MikeyJC: Olanzapine withdrawal

[MikeyJC]

Hey all, glad to have found this community, though wish I had found it earlier..

 

I just tapered off Olanzapine 10mg over the past 9 weeks as per the Dr's instructions. It has been sheer terror to say the least, massive increase in insomnia, depression, anxiety, fatigue, etc. Fortunately I'm not working at the moment so have been able to rest most of the day aside from a daily walk which is the extent of exercise I've been capable of managing.

 

Anyway, I think if I could only sleep better then I'd be able to knuckle through this, so my question is, now that I'm off the poison...what can I do to help with insomnia. OTC antihistamines do the trick but I'm assuming they are unsafe for continued use? 

 

Any help would be much appreciated.

Edited April 10, 2020 by manymoretodays
added name to title

[Gridley]

Welcome to SA, MikeyJC.

 

Here are some links on dealing with insomnia.

 

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Tricks and tips to fall asleep faster

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

This link contains helpful information, including insomnia and also non-drug coping skills.  

 

 Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.   

See Melatonin for sleep   It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  

The following post by one of our moderators, Apace, has several excellent tips.

 

There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

As Gridley said and you by now clearly understand, insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict. 

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

---

 

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 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.

[MikeyJC]

Thanks so much for your thorough response Gridley. I will check out those links.

[MikeyJC]

Olanzapine withdrawal - What is actually going on?

 

Hi there,

 

As a sufferer of extreme withdrawal symptoms coming off Olanzapine I'm hoping someone can help me with an answer to my question. I'd like to know WHY exactly withdrawing causes insomnia? As in what is the specific mechanism behind this occurring? What's going on neurochemically that is resulting in this effect?

 

Thanks in advance!

 

Edited July 3, 2020 by ChessieCat
added topic title

[ChessieCat]

what-is-the-sleep-cycle

 

[MikeyJC]

Sorry but how does this answer my question? I'm well aware of the sleep cycle.

[Hopela]

MikeyJC, 

You "got sentenced" to 9 weeks and then a CT from 2.5mg, I went from 10 mg too and got 6 weeks and then CT from 2.5mg. After two weeks I thought I was going to die right there so I reinstated. Im still on the drug with severe insomnia and other problems 7 months later. My taper was doctor supervised but on my intitiative (they said I should stay on  for 2 years instead of tapering and they wouldnt buckle to give me a tapering plan until I had been on it for a month), however I was never told of any of the dangers of this drug, either of being on it or of getting off it. Doctors said it was my underlying condition emerging now when going off this protective drug, but in my view a condition I've never had before. Nor did I need the drug in the first place. I needed a sleeping pill due to external stress reaction but was forced on this. Hang in there.

 

They refused to give me melatonin, just various drugs, so I'm trying kiwi for sleep now: https://pubmed.ncbi.nlm.nih.gov/21669584/

This research is not conclusive: funded by a kiwi producer and I've found no follow up studies from 9 years after. However if youre grasping for straws you might aswell grasp for a kiwi and see if it does anything. I'm not sure with me but it's generally considered a healthy tasty fruit.

 

I also do intense workouts. It forces the body to behave properly and creates change. I use supplements and go to bed the same time every day. Also I do intermittent fasting which In my view gives a prolonged recovery windows every day when not bothered by food digestion.

 

 

[BadMedicine]

7 hours ago, MikeyJC said:

Sorry but how does this answer my question? I'm well aware of the sleep

Olanzapine is a potent histamine receptor inhibitor which causes drowsiness. As you continue to take it over time the body adjusts to make the sedative effect less strong potentially by producing more histamine or producing more receptors. When you remove the drug you have these increased levels of histamine signalling which keeps you awake. Over time the histamine signalling will down regulate back to pre- drug levels but it will take time. Over the counter sleep aids are also anti- histamines which is why they can substitute for the olanzapine although I think they are less potent than olanzapine so it is a good sign that they work and suggests you have made some adaptation back to pre- drug levels of histamine signalling. Using those once in a while is OK when things get desperate but it will ultimately hinder your adaptation back to being able to sleep without drugs.

I too am tapering off olanzapine. It is very difficult even going slowly but the brain tends towards healing so it can be done. Healing is inevitable - it just takes time unfortunately.

[MikeyJC]

11 hours ago, BadMedicine said:

Olanzapine is a potent histamine receptor inhibitor which causes drowsiness. As you continue to take it over time the body adjusts to make the sedative effect less strong potentially by producing more histamine or producing more receptors. When you remove the drug you have these increased levels of histamine signalling which keeps you awake. Over time the histamine signalling will down regulate back to pre- drug levels but it will take time. Over the counter sleep aids are also anti- histamines which is why they can substitute for the olanzapine although I think they are less potent than olanzapine so it is a good sign that they work and suggests you have made some adaptation back to pre- drug levels of histamine signalling. Using those once in a while is OK when things get desperate but it will ultimately hinder your adaptation back to being able to sleep without drugs.

I too am tapering off olanzapine. It is very difficult even going slowly but the brain tends towards healing so it can be done. Healing is inevitable - it just takes time unfortunately.

 

Thanks, this is what I was looking for.

[ChessieCat]

@BadMedicine

 

Thank you.  May I ask where you got that information from please?  It would be good for members to be able to know this.  Thanks.

 

[BadMedicine]

@ChessieCat there is a good article on wikipedia that lists and describes the pharmacology of olanzapine. The compensatory mechanisms that lead to insommnia upon withdrawal is best guess based on general reading about increased sensitivity of certain receptor systems following withdrawal of an antagonist.

[MikeyJC]

 

Well this pretty much sums it up (though talking about Dopamine, assuming same would apply to Histamine)

[Hopela]

The theory says that the affinities to different receptors decide which receptors get filled first. Olanzapine has the highest affinitiy to the H1 histamine receptor causing sedation and possibly weight gain. That's why the theory would have you on at least 5mg for antipsychotic effects, ie Dopamin receptor binding. The "antidepressant" serotonin receptor 5-Ht2a also a higher affinity with olanzapine than D-receptors. With lower doses it only functions as a sedative weight gainer in theory. Insomnia should then mainly manifest going below 5mg. Me coming off a low dose (0.12mg) and just then getting tardive dyskinesia supposedly a dopamin sensitivity dysfuinction it would appear there is significant dopamine receptor binding at low doses aswell though. This is also what I've read others believe. And some might have gotten insomnia tapering at higher doses.