AntiDyatlov - Geodon (Ziprasidone) taper with brassmonkey slide method

[AntiDyatlov]

Hello everyone,

 

First I'm gonna lay out how the taper I just started is going, then I'll describe my overall history.

 

I was taking Geodon (Ziprasidone) 60 mg in capsule form, at night. I got a compounding pharmacy to make me a 10 mg/ml solution to do my taper with. At first, I attempted a 10% reduction, which produced the mild side effect of now waking up at 5am (sometimes at 4am), most of the time being able to go to sleep again afterwards. Also noticed that I am dreaming again, I have a feeling being on the original dosage was by and large suppressing my dreams. Because the guideline on this forum said side effects like this should clear up in a few days, and this didn't in a week, I switched to the brassmonkey slide taper, calculated using this: Micro taper calculator - Google Sheets. I started this taper last Thursday, Jan 2, 2025. It produced the same side effect, except this morning I woke up at 6am instead, so maybe that's progress? I'm unclear as to whether the presence of a side-effect should deter me, or whether I can just keep going. It doesn't affect me much, I guess I start feeling pretty tired at night, but that's it.

 

--------------------------------------------------------------------

 

As to my story. I used to do psychedelics with my friends. There was a period in 2019 where I was basically doing LSD (acid) and sometimes other psychedelics like once a month. After one particular acid trip, I didn't fully come down, and I was in a state I now recognize as manic for 3 days, in which I didn't sleep a single wink. On the night of the 3rd day, this became a full blown psychosis, and I ended up in a psychiatric hospital. They put me on a cocktail of drugs there, eventually this got pared down to just Abilify 2 mg. I have never liked the idea that I could be permanently on a psychiatric medication, much earlier in my life, I was suicidally depressed and ended up in a psychiatric hospital, and back then I went off the meds not long after leaving. My psychiatrist agreed with me that my psychosis was the result of psychedelic usage, and that it's likely that if I just stay away from psychedelics, it won't happen again. She told me because I hadn't been very long on Abilify (like 5 months), I could just stop immediately, no taper of any kind. I did, and like 3 months later, in which I presented no symptoms or side effects, I went psychotic again and ended up in a psychiatric hospital again. This time, they put me on Olanzapine (don't remember dose), and later, because I didn't like the idea of being permanently on medication, I attempted to discontinue by myself with no taper. That didn't last long, because I discovered that if I don't take the pill, I literally can't sleep. I spoke to my psychiatrist about this, and she switched me to Geodon 60mg, my current drug. Then I read a book by a psychiatrist arguing that the condition known as psychosis isn't necessarily pathological and could be considered a spiritual phenomenon. I did my feel like both my psychotic experiences felt like ecstatic, transcendent experiences, so I was planning to go off the meds again. I discussed this with my brother, who was very against, due to all the pain I had inflicted on my family while being psychotic, and I ultimately realized that I was acting very selfishly in actively seeking out psychosis again, and this is very against the essence of spirituality. This induced some sort of actual spiritual awakening, and I became a pretty different person after choosing to stay on the Geodon, to the point my family commented on that.

 

But then, while travelling his year, there was a night I forgot to take my medication, and I discovered that I cannot sleep if I don't take it. This rubbed me the wrong way, and then I saw someone talking about all the various ways antipsychotics can screw with you. I even read in a scientific paper that they shrink your brain. Later I came across this site, where it says abrupt discontinuation of one can lead to a withdrawal symptom that is identical to the psychosis that caused me to be put on the meds in the first place. So now I want to attempt a taper, on the hypothesis that the first psychosis was drug induced, the second one was withdrawal induced, so I should be ok not being on medication as long as I stay away from drugs. This is fine by me, I don't care about "transcendent ecstasies" anymore, I don't want to repeat the psychotic experience again. I spoke to my psychiatrist, and she agreed to get me a prescription for liquid Geodon, which isn't on the market anymore, but which I was able to take to a compounding pharmacy. And that's where I am, attempting this taper, but having questions about it.

 

[Jane318]

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

 

Thank you for completing your drug signature and for the great, concise summary of where you are now and how you got there. 

 

I am sorry for all you have been through but glad you found us.  I commend you for all the research you have done to set yourself up to succeed in getting of ziprasidone! You are on the right track for sure, as you realize how important it is to keep tabs on your symptoms and to adjust your tapering schedule as needed to keep withdrawal symptoms in check. 

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

I was taking Geodon (Ziprasidone) 60 mg in capsule form, at night. I got a compounding pharmacy to make me a 10 mg/ml solution to do my taper with. At first, I attempted a 10% reduction, which produced the mild side effect of now waking up at 5am (sometimes at 4am), most of the time being able to go to sleep again afterwards. Also noticed that I am dreaming again, I have a feeling being on the original dosage was by and large suppressing my dreams. Because the guideline on this forum said side effects like this should clear up in a few days, and this didn't in a week, I switched to the brassmonkey slide taper, calculated using this: Micro taper calculator - Google Sheets. I started this taper last Thursday, Jan 2, 2025. It produced the same side effect, except this morning I woke up at 6am instead, so maybe that's progress? I'm unclear as to whether the presence of a side-effect should deter me, or whether I can just keep going. It doesn't affect me much, I guess I start feeling pretty tired at night, but that's it.

Most of us do experience some level of withdrawal even in a slow taper.  As long as you feel your symptoms are manageable, I would keep going if I were you.  If at any time you become very uncomfortable, stay at current dose until you "settle," before making the next cut.  Also, I do strongly encourage you to do BrassMonkey's recommended two-week hold after each 4-week reduction cycle, even if you feel okay - this helps our bodies "catch up" before starting the next reduction cycle.  If at the end of this hold, things are uncomfortable, hold for another week or two before moving on.  In summary - listen to your body and adjust as needed.  This is the way to best assure success.

 

A couple notes / questions:

+ Sometimes people have a hard time switching from a pill to the liquid form, so we generally recommend making this transition gradually. It sounds like you made that transition without any problems.  

+ Please confirm you are taking your dose twice per day.

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

I have never liked the idea that I could be permanently on a psychiatric medication, much earlier in my life, I was suicidally depressed and ended up in a psychiatric hospital, and back then I went off the meds not long after leaving. My psychiatrist agreed with me that my psychosis was the result of psychedelic usage, and that it's likely that if I just stay away from psychedelics, it won't happen again.

Psychedelics, weed, and even some prescription medications are known to induce psychosis.

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

She told me because I hadn't been very long on Abilify (like 5 months), I could just stop immediately, no taper of any kind. I did, and like 3 months later, in which I presented no symptoms or side effects, I went psychotic again and ended up in a psychiatric hospital again

We have found that our bodies become adapted to these drugs within 2-4 weeks.  Cold turkeys are enormously hard on our bodies, and it is not unusual for problems to crop up weeks and even months later.

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

This time, they put me on Olanzapine (don't remember dose), and later, because I didn't like the idea of being permanently on medication, I attempted to discontinue by myself with no taper. That didn't last long, because I discovered that if I don't take the pill, I literally can't sleep. I spoke to my psychiatrist about this, and she switched me to Geodon 60mg, my current drug.

A slow taper is the surest way to succeed in getting off medication for good.  Sleep problems are a common in withdrawal.

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

Later I came across this site, where it says abrupt discontinuation of one can lead to a withdrawal symptom that is identical to the psychosis that caused me to be put on the meds in the first place.

Although it is starting to change, most doctors do not understand withdrawal and immediately associate withdrawal symptoms with relapse.

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

So now I want to attempt a taper, on the hypothesis that the first psychosis was drug induced, the second one was withdrawal induced, so I should be ok not being on medication as long as I stay away from drugs.

You have clearly thought through this, and from what you have written I would concur!

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

I don't want to repeat the psychotic experience again. I spoke to my psychiatrist, and she agreed to get me a prescription for liquid Geodon, which isn't on the market anymore, but which I was able to take to a compounding pharmacy.

It sounds like you are committed to tapering carefully and safely.  As you've come to see, the psychotic episodes can be triggered by other drugs and by tapering too quickly,  I am grateful your psychiatrist is willing to support yo in this taper!

 

On 1/7/2025 at 8:11 AM, AntiDyatlov said:

And that's where I am, attempting this taper, but having questions about it.

We are here to answer your questions and support you in anyway we can!

 

Tapering Info - If you have not already, please read:

 Important topics in the Tapering forum and FAQ  

Tips for tapering off ziprasidone (Geodon, Zeldox)

The Windows and Waves Pattern of Stabilization - As you taper, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization.

 

 

Tracking your Symptoms.  It’s important to keep tabs on your symptoms and adjust your taper amount and schedule as needed.  This will help you identify your windows and waves and reveal your progress, which is encouragement we need! You can use the following list of typical withdrawal symptoms to track the severity of your symptoms over time:  Daily Checklist of Antidepressant Withdrawal Symptoms (PDF)

 

Managing your Symptoms.  We have many threads on how to cope with symptoms – I encourage you to check out the various forums / links on the SA.org home page.

 

Supporting your Healing  - We do encourage people who are tapering to avoid caffeine, alcohol, and recreational drugs.  Many prescription and OTC drugs can cause problems too and should be avoided as much as possible.  

We recommend only two supplements here - magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

This is your introduction topic.  Each member gets one intro topic- please post updates and questions here, in this thread.

 

I look forward to following your journey, and helping out in any way I can.  Best wishes.

[AntiDyatlov]

Thanks @Jane318, really needed that clarification about if the presence of any withdrawal symptoms means I need to slow down. You know, my psychiatrist never told me to take Geodon twice a day, even now the bottle from the pharmacy says 6ml daily. It's not like anything happened to me during all that time I was taking just the 60mg pill at night.

 

Do I really need to quit caffeine and alcohol entirely? I feel like my morning coffee is such an important part of my morning, and I have a beer every now and then.

[Jane318]

12 hours ago, AntiDyatlov said:

my psychiatrist never told me to take Geodon twice a day, even now the bottle from the pharmacy says 6ml daily. It's not like anything happened to me during all that time I was taking just the 60mg pill at night.

I was going by this statement on our tapering page:  "Because of its short half-life, Geodon is usually taken twice a day."   You may well have an extended release formulation - you might ask your doctor of pharmacist about this.  Or if you are not noticing a noticeable daily pattern of symptoms worsening before your evening dose, it may not be an issue for you now.  However, it may become an issue as your dose gets lower.  I was taking my venlafaxine IR in the morning only. After learning about its short half-life and since I was down to a pretty low dose, I started taking twice per day.  It seems to help even things out for me.

 

12 hours ago, AntiDyatlov said:

Do I really need to quit caffeine and alcohol entirely? I feel like my morning coffee is such an important part of my morning, and I have a beer every now and then.

We only suggest you consider it.  Many people find that caffeine and alcohol, in moderation, pose no problems for them.  Others discover that their system has become so sensitized that either can trigger bad symptoms.  You must decide for yourself - just listen to your body.

 

I'll share my story.  I have been a life-long coffee-drinker and LOVED that morning coffee too.  I NEVER thought I would (or could) quit.  I also enjoyed a glass or two of wine on a regular basis.  But I got to a really bad place last summer and as I learned that alcohol, caffeine, and other medications / substances affect neurotransmitters and can "mess" with the healing process, I decided to do everything I could just in case it might help me get better sooner.  I gradually phased out coffee and switched to non-caffeinated alternatives.  Now that I am more stable,  I find that I can tolerate de-caf coffee, although I limit it to 1 cup per day (it still has some caffeine in it).  Since I am weaned off fully caffeinated coffee, it tastes just as good to me.  I eliminated alcohol entirely for many months.  I find I can now tolerate a half-glass of wine (special occasions) and even a regular cup of coffee now and then.  

 

So it is very individual.  Just something for you to consider / think about.

[AntiDyatlov]

Looking at your taper in your sig, it's interesting that you started at Effexor 112.5mg and it only really started screwing with you at 1.36mg, I would have thought the body wouldn't have that much of a dependency at such a low dose. But I think I read that even at a 1mg dose, it's like 20% neuroreceptor occupancy or something like that? Thanks for your other comments, I'll keep them in mind in case my withdrawal symptoms get worse. Today I actually woke up at 7am, so they're getting better. 

 

Up until that drop to 1.36mg, how was your Effexor taper like?

[Jane318]

10 hours ago, AntiDyatlov said:

I would have thought the body wouldn't have that much of a dependency at such a low dose.

I know - it doesn't make sense...  until you look at the SERT occupancy charts.   I recently posted some information about this in my intro topic if you are interested.  This is what get so many of us - and why ill-informed doctors give such bad advice.  If you go too fast or quit too early, it's like throwing your brain off a cliff.  

 

10 hours ago, AntiDyatlov said:

it's interesting that you started at Effexor 112.5mg and it only really started screwing with you at 1.36mg

10 hours ago, AntiDyatlov said:

Up until that drop to 1.36mg, how was your Effexor taper like?

I thought I was doing.  In hindsight, I wasn't.  I was getting increasingly irritable, self-isolating, depressed.  But since these changes were happening somewhat gradually (over more than a year of tapering), and since I wasn't monitoring my symptoms, I wasn't clued in.  And then I got to the low dose region, where things get really tricky, and it caught up with me all of a sudden.  Last summer was grim for several months.  That was when I discovered this website and reached out for help.  Even just that tiny updose helped me start to stabilize again - stayed there for 5 months.  In all, it could have been much worse.  What helped me, I think, was:  (1) Although I was tapering too quickly, it wasn't super fast or cold-turkey.  (2) My recent history was stable at 112mg for many years - no other drugs, dose changes, failed tapers or cold-turkeys.  

 

11 hours ago, AntiDyatlov said:

Today I actually woke up at 7am, so they're getting better. 

Good news!  You may still experience a "wave" - which is normal, so don't get discouraged by thinking you are not getting better after all.  

 

Hang in there and keep us posted.  Questions welcome!