Supermowie Reinstatement of Zyprexa?

[Meimeiquest]

Until you get moved to liquids, you need to take pill pieces that resemble a quarter of a tablet. So you can't just take the four irregularly broken fourths from one tablet, plus you did an eighth of a tablet one night right? Even though 1/4 of a tablet seemed to over sedate you once, your body will adjust over time. It sounds like a good dose where things are for you right now, and you said you felt "almost normal"?

 

Almost everyone finds making a liquid easier than weighing, and syringes are much cheaper than scales. Another option is to have Zyprexa compounded into a stable suspension by a compounding pharmacy. In the Tapering forum (I believe) is a thread on compounding pharmacies.

 

Everything won't necessarily be easy once you get to a new stable dose. That's when you start working on the self-care skills to enable drug-free living.

 

Would you like to share more about your cancer story? It is a very emotional, stressful thing to face down a cancer diagnosis, and obviously has physical ramifications as well.

[Supermowie]

Hi Dalsaan: I will go to a pharmacy that can make the liquid suspension. My doctor has to approve the amount which is 1/2 of 1.25. I hope she can approve it. She mentioned that the smallest dosage is a 2.5 mg pill. And, for insurance purposes she can't approve anything less since there's no pill that is less than that.

 

Thank you for your info and support.

[Meimeiquest]

Sadly, insurance doesn't usually cover compounding. The pharmacy should be able to explain to you how the script needs to be written.

[Altostrata]

See Tips for tapering off olanzapine (Zyprexa) for explanations about how to make a liquid.

[Supermowie]

Thanks Altostrata. Last night was the first night I had slept a good 7 hours. I didn't wake up until 5:30. I got up to tinkle and went back to sleep. That was not possible for a whole month. So, tonight I hope I get the same amount of sleep as I did last night.

[Supermowie]

Hi Meimeiquest. No, I have not taken 1/8 of a pill ever. I just took 1/4 every night since Wednesday night. Last night I slept practically the whole night, which I haven't been able to do the past month. So, tonight I hope will be the same as last night. Nice to wake up for once without anxiety. Thanks for the tapering info.

 

The compounding pharmacy told me how they want the script written. The pharmacist said that the insurance might cover it. We will see.

 

Tell you about my cancer diagnosis in another post. I'm falling askeep now. I can just tell you again that these withdrawal symptoms I consider worse than the chemotherapy process. I was able to sleep and eat during chemo and did not have anxiety and panic attacks like I had this past month.

[Supermowie]

Dear Opalowl, When you tapered to .3 Zyprexa, was it in liquid form?

[OpalOwl]

.3 is an estimate. I cut my 2.5 pill into 4 pieces, and then broke those pieces even smaller, as small as I could get. I wasn't aware of a liquid taper at that time.

[Supermowie]

Dear Altostrata and Rhiannon: I might not be able to afford a liquid suspension from a compounding pharmacy. I am at 1/4 of 2.5mg. If I am correct, I should take that 2.5 pill, crush it, place it in water or other liquid mentioned in the instructions and use the syringe to take how much liquid in ml which equals .625? I read Rhiannon's post on this. Pls advise if you can.

[Supermowie]

Thank you, Opalowl. I think that is hard to do since the pill is so small. I would have to weigh mine if I did it that way, just to get it exact. I don't have a scale yet. Many are saying on this site that liquid suspension is better for accuracy.

[nz11]

Hi Supermowie i just noticed your question.

Here is my opinion

you could

1. try to cut it into quarters as in the zyprexa tapering link it says it is easily split.

 

To make a liquid which may be difficult as i read it but with out the option of ordering compounding pharmacy suspension

here is one way

dissolve the 2.5mg in 10mls of water

take 2.5 ml that is the same as 0.625 mg

Because of the seriousness of the repurcusions of  making a mistake it is best to satisfy yourself this is right.

logic being:

2.5mg in 10ml

Dividing each side by 2.5 gives

1mg in 4ml

Multiply each side by 0.625 gives

0.625mg in 2.5ml

Take 2.5ml of the 10ml liquid....that is equivalent to 0.625mg.

[Supermowie]

Thank you NZ11. Just one question since I am not math savvy. The 10ml of liquid, how did you come to that number?

[nz11]

Good question.

In one sense its an  irrelevant number.

It could work if one puts it into 5ml or whatever x mls of course the numbers crunched would be different coming out the other side and maybe difficult to measure out. eg 3.333ml is not as nice and tidy as say 2.5mls

thats why its always easy to work with a nice tidy easily multiplied and divided number like 10.

 

Lets consider for instance putting

2.5mg into 5mls of water

then that is

1mg in 2mls, which is equivalent to

0.625mg in 1.25mls

 

Personally its easier i would think to measure  2.5 mls from the 10ml solutn than 1.25mls from the 5mls solutn

 

I hope this hasnt confused you more. If it has ignore it.

 

Basically putting it into 10mls (in this case )  makes life easy.

[Supermowie]

Thank you, nz11.

[nz11]

You're welcome,

Hey Supermowie, going forward you could  dissolve the 2.5mg in 10ml of  water each time and then do a 10 percent taper on the 2.5 ml of current dose.

 

so the next drop would be to 2.5 ml x 0.9  = 2.3 ml (take 2.3ml from the 10ml solution)

 

the next drop would be to 2.3 ml x 0.9 = 2.1 ml (rounded to one decimal place)

 

etc...

[Supermowie]

Thank you again. I am math challenged.

[nz11]

No worries.

[nz11]

Supermowie

i just realised something 10ml may be a very small amount of liquid and difficult to make up. It might be hard to crush the pill in it.

 

Alternatively you could put 2.5mg into 50ml...

thats 1mg in 20ml

so thats 0.625mg in 12.5ml.

 

nz11

[Supermowie]

Thank you, NZ11.

[Supermowie]

Hi Altostrata: This is an update of my reinstatement of Zyprexa. It's been 11 days at .625 mg.I take the 1/4 portion at 7 p.m. every evening. I've been able to sleep 5 to 7 hours a night. I sleep around 10 to 3 a.m. then go back to sleep at 4 a.m. until 6 a.m. I have a pretty decent appetite. I will pick up a liquid suspension on Tuesday of the same dosage. Not sure when I should lower the dosage. Should I hold for a month? Thanks.

[Supermowie]

Hello everyone. I believe I can say I successfully weaned from zyprexa. A month ago, I took the last dose at .55. I sleep for 6 hours and have a little bit of depression and anxiety when I wake up. That last a few minutes to an hour. I am ok usually after I eat something. My nurse practitioner wants me to take gabapentin 100mg 1 to 3 tablets at night. I have not taken the gabapentin. I read that alphalipoic is good take as a natural alternative. Does anyone know about this? Thanks in advance for your input.

[Fresh]

Hi Supermowie , welcome back.

Please could you update your sugnature to include the date / dose you reinstated in December 2015 and the date you ceased 0.55mg one month ago.

 

What symptoms are you having that your nurse practitioner thinks gabapentin will help with?  

 

Gabapentin is a dangerous drug that needs tapering after a few weeks to avoid w/d syndrome.

If you want to live without drugs , there are loads of non-drug methods to help you manage anxiety and stress. Take a look through the Symptoms and Self Care section for ideas.

 

bw ,  Fresh

[Supermowie]

Hi Fresh. I was given a diagnosis of bi polar 2 last June 2015. So, when the Zyprexa dosage was lowered during the taper, I would experience mild depression, I was advised to take the gabapentin. I decided not to take the gabapentin. As you said, it would require a taper to get off of it. I don't want to do that again. I am experiencing depression every morning. I'm ok after I eat breakfast. I'll read through the self care section. I hope there is something for bi polar. I plan to get a second opinion on that. I'll work on adding to my signature the new info. Thanks.

[Altostrata]

When you say you are "experiencing depression every morning," what do you mean?

 

If you are okay after you eat breakfast, why are you worrying about a very short-lived symptom?

[ChessieCat]

Hi Supermowie,

 

If you feel better after you eat breakfast, it may just be because you blood sugar levels have dropped.  I have found that since tapering I sometimes get irritable and realise that I need to eat something, even though I might not be getting hunger pains.  Once I eat I feel better.  As Alto said if it short-lived, and it looks like you have a solution, it's probably not worth the effort of being concerned about it.

[Supermowie]

Hello Alto and Chessie Cat. I had depression on and off before I had taken Zyprexa. Usually, it was in the morning. Not every day. Lately, it has been every morning. I mentioned it in my post because I'm not used to a daily morning episode. It is different than before I took Zyprexa. I have like a nervous sensation which turns into anxiety then to depression. Sometimes, I don't want to get out of bed, but I force myself out and make myself eat something because some mornings I don't have an appetite. I am not too concerned, but it is different than before. That is why I mentioned it. I'm probably just too sensitive about any changes that happen to me.

[Fresh]

I wouldn't get too attached to a diagnosis of bipolar 2 , unless you were floridly manic before you went on zyprexa.

 

The fact that you've not been on a mood-stabilizer , yet haven't had a manic episode since then , makes it seem

unlikely.  Of course , you've said very little about the traumatic event last June that started this situation off.

FYI , if you had taken any street drugs , a diagnosis of bipolar doesn't count - your reaction was substance induced.

 

Good for you for managing without trying gabapentin.  

It's still early days since stopping zyprexa , so let's keep an eye on your symptoms.   If things start to get bad , you

can reinstate again and go off slower.

 

[KarenB]

Perhaps keep some food on your bedside table?  Munch when you first wake up?  Anxiety in the morning is common with a destabilised Central Nervous System.  I fix mine by eating then getting on my bike. 

[Supermowie]

Thank you, Fresh and KarenB.

Yesterday, I had depression in the afternoon. I believe it is part of w/d symptoms. It lasted a few hours. Usually, the depression is in the morning. Upon arising, I don't eat untiI I take Strontium for my bones. I wait a couple of hours before eating. Then calcium and later a pill for other physical ailments.. I might have weaned too early from Zyprexa, but the advantage is that I no longer suffer from constipation.

 

I was a victim of home invasion last year. So, I was stressed out.

[Supermowie]

Hello everyone:

Today, I woke up with major anxiety and dread. Eating breakfast didn't help much. I've been under a lot of stress lately so that is probably why I have the anxiety and I believe it is withdrawal I'm still suffering from. I'm have a nervous stomach as I write this. Also, I have gone to an acupuncturist the past week. I went three times and the next morning after each acupuncture session I suffer from depression. Today was worse than I have experienced in a long time. I was told by my NP if I have a depressive episode to take a small portion of the Zyprexa. If I do that, I would have to take the med again. I would be reinstating, and then would have to wean off of that eventually. If this happens tomorrow morning, should I reinstate? Would like advice from folks who have weaned off after 2 months. I'm probably going through a wave, but would like to know how to deal with it. I weaned off of Zyprexa this past February.

[KarenB]

An episode or two (or three) of depression isn't a very good reason to reinstate. 

 

It sounds like the accupuncture may have exaccerbated your symptoms.  In that case, they will settle down again of their own accord, but it may take a few days or weeks.  Learning to ride out a wave is a much better option.  It involves acceptance and good self-care.  Note your symptoms, care for yourself, but don't fight or panic against them.  They are here, they will go again.  

 

Let us know how it goes,

Karen 

[Supermowie]

Thank you, Karen. I read a few of the blogs in the acceptance section that you referred to. I felt better as I read them.I know that my current episodes of anxiety and depression stem from indecision. Should I go on disability or go back to work? I have been off of work for many months now. I had undergone chemotherapy a couple years ago and it has been difficult to accept that my body and mind will not return to what it used to be. I was more physically active than I am now.I get fatigued very easily.

 

Will I be able to handle my stressful job? Can I afford living off of less? Those questions have been bothering me these past months. I am at retirement age and I don't have enough to retire on, the way I want to retire. I think once I make a decision, the anxiety will go away. This is a major life change for me if I decide not to work. My heart says to stop working my job so that my body can rest and the breast cancer not return. Now, healing my mind after zyprexa and healing my body from the effects of chemo is what I will continue to do. I need to accept things as they are. Major decisions have always been hard for me to make.

[Supermowie]

When I say the anxiety will go away, I don't think entirely. But, once I make a decision on what my future life will be, a major portion of what I am going through now will abate.

[KarenB]

True - that is a big decision for you.  Hopefully your heart will settle on something soon.  I'd go for whichever way brings the most healing, but that is easy for me to say when I am not yet near retirement age with it's different financial concerns.