meireaz: withdrawal of antipsychotics

[meireaz]

Hi
I would like you recommend me a effective plan for withdrawing antipsychotics. More specifically, treatment with clozapine. Thanks
 

Edited July 13 by Emonda
Name to title

[meireaz]

Hi, 

I would like you recommend me an effective plan for withdrawing of antipsychotics. More specifically, treatment with clozapine. Thanks

[meireaz]

Can you recommend a plan to progressively reduce antipsychotics? More specifically clozapine. Thanks

[Catwoman73]

Hi @meireaz, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications and their associated withdrawal syndromes. 

 

I know Emonda has already sent you a warning, but if you could kindly complete your drug signature, describing your entire history with psychiatric medications, we would greatly appreciate it.  We need to know all the details in order to know how to best help you.  To complete your signature, click the following link, fill in your drug history in the box, and then click save.  You can see mine at the bottom of this post as an example.  

 

Your Drug Signature

 

Once I know some more details on your history, I'll be more than happy to assist you in coming up with a safe plan to taper your clozapine.  

 

I look forward to chatting with you!

[Catwoman73]

Hi @meireaz, and thank you so much for completing your drug signature. 

 

I'm so sorry for all you've been through.  Unfortunately, there are very few doctors on this planet who really understand the negative impacts of these drugs, or how to taper them safely.  I'm so very glad you've found us. 

 

It looks like you tapered your risperidone and olanzapine (and have started to taper your clozapine) quite a bit faster than we recommend on this site.  Here, we recommend reductions of no more than 10%, no more frequently than every four weeks.  Tapering this way can drastically reduce acute withdrawal symptoms, and can reduce the risk of developing protracted withdrawal.  Check out the following link to understand this process a bit better:

 

Why taper by 10% of my dosage?

 

You have been on these drugs long enough for them to have had a significant impact on how your brain and body function.  Read the following links for a greater understanding of these concepts before proceeding:

 

How Psychiatric Drugs Remodel Your Brain

What is happening in your brain?

 

I am a bit concerned that you might develop some delayed/protracted withdrawal effects due to the rapid taper.  Many of our members have a a sudden increase in withdrawal symptoms at around the 6-7 month mark after a rapid taper, so you are going to want to be extremely cautious moving forward.  This is what causes many people to end up going back on their medications.  I would strongly recommend holding your clozapine at your current dose for a few months, just to make sure that you don't develop any protracted withdrawal symptoms. The last thing I would want is for you to start tapering the clozapine, and start having severe protracted withdrawal symptoms. Read more about protracted withdrawal here: 

 

Protracted Withdrawal or PAWS (post-acute withdrawal syndrome)

 

The good thing about holding is that it will give your body and brain a chance to catch up to all the changes you have made.  You may even find that your period returns during a long hold.  

 

Once some time has passed, and you are certain that you have not developed any withdrawal symptoms, you could proceed to taper the clozapine the same way I recommended above- 10% of the current dose, no more often than every four weeks (so, as an example: 10mg, 9mg, 8.1mg, 7.3mg, etc).  This is a hyperbolic taper- you will be making smaller and smaller decreases as you get lower on your dosage in order to account for the proportionately larger effect the drugs have on the brain at lower doses. 

 

I'm assuming you are on the oral dissolving tablets- at some point, to make tapering easier, you may wish to switch to the liquid formulation of clozapine, if that is available in your area.  If not, you may wish to invest in a mg scale- one that goes to 3 decimal places, and an exacto knife, in order to shave very small amounts off of your 100mg tablet.  It's an expensive investment, but worth it in order to get off of these meds safely.  Just a warning about switching to liquid formulations- some people do not react well to this.  Make sure the liquid is the same brand as your tablet, and always switch to liquid by holding your current dose for at least a week.  Better yet- make the liquid transition slowly- 1/4 liquid, 3/4 tablet, then half and half, etc.  

 

I know you are probably very eager to get off your meds completely.  We all feel this way!  But I can assure you that moving VERY slowly is the best way.  I once tapered three medications at once over a one month period.  I was in withdrawal for seven years.  I wouldn't wish that on anyone- it was a terrible time.  I so wish this site had existed back then- I most certainly would have ignored my doctor's tapering plan, and followed the advice here.

 

In summary, I would strongly recommend holding right where you are, at 100mg of clozapine, for several months before proceeding with a taper.  When you do start to taper, do so by decreasing no more than 10% of your dosage every four weeks.  Be aware than many of us have to taper much slower than this- either less frequent drops, or smaller drops.  And that's ok- the idea is to keep you stable as you proceed. 

 

Generally speaking, I know it looks bleak, and like there is a long road ahead, but every day is a step closer to healing.  Every day is progress.  When I get discouraged, I find it very helpful to engage with other members- read and respond to their intro threads, offer support, and learn from those who have been walking this path for a while.  This is a wonderfully supportive community!

 

Wishing you lots of luck in your taper! ❤️

 

This is your introduction topic- each member gets one intro topic- please post any updates, comments or questions about your progress here. 

 

 

[meireaz]

Thank you very much for providing me with all this information and with so much detail. I will try to follow your recommendation and all the steps as rigorously as possible. I'm sorry you had to go through a seven-year withdrawal process.

 

Another question, I live in Spain, but do you know or can you recommend a doctor who follows your medication discontinuation plan, or who recognizes the problems that exist with psychiatric drugs, and helps people in their medication tapering process?

 

Thank you very much for the help!

[Catwoman73]

I don't personally know of anyone in Spain, but we do have a thread on providers.  I had a quick look through the first page- there are none in Spain in the initial post, but you may wish to go through each page of the thread in detail to see if you could find someone who could support you locally.

 

Recommended Doctors, Therapists, and Clinics

 

That being said, most people here are doing this on their own, without the support of our doctors.  It's unfortunate that we have to do it that way, but until severe and protracted withdrawal becomes better known and understood by the medical community, we've had absolutely no choice.  If you can't find anybody, we're happy to help you along the way- we can assist you with troubleshooting, symptom management, calculations (if you're not mathematically inclined), etc.  I'm very lucky to be working with one of the Canadian providers on the list, but most people are not so fortunate. 

[meireaz]

I´m looking for a doctor because I´ve had a very bad experience with the psychiatrists who treated me in public health. I had very bad luck! Some use threat techniques against the patient. With me they did it!  In fact, my admission to the hospital was involuntary. That´s why, I had to ask for the help of a private psychologist. But, he has told me that it´s very difficult to find psychiatrists who believe in discontinuing medication, that most believe only in pharmacology (problems with neurotransmitters) and not in psychotherapy. And, furthermore, they don´t like to work together with psychologists, because they can´t prescribe drugs. And, for that reason, they tend to make mental health problems chronic, because they don´t believe in the recovery of patients' health. That´s why, I´m looking for a psychiatrist who is confident in the patients' recovery and who supports me in the process of discontinuing medication.

Thanks for the thread.