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BadMedicine: tapering off sertraline / Zoloft and olanzapine / Zyprexa

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BadMedicine

Hi,

I would like to introduce myself as I’m new to the forum. I’m really glad I found this website – some really good information regarding withdrawal and can definitely see some of the characteristic signs of withdrawal in what I’ve experienced since reducing some of my psychiatric medication.

So to give you a bit of background about what drove me to investigate adverse effects to psychiatric medication – both being on it and trying to get off it! (Sorry it’s a bit long!). It all started with a psychotic episode that I endured for 3 months before finally getting help. I know that I needed some treatment – I wasn’t getting better on my own and I was struggling to live my life not to mention being scared out of my wits most of the time. I have no problem with the fact that I needed psychiatric medicine to intervene at this time. I was put on mirtazapine as the doctors put my symptoms down to depression. I started sleeping again which I hadn’t been doing for more than 2 – 3 hours a night for over 3 months. Very quickly the worst of the psychotic symptoms – the paranoia, fear of being in the house and the worst of the voices went away and I started living my life again. However, I still had some residual voices which I wanted to get rid of. I saw a psychiatrist and he prescribed aripiprazole and this is where everything started to go downhill. I wish I had just lived with the voices as they weren’t very bad (certainly nothing like when I was first ill.) and I felt good on the mirtazapine. The aripiprazole made me extremely depressed and gave me bad anxiety. The psych tried upping my dose of mirtazapine to 45mg to combat this. This left me extremely agitated and unable to sleep at all for days so I reduced it back down. I decided to taper off the aripiprazole. For a whole month after reducing the aripiprazole I had the worst suicidal depression I have ever had, which took me back to the psychiatrist. He changed my medication completely – taking me off the mirtazapine which had worked initially and putting me on sertraline and olanzapine. This, also has been a disaster. I wish I had just ridden out the depression after the aripiprazole which I expect was withdrawal symptoms. I think the sertraline gave me anxiety, although I would have a few good days here and there, so just thought the dose needed increasing. Ended up on 200mg sertraline and 7.5mg olanzapine for good measure. I was so anxious I was having trouble just talking to people about very mundane things, as well as days of bad depression, punctuated by a few good days here and there. I also still had some voices so the anti-psychotic wasn’t that helpful anyway. Eventually the inability to live my life properly made me suicidal and I told the psychiatrist that we needed to do something. I wanted to go back onto mirtazapine and get off the sertraline. He wouldn’t take me off the sertraline but did agree to add mirtazapine back into the mix so I was on 200mg sertraline, 30mg mirtazapine and 7.5mg olanzapine. I definitely improved with the addition of the mirtazapine but still felt the sertraline was doing more harm than good so set about reducing it once I had stabilised after the addition of the mirtazapine. I reduced from 200 down to 50mg over the course of 6 weeks – back in January 2019. Way too fast. Have been experiencing waves of severe depression and crying spells (although these are getting less intense) and windows where I have felt better. Generally apart from the nasty waves I feel much better than I did when on 200mg sertraline. Have also decreased the olanzapine to 5mg which resulted in 6 weeks of extreme fatigue and severe depression again. Ironically, since the addition of the mirtazapine and in combination with the olanzapine the voices have nearly gone. My aim is to get off the sertraline completely and also get off the olanzapine, which makes me very tired and lacking in motivation. I am holding for the moment as we are due to go on holiday in 5 weeks time and I don’t want to have any nasty withdrawal symptoms to deal with. I would like to do the remainder of the reductions with your support as doing it with people who understand what you are going through will, I reckon, make it a whole lot easier. I look forward to interacting with you all.

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Sassenach

Hi BadMedicine

 

Welcome to SA.

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can. 

  • Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • This is a direct link to your signature:  Account Settings – Create or Edit a signature.

Your signature will give the mods your  history and current drug/supplements regime at a glance.

It will appear below every post and should be updated with any changes.

I am glad to see you are holding at present and should continue to do so until the senior mods on here get the chance to review your info.

All the mods on here are volunteers with an increasing workload, so please ensure requests from them are complied with.

We are here to help you, help,yourself.

 

Here are links for your information.

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

https://www.survivingantidepressants.org/index.php?/topic/3949-stabilizing-after-a-reduction-what-does-that-mean/?view=findpost&p=51543&hl=%2Breinstating+%2Bupdosing

 

Sassenach

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BadMedicine

Hi Sassenach, 

Thanks for your reply and the information. Have updated my signature to include my drug history. When I look at it like that I can't believe how many changes I have made over the course of the last two years! No wonder my brain is struggling a bit! 

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ChessieCat
On 8/5/2019 at 10:16 PM, BadMedicine said:

Gosh it's a long road isn't it but I guess it's worth taking it so slow if it means the taper is successful and relatively painless.

I am holding at the moment at 5mg (down from 10). we are going on holiday (myself and the husband) in 2 weeks time and will recommence my taper when we get back. I think from reading around this site I might have to do the sertraline first before I carry on with the olanzapine taper though. Thanks for asking. 

 

It's a good idea to wait for a couple of weeks after returning from the holiday to allow your nervous system to recover from the stress of the holiday, and the stress of returning to your regular routine.

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hayduke

Hope your holiday is relaxing and fun BadMedicine!

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BadMedicine

Thanks chessiecat for the advice and thanks Hayduke for the best wishes. 

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BadMedicine

 Well I had a really nice holiday. Was so good to be away from work for a few weeks. Not sure it was restful as we packed a lot in but it was certainly restorative. Due to taking quite a long time to stabilise after cutting olanzapine from 7.5mg to 5mg and going on holiday and giving myself time to recover after getting back I have been holding for nearly 4 and a half months. So it is time to start tapering again. I am desperate to get off the sertraline. Think it has only done bad things to me. Although I started the sertraline at the same time as the olanzapine so it is difficult to pick apart one drug effect from the other the change in personality to becoming someone who finds it very difficult to talk to people now because of severe anxiety got worse as the dose of sertraline increased. I therefore have my suspicions that these problems were caused by the sertraline. Also I had a severe adverse reaction to escitalopram which suggests ssri's don't agree with me. Owing to my impatience I dropped the dose of sertraline by 25%. It hasn't been too bad to be honest. A few days where I dissolved into tears at the slightest thing but that has been the worst of it. Plus I have had a few days where I've felt a bit more like my pre-drug self who enjoyed social interaction which gives me confidence I might get my old personality back and that I am doing the right thing trying to get off these drugs. Luckily I've not had the bouts of crippling depression I had after I dropped the dose of sertraline from 200 to 50 in the space of 6 weeks that took me 9 months to stabilise from! Still I count myself lucky that it didn't go on for longer given some people's stories. Will give myself another week at this dose and then make the next cut. I just hope that my aggressive tapering schedule doesn't come back to bite me.

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BadMedicine

After holding for four weeks at 37.5mg I have made another cut to 25mg sertraline. Finding I am crying at the smallest thing which is a bit tricky when you have to work but otherwise OK. I have noticed for the good is a decrease in the anxiety I felt when I was on higher doses and talking to people, although still difficult is getting a bit easier.

I really think that people need to know how dangerous these drugs are. I think it's the sertraline that caused my problem with talking to people because that got worse the higher I went with the dose. I only went higher because I thought it was me not the drug. Then when I was on the highest dosage I had a bit of an epiphany and realised I needed to get off it. Sertraline nearly killed me I think. My inability to talk to people made me suicidal. I'm so glad I'm seeing improvement in this and although not back to my normal self I feel like I am moving in the right direction. Then once I get rid of the sertraline I have the olanzapine, which kills my motivation  to go! Oh joy!

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hayduke

Good to hear things are improving @BadMedicine - I hope it's a smooth ride off the sertraline.  I've done a lot of crying during my tapering, good to just go with it and let it out.

 

I can relate to the difficulty talking to people - when I was on the higher doses I found small talk difficult and sometimes clumsy and it's now improving a lot.  Hopefully you'll be more relaxed and comfortable before long!

 

Cheers

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BadMedicine

Looks like I was too optimistic about being able to go down on these drugs so quickly. They hold their chains tightly around you! Depression has started to creep in again. Pretty sure it is a withdrawal symptom as had this when I reduced from 200 to 50 over the course of 6 weeks. Hopefully it won't last as long as the previous time.

@hayduke. Thanks for your comments. Yes crying is a good release of pent up emotions. Always makes me feel better! These drugs have such profound effects on us but I'm glad you are coming out the other side and seeing major improvements.

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Sassenach

Hi BM

 

Are you currently at 25mgs Sertraline?

You are in real danger of entering full W/D if you continue to taper so quickly.

Your CNS is not keeping up with the large dose changes.

It is important to realise that there is a timelag before your brain reacts.

It then becomes a snowball rolling downhill bigger and faster.

Your last cut was over 30%, way beyond the 10% of current dose recommended on here.

why-taper-by-10-of-my-dosage/

Please put your full withdrawal history in your drug signature.

Have symptoms ramped up in the last week.

On 11/2/2019 at 2:19 PM, BadMedicine said:

Owing to my impatience I dropped the dose of sertraline by 25%.

This was only 3 weeks ago if the info. in your posts is correct.

The likelihood is that you are just beginning to feel the symptoms from this, and now you have made another large cut.

If matters deteriorate further it may be necessary to updose to keep matters under control.

 

Sassenach

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BadMedicine

Hi @Sassenach. Thanks for your message. Yes I am still on 25mg sertraline. It was actually 7 weeks ago that I made the initial drop. I didn't post until I was a few weeks into the drop. I held for four weeks before making the second cut. The first four weeks after the initial cut were OK. A bit emotional but nothing too bad. However the symptoms have ramped up  this week after the 2nd larger cut. I am quite keen to get off this medication so would like to avoid an up dose if possible. I will see how things go and hold until I feel more stable. I appreciate your advice about only dropping by 10%. I just wanted to push the envelope to see what I could get away with! I should have heeded the warnings from the evidence on this site. I'm hoping that holding at this level will allow me to stabilise.

Will update my signature later today/ tomorrow.

BadMedicine.

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BadMedicine

Well the depression lifted within a week but have been having uncontrollable crying spells with suicidal ideation again punctuated by days of feeling OK. So doesn't seem bad enough to need to re-instate but am holding for longer than the 4 weeks I was hoping for until things settle down a bit more.

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Sassenach

Hi BM

 

Good call

4 minutes ago, BadMedicine said:

uncontrollable crying spells with suicidal ideation

These are typical W/D symptoms so you should not make any cuts until this settles down.

Tapering is hare and tortoise stuff and too fast will put you back where you started.

Please complete your taper info. so we can see it at a glance if needed.

 

Sass

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BadMedicine

@Sassenach have updated signature. Was too many lines so have deleted some of the earlier stuff so more recent info is viewable.

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Sassenach

Thanks BM

 

Be patient, you will get there.

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BadMedicine

Thanks Sass.

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Sassenach

Hi BM

 

Are you stabilising?

 

Sass

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BadMedicine

Hi Sass.

 

Thanks for enquiring. Yes came out of the first wave with excess crying and suicidal thoughts had a few good days then had another mini wave. Have come out of that and have been really good for about a week. Think I am quite lucky in that I seem to recover quite quickly from these redictions. Saying that will probably jinx it and I'll head into another wave tomorrow!. 

BadMedicine.

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hayduke

Hey @BadMedicine, hope you're doing well

 

Cheers

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BadMedicine

Hi @hayduke. Thanks for popping by. I'm doing OK thanks. The withdrawal symptoms from the pretty big drops of sertraline hit quite hard with excess crying and suicidal thoughts but luckily don't seem to hang around too long. By about 4 - 6 weeks I generally feel reasonably stable and have definitely noticed an improvement in my anxiety talking to people at the lower doses once stabilised. Have been holding last drop for nearly 8 weeks. Have been feeling good for a couple of weeks so think it might be time to make another cut.

How are you getting on?

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Sassenach

Hi BM

 

Good to see you doing so well.

Keep it steady and remember as you reach lower doses the reductions need to be smaller, or they will increase percentagewise.

 Sass

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hayduke

Nice to hear you're going well @BadMedicine

 

Agree with Sassenach smaller cuts are likely to be less bother and you can probably make them more frequently then
 

I'm doing ok thanks, still holding at 1.25mg and quite content with that.  The fires are a national emergency here at the moment and I have to be functional in case I need to evac or help friends and family, so I'll wait till things are safe again before considering another cut.  But I feel like I'd be ready pretty quickly once that all settles. 

 

Been having B12 booster shots and got some methyl folate.  I think that is helping a fair bit too.

 

Cheers

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BadMedicine

@hayduke I hope you and your friends and family are safe from the fires. They are on the news over here and look horrific.

Glad you are feeling settled on 1.5mg. Good luck with your continued taper when you resume.

@Sassenach @haydukethanks for your advice about the rate of tapering. Agree that smaller cuts are likely to be easier but am so desperate to get off this stuff that I am going to continue with the same rate of taper that I have been doing and put up with the withdrawal symptoms. So I have made another 25% cut to 18.75mg. Hopefully it won't be too bad but at least it's another step closer to being off this stuff.

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BadMedicine

I haven't updated in a while. Have come a long way since my last post. Got down to 18.75mg sertraline and then cold turkeyed from there. Had really bad withdrawal symptoms for about 2 weeks. Suicidal thoughts and bad crying spells but they subsided pretty quickly. I also reduced my dose of olanzapine from 5mg to 2.5mg 2 weeks after dropping the dose of the sertraline. Gave me tiredness and depression for a couple of weeks. Thankfully no insommnia. Things eased after 2 weeks although I did continue to get occasional waves of 3 or 4 days where the depression and crying spells came back a bit stronger and at other times I felt a bit flat for about 3 months. Then had a last wave and then suddenly woke up feeling much better.

 

Since then I have reduced the dose of olanzapine to 1.8mg. This time I did have some mild insommnia where I was sleeping about 4 hours each night punctuated by a couple of nights where I slept my usual 9- 10 hours so it was doable. About 4 weeks after the reduction I also got some nausea, loss of appetite and heightened anxiety which has all settled now. Sleeping seems to be back to about 9 gmhours again and I am having trouble waking up in the morning again. Will hold at this level for 3 months then reduce to 1.25mg.

 

So glad to be off the sertraline and significantly down on the olanzapine. It hasn't been comfortable going as quickly as I have but worth it to have got down on the drugs. Definitely starting to feel more like the person I was before taking these drugs. The sertraline gave me really bad anxiety and now that it is gone I am finding talking to people easier although there is a lot of psychological damage to undo. The olanzapine killed my motivation. I used to be a very driven person and have got lazy since I started taking it. Although a long way to go I can feel some sparks of my old drive coming back occassionally and my emotions seem to be returning. I was a zombie at higher doses.

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Gridley
27 minutes ago, BadMedicine said:

then suddenly woke up feeling much better.

I'm glad you're feeling better, BadMedicine.

 

Could you please update your signature to reflect the changes you describe?  Here's the link:

 

Account Settings – Create or Edit a signature.

 

 

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BadMedicine

@Gridley signature updated. Thanks for your reply.

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hayduke

Hey @BadMedicine, glad to hear you're doing ok. 5 to 2.5mg is a huge cut in one go.  Don't forget to hold when you need a break.  It often feels a bit frustrating but then you get to feel stable at a better level than you were at before and smell the roses for a bit, and look at how far you've come.  Know what you mean about feeling the lights coming back on, it's always a balance between that and going well my body is saying don't cut more just now...we'll get there!

 

Cheers

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BadMedicine

Hi @hayduke. Thanks for your reply. You're right about needing to hold for a bit every so often. 5 to 2.5 wasn't too bad but dropping from 2.5 to 1.8 has been much more challenging. Am wondering whether it was because I hadn't fully settled from the last reduction. Either way I think a long hold is on the cards at this level. Thought the withdrawal symptoms had settled down but had another little wave of nausea and my sleep isn't entirely where it should be. Quite a few night time awakenings although I seem to get at least 7 hours of sleep at the moment so it's not too bad. Would be nice to feel stable for awhile as well, as you allude to. It is quite wearing almost constantly dealing with withdrawal symptoms.

Sorry to hear your body is protesting about reducing further. Hopefully an extended hold will sort that out and you'll be on your way again. You have come a long way and you should be very proud. Won't be too long now before you're off this nasty drug.

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Mewmewkitty

I neither didn't have problem between 5 mg to 2.5, but everything under 2.5 was really hard. Medicine says 2.5mg only have an antihistamine effect but I really doubt that..

 

Remember healing inevitable. Everything will be ok!

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BadMedicine

Hi @Mewmewkitty. Thanks for your response and encouragement and affirmation that it is difficult at these doses. Really helps. Yes I agree there's definitely more going on at these dosages than just histamine activity. 

Did you successfully get off olanzapine? How did you do it and how long did the withdrawal symptoms last? Thanks.

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BadMedicine

Well it's been nearly 9 weeks since I dropped my dose of olanzapine from 2.5 to 1.8mg. I am glad to say the nausea has abated which was troublesome but at least I have lost a few lbs of some of the 3/4 stone that i have put on on this drug. Sleep is still a bit disrupted getting between 6 and 9 hours a day with the occasional night of 4 hours so workable. I do feel though that I am getting glimpses of my pre- drug personality coming back which makes me determined to forge ahead. 

Another 3 and a half weeks till my next planned reduction. Hopefully things will have settled enough to be able to carry on as planned but if I need to I will hold a bit longer. These are very powerful drugs!

Anyone else have any experience of how long sleep disturbances lasted after dropping below 2.5mg olanzapine? 

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Hopela
7 hours ago, BadMedicine said:

Anyone else have any experience of how long sleep disturbances lasted after dropping below 2.5mg olanzapine

Under doctor supervision dropping from 10 mg to 2.5mg in 4 weeks, then staying 11 days on 2.5 mg before quitting that smallest of tablets and Olanzapine altogether I thought. From fear of dieing I reinstated 7.5mg after 14 days but still got 0 hours sleep, a dose that I prior to 0 mg got 12 hours of sleep at. I have slept very little sleep in 9 months. Most nights still I don't think I'm sleeping. Just resting. People say it's impossible so I assume I've slept some based on how tired I feel. But I think my brain has learned to recover some without sleep. I'm hoping to get to 5+ hours sleep back within 3 years time since dropping below 2.5mg.  Im now on 0.16mg and just 1 hour sleep after a second failed attempt at 0 mg, prior to that I think it might have been 2-3 hours. That is my experience even if not very relevant to a proper taper.

 

Also I want to add that except for going to 0 mg, due to "tablet practicallities" there are common mistakes made going from 5mg directly 2.5mg, and from 1.25 mg directly to 0.625mg and from 0.625mg directly to 0.31mg. I see you've been cutting a quarter of 2.5mg last time. I fyou continue that way that could work even the next cut, but once it becomes a halving, like you had between 5 and 2.5mg and like a potentially coming 1.25mg to 0.625mg,  it's begging for trouble no matter how "tolerant" you are. Going by 33% reductions at a maximum is what I need to do both below and above 2.5mg to avoid worsening sleep/restability. And I think of myself as having been able to deal with reductions very well, as wrong as they were.

 

 

 

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hayduke
15 hours ago, BadMedicine said:

Anyone else have any experience of how long sleep disturbances lasted after dropping below 2.5mg olanzapine? 

Hey BM, good that things are evening out.

 

By the 3rd or fourth weekly 2.5% cut in a set my sleep often gets around or below 7hrs a night.  Holding always resolves it within a few weeks.  If I’m only getting 6hrs or less for more than a few days I know to hold.

 

I think this is one of the downsides of the large cuts you’re making, it takes your body longer to catch up and it’s probably more uncomfortable for longer.

 

Water titration is my choice for these finer measures, easy once you get the hang of it

 

Cheers

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BadMedicine

@Hopela Thanks for your reply and sharing your experience. I have no idea how you are coping with so little sleep. You are a trooper. I will heed your advice about slowing down the lower I go with the dose. Your experience is a stark warning of what can happen. Its so hard not to be impatient when you desperately want to get off the drug but i can see the consequences are far worse than being on the drug for an extended period of time.

 

@hayduke Thanks for sharing your experience. These drugs are powerful aren't they. Even with a very considered slow taper it seems impossible to proceed without developing withdrawal symptoms. Glad they don't last long for you before they settle down. I think I might have to slow my taper down a bit now I have got to these lower doses. I hope as i continue to hold that the sleep disturbance from my last cut will normalise itself. It's definitely a bit better. Although the number of hours that I sleep isn't that different when I wake up in the night I don't feel wide awake and like my eyes are on stalks anymore so it is easier to get back to sleep. I guess all we can do is take it one day at a time. You are right patience is the key to getting off these drugs successfully.

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hayduke

Way too powerful.  I keep thinking the goblin who put me on them should try taking it for a year himself.  At least I never have to see him again.

 

Another way of looking at smaller cuts is you can do them more often.  Doing a few months at 10% month is helpful because it gives you a baseline you can tune future cuts from

 

Cheers

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