BadMedicine: tapering off sertraline / Zoloft and olanzapine / Zyprexa

[BadMedicine]

Thanks for your advice @Rrsfc. It seems much more civilised where you are. I think it is like it is here because the NHS foots the bill for most of the medication other than a nominal charge for each item. The pharmacies are therefore forced to source the cheapest available brand which changes from one week to the next. Have to take the tough with the smooth I guess. Good that we don’t have to pay much but not so good that we get a lot of variation. Will try to get orodispersibles though. I think that sounds like a good idea.

I hope you’re right @hayduke that a longer hold will sort the problem. I wish I had transitioned to liquid at higher doses where small variation in dose seemed to have less effect. Having said that I’m glad I’m on 2.5mg as the side effects are much less noticeable. 
Anyway I will continue to hold for another couple of months and see how it goes.

[BadMedicine]

Thought it was time for an update. It’s been just over a year since I cold turkeyed from 18.75mg sertraline and at the same time dropped olanzapine from 5mg to 2.5mg. I don’t think I realised at the time how much this affected me. It’s only now that I am starting to recover that I recognise the bad things that this did to me. I know that sounds odd but I really wasn’t doing very well on sertraline and higher doses of olanzapine as well as Mirtazapine and I think the withdrawal symptoms just merged in with the adverse effects although they became more pronounced I think. After the initial acute stage of severe uncontrollable crying and suicidal ideation that lasted about two weeks it was mostly effects on my personality. I found I was jealous of everything - even really small things and felt differently about the people I loved. Just felt like the love I used to feel had gone and was replaced with ambivalence and even dislike. I have always had a really good relationship with my sister and this completely disappeared. I thought this was just who I was because it felt a part of me. Now a year later the feelings that I used to have have started to come back in fits and starts and I realise it was the drugs. I can’t believe how profound the effects on your personality can be. I turned into a completely different person that I really didn’t like very much. I am still struggling with the feeling of being a bad person because I was like this for so long (on sertraline as well as coming off) and I think it’s going to take a while to get my confidence back.

I also tried to drop the olanzapine to 1.8mg 3 months after the original drop to 2.5mg and this affected my sleep.I re- instated in the end to 2.5mg and this helped my sleep but it didn’t go back to the solid sleep I had before this drop. I can finally say my sleep has restored itself in the last few weeks and this has helped give me more windows of feeling like my old self. Still have a way to go but I have hope that I will get my old self and life back. Because I didn’t like myself on these drugs I have pulled away from my friends and haven’t been living my life really for the last few years. I am now getting to the stage where I feel confident in myself to tentatively start heading out into the world again. It is going to be baby steps but hopefully as I recover more I will feel more confident about meeting with other people and hopefully my great relationship with my sister will be restored. It was the best thing I have done getting off these drugs. It has been hard but the benefits are now starting to show which makes me realise I definitely did the right thing. 
Need to get off the rest of the olanzapine but for now I think holding is the best option to really consolidate my sleep and personality restoration.

[SeekingMeaning]

Just wanted to say I'm so pleased to read a little bit of goodnews from someone going through similar to myself (Off Sertraline now but seriously suffering from trying to reduce olanzapine, definitely bad panics and sleeps happening)

I lived in Leicester from 1984 till 1987, fond memories of the place.

I'm glad you feel good about the changes you made.  For all the harsh effects I'm having I prefer myself off the meds too.  Perhaps Sertaline and Olanzapine are poor bedfellows.  I never felt I had any benefit from the sertraline and as the years went on I felt sure it was making me more depressed not less.

[helpful]

wanted to ask, does anyone know, if your doing a micro taper, if you wait long enough to stabilize the best it gets, can each lowering at same dose become a little easier with each continued lower.

[BadMedicine]

Hi @SeekingMeaning. Thanks for your comment and great to hear from a fellow Leicester dweller. I have lived here for the last 7 years. I live just outside Leicester and really enjoy the lovely countryside surrounding the city.

 

Really glad I could provide some encouragement with my experience. Also pleased you have got off sertraline and are feeling better for it. Hopefully as time goes on you will feel better and better as the effects of the drug gradually disappear. Olanzapine is notoriously difficult to get off. I read your signature and see you have got down to 0.6mg. You have done extremely well to get down so low so quickly. I really hope the withdrawal symptoms ease for you soon with a hold at this dosage. 

 

I was interested to read you got prescribed an oral suspension of olanzapine. I didn’t realise it existed. I tried to make a home made suspension to try to taper off the 2.5mg that I am on but I got insomnia so had to abandon it. Will try and get a prescription for the oral suspension myself.

 

@helpfuli didn’t do a micro taper so don’t have experience of small dose reductions. However I have read other people’s experiences and think that as you transition down you have dose levels where the reductions are easier and levels where it is harder depending on the relative affinities at each dose for different receptors. At times when the occupancy curve is steep so small changes make big differences in percentage binding of the drug to its receptor the tapering will be more difficult. At times when big changes make small effects on receptor occupancy tapering will be easier. I think for most of the ssri’s the receptor occupancy curve for the serotonin reuptake receptors is fairly steep at lower dosages so may mean that tapering becomes more difficult as you get lower. Hope that makes sense. As I said I don’t have personal experience myself so might be best to ask that question to someone who has done a micro-taper. It may also depend on the drug.

[SeekingMeaning]

My GP was very reluctant to prescribe the oral suspension long term leading me to blithely say it's ok, I'll get off it in a month.  Ha ha.  I did drop quite a long way but every single drop was accompanied by dreadful lurching anxiety and insomnia.  I've realised I've over done the reduction and am toying with taking a bit more again as the insomnia and overwhelming dread at night is getting wearisome.  I'm trying to stick it out though, as any experiment upward would just be more tedious withdrawal down the line...

 

Personally I am coping much better on home made suspension than the prescribed one.  I have read somewhere that people can have trouble with the liquid formulae and it does seem I am one of those.  I'm on my second night of using a self made suspension (one 2.5mg tablet in 10ml and take 2.5ml to get 0.6mg - had to get husband to check this, I am so challenged numerically at the best of times).  Using my own suspension I get a slower hit, less woozy and zombified immediately on taking it.

 

Good luck with the suspension if that's the way you decide to go.  Be interested to hear.

[helpful]

4 hours ago, BadMedicine said:

Hi @SeekingMeaning. Thanks for your comment and great to hear from a fellow Leicester dweller. I have lived here for the last 7 years. I live just outside Leicester and really enjoy the lovely countryside surrounding the city.

 

Really glad I could provide some encouragement with my experience. Also pleased you have got off sertraline and are feeling better for it. Hopefully as time goes on you will feel better and better as the effects of the drug gradually disappear. Olanzapine is notoriously difficult to get off. I read your signature and see you have got down to 0.6mg. You have done extremely well to get down so low so quickly. I really hope the withdrawal symptoms ease for you soon with a hold at this dosage. 

 

I was interested to read you got prescribed an oral suspension of olanzapine. I didn’t realise it existed. I tried to make a home made suspension to try to taper off the 2.5mg that I am on but I got insomnia so had to abandon it. Will try and get a prescription for the oral suspension myself.

 

@helpfuli didn’t do a micro taper so don’t have experience of small dose reductions. However I have read other people’s experiences and think that as you transition down you have dose levels where the reductions are easier and levels where it is harder depending on the relative affinities at each dose for different receptors. At times when the occupancy curve is steep so small changes make big differences in percentage binding of the drug to its receptor the tapering will be more difficult. At times when big changes make small effects on receptor occupancy tapering will be easier. I think for most of the ssri’s the receptor occupancy curve for the serotonin reuptake receptors is fairly steep at lower dosages so may mean that tapering becomes more difficult as you get lower. Hope that makes sense. As I said I don’t have personal experience myself so might be best to ask that question to someone who has done a micro-taper. It may also depend on the drug.

 

[helpful]

Just now, helpful said:

 

thank you.

[BadMedicine]

@SeekingMeaning Olanzapine withdrawal symptoms are brutal. I have tried once to go below 2.5mg by taking 3/4 of a2.5mg tablet and had similar symptoms to you. Severe anxiety, a feeling of dread in the morning, insomnia and nausea. The anxiety and nausea went away after nine weeks but at 12 weeks I still had insomnia. I got some sleep but I would wake up in the night and be completely wide awake with no chance of getting back to sleep. In the end I got a return of some psychotic symptoms which I hope were withdrawal related and by going more slowly I can avoid. So I had to re-instate 2.5mg of the drug which thankfully worked so I didn’t have to go any higher. It might be wise to consider a small re-I statement to make yourself more comfortable. I completely get where you’re coming from that you don’t want to go backwards which means more reductions further down the line but it might actually be of benefit in the long term.

incidentally, you’ll be interested in this I’m sure. I spoke to my psychiatrist yesterday who said he’d never come across people having trouble withdrawing from Olanzapine and I was on such a tiny dose that I could just stop it! But when I told him I was having trouble getting off it because I would be hit by insomnia, anxiety etc he just said that meant that the drug was doing something positive and I was relapsing. No wonder they don’t think that people get withdrawal symptoms - they just chalk it down as relapse. Never mind that I was sleeping fine on just Mirtazapine before I started olanzapine and am still on Mirtazapine but have trouble sleeping as soon as I reduce the olanzapine. After a long discussion where neither of us agreed with each other he did agree at least to ask the GP to prescribe liquid olanzapine so I can give that a go. I’ll let you know how I get on although I think it will be a couple of months before I start reducing again. 

[BadMedicine]

I was wondering if anyone has experienced an increase in speed of cycling of waves and windows.Afterstopping sertraline and reducing olanzapine from 5 to 2.5 Feb 2020, then to 1.8 in May, then back up to 2.5 mg where I have been holding since August/sep last year I have had waves of depression and wanting to cry for no reason. But they have been quite infrequent and in between I have actually had a quite good mood as well as my personality and ability to talk to people slowly coming back. Recently, however I have been cycling rapidly between depression and feeling a bit better maybe 2 to 3 days of each and back again. I was never like this before I took drugs so I don’t think it is bipolar or anything. I was wondering whether this is my brain speeding up the healing or whether it is just the full force of the withdrawal symptoms hitting me one year later. Does anyone have any experience with this and can shed some light on why my pattern of symptoms may have changed?

[morgana]

hi @BadMedicine i also experience these waves of emotions, i have been on 2.5mg for nearly a year now, in early feb 2021 the only change i made was taking it 3/4 solid and 1/4 liquid with 5mls of water...i feel i am on a roller coaster of emotions, i feel really happy, alive, positive, sociable and i am thinking more as well, however the more i think the more i  become emotional which i am not use to. i start crying and i get angry.......zyprexa took away my feelings now i am experiencing them...especially now that i am thinking more....i need to learn how to deal with them in a positive way....as zyprexa took away the need to speak, i think i really need to now express how i feel by talking to someone....i think just having someone who will listen and not judge us is what will help with our emotions....so no your not the only one going through with it..i am too...cheers morgana

[BadMedicine]

@morgana thanks very much for your reply. It’s incredible what these drugs do to us isn’t it. I guess it is a good sign that emotions are coming back but it is difficult to cope with the extremes. I guess these will even out as time goes on and our bodies get used to functioning without the drugs. It’s great that you are becoming more sociable. I have as well since dropping the sertraline and olanzapine to 2.5mg last year. I still feel like I have got a long way to go in that department though and it gives me hope that you are noticing improvements in this area even if the emotions are difficult to deal with at the moment. Better to have strong emotions than no emotions. Regulation will come with time as our bodies adapt to the new status quo.
 

It is surprising that you have such strong symptoms having just converted a quarter of the tablet to liquid. I too had trouble moving to liquid but I tried converting the whole dose. Had to give up because it gave me insomnia. I do wonder whether the bio-availability of the drug is less in liquid. I am going to try and get the prescription liquid to taper but feel I need to be a bit more stable before I continue tapering- frustrating as it is to hold longer.

[BadMedicine]

Well I have started to make steps to reduce the olanzapine. Got my psychiatrist to recommend to the GP that I be prescribed liquid olanzapine. However GP refused due to cost and said she wouldn’t be able to prescribe more than one month anyway. She did agree to prescribe orodispersible olanzapine which will hopefully be more successful in solution than when I tried to dissolve solid tablets. It actually says in the product insert you can take it as a solution. Thanks @Rrsfcfor the recommendation for using these. So I’ll  take the full 2.5mg dose for a month then very conservatively start reducing by 2.5% every 15 days. Still not completely stable after my big drops last year but feel I need to start reducing this drug further. My sleep is really good so from that perspective at least things are in a good place. Quite excited to start reducing again. 

[Rrsfc]

You're welcome, hope you are successful. I will follow the same plan as you starting in October if all goes well, but I'm planning to extend from 15 days to a month maybe between drops. I will be extra careful, better go slow than having to go back up again 😔. We have to be really patient with this drug. Best wishes on your journey! 

[morgana]

hi @BadMedicine i wish you all the best and let us know how you go with your taper

 

[hayduke]

Good to hear you’re feeling steady enough to look at tapering again BM.

 

Interesting you can get the dissolving strips in 2.5mg - here they’re only in 5mg.  Was it @Nicjk asking about these?

 

How are you feeling with the new tablet type?

[BadMedicine]

Thanks for the best wishes @Rrsfc, @morgana. I will keep my thread updated once I start.

 

@haydukei don’t think the orodispersible tablets do come in 2.5mg here. The doctor told me they did and said she’d prescribed them but I can only find references to 5mg. I haven’t picked up the prescription yet so I ‘ll see what I get but I think she may have prescribed the normal tablets by mistake. Another thing to sort out again before I can start!

[Rrsfc]

Hi, I used the 5mg ones, there are no 2,5mg orodispersibles here. I just break the pill in 2 with my nails. It's not perfect but it worked for me. I am rooting for your success. Keep us posted so we can support you! Hope you have a nice day 😊

[BadMedicine]

Thanks @Rrsfcfor your encouragement. There was a misunderstanding with the Drs who kept asking the pharmacy if they could source 2.5mg orodispersible tablets which they could not as they don’t exist. Despite me telling the dr the lowest dose they come in is 5mg she was convinced the pharmacy could get orodispersible tablets at all. So I am still getting the normal tablets. However I have been more successful making home made liquid from these. By using distilled rather than tap water i seem to get a solution that remains effective. No insomnia like last time. I took this for 2 weeks and have now dropped by 2.5% to 2.43mg. I have taken this for the last 3 days and so far so good. No discernible withdrawal symptoms yet( but it is early days). I’m excited although a little nervous to be getting going again. 

[Rrsfc]

That seem to be great news! No withdrawal is wonderful, hopefully it stays that way. I wish you all the best. 

[morgana]

hello @BadMedicine, great to hear your sleep is back and your tappering again....i am crossing over to water as well, but my sleep has gone down hill...why do you think would be the reason for the distilled water to help you with your ability to sleep?  was that the only thing you changed? let me know cheers morgana

[NNhope]

I am currently on 5 mg olanzapine dropping from 10mg. Still experiencing some withdrawal symptom cause it's only been 3 in a half week since I drop. The first 2 weeks were awful. I kept pacing around the house and wasnt able to relax. That has settled quite a bit though. Was looking for others who are also getting off this drug and found you and hayduke. I hope after some stablising I can drop to 2.5 mg without problems like you were able to.

 

Will be following your progress and journey.

[BadMedicine]

Hi @morgana. I tried to cross-over to water in January and just went straight to dissolving the whole tablet in tap water. Immediately got hit with bad insomnia. It was notable because prior to that I had been getting good sleep. It felt like I wasn’t really getting very much of the dose at all. So I had to go back to the solid tablet. I did wonder whether the chlorine in the water might be reacting with the tablet and making it ineffective so this time I used distilled water. I have also only dissolved a quarter of the tablet and am going to taper down that portion and then when I get down to 3/4 of a tablet dissolve another quarter and so on. But this feels really different. I haven’t noticed any difference in effect so it feels like I am getting an effective dose from the dissolved portion. I have tried reducing by a quarter of a solid dose before and had massive insomnia from that reduction so I think I’d notice if it wasn’t working.  @haydukeyou have quite a lot of experience in water titration. Do you use tap or distilled water?

[BadMedicine]

@morganaalso just to add. Sorry your sleep has gone downhill again. I hope it picks up soon for you. Insomnia is such a horrible symptom. Makes everything else 10 x worse.

[hayduke]

That’s good news you’re on the way again @BadMedicine

 

I use filtered water from a britta style jug.

 

The water here is good to start with, I brew beer with it straight from the tap and it’s better than fine.

 

In any case it may be impurities in your local tap water, there can be all sorts of minerals, chemicals, microorganisms etc in it.  If distilled water works for you, may as well stick with it.

[Altostrata]

Please start an Introductions topic for yourself, @NNhope, so we can discuss your situation without taking badmedicine's topic off-track.

[NNhope]

@Altostrata I did yesterday but it still  needs to be approved. 

[BadMedicine]

Thanks @haydukefor your input on the water titration. 

 

Spoke too soon about not getting any withdrawal symptoms. Was fine for first 4 days, felt fine and sleep was still 8 -10 hours. Last couple of days sleep has been more like 5- 6 hours. Still manageable but a reminder that this process needs to be done excruciatingly slowly!

[hayduke]

Maybe it's more just the longer time period that's let you cross over easier now BM.  Either way, why mess with what's working.

 

Sleep going from 7-8 down to 6 hrs sounds pretty routine after a 2.5% cut for me, too.  Bear in mind it generally takes our bodies about 4 days to feel the effects of a cut.  Don't be shy of waiting a day or two for better sleep before making the next cut.  The calendar is a guide and a record of what your body's telling you, not marching orders 🙂

 

Cheers

[BadMedicine]

You could be right hayduke. It could just be that I have given it enough time for the dust to settle after my drip from 5 to 2.5mg. We’ll never know but as long as it’s working I guess it doesn’t matter.

 

Thank- you for sharing your experience with your sleep after a 2.5% drop. I was getting a bit worried that I was having a really strong reaction and that I was really sensitive but it seems like it’s par for the course. It’s gratifying that it seems to improve quite quickly though. Am back to sleeping 8 hours again although it is still a bit broken. Planning to reduce again on Sunday but I will heed your advice and not push it if the withdrawal symptoms start hanging around for longer.

[hayduke]

Sounds like you're on the way again.

 

I think around 1.5 or 1.25mg I crossed a neurochemical line that reverted my 'normal' sleep from a drugged 9-11 hrs down to 6-8.  I had to do a longer hold there for a while, not surprised, but now I'm pretty good on those sorts of hours.  It's winter here now so tapering a bit more enthusiastically while the cold and dark fosters better sleep.

 

I take nanna naps too...getting older, everybody tells me they sleep less at night.  But mostly seem happier too.

 

When I know I'm not getting enough...cranky, flaky etc...that's when I hold.  Under 6 hrs for 3 nights in a row and I know to let things even out before another cut.

 

Cheers

[BadMedicine]

Time for a little update. I have got down to 2.3mg by tapering 2.5% every two weeks. It feels like slow progress but I am pleased with to be moving forward and hope that this pace will be slow enough to prevent any super sensitivity psychosis. 
 

I have noticed some withdrawal symptoms. My sleep sometimes gets a bit broken about 4 days after a cut and sometimes drops down to 6 hours for a couple of nights. But this seems to quickly rectify itself. I had a couple of weeks where I was in a bit too good of a mood but this has resolved now. Unblocking of dopamine receptors I expect which have now normalised a bit. Also some days of fatigue and headaches but nothing unmanageable. All in all it is very tolerable and I encouraged by this even if it does feel painfully slow. If that’s what it takes to get off this drug safely though then that is what I will do.

 

I’ll look out for the effects at 1.5 - 1.6 @hayduke. Thanks for the heads up. It’s so good to have your experience as a guide for what to expect during this process.
 

[Rrsfc]

Well done, hope it continues to go well for you! 

[BadMedicine]

Thanks @Rrsfc. Hope you are doing well too. X

[morgana]

its good to hear you are doing so well @BadMedicine, you know i read stories such as yours, hayduke, venkat, rupa and many others who are all tappering and slowly but surely they are achieving their goal, of one day not being on this horrible medication, they inspire me and give me hope that i will achieve my goal too....and know i am not the only one experienceing these issues of insomonia and so forth....keep going...and keep us up-dated because i am following in your foot steps...cheers

[Venkat]

Hi @BadMedicine,we haven't been introduced to each other so far.

 

Hope you don't mind my intrusion in your thread. Just couldn't avoid the temptation. 

 

Hope you are doing well. 

 

Best wishes and regards 

Venkat