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Nomad

Nomad: Olanzapine, alprazolam withdrawal nightmare

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Nomad

Thank you all so much for all your hard work here! I am a 46 year old male. I was diagnosed with depression in 2005. I was prescribed Zoloft. A manic episode then ensued lasting about 6 months. I also developed insomnia and hyperhydrosis. I went to another doctor in 2006 who diagnosed me with Bipolar II. I was then preescribed Lamictal, Depakote and Effexor. I do not recall the dosages this far back, except the Lamictal (200mg)

   Around 2009 I began seeing another doctor after I moved. I remained on the Lamictal (200mg) discontinued the Effexor, and added Abilify (5mg). Around this time the insomnia worsened. I then was prescribed 2mg of Xanax and 25mg benadryl each evening for the insomnia. I was relatively stable (except for a string of toxic relationships) over the next several years and reduced the Abilify to 2.5mg. However the insomnia and hyperhydrosis still remained very problematic throughout this period. In an effort to find relief from the insomnia (At that time I believed that it was just a side effect of the Lamictal) I tapered myself (without a doctor) off of the Lamictal over a few months in 2017. I did not notice any withdrawal symptoms. However the insomnia persisted leading me to believe that the Abilify was also causing the insomnia. At this time I was taking 2.5mg of Abilify but only 2x per week, and still needed to take 2mg Xanax and 25mg benadryl. In 2018 I attempted to discontinue the Abilify and taper off the Xanax over a period of about 2-3 weeks. I suffered from moderate panic attacks and anxiety (presumably Xanax withdrawal symptoms) Those withdrawal symptoms dissipated. About 2 weeks after discontinuing the Abilify my sleep was restored to normal for the first time in nearly 13 years! However the hyperhydrosis persisted.

   Unfortunately I soon began to feel extremely unstable mentally and was forced to reinstate the 2.5mg of Abilify. The insomnia returned and I then started the 2mg of Xanax and 25mg of benadryl again. 

   Throughout 2019 my insomnia seemed to progressively get worse. I did not want to take more Xanax so I went to another doctor who prescribed Olanzapine. I discontinued the Abilify and started taking 1.25mg of Olanzapine. At first I only needed 1mg of Xanax at night and discontinued the benadryl. Then after about only one month the insomnia progressively got worse. I reinstated 25mg of benadryl. Then had to increase to 1.5 mg of Xanax. I was getting really worried about the progressive insomnia so I decided to stop the Olanzapine (without a doctor) cold turkey and taper off the Xanax. This is when things started to get really scary.

   Symptoms of panic, anxiety and hypomania ensued after 3 or 4 days of withdrawal.  And the insomnia was worse then it ever had been in my entire life! I was really getting scared. I reinstated 1mg of Xanax. Also increased to 50mg of benadryl and added 15mg of cbd oil orally for sleep. Also, It was around this time that I was doing research and discovered this website. 

   After 10 days of being off the Olanzapine my sleep was still horrible. Dealing with withdrawal and almost no sleep suicidal ideations returned.
  I reinstated Olanzapine at 1.25mg. I have now been back on the Olanzapine for 3 weeks. My sleep has slightly improved. I am currently taking 1.25mg Olanzapine, 1mg Xanax, 25mg benadryl and 15mg cbd as needed when I awake in the middle of the night. I absolutely do not want to increase the Xanax. 

   My desire is to safely taper off of all medications. The progressive nature of my insomnia on the antipsychotics has convinced me that remaining on them is unsustainable for the long term. Additionally the hyperhydrosis limits my ability to exercise. Strenuous daily exercise has proven to be one of the most effective ways to manage my mood. If I stand any chance of remaining stable without medication I must try to reverse both the insomnia and hyperhydrosis. Obviously I am sensitive to even the smallest doses of antipsychotics. From my research I am convinced the tapering strips from taperingstrip.org in the Netherlands is my best option for tapering off Olanzapine. Unfortunately I have not been able to find a doctor willing to order them. Can you recommend a doctor anywhere (preferably in the Western or Northwest United States who is cooperative with efforts to taper off antipsychotics?) I am a perpetual travel and have to ability to some extent to go to where the doctor is at. Thank you again for your help. Your work with this website may have already saved my sleep and even my life.

Edited by manymoretodays
reduced font size to 14, for ease of reading, mmt

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Gridley

Welcome to SA, Nomad.

 

Here is our list of recommended doctors.  It dates back to 2011 but does have some recent posts, so I'd start at the end and work back.  In additional to the tapering strips, a compounding pharmacy is another possibility.  Some doctors might be more willing to prescribe going that route.

Recommended doctors, therapists, and clinics - Tapering ...

Your system is very sensitized from the cold turkey and all the changes in dose.  One other factor to consider is that you are taking three sedating drugs.  Sometimes when you are taking too many sedating drugs, the body fights to overcome them, producing a paradoxical effect that produces the very insomnia you're trying to escape.  You are also in withdrawal, and one of the most common symptoms of withdrawal is insomnia.

 

What is withdrawal syndrome.

 

We recommend tapering by no more than 10% of current dose every four weeks. We recommend tapering only one drug at a time.  Since your system is destabilized from all the changes, you might consider holding at your current dose for a few months to stabilize before beginning your taper.

 

Why taper by 10% of my dosage?

 

This is link is specifically about tapering Olanzapine.

 

Tips for tapering off olanzapine (Zyprexa)

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

 

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Nomad

   Thanks Gridley for your quick reply. It makes a huge difference to know that I’m not completely alone going through this. I’m excited and hopeful about calling some of the recommended doctors tomorrow. 
   Also great suggestion regarding fish oil and magnesium. I should have included that in my intro but it was already quite long. For several years I have been taking magnesium glycinate, vitamin D3, and fish oil with the suggested ratio of omega-3’s as found here: https://psycheducation.org/treatment/mood-stabilizers/omega-3-fatty-acids/fish-oil-research-details-2/

  • “highly concentrated so you can get to 1,000 mg (1 gram) of EPA per day in 2 or 3 pills  per day
  • at least 60% EPA. “

I credit these supplements, along with freeing myself from toxic relationships with attaining stability on very low doses of medicine. Such low doses were not possible several years ago. And I am hopeful that with a strict exercise regimen, and positive social environment that I will be able slowly taper off all medicine. 

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Gridley
1 hour ago, Nomad said:

Thanks for the great link, Nomad.  I've been taking OmegaBrite brand (warning:not cheap) for years.  Three pills gives me 1050 EPA and 150 DHA, for a percentage of 87% EPA.

 

Good luck on your doctor search and taper.

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hayduke

Hi Nomad, trouble sleeping seems to be the norm when coming off this stuff.

 

Good work ditching the abilify, I tried it for a couple of weeks years ago and it was worse than four cups of espresso a day.  Speaking of which, getting clear of caffeine is a good idea during this process too.

I've been tapering off olanzapine for a while and found that the sedative effects of the drug basically petered out below 1.4mg.  I used to sleep 9 to 11 hrs most nights on it, even at 2.5mg when things were noticeably improved compared to 5 and above.

 

On my way down I held for several months at 1.25mg because that part of the transition was challenging and it felt like no man's land.  The drug isn't really doing anything for you at this point that I can tell, but you're not off the hook at that point either.  I suspect this is why they don't sell it in that dosage.  It is interesting as you reduce the drug over time that there are a number of quite distinct stages of 'terrain'.

 

FWIW I'm at 1.00mg right now and am sleeping fewer hours but still getting good rest. 

 

I'd guess that the Xanax is giving you whatever sleep you're getting.

 

The link Gridley gave you about tapering olanzapine has links to other threads about ways to titrate your doses instead of relying on the expensive and potentially hard to import tapering strips.  They're a great idea but out of easy reach here. 

 

I use a liquid suspension with a pipette, and when I'm on the road I use a 50ml syringe which I've found accurate enough.

 

Cheers

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Nomad

   Thanks for sharing your experience Hayduke. You’re really tapering down slow. That’s good. And good idea to get off caffeine! I quit caffeinated coffee a week ago. Seems like it did help.
    I have also been keeping a brief journal tracking my sleep quality, mood and medicine dosages. When there are so many variables it’s really helpful to have that information as a reference. 
   As was recommended, I’m going to wait before I try to taper down. I will reconsider using the liquid suspension method for tapering if I can’t get the strips.  👍🏻

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Nomad

Just a quick update: I gave up trying to find a doctor to help me acquire tapering strips. I opted to make a suspension myself. Fortunately I had a sufficient cache of Olanzapine. I began tapering from my original dose of 1.25mg on April 4, 2020. I’m now at .6mg. Half way there!!! Yay!!! My sleep has actually improved a bit, although there were some bad nights especially in the beginning of the taper. I included REMfresh melatonin .5mg to help with sleep. I would highly recommend doing your own research on this melatonin. It seems to help myself and my brother more than regular melatonin. 
   To stabilize myself without medication I am implementing a daily routine of exercise, breathing, meditation, positive social interaction and more meaningful time in nature. I find that not relying on medication forces me to spend much more time and effort to keep stable. Fortunately I’m not working so I have sufficient time to dedicate to my healing. I’m keeping a brief daily journal detailing my taper progress, mood and sleep quality. 

   I’m also trying to achieve a healthier gut/digestive system by eating more organic whole foods. I would like to include probiotics and was wondering if anyone could offer information about gut health and which specific probiotics they are taking. Thank you all! I could not have gotten this far without your help!

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hayduke

Hi Nomad, glad to hear your taper's going well.

 

I'm not sure there is much conclusive data about which probiotics are best.  Gut health seems to be a bit of a frontier, obviously it matters a lot.

 

You can spend a lot on capsules but I find pretty much any decent yogurt is good enough.  A few times a week I like to have a bowl after dinner - I blend a few shots of hemp seeds for omega 3/6 (since I don't eat seafood), and throw in a gramme or three of magnesium l-threonate.  Always seems to settle things down nicely.  Add fresh fruit, chia or linseeds at will.

 

Cheers

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Nomad

Hi, Hayduke! Good suggestions. I believe nature gives us most of what we need. Today I bought some fermented foods at the local farmers market. Between that and yogurt, I think I’ll call it good and skip probiotics in capsule form. 

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Artistic1

Hi, Nomad. It sounds like you are trying lots of good things. I'm not on the meds that you are, but I still have a recommendation. Nowhere do you mention whether you're doing therapy or not. I highly recommend finding a good Cognitive Behavioral Therapist that perhaps specializes in sleep disorders and insomnia. My CBT therapist has been invaluable in helping me deal not just with my original condition (anxiety and depression) but with tapering the meds and the sleep problems. My belief is that you have to address everything involved. That means not just the meds, exercise, and diet, but the mental thought processes as well. The CBT has reduced my anxiety by 85% and the depression by about 65%, making it possible for me to taper off Zoloft. Best of luck!

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hayduke

That's a good result for the CBT @Artistic1.  It can be very helpful, depending on what you're working with.  In my case last year my psychologist and I weighed up CBT vs EMDR and decided the latter was more appropriate for the trauma we were unearthing.  It's probably not an understatement to say it's given me my life back (better late than never!).

 

I would like to see these sorts of options replace drugging as the common first option when people want or need help.

 

Main thing is finding a clinical psychologist you like.

 

Cheers

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Artistic1

That's great that the EMDR worked for you. And I agree - the psychological therapies should be the first line before pills are dispensed. Good luck!

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Nomad

Thanks for the reminder about psychological therapy, Artistic1. Great to hear your success story with it.

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