the same dose is a good idea.  It does feel a bit different, and some people struggle with it.  I didn't, it just felt like any other dosage adjustment.  If you do struggle with sleep, nerves etc after a couple of days, let us know.
2) That's the general idea
3) I did each four cuts in the cycle as constant amounts, so it would add up to 10% of the starting dose of the previous cycle.  I only recalculate from the preceding dose once, at the start of each cycle

 

I really appreciate your feedback here. I know it's partly due to my control/OCD issues but have a better understanding of the taper leaves me feeling a little more in control of the situation.

[FireflyFyte]

For manymoretodays, here is my log from yesterday -

 

• 7:15 AM - Wake up. Slept well.
• 8:00 AM - Breakfast (think! bar and coffee)
• 8:15 AM - Prozac (40mg) and Gabapentin (300mg)
• 10:45 AM - Walked the pups for 20 minutes
• 11:45 AM - Lunch (1/2 apple, almonds, and pepper jack cheese)
• 2:45 PM - Gabapentin (300mg)
• 5:30 PM - Dinner (chicken leg quarter, pasta salad, and asparagus)
• 8:00 PM - Zyprexa (2.5mg) and Gabapentin (300mg) (forgot to move the Gabapentin - will do so today)
• 10:00 PM - Fell asleep

[hayduke]

3 hours ago, FireflyFyte said:

Thank you. I am leaning towards this method especially given that I need to work and live alone (with two dogs and three cats to care for) because I have to be mostly functional.

 

No reason to make anything harder than it needs to be, anycase.  The outside world has been taking care of that for us in recent times  🙂

 

3 hours ago, FireflyFyte said:

I really appreciate your feedback here. I know it's partly due to my control/OCD issues but have a better understanding of the taper leaves me feeling a little more in control of the situation.

 

I don't see anything wrong with wanting a solid plan and a thorough understanding of the process.

 

Cheers

[FireflyFyte]

20 hours ago, hayduke said:

I don't see anything wrong with wanting a solid plan and a thorough understanding of the process.

 

Cheers

 

I appreciate it. Having a plan in place is helping to ease some anxiety and have all my supplies ready to begin my taper in a month or two.

[FireflyFyte]

Yesterday's log -

• 6:45 AM: Wake up. Mild anxiety (2/10)
• 7:45 AM: Breakfast (think! bar and coffee)
• 8:00 AM: Prozac (40mg) and Gabapentin (300mg)
• 11:50 AM: Lunch (sundried tomato chicken and zucchini)
• 2:15 PM: Weights session (25 minutes)
• 2:45 PM: Gabapentin (300mg)
• 8:00 PM: Dinner (pizza)
• 10:00 PM: Zyprexa (2.5mg) and Gabapentin (300mg)

I went to a friends' place yesterday which threw my dinner and evening medication off my normal schedule. Tomorrow, I will begin spacing the evening Zyprexa and Gabapentin.

[manymoretodays]

Hi FireflyFyte,

Very cool......you are posting some preliminary Notes.  And I did not even give you the link to how to or that topic I see.

So here is that:

Recording drug schedule and symptoms to track patterns and progress

And then in the first post you'll see a quote.  Open that too and take a look.

 

Oh, I'm so glad that hayduke is giving you some good tips now too regarding the Zyprexa.

 

On 12/3/2022 at 6:19 AM, FireflyFyte said:

• 7:15 AM - Wake up. Slept well.
• 8:00 AM - Breakfast (think! bar and coffee)
• 8:15 AM - Prozac (40mg) and Gabapentin (300mg)
• 10:45 AM - Walked the pups for 20 minutes
• 11:45 AM - Lunch (1/2 apple, almonds, and pepper jack cheese)
• 2:45 PM - Gabapentin (300mg)
• 5:30 PM - Dinner (chicken leg quarter, pasta salad, and asparagus)
• 8:00 PM - Zyprexa (2.5mg) and Gabapentin (300mg) (forgot to move the Gabapentin - will do so today)
• 10:00 PM - Fell asleep

 

12 hours ago, FireflyFyte said:

• 6:45 AM: Wake up. Mild anxiety (2/10)
• 7:45 AM: Breakfast (think! bar and coffee)
• 8:00 AM: Prozac (40mg) and Gabapentin (300mg)
• 11:50 AM: Lunch (sundried tomato chicken and zucchini)
• 2:15 PM: Weights session (25 minutes)
• 2:45 PM: Gabapentin (300mg)
• 8:00 PM: Dinner (pizza)
• 10:00 PM: Zyprexa (2.5mg) and Gabapentin (300mg)

 

I would certainly get into the habit of adding more times on the left, and getting more descriptive as to how you feel- any symptoms that you notice.  You might even go with good and not so good symptoms.  Like you could note when you feel like yourself, or at your best during the day.......to the left of the time, as well as when you are having some old familiar, yet unwanted types of symptoms.

 

And applause FFF.  Did you say you are managing to keep on working right now too.....I mean that is stellar!!  And don't forget that you are still in the shadow of that recent hospitalization too.......it can feel pretty nerve wracking.....and you've had a real shift in medications too.

 

Honestly, I've have got to look a bit more at your interactions......now I'm wondering if we need to split out the Prozac too, from the Gabapentin.  And I will, when time allows.  I get nerdy that way and find it funnish? interesting?  I guess I missed my calling.......LOL....I don't know.

 

What kind of interval are you supposed to have between those 3 Gabapentin doses?  As I notice almost 7 hours between the morning and mid afternoon dose, and then about the same 7 hours between the mid afternoon to night dose.  Then almost 9 hours from your nighttime dose to the morning dose.

So......your other assignment right now, and report back......would be to find out how you should be dosing the gabapentin right now, intervals between doses.

 

And I don't wish to get too, too into your present medication/drug management either.  So do your research too, empower yourself FFF.  Learn about your drugs in other words.....it will help in the long run for you........I think it will. 

I am glad you will stay put at least until January, but then start to work on some tapering.

 

All for now.

L, P, H, and G,

mmt

[FireflyFyte]

10 hours ago, manymoretodays said:

And applause FFF.  Did you say you are managing to keep on working right now too.....I mean that is stellar!!  And don't forget that you are still in the shadow of that recent hospitalization too.......it can feel pretty nerve wracking.....and you've had a real shift in medications too.

 

Thank you, ManyMoreTodays. I have been working but am lucky to work from home so can take breaks when needed which is helping with the transition.

10 hours ago, manymoretodays said:

What kind of interval are you supposed to have between those 3 Gabapentin doses?  As I notice almost 7 hours between the morning and mid afternoon dose, and then about the same 7 hours between the mid afternoon to night dose.  Then almost 9 hours from your nighttime dose to the morning dose.

So......your other assignment right now, and report back......would be to find out how you should be dosing the gabapentin right now, intervals between doses.

I will do more research but the only interval I read is that any dosage shouldn't be more than 12 hours apart to avoid interdose withdrawal. 

10 hours ago, manymoretodays said:

And I don't wish to get too, too into your present medication/drug management either.  So do your research too, empower yourself FFF.  Learn about your drugs in other words.....it will help in the long run for you........I think it will. 

I am glad you will stay put at least until January, but then start to work on some tapering.

I will continue to do research and take advantage of the fact that I feel decent at the moment. 

[FireflyFyte]

Yesterday's log -

• FitBit sleep score of 79
• 7:30 AM: Wake up. No noticeable anxiety.
• 8:00 AM: Breakfast (think! bar and coffee)
• 8:15 AM: Prozac (40mg) and Gabapentin (300mg)
• 10:30 AM: Tylenol (500mg) (twisted my ankle the night before)
• 11:00 AM: Walked the pups (25 minutes)
• 12:20 PM: Lunch (mahi mahi and corn)
• 12:30 PM: Hands trembling (2/10)
• 2:35 PM: Gabapentin (300mg)
• 5:30 PM: Dinner (sushi)
• 8:00 PM: Zyprexa (2.5mg)
• 9:00 PM: Gabapentin (300mg)
• 10:00 PM: Fell asleep without any issues

Overall evaluation of the day - A decent day without many issues other than my hands trembling for a bit in the middle of the day. I had a few periods of sadness but hard to say if that it related to the medication or an incident that happened the day before that really upset me and still continues to do so. I was able to focus on a video game for a few hours which I wouldn't have been able to do a few weeks ago.

 

ManyMoreTodays, I will work on expanding my log and tracking my mood for better or for worse.

[FireflyFyte]

Yesterday's log -

• FitBit Sleep Score of 85
• 6:30 AM: Wake up with no noticeable anxiety
• 8:00 AM: Breakfast (think! bar and coffee)
• 8:30 AM: Prozac (40mg) and Gabapentin (300mg)
• 10:00 AM: Walk the pups (25 minutes)
• 11:30 AM: Lunch (sushi)
• 3:00 PM: Gabapentin (300mg)
• 4:30 PM: Mild anxiety regarding withdrawals
• 5:00 PM: Dinner (sage chicken and sweet potatoes)
• 6:30 PM: Snack (Sour Patch Kids)
• 6:45 PM: Mild tightness in chest (2/10)
• 8:15 PM: Zyprexa (2.5mg)
• 9:15 PM: Gabapentin (300mg)

Overall evaluation of the day - A pretty standard day for me with periods of mild anxiety that usually cultivate around worrying about medication side effects and/or pending withdrawals. I think the tightness in the chest might be related to sugar given I ate candy shortly beforehand so while I don't usually indulge in many sweets anyway appears I might have to avoid them altogether for awhile.