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Bokart: withdrawing from Olanzapine

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Bokart

Hello fellow withdrawers (if that's a word), I'm Bokart and I'm here on a journey to quit my medication of Olanzapine. Down to 7,5 mg at the moment (see my signature).

 

My story short: back in February 2015 I got admitted in psych ward due to psychosis (due to my destroyed sleep because of my night-shift work). There began my involuntary medication of Olanzapine, which pulled me out of a psychosis, so at least it did some good. I was released from the hospital after two weeks of being there.

 

Now, after jojoing with my olanzapine dose (see signature), I'm finally set to quit it for good. I found this community after searching for succesfull withdrawal stories on the internet and found this community to be great, people being helpful and supportive and giving good advice... I know it can get rough when I approach smaller doses so I do know I will need support. And hopefully I can give support too and offer people hope after and during my taper. I know lots of people are in the same boat as me.

 

Why I want to quit? I got no sexuality anymore, my motivation lacks big time, even personal hygiene is suffering because of that. I can't memorize things like before - learning is difficult. I have very little emotions left in me, basically I'm a dumbed down version of myself nowadays with this drug. I have little social skills - which I would badly need because I plan on working with children in school so some situational awareness is needed (I might have to quit my studies due to me making no progress in my studies... due to this drug). No happines, no enjoying things, lethargy and demotivation...

 

About my psychosis, after it was gone I haven't had any symptoms of it returning (like delusions, paranoia, hallucinations), even after trying to quit my drug cold turkey once, which I see as a good sign. Now I don't want to slip into psychosis again so I need to be extra careful with my taper. After I hit 5,625 mg I will go on tapering by feeling, so no reductions until I feel stable enough.

 

My main concern is sleep. I have a prescribed medication of temazepam (a benzodiazepine), which I can use when my insomnia has hit a threshold of needing immediate attention. I'm trying to limit my use of it to every three days to prevent tolerance and dependence (I know benzodiazepine withdrawals can be bad). But the thing is, lack of sleep led me to psychosis once, so it is a big deal to me. I need at least one night on a while to hit at least 4 hours of uniterrupted sleep, which 40 mg of temazepam does. I've tried many other sleep aids such as low to medium dose of quietiapine (no effect), low to medium dose of levomepromazine (didn't help), low dose of doxepine (no effect), even melatonine and l-tryptophan and 5-htp and none of those helped. One thing that helped me though was phenibut combined with temazepam - I slept 13 hours with that combination! So I know I have an emergency brakes on my train now (assuming that combination works again, haven't taken phenibut in 2 months to avoid tolerance and dependency), but I'm planning on limiting the use of this combination to once a month. On this dose of 7,5mg I'm currently having 2-3 hours of good uninterrupted sleep plus 3-4 hours of bad, constantly waking up kind of sleep

 

So, thank you all for being here! And I wish a speedy recovery to those who are withdrawing from their drugs, we are all here together.

Edited by JanCarol
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AliG

Hi Bokart. Welcome. I'm sorry for what you have been through.  Your CNS has been destabilized, with all the changes in dosing, including alternating. This can be very tough on the  nervous system and bring on withdrawal symptoms.  It would be wise, to do a long hold now, to let your CNS settle and then taper off very slowly when the time comes. We can help you with that, in the future.

We recommend a 10% taper method. Why taper by 10% of my dosage?

Have a read of these links, and come back with any questions or concerns. What is withdrawal syndrome?

Temazepam can cause dependence, but I will leave that question  for someone more experienced with this drug. We don't advise tapering two drugs at once, so you will likely have to taper that at a later date. In the meantime, this link might help you with some ideas for sleep.

Tips to help sleep -- so many of us have withdrawal insomnia

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blazesboylan

Hi Bokart,

 

I am currently taking olanzapine also, as per my signature, which is up to date. I plan to start to taper off the olanzapine at some point in the future. However, I am focussing on the Effexor (venlafaxine) for now. I would hope to eliminate that completely first if possible. It will be a long time before I am free of it completely. Many months.

 

I am sorry to hear about your sleep difficulties by the way. I wish you the best of luck with your taper anyway.  :) 

 

All the best,

Blazes.

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Altostrata

Welcome, Bokart.

 

Are you still working at night?

 

Lack of sleep can cause psychosis-like symptoms. Did you ever have such symptoms before working the night shift? How old are you?

 

If you are still working at night, and still having trouble sleeping, it could be your system is not going to adapt to the reverse schedule. Continued use of drugs to maintain a reverse schedule is going to cause you continued problems in side effects, dependency, etc. Have you talked to a sleep specialist about this?

 

Please see Tips for tapering off olanzapine (Zyprexa)

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apace41

Lack of sleep can cause psychosis-like symptoms. Did you ever have such symptoms before working the night shift? How old are you?

 

If you are still working at night, and still having trouble sleeping, it could be your system is not going to adapt to the reverse schedule. Continued use of drugs to maintain a reverse schedule is going to cause you continued problems in side effects, dependency, etc. Have you talked to a sleep specialist about this?

 

Further to Alto's point, Bokart, while it is not a usual request, perhaps you can give us a sense of your daily routine as many people have circadian rhythm issues that can be addressed in ways other than drugs. When you say you've tried a lot of different things, all of them are in the drug/supplement family.

 

If you can tell us other things you have done in terms of "what's a typical night for Bokart" look like, that might allow us to brainstorm on your sleep.

 

Best,

 

Andy

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Bokart

Hi Bokart. Welcome. I'm sorry for what you have been through.  Your CNS has been destabilized, with all the changes in dosing, including alternating. This can be very tough on the  nervous system and bring on withdrawal symptoms.  It would be wise, to do a long hold now, to let your CNS settle and then taper off very slowly when the time comes. We can help you with that, in the future.

We recommend a 10% taper method. Why taper by 10% of my dosage?

Have a read of these links, and come back with any questions or concerns. What is withdrawal syndrome?

Temazepam can cause dependence, but I will leave that question  for someone more experienced with this drug. We don't advise tapering two drugs at once, so you will likely have to taper that at a later date. In the meantime, this link might help you with some ideas for sleep.

Tips to help sleep -- so many of us have withdrawal insomnia

 

Thank you for your post. Hmm, do you think my CNS is destabilized? I don't seem to have any symptoms, though, except the poor sleep. And yes, I'm doing a larger percentage tapering than 10%, because I have had previous success in doing so. As an example (as in my signature), 26th April I dropped my dose to 5,625 mg from 7,5 mg and five days later I suffered from crying spells, anxiety and slight insomnia (only 4 hours of sleep). Then, after being wisened up by the experience, I tried again with alternating doses: first between 7,5 mg and 5,625 mg every second day, then 7,5 mg every fourth day and 5,625 mg three of four days (sorry, my signature had wrong info, now fixed), and then succesfully dropped to 5,625 mg _every day_, no withdrawal reaction like before. Or could my 9th August anxiety be a delayed withdrawal reaction? The reason why I started alternating doses was because here: http://patient.info/forums/discuss/coming-off-olanzapine-27414one responder said that the advice to alternate doses was from the Zyprexa manufacturer (scroll down to first post by user named marbel). It seemed like a good advice, and worked for me before, so should I continue with it?

Hi Bokart,

 

I am currently taking olanzapine also, as per my signature, which is up to date. I plan to start to taper off the olanzapine at some point in the future. However, I am focussing on the Effexor (venlafaxine) for now. I would hope to eliminate that completely first if possible. It will be a long time before I am free of it completely. Many months.

 

I am sorry to hear about your sleep difficulties by the way. I wish you the best of luck with your taper anyway.  :) 

 

All the best,

Blazes.

 

Thank you! Do you have an introduction thread so I could see your situation too? Best of luck to your withdrawal process as well!

Welcome, Bokart.

 

Are you still working at night?

 

Lack of sleep can cause psychosis-like symptoms. Did you ever have such symptoms before working the night shift? How old are you?

 

If you are still working at night, and still having trouble sleeping, it could be your system is not going to adapt to the reverse schedule. Continued use of drugs to maintain a reverse schedule is going to cause you continued problems in side effects, dependency, etc. Have you talked to a sleep specialist about this?

 

Please see Tips for tapering off olanzapine (Zyprexa)

 

No, I didn't have any psychotic symptoms before the night-shift work. I really screwed up my circadian rhythm there, trying to sleep two 4 hour periods before and after work... resulting in psychosis. Thank you for the link, I read it. I do have some problems with 10% taper though. I don't know how to properly do precision taper like that, I have 7,5 mg tablets and I am reducing my dose by quarters. So, what I get from the article, is that I should start mixing olanzapine with liquid? I do have a precision scale so could I use that in some way (chipping off pieces with some tool and measuring the weight, what tool is recommended?) And no, I haven't talked to a sleep specialist, and don't think I have money for the either.

I'm 23 years old.

 

Lack of sleep can cause psychosis-like symptoms. Did you ever have such symptoms before working the night shift? How old are you?

 

If you are still working at night, and still having trouble sleeping, it could be your system is not going to adapt to the reverse schedule. Continued use of drugs to maintain a reverse schedule is going to cause you continued problems in side effects, dependency, etc. Have you talked to a sleep specialist about this?

 

Further to Alto's point, Bokart, while it is not a usual request, perhaps you can give us a sense of your daily routine as many people have circadian rhythm issues that can be addressed in ways other than drugs. When you say you've tried a lot of different things, all of them are in the drug/supplement family.

 

If you can tell us other things you have done in terms of "what's a typical night for Bokart" look like, that might allow us to brainstorm on your sleep.

 

Best,

 

Andy

 

Right now my typical night is this: go to sleep between 9 and 10 pm, alarm set up at 6.55 am in workdays. My nights vary, fri-sat was a very good night with few awakenings, sat-sun night was good till 10 pm to 2 am (only 1 awakening in-between), and after that constant awakenings, sun-mon was horrible with seemingly no sleep (I woke up constantly, at least once per hour). All these nights can be explained: At friday I travelled to mom's, I almost always sleep the first night well there. Second night was my average night. Third night was back in my own place, and I usually have a bad first night there. Mon-tue night was slightly better than the night before, but still below my average night.

 

My daily routine consists of browsing the internet, not much exercise. In weekdays I have activity in school. Coffee 1-3 times a day, last coffee usually before 6 pm. About coffee and sleep, before (in the summer) I got good sleep with 7,5 mg of olanzapine AND despite me drinking coffee at whatever time, so I think coffee is not a problem for me. However, before medication my sleep WAS sensitive to coffee, me not being able to sleep before late night hours if I ingested coffee after 6 pm. Maybe I should try a week without coffee and see how it goes.

 

I take many supplements, these in the morning:

Panax ginseng 1.5g, adaptogen, hoping these could help my brain and nervous system to adapt to reduced amounts of drug

Fish oil capsules

Green tea extract with 117mg EGCG (protect brain cells, link http://www.perpetualcommotion.com/a/Green_Tea.html)

Vit. D3

Zinc bisglycinate 22mg to help with motivation, should raise dopamine levels in the brain

Various b-vitamins

Vit. E

Schizandra 5g, another adaptogen

Chaga 200mg, said to be world's most powerful exogenous antioxidant plus an adaptogen

L-carnosine, brain protector (will stop this soon because no money to renew)

Sarcosine, helps schizophrenics with motivation, maybe it helps others on antipsychotics too? (also a NMDA agonist)

 

These before bed if I remember to take them:

Magnesium-L-Threonate (to help with sleep and should improve cognition)

Uridine Monophosphate (should help with sleep, and help coping with sleep deprivation [haven't yet started this])

 

One great reason for quitting olanzapine for me is the fact that I seem to require more and more medication to get the same amount of sleep. I don't want into this downward spiral of ever-increasing medication, I rather suffer 2 years of horrible sleep than to increase my olanzapine dose. This isn't unheard of, right? That a sleep-aid loses its effectiviness over time.

EDIT: Also, how can I add "Zyprexa" as a tag to this thread? I can't seem to find a way to do it.

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AliG

Hi Bokart.   Alternating dosages is not recommended , as it bounces your brain around . I'll post some links.  Coffee , also is a problem particularly if you're taking it at 6 pm . That's asking for trouble with your sleep.  Sleep  medication is not the way to go . Look at more natural alternatives, if you can.

 

This is taken from tapering :  

 

How about taking my medication every other day to reduce my dosage?

DO NOT TAKE YOUR MEDICATION EVERY OTHER DAY TO TAPER.

If your medication is not designed to take every other day (very few are), don't try to taper by alternating doses. The half-lives of almost all psychiatric drugs are too short for this to make sense. It causes the amount of the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse.

Your brain likes stability, to be treated gently. The object is to gradually accommodate it to lower and lower dosages. Don't throw it off a cliff every day. Move it slowly down a ramp by gradually decreasing dosage by an amount it may hardly notice. A 10% reduction in dosage may be appropriate. Stay at that dosage for 3-4 weeks, then decrease again -- by 10% of your last dosage. Your decreases will be progressively smaller the lower you go in dosage.

 

I would give up the coffee and the supplements for now as well, to give your nervous system the best chance of healing.

Ali

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Colonial

Hello Friend,

 

Not taking the exact dose every day can set you up for a lot of problems, and in my case I think did me more harm than if I had just made one complete drop all at once.  And I'm concerned that if you're withdrawing too deep of a cut that it's giving you insomnia, that your plan to use a sleep aid the is also going to change the chemistry in your brain further is setting you up for more problems down the road.  I as well had to give up all but my first cup of coffee in the morning or suffer neurological issues.  My concern is you may confuse withdrawal anxiety with your original condition and rely too much on another drug to push through it.  The good news is that the side effects of the drug will lessen as you withdraw further, and you don't necessarily have to be completely off the med 100% before you notice a lessening of the negative side effects that you were experiencing.  Please just go slow.  I know we all want to be rid of the side effects ASAP, but the suffering you are in for if you completely destabilize your nervous system by going too fast or taking alternate doses from one day to the next is unspeakable.  Since you really didn't have the sleep issues until you started sleeping 2 four hour shifts it does seem the issue is behavioral and you shouldn't need the med long term. You are in my prayers!   :)

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blazesboylan

 

 

 

Hi Bokart,

 

I am currently taking olanzapine also, as per my signature, which is up to date. I plan to start to taper off the olanzapine at some point in the future. However, I am focussing on the Effexor (venlafaxine) for now. I would hope to eliminate that completely first if possible. It will be a long time before I am free of it completely. Many months.

 

I am sorry to hear about your sleep difficulties by the way. I wish you the best of luck with your taper anyway.  :) 

 

All the best,

Blazes.

 

Thank you! Do you have an introduction thread so I could see your situation too? Best of luck to your withdrawal process as well!

 

I certainly do. Here it is.

 

http://survivingantidepressants.org/index.php?/topic/6770-blazesboylan-why-should-i-taper/

 

Have a good weekend  :)

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Bokart

Thank you all for your answers. I'm sorry I haven't been able to respond earlier, but I've been rather busy lately.

I think I have completely accustomed to my fractured sleeping cycle, I don't feel bad or sleepy at all, only somedays I tend to yawn much in the morning hours but it is gone after noon. And now I go to bed even earlier -many days even before 9 pm! I only use my sleep medication once a week, but since I've been so well lately, I've decided not to use any this week.

 

I have also been having more energy throughout the day, accomplishing more tasks. I have motivation to do thing, which I find nice. Oh, and it seems my emotions aren't completely numbed out, either. I have some empathy in me still, despite it being very faint. Hoping this will get even better as I lower my dose

I also have decided to slower my tapering process, being on this dose of 7,5 mg olanzapine for one extra month. I was supposed to lower my dose again tomorrow, but due to your advice and my mother's recommendation, I will slow my tapering down. Hopefully I'll see improvement in my sleep, but I'm not having very high expectations of it happening... I think it will be a rough road for me. I have also decided that I will do my next dose reduction in every-other-day kind of way, because I know it works for me. But I will start a 10% taper after I've hit 5 mg, so my plan is this:
alternating between 5,6 mg and 7,5 mg

5,6 mg

5 mg

--> 10% reduction starts

 

Hopefully I will get prescribed 5 mg pills by my doctor, which I will have an appointment next month. She thinks I should be on this medication for at least 5 years due to severity of my psychosis (yeah, it was rough for me but I still disagree - I'm much better nowadays with zero psychotic symptoms, and my psychosis was due to loss of sleep anyways, I don't think it will go back if I'm not pushed over the edge again in that regard).

Oh, and I had a nurse's appointment too last week, and she doesn't think the lowered effectiveness of my medication in providing sleep is due to actually lost potency of it, but due to other factors such as stress. I kind of agree but kind of disagree with her... I mean stress does play a part in it, but I don't think it's completely ruled out that my body is just being accustomed to the medication and compensating the sleep providing aspects of my medication with something that is making me sleep less.

I also read this forum thread here, from which I found Altostrata's this post, which had a link to some interesting graphs about olanzapine. This:

Kapur%202001%20binding%20curve.JPG

 

So I have, at the dose of 7,5 mg, a 95% of serotoning receptor occupancy. My first reaction was: are they mad?!? I didn't have depression, why touch my serotonin receptors? I only had inability to sleep and psychotic symptoms, why not something like haloperidol would have worked? Or just get me some good quality sleep to alleviate everything? I hope they would have pushed some sleep med solutions when I was admitted...
This graph also demonstartes why it's important to do a gradual taper: the lower the dose, the more rapid decline in receptor occupancy. So this means at lower doses the tapering should be more careful.

 

Oh, and I also cut my coffee consumption: only 1 cup a day before 3 pm (usually before 2 pm), but I'm also considering to drop it completely to just to see if it helps my sleep.

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Altostrata
This graph also demonstartes why it's important to do a gradual taper: the lower the dose, the more rapid decline in receptor occupancy. So this means at lower doses the tapering should be more careful.

 

 

Exactly!

 

Caffeine has a very long half-life. This definitely could be affecting your sleep.

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blazesboylan

Hi,

 

On the subject of caffeine I drink maybe 4 coffees a day and a couple of cans of cola as well. That's probably far too much but I don't think that it really affects my sleep. I feel that some people are more sensitive to caffeine than others though. Hopefully cutting out caffeine will help you though. Let us know. It sounds as if you are doing relatively well anyway Bokart. It is good to hear it.

 

Blazes.

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Campervan41

Hi Bokart

 

I've just read your thread and although I'm not a shift worker I was diagnosed with Psychosis due to insomnia and stress. They think insomnia played a huge part in it. I'm currently tapering liquid Respiridone. I started tapering from a much lower dose than your Olazipine but I've found tapering really difficult. I was on 1 mg for over a year and I'm now on 0.5mg it took me 11 months to reduce to that, I have to go really slow.I'm on liquid medication and measuring doses by using a 1ml dosing syringe. It allows you to reduce the dose very accurately.

I too really struggle with sleep so I can really sympathise . My sleep pattern when I sleep seems very similar to yours 10pm-2am then waking up.

I know one of the side effects from Respiridone and withdrawing from it is insomnia. Perhaps that's the case with Olazapine?

I've read your comments about coffee. I find it really affects my sleep. Trying to cut it out or reduce it might be a way to see if your sleep improves? I wouldn't recommend drinking any caffeine after 2pm because of the half life in it.

I also find my sleep is better if I've had some fresh air and exercise. It's something I'm not great at at the moment but I'm going to try to walk for at least 45 minutes - one hour a day and joking a gym to see if things improve.

 

I also take Magnesium which seems to help my sleep. I can see you take that too. I also noticed your taking Ginseng - I think that is quite a stimulating herb from what I've read so I have avoided that.

I've been following the guidelines here on my taper, reducing by 10% every 4 weeks and often longer. Tapering off anti psychotic medications can be dangerous as it can trigger a relapse into psychosis do that's why it's important to go slow and monitor symptoms, which you are doing.

Best of luck with your taper Bokart

Best wishes

Camper

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Campervan41

Hi Bokart

 

Sorry can I also tell you that I've read that it's not recommended to take different doses of anti psychotic medications when tapering as AliG and Colonial have already advised you it's important to stick to the same dose. Otherwise you get different amounts of the antipsychotics in your system and it just messes it up. The first time I tapered from Respiridone too fast I ended up with complete insomnia and a full blown relapse into Psychosis after 2 months. That was tapering from just 1 mg to zero over 3 months. Anti psychotics are really powerful drugs so you have to be really careful when tapering.

 

Take care

Camper

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Bokart

Hello all, I just thought to update my progress here.

I've some good news: I've made great progress in my tapering! I have followed your advice and instated a 10% taper method. I got a receipt for dissolving Olanzapine tablets and use a syringe to reduce my dose. I'm now on a 5 mg dose of Olanzapine and I just started waking up 3 times a night after latest dose reduction. I suspect this has something to do with switching to 5 mg pill from 15 mg pill (both dissolving, my country didn't have 7,5 mg dissolving pills). I mean, theoretically I jumped from 5,4 mg to 5 mg, but how do I know I really was on 5,4 mg, does the olanzapine float on water or is it heavier than water, does it spread evenly in water when stirred? I have my doubts. But anyways I find my current amount of sleep manageable. I also haven't used temazepam to help sleep in whole summer! I have that as a backup, but I suspect I won't be needing it.

I'll update my signature so you can see my reduction phase.

 

As you see I dropped to 5 mg in 16th of August, because I reasoned that because the drop is less than 10% (it was 8,5%) and I have done so well so far, I could drop faster this time. We'll see if that was a good decision, hopefully it was. I could also hold this dose for longer if I need to.

 

Also, just a little update on how I'm feeling overall. So I still don't have all the emotions I usually have like sadness, happiness, but I seem to have more motivation to work on things, I enjoy music (except don't find any tracks beautiful or touching, but I do find some music to be uplifiting and energetic), and am feeling great overall. I go to sleep 11 o' clock and wake up a few times in a night, and wake up 8 o' clock after which I spend 3 hours in slumber (very light sleep, lost of dreams usually), and after 11 o' clock I get up. Except on schooldays I have to wake up 7 o' clock, which is hard but manageable. During summer I used to go to sleep in 1 am, but school set my bedtime to 11 pm.

 

I also seem to be learning things better than a year ago, which is nice. Overall I feel great and don't mind that this 10% taper will last me at least 1,5 years still. Better safe than sorry! :)

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scallywag

Thanks for posting such a positive and helpful update.  I'm happy to read that things are going well for you. :)

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herewego

Bokart,

if you can get your hands on some ORA-Plus and dissolve your olanzapine in say 10 ml of water, then add say 10 ml of ORA-Plus, it keeps the olanzapine evenly suspended throughout the solution.

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Bokart

Thank you for your advice, herewego. I actually bought a bottle of it and find it really nice: the medicine does spread evenly now! So now I'm on 4,5 mg of olanzapine - no withdrawal effects whatsoever so far. I'm even thinking of doing faster taper, to taper 10% every 3 weeks. But I don't know yet.

 

Anyways, I've come across a few reports from people that have tried to taper this drug, and a few have said that the real problem for them have started when they went below 2,5 mg. That's interesting, as by then the only receptors still occupied by the drug are more or less histamine and serotonin... I've read about antihistamine withdrawal and it seems it causes anxiety and insomnia.

 

But I'm interested about serotonin, particularly inverse agonism of it and withdrawal from that causes. I've read this link: https://rhochistj.org/RhoChiPost/differences-between-antagonists-and-inverse-agonists/and it mentions serotonin inverse agonist having an antipsychotic properties... interesting, and I would very much like to know what happens when such substance is withdrawn... will the receptors become hyperactive or slowly return from their inactive state to baseline? I'm guessing the former, as I just cannot believe the withdrawal process is being that peaceful to the affected receptors.

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herewego

Hi Bokart,

I'm glad the ORA-Plus worked for you & that you are having little withdrawal effects - that is great!

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Bokart

So it seems my beaker and/or medicine dropper isn't/aren't very accurate at measuring doses... When I measure 3 ml of liquid in my medicine dropper and put that amount in my beaker and do it 2 more times, I get 7,5 ml of liquid in the beaker, instead of 9 (3 times  3 ml should be 9 ml)... so it's 16,7% less than intended. However when I measure 1 ml of liquid into medicine dropper and add it to beaker 11 times, it adds up to being just over 10 ml in the beaker, so that's far better.

 

But I used the first method to reduce my dose... I mean I measured 2,7 ml in my medicine dropper and discarded it, instead of reducing 1 ml + 1 ml + 0,7ml in separate doses... So I didn't take 5,5 ml of olanzapine in August, I took more, which explains why the drop to 5 mg in 16th of August was harder than expected. It actually was a drop from 5,8 mg to 5 mg, so it was a 16% drop... not 10%.

Well, for now I'm going to always to do reductions in 1 ml increments, and not in one bulk dose, so I avoid the inaccuracy. And because 11 times 1 ml in the medicine dropper equals roughly 10 ml in my beaker, it means 1,1 ml will be 10%, so I have to take that into account too. So my next reduction next tuesday will be 1,1ml + 1,1 ml * 0,9 = roughly 2 ml, so 2 x 1 ml reduction.

Point out if my math fails somewhere, but I think I'm good to go now :P

PS: coffee doesn't seem to affect my sleep at all, I mean I took coffee at 9 pm yesterday and also the day before that, and slept as well as any night. Dunno what happens when the dopamine receptors are freed as the drug withdraws, so I'm still definitely keeping an eye on that though.

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scallywag

If you're using the same beaker and dropper for your doses, the fact that the measurements/doses are shifted from the true value isn't that important. It's more important that the dose is consistent - use the same equipment, take the dose at the time -- than that the dose is exactly 5.0 ml.

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Bokart

Yes, but I want a 10% drop, but the dropper isn't giving me that if I fill it up to more than 1 ml, I mean my next dose reduction is due in tuesday, I'm going to reduce 4,5 mg, to about 4,05 mg... a total of 19% reduction from 5 mg tablet. BUT if I take that reduction as a single dose in the dropper, it isn't the same reduction as the reducing it two times of max 1 ml in the dropper... The dropper seems to have the 3 ml marker in an wrong place, making it inaccurate. But the 1 ml marker seems to be in about the right place (as evidenced by my tests, 10 times the 1 ml dose was about 10 ml in the beaker).

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scallywag

Take 4 draws of 1 ml then.

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Bokart

Hello again everyone. I was thinking I could do a little summary of what's gotten better -or worse- compared to last autumn. This is for reference to me in the future and also to fellow withdrawers. So here we go:

Sociability. I've gotten more sociable, and I even make jokes. That's a good thing. Throughout the whole last school-year I was struggling with talking to people. Not a problem anymore.

Motivation. It's definitely risen (except in the morning). I do a lot of stuff throughout the day. Last school-year I had a really bad motivation to do anything... I dropped my studies too, due to not progressing in them.

Sleep. Much better than last school-year. Even getting out of bed is easier, even at 9 o' clock it's now feasible.... 7 o' clock is still hard. Compare to last year in which wgetting out of bed (which is very different than waking up I've noticed) before 11 o' clock was very hard. I haven't taken any benzodiazepine sleep-meds since last May. I used to take them at least once a week before that. This might have also gotten better due to lower stress levels, and that leads me to next thing:

Stress. I stress less often. Might be due to better suited studies (for me) I take now, so I don't know if I really tolerate stress better. This probably was the reason I had to increase my meds last autumn, as I was having lots of new and challenging situations to deal with back then: moving to my own (and all that that comes with it) and starting studying a new occupation. I don't seem to tolerate stress very well, at least not a year ago.

Learning. I can confidently say I learn things much better than last year. It WAS a struggle, not anymore. Thank God for that.

And the bad things which I still need to learn to cope with:

Stress/fear sensitivity. I seem to get stressed very easily. I experience fear more easily... actually there was one night I didn't sleep at all due to scary though I couldn't shake off. OK, I should have gotten up and drink a cup of tea when that happened; to reason with the thought, it wasn't very logical fear after all. Instead I just stubbornly tried to sleep and rolled in bed. But anyways, now I know better.

Distracting involuntary thoughts. This has actually been a problem since last autumn, but I think it's more pronounced now as many other of my problems have dissipated or dampened. This has stayed. Especially accompanied with stress and/or when I'm alone not doing anything of importance... So after a stressful schoolday I might be home, browsing the wed in almost obsessive manner. Then I might have these, a thought like "I kill everyone". Well, I find it distracting, but I don't really fear these, they just are. I guess if I've started to be afraid of them psychosis wouldn't be far away. But I know better. Now I have just to figure out what triggers them, or what triggers those triggers. All in all less stress = less of these thoughts. I can go forward with that in mind. And also more stress = more compulsive pastimes = more involuntary thoughts.

So, that's it for the past 12 months, and I think it's overall positive.

Also, I have switched to using 5 mg of liquid with my dissolving tablets, because ORA-PLUS costs 40-45€ and it lasts for 3 months if I use 5 ml of it each day (5ml of water + 5ml of ORA-PLUS), but it last for half a year if I use it only 2,5ml (+ 2,5ml of water) a day. Student's gotta save, and saving 7€ a month is very desirable (and I depend less on my mother, who doesn't have a lot of money anyways...)

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jmncrr

Bokart,

 

Glad your having success with your taper now, and doing well.

 

Have you had any withdrawal anxiety with your decreases in dosage, or any other withdrawals?

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Bokart

@jmncrr, no, or not noticeable at least. I had anxiety when I started vocational school last autumn, but it's up in the air if it was due to withdrawal or due to drastic changes in my situation in life, I think it was both though, but to what degree it was due to withdrawal, it's hard to say. My theory is that the more I taper the more it makes me susceptible to stress EDIT: and fear... maybe it cause direct anxiety when I get to lower doses, but I don't know yet.

As for the other withdrawal reactions, yes, my latest withdrawal insomnia was when I changed to 5 mg dissolving tablet from a 7,5 mg tablet (a halved 15mg dissolving tablet) dissolved in water tapered to 5,75mg by using a dropper and a beaker, so it was a 15% drop. It was intended to be 10% drop but because of the inaccuracy in my medicine dropper it was actually 15% (see my post here about it: http://survivingantidepressants.org/index.php?/topic/11253-bokart-withdrawing-from-olanzapine/#entry254541).However I managed that by going to sauna; actually I think sauna is better than sleeping meds in my case! Those nights I usually slept much better.

Before that I suffered from insomnia the whole last school year, but that was probably due to stress because it didn't go away even when I raised my dose, even up to 15 mg. (I dropped from that dose soon after though). I studied an unsuitable occupation for me and it very stressfull to me because I struggled to make progress This was my sleep 10 months ago:

 

"Right now my typical night is this: go to sleep between 9 and 10 pm, alarm set up at 6.55 am in workdays. My nights vary, fri-sat was a very good night with few awakenings, sat-sun night was good till 10 pm to 2 am (only 1 awakening in-between), and after that constant awakenings, sun-mon was horrible with seemingly no sleep (I woke up constantly, at least once per hour). All these nights can be explained: At friday I travelled to mom's, I almost always sleep the first night well there. Second night was my average night. Third night was back in my own place, and I usually have a bad first night there. Mon-tue night was slightly better than the night before, but still below my average night."

 

And of course I had insomnia when I cold turkey'ed olanzapine 5th March 2015, 3 weeks after I had first started this med, but that's also debatable how much of it was still my psychosis returning (since I was in it a 3 weeks before that) and how much was it due to withdrawal reaction.
 

So I think that's all, if I've forgotten something it can be found in somewhere in this thread though.

 

EDIT: I also have to mention, about sleep, that most of the evenings when I have to go to sleep, I don't feel tired at all. This has been this way since I started this medication. 5-6 nights a week are like this and 1-2 nights I'm actually sleepy when I go to bed.

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Bokart

Hi again, I just thought of updating my progress and maybe get some advice from you too.

So, it seems I have started waking up again at night-time, maybe 1-3 times a night or more(but I don't really count, I just want to go back to sleep). This isn't new, I had this almost through the whole last school-year. What's also not new is that I seem to be sleeping better at weekends, and worse at the start of the week when I have school.

 

But what's new is that I seem to have this strange feeling of "uneasy energy", or "low grade alert-mode", it's hard to name, but what really triggered me to post is that it started being more pronounced last weekend. I don't feel bad actually, just alert and more prone to fear, and if I have fear-reaction it is stronger than it ought to be. It's very close to being anxiety... at times it almost feels like it... but I don't know.

So I theorize this might be because my dopamine receptors are being freed from antagonism, which causes more dopamine in my system, which in turn causes more adrenaline in my system. I read from this page that dopamine raises adrenaline levels: http://mentalhealthdaily.com/2015/04/01/high-dopamine-levels-symptoms-adverse-reactions/

A quote:

 

"Stress: Those who experience high levels of stress such as those associated with a nervous breakdown may experience boosted dopamine production. This dopamine is produced by the sympathetic nervous system that senses “danger.” Dopamine also initiates the production of adrenaline, leading you to feel extremely alert and less relaxed."

 

So it would explain my (light) insomnia during week, bacause stress produces dopamine which produces adrenaline which reduces quality of sleep.

I must admit I have a habit of overanalyzing, but this just seems the likeliest explanation, because at these doses I'm at, the dopamine occupancy is dropping the most rapidly during reductions.

 

Which leads to coffee... maybe I should cut out coffee to see what happens. Maybe only 2-3 cups before 2 pm? Right now I'm taking coffee quite liberally, even at 9 pm, but if excess dopamine is the problem, then cutting caffeine would be the logical thing to do.

 

I must also say that so far I haven't experienced any loss of daytime-functionality due to worsened sleep quality... but maybe the influx of dopamine might have something to do with it? More dopamine I think means less feelings of tiredness.

But after all this I'm just left pondering that should I hold my dose for a bit longer or just go on (my next drop is in thursday)? I mean this doesn't feel serious because the symptoms are not very pronounced, but then again what hurt can it do to go slower? But I could also take the next reduction more easily because Christmas vacation starts soon, and I sleep better during holidays... I don't know.

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jmncrr

I take a dopamine norepinephrine  agonist (wellbutrin) with risperidone and paroxetine, and i find myself having more energy as i lower my risperidone. I don't however experience any increase in anxiety. However i am still on an ssri, and wellbutrin also has anxiolytic effect also, which may account for the lack of anxiety. Ive had no disturbances in sleep, and no other withdrawal symptoms to this point so far. Not sure if the release of dopamine is the cause of your uneasiness though, because lack of dopamine can cause anxiety as well, and your dopamine levels are just slowly returning to normal. I think you might be tapering too fast for yourself, and that might explain your insomnia. You do seem to have insomnia problems with your taper in the past. I would wait for my sleep to stabilize before any more reductions.

 

Good luck 

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ChessieCat

"Which leads to coffee... maybe I should cut out coffee to see what happens. Maybe only 2-3 cups before 2 pm? Right now I'm taking coffee quite liberally, even at 9 pm, but if excess dopamine is the problem, then cutting caffeine would be the logical thing to do."

 

I think reducing your coffee/caffeine intake would be the sensible thing to do.  I would suggest reducing gradually, maybe a few days not having the last cup and the penultimate one for a few days etc.  This way you will be less likely to feel the effect of reducing the caffeine.

 

One suggestion if you are using a granulated or powdered coffee is to combine it with a cereal beverage.  In Australia we have Caro and Ecco and you can buy dandelion coffee too I think.

 

Do you drink cola and/or other drinks (eg Red Bull) which contain caffeine?

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Bokart

jmncrr, yeah, and I don't really know what happens when the antagonism ends, does the dopamine go up or down, I just theorize it goes up, because when agonist is withdrawn it goes down. Don't ask me about inverse agonists... (olanzapine is an inverse agonist at 5HT2 receptor and I have no idea what happens when it withdraws from there). Thanks for your advice though, I take it into account.

 

ChessieCat, No, I don't drink any other caffeinated beverage, save some occasional cup of tea.

 

I have withdrawn from coffee (caffeine) many times in my life, and my only symptom has been a headache. But I still might follow your advice and do a gradual reduction. Today I took half the amount of coffee I usually take, and have felt nothing, but that's expected because I usually have started to feel it the next day after quitting (or in this case reducing).

Surprisingly today I haven't had any "uneasy energy", or "low grade alert-mode" today, actually I have felt very calm and at peace. This is also surprising because I had an early appointment today at 7 am, so I had to woke up at 6 am... I don't even remember when was the last time I had to wake up that early and I anticipated some stress due to this. But no, all fine, and waking up was not that hard (it usually is not hard if I have important appointment, somehow my subconscious overrides the morning fatique/sleepiness). I did wake up 2 times in the night, but overall I felt fine in the day.

I'm contemplating to hold this dose for 5 extra days, but I will also see how tomorrow goes.

Thank you all for your advice so far, it's appreciated.

Bokart

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Renewedmind

Bokart,

Reading through your updates gives me hope at the current moment. Hopefully I too will be starting a liquid taper of olanzapine very soon. 

 

I too am a night shift worker. I have been for two years and started having trouble with sleep this summer. Psychosis due to sleep deprivation terrifies me and is something that I want to avoid, which has left me no choice but to go back on olanzapine. I cannot afford to lose my job.

 

I am going to follow your updates and am wishing you a successful journey in tapering off of this miserable drug.

 

Are you still using Temazepam for sleep? My doc has prescribed it for me to use as a last result if I cannot get to sleep days on end. Although I have not had to use it. How many miligrams do you use and how long does it let you sleep when you can't naturally?

 

Wishing you a successful journey in getting off of this med!

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Bokart

Bokart,

Reading through your updates gives me hope at the current moment. Hopefully I too will be starting a liquid taper of olanzapine very soon.

 

I too am a night shift worker. I have been for two years and started having trouble with sleep this summer. Psychosis due to sleep deprivation terrifies me and is something that I want to avoid, which has left me no choice but to go back on olanzapine. I cannot afford to lose my job.

 

It's good that you are careful, it's really a necessity when tapering. It's great we have a site like this, it's great information and great people that help us, I don't know where I would be if I didn't find this site. And I too have to be functional at school, I don't think it could happen with faster taper, even if I could pull it off.

 

And about my psychosis, I have come to understand it was a sum of many factors: my trait of punishing myself for error coupled with following a religious teaching, an unbearable social circumstance (right before psychosis), and my sensitive personality type. I mean, I worked in newspaper delivery, and I scratched both my mother's and my uncle's car at my work ( I didn't have my own car and they kindly provided me their's as long as I pay all the costs for the use of them)... I had trouble falling to sleep some weeks after those incidents, After falling asleep I actually thought my room's wall opposite my bed was a mailbox and had some kind of dream that I was colliding my car to it and I of course pushed the brakepedal with all my might (I actually pushed the edge of my bed with my foot). I woke up after I realized it was dream, but only after moments of extreme stress and pushing the edge of my bed with my leg. First time I had those kind of dreams, where I actually sit in my bed, eyes open, pushing the edge of my bed, and still be "dreaming" in some level.

 

 

I am going to follow your updates and am wishing you a successful journey in tapering off of this miserable drug.

 

Thank you, so far it's going well. By the way, I felt good today and yesterday too, and decided to taper 10% today as planned. Finger's crossed it was a good decision, but if the same symptoms appear, they might appear at the end of the month like in this month, and it's Christmas vacation then, and those symptoms didn't even feel that bad to be honest. Just a tad worrying.

 

 

 

Are you still using Temazepam for sleep? My doc has prescribed it for me to use as a last result if I cannot get to sleep days on end. Although I have not had to use it. How many miligrams do you use and how long does it let you sleep when you can't naturally?

 

Haven't used a pill since May. I used 40 mg because 20 mg wouldn't have an effect on me, which surprised my doctor. The drug let me sleep with only 1 interruption per night from 10 pm to 8-9 am instead of waking up up to 4 times a night and sleeping to 5 to 7 am. Using the pills might become relevant after I'm closing 2 mg, when the medicine is starting to withdraw from H1 histamine receptor (wiki link for reference: https://en.wikipedia.org/wiki/Histamine_receptor).By the way, at your dose (1 mg) I think at that dose olanzapine only binds to histamine, causing mainly sedation. You can imagine this medicine like on the lastpsychiatrist's blog:

fountain.JPG

The site: http://thelastpsychiatrist.com/2007/07/the_most_important_article_on.html

 

The image's about quietapine, but the concept is the same on olanzapine. In case of Olanzapine, H1 is the highest level too, difference is that the second level is 5HT2A (might also cause sedation), and the third level is D2. So when you up the dose, at certain thresholds, the drug begins to affect different type of receptors. (So I've a plan that if/when my sleep begins to suffer more (when reduction nears 2 mg [my guess] I might begin to take temazepam 1 times a week, but only if I really have to)

 

 

I too wish you a successful journey in getting off of this med!

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Bokart

Quick update. I'm doing well. Actually great. Have a 4 day vacation from school which ends tomorrow. Sleep is good as expected (vacation) even though I wake about 2 times in the middle of the night and about hourly if I sleep after 8 o' clock (or 7 am, haven't really inspected this). I also seem to have a fluctuation mood, at least yesterday I had a really high mood for an hour or two and then after that slightly anxious mood for a few hours... just enough anxious that I noticed it, so not that anxious.

I don't actually care about my awakenings like last school-year. It's easy to take it easy when you feel good, and so this might be just temporary thing. Hopefully my happy feelings last.

I bought magnesium oil, to help with my aching muscles, and maybe with sleep too.

So I'm adding these supplements to my regime:

Zinc in the morning
Magnesium in the evening
... and maybe vit. D3 as I have them and it's winter and I live in the north. These in the morning as I read somewhere it's activating.

I take only these supplements and nothing else. Oh, and maybe I'll add them one at a time to see what effects they cause (like adviced in these forums). Should I add fish-oil? I don't have much money so I don't want to take unneeded supplements. I only take zinc because I bought a bottle of it last year when I had low motivation and tried to seek some help to it.


Good tapering to all of you!

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Bokart

Quick update (and for my future reference too):

 

I forgot to tell here last time that it's been 3 weeks since nearly all my intrusive thoughts stopped! I don't know how this happened, but either way it's very nice. I still have stress, but it just doesn't trigger the thoughts anymore.

 

Second, my libido has, I think, now returned completely.

 

Third, it's seems I can get insomnia from excitement! Reminds me of one pre-psychosis day I was so in euphoria I couldn't sleep the whole night... It was a supposed "spiritual experience", or my imagination was in overdrive... I mean in psychosis my imagination literally took over so it might have been the starting point to my decline. But I'm refraining from all practices & beliefs that led to the start of my medication until I make sense of all my experiences and establish some safe perimeters for spiritual exercise. My mind still likes to play "benevolent spirit" to me when I'm meditating... I don't think real spirits answer my questions whenever I make them and start conversations with me (when I meditate), nope, just my mind playing tricks. I just read about cpuusage's post about Emmanuel Swedenborg: http://survivingantidepressants.org/index.php?/topic/13116-spirituality-philosophy-etc/?p=248945 and from that I take my "voices" would be of the lower order. Or my imagination, not sure.

 

Fourth, how can I lose weight? I have gained too many kilos and seem unable to shed any weight... And it's hard to refrain from sugar since I have sometimes enormous cravings for them... I don't like my body weight, and olanzapine + being overweight = high probability for diabetes. What I've done so far to control my weight is that I changed all carbohydrates (potatoes, pasta, rice, etc) to cauliflower, broccoli and Brussels sprouts.

Except that I still get a lot of carbohydrates from my free school meal, which for monetary reasons I won't skip. It's hard when you don't have money for decent food... Can I take some supplements to control my hunger? I think my mother will be supportive in my goal to lose weight, and might support me financially to reach it if need be. Is low-carbohydrate diet the way to go?

 

Thank you all and the best of success to your tapering,
Bokart

 

PS: had a slight anxiety today for maybe an hour, so nothing serious. So far my taper is progressing steadily.

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Bokart

Hello again. Some updates are due.

RE: gaining weight and diabetes, I think I can control it with yoghurt mixed with oat bran, 1 dl of oat bran really stops the hunger, but I still find that if I eat even a little bit of something sugary in the evening, my sugar cravings increase 10-fold, hard to stop after that point.

 

Also my fasting glucose lab test results arrived this weeks, and it was slightly over the maximum recommended value (max is 5, I had 6 point something). My nurse said that I just have to change my dietary habits, and I agree... Im working on it. I will also request all the results in paper so I can check them myself.

 

I will also cut coffee completely next week and will switch to tea and hot chocolate. Also, only herbal tea in the evening because even black/green tea has caffeine.

 

Adding magnesium has been fine. Sleep has been normal, but I don't have sleeping problems at the moment, except the sunday-monday night which I will sleep poorly due to stress. I find magnesium is a great muscle relaxant too, and the pain in the back of my hand has lessened when I started spraying magnesium on it. The pain started a month ago, out of nowhere, it's in the left hand. Also my lower back on the left side also has pains. I should do something about this... my mother also noticed my feet aren't the right way when I stand, so there's some kind of misposture... It might be the original cause of my left side back/neck/hand problems... I have to stop the problem from going worse.

 

All the best for you all,

Bokart

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scallywag

If you're reducing caffeine overnight, please be prepared for the possibility of 4-7 days of feeling fatigued and irritable.

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