MarWin58 Prozac and Olanzapine

[MarWin58]

Hi all. I am new to this forum, and I am grateful to be part of this group.

 

I have been a long-term user of Prozac and Olanzapine for the treatment of treatment depression.

It's been 8 years since I had my complete breakdown from which I have never recovered. I had to cease my employment forcing me into early retirement. 

My life is a shadow of what it used to be, (existing not living) where I struggle to do my daily activities, avoiding social contact including withdrawing from family activities. Simple activities / tasks I find exhausting. My go to activity is swimming which seems to help with the symptoms for a few hours each day.

 

Since 2017, I have had 11 admissions to a mental health clinic for numerous treatments (ECT, CBT, ACT, TMS and of course drugs)

For the past few years, I have been on Prozac 20mg and Olanzapine 5mg.

This drug combination has left me emotionally numb which I accepted initially as part of the treatment and my condition but I was not happy about it.

 

At the start of 2024 I did a review of my last 8 years and decided that all the treatments I have tried for the Depression / Anxiety had not improved my life.

Little to no improvement and emotionally numb from drugs was where I was at, and I needed to do something different. I decided to go off the Prozac.

My psychiatrist was not in favour of my plan for fear of major relapse, but he agreed given I was still staying on Olanzapine.

In May and June I came off the Prozac 20mg over 8 weeks and did ok for a few weeks. 

More recently my anxiety has increased, and the depressions is heavy. I am now unsure if I am in withdrawal or not and how long this will last.

 

I am reaching out to any member for their advice and experience with a similar situation to mine.

 

Thank you 

[Emonda]

Welcome @MarWin58

 

Sorry to hear of your story. You'll find you're not alone here.

 

15 hours ago, MarWin58 said:

This drug combination has left me emotionally numb

 

This is a common side effect of ADs. In my experience, when you taper off the AD slowly, the emotional numbness subsides.

 

15 hours ago, MarWin58 said:

Little to no improvement and emotionally numb from drugs was where I was at, and I needed to do something different. I decided to go off the Prozac.

 

It's good to review these things. If the drugs don't work and you have side effects, then is seems reasonable to reconsider their use.

 

15 hours ago, MarWin58 said:

In May and June I came off the Prozac 20mg over 8 weeks and did ok for a few weeks. 

 

This was way too fast. The recommendation on this site is to reduce by a maximum of 10% per month of the most recent dose. If you were on 20mg of Prozac, then it would look as follows: month 1 = 18mg, month 2 = 16.2mg, month 3 = 14.58mg, etc. This gives your brain/body time to adjust to each step after being on the drug for years.

 

If you taper too quickly, as you have, WD symptoms are the predictable outcome: With Prozac, there would likely be a delay of perhaps 3 or 4 weeks before you notice an uptick in symptoms, given the long ‘half-life’ of the drug.

 

15 hours ago, MarWin58 said:

More recently my anxiety has increased, and the depressions is heavy. I am now unsure if I am in withdrawal or not and how long this will last.

 

This Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) is a helpful summary of what many experience. Symptoms of depression and anxiety are items 1 - 10 on this list, and are very common.

15 hours ago, MarWin58 said:

I am reaching out to any member for their advice and experience with a similar situation to mine.

I’d start by reading these two links:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

Kindling

Reinstatement works best in the first 3 months.

 

So, you’re 6 weeks off your AD? If so, perhaps you might consider reinstating a partial (small) dose. Before confirming a dose, we'd need to know the details of your 8-week taper dates/doses.

Recovery from ADs and tapering is not linear. There are good days and not-so-good days/weeks/months. This is referred to as the Windows and waves pattern of stabilization.

The following general links are worth reading:

Emotional Spirals

Non-drug coping strategies

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 fatty acids (fish oil)

Avoid alcohol.

Don't change the manufacturer of your AD if you reinstate.

Once again, welcome to S.A.

Emonda

[MarWin58]

Dear Emonda

Thank you for the reply and the detailed information ... I really appreciate it.

It's very comforting to know that I am not alone in this journey.

A correction on my detail of phasing out Prozac - I did it over April / May not May / June as I previously mentioned.

Information on my tapering:

     April - Week 1: 7 x 20mg

                Week 2: 6 x 20mg

                Week 3: 5 x 20mg

                Week 4: 4 x 20mg

     May - Week 1:  3 x 20mg

                Week 2: 2 x 20mg

                Week 3: 1 x  20mg

  The withdrawal symptoms started at the end of June.

 

It has been 11 weeks since I finished Prozac completely so I fear that I may have missed the window to reintroduce the smaller doses.

If reintroduction is off the table, then I assume I just ride out these withdrawal symptoms for the next few weeks / months. ..... is this how you see it Emonda?

 

I get relief from my daily exercise (swimming and walking) but it only lasts a few hours...... but I'm very grateful for that window of relief.

 

I'm still on Olanzapine 5mg which I plan to stay on at least until the withdrawals from the Prozac subsides.

My long term plan is to get off both Prozac and Olanzapine.

 

I do not drink alcohol and more recently have eliminated caffeine from my diet to help with the anxiety.

 

Thank you 

           

[Emonda]

Thanks for the response and correction, @MarWin58

 

2 hours ago, MarWin58 said:

I did it over April / May not May / June as I previously mentioned.

 

On this basis, I'd expect the WD symptoms to kick in towards the end of June, and you confirm the timeline fits:

 

2 hours ago, MarWin58 said:

The withdrawal symptoms started at the end of June.

 

 

3 hours ago, MarWin58 said:

April - Week 1: 7 x 20mg

                Week 2: 6 x 20mg

                Week 3: 5 x 20mg

                Week 4: 4 x 20mg

     May - Week 1:  3 x 20mg

                Week 2: 2 x 20mg

                Week 3: 1 x  20mg

 

For anyone else reading this, skipping doses is not the way to taper: Never skip doses to taper

 

 

2 hours ago, MarWin58 said:

It has been 11 weeks since I finished Prozac completely so I fear that I may have missed the window to reintroduce the smaller doses.

 

Not necessarily too late. You're right on 3 months. You may have heard of Dr Horowitz, who mentions a small test reinstatement amount of 5% of the amount you previously took to be conservative. You could try 0.5mg to be ultra cautious, given you are at the 3 month mark. You'd have to monitor/record your symptoms each day. If nothing causes you grief initially, you'd reassess after say 3 or 4 weeks.

 

The decision is 100% yours. I'm simply sharing what has given others some relief. Those that reinstate too high can end up experiencing Kindling.

 

To be clear, you would take the same dose and the same time, each and every day.

 

2 hours ago, MarWin58 said:

just ride out these withdrawal symptoms for the next few weeks / months. .

 

Sadly it can take quite a while, hence mentioning the possibility of a small reinstatement...but your decision, and I'm not a doctor.

 

2 hours ago, MarWin58 said:

I get relief from my daily exercise (swimming and walking) but it only lasts a few hours...... but I'm very grateful for that window of relief.

 

Plenty do find relief from regular exercise, I certainly do. You just need to listen to your body and not overdo it.

 

2 hours ago, MarWin58 said:

My long term plan is to get off both Prozac and Olanzapine.

 

You only ever touch one at a time. So long as you have WD from the Prozac, you'd not touch the Olanzapine. When you adjust two drugs at the same time, you don't know what has caused a particular WD effect.

 

2 hours ago, MarWin58 said:

I do not drink alcohol and more recently have eliminated caffeine from my diet to help with the anxiety.

 

Good to hear. I've heard of some just having one beer on a special occasion and it sets their recovery back.

 

Let us know what you decide.

 

 

[MarWin58]

Hello Emonda

Thank you for your reply and guidance. I really appreciate it.

Seems my Prozac tapering wasn't tapering at all. Just skipping doses😪. I'm very disappointed with the advice I was given by 3 medical professionals, however that is in the past and I need to focus on the future.

Yes, I have heard of Dr Horowitz thank you.

I will make an appointment with my General Practitioner (GP) to discuss the reinstatement at 5% ...... I trust my GP.

If we decide to go ahead with reinstatement I will a prescription for Prozac .........I guess the liquid form would be best to measuring 5% of the 20mg I was originally on. Is my assumption correct Emonda?

Thanks again for your invaluable assistance.

[littlebird]

Hi, glad you're here! I'm so sorry you were given that step-down, just reading that made me wince. I'm LB, just wanted to offer some solidarity and welcome.

 

On 8/13/2024 at 5:01 AM, Emonda said:

In my experience, when you taper off the AD slowly, the emotional numbness subsides.

At a slow and steady rate, before finding this site I was going too fast, this absolutely got better with time for me too. I feel a lot more connected to the people in my life as a result.

 

2 hours ago, MarWin58 said:

Just skipping doses😪. I'm very disappointed with the advice I was given by 3 medical professionals, however that is in the past and I need to focus on the future.

I got the same advice, doctors really aren't educated on safely getting off these things and I have yet to meet a psychiatrist fully aware of the dangers of doing what the drug companies recommend to get off. There's a whole grieving process I've been having about not being able to trust the medical system as a whole, it's a lot, but you're connected with some very helpful advice on here that should help you safely lower/get off with less side effects.

 

2 hours ago, MarWin58 said:

I trust my GP

I've found even the best doctors sometimes need a little guidance because they simply do not know the risks if they haven't experienced the hells of getting off psych meds themselves. Had to say more than once, to even the best docs, "That might be what the drug company says, but if you look at the anecdotal experiences of the people taking these, you'll see that slower is safer." 

 

Sometimes had to say, "Thank you for the advice, I'm going to err on the side of caution so I don't destabilize my nervous system, and go slower/try less/not try that." Been a real good exercise in boundaries and advocating for myself if nothing else.

 

Good luck, and keep us updated!

[MarWin58]

Thank you for your advice and understanding LB. I really appreciate it.

[Emonda]

8 hours ago, MarWin58 said:

however that is in the past and I need to focus on the future.

 

Great attitude! We accept the past, learn what we can, and move forward.

 

It is alarming how little some doctors/psychiatrists know about tapering and these drugs in general.

 

8 hours ago, MarWin58 said:

I will make an appointment with my General Practitioner (GP) to discuss the reinstatement at 5% ...... I trust my GP.

 

Be clear that you don't want to start too high....well said by littlebird.

 

5 hours ago, littlebird said:

Thank you for the advice, I'm going to err on the side of caution

 

We've seen others here start low as suggested, only for the GP to scoff, and tell them to go back to the original dose...then problems can kick in.

 

You lose nothing by starting low and slow. You also have to be patient for Prozac to kick in. Think one month +.

 

I don't believe liquid Prozac is available in your country...assuming you are in Australia.

 

Were you taking tablets or a capsule? The Maudsley Deprescribing Guide (co-authored by Dr Horowitz), indicates the tablet/capsule can be used to make a DIY liquid.

 

Many here use a digital scale to weigh their dose, and others make their own liquid (you can't do that with every AD, however (writing this for anyone else reading with a different AD)).

 

I make my own liquid and draw up the amount with a 0.5ml syringe.

 

Have a read of this link:

 

 

 

...you've got a little more reading now. But, best to educate yourself to get out of the position others have put you in. It seems the advice you've been given for 8 years has not helped.

 

Warm wishes, Emonda

[MarWin58]

Thank you again Emonda for your prompt reply and information which I will study before my next doctor's visit.

You are right, the Prozac liquid form is not available in Australia which leaves me to manage breaking down 20mg tablet form.

I'm ever so grateful to have found this forum and to know I am not alone.

 

Kind Regards

 

[Emonda]

23 hours ago, MarWin58 said:

which leaves me to manage breaking down 20mg tablet form

 

As mentioned, some make their own liquid, and others use a digital scale:

 

LostinCanada (a member on this site) speaks highly of this digital scale: https://www.ebay.com.au/itm/275185411474

 

Others use the the Gemini 20 (much cheaper), however I don't believe it measures anywhere neas as low a the more expensive one above.

 

Hope this helps.

[MarWin58]

Thank you so much Emonda ..... you are very helpful indeed and I really appreciate it.

 

Kind Regards

[MarWin58]

On 8/16/2024 at 8:09 PM, Emonda said:

 

As mentioned, some make their own liquid, and others use a digital scale:

 

LostinCanada (a member on this site) speaks highly of this digital scale: https://www.ebay.com.au/itm/275185411474

 

Others use the the Gemini 20 (much cheaper), however I don't believe it measures anywhere neas as low a the more expensive one above.

 

Hope this helps.

Hi Emonda.

I hope this note finds you well.

My symptoms have settled slightly, and I have decided not to commence the option of microdosing of the Prozac.

I will ride out and further waves of withdrawal on my own. I'm still on Olanzapine 5mg.

I have taken the advice about Magnesium thank you and am looking to look at diet options / modifications to help manage my depression.

In Mid-September I will be commencing another 10 - 15 TMS treatments. I do this every 3 month and am happy as is non drug treatment with no side effects.

My plan for the Olanzapine is to commence tapering in January 2025 and allow myself the full year to get off it

My hope is to be off all drugs by end 2025

Kind Regards

On 8/16/2024 at 8:09 PM, Emonda said:

 

As mentioned, some make their own liquid, and others use a digital scale:

 

LostinCanada (a member on this site) speaks highly of this digital scale: https://www.ebay.com.au/itm/275185411474

 

Others use the the Gemini 20 (much cheaper), however I don't believe it measures anywhere neas as low a the more expensive one above.

 

Hope this helps.

 

[Emonda]

I had been wondering how you were doing...thanks for the update.

 

I can't comment on TMS - there is some info on this site about it.

 

On 9/2/2024 at 3:01 PM, MarWin58 said:

My plan for the Olanzapine is to commence tapering in January 2025 and allow myself the full year to get off it

My hope is to be off all drugs by end 2025

 

I would caution you on your tapering timeline.

 

Firstly, wait until you feel 'stable' from stopping the Prozac before contemplating the next drug. You may need to wait much longer than you think. If you start tapering when you're not quite right, you'll make things much worse for yourself.

 

Once stable, I'd urge you to read the following paragraphs/links. Tapering according to the 10% rule below will take you longer than 12 months. Many on this site think they can go faster, and eventually, many of them regret not heeding the warning to go SLOW.

Why taper by 10% of my dosage? The reductions should get smaller and smaller each month, for example: 10mg, 9mg, 8.1mg, 7.3mg etc. This process involves a degree of trial and error, as there is no way of predicting how an individual will respond. Importantly, if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward. The experience of others suggests that the lower you go in dose, the slower you need to go with tapering.

Those that taper too quickly often develop very unpleasant withdrawal symptoms. This Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) is a helpful summary of what many experience.

Some people find tapering by smaller weekly amounts more tolerable. You can read more about this approach here: The Brassmonkey Slide Method of Micro-tapering

Keep us posted.

Warm wishes to you.

Emonda

[MarWin58]

Thank you for the reply Emonda 

I really appreciate your wise advice and links to enable me to eventually be free of the antidepressant and antipsychotic.

Thanks to your guidance I will wait until I'm settled from discontinuing the Prozac before I tackle the Olanzapine.

I have a bad habit of putting timeframes on things .... a hangover from my work career I'm afraid.

Thank for the links which I will use for my tapering when I eventually get started.

The "Withdrawal Symptoms check sheet" will be very useful thank you..... this suits my analytical brain. To date I have been using the DASS42 to gauge my feelings.  

Thank you again Emonda

 

Warm Regards

[Emonda]

4 hours ago, MarWin58 said:

I have a bad habit of putting timeframes on things .... a hangover from my work career I'm afraid.

 

I can relate.

 

I have found on my tapering journey that WD symptoms are not interested in my tapering schedule!

 

I have a detailed spreadsheet with various dates/drops and an end date...but I am learning to be more relaxed about the whole process.

 

The tortoise beats the hare on this journey. I wish I picked the username Tortoise!