Pidgeon: Sertraline & Olanzapine Tapering

[Pidgeon]

Hey all. Though as I write this I feel relatively healthy, I prefer to quit anyway. My history of this treatment is long, tough and spans 6 years. Started with Sertraline and anxiety which led me to develop psychotic symptoms, though very few of these symptoms - 1 or 2 to be exact. Either way, I suspect my diagnosis is off the mark or entirely wrong because I've had friends tell me I am healthy and family members tell me it's been 2 years since they saw symptoms of my "chronic" illness. Strangely, if we diagnosed me according to DSM and other books then I would just barely qualify for a psychotic disorder in the past, but totally not in the most recent 2 years - I got better. Anyway, as of today I settled on Zoloft 50mg and Zyprexa 15mg (brands of Sertraline, Olanzapine). These are totally ok for me. Or so I thought!

 

Here is my plan.

 

Blood tests came. I have high prolactin. Remains to be figured out whether this high prolactin is from sertraline or from olanzapine. All I am sure is that I definitely have poor libido and some anhedonia which are typical for high prolactin. Better if it's sertraline 'cause I may keep on taking olanzapine in that case.

 

This is the straw that broke the camel's back, since I believed these drugs to be 100% safe for me.

 

How do I plan to come off these drugs, and will it go well? I will just persuade my doctor to give me a tapering plan. This is my own tapering plan based on my experience and how these drugs work with my body:

 

Sertraline, month 0: 50 mg

month 1: 25 mg

month 2: 0 mg

 

Olanzapine, month 0: 15 mg

- month 1: 10 mg

- month 2: 7.5 mg

- month 3: 5 mg

- month 4: 0 mg

 

Cheers!

Edited November 29, 2023 by Karma
Name update

[Emonda]

Welcome to S.A @Pidgeon,

 

As a starting point, please follow these Drug signature instructions. This will help the moderators help you.

 

As to your tapering plan, I'd encourage you to read this first: Why taper by 10% of my dosage? I would not suggest you follow your draft plan - it's way too fast in my experience.

 

To ensure you go into this with your eyes open, please have a read of this link: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Also, we don't recommend tapering two medications at a time. If you feel off, you won't know which medication is the cause. This link will give you some guidance on which medication to start with: Taking multiple psych drugs? Which drug to taper first? I don't have experience with Olanzapine. I believe you'd start tapering the Sertraline first.

 

Once you start tapering, you are likely to experience the Windows and waves pattern of stabilization. Many of us find that these Non-drug coping strategies help.

 

We don't suggest many supplements, but two that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. Add one at a time and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

Avoid alcohol. 

 

Please post any updates here in your thread. It is helpful to keep everything related to your journey in one spot. You are very welcome to jump onto someone else's page and interact with them. The encouragement members give each other on this site is wonderful to see.

 

Sing out with any questions....and please remember to add your drug signature. 

 

Emonda.

 

[getofflex]

Hello, Pidgeon.  To add to all the good info that @Emondagave you, I want to help you understand why it is so extremely important to taper very slowly.  Many/most who taper fast end up with significant withdrawal that can take months, or even years, to recover from.  If you use our harm reduction approach, you will probably only have minimal to no withdrawal, and still be able to lead a normal life while tapering.  These links will explain why this is: 

 

How Psychiatric Drugs Remodel Your Brain

 

Too Fast Tapers and Cold Turkeys

Edited November 29, 2023 by getofflex

[Pidgeon]

Hello @Emonda and @getofflex,

 

I will follow your advice. Some stuff I am already well aware of, but the key point is making my olanzapine tapering slower by adding a step for 12.5 in between 15 and 10. This entirely exhaust all my options with olanzapine regarding its dosages available in our pharmacies. I don't want to cut pills or use liquid.

 

Still not sure of only one thing: whether to taper olanzapine or zoloft(sertraline) first. If you wish to help me better, there are good reasons for doing either way that I can list.

 

I have an appointment within a few days where I will discuss my tapering. My doctor will most likely be surprised or alarmed that I want to come off meds.

I've been taking zoloft just for a few months. This should make withdrawal easier. Also this will be my second withdrawal from zoloft -- I know what to expect. Added signature with my meds from the last 18 months.

[getofflex]

2 hours ago, Pidgeon said:

Still not sure of only one thing: whether to taper olanzapine or zoloft(sertraline) first. If you wish to help me better, there are good reasons for doing either way that I can list.

We generally suggest you taper off the more activating drug first, assuming there are no adverse reactions to your drugs.  It doesn't sound to me like you are having any adverse reactions.  Anhedonia and poor libido are typical side effects.  That way, the sedating drug can help buffer any withdrawal symptoms you may have.  I would suggest you taper off the sertraline first. 

 

Tips for Tapering Sertraline

 

2 hours ago, Pidgeon said:

I have an appointment within a few days where I will discuss my tapering. My doctor will most likely be surprised or alarmed that I want to come off meds.

 

Not only that, doctors are notorious for tapering their patients off way too fast.  If it were me, I would tell your doctor about our tapering protocol of 10% reduction every 4-6 weeks.  This link has some suggestions and material you can print out to show your doctor.  

 

How to Talk to a Doctor About Tapering and Withdrawal

 

It looks like you have recently done fast tapers off of pregabalin and amisulpride.  Do you still have any symptoms from those tapers?  If so, what are they?  I strongly suggest you wait until you have been symptom free for a few months before you start another psych drug taper.  

Edited December 4, 2023 by getofflex

[Pidgeon]

@getofflex,

Indeed no major adverse reactions from either med as of today.

 

Re: adverse reactions: I am misleading you -- anhedonia passed as I withdrew from pregabalin, but it's tricky for me to keep track of feeling diminished pleasure on a daily basis, because I'd have to e.g. eat chocolate or a good meal.

 

Re: sedation: olanzapine does not have any sedating effects on me. In fact, very few meds sedate me. Perhaps it's for the better, as I believe sedation is a troublesome side effect of many meds.

 

Re: libido: this one recently started getting stronger and looking a lot more like it's from sertraline. My neurologist is well versed with these meds and he confirmed it can be sertraline. Such libido is very common with antidepressants, but not nearly as big of a life impediment for me as anhedonia was.

 

Re: fast tapers: I did several fast tapers: amisulpride, pregabalin, sertraline, aripiprazole. I withdrew from amisulpride, once CT and once fast taper! I had little trouble with most of the fast tapers and a terrible experience with CT. Specifically, the fast taper of sertraline (50) within 10 days resulted with me lying down with muscle weakness for a good portion of the day. Luckily, I had nothing scheduled for that day. My intention back then was to taper sertraline (50) for at least 14 days, but I got impatient. Perhaps I am not too sensitive to withdrawals, but I agree these risks are not worth taking and that one CT was clearly my mistake.

 

I came to the conclusion that I can wait for a better moment in my life to start a taper. Perhaps within a few months I will be able to follow your advice. These doses are quite low anyway.

Thanks.

[getofflex]

2 hours ago, Pidgeon said:

I came to the conclusion that I can wait for a better moment in my life to start a taper. Perhaps within a few months I will be able to follow your advice. These doses are quite low anyway.

I think this is a very wise decision, especially considering all the fast tapers you have done.  Your nervous system needs lots of time to heal before making any more drug changes.  

[Pidgeon]

@getofflex Right, I will give time to both myself and my nervous system.

 

14 hours ago, getofflex said:

especially considering all the fast tapers you have done.

Those fast tapers weren't that bad in my opinion, but Cold Turkey of a short half-lifed med was terrible mistake. My nervous system is still gradually recovering from that Cold Turkey, but slowly doing better overall.

I will start taking magnesium today.

Good news: I successfully quit cigarettes recently.

[Emonda]

5 hours ago, Pidgeon said:

I will give time to both myself and my nervous system.

 

5 hours ago, Pidgeon said:

I will start taking magnesium today.

 

5 hours ago, Pidgeon said:

I successfully quit cigarettes recently.

 

All good to read 👍

 

5 hours ago, Pidgeon said:

Those fast tapers weren't that bad in my opinion

 

They have a habit of catching up on you. You might think you're okay initially, but then it hits you.

 

I read of another member only recently who did a rapid taper of ~50% over a few months, and now they are paying for it.

 

I did similar before finding this site and it hit me hard, I ended up in a holding pattern for 5 months to let my body catch up to the rapid taper. Others have taken much longer than 5 months.

 

Time and much patience are your friends on this journey. Rapid tapers are not a short cut to successfully getting off these meds.

 

 

[Pidgeon]

Sure. Sometimes I will have good days, and other times get 5-10 hours of feeling a bit sick. This must be Windows And Waves from that Cold Turkey, isn't it? Makes me more confident that this will pass.

[Pidgeon]

On 12/8/2023 at 8:25 PM, Emonda said:

Time and much patience are your friends on this journey.

So I will give my health a slow approach. Any advice on how to find easy hobbies instead of getting goddamn bored at home while recovering?

[Emonda]

7 minutes ago, Pidgeon said:

So I will give my health a slow approach

 

Good idea

 

7 minutes ago, Pidgeon said:

Any advice on how to find easy hobbies instead of getting goddamn bored at home while recovering?

 

Where to start...so many options! I love getting outside for a short daily walk. Not sure how cold it is in Poland right now...reading... I try to live life as normal, just not overdoing it.

[Pidgeon]

Little to no changes. Same drugs. Still no cigarettes. Still taking magnesium, fish oil, D3, B Complex, all recommended daily doses. May start taking calcium for tooth health. I took one month of rest, then did some work, a few days more rest, and my symptoms appear to be smaller after rest. It's the slow approach. I'll have to figure out how to explain my absence at work and help the company avoid bad effect of my absence.

[Pidgeon]

Anyone here has experience with physical exercise near the end of recovery and later?

[Pidgeon]

Every time a slightest sign of something uncomfortable happens, I get worried and immediately turn my attention to the danger. I am doing it right now with a tiny stomach ache. What is it? Trauma? Can you relate?

[Emonda]

15 hours ago, Pidgeon said:

Anyone here has experience with physical exercise near the end of recovery and later?

 

I do plenty of exercise, always have, and I find it beneficial.

 

However, there are others here who find that any more than a gentle walk flares up their anxiety. Trial and error. Start slow and steady and see how you respond.

 

Hope this helps. 

[FireflyFyte]

17 hours ago, Pidgeon said:

very time a slightest sign of something uncomfortable happens, I get worried and immediately turn my attention to the danger. I am doing it right now with a tiny stomach ache. What is it? Trauma? Can you relate?

 

This sounds like health anxiety which many others on this site, including myself, have struggled with. You can read more at Health anxiety, hypochondria and obsession with symptoms. Often times, therapy such as CBT or DBT can help lessen health anxiety so might be something you want to consider.

[Pidgeon]

My waves are getting less frequent and windows are getting longer, up to 3 days rest from discomfort recently.

[Pidgeon]

I felt pretty fine for one day after my last update. Then I got worse and the likely reason is that I lost appetite a while ago and got weak from eating little. That's 4-7 January. My liver is doing better and my GP told me to slowly stop my current med, I want to take milk thistle instead, a natural remedy for the liver.

[Pidgeon]

On 12/27/2023 at 11:01 AM, Emonda said:

Hope this helps.

 

Thank you. Yes, it will help me to start slow rather than putting your body through something too tough. We sometimes need a reminder about that.

[Pidgeon]

On 12/27/2023 at 2:07 PM, FireflyFyte said:

This sounds like health anxiety

I have health anxiety for sure. Always have.

 

"People also find their own effective self-treatments, such as taking up various sports or hobbies."

 

I am interested in finding my own self-treatment. Thoughts?

[littlebird]

59 minutes ago, Pidgeon said:

"People also find their own effective self-treatments, such as taking up various sports or hobbies."

 

I am interested in finding my own self-treatment. Thoughts?

What interests you or makes you happy? These tend to be the things that stick, habit-wise. Personally not that into traditional exercise, but I like to hike and dance with my partner to get my heart-rate going. I also experiment with art sometimes and I like to garden/tend houseplants. What do you enjoy doing? Sometimes an easier question (since so many of us work all the time and don't have much free time) might be what did you enjoy doing as a child?

[Pidgeon]

I still have some "waves" mostly after effort, after doing some stuff, and today I discovered that the discomfort goes away when I focus on the "wave" and will it to go away. Could this be emotional or a habit of the mind? Anyone had such experience?

[Pidgeon]

I finally know. I no longer have any withdrawal, that passed, but rather an easily fatigued nervous system. I feel fine as long as I avoid fatigue.

[Pidgeon]

I had to increase Sertraline to 100 mg. It must be this winter season and staying home a lot that gave me trouble. The other med is left the same. I don't plan to stay at this dose for that many months let alone years.

 

I no longer have any anhedonia since stopping Pregabalin and no side effects are as much trouble anymore as anhedonia.

[littlebird]

On 1/24/2024 at 1:11 PM, Pidgeon said:

today I discovered that the discomfort goes away when I focus on the "wave" and will it to go away. Could this be emotional or a habit of the mind? Anyone had such experience?

I haven't had much luck in willing it to go away, but "tuning in" to it and feeling the feelings (or processing the trauma) underneath it (or just letting myself cry) can ease it a bit. That's amazing you're able to use willpower to get it in check!

 

Love your name and photo, btw. Hope you're holding up well!

[Pidgeon]

15 minutes ago, littlebird said:

That's amazing you're able to use willpower to get it in check!

I believe it has to be something odd and rare with the nervous system.

[Pidgeon]

I've finally recovered from withdrawal! It's been a long 2 years and 3 months. Changes to meds remain to be seen.

[Pidgeon]

Could anybody share their exprience on what is the top priority after finishing withdrawal? My idea is to rebuild life, talk to some people, slowly add activities and plan for some rest in between. I'm planning to admit myself for some not so strict daily stay for rehabilitation.

 

My depression is probably getting better. Yesterday, I had the first "wave" since last month.

[Pidgeon]

On 2/15/2024 at 7:50 PM, littlebird said:

I haven't had much luck in willing it to go away, but "tuning in" to it and feeling the feelings

 

Thanks. You are exactly right, because the thing I "willed" to go away is probably emotions from trauma. You can will away an emotion, but the withdrawal itself must run its course until you are healed. In my experience, you learn as you progress through the experience of withdrawal, as you eventually may end up with plenty of helpful familiarity with your body and mind if you pay dilligent attention to your body and mind. I wish you all to learn the right things.

 

What do you mean by processing the trauma?