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gladtobehere1984: switching antipsychotics


gladtobehere1984

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Hi Hayduke,

 

Thank you for asking! I'm doing so so recently. I managed to go down to 3.75mg from the 10mg I started with, but I think 5mg onwards I accelerated the process a bit too much. (I went from 5mg to 4.375mg and waited there for 3 weeks, then 4.375 to 3.75mg) After that last drop I thought I was getting better as I seemed to have a little bit more motivation. I also started sleeping less though, for a couple of days in a row. Then 2.5 weeks into the 3.75mg dose, I found some 5HTP I had at home and decided to try it, thinking maybe it might help me feel better. (As you might remember, I'm pretty much paralyzed by the emotionlessness and the lack of motivation the drug brings on) That night I woke up with fear and hallucination like thoughts.

 

Now it was either the 5-htp triggering a psychotic episode (which I read somewhere can occur), or that that night was the culmination of me going down too fast to 3.75mg. I read about an intervention in a paper by a guy who went from 7.5mg to 0 in 5 years and documented it, where he would give himself a high 15mg stabilizing dose for 2-3 days, and then continue with 7.5mg for the remainder of the 2 weeks until things settle down.

 

So I took 10mg , and some clonazepam the next night and was able to sleep and woke up pretty normal.  I thought this meant that I stabilized. However the next night I was again having difficulty sleeping. So I decided to prolong the process a bit. (While at the same time being extremely scared of getting used to the high doses and going back to square one) Right now I'm at 15mg a night and every night I'll reduce the dose by 2.5mg until I get down to 5mg. After 5mgs I'll either try one more drop to 4.375mg (because I don't want to have to wait more months in agony before i feel anything) or I'll stay at 5mg for a couple of weeks and try again.

 

2 of my hopes are that I can stabilize fine after this protocol, and that I can go as far below 5mg as possible without risking things.

 

By the way, I have a question while I'm here (for you and everyone else), I know here we practice the method of %10 of the last dose every 4 weeks. Does this also mean that if I drop (lets say) %7.5 , I can instead wait 3 weeks till the next drop? Or by the same token, %5 drop every 2 weeks etc. So calculating the exact days of waiting according to what percentage you cut: (ie. if %10 equals 28 days, %6 equals  16.8 days)  It sounds kind of reasonable to me as it is similar to what the brassmonkey method is all about. I plan to compensate the imperfections of cutting pills with this type of calculation and waiting specific number of days instead of waiting 4 weeks each time. If you have any ideas about this I'd love to hear them.

 

And how are you holding up, yourself Hayduke?

 

 

Risperidone: July 2013-July 2016, 1.5mg; July 2016-July 2017, tapered to 0mg

January 2018: First ever episode of full-blown psychosis (I believe it is rebound psychosis since I didn't have psychosis before)

Olanzapine: August 2018-February 2019, 10mg; February 11 2019, 9.375mg; March 14 2019, 8.75mg; April 17 2019, 8.125mg; May 16 2019, 7.5mg; June 13 2019, 6.875mg; 

 

 

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Hey, best to keep it slow and steady.  Holding is usually better than jumping back up, but I have done that a couple of times.

 

Like you I found below 5mg is where the real work starts.  I had to go back to 5 after trying 3 1/3, then start again from 4.5, 4 etc.  I have a graph of my taper so far at

 

2064402417_ScreenShot2019-11-08at3_58_01

 

which might be useful as it shows the limits I found at several points and had to adjust.  Yours of course may vary, but you can see I found dropping from 5 to 4 too much too soon and held at 4.5 for a while.  You can also see the rapid step down from 3 to 2.5 - I was on holidays so didn't have too much to worry about, and it led to a planned 6 month hold which was was good at that time.  Plus simply convenient to just take the tablet instead of titrating for that time.  I think my support network appreciated me demonstrating stability at a steady 2.5, because the goblin said it wasn't enough, but my psychologist, G.P, family and friends were all satisfied I was ok.  My psychologist said 'If the psychiatrist says it isn't enough, but you're doing this well, I think it's a good sign you can probably do without it altogether'. ❤️

 

I'm well thanks, continuing with the brass monkey slide taper and finding it very workable.  It's slower than I'd like (p sure everyone on here says that 🙂 ), but worth it to keep things steady, and the progress continues.  I'm below 1.25mg now which is a nice milestone, and all the feedback is good.  Will think about where to jump off some time over the next year.

 

Regarding customising your taper, I've done a fair bit of tinkering round the edges to see what my body will accept and what's comfortable, so if you want to try 7.5% over 3 weeks I don't see why not.  For me, I'm finding brass monkey's slide taper the least bother of anything I've done so far.

 

Cheers

I am not a health professional - your actions are your own.  

Please do not seek tapering support via private message - "Any reason to hold is a good one"

My taper visualised as a graph   |   My intro thread

Backdrop:  2003 10mg olanzapine | 2004 2-3mg risperidone | end 2014 3wks aripiprazole

2015: olanzapine  10 -> 7½ -> 6⅔ -> 5mg  by crude pill cutter

2018:  Mar 5.00mg -> water titrated taper -> Aug2.5mg tablet and hold

Jan 2019 2.50mg water titration -> Jan 2020 1.214  -> Jan 2021 0.44 -> 2 Oct 0.205 ->3 Oct ZERO🥂

Jun 2023 💉150mg paliperidone "loading" depot shot, 100mg 1wk after Jul 100mg Aug-Dec 75mg/4wks

Jul 2023 2.50mg aripiprazole/day attempt to lower prolactin^

Jan-Feb 2024 cross taper off shots to 1mg risperidone

 

Ask not what you can do for your country, but what your country did to you"  -- KMFDM

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Oh yeah, forgot to mention re 5-HTP - I took 50mg (I think) a few times during my taper, the first day is pleasant, everything has a nice clear glow to it.

 

But the day after is moody and overall not worth the 'high'.

 

I believe olanzapine and 5-HTP are contraindicated, high doses can be very dangerous or fatal.  (serotonin syndrome)

 

I decided to shelve it until some time after I've completed my taper.

I am not a health professional - your actions are your own.  

Please do not seek tapering support via private message - "Any reason to hold is a good one"

My taper visualised as a graph   |   My intro thread

Backdrop:  2003 10mg olanzapine | 2004 2-3mg risperidone | end 2014 3wks aripiprazole

2015: olanzapine  10 -> 7½ -> 6⅔ -> 5mg  by crude pill cutter

2018:  Mar 5.00mg -> water titrated taper -> Aug2.5mg tablet and hold

Jan 2019 2.50mg water titration -> Jan 2020 1.214  -> Jan 2021 0.44 -> 2 Oct 0.205 ->3 Oct ZERO🥂

Jun 2023 💉150mg paliperidone "loading" depot shot, 100mg 1wk after Jul 100mg Aug-Dec 75mg/4wks

Jul 2023 2.50mg aripiprazole/day attempt to lower prolactin^

Jan-Feb 2024 cross taper off shots to 1mg risperidone

 

Ask not what you can do for your country, but what your country did to you"  -- KMFDM

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Thank you so much @hayduke for sharing your graph, I'll surely check it from time to time for insights and guidance.

 

And you are right, slow and steady is the way to go. If only I had a little more motivation and could at least be able to watch TV shows and such, I would be less hurried in going down to lower doses. But anyways, going too fast didn't go too well, so I guess I'll have to go slow whether I like it or not. (I guess I can never know if it was the 5-htp or fast taper, but I know I didn't feel any withdrawal effects in any of the dose reductions I had done so far so maybe it was the 5-htp)

 

In the meantime, I also bought some protein powder a week ago and tried that as well, because I don't seem to get enough protein through my diet. (I'm sedentary and need around 60 grams a day, but only get 30 or so) That also resulted in insomnia and unusually high energy for me. Lo and behold, I checked the label and there was a lot of l-tryptophan, sarcosine and l-tyrosine in the protein. L-tryptophan is the precursor to 5-htp and sarcosine gave me insomnia before when I tried it alone for easing the "negative" symptoms of schizophrenia. Live and learn.

 

Anyways it's great to hear that you are at below 1.25 mg and still stable. Way to go!

 

Cheers

 

 

 

Risperidone: July 2013-July 2016, 1.5mg; July 2016-July 2017, tapered to 0mg

January 2018: First ever episode of full-blown psychosis (I believe it is rebound psychosis since I didn't have psychosis before)

Olanzapine: August 2018-February 2019, 10mg; February 11 2019, 9.375mg; March 14 2019, 8.75mg; April 17 2019, 8.125mg; May 16 2019, 7.5mg; June 13 2019, 6.875mg; 

 

 

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Hi again @hayduke,

 

After your post I decided to review again the brassmonkey method and see if I can apply it as well, since you seemed not to face any relapse related issues while applying it.  

 

I checked your signature to understand exactly how you apply it but still want to ask you 2 quick questions to clarify things:

 

1-Brassmonkey seems to drop %10 every 28 days, but then wait 2 weeks on top of that for things to really stabilize. Have you also done that? (It seems from your signature you didn't but still wanted to ask) If not, did you find that it wasn't needed in your case?

 

2-Have you at one point (I guess at 2.115mg) switched to dropping %5 every 28 days? If so, was there a particular reason you didn't keep going with %10 drops every 28 days?

 

Thank you and take care

 

Risperidone: July 2013-July 2016, 1.5mg; July 2016-July 2017, tapered to 0mg

January 2018: First ever episode of full-blown psychosis (I believe it is rebound psychosis since I didn't have psychosis before)

Olanzapine: August 2018-February 2019, 10mg; February 11 2019, 9.375mg; March 14 2019, 8.75mg; April 17 2019, 8.125mg; May 16 2019, 7.5mg; June 13 2019, 6.875mg; 

 

 

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Hey, yes I do take the extra two week hold after each four cuts.  The second half of the long hold is generally pretty comfortable.  Occasionally I've even added a third week to the hold if I feel that's what my body wants.  The hold gives your physiology time to adapt to the cuts.

 

I dropped to a 5% rate to try and bracket a comfortable rate with small increases.  10% has a bit too much at times.  Having to act professionally at work is probably the limiting factor.  I've been on these drugs for sixteen years now all up so keeping it gradual makes sense to me.

 

I did quite a bit of experimentation with cuts on the way down and learnt the various ways my body would signal me to hold up a bit before settling on the current method.

 

Avoiding relapse for me has been respecting my limits and not getting impatient and going too fast - and resolving the underlying trauma beneath my initial problems with the help of my excellent clinical psychologist (EMDR).

 

One very valuable lesson from doing that was realising that there's nothing inherently 'wrong' with me.  What got called 'psychosis' is a natural enough reaction to the traumatic events I've been through.  And that opens the door to healing fully.

 

Cheers

I am not a health professional - your actions are your own.  

Please do not seek tapering support via private message - "Any reason to hold is a good one"

My taper visualised as a graph   |   My intro thread

Backdrop:  2003 10mg olanzapine | 2004 2-3mg risperidone | end 2014 3wks aripiprazole

2015: olanzapine  10 -> 7½ -> 6⅔ -> 5mg  by crude pill cutter

2018:  Mar 5.00mg -> water titrated taper -> Aug2.5mg tablet and hold

Jan 2019 2.50mg water titration -> Jan 2020 1.214  -> Jan 2021 0.44 -> 2 Oct 0.205 ->3 Oct ZERO🥂

Jun 2023 💉150mg paliperidone "loading" depot shot, 100mg 1wk after Jul 100mg Aug-Dec 75mg/4wks

Jul 2023 2.50mg aripiprazole/day attempt to lower prolactin^

Jan-Feb 2024 cross taper off shots to 1mg risperidone

 

Ask not what you can do for your country, but what your country did to you"  -- KMFDM

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Thank you for the thorough explanation @hayduke. After reading your insights, I'll reconsider doing the brassmonkey method. (Although you went down to 2.5mg without it and and without issues it seems)

 

My main problem is that the anhedonia, lack of motivation, and emotionlessness that I feel because of Zyprexa is totally unbearable to me and thus forces me to speed up. Like you I've used Risperdal in the past, and I don't recall having the same issue when I was on it. So one part of me is thinking of switching to Risperdal over a period of a month or two and continue with that in a slower more controlled fashion. Still, I know that switching between antipsychotics is hard on your system as well.

 

On a side note, I took about 12.5-15mg to stabilize things for the last 2 weeks, and now I'm back to 5mg, but I seem to have withdrawals. I didn't know one can get used to a high dose so quickly. I'm hoping that the withdrawals will pass quickly since I only used the higher doses for a couple of days. (a week or so) Hoping I won't have to go back to the hell of 10mgs a day and lose 10 months progress.

 

Btw, funny thing with my psychosis is that I don't think it has any psychological background as I don't recall or was affected by any trauma in my past. And I was given the antipsychotic not for a psychotic break but over the breakup with my girlfriend, when I told the psychiatrist I was suicidal. So I think in my case it might be even more important to go slowly, because the supersensitivity psychosis is probably what has given me a psychotic break last time when I went from 1.5 mg of Risperdal to 0mg in a year.

 

Cheers

 

 

Risperidone: July 2013-July 2016, 1.5mg; July 2016-July 2017, tapered to 0mg

January 2018: First ever episode of full-blown psychosis (I believe it is rebound psychosis since I didn't have psychosis before)

Olanzapine: August 2018-February 2019, 10mg; February 11 2019, 9.375mg; March 14 2019, 8.75mg; April 17 2019, 8.125mg; May 16 2019, 7.5mg; June 13 2019, 6.875mg; 

 

 

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On 11/25/2019 at 6:07 PM, gladtobehere1984 said:

My main problem is that the anhedonia, lack of motivation, and emotionlessness that I feel because of Zyprexa is totally unbearable to me and thus forces me to speed up.

 

I hear you, but it's still preferable to taper at the rates recommended here, or you're likely to find even worse symptoms.

 

Willpower doesn't have a lot to do with it...it's a physiological limit that your body demands to be able to keep up with the changes.  You can't really 'outrun' it without, well, breakdowns.

 

Then there's the plain old mental health as well - I'd want to talk to a sympathetic psychologist about why someone else could make me feel suicidal.  Those feelings are bound to become unmasked again as you taper.  You can likely work it out with good help. 

 

The good thing though is that as you taper, your faculties come back gradually - in a manner that I've actually found very pleasing.

 

Cheers

I am not a health professional - your actions are your own.  

Please do not seek tapering support via private message - "Any reason to hold is a good one"

My taper visualised as a graph   |   My intro thread

Backdrop:  2003 10mg olanzapine | 2004 2-3mg risperidone | end 2014 3wks aripiprazole

2015: olanzapine  10 -> 7½ -> 6⅔ -> 5mg  by crude pill cutter

2018:  Mar 5.00mg -> water titrated taper -> Aug2.5mg tablet and hold

Jan 2019 2.50mg water titration -> Jan 2020 1.214  -> Jan 2021 0.44 -> 2 Oct 0.205 ->3 Oct ZERO🥂

Jun 2023 💉150mg paliperidone "loading" depot shot, 100mg 1wk after Jul 100mg Aug-Dec 75mg/4wks

Jul 2023 2.50mg aripiprazole/day attempt to lower prolactin^

Jan-Feb 2024 cross taper off shots to 1mg risperidone

 

Ask not what you can do for your country, but what your country did to you"  -- KMFDM

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Thank you very much for your words of wisdom @hayduke.

 

I agree with you that it is probably a physiological limit. Although it was the accumulation of many months of agony(the anhedonia),as soon as I started cutting corners, it resulted in things getting worse. From now on,  I will probably follow the brassmonkey method as well. (It almost sounds like it is impossible to relapse if one adheres to it)

 

As you know, I had upped the dose to about 10-15mg for 2 weeks, and now I am back to 5mg for the last week. Even that gave me withdrawals and there is some minor discomfort still. (kind of like a little higher than normal energy) I had an email correspondence once with Philip Seeman who is a prominent dopamine hypothesis of schizophrenia researcher, and also studies supersensitivity psychosis, and he said that in mice it took about the same time the drug was given, for the receptors to revert back to normal after the drug was stopped. So in my case I took 10-15mg for two weeks, and it should take 2 weeks for things to normalize. The way the withdrawals are fading, that seems somewhat accurate. I don't know about the longer term though. (ie. I took it for 6 years and you took it for 16, does that mean we have to wait that long? Probably not, as your case shows)

 

I'm now contemplating about switching to Risperdal, as I was on 1.5mg of it for a couple of years and didn't have the terrible anhedonia. That scares me a little as things might go wrong during the switch, but at the same time if I stay with Zyprexa, I might be forced to cut corners again which will definitely screw things up. So being somewhat more normal and less desperate on Risperdal might give me the strength to go as slow as it takes. I haven't decided yet, so we'll see. Thank you again for your helpful advice.

 

Cheers

Risperidone: July 2013-July 2016, 1.5mg; July 2016-July 2017, tapered to 0mg

January 2018: First ever episode of full-blown psychosis (I believe it is rebound psychosis since I didn't have psychosis before)

Olanzapine: August 2018-February 2019, 10mg; February 11 2019, 9.375mg; March 14 2019, 8.75mg; April 17 2019, 8.125mg; May 16 2019, 7.5mg; June 13 2019, 6.875mg; 

 

 

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