gladtobehere1984: switching antipsychotics

[gladtobehere1984]

Hi everyone,

 

Thank you first of all for this helpful forum. My question is about switching antipsychotics.

 

About 4 weeks ago, I was hospitalized due to a psychotic episode, and in the hospital I was given 20mg of haloperidol and akineton to go along with that for 3 weeks. That stabilized things, but also gave me extreme akathisia and dystonia, along with an "always on" confusion state.

 

So when I got out, I visited a psychiatrist. He said he would switch me to Abilify monthly injection, and that I should reduce the dosage of Haloperidol to 5mg (which I did), keep using haloperidol for 2 more weeks and while also getting the Abilify injection and then drop the haloperidol.

 

I however do not want to go on an injection type of drug. The reason is it is planned for 2 years at least, but most probably for life.  I have high hopes for my recovery and am doing something called Focused Listening which seems to have helped some people. I don't want to resign to the idea that I'm a schizophrenic for life, by accepting a life long injection.

 

So I told him I want to switch to Abilify pills (which he refused to do), and thus now I plan to switch to Risperidal (available over the counter, and I have some experience using it in the past)

 

Right now I'm stable on 5mg of haloperidol, and I checked the dosage equalivancies from here https://academic.oup.com/schizophreniabulletin/article/40/2/314/1944491 and found that 2.5 mg of Risperidone would equal to 5mg of haloperidol.

 

My question is, would it be ok if I used 5mg of haloperidol for 2 more weeks like the doctor suggested, and at the same time start the risperidone 2.5mg(I already started), and when the 2 weeks are over simply continue with the 2.5 mg risperidone?

 

My reasoning behind this is when the therapy I'm working with starts showing results, I'll gradually taper the 2.5mg risperidone. I think it'd be much easier to taper that than an injection type of drug.

 

I would really appreciate your thoughts on this. Thank you.

 

[Petunia]

Welcome Gladtobehere,

So sorry you are finding yourself in this difficult situation. I know how awful akathisia is as I've had it myself. Has reducing your dosage of Haloperidol helped at all?

 

Unfortunately, we can't give advice about switching medications, we only offer support and information related to safely coming off them. I'm surprised to hear that Risperidal is available over the counter in your country, it's prescription only in most parts of the world.

 

Personally, I also would not like to accept any medication by long acting injection, if there is a bad reaction, you have no alternative but to wait until it wears off. Perhaps you will be able to manage your symptoms with a lower dose of what you are currently taking and the program you have started.

 

Could you look for a different psychiatrist, one who will work with you and respect your wishes.

 

You might find some useful tips here:  How do you talk to a doctor about tapering and withdrawal?

 

I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker. Psychiatric drugs can cause harmful side effects and long term, they can worsen health, increasing the risk of other illnesses. They don't cure anything, but work by creating a chemical imbalance in the brain, which alters natural brain function. For some people, these changes may seem helpful. But evidence is starting to show that long term, they cause more harm than good. From personal experience, my own research, and reading thousands of anecdotal stories, I've come to the conclusion that psychiatric drugs should only be used in the most serious of cases and then for the shortest possible amount of time. But you do need to find other ways to manage any difficult emotions and behaviors if you are going to come off your medications.

 

Other resources you may find helpful are Your Drug may be you Problem by Dr. Peter Breggin and Council for Evidence Based Psychiatry

 

The Icarus Project   Hearing Voices Network   Beyond Meds   Bipolar or Waking Up

 

I wish I had more to offer in support of your plans, it does sound like a good long term goal and I wish you well.

 

Please stay in touch and let us know how you are.

 

Petunia.

[gladtobehere1984]

Petunia thank you very much for your warm welcome and helpful reply.

 

To my surprise I found that Abilify pill form is also sold without a prescription here, so I might go with that. That way I might not have completely refused the doctors prescription but also not be forced to an injection.

 

One question, in your experience here, have you seen that it is easier to withdraw from Risperdal vs Abilify? Or vice versa?

 

Cheers

[arwilliams]

Risperdal/Risperdone has affinity for h1 receptors so I wouldn't take that which means you might stop sleeping with out it eventually.  Abilify is likely better of the 2.  That is interesting you don't need a prescription for abilify.  You definitely do in the USA.

[Altostrata]

Welcome, glad.

 

Please Google for a method called cross-tapering, which is the best way to change psychiatric drugs.

 

As Petunia said, we don't do drug switches here unless it's for the purpose of going off the drugs. Drug switches can be hard on your nervous system.

 

There is no antipsychotic that is easier to taper than another. They are all high-risk drugs. You have already had a sample of adverse effects, they could get a lot worse. No one should be taking them for insomnia.

 

The injectables gradually wear off, so you might say they taper themselves. However, once they wear off, we have seen some people still get withdrawal syndrome from the absence of the drug.

[Songbird]

19 hours ago, gladtobehere1984 said:

I have high hopes for my recovery and am doing something called Focused Listening which seems to have helped some people. I don't want to resign to the idea that I'm a schizophrenic for life, by accepting a life long injection.

...

My reasoning behind this is when the therapy I'm working with starts showing results, I'll gradually taper the 2.5mg risperidone.

 

I really like your attitude about not letting one psychotic episode be a life sentence on meds, and finding non-drug ways to help yourself instead.

 

Please keep us updated with your progress.

[gladtobehere1984]

Quote

The injectables gradually wear off, so you might say they taper themselves. However, once they wear off, we have seen some people still get withdrawal syndrome from the absence of the drug.

 

Thank you for all of your replies, they are very helpful.

 

Altostrata, you said that the injectibles taper themselves off. I'm wondering if that applies when I would be getting a monthly injection for some months as well? So say I got the injection for 12 months, would withdrawing then be just as easy as not getting a further injection on the 13th month?

 

If that's the case then maybe I should go with the injection for 12 months and then I can simply stop it when the right time comes and not have to deal with tapering as in pills?

 

Did I get you right or am I missing something? Do injections basically (usually) not need tapering?

 

Thank you

[ChessieCat]

12 hours ago, Altostrata said:

The injectables gradually wear off, so you might say they taper themselves. However, once they wear off, we have seen some people still get withdrawal syndrome from the absence of the drug.

 

[gladtobehere1984]

 

2 hours ago, ChessieCat said:

 

So would it mean one has to do a seperate taper for injectables as well(possibly by using pills) or am I right to understand that if you are using injectables you simply stop and hope that withdrawal symptoms don't happen? If so, that sounds too good to be true to me. Btw, the reason I'm asking these questions is because I'm trying to decide between Abilify pills vs injection. Whichever one would be less hassle to taper off would be my choice. Injectable sounds easier but I need to be sure before I commit to it.

 

Thank you

 

[ChessieCat]

This is SA's topic:  Tips for tapering off aripiprazole (Abilify)

[Songbird]

I think the advantage with pills is that you would be able to control the rate of your taper.  If you started having withdrawal symptoms you could slow it down accordingly.

[Altostrata]

I updated Tips for tapering off aripiprazole (Abilify) to include the injectable forms.

 

The injectable forms deliver a huge amount of drug at once. I would not do this except as a very last resort, and only if I already know I can tolerate Abilify.

 

gladtobehere, I would not request an injection for the convenience of tapering. You might end up with tardive dyskinesia.

[gladtobehere1984]

Thank you everyone and Altostrata. I'm planning to go with the pills as of now. Cheers

[arwilliams]

You are very smart to do this research before starting the medications.

 

Everything has withdrawals and it is rather hard to compare issues because everyone experiences them differently, but they sedating ones are definitely on my do not take recommend list.

[gladtobehere1984]

Tapering off 10mg of Zyprexa and supersensitivity psychosis

 

Hi everyone,

 

Hope you are all well. (or recovering swiftly)

 

I am soon going to start tapering off 10mg of Zyprexa and I have 2 questions. I'd be grateful if you chime in with your thoughts.

 

1-I'm going for an extremely slow taper. 0.2 mg every 3 weeks until I drop from 10 to 6mg. Then I'll drop by 0.1mg until 2mg, and so on. The dosage drops will decrease as I approach the lower doses and between 1 and 0mg, I'll wait for 8 weeks after each dosage reduction. It'll take about 7-8 years to complete it. First of all do you think this type of taper is a good idea? (ie. dosage drops around only %2 but waiting for 3 weeks instead of 8 ) The reason I decided a taper like this is because I was given antipsychotics 6 years ago after a breakup with a girlfriend. There was no psychosis involved, but I did use the drug for 3 years since it seemed to help at the time. Then I withdrew from it in 1 year. 5 months after the withdrawal was complete I had my first ever real psychotic break. So I'm pretty sure the drug increased the D2 receptor numbers in my brain and caused supersensitivity (rebound) psychosis when I withdraw from it in a year. I don't want the same thing to happen again and hence why I'm extremely careful. Although Zyprexa turns me into a zombie and makes my life hell, I'll hold on. So first question, is this a good taper method? (Going slower than %10 every 4 weeks) The big issue here is that the psychosis shouldn't repeat, because that's been much worse and filled with unknowns for me, compared to the other withdrawal effects. What do you think?

 

2-I've read Rhiannon's slow taper posts and I agree with them. A couple of times she mentions how it was possible to taper faster in the beginning stages and that it's a better idea to go slower as we approach the lower doses. I agree with her and have designed my taper according to that idea. But then I saw a link Altostrata shared (https://thelastpsychiatrist.com/2007/07/the_most_important_article_on.html) where the author talks about how because of receptor affinity  (to H1, a1, 5HT2a at first then D2) Zyprexa starts being effective as an antipsychotic at 10mg or so. So at 5mg since the drug will go and block the other receptors first, and it'll not show an antipsychotic effect. So that seems to mean the most important decreases in terms of getting or not getting rebound psychosis are the ones between 10mg and 5mg. Or is that so? And if so, does it mean that I have to go slower at the higher doses as well? That article confused me, but then I looked up some receptor occupancy studies and it seems the higher the dose, the more the D2 dopamine receptor blockade. At the same time I have my lived experience. When I had the psychosis, I had withdrawn from 1.5mg of Risperdal in 1 year. That's the most I ever took (at the time). That's equal to about 5mg of Zyprexa, which means that according to the article's logic I shouldn't have a rebound psychosis because the drug doesn't do much at 5mg. But apparently it did and I had the psychosis when I withdrew. If you could help me with this dilemma I would be grateful. 0.2mg decrease every 3 weeks is a pretty slow taper, but do I have to go even slower?

 

Thank you for this wonderful resource and I'm looking forward to your thoughts.

 

Edited February 6, 2019 by ChessieCat
added topic title to post before merging with existing intro

[gladtobehere1984]

Topic title:  tapering 10mg of Zyprexa

 

Hi everyone,

 

I'm at the beginning of tapering from 10mg of Zyprexa. It makes my life completely unlivable and feels like somebody took all life out of me with a syringe. No motivation to do anything, completely emotionless, with extreme social phobia and a lot of weight gain. I really need to get off this evil drug. 

 

I have 2 choices:

 

1-Make a %10 reduction every 8 weeks. (But at first I'll go down 0.625mg -the smallest a 2.5mg pill can be cut-  each time until I get to 5.625mg. After that I'll go with a %10 taper.)

2-0.2 mg every 3 weeks between 10mg-6mg. Then 0.1mg every 3 weeks between 6mg-2mg. And so on.

 

My main concern is psychosis coming back. I can't say I'm schizophrenic because I had my first psychotic break after I got off Risperdal, which was given to me after I broke up with my girlfriend. I was on Risperdal(1.5mg) for 3 years, then took 1 year to withdraw. 4 months after the taper was over, I had my first psychotic break. (So it was not the illness but was either caused by the drug withdrawal, or what is termed supersensitivity psychosis) I don't want the same thing to repeat this time, and want to get off of it however long it takes.

 

My question is , of the 2 tapering methods, which one do you think has the least risk of relapsing? Should I do smaller taper every 3 weeks or %10 every 8 weeks?

 

I'd appreciate your thoughts and comments,

gladtobehere1984

 

Note to mods: This is my second post in the introduction area, my first one was about switching antipsychotics. Now I'm at the beginning of a taper, so I wanted to separate the threads out. (otherwise people will need to read unnecessary past material, and the title will be wrong. If you could take this thread as my main thread I'd be grateful)

 

Edited February 11, 2019 by ChessieCat
added topic title

[ChessieCat]

19 hours ago, gladtobehere1984 said:

Note to mods: This is my second post in the introduction area, my first one was about switching antipsychotics. Now I'm at the beginning of a taper, so I wanted to separate the threads out. (otherwise people will need to read unnecessary past material, and the title will be wrong. If you could take this thread as my main thread I'd be grateful)

 

SA works differently to many other forums.  Each member has only 1 Introduction topic where they can ask questions about their own situation and journal their progress.  This keeps their history in one place.  Please do not create any more Introduction topics.  Thank you.

 

This is SA topic:  Tips for tapering off olanzapine (Zyprexa)

 

You consider this taper method:  Brass Monkey Slide   You can choose what percentage rate you taper at.

[Glosmom]

HI Gladtobehere,

I am no expert but i would vote for holding at least 4 weeks after each taper no matter your percent reduction. So your plan to hold 8 weeks sounds even better.  I noticed that my daughter would get worse after a couple 3 week tapers, even when the amount was smaller than 10%.  Follow your body is the best advice and keep track of your symptoms...maybe you will find a pattern and can work with that.

 

At what dose did you jump off risperidone to zero the first time (after being on it for 3 years and then tapering for 1 year)?

 

Best wishes in getting off zyprexa...you have a very good attitude about the whole process. That will serve you well. best regards, glosmom

[ChessieCat]

Copying this here because it is member's history:

 

6 hours ago, gladtobehere1984 said:

Thank you Evoldnahturt. I've just remembered that I actually did read your previous post before. I forgot it was yours though

 

My current taper is %5-10 every 8 weeks or so.(tapering from Zyprexa 10mg) I'll wait at least 4 weeks after the withdrawal symptoms are gone. If that's more than 8 weeks I'll wait. If not I'll hold for 8 weeks anyways by default.

 

The reason I'm doing such a conservative taper is because I had my first psychotic break after I tapered from 1.5mg of Risperdal in around 1 year. The psychosis happened about 5 months after I was drug-free. Apparently, that was too fast. It's a big mess when one is psychotic so I'm hoping this slow taper won't trigger psychosis again.

 

My taper will take around 7.5 years. 

 

Once again thank you for sharing your method.

 

P.S. Does anyone have an idea why I might have developed psychosis 5 months after I was drug free? I couldn't find an explanation other than supersensitivity psychosis, but even that seems to happen only days weeks after being drug-free or reducing the dose and not 5 months after it. I also didn't have any withdrawal symptoms remaining at the time, and never had psychosis in my life before.

 

[gladtobehere1984]

2 hours ago, Glosmom said:

HI Gladtobehere,

I am no expert but i would vote for holding at least 4 weeks after each taper no matter your percent reduction. So your plan to hold 8 weeks sounds even better.  I noticed that my daughter would get worse after a couple 3 week tapers, even when the amount was smaller than 10%.  Follow your body is the best advice and keep track of your symptoms...maybe you will find a pattern and can work with that.

 

At what dose did you jump off risperidone to zero the first time (after being on it for 3 years and then tapering for 1 year)?

 

Best wishes in getting off zyprexa...you have a very good attitude about the whole process. That will serve you well. best regards, glosmom

Hi Glosmom,

 

Thank you for your suggestions. Very interesting about the 3 week tapers and getting worse. I will definitely stick to 8 weeks or longer even though life is pretty hard at 10 mgs at this point.

 

I can't seem to remember exactly what dose I jumped off from. I believe it was 0.125mg of Risperdal, but it might be 0.25 as well. I think I was able to cut the 1mg pill into 8 pieces so it might be 0.125mg. But then again all dose reductions were 0.125mg as well so they were more than %10 past a certain point. To this day I can't figure out how I had my first psychotic break 5 months after my taper was over. I didn't even have any withdrawal symptoms at the time. 

[Glosmom]

it would be wonderful if we knew what caused psychosis and how to fix it without meds.  some have reported that time heals it.   ..... my daughter became psychotic from prednisone....who would of thought that??    I am sure the slow taper route will be the right way for you.  none of us know if the psychosis will return in the long run but at least we are all better prepared for it now.   Again, best wishes to you during the process...

[Altostrata]

10 hours ago, gladtobehere1984 said:

Thank you Evoldnahturt. I've just remembered that I actually did read your previous post before. I forgot it was yours though

 

My current taper is %5-10 every 8 weeks or so.(tapering from Zyprexa 10mg) I'll wait at least 4 weeks after the withdrawal symptoms are gone. If that's more than 8 weeks I'll wait. If not I'll hold for 8 weeks anyways by default.

 

The reason I'm doing such a conservative taper is because I had my first psychotic break after I tapered from 1.5mg of Risperdal in around 1 year. The psychosis happened about 5 months after I was drug-free. Apparently, that was too fast. It's a big mess when one is psychotic so I'm hoping this slow taper won't trigger psychosis again.

 

My taper will take around 7.5 years. 

 

Once again thank you for sharing your method.

 

P.S. Does anyone have an idea why I might have developed psychosis 5 months after I was drug free? I couldn't find an explanation other than supersensitivity psychosis, but even that seems to happen only days weeks after being drug-free or reducing the dose and not 5 months after it. I also didn't have any withdrawal symptoms remaining at the time, and never had psychosis in my life before.

 

Hello, gladtobehere.

 

What were the symptoms identified as psychosis? There are a lot of things misidentified as "psychosis." Someone who's never had psychosis cannot relapse into psychosis.

 

If you never had any such symptoms before, your nervous system might have been sensitized by going off Risperdal. Something happened to trigger the symptoms. Some people, for example, are very sensitive to lack of sleep. You might have taken a drug, such as an antibiotic, that destabilized your sensitized nervous system, or perhaps overdone celebrating with alcohol.

 

Sometimes people who never had any signs of such symptoms before experience psychosis-like symptoms as withdrawal symptoms. It's not unheard-of.

[gladtobehere1984]

8 hours ago, Altostrata said:

 

Hello, gladtobehere.

 

What were the symptoms identified as psychosis? There are a lot of things misidentified as "psychosis." Someone who's never had psychosis cannot relapse into psychosis.

 

If you never had any such symptoms before, your nervous system might have been sensitized by going off Risperdal. Something happened to trigger the symptoms. Some people, for example, are very sensitive to lack of sleep. You might have taken a drug, such as an antibiotic, that destabilized your sensitized nervous system, or perhaps overdone celebrating with alcohol.

 

Sometimes people who never had any signs of such symptoms before experience psychosis-like symptoms as withdrawal symptoms. It's not unheard-of.

Hi Altostrata,

 

Thank you so much for chiming in.

 

My symptoms were textbook psychosis, I thought I was able to telepathically communicate with people, I thought I was a god-like being, and others were villains, I had extreme paranoia of even my family, and I talked in ways that don't make sense. (All very embarrassing even to write about) This went on for 4 months and I was hospitalised 4 times during that time. At the end of my 4th hospitalization where I was given 20mg of haloperidol and some akineton, I developed insight into my situation. That helped me normalize.

 

I didn't have these symptoms before. I was given antipsychotics in 2013, after I broke up with my girlfriend and told my doctor, I have a pain in my heart that'll cause me to commit suicide. He gave the drug and the pain went away so I kept on taking it. I took it for 3 years and I was totally over the breakup by this time. So I started reducing the drug at a fixed amount of 0.125mg as far as I can remember. It took about 1 year.

 

I don't drink alcohol, but interestingly the "relapse" happened while I was in a meditation retreat at a Buddhist monastery. Somehow one night I heard noises and thought I might be killed. Then in a meditation session I thought I attained some level of attainment and can communicate with the people there telepathically. It all went downhill from there and I ended up with the symptoms I described above.

 

I know you can't relapse if you didn't have psychosis before, but as you probably know very well as well, there is the supersensitivity or rebound psychosis theory. It might be that. But then they seem to explain that it happens within the first few days or weeks after a dose reduction or stopping the drug. Mine happened about 5 months later. And I remember that my emotions were not as vivid as before I took antipsychotics at the time, but I don't recall any withdrawal symptoms were remaining at that 5 month mark.

 

 

[gladtobehere1984]

20 hours ago, Glosmom said:

Again, best wishes to you during the process...

Thank you Glosmom, I also wish your daughter a swift and stress-free recovery. Hopefully full recovery as well. Cheers

[Altostrata]

You still might be slightly various neurologically, not to the extent that you would ordinarily be overwhelmed by psychosis, but still sensitive enough that you might be triggered in a Buddhist retreat.

 

It could be, as you surmise, a sensitivity induced by the action of the drug. This does not mean you have psychosis, but that your nervous system might be exceptionally vulnerable to dosage reduction and you will need to be careful to allow it to adapt while tapering.

[gladtobehere1984]

12 hours ago, Altostrata said:

You still might be slightly various neurologically, not to the extent that you would ordinarily be overwhelmed by psychosis, but still sensitive enough that you might be triggered in a Buddhist retreat.

You are right, I might have somehow gotten triggered in the retreat. At the end of the day, it went really weird once I thought I attained some level of attainment and could communicate with people by thought. The thought of attainment might be what triggered the whole mess.

 

 

12 hours ago, Altostrata said:

It could be, as you surmise, a sensitivity induced by the action of the drug. This does not mean you have psychosis, but that your nervous system might be exceptionally vulnerable to dosage reduction and you will need to be careful to allow it to adapt while tapering.

 

Thank you. I will definitely keep a close watch on how the taper goes. ( Although I'm not sure what to look for to keep psychosis from coming) Hopefully the minimum 8 week-hold taper will assist in that. I also won't reduce more than %9 according to my calculations. More of the time it is 6-7% each time.

Another reason I thought of as to why the psychosis might have happened 5 months later is the idea that antipsychotics get stored in the fat tissue. If that's the case, then once you don't take the drug anymore it could still be released to the body randomly from the fat stores and hence mess up the taper, couldn't it? I did lose some weight in the last 3-4 months leading up to the retreat. Can that be why? And if so, how does one control how much of the drug gets released from the fat stores? Is there a way to control that? (Apologies if my theory is too far off) 

[gladtobehere1984]

Hi,

 

Hope all of you have been well. (or better)

 

I've been holding for the last 4 weeks. I initially decided to hold for 8 weeks with each dose drop, but recently decided to go with 4 weeks between drops instead. This is because life with Zyprexa is unbearable, and I didn't have much in terms of withdrawal symptoms in the last 4 weeks with a drop from 10mg to 9.375mg. I will listen to my body and go with 4 week drops until I get to 5mg. After that I'll probably go with longer holds. I would be happy to hear your comments.

 

I also have a question. It seems that for antipsychotics like Zyprexa, a 65-80% dopamine receptor occupancy is required for the antipsychotic to be effective. This is usually at 7.5mg to 10mg range. Would this mean that the drop from 10mg to 5mg will make the bigger difference (as compared to say going from 1mg to 0mg) and thus I should actually be more careful and hold longer for this initial phase rather than the last part of the withdrawal? I'm quite confused and scared about this. I don't know if it's the same with AD's but with AP's there seems to be a consensus saying that 65-80% receptor occupancy is needed to keep a person stable. In your experience, do people who take AP's relapse during the initial stages, or the last stages?

 

Thank you and all the best. I'll update this thread from time to time.

 

 

[Altostrata]

Hello, glad. 

 

While theoretically a certain amount of receptor occupancy might be needed for the "therapeutic" control of psychosis, we can't know what that level is for any individual in terms of dosage. 

 

It could be that much less olanzapine still is enough to control your psychosis symptoms. Or it could be that your underlying condition is controlled by a different action of the drug. Or it could be you have no underlying psychosis to trigger. 

 

The slow taper rate allows a period of observation after a dosage reduction. If symptoms of psychosis occur, you'll know that dosage is a bit too low for you, at that time. (We sometimes see if people hold for a while, the threshold of sensitivity decreases and they can continue to taper.)

 

So the slow tapering method already has that measure of safety built in, in order to taper to the lowest effective dosage if not zero. You do need to be sufficiently introspective to identify odd thinking patterns, but it sounds like you can do that.

[gladtobehere1984]

1 hour ago, Altostrata said:

So the slow tapering method already has that measure of safety built in, in order to taper to the lowest effective dosage if not zero. You do need to be sufficiently introspective to identify odd thinking patterns, but it sounds like you can do that.

 

Thank you Alto for your informative answer. The slow tapering method we are talking about is the "10% of the last dose-4 weeks hold" one right?

 

Also, my plan, if I saw any odd thinking patterns appearing was to go to the hospital and admit myself before the whole thing gets out of control. Because from what I've experienced, things started with a bit of paranoia, then quickly got out of control. Is there a strategy you would recommend in place of doing that? Maybe up dosing by a certain percentage?

 

Cheers

 

 

[ChessieCat]

3 hours ago, gladtobehere1984 said:

Hi Altostrata,

 

I was reading on Laura Delano’s withdrawal project site that splitting pills is not recommended because the active ingredient in the pill is not evenly distributed.

 

As well, I read in the above paper “Pros and cons of pill splitting” by Rakesh Jain that there would be slight variations in dose when the pill is split and  that can result in a relapse.

 

I’m withdrawing from Zyprexa 10mg and my plan was to go with pill splitting until I get to 5mg. Then I will switch to a liquid taper.

 

Do you think pill splitting increases the chance of relapse because of dose variations? Or should I not worry? I split the pills pretty evenly.

 

Cheers

 

Please see Tips for tapering off olanzapine (Zyprexa)

 

SA's discussion of:  inner-compass-and-the-withdrawal-project

 

 

Edited May 13, 2019 by ChessieCat

[gladtobehere1984]

10 hours ago, ChessieCat said:

 

Please see Tips for tapering off olanzapine (Zyprexa)

 

SA's discussion of:  inner-compass-and-the-withdrawal-project

 

 

Thank you very much Chessiecat.

 

Cheers

[hayduke]

On 3/15/2019 at 7:02 PM, gladtobehere1984 said:

Also, my plan, if I saw any odd thinking patterns appearing was to go to the hospital and admit myself before the whole thing gets out of control. Because from what I've experienced, things started with a bit of paranoia, then quickly got out of control. Is there a strategy you would recommend in place of doing that? Maybe up dosing by a certain percentage?

 

Cheers

 

Hi gladtobehere1984

 

I've been coming off olanzapine ('zyprexa') for a while now.

 

I was easily able to get from 10mg down to 5mg over a few months with simple and large reductions.  I hung out at 5mg for a while.

 

5 to 2.5mg took a fair bit longer and was more challenging.  Now I'm below 2.5mg looking for zero.  Slowly!  You can see the general outline in my signature.

 

I would certainly agree that you will probably want to be going more slowly the lower the dose goes.  The effects of these classes of drug seem to be non-linear.  This is the idea behind making each 10% reduction of the dose 10% of the _previous_ dose instead of the initial dose.

 

You quickly gain a sense of when to say go or whoa.  Someone else on here said any reason you're thinking of to hold is a good one and I agree with that.  Even if only for an extra week.  You quickly get a sense of how fast you can go and how to best manage it to suit you.

 

Lately I've been using

The Brassmonkey Slide Method of Micro-tapering - Tapering - Surviving Antidepressants

as my basis and find this the most comfortable. 

 

In response to your quote above, you're on the right track with keeping an eye on signs of trouble.  Though I wouldn't be too quick to hand control back over to the same mob that got me on this muck in the first place. 

I found this booklet to be very helpful: https://www.bps.org.uk/what-psychology/understanding-psychosis-and-schizophrenia

I suggest downloading and reading that.  It explains how, during withdrawal, you can set up a support network among your friends and family as well as health professionals that you choose - i.e. understand and support what you are doing - rather than just be thrown back to the same bad old scene.

Finding supportive clinical psychologists has been the key for me.  With their help I was able to unearth and release what lay beneath all my difficulties.  I knew something was wrong most of my life but I didn't know what.  Turned out I was sexually abused when I was 4 or 5.  Enormously relieved to have it by the tail now and I can get on with the rest of my life.

 

The psychiatrist I was sent to in the old days didn't give a stuff about treating my trauma, he wanted to drug me endlessly even when I was getting appalling side effects from the olanzapine.  Good riddance.

 

I hope you can find some resolution for your troubles and good luck with your taper.
 

 

[gladtobehere1984]

Hi Hayduke,

 

Thank you very much for your informative reply. It's great to hear you are doing well.

 

I agree with your statement about handing the control back to the mob, that really isn't what I want to do again. I know they'll up the dose to 15-20mg and insist I stay there. That's why I also am going very slowly, to not have a psychotic break again, because I was a very "wild" psychotic. I even had problems with the traffic police and had to go on a mini-trial for driving recklessly while psychotic. I don't want that to ever happen again, because that's just not me.

 

My current plan is this:

(I'm at) 6.875mg to 5mg = total 12 weeks by dropping 0.625mg every 4 weeks

5mg to 3mg= total 56 weeks by dropping 0.3mg every 8 weeks

3mg to 2mg= total 40 weeks by dropping 0.2mg every 8 weeks

2mg to 1mg=total 80 weeks by dropping 0.1 every 8 weeks

1mg to 0mg=total 160 weeks by dropping 0.05 every 8 weeks

 

It takes around 6-7 years to totally get rid of the drug but I hope doing it this slow won't trigger psychosis. And it gets way slower after 2mg. As of now the zombifying effect of Zyprexa at 6.875mg , having no motivation and being in a drug prison is hell. But I know I will be at 3mg in 1 year 4 months, and hopefully at that dose I'll be less zombified. Now that you are at 1.775mg, are your side effects from the drug better?

 

And I'll definitely check out the BPS guide. Thank you again.

 

Cheers

 

 

[hayduke]

Nice, sounds like you've got a path mapped out.  Ultimately learning to go by feel and listen to your body is where it's at, and a plan is a great template to gauge that against.  One of the many big plusses to coming off slowly is keeping on the right side of sleep disruption and getting enough rest - the more sleep you get the more healing your body/brain can do.

 

Bugger about the traffic cops, hope you're staying safe.  Jan Carol on here had a beaut post somewhere about not standing out and staying out of trouble when things get 'weird' :-)  My usual tactic if a cut doesn't feel right is to hold until it does, usually within a week.  And you'll know when you're ready for the next one.  Very occasionally I might reverse the latest cut but I don't think that's usually necessary.  Avoiding stress is a big help too.  It's frustrating to miss parties or whatever occasionally but hey, there'll be more.

 

I've definitely noticed side effects reduce as the dose comes down.  It's a big part of the motivation to keep going for me.  I can't help but want to giggle a bit when the same people who would dogmatically tell me how much I need this drug unknowingly comment on how much better I look to be doing on a relative sliver of it!

 

The weight hasn't sloughed off by itself quite as much as I'd like but I'm going to keep exercising (more gently during wd) and probably ramp up the cardio at the end of the taper and burn off some more of that fat.  Cholesterol is higher than ideal, I still feel great discomfort in heat (such a bastard side effect they never tell you about) and fatigue is still present to some extent, but many other symptoms have lessened or abated as the dose comes down.  Prediabetes is gone, blood sugar is normal (I've done about four 3-day fasts now over the last year or two which work very well for me), hives and allergies have settled right down, rheumatism and joint issues are a lot better too. Mentally, emotionally and socially I feel a lot more present and tuned into my friends, which is really rewarding.  Helps at work too.

 

Of course there are a lot of hard days, derealisation, mental fog, headaches, sensitivity to light/sound/everything, irritability, low mood, fatigue, akathisia, all that jazz pop up here and there... but I'm of the view that those are the withdrawal symptoms, and they typically settle quite quickly when I hold for a week or two.  More motivation to get off this crap.

 

Magnesium chloride or epsom salt baths are a bit of a godsend too.  Plenty of info on the site here about magnesium.

 

Working through the underlying issues with the trauma is probably a lot more accessible on these smaller doses too.  It's hard, confronting work but the result seems to be that I feel like I'm fundamentally ok now.  There's more to do but I feel like the formerly unrecognised pain under the surface is now brought up, known and released, and that's been the top of the mountain to get over.

 

Cheers

[gladtobehere1984]

48 minutes ago, hayduke said:

Nice, sounds like you've got a path mapped out.  Ultimately learning to go by feel and listen to your body is where it's at, and a plan is a great template to gauge that against.  One of the many big plusses to coming off slowly is keeping on the right side of sleep disruption and getting enough rest - the more sleep you get the more healing your body/brain can do.

 

Yes, hopefully I'll go by feel at some point too. I usually get mild withdrawal symptoms for a few days (maybe a week) after each drop and then it normalizes. I did make a pact with myself to be symptom free for at least 2-3 weeks before I make another drop. So far so good. And you are right about the sleep part, thankfully I'm sleeping well as of now, which probably means the drops aren't too much.

 

51 minutes ago, hayduke said:

Bugger about the traffic cops, hope you're staying safe.  Jan Carol on here had a beaut post somewhere about not standing out and staying out of trouble when things get 'weird' 🙂 My usual tactic if a cut doesn't feel right is to hold until it does, usually within a week.  And you'll know when you're ready for the next one.  Very occasionally I might reverse the latest cut but I don't think that's usually necessary.  Avoiding stress is a big help too.  It's frustrating to miss parties or whatever occasionally but hey, there'll be more.

I'll check Jan Carol's post. Thanks.

 

52 minutes ago, hayduke said:

I've definitely noticed side effects reduce as the dose comes down.  It's a big part of the motivation to keep going for me.  I can't help but want to giggle a bit when the same people who would dogmatically tell me how much I need this drug unknowingly comment on how much better I look to be doing on a relative sliver of it!

Great to hear that the side effect hell subsides as the dose comes down. Yeah, unfortunately people (and even doctors) are mis-educated about these drugs. They think it's the negative symptoms of schizophrenia that turns you into a zombie, when it's obviously the drug that does that. My psychiatrist even told me about the "This is like insulin for diabetes" story, totally believing in it.

 

Great to hear that you are getting better physical health wise as well. I also put on 20 pounds, and am counting calories now to not put on another 20. I'm at prediabetes stage too and I'll probably also try the fasts at some point. I've read that they are very effective in reversing diabetes.

 

Btw, I'm also using magnesium citrate, although at 200mg I don't think I'm feeling much of an effect. It might also be because the Zyprexa numbs me to the point of not feeling much though.

 

Take care

[hayduke]

Hey @gladtobehere1984, how are you getting on?