Sabathil: Recovery from Clopixol (Zuclopenthixol) Injections

[Sabathil]

Hi All,

 

In August 2022 I was given 400mg Clopixol injections, and due to side effects have been reducing the dosage. In November 22 I went down to 300, and to 200mg in January. I want to stop the injection and switch to tablets and taper off them slowly.

 

Is there anyone out there who has had this drug and recovered? I was on olanzapine in the past and the akathisia from clopixol is much worse

Edited January 30, 2023 by manymoretodays
just reorganized Title and name :-)

[manymoretodays]

Hi Sabathil, and welcome aboard here!

I am having to look up your drug and so far here is what I have found:

Zuclopenthixol- Wikipedia

It is a typical antipsychotic(AP) or first generation AP.

I haven't seen it here before, but I think we can help you with tapering it.

And there may be someone who has tapered it who stops by too.

 

Today, I just want to get you started.

How are you doing right now?  Any symptoms noted from your reductions that you might attribute to WD(withdrawal)?

I did see you mention akathisia.  Is this while on the drug or while coming off the drug, or both?  And then would you describe what you experience, if you can, with this symptom?

 

See:

Dr. Joseph Glenmullen's withdrawal symptom list

and you'll see a PDF that will download to look at

 

We go with a harm reduction approach. The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

Are you on any other drugs/medications right now?

 

And you can answer that by doing a signature ASAP.  See:

How to Summarize Your Drug History in Your Signature

 

Welcome again Sabathil. 

This is now your introduction/journal page where you have introduced yourself to the community, you can ask questions here,  regarding your tapering, and anything else, give updates, and just keep a record of your journey.

 

All for now.  I can certainly give you more information as time goes on.  I don't want to overwhelm you right now.

 

Best, Love, peace, healing, and growth,

moderator manymoretodays(mmt)

 

[Sabathil]

Hi mmt, thank you for your reply 😀

 

yes I’ve noticed it’s not a very common drug and it appears it’s banned in the USA. My treating team said it’s for violent people, but I never was not an angry person by nature, so I’m not sure why it was chosen for me.

 

the akathisia for me manifests as horrible restlessness and a constant need to be moving. My legs are also restless fortunately no pain. When I try watch a movie I have a  sudden need to move and jump up. It’s quite severe, debilitating. I haven’t been able to return to anything I once loved (reading, work, riding my bike) since being treated…

 

im a little confused about my next drop. The psychiatrist said he would keep me on 200mg but increase the time between the depot from 2 to 3 weeks, I understand this is still a reduction but not sure how to calculate it lol. I’ll try for 100mg at my next appointment later this month and commence the 10% reductions when I’m on orals. I’m not coping on the injection😌

 

 

thanks again for your response

hopefully someone out there on the forum has experience with this clopixol drug

[Altostrata]

Hello, @Sabathil When did the akathisia start?

 

If this is the adverse effect that has caused you to decrease the dosage, the amount you're taking is still causing this adverse effect. It is not a withdrawal symptom.

 

On 2/7/2023 at 5:45 PM, Sabathil said:

The psychiatrist said he would keep me on 200mg but increase the time between the depot from 2 to 3 weeks, I understand this is still a reduction but not sure how to calculate it lol.

 

Suggest you ask the prescriber to explain to you how this might be a reduction. Most likely, if you have drug-induced akathisia, it is more intense shortly after an injection. An injection at longer intervals only means the adverse reaction may fade towards the end of the period and will be renewed after the next injection.

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[Sabathil]

Ok thanks @Altostrata, yes I am getting the adverse effect akathisia since lowering to 300mg in roughly November, it has gotten a lot worse since lowering to 200mg.

 

And is most prominent a few days following an injection.

 

Would you suggest I try push for 100mg every 2 weeks or change drug to a second gen? My CTO is up for review in April, but they said they want another 6 months so it won't be till October this year that I am free to switch to orals. I am wondering is it best to taper on this drug that I know and am now used to or should I switch to something more tolerable and taper that?

 

 

 

 

 

 

[Altostrata]

You should report that you're getting akathisia after your injection. It's a sign the dosage is too high.

 

You only changed to 200mg in January. How has the akathisia symptom changed since you got the injection?

[Sabathil]

okay i will do this, should i avoid using the medical terminology though? i feel insecure and weak when facing these treating teams

 

whole-body pain from urgent rapid movements from laying down to standing up, restless legs and involuntary leg and jaw movements. in hospital, they put me on benztropine to deal with my pain and tongue, but i was on 400mg clopixol then also.

 

the Dr did say he'd switch me to a second generation drug if i wished, but i cant decide

 

ps thankyou for taking the time to help me out by the way

[Altostrata]

How has your symptom pattern changed over the weeks since you got the injection in January?

[Sabathil]

@Altostrata

whole-body pain from urgent rapid movements from laying down to standing up, restless legs and involuntary leg and jaw movements. 

 

Does that answer your question? My symptoms are suicidal urges but I haven't acted, I feel horrible pain and out of control in my life like im on auto pilot each day of destructive habits 

[Altostrata]

How did you feel in January before you go the injection? How did you feel after the injection? How has your symptom pattern CHANGED since you got the injection in January?

[Sabathil]

the akathisia wasn't as bad on 300mg. maybe i just didn't notice it as much because of sedation. 

[Altostrata]

How did you feel in January as the 300mg injection was wearing off, before you got the 200mg injection?

 

What was the effect after the 200mg injection?

 

How has your symptom pattern CHANGED since you got the 200mg injection in January? Compare symptom pattern shortly after the injection to how you feel now.

[Sabathil]

I feel horrible and don’t understand why you keep asking the same question. 
 

has anyone got any experience with clopixol? I’m worried about withdrawal because I can’t find any information about withdrawal from clopixol? 😪

[Altostrata]

I ask these questions because I need to know more about your symptom pattern.

 

How did you feel horrible as the 300mg injection was wearing off? Was there any difference in your symptom pattern in the 2 weeks after you got the 200mg injection?

 

If you cannot answer these questions, there is no way for me to understand the effect of the drug on you. "I feel horrible" is not enough information.

 

There is very little information about withdrawal syndrome from any of the antipsychotics. See this article and its references https://psychscenehub.com/psychinsights/antipsychotic-withdrawal-syndrome-tapering/

 

 

[Sabathil]

Thankyou.

The akathisia became more prominent after the first dose of 200mg yes. I don't remember how bad it was on 300mg, but lately it's gotten a lot better on the 200.. but my life in general is bad, I don't leave the house and am not involved in anything at all, I feel very stupid like my mind and soul have been killed. But this has been the case ever since starting Clopixol

 

Even on the lowered dose of 200 nothing has improved for the better, the akathisia has, but my life has not improved im still suffering from the effects of being medicated

[Sabathil]

I've seen dr Yolande lucire and dr Niall McLaren who both said I definitely don't have schizophrenia.

 

But 8 years ago when I first got admitted I smoked weed once and got labelled, the public system have just followed that diagnosis ever since. I'm not violent, never have been, I don't hear voices, never did. No symptoms whatsoever, they just want me drugged and I'm sure you know how it goes.

 

Also I'm on the Clopixol every 2 weeks, would it be better to switch to 3 or 4? Or aim for a lower dose

[Altostrata]

8 hours ago, Sabathil said:

Even on the lowered dose of 200 nothing has improved for the better, the akathisia has

 

This is, in fact, an improvement.

 

You are going to have to figure out how to taper off 200mg with the help of your prescriber. We cannot fix this for you, you're getting an injection and once it's in your body, you'll have to wait for it to wear off.

[Carmie]

Hi @Sabathil

 

I’m so very sorry to hear about your dilemma. I hope you can figure out with the help of your prescriber how to lower the doses of your prescription. It’s hard when you’re getting injections as you can’t do your own tapering at home. 
 

It’s actually a really good sign that your Akathisia has gotten a bit better once you lowered the dose of the injection. I’ve had Akathisia, it’s the most horrific thing I’ve experienced in my whole life.
 

You said that you feel stupid, like your mind and soul have been killed. A lot of us on medication and the withdrawals that come from these feel like that. Brain fog is very common and so is anhedonia, as well as lots of other emotional and mental symptoms. I had CFS before being on these drugs so I was already dealing with a lot of these symptoms, the main one being brain fog. I find it hard to think straight a lot of the time and my memory is shocking. 
 

Please keep us updated on  how you go with your prescriber, sending hugs🤗

[Sabathil]

Thanks Carrie, yes the brain fog is horrible. I want to move state to breach the involuntary order and save myself, but without the ability to think clearly it’s becoming impossible to organise and stay motivated on my goal.

 

I saw a junior psychiatrist last week who refused to lower my dose and told me to fix my diet and exercise to lose weight. It’s sickening

[Sabathil]

Does anyone know how I can find out what oral dosage I should be taking when I quit the injection? Ie. what dose of tablet is the equivalent to 100mg depot? This would be a huge help to know, thanks

[Altostrata]

@Sabathil Through Google search, I found the official Australian information for Clopixol If your doctor won't do it, you will need to learn to look things up yourself to answer your questions, because we don't know much about Clopixol.

 

As a drug consumer, you must look up adverse effects and other information about each of your drugs to be properly informed.

 

For injections, it says

 

Quote

 

• Clopixol Acuphase 50 mg/mL injection - 50 mg zuclopenthixol acetate per 1 mL or 100 mg zuclopenthixol acetate per 2 mL
• Clopixol Depot 200 mg/mL injection - 200 mg zuclopenthixol decanoate per 1 mL.

 

I don't know what kind of injection you're getting or the dosage. Please ask your doctor or pharmacist to do the math for you, to estimate your equivalent daily dose in tablet form.

 

As the injection gradually wears off over 2 weeks, the last daily dose on the 14th day is probably weaker than the first dose on the first day of the injection. I might allow the injection to wear off and start at the low end of an estimated tablet dose. You may need to split tablets. 

[Sabathil]

Hi Alto, is there any particular antipsychotic we know more about for tapering? I could ask to switch to zyprexa or abilify

[Altostrata]

Sorry, we don't know of any relative of Clopixol that would substitute. Zyprexa and Abilify are far different drugs. Suggest you talk to a pharmacist.

 

Every drug switch is high-risk for withdrawal from the first drug or adverse reactions to the second. If you want to do this, please confer with your doctor.

 

On 3/7/2023 at 11:30 AM, Altostrata said:

I don't know what kind of injection you're getting or the dosage. Please ask your doctor or pharmacist to do the math for you, to estimate your equivalent daily dose in tablet form.

 

As the injection gradually wears off over 2 weeks, the last daily dose on the 14th day is probably weaker than the first dose on the first day of the injection. I might allow the injection to wear off and start at the low end of an estimated tablet dose. You may need to split tablets. 

 

This is my best advice to you. You will need to do some work to find out more about the injection you're getting.

 

[Sabathil]

Hi @Altostrata,

 

I don't have a doctor I trust, so am trying my luck at this community. Is there any general consensus about which antipsychotic might be easiest to taper? I read here that Haldol should be easier than Zyprexa for example, because it affects 2 receptors as opposed to 17, respectively.

 

I have experience with Zyprexa, but at low doses (5mg and under) I struggled to sleep, so I'd prefer to stay away from second-generation atypicals. Although, I didn't feel bad on Invega.

 

Currently I'm taking 200mg Clopixol fortnightly, the akathisia has eased but I still struggle with my weight and the common effects which are listed in the product information for this drug. I would like to switch to something else but am still 6 months away from being free from a CTO, so I have time to adjust to withdrawals from the Clopixol and adjust to any new side effects of the new drug...

 

I'm just wondering if you noticed people to have an easier time coming off a certain drug over others? 

 

Thankyou very much for your help and support so far, It means a lot :-)

[Altostrata]

All of the antipsychotics in tablet form carry the same tapering risks. Plus, when you switch drugs, you may get withdrawal from the first drug.

 

Are you still getting injections?

[Sabathil]

Thanks heaps for your reply @Altostrata I was really hoping you would because this community is my only source of help and trustworthy information 

 

I understand. As I have been on this Clopixol for roughly 8 months, I will continue with it. I think I’m pretty well used to it now.

 

yes, still on injection. At the tribunal recently they mentioned a switch to orals and the treating psychiatrist I saw a few months ago also mentioned he would stop the order in October later in the year. So, I’ve still got a while to go before being free to switch to orals and commence a taper.. the dose I am taking of injection is 200mg which is standard maintenance treatment although I’d like to change to every 4 weeks because I read in the information about clopixol that it is eliminated every 19 days,

 

I was put on this drug because I cold turkey a one off 400mg Abilify injection. And experienced withdrawal psychosis.they put me on a cto because of history of non compliance. Public system is horrible.

[Sabathil]

Also I applied for the cto psychiatrist notes to the tribunal and was shocked. She said I have no insight, lol

 

of course I have no insight I am educated enough about psychiatry to know I’ll never have insight

[Sabathil]

Days 2 and 3 following an injection I sleep for around 1 hour during the day, I fall asleep.

 

every night since starting clopixol I wake at least. Once but usually twice during the night. I have very strange abnormal dreams and usually they are nightmares. I can fall back to sleep after a cigarette to calm me down. Often the dreams are recurring places or theme about my life before taking psychiatric drugs, such as when I was in school.

 

throughout the day I am paranoid about going back to hospital. Thoughts like- what if I become psychotic from drug withdrawal, what if I don’t taper right. The dr at my local hospital said clozapine would be what they drug me with if I ever go back, so I’m rightly a little scared 

 

There’s still some time before my cto ends but when it does I want to be drug free. I’ve been off cannabis now for 18 months, and regret ever using it . 
 

im heavily medicated but have been this way now for 8 years so I’ve gotten used to it but I feel pretty hopeless at ever healing because I’m alone in my journey

[Altostrata]

On 4/18/2023 at 12:24 AM, Sabathil said:

I’d like to change to every 4 weeks because I read in the information about clopixol that it is eliminated every 19 days,

 

If the injection is washed out after 19 days, you might get withdrawal symptoms before you get another injection 9-11 days later.

 

The way you taper an injection is by injecting a little less than 200mg -- 175mg for example. Suggest you tell your doctor the 200mg injection is too strong for you because you cannot sleep after the injection, it has to wear off some.

[Sabathil]

@Altostrata hey Altostrata 🙂 thanks as always for your post.

 

Okay I understand best for me to stay with two-weekly due to risks of withdrawal symptoms and instead lower to 175mg.

 

I have seen two psychiatrists on my CTO (community treatment order forcing me to comply with schizophrenia treatments BECAUSE I initially smoked cannabis in 2015 and have been relapsing with medication withdrawals ever since)

 

1st psychiatrist said I could increase duration (never happened though) between injection when I commented I had cognition issues with work (I drive trucks and work around heavy machinery) and prescribed seroquel to help with sleep, as a PRN, which I never took.

 

2nd psychiatrist, she's his junior, said I am already on a therapeutic dose and wasn't prepared to make any changes because im apparently already on a low dose, I am seeing her mid-May for another review and will ask again if she thinks its safe to reduce just 25mg to 175.

 

if you have time could you tell me is it best to ask for reductions as a response to side effects? Can I tell them I have restless legs, strange dreams and put on too much weight as well as extra pyramid symptoms like jaw and crunching of teeth? 

 

I'm very afraid of these people they have too much power over me and I swear I were never schizophrenic (I don't tell them that), at my recent tribunal hearing - to determine whether I need another 6 month CTO - they the treating team say I have no insight into my apparent illness. I'm excited to taper though, the right way this time, and I look forward to using all the Info on your website

 

thanks again for reading and sharing posts with me, helps a lot, I don't feel as alone or afraid

 

-ZombieMode/Sabathil

[Altostrata]

5 hours ago, Sabathil said:

 

if you have time could you tell me is it best to ask for reductions as a response to side effects? Can I tell them I have restless legs, strange dreams and put on too much weight as well as extra pyramid symptoms like jaw and crunching of teeth? 

 

Yes, I told you this already. Suggest you ask their assistance to find the lowest effective injection dose.

[Sabathil]

They denied my request to reduce dose. But did say I could switch to a different drug if the side effects are so bad.

 

I don't tolerate atypicals very well and always struggled with withdrawals from those...

 

There's still 5 months before my CTO expires, so I'm looking at swapping to Haldol because life on clopixol is horrible, I can't cope. By far it is the worst experience I've had with psychiatric drugs in my 8 years as a user!

[Altostrata]

Please update your signature with your prior psychiatric drug use.

[Sabathil]

done

[Altostrata]

On 5/20/2023 at 11:40 AM, Sabathil said:

There's still 5 months before my CTO expires, so I'm looking at swapping to Haldol because life on clopixol is horrible, I can't cope.

 

I am sorry you are having such a bad time with clopixol. We cannot comment on a switch to Haldol, we don't know anything about doing this or if that would be better.

[Sabathil]

Hi @Altostrata,

 

is there anything you might suggest to help improve nightmares from the Clopixol?

 

thanks,

sabathil