Tips for tapering off Zyprexa (olanzapine)

[BoyMom70]

On 3/24/2024 at 10:21 AM, Venkat said:

@BoyMom70 I was on olanzapine from 2015 to 2020 ( about 5 years ). It was unimaginable hell. I was extremely sensitive to olanzapine. Tapering was the only way out. When I started to taper at 10% of the previous dose every month, I suffered from very bad withdrawals and had to updose and hold for a long time. 10 % rule may have helped many. But when I started tapering at 2.5% of the previous dose every 2 weeks ( ie 5% of the previous dose every month) I was able to move forward, although I did suffer from insomnia for sometime. When I come down to around 2mg I just began to feel like a human being again and became hopeful of recovery. At 2.5 % taper I think I updosed only once by 2.5%. Yes at 2.5% taper every 2 weeks it was relatively smooth. I did hold a few times for a little longer periods without sticking to the dates strictly. 

I am currently on 0.75mg, so far so good. Right now no difficulties in the taper and also feeling like a normal human being and doing justice to my profession and family as well.

I found being slow, slow and slow has been helping me.

With the experienced and wonderful mods and supporting friends or fellow travelers you are in safe hands on SA.

Hope this helps. Please take care Boymom, be safe.

I’m so happy to know you are doing better now, and feeling more 

“human”. It gives me hope for myself. 
I too am extremely sensitive to Zyprexa. from the very beginning it gave me a feeling of being “off” and as time went on I just felt like there was no joy in my life anymore, and it felt like the floodgates had been opened on my anxiety and depression. Not to mention I put on 60lbs. 
It’s an awful drug , no one should take it. I’m looking really closely at your tapering schedule, it’s the closest to what I feel I may be able to tolerate. 
I had the same issue as you did, 
the 10% cut put me back in the hospital, and a 4% cut had me awake for 3 days without eating. We have to be so careful because we have no idea where our personal Threshold is. 
   I just started shaving my pills down by 1mg a week ( in weight ) like people do with benzodiazepines. My pills weigh about 126mg and I’m down to 123mg. I’m sleeping and eating so I guess I’m still ok. I guess it’s like the equivalent of reducing by like 1% a week or less. I’m so bad at math. 
that’s why I’m so interested in your 

taper .. it sounds like it may be just what I need. I’m a little concerned about doing water titration, but it seems to be working for so many other people and I’m sure it’s probably more accurate than shaving down pills. I’m just intimidated by the whole process honestly so I’m being overly cautious. Even at these low dose reductions I’m still having some mental withdrawal symptoms. Anxiety, depression, weird thoughts when I wake up. It’s like everything is scary. 
Im sure the fact that I’m going through menopause simultaneously isn’t helping either.  Did you have any emotional withdrawal symptoms ? 
what kind were you having ? 
I don’t mean to pry I’m just trying to gauge whether or not what I’m experiencing is normal. Anyway.. 
 I’m truly happy for you @Venkat

it seems like you really Feel better.
You’re feeling good about your career and your family life… That’s amazing!

Honestly,that’s really what we’re all trying accomplish right?  
 SA is wonderful, the entire community here are doing so much good in the world. The help they provide is immeasurable. They are truly a port in the storm. 
I do feel as if I’m in safe hands.. that was beautiful said. 
I will be taking your advice and going slow, slow and slow.
My goal is to make this a painless as possible.

I look forward to the next page of your tapering schedule, I will need it.
  Thank you for your kind words and support, it really means a lot to me. 
please take good care of yourself and 

keep us updated on your progress.

 I look forward to hearing from you. 

 

[Venkat]

Tapering Olanzapine from 1 mg to 0.1 mg at the rate of 2.5 % of the previous dose every two weeks, work sheet table could not be uploaded as it is. Posting the pdf format instead.Olanzepine taper from 1mg downwards_240331_141215.pdf

 

This is in continuation of the previous table where  Olanzapine tapering started from 2.5 mg and stopped at 1.0 mg.

 

Dates can be entered as per ones need.

 

For withdrawing of additional 0.1ml upto 0.9ml, a 2ml syringe along with the 20ml syringe will be helpful and easy.

[Venkat]

On 3/23/2024 at 9:20 AM, Venkat said:

 

 

 

 

Tapering Olanzapine from 1 mg to 0.1 mg, work sheet table could not be uploaded as it is. Posting the pdf format instead.Olanzepine taper from 1mg downwards_240331_141215.pdf

 

This is in continuation of the previous table where  Olanzapine tapering started from 2.5 mg and stopped at 1.0 mg.

 

For withdrawing of additional 0.1ml upto 0.9ml, a 2ml syringe along with the 20ml syringe will be helpful and easy.

 

 

Also, To taper at 5% of the previous dose once a month, follow every 2nd row once a month.

 

To taper at 7.5% of the previous dose once a month, follow every 3rd row once a month.

 

To taper at 10% of the previous dose once a month, follow every 4th row once a month.

 

It can also help in gradual updosing starting from 2.5% of the dose being taken by moving upwards in the table. 

 

 

 

[BoyMom70]

5 hours ago, Venkat said:

 

Thank you @Venkat

Im not sure when I’ll be transitioning to 

the water titration method,  but now I feel prepared for when I do. 

[BoyMom70]

2 minutes ago, BoyMom70 said:

Thank you @Venkat

Im not sure when I’ll be transitioning to 

the water titration method,  but now I feel prepared for when I do. 

Ps. How’s your taper going? 
have you been able to move down from the .75 ? I’m curious to know how it’s going? 

[Venkat]

15 minutes ago, BoyMom70 said:

Ps. How’s your taper going? 
have you been able to move down from the .75 ? I’m curious to know how it’s going? 

I am on 0.75 only since 2 weeks Boymom, due for a cut on 4th April. I am hopeful that it will go well no anxiet at all about it right now but definitely not over confident because I have learnt it the hard way.

[Venkat]

On 3/23/2024 at 5:13 PM, JandD said:

Thanks Venkat - the list is certainly helpful. However, the video can only be viewed after approval.

We have also had very good experiences with dissolving in water and using a pipette for 1.5 years. 
However, we dissolve the 2.5mg tablet in 100ml of water in a small brown bottle.
It seems to us that the dosage of the reduction has a slightly lower margin of error, which is particularly important for low dosages.

Hi JandD, managed to alter settings where approval for the video is not needed anymore. I am not really good in computers anyway. 

[Venkat]

59 minutes ago, Venkat said:

I am on 0.75 only since 2 weeks Boymom, due for a cut on 4th April. I am hopeful that it will go well no anxiet at all about it right now but definitely not over confident because I have learnt it the hard way.

I realised I am on 0.84 and not 0.75 and due for a cut in a couple of days.

[BoyMom70]

56 minutes ago, Venkat said:

I am on 0.75 only since 2 weeks Boymom, due for a cut on 4th April. I am hopeful that it will go well no anxiet at all about it right now but definitely not over confident because I have learnt it the hard way.

Oh ok, I thought it had been a while. 
well I hope it goes well without to much withdrawals. Please keep me updated on your progress. You are doing great! You have come so far. Just keep being careful and you should be fine.  I’ve found that a positive attitude goes a long way in this endeavor. 

[BoyMom70]

What symptoms if any are you experiencing when you make your reductions?  I’m curious to know if the change at the lower doses. That hyperbolic curve scares me to death. 

[N2deep]

A couple things:

 

- When I put the pill in the water to dissolve, it really sticks to the bottom of the container (I use a shot glass) and I use the handle end of a little fork as a stir stick to scrape the bottom of the shot glass to get the dissolved pill unstuck. I'm sure the rest of you also experience this?

 

- After I stir up the pill (in 5ml of water), I then add 5ml of Ora-plus to make a suspension. I then stir for quite a while because I'm OCD about it, but I stir gently because I don't want the suspension to get stuck to the sides of the glass above the level of liquid, which could make the doses uneven. I don't know if this issue applies to just water, but I imagine it does. But even though I stir gently, the Ora-plus suspension still does form a bit of a crust with what is obviously pill ingredient around the sides of the glass just above the level of liquid. I fear not getting perfect dosing from day to day because of this. I've thought about stirring for a set time every time, maybe that will help.

 

I imagine for most everyone else doing water only, agitating causes the drug to go on the sides of the container you are using also.

 

I guess this doesn't really matter if one is taking out the amount with a syringe that one is consuming, and discarding what is in the glass, but if one is consuming what is in the glass, I think this might cause uneven dosing. I dunno.

[hayduke]

51 minutes ago, N2deep said:

A couple things:

 

- When I put the pill in the water to dissolve, it really sticks to the bottom of the container (I use a shot glass) and I use the handle end of a little fork as a stir stick to scrape the bottom of the shot glass to get the dissolved pill unstuck. I'm sure the rest of you also experience this?

 

- After I stir up the pill (in 5ml of water), I then add 5ml of Ora-plus to make a suspension. I then stir for quite a while because I'm OCD about it, but I stir gently because I don't want the suspension to get stuck to the sides of the glass above the level of liquid, which could make the doses uneven. I don't know if this issue applies to just water, but I imagine it does. But even though I stir gently, the Ora-plus suspension still does form a bit of a crust with what is obviously pill ingredient around the sides of the glass just above the level of liquid. I fear not getting perfect dosing from day to day because of this. I've thought about stirring for a set time every time, maybe that will help.

 

I imagine for most everyone else doing water only, agitating causes the drug to go on the sides of the container you are using also.

 

I guess this doesn't really matter if one is taking out the amount with a syringe that one is consuming, and discarding what is in the glass, but if one is consuming what is in the glass, I think this might cause uneven dosing. I dunno.

Typically this is just binding agent for the tablet left over, not part of the active ingredient.  Making a suspension in water is a proven and reliable method once you have the technique down pat.

Of course shaking and stirring vigorously after leaving the tablet to disintegrate for a while is wise.

[BoyMom70]

Does anybody know if tapering olanzapine is anything like tapering an ssri ? I ask because I know olanzapine also works heavily on Serotonin only I’m not sure if it works in the same way. 
 I think ssri’s work by blocking receptors to inhibit the Re uptake of serotonin. But .. zyprexa might work by blocking at the transmitter as to block the release of serotonin altogether which might make more sense for an antipsychotic.

 

does anyone know the answer? 

[Altostrata]

Don't worry about the receptors involved. They all require gradual tapering. Tapering is similar across all psychotropics.

[BoyMom70]

On 4/12/2024 at 9:23 AM, Altostrata said:

Don't worry about the receptors involved. They all require gradual tapering. Tapering is similar across all psychotropics.

Yeah , I’m overly analytical so I feel more comfortable when I have more information.  I feel like I can make a better, more informed plan if I know if it has ssri like qualities though I’m pretty sure it’s a serotonin antagonist not a Re uptake inhibitor..it just makes more sense. 

but.. you’re right. No matter what the target receptors, you still need to taper slowly regardless. It’s just the best strategy no matter the target.

 Ty for bringing me back to center.