HerrNiklasRaab: Tapering Zyprexa - Paradoxical reactions to everything

[HerrNiklasRaab]

Hello together,

 

I was put on 5mg of Olanzapine in the hospital. In the hospital I was because I was overmethylating from to much methylfolate which caused insomnia and then suicidal ideation.

The doctor thought I had a psychosis, because I was so convinced that a b vitamine can cause insomnia so, he put me on the Olanzapine.

 

I was able to fix the methylation issues and my orignal insomnia and overmethylation symptoms are gone.

 

Because I knew the whole time that, a problem with overmethylation caused my insomnia, I was ready to taper of Olanzapine.

 

I was on Olanzapine 5mg for 2,5 weeks

 

I started my taper by cutting 1/8 of 5mg. I had sleep problems for 2 days. Then I was sleeping fine. So I cut another 1/8 of 5mg. I had sleep problems for 2 days. Then sleeping was fine.

 

The next evening I took L-Tryptophan and L-Theanin supplements with my Olanzapine. I was doing very well with those two supplements for years. Only positive experiences.

 

This night instead of getting drowsy, the Olanzapine woke me up. Couldn't sleep the whole knight.

 

I stopped taking L-Tryptophan and L-Theanin that day.

 

For the next 5 days, I had the the exact paradoxical reaction, after taking Olanzapine I would get a little bit of drowsiness and the it woke me up and I couldn't sleep all knight. Without taking those supplements.

 

I decided to cold turkey the Olanzapine, because if I can't sleep without medication and I can't sleep with medication, I'd rather can't sleep without medication.

 

The next 2 days I took 12.5mg of diphenhydramin before sleeping which went very well. Sleep soundly the whole knight.

 

I tried one knight without diphenhydramin, but couldn't sleep well.

 

Next day I drank a coffee because of that which resulted in a massive panic attack.

 

Usually when I have panic I take L-Theanin, which calms things down. Not this time though.

 

I went to sleep with 12.5mg of diphenhydramin, I got the same paradoxical reaction as with the Olanzapine. I would get tired for a short moment and then I would be wide awake.

 

I stopped L-Theanin that day.

 

The next 5 days I tried it again with 12.5mg of diphenhydramin but got a paradoxical reaction every time and couldn't sleep.

 

I thought ok, maybe I got the same reaction because both drugs block histamine to induce sleep.

 

So I changed to Daridorexant 50mg. I slept relatively well. I was relieved.

 

Next day I went into the Sauna.

 

That day I slept very badly with the 50mg Daridorexant.

 

The second day after the Sauna I again took 50mg of Daridorexant. And I got again a massive paradoxical reaction, this time I couldn't sleep the whole knight. I got massive headache, a painful pressure in my ears and a stiff neck.

 

From that moment on I decided to go without any sleeping aids.

 

I didn't sleep for 4 days straight.

 

I was hospitalized again because of suicidal thoughts.

 

They gave me 7.5mg of Mirtazapine. I sleept 16h straight.

 

Next 5 days sleep was good with Mirtazapine and later 25mg of Daridorexant was added.

 

I started to feel hopefull again and decided to go for a run (4km).

 

 

Since that run, the same sleeping medications don't really work anymore. I get a few hours 1-3h of more solid sleep 8am - 11am. (This lasted for 5 days)

Off course they deny that Olanzapine can cause withdrawl effects.

 

Today I will try double the dose of Mirtazapine, but I doubt it will work.

If that doesn't work, they want me to put back onto Olanzapine, but I fear I will get a paradoxial reaction again.

I would like to reinstate 2.5mg Olanzapine and then taper down, but I seem to get paradoxical reactions to everything now.

What should I do?

Any help is very much appreciated.

Best regards,

Niklas

 

 

 

 

 

[HerrNiklasRaab]

Ok, short update:
 

Doubling the dose to 15mg Mirtazapine, killed the 1-3h of more solid sleep i get in the morning. I am experiencing the same sensation as described in this comment. I take the Mirtazapine, I get sleepy then I am wide awake the whole night and in the morning around 8am a can fall into a deeper level of sleep. Not perfect but it feels more like real sleep. I think the Mirtazapine wears off around that time letting me drift into sleep. I had the exact same experience also with the diphenhydramin, Daridorexant and the Olanzapine.

 

Today they want to make a single day experiment with 1mg of Lorazepam. I will go along as I had taken a single dose like this in the past. My feeling is that I will get a paradoxical reaction from that as well.

I know it's not recommended but this seems to be very very intresting as well: 

 

 

[FireflyFyte]

Hello HerrNiklasRaab,

 

Welcome to SA. Can you please update your signature to reflect recent changes to your medication?

 

Given all of the changes made in the last few weeks, it is difficult to pinpoint the exact cause of your issues with sleep as it might be withdrawal from the Olanzapine (sadly, 2 weeks is enough time for your body to build a dependence) and and/or Hypersensitivity and Kindling. Re-instating a dose of Olanzapine for 5 days might not have been long enough for your system to adjust and stabilize and might have also been too high of a dose.

 

3 hours ago, HerrNiklasRaab said:

Today they want to make a single day experiment with 1mg of Lorazepam. I will go along as I had taken a single dose like this in the past. My feeling is that I will get a paradoxical reaction from that as well.

 

The Lorazepam may help but it is in a powerful class of medications that are often incredibly difficult to taper and we generally do not advise adding more medications to address issues with withdrawals and/or kindling.

 

3 hours ago, HerrNiklasRaab said:

Doubling the dose to 15mg Mirtazapine, killed the 1-3h of more solid sleep i get in the morning.

 

Are you saying that last night's dose was double at 15mg? 

 

Thanks,

 

Firefly

[Alfred1977]

Hi Niklas,

prolonged insomnia is really tough. It's been one of the most devastating symptoms I had. Personally I don't know of any medication that really helps insomnia and is not dangerous. Benzos, Mirtazapin and things like that helped me sleep, but they are actually quite dangerous because you can get addicted/dependent very quickly. My sleep got better when I stabilzed and that took a while.

 

I don't think it is a good idea to try one drug after another. Sadly a lot of doctors proceed just like that. According to your drug history you are involved in psych meds only for a couple of weeks. So you have good chances to get rid of the drugs completely. Of course insomnia and suicidal thoughts are serious issues and can justify taking drugs temporarly. But I hope for you that you don't get hooked up like so many others here and end up with years of medication and addiction.

 

Can you somehow take time off, get sick leave and find some rest? I think lots of rest and also therapy can help to find stability - even if the issue is mostly drug related. Do you have friends, family or a partner that support you? 

 

Alles Gute und viele Grüße

[HerrNiklasRaab]

@FireflyFyte thanks for your answer. I updated my signature already, but right now I am in the psychiatric hospital, so there might come a few more drug changes. Although I am quite careful and turned down already a lot of drugs they wanted me to try.

I am not sure if my case is really a case of hypersensitivty or kindling. From what I understand ist that kindling or hypersensitivy starts after repeated drug withdrawls, drug changes or reinstating. I seem to had an adverse drug reaction between the Olanzapine and the L-Theanin. Can this trigger also hypersensitivty?

@Alfred1977 thanks for the encouriging words  I am very very worried about taking more drugs the Lorazepam was just a one night test from the doctor. And yes I have a family who is supporting me through this. Also I have friends who would support me if I would ask them for help which I am not right now. I am also very fortunate that I am financially stable indefinitly without working. Although some kind of work may be theraputic.

Here are my experiences from the last 3 days:

 

Fri. 6.Dec: 3.5mg Mirtazapine / 50mg Daridorexant:

The Daridorexant made me very very very very sleepy and it felt like it pushed me against some kind of wall into a state of unconciousness. It felt like a lot of force was needed to push me there. Then after 4h of unconciousness I woke up again and the rest of the night I was getting more and more tired but there seem to be some kind of barrier the prevented me to fall asleep. No matter how tired i was, I couldn't get through this barrier. This was a really strange knight. 

 

Sat. 7.Dec: 1mg Lorazepam / 7.5mg Mirtazapine / 25 mg Daridorexant:

Amazing 11h uninterupted sleep. I totally expected the Lorazepam or at least the Mirtazapine to wake me up again, but this was the best night I ever had since all of this started. But my mood might have gone down a little bit.

 

Tonight will be 7.5mg Mirtazapine / 25 mg Daridorexant again. My expectation would be that I sleep very good on that regime. And if so then I would go for a run again and see if this triggers insomnia again for me. More or less just trying to gather information about my situation.

 

 

[FireflyFyte]

13 minutes ago, HerrNiklasRaab said:

Tonight will be 7.5mg Mirtazapine / 25 mg Daridorexant again. My expectation would be that I sleep very good on that regime. And if so then I would go for a run again and see if this triggers insomnia again for me. More or less just trying to gather information about my situation.

 

It will be difficult to gather reliable information on your situation if you make daily changes to your medications. While I know it is tough, especially while hospitalized, I would encourage you to try to hold steady for more than a night or two to see how you are feeling.

[HerrNiklasRaab]

Hello together,

 

so my last two nights with 7.5mg Mirtazapine / 25 mg Daridorexant went bad without any sleep. Both tablets felt like placebo.

 

The thrid night I added 10mg of Melatonin, which was much more effective than I anticipated. It felt like a sleeping pill. I can remember that I dreamt once and was in light sleep the whole night. Never felt like real sleep though. Today I feel dizzy from the melatonin.

 

The scary thing is that even though I get 0 sleep for two nights I don't feel exhausted like I did before quiting those drugs. There is no sleep pressure. I feel fully functional. A lot of people describe to feel wired but awake. But I don't feel wired. I feel like I had a normal night of sleep. Sometimes I get sleepy, then I lie down expecting to fall asleep, but the sleepiness goes away after lying down within minutes. It's ******* scary. Can someone relate?

This loss of sleep drive happend after I had this paradoxical reaction to the Daridorexant. Now when I take Daridorexant nothing happens.

 

It's scary that blocking the two chemicals responsible for being awake Histamine and Orexin isn't doing anything.

 

Before the night with Melatonin I went on a run again expecting a paradoxical reaction but nothing happend. Maybe a good thing.

 

They offered my to take eszopiclone for sleep but I declined for now, as I am not really afraid of not sleeping anymore. I am only afraid of not sleeping ever again.

 

The next days I will continue to take 7.5mg Mirtazapine / 25 mg Daridorexant and 10mg of Melatonin.

 

Best regards,

 

Niklas

PS: Not feeling an accumulating sleep drive scares the hell out of me.

[HerrNiklasRaab]

Ok my last two nights:

 

11.Dez: I took Mirtazapine and started to feel sleepy. Then I took the Daridorexant and got another paradoxical reaction. 100% awake. Then took the 10mg of Melatonin and slowly drifted into some kind of half sleep. 

12.Dez: I left out the Daridorexant, because I was afraid to get another paradoxical reaction. I was able to sleep well with the Mirtazapine and the Melatonin.

 

Slowly I can start to see a pattern emerge. I seem to flip flop between two types of states. 

 

State 1: My brain seems dysfunctional kind of like a brain fog and I get decent sleep.

State 2: I feel totally normal. My brain works and I am kind of happy, but sleep is blocked.

 

If I go for a run I switch from State 1 into State 2.

If I have a paradoxical reaction to Daridorexant I switch from State 2 into State 1.

 

If my theroy is correct I should be able to sleep tonight with Mirtazapine and Melatonin. And if I go for a run tomorrow, my brain should return to normal function but sleep will be blocked again.

 

I will report back to confirm or falsify my hypothesis.

[FireflyFyte]

Again, I would encourage you to try to not make any changes as they may be further destabilizing you and it is difficult to know what is causing which symptom(s).

[HerrNiklasRaab]

Reporting back after a while:

So after running I returned to State 2, where the Mirtazapine would NOT give me sleep. But State 2 feels to me like my normal state if I am being honest.

 

After a few more knights with only 7.5mg of Mirtazapine, I consistently got tired 1.5h after taking the med then, I would be wide awake and in the morning hours I would get some broken sleep. It was a 100% match to the comment here.

 

So I reduced the dose to 6.5mg, then it would take 3h until I fell asleep and my sleep in the morning was also better.

 

Next day I reduced by another 4.5mg. Which resulted in the best sleep that I had so far in State 2. I had real sleep with dreams and stuff.

 

I stayed on that 4.5mg the next 3 days, with the same result. I got like 5-6 hours of real sleep with dreams. On the second and especially on the third day I noticed how my feeling of sleep deprivation came back which I lost completly. I was very happy about that development.

 

On the third day of 4.5mg I was so sleepy and sleep deprived that I thought I would immediatly fall asleep. I took the 4.5mg of Mirtazapine and I noticed how I got even more tired than I already was. And then 30min after taking the dose BAM, I was again wide awake at 4.5mg. That knight I didn't get my usual sleep in the morning hours.

 

 

So I decided the next day that to decrease again to 2.5mg. The duration of tiredness after taking the pill increased again to 1.5 h and I got my morning sleep back.

 

Next day I decreased the dose again to 1.5mg and on that dose I was NOT getting a paradoxical reaction. But I am also not sleeping very much if at all. Maybe 1h in the later part of the knight. 

 

I stayed on that dose now for about 5 days now, I don't notice any worsening but also not any improvment (except my appetite decreased to normal levels).

 

My feeling of sleep deprivation and sleepieness is completly gone again.

 

----

 

Because this time I got a paradoxical reaction form the bodies own sleep pressure, I believe that there seems to be a "bucket of sleepyness" and if this bucket is full, I get a paradoxical reaction. If I fill the bucket with Olanzapine, I get a paradoxical reaction. If I fill it with Antihistamines or Mirtazapine I get a paradoxial reaction. If I fill the bucket with Daridorexant. I get a paradoxical reaction.  If I fill the bucket with high dose Melatonin. I get a paradoxical reaction. Even if the body get's tired naturally the bucket gets full and I react paradoxically.

 

----

 

I know I should try to stabilize on a dose and stick with it for longer, but I just didn't know which medication and which dose, because I was reacting to everything.

 

----

 

I read about cases where people react paradoxically to a specific drug or dosage. But I can't find anyone who reacts to everything under the sun. What should I do now?

 

[FireflyFyte]

53 minutes ago, HerrNiklasRaab said:

What should I do now?

 

As it has been stated, it is nearly impossible for us to advise you when you make nearly constant changes to your medication and dosages.

 

What you are labeling as paradoxical reactions could well be withdrawal symptoms starting to surface after a decrease in dose.

 

I would encourage you, again, to stop making changes and allow your system to stabilize. One night of poor sleep is not justification for making changes and said changes are likely responsible for your back and forth symptoms as your system tries to adjust to constantly shifting dosages.