Boomer: Olanzapine + Effexor XR + others

[mammaP]

I am glad that your husband was calmer, it is a good sign. He was taking 112 some days and 150 on other days before settling on 112   so needs to stay there for a while to get stable.  It is really promising that he was calmer yesterday, he is starting to get more stable. This must be really hard for you both, it isn't easy watching someone you love suffer, you have a great need to do something but sometimes the best thing to do is nothing, just be there and keep him as comfortable as possible, encouraging him to move around as he is able and take food and drinks. He will get better, he really will. 

 

[Boomer]

I am glad that your husband was calmer, it is a good sign. He was taking 112 some days and 150 on other days before settling on 112   so needs to stay there for a while to get stable.  It is really promising that he was calmer yesterday, he is starting to get more stable. This must be really hard for you both, it isn't easy watching someone you love suffer, you have a great need to do something but sometimes the best thing to do is nothing, just be there and keep him as comfortable as possible, encouraging him to move around as he is able and take food and drinks. He will get better, he really will. 

 

Thank you for your encouraging words.

[JanCarol]

Hey Boomer - 

 

I'm so sorry for what you and your husband have been through.

 

I don't have much to add to the excellent suggestions already made here, and you've been sent on enough research to last a month or more!

 

The only thing I have to add - especially since you are a carer, looking after someone, is a list of potential symptoms.   This is not a complete list, just a list of the most common side effects of psych drug withdrawal:

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

You may print out several copies and use it as a log to track his progress, and note how he responds to the tiny changes that you will be making from here on in.

 

Once he's stabilized for a month, you can start counting beads and bringing him down.  

 

Yes, the process is long, but - you noticed "himself" starting to peek through at 112 mg - so as you get down to 75 mg and below, he will be more able to start participating in the process.  Once he is more "awake," the rewards of slow, careful tapering will become more evident.

 

Hang in there - it is a slow process, but it does get better.

 

And - Karen had excellent advice about taking care of yourself.  You cannot take care of him if you get all frazzled and burned out - so be sure and find ways to take breaks for yourself.  Maybe they will be brief moments where you step outside and take a breath of fresh air before going back to your carer role - or maybe you are lucky enough you can go for a massage or take an epsom salts bath to relax.  The better you take care of you, the better you will be able to help him.

 

He's really lucky to have someone like you looking out for him.  HINT:  sometimes it's not best to tell the psychiatrist EVERYthing.  Sometimes you tell him what he wants to hear so that he gives you what you want (work release, new scripts, etc.).  There is one couple here who works out a play-acting script of he-says, she-says to convince the doc that everything is as he thinks it should be - then take their scripts and run, giggling all the way home.  Very few doctors understand this process:  What Should I Expect From My Doctor About Withdrawal Symptoms?   Another strategy is to not talk about "going off meds" (that just scares them into thinking more drastic action is needed) - but instead to talk about "lowest effective dose" to minimize drug load.  They usually like that one.

 

I wish you the best on this journey, and look forward to hearing your tales of his healing.  It does get better.

[Boomer]

Hey Boomer - 

 

I'm so sorry for what you and your husband have been through.

 

I don't have much to add to the excellent suggestions already made here, and you've been sent on enough research to last a month or more!

 

The only thing I have to add - especially since you are a carer, looking after someone, is a list of potential symptoms.   This is not a complete list, just a list of the most common side effects of psych drug withdrawal:

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

You may print out several copies and use it as a log to track his progress, and note how he responds to the tiny changes that you will be making from here on in.

 

Once he's stabilized for a month, you can start counting beads and bringing him down.  

 

Yes, the process is long, but - you noticed "himself" starting to peek through at 112 mg - so as you get down to 75 mg and below, he will be more able to start participating in the process.  Once he is more "awake," the rewards of slow, careful tapering will become more evident.

 

Hang in there - it is a slow process, but it does get better.

 

And - Karen had excellent advice about taking care of yourself.  You cannot take care of him if you get all frazzled and burned out - so be sure and find ways to take breaks for yourself.  Maybe they will be brief moments where you step outside and take a breath of fresh air before going back to your carer role - or maybe you are lucky enough you can go for a massage or take an epsom salts bath to relax.  The better you take care of you, the better you will be able to help him.

 

He's really lucky to have someone like you looking out for him.  HINT:  sometimes it's not best to tell the psychiatrist EVERYthing.  Sometimes you tell him what he wants to hear so that he gives you what you want (work release, new scripts, etc.).  There is one couple here who works out a play-acting script of he-says, she-says to convince the doc that everything is as he thinks it should be - then take their scripts and run, giggling all the way home.  Very few doctors understand this process:  What Should I Expect From My Doctor About Withdrawal Symptoms?   Another strategy is to not talk about "going off meds" (that just scares them into thinking more drastic action is needed) - but instead to talk about "lowest effective dose" to minimize drug load.  They usually like that one.

 

I wish you the best on this journey, and look forward to hearing your tales of his healing.  It does get better.

Thank you JanCarol I appreciate the information you have provided in your post.  Interestingly with this Psych he wants to taper him off Effexor XR but his idea of tapering and SA idea of tapering is quite different.  He told me there is no proven safe method of tapering!!  He reduced to 112mg capsules because as you most probably are aware Effexor comes in 37mg, 75mg 150mg.  But the reduction caused my husband to have terrible withdrawals and I find it too distressing.  He wants to reduce him to 75mg which is a drop of 37mg on our next appointment which is 14th June.  Just wondering if you know of an official document that I could hand to him that states the taper needs to be 10% or less every month?  The last few days I notice my husband is extremely tired and with that he 25% more stable.  This morning he slept the longest in months - 10 hours!  The Psych also said to start reducing my husband off the Olanzapine a day or two before our appointment!  Oh dear!

[Boomer]

I am just wondering about which drug should I taper when my husband is more stable please?  The Psych wants him off the 2.5mg Olanzapine as soon as possible and also the  Effexor.  I am finding it difficult to read alot at the moment as I feel under stress. So I hope you don't mind me asking.  Thanks

[mammaP]

When was olanzapine added? I can see that he has been on  and off it a few times. 

 

You could print off this paper to show the psychiatrist, he might take notice of something scientific! 

 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

He is lowering doses by the size of capsules, so if he carries on writing scripts  for 112mg, (1x75 and 1 x 37.5 ) you could count the beads in the 37.5 to get the 10% reduction, or use a scale to weigh them. When you have tapered down to 75 you could then tell the psychiatrist he is ready to go to 75. and ask for 37.5 caps so it will be easier to carry on counting instead of counting from 75mg.  Does that make sense?  

[Boomer]

When was olanzapine added? I can see that he has been on  and off it a few times. 

 

You could print off this paper to show the psychiatrist, he might take notice of something scientific! 

 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

He is lowering doses by the size of capsules, so if he carries on writing scripts  for 112mg, (1x75 and 1 x 37.5 ) you could count the beads in the 37.5 to get the 10% reduction, or use a scale to weigh them. When you have tapered down to 75 you could then tell the psychiatrist he is ready to go to 75. and ask for 37.5 caps so it will be easier to carry on counting instead of counting from 75mg.  Does that make sense?  

Thanks MammaP - Hubby started 2.5mg Olanzapine on 25th May 2016.  I will have alook at the information provided.  Thank you.

[nz11]

The way i see it you have two choices

1. you tell the psych what YOU are doing or

2. Just say yes to the psych ideas and then follow sa advice covertly

[Boomer]

The way i see it you have two choices

1. you tell the psych what YOU are doing or

2. Just say yes to the psych ideas and then follow sa advice covertly

Thans NZ11

[Boomer]

My husband is in bad withdrawals - started late last night and is still very unstable this morning.  I now have to give him fluids and feed him.  He has some unusual thinking about the food and drink.  He keeps telling me it to too late, its gone on too long.  He talks to himself.He is very agitated and I find it difficult to calm him down. I am wondering if I should hang in there or reintroduce the effexor slowly?  I really want the best for him.  

[btdt]

 10mg Olanzepine and 75mg Effexor XR then increased it up to 150mg.  He was released after three weeks. He was on Olazepine for about three months and the Psychiatrist reduced him off that

 

could it be the olanzepine wd?  I am putting this out there to the mods as I don't know the drug.  

 

If I had found this thread earlier I would have suggested you put him in an epsom salt bath with 2 cups of epsom salts for 12 minutes... if he will stay there.  It may help calm him and could help his liver detox the drugs. 

 

I still think a bath could be helpful... a cup of warm water with the juice of half a lemon... could help. If he will eat some boiled beets it could help. 

 

Does he have any torso pain?  

 

I would not worry that he talks to himself I did  that for years in wd I did it to talk myself thru things as I could not think... I also talked to myself even when other people were in the room I could have talked to.  For me it was part of thinking I could not think without talking myself through it... this may actually be a good sign that his brain is trying to work. Since he is a bit like I was it could be that the beets could help if he would eat them... or the lemon and water the water has to be warm. Effexor is hard on the liver I don't know about the other drug. 

 

I hope things turn around soon for you both

peace

[JanCarol]

Boomer, do you feel safe?  I know he is very agitated and frustrated, but do you need help taking care of his body until his mind comes back?

 

In the days before psychiatry (18th-19th century), the Quakers took it upon themselves to care for patients in distress.  Many of whom would be now considered "psychotic," or "schizo-something" or just "stark raving mad."  It was called the Moral Treatment.

 

What they did was take care of the body, and listen.  They were not doctors or nurses or specialists.  Just people who listened, and food, and sunlight and rest.  And after a time, people got better.

 

Right now, I know your frustration at not being able to reach him or get through to him.  I know this frustration, as I have lost friends deeply down the rabbit hole of their minds.  Sometimes all you can do is wait for them to return.  They will return.

 

Just a few days ago, his symptoms were improving (by about 25% you said).  That gives me great hope that he can improve.

 

The drugs complicate things; the Quakers didn't have this complication.  But if you can be calm, and reassuring, and comforting, and nourishing and just be there for him, keep him safe, and wait -  the waves will pass, and things will settle.

 

Can you get others in to help you?  This is a 24/7 job, and the Quakers had each other to help out.  Do you belong to a church where people can just come and help, and sit and listen and offer comfort?  Do you have access to respite?  Are there good friends who understand what is going on, and can help sit watch with you?

 

Is there anything your husband seems to enjoy right now - football?  TV shows?  Is it safe to take him outside for walks?  Or even sit in the yard, like the Quakers, and let him soak up some green colors and fresh air?

 

If the job is getting to be too much, or you feel unsafe in any way, it is possible that you need to get him to a hospital.  You can try and convince them that he is under medical care, his doc is "overseas" and hubby just needs to be kept safe until his "med changes" settle down; that is a good option.

 

I do not think it is a good idea to let the doctor taper him when he is symptomatic.  Convince the doctor that he's still upset from the last taper, and that he needs to continue 112.5 for awhile.  

 

So much rests on your shoulders right now, dear lady.  I feel for you at this time.  I hope you can get some help in to manage him, or even get him to safety in a hospital.  You kind of lose control in a hospital - they might put him on more drugs, or they might "commit" him - I don't know the laws in NZ.  But if you keep a cool head, and explain carefully that this is all due to a "med change," the emergency rooms see quite a lot of these sorts of things, and you might get lucky - a safe place for him, and a respite for you.

[Altostrata]

Yesterday was the first time in three weeks that my husband was alot calmer.  Still can't focus, concentrate and takes along time (an hour or more) to get his brain to process actions.

 

Boomer, what was his drug schedule on May 30 and June 1? What was his symptom pattern?

 

Please keep daily notes on paper about symptoms, when he takes his drugs, and their dosages.

 

Thank you JanCarol I appreciate the information you have provided in your post.  Interestingly with this Psych he wants to taper him off Effexor XR but his idea of tapering and SA idea of tapering is quite different.  He told me there is no proven safe method of tapering!!  He reduced to 112mg capsules because as you most probably are aware Effexor comes in 37mg, 75mg 150mg.  But the reduction caused my husband to have terrible withdrawals and I find it too distressing.  He wants to reduce him to 75mg which is a drop of 37mg on our next appointment which is 14th June.  Just wondering if you know of an official document that I could hand to him that states the taper needs to be 10% or less every month?  The last few days I notice my husband is extremely tired and with that he 25% more stable.  This morning he slept the longest in months - 10 hours!  The Psych also said to start reducing my husband off the Olanzapine a day or two before our appointment!  Oh dear!

 

Boomer what was your husband's drug schedule on June 3 and June 4?

 

The psychiatrist is correct, psychiatry doesn't know any proven safe method of tapering. That is why this site exists. Every single person here was either misinformed or misdirected by a doctor about tapering

 

You're going to have to ask the doctor to stop changing your husband's drugs, the changes are causing him problems.

 

Meanwhile, if you have a steady prescription, you can make plans to taper gradually.

 

Please tell your husband he is experiencing adverse effects of psychiatric drugs. He has not lost his mind. He is frightened and expressing himself in ways -- such as he wants to kill himself -- that will cause a psychiatrist to prescribe more and more drugs.

 

Being afraid of his symptoms is making his situation so much worse. Please ask him to stay as calm as possible while the two of you dig him out of this.

 

What exactly is he taking now? Is he taking any drugs other than Effexor and olanzapine?

[Boomer]

 10mg Olanzepine and 75mg Effexor XR then increased it up to 150mg.  He was released after three weeks. He was on Olazepine for about three months and the Psychiatrist reduced him off that

 

could it be the olanzepine wd?  I am putting this out there to the mods as I don't know the drug.  

 

If I had found this thread earlier I would have suggested you put him in an epsom salt bath with 2 cups of epsom salts for 12 minutes... if he will stay there.  It may help calm him and could help his liver detox the drugs. 

 

I still think a bath could be helpful... a cup of warm water with the juice of half a lemon... could help. If he will eat some boiled beets it could help. 

 

Does he have any torso pain?  

 

I would not worry that he talks to himself I did  that for years in wd I did it to talk myself thru things as I could not think... I also talked to myself even when other people were in the room I could have talked to.  For me it was part of thinking I could not think without talking myself through it... this may actually be a good sign that his brain is trying to work. Since he is a bit like I was it could be that the beets could help if he would eat them... or the lemon and water the water has to be warm. Effexor is hard on the liver I don't know about the other drug. 

 

I hope things turn around soon for you both

peace

Unfortunately we don't have a bath so can't do that and anyway I would have to help into the bath and out and it would be too much.  He has no torso pain.  It has been difficult enough to get him to eat any food so I doubt whether he would co-operate with beets.  But thanks for your concern and suggestions. 

[Boomer]

 

Yesterday was the first time in three weeks that my husband was alot calmer.  Still can't focus, concentrate and takes along time (an hour or more) to get his brain to process actions.

 

Boomer, what was his drug schedule on May 30 and June 1? What was his symptom pattern?

 

Please keep daily notes on paper about symptoms, when he takes his drugs, and their dosages.

 

Thank you JanCarol I appreciate the information you have provided in your post.  Interestingly with this Psych he wants to taper him off Effexor XR but his idea of tapering and SA idea of tapering is quite different.  He told me there is no proven safe method of tapering!!  He reduced to 112mg capsules because as you most probably are aware Effexor comes in 37mg, 75mg 150mg.  But the reduction caused my husband to have terrible withdrawals and I find it too distressing.  He wants to reduce him to 75mg which is a drop of 37mg on our next appointment which is 14th June.  Just wondering if you know of an official document that I could hand to him that states the taper needs to be 10% or less every month?  The last few days I notice my husband is extremely tired and with that he 25% more stable.  This morning he slept the longest in months - 10 hours!  The Psych also said to start reducing my husband off the Olanzapine a day or two before our appointment!  Oh dear!

 

Boomer what was your husband's drug schedule on June 3 and June 4?

 

The psychiatrist is correct, psychiatry doesn't know any proven safe method of tapering. That is why this site exists. Every single person here was either misinformed or misdirected by a doctor about tapering

 

You're going to have to ask the doctor to stop changing your husband's drugs, the changes are causing him problems.

 

Meanwhile, if you have a steady prescription, you can make plans to taper gradually.

 

Please tell your husband he is experiencing adverse effects of psychiatric drugs. He has not lost his mind. He is frightened and expressing himself in ways -- such as he wants to kill himself -- that will cause a psychiatrist to prescribe more and more drugs.

 

Being afraid of his symptoms is making his situation so much worse. Please ask him to stay as calm as possible while the two of you dig him out of this.

 

What exactly is he taking now? Is he taking any drugs other than Effexor and olanzapine?

 

Thanks Altostrata for your reply.  Husband drug schedule is  Olanzapine 2.5mg at night before bed and 112mg Effexor in the morning and it has been this way for a couple of weeks.  It is difficult to stay calm when like the other morning he wakes in absolute panic at 5.45am and it became difficult to calm him down and then he doesn't want to eat his breakfast (he is skin and bone) or take his meds in the morning.  I am also giving him a formulated meal replacement which is a powder that is mixed with milk.   He can't find the words to speak, his cognitive function is hugely impaired.  Sometimes he cannot get the toothbrush up to his mouth - he will try several times.   It sounds like I really need to stand up and say I am not going to taper until he is more stable!

[Boomer]

 

Yesterday was the first time in three weeks that my husband was alot calmer.  Still can't focus, concentrate and takes along time (an hour or more) to get his brain to process actions.

 

Boomer, what was his drug schedule on May 30 and June 1? What was his symptom pattern?

 

Please keep daily notes on paper about symptoms, when he takes his drugs, and their dosages.

 

Thank you JanCarol I appreciate the information you have provided in your post.  Interestingly with this Psych he wants to taper him off Effexor XR but his idea of tapering and SA idea of tapering is quite different.  He told me there is no proven safe method of tapering!!  He reduced to 112mg capsules because as you most probably are aware Effexor comes in 37mg, 75mg 150mg.  But the reduction caused my husband to have terrible withdrawals and I find it too distressing.  He wants to reduce him to 75mg which is a drop of 37mg on our next appointment which is 14th June.  Just wondering if you know of an official document that I could hand to him that states the taper needs to be 10% or less every month?  The last few days I notice my husband is extremely tired and with that he 25% more stable.  This morning he slept the longest in months - 10 hours!  The Psych also said to start reducing my husband off the Olanzapine a day or two before our appointment!  Oh dear!

 

Boomer what was your husband's drug schedule on June 3 and June 4?

 

The psychiatrist is correct, psychiatry doesn't know any proven safe method of tapering. That is why this site exists. Every single person here was either misinformed or misdirected by a doctor about tapering

 

You're going to have to ask the doctor to stop changing your husband's drugs, the changes are causing him problems.

 

Meanwhile, if you have a steady prescription, you can make plans to taper gradually.

 

Please tell your husband he is experiencing adverse effects of psychiatric drugs. He has not lost his mind. He is frightened and expressing himself in ways -- such as he wants to kill himself -- that will cause a psychiatrist to prescribe more and more drugs.

 

Being afraid of his symptoms is making his situation so much worse. Please ask him to stay as calm as possible while the two of you dig him out of this.

 

What exactly is he taking now? Is he taking any drugs other than Effexor and olanzapine?

 

I meant to add in my previous post to you whether I should slowly reinstate to relieve his symptoms or because it has been too long to try and ride it out?

[KarenB]

It sounds like evening is the best time to try and get nourishment into your husband, plus do other things like cleaning teeth.  Can you have soothing things ready to go when he wakes in the morning - such as gentle music or something else he likes?  It may also help you to get through those hours. 

 

I'm not sure what your specific diet requirements are, so I thought I'd outline what I'd be giving my hubby if he needed good nourishment at a crisis time.  If anything appeals, you can give it a try. 

 

-Bone & vegetable broth, perhaps with some himalayan rock salt (it has heaps of minerals).

-Coconut oil and/or cream

-Avocado

-Eggs, either cooked, or raw in a smoothie with fruit/berries

-Cheese

-Milk

 

Really feeling for you right now Boomer.  There are some limited care options in NZ (which you may already be aware of) such as http://www.access.org.nz/get-started/funding-options It's often hard to qualify for those things, but might be worth a look.

[JanCarol]

 It is difficult to stay calm when like the other morning he wakes in absolute panic at 5.45am and it became difficult to calm him down and then he doesn't want to eat his breakfast (he is skin and bone) or take his meds in the morning.  

 

This sounds like a cortisol spike, a common occurrence in withdrawal and drug changes.  Please see:  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

 

to see what you can do for him about this.  I use a blindfold to keep my sleep from interruption, but he may not feel safe with that.  

 

You may achieve some benefit from black-out curtains (if you have to, tape heavy trash bags over the windows until you can get something more permanent in place.  Ugly, but effective!).  There may be other tips you can learn from on the thread about cortisol spikes.

 

How are you holding up?

[Altostrata]

In late January 2016, your husband was on 10mg olanzapine. Why was Effexor added then?

 

After 2.5mg olanzapine was added May 25, was he better or worse?

 

Is he better or worse since the Effexor was recently reduced from 150mg to 112mg?

 

You mentioned he's better in the morning before he takes Effexor, is this still true?

[Boomer]

In late January 2016, your husband was on 10mg olanzapine. Why was Effexor added then?

 

After 2.5mg olanzapine was added May 25, was he better or worse?

 

Is he better or worse since the Effexor was recently reduced from 150mg to 112mg?

 

You mentioned he's better in the morning before he takes Effexor, is this still true?

 

In late January 2016, your husband was on 10mg olanzapine. Why was Effexor added then?

The Olanzapine 10mg and the Effexor XR 150mg was reinstated when he was admitted to hospital.  

 

After 2.5mg olanzapine was added May 25, was he better or worse?

Regarding the 2.5mg Olanzapine I am unsure whether it has really helped him, it seemed to help with his sleeping but he is still saying unusual stuff.  

 

Is he better or worse since the Effexor was recently reduced from 150mg to 112mg?

Since his reduction from 150mg to 112mg he is worse - much worse and still deteriorating.  That is why I wondered whether to reintroduce the Effexor.  When on 150mg even though he couldn't think well and seemed flat - no emotion at least he was stable.  Yesterday he had difficulty with finding his words to speak and last night he lost his speech and this morning woke at 3am in a terrible state - agitated as he couldn't speak at all.  The words have returned at 9am today but he is very agitated and believes he has lost it (I am assuming insane).    

 

You mentioned he's better in the morning before he takes Effexor, is this still true?

For the first couple of days before taking the 112mg Effexor I noticed some of his old self return but that only lasted a few days and then he has been up and down since then.  Actually more down than up.

 

Hope this helps to answer your questions and shine some light on this awful situation.  Thanks in advance for any assistance.

After 2.5mg olanzapine was added May 25, was he better or worse?

[Boomer]

 

 

 

 It is difficult to stay calm when like the other morning he wakes in absolute panic at 5.45am and it became difficult to calm him down and then he doesn't want to eat his breakfast (he is skin and bone) or take his meds in the morning.  

 

This sounds like a cortisol spike, a common occurrence in withdrawal and drug changes.  Please see:  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

 

to see what you can do for him about this.  I use a blindfold to keep my sleep from interruption, but he may not feel safe with that.  

 

You may achieve some benefit from black-out curtains (if you have to, tape heavy trash bags over the windows until you can get something more permanent in place.  Ugly, but effective!).  There may be other tips you can learn from on the thread about cortisol spikes.

 

How are you holding up?

 

Hi JanCarol - Thanks for that - we do have blackout curtains.

[mammaP]

Hi Boomer, I am having computer problems and might not be about for a few days but just wanted to check in and say that I think you are doing amazing and your husband will be so proud of you when he is through this. We are trying to work out if the problem is withdrawal or adverse reaction to either effexor or olanzapine . Do you think he is worse since reinstating olanzapine? I know we ask so many questions and it must be so annoying but it is important to get it right. I truly hope that there is some improvement very soon.

[Boomer]

Hi Boomer, I am having computer problems and might not be about for a few days but just wanted to check in and say that I think you are doing amazing and your husband will be so proud of you when he is through this. We are trying to work out if the problem is withdrawal or adverse reaction to either effexor or olanzapine . Do you think he is worse since reinstating olanzapine? I know we ask so many questions and it must be so annoying but it is important to get it right. I truly hope that there is some improvement very soon.

Thanks MammaP I really don't mind you asking as I would like to see him more stable before our appointment with Psydoc on 14th June.  His condition is more of less the same as when he crashed in January 2016 after he had tapered off the Effexor Xr six months earlier.  He was agitated, anxious, psychotic, speech problems, cognitive impairment basically all that I have mentioned in previous posts.

[Boomer]

Hubby not having a good day today.  Regained his speech which is a relief but he is muttering and saying unusual things, I can't have a conversation with him he is not with it.  He is not in a good place.  I am trying to work out whether I should reinstate a higher dose of Effexor to try and stablise him or it too late as he has been on the 112mg for about three weeks and I feel like I am living in a nightmare!

[Boomer]

Is anyone able to provide information on whether it is better to hold at the lower dose and ride through the terrible withdrawals that my husband has been experiencing for over three weeks or to reinstate.  If I am not allowed to ask this question on this forum could you please advise?  Thank you.

[apace41]

Boomer,

 

There is no restriction on asking about up-dosing or reinstatement. I think people are pretty unsure about what the best path is at this point and nobody wants to make things worse. The reality is that there is no magic formula in this stuff. Our general advice would be that bouncing around in dose is likely to be more destabilizing than simply holding at 112. Having said that, reasonable minds could differ and someone might rationally think going back up to 150 would make sense.

 

Personally, I would advocate holding where you are and hoping he stabilizes here. Wish it were more cut and dry but this is an art and not a science.

 

Best,

 

Andy

[Boomer]

Boomer,

 

There is no restriction on asking about up-dosing or reinstatement. I think people are pretty unsure about what the best path is at this point and nobody wants to make things worse. The reality is that there is no magic formula in this stuff. Our general advice would be that bouncing around in dose is likely to be more destabilizing than simply holding at 112. Having said that, reasonable minds could differ and someone might rationally think going back up to 150 would make sense.

 

Personally, I would advocate holding where you are and hoping he stabilizes here. Wish it were more cut and dry but this is an art and not a science.

 

Best,

 

Andy

Thanks Andy I appreciate your reply.  I have made a decision to hold at 112mg and will try to ride it through.

[Boomer]

Oh my gosh - my husband has deteriorated further - he is finding it difficult to swallow and talks to me in a whisper!  

[nz11]

I am so sorry you are in this difficult position.

[JanCarol]

Hey Boomer, please hang in there.  Please - we're really worried about a drug reaction here - so I believe it is important to not change dose if at all possible.

 

How are you going?  Are you able to rest and sleep and eat yourself?

 

Did it help to move his hygiene and eating to the late afternoon / early evening like Karen suggested?

[Altostrata]

Boomer, what time of day does he take olanzapine? What happens after that? Can he explain how it makes him feel?

 

How bad is the swallowing problem? Can he eat applesauce and smoothies?

[Boomer]

Boomer, what time of day does he take olanzapine? What happens after that? Can he explain how it makes him feel?

 

How bad is the swallowing problem? Can he eat applesauce and smoothies?

Olanzapine 2.5mg is taken when he is in bed ready for sleep.  He usually just goes to sleep.  I have to feed him small pureed amounts at a time.  On two occasions I have seen him swallow and then he looks very uncomfortable in the face and his eyes fill with water.  This morning he said he couldn't swallow his Effexor but after alot of talking and prompting he managed to get it down.  I spoke to his key worker at Mental Health this morning as I wasn't sure how I was going to get his medication down.  He said that by the way the locum Psychiatrist said that cognitive impairment is not a side affect of Effexor reduction!

[Boomer]

Hey Boomer, please hang in there.  Please - we're really worried about a drug reaction here - so I believe it is important to not change dose if at all possible.

 

How are you going?  Are you able to rest and sleep and eat yourself?

 

Did it help to move his hygiene and eating to the late afternoon / early evening like Karen suggested?

Not sleeping very well, eating ok but certainly very very concerned about my Husband.  I will try moving to late afternoon for Hygiene.

[Boomer]

Had difficulty getting him to swallow his medication this morning, I was advised to take him to the Emergency Department at the Hospital and get them to check for Dysarthia?

[Shep]

Hi, Boomer.

 

This is a good description of dysarthria written in the context of psychiatric drug withdrawal:

 

https://beyondmeds.com/2014/10/13/it-gets-better-speech-dysarthria/

 

Many of us have speech problems during withdrawal, but it resolves as we heal. It's concerning that he's having trouble swallowing. Is he getting enough fluids? 

 

Please keep us informed about your husband's symptoms. We are all hoping he pulls out of this really soon. 

[Boomer]

Hi, Boomer.

 

This is a good description of dysarthria written in the context of psychiatric drug withdrawal:

 

https://beyondmeds.com/2014/10/13/it-gets-better-speech-dysarthria/

 

Many of us have speech problems during withdrawal, but it resolves as we heal. It's concerning that he's having trouble swallowing. Is he getting enough fluids? 

 

Please keep us informed about your husband's symptoms. We are all hoping he pulls out of this really soon. 

Thanks will read that.  I am trying to give him fluids but it is difficult - I am not clear on whats going on for him.  He nearly fainted 2 hours ago and I now have him on the bed.  He is weak as I tested his strength against my arm.  I have the ambulance number nearby incase I have to phone for assistance.