Svie: olanzapine - ever greatful for any advice

[Svie]

Hello.

I´ve been doing a taper from Olanzaine, on and off, since middle of 2017. Now I´ve come to a stop, and I am ever greatful for any input. Let me explain. This is what happened:

Started at 10mg in early 2017. After a few months i started to taper, with a cut of 2.5mg every 3 yeeks. I ended up at a dose of 2.5mg, then stopped taking it all together. 2 weeks later I went back to 2.5mg and stayed there for 8 months. I felt fine but very dull, as what this medicine does. 

 

Then went ahead and tried again. I cut 1 fourth of the tablet (2,5mg) and stayed for 3 weeks. Went fine. Then did another fourth, and was down at a half tablet. Went fine. At the next cut, down to 1 fourth of a tablet,, it got too much for the nervous system, and there was a panic attack. To stop it, i took another half tablet, then continued by going back a step, taking it slower. Then down at 1 fourt of a tablet. Stayed for 3 months. All felt fine. No symptoms and the side effects from the medicine, was minimal. 

 

Later, 1 year ago. I started again. This time harder to get a precise dose each day. (Did not know about liquid tapper) By crushing a (eye-measured) fourth-piece, then removing 1 third of it. Means that about 33% was taken off. I stayed for 3 weeks, then took away another 33%. This got too much a short while after, and had another panic attack. Had to take 6 tablets of 2.5mg to stop it. Then I went back to 1 fourth of a tablet again. Felt fine, and stayed for 2 months. 

 

Then i started again, much more slowly. Still measuring by eye. After a few months the current dose was a 16th of a whole tablet. Nervous system was not recovering at that rate and got issues with sleep and could not have regular days any longer, with all the stress. Then I started measure by liquid, thinking that a stable precise dose would help. It did not. Started having panic attacks again, and develope symptoms as chronic tinnitus, dark spot in my vision, indigestion. I went up slowly, going from 1ml to 2ml then up to 3ml (which would be 1/8th of a tablet) Panic attacks happened more frequent, and felt worse the more i raised the dose.

Went back to 1 fourth of a tablet which was the last dose i was stable at. This was 1 week ago. I still have these attacks, or nervous system attacks. I cannot even read and process a book, or watch a televesion without feeling extremely tense.  Nor going to the supermarket, without feeling of panic. "Processing" things seems to be the issue. Still having chronic tinnitus and vision issues. Also heart pains.

 

Why do I not get the effect off 1 fourth of a pill as i did 1 year earlier? Is it a matter of time? Should I give it time? Could taking 1 big dose of 10mg make things better, seeing that last time i was fine after a big dose? Should I raise the dose a bit and then give it time? And so, by how much should the raise be?

 

I´ve read this, https://www.survivingantidepressants.org/topic/22025-fluctibelle-don´t-know-what-to-do/?do=findComment&comment=463258 but I´d like a more personal response.

 

I am MUCH greatful for any help or input.

 

 

[Gridley]

Welcome to SA, Svie.

 

You are suffering from withdrawal from tapering too fast.

 

What is withdrawal syndrome.

 

The reason you don't get the same effect with 1/4 pill that you did a year ago is that your system is destabilized from tapering too fast and many dose changes. What you need now is stability, not more changes.  I would not take a big dose, since that could be overwhelming to your system.   I suggest you stay at 1/4 pill for several months, at least six, to allow your system to stabilize.  At that point, if you are feeling stable, you can begin to taper.  But not now.

 

We recommend tapering by no more that 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

For future reference, this 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 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.

 

 

 

 

 

 

 

[Svie]

18 hours ago, Gridley said:

Welcome to SA, Svie.

 

You are suffering from withdrawal from tapering too fast.

 

What is withdrawal syndrome.

 

The reason you don't get the same effect with 1/4 pill that you did a year ago is that your system is destabilized from tapering too fast and many dose changes. What you need now is stability, not more changes.  I would not take a big dose, since that could be overwhelming to your system.   I suggest you stay at 1/4 pill for several months, at least six, to allow your system to stabilize.  At that point, if you are feeling stable, you can begin to taper.  But not now.

 

We recommend tapering by no more that 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

For future reference, this 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 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.

 

 

Thank you kindly for the reply. 

I took 1 third of a tablet yesterday, before I read this message. This brought some relief. Would it be Ok to continue with this, in assumption to ease the stabilizing period?

 

When should one start to see improvements?

 

Is heart ache a typical symptom with this medicine?

 

Thanks a lot for any input  

 

 

 

 

 

[Gridley]

2 hours ago, Svie said:

 

Thank you kindly for the reply. 

I took 1 third of a tablet yesterday, before I read this message. This brought some relief. Would it be Ok to continue with this, in assumption to ease the stabilizing period?

 

When should one start to see improvements?

 

Is heart ache a typical symptom with this medicine?

 

 

Yes, you can stay on 1/3 tablet but make no further changes.

 

Unfortunately there is no way to predict how long it will take to see improvements.  I urge you to be patient and to treat yourself gently.

 

Chest pains are a known withdrawal symptom, but I would advise you to check this with a doctor.

[Svie]

Hello again. Long time since i last wrote here. I´ve been gradually trying to stabilize. It´s not going that well, therefor this making this post. I stayed put on a dose as i mentioned in my first post above, for several months, then by the guide in this forum I raised the dose a little bit and stayed put. All in all i stayed put for a year, not seeing much improvement. Then i raised it bit more in march this year.

 

Now I am about 10% from a half tablet of 2.5mg. This was in consent of Gridley here in this forum (through private messages). So here I am at, I do see improvement immediately after a raise, but I am far from well. I still have symptoms, my nervous system always struggle. I haven't been able to work in over a year, as everything in the least stressful can put my system over the edge. (and end up in panic attack)

I do feel a relief each day when i take the dose. However, this level of upside down throughout the day, and by the time nearing the evening by the time when i take the dose, i get very anxious and if I miss the time by just 20 minutes it gets worse. If I accidently take 1-2% lower dose it gets very rough. Being stable in my opinion means there would not be any ups and downs or that there would be a relief when I take the dose. There should be completely level, as it was when i was on a whole tablet of 2.5mg (I remember thinking then that i never felt that I was taking anything)  

 

I can´t see that i would get much better just staying put on this dose. I can´t just stay put another year. 

I´ve read about a person with the same experience (I´ll link below) and he only got well by going back (gradually) to 2.5mg and stayed put for several months and then tapered it out properly from the start. My intuition says that this is what must be done.

https://www.reddit.com/r/Drugs/comments/cil2df/olanzapine_withdrawal_success_story_you_can_do_it/

 

On a side not on the same website, i read about another person who like me just stayed put over a year and did not see much improvement. I´ll link below

https://www.reddit.com/r/Antipsychiatry/comments/aagm4i/any_success_stories_for_quitting_olanzapine/

 

What should I do? What is recommended? If i would go up to a whole tablet- How would I do that?

Much thanks for reading and for eventual answers and help. All is much appreciated

[Erell]

Hello @Svie

 

Could you please create your signature, it will help us to understand your situation and see all your history at a glance.

Here is a direct link to your signature  : Create Your Signature in "Account Settings". 

 

Please include the dates of the changes you made. Also include the supplements if you take some.

 

Take care ☀️

[Svie]

Hello. Alright I made a signature.

 

Basically it all went bad when I went under a tablet of 2.5mg- too fast. And kept struggling down mostly until 2020-03 when by the guidelines from this forum I stayed put at a dose to stabilize. 

 

Thanks for any input!

[JohnBanes]

There are many of us on this website that have had terrible experiences with Olanzapine.  It's a nasty drug.  Are the challenges of your withdrawal primarily anxiety or are you also having insomnia?

 

The first Reddit story you linked to about brain training, etc. with a "Peter" sounds a bit odd to me.   

[Svie]

12 hours ago, JohnBanes said:

There are many of us on this website that have had terrible experiences with Olanzapine.  It's a nasty drug.  Are the challenges of your withdrawal primarily anxiety or are you also having insomnia?

 

The first Reddit story you linked to about brain training, etc. with a "Peter" sounds a bit odd to me.   

Nasty to say the least. I´ve come off several other medicines (Lyrica, Mirtazapine, Diazepam) but this one is on whole other level.
Yes anxiety and insomnia. Back at 1/3 of a tablet it felt as if I had taken 10 cups of coffee and hadn´t slept for a week- And back on the few days I was on 1/16th I had hallucinations and panic attacks daily.

Nowadays I´m pretty much self confined to home due to overwhelmed. Going 1km for groceries is almost the limit. 

Other symptoms are tinnitus and heart issues, I guess due to chronic stress

It´s no fun. being pressed into a corner, needing a solution

[JohnBanes]

The effects of withdrawal from Olanzapine (like other psychiatric drugs) can be debilitating.  I hope that the symptoms even out with time, and then you are ready to make another cut.  

[Svie]

Thank you for the input. I do hope so as well. However the only thing that helps is when i increase the dose. Holding on to a dose not so much. It seems impossible far away to when I´d be able to start cutting down again. Even if i miss the dose by 1% my body goes in high alert mode until the next 24 hours. More likely it would take a year or more, if ever, to recover. I think that my body is still trying to adjust to that 25% cut from the 2.5mg tablet from late 2018. Am i wrong then to think that going back to a whole tablet is the key to recover in my case? And then start cutting down properly from there. What are the downsides of doing that?

 

Appreciate any idea´s tips and cautions, thank you

[Greatful]

@Svie  I am so sorry you are struggling with stabilizing.  I am trying to stabilize, the wait is painful.  You chase your tail on how  to feel better is constantly on your mind.  I did that last winter and stopped and started  5 meds.  Finally I stopped and now I wait. I still think is there something I can do.  My cns is way out of control.  My heart goes out to you.  I also get over simulated easy, hard to go out in the public, hard to watch tv, hard to read.  Some how it is easy to ruminate and dwell on the pain the your in and what you can do to stop it.  

Do you have support that is with you?

Hang in there.

 

Post as many times as you need to get in encouragement and to share what is going on with you.  You are not alone

 

 

If you want to talk to a mod, or any one specifi  it will get their attention quicker if you tag them @  ke, start typing their name, their name will come up, then click on it. It will be in blue like your name here.

[Svie]

@GreatfulThank you so much for the reply. It meant a lot! I hope wholeheartedly for the better with your own progress. I have family and relative, I however have difficulty in reaching out when under strain. I speak weekly over the phone with a psychiatrist (whom by the way do suggest me going back to the last stable dose)

 

Yes even  reading strains the CSN, what seems to be of help is reading the same books over and over.

 

Thanks a ton again

[Svie]

@Gridley Hello. We´ve been speaking earlier about my progress, if you recall. Do you still advocate on holding, and what are your opinion on the post I made yesterday? 

 

I´m thankful for the advice 8 months ago to either stay put or raise a tiny bit (I did the latter). It did help. Thank you  

[Gridley]

On 7/5/2021 at 6:45 AM, Svie said:

Am i wrong then to think that going back to a whole tablet is the key to recover in my case? And then start cutting down properly from there. What are the downsides of doing that?

 

1 hour ago, Svie said:

Do you still advocate on holding, and what are your opinion on the post I made yesterday? 

I have to go out of town and will be offline for several days, starting after this post, but wanted to respond this morning to your post.  The downside of going back to a whole tablet is that your system has gotten accustomed to the lower dose and too much can overwhelm your system, destabilizing you further.  So I would continue to hold.  It takes months to stabilize from a dose change, and according to your signature, your last change was in March, only four months ago.

 

 

[Svie]

18 minutes ago, Gridley said:

 

I have to go out of town and will be offline for several days, starting after this post, but wanted to respond this morning to your post.  The downside of going back to a whole tablet is that your system has gotten accustomed to the lower dose and too much can overwhelm your system, destabilizing you further.  So I would continue to hold.  It takes months to stabilize from a dose change, and according to your signature, your last change was in March, only four months ago.

 

 

Thank you @GridleyThis makes sense. It leans towards holding then. But if I were to try get back to a whole tablet @2.5mg, what would a safe and slow way to do this be?

 

Have a good time out of town

[JohnBanes]

Quote

I think that my body is still trying to adjust to that 25% cut from the 2.5mg tablet from late 2018. 

I doubt that is the case Svie.  That cut was a very long time ago, and although continued withdrawal effects are possible, in most cases they will be attenuated by this point.  I would reflect on what else could be causing the symptoms, and as I suggest below, you should reflect on whether you accurately captured your taper history.  From your signature, it looks like you have gone up since 2018 (being on one third of a tablet for almost a year) and later had more cuts.  Were you stable on one third of a tablet between April 2020 and March 2021?  If you stabilized, the 2018 cut is unlikely to be still effecting you.  If you did not stabilize, then perhaps you should not have started cutting again in March 2021 (and it may benefit you to go back to that dosage of one third of a tablet).  It also seems odd that you were on one third of a tablet from April 2020, and then made a cut of 10% from half of a tablet in March 2021.  This part of the story means your "cut" took you above where you were (from 0.33 of a tablet to 0.45 of a tablet).  Again, something seems off about this story. 

 

Finally, I don't think tablet weights are helpful -- you should present the dosages in terms of how much Olanzapine you are taking (ignoring the inactive ingredients and other parts of the vehicle).  I would update your signature.      

[Greatful]

@SvieOh, I feel your pain.  If you are seeing any improvements, try to hold. I have been holding for a little over 2 months and I have seen very small improvements.  Try not think to far ahead.  I am very much in a hurry to start tapering also, but I worry about making changes to soon.  They had me move my Lexapro up 5h ours in the day, it sent me into a horrible wave of really increased anxiety and depression.  Still trying to recover.

 

What time of the day do you take your Magnesium?  They say that it is better to take it in small amount over the course of the day.  I take magnesium glycinate.  It comes in 100mg capsules,  I open up a  capsule and pour about half in a glass of water and then drink.  I put the capsule back together and do the same thing about 4 hours later.  I do this about four times a day (so I use 2 capsules)  I can  usually feel a difference in my anxiety a little later.  It doesn't  always make a big difference and then some times it does.   Have you tried Melatonin for sleep?  If not I will post a link to tell you more about it.

You are taking a large dose of Vit D.  What time of day do you take that. Vit. D can be stimulating.  Can you lower the dose a little bit and see if that helps?

 Have you tried Omega 3? It is good for the brain.  I can post you a link for that also.

Click on the title and read about it.

Hang in there, we will get this figured out

 

[Bobblehead]

I've been trying to come off olanzapine for about 4 years now. It's one hell of a drug. Insomnia is brutal, I am on clonazepam to sleep.

 

Good luck, i hope you figure it out.

[Svie]

20 hours ago, Greatful said:

@SvieOh, I feel your pain.  If you are seeing any improvements, try to hold. I have been holding for a little over 2 months and I have seen very small improvements.  Try not think to far ahead.  I am very much in a hurry to start tapering also, but I worry about making changes to soon.  They had me move my Lexapro up 5h ours in the day, it sent me into a horrible wave of really increased anxiety and depression.  Still trying to recover.

 

What time of the day do you take your Magnesium?  They say that it is better to take it in small amount over the course of the day.  I take magnesium glycinate.  It comes in 100mg capsules,  I open up a  capsule and pour about half in a glass of water and then drink.  I put the capsule back together and do the same thing about 4 hours later.  I do this about four times a day (so I use 2 capsules)  I can  usually feel a difference in my anxiety a little later.  It doesn't  always make a big difference and then some times it does.   Have you tried Melatonin for sleep?  If not I will post a link to tell you more about it.

You are taking a large dose of Vit D.  What time of day do you take that. Vit. D can be stimulating.  Can you lower the dose a little bit and see if that helps?

 Have you tried Omega 3? It is good for the brain.  I can post you a link for that also.

Click on the title and read about it.

Hang in there, we will get this figured out

 

@GreatfulTypically I see improvements up to 2 months after every raise, but not further so much. Yes indeed holding on is tough! I

I take my magnesium (citrate) with each meal, so 3 times a day. I might try glycinate! I do take omega 3 which does help, and previously taken Melatonin (I might start that up again). Vitamin D on the evening, I´ll move the dosage till the morning then, thanks for pointing that out. Thanks greatly for the support!

 

19 hours ago, Bobblehead said:

I've been trying to come off olanzapine for about 4 years now. It's one hell of a drug. Insomnia is brutal, I am on clonazepam to sleep.

 

Good luck, i hope you figure it out.

Thank you @BobbleheadWish you all the best!

 

21 hours ago, JohnBanes said:

I doubt that is the case Svie.      

@JohnBanes

hanks for the input. Yes I understand the confusion around my tapering. Basically I did cut too much, then having to go back up again to stabilize and then go at it again but more slowly which even that wasn´t good enough since I was already too destabilized from earlier cuts.

To the question no I was not stable on 1/3 of a tablet between April 2020 and March 2021. I could barely leave the home except for a quick turn for groceries as I too easy got panic attacks due to stress/destablization. I saw no improvements those last 6 months so I decided to raise the dose after talking with a moderator here. This helped much! I did went up yet again in March 20121 (I did not cut) to almost a half tablet (10% from a half) which also have helped very much. But I´m still not nearly to being Ok which is the reason I made the returning post last Friday speaking of my thought of going back a whole tablet. 

I´ll update the signature. Thanks for pointing that out and thank you very much for your thoughts, much appreciated.

[Gridley]

On 7/6/2021 at 9:35 AM, Svie said:

But if I were to try get back to a whole tablet @2.5mg, what would a safe and slow way to do this be?

Going back up to 2.5mg is not necessarily a goal that you should pursue or that you would benefit from.  You have made a lot of dose changes  in the last 2 years and are down, as best as I can tell from your signature, below half your original 2.5mg dose.  Your system has gotten accustomed to having less of the drug and is very sensitized from all the dose changes.  Due to all these changes, your system is not the same system it was when you were originally on 2.5mg.  The effect on your system of 2.5 is not necessarily going to be the same as it was before and going back that high could make things worse.  It also would increase greatly the time it will take to taper off the drug.

 

If you do decide to increase (my advice, again, is to continue to hold), the increases should be very, very small.  That way, if you have an adverse (bad) reaction to the drug, it will likely be less than with a larger increase and you can back off to the previous lower dose.

 

Please change your signature to indicate the doses in milligrams that you have taken during your taper and are currently taking.  It is difficult for us to help you when the doses are indicated in half-tablets, etc.  We need the milligrams in doses, not in tablet weight or percentage of tablet.  Please use this link to make these changes.  You'll need to use a computer, not a phone.

 

Account Settings – Create or Edit a signature.

 

[Svie]

22 hours ago, Gridley said:

Going back up to 2.5mg is not necessarily a goal that you should pursue or that you would benefit from.  You have made a lot of dose changes  in the last 2 years and are down, as best as I can tell from your signature, below half your original 2.5mg dose.  Your system has gotten accustomed to having less of the drug and is very sensitized from all the dose changes.  Due to all these changes, your system is not the same system it was when you were originally on 2.5mg.  The effect on your system of 2.5 is not necessarily going to be the same as it was before and going back that high could make things worse.  It also would increase greatly the time it will take to taper off the drug.

 

If you do decide to increase (my advice, again, is to continue to hold), the increases should be very, very small.  That way, if you have an adverse (bad) reaction to the drug, it will likely be less than with a larger increase and you can back off to the previous lower dose.

 

Please change your signature to indicate the doses in milligrams that you have taken during your taper and are currently taking.  It is difficult for us to help you when the doses are indicated in half-tablets, etc.  We need the milligrams in doses, not in tablet weight or percentage of tablet.  Please use this link to make these changes.  You'll need to use a computer, not a phone.

 

Account Settings – Create or Edit a signature.

 

Thank you @Gridleyfor the explanation. I truly understand your point. I take every caution seriously. But what I can´t wrap my head around is the fact that I do get more stable each time I raise. For example, I´m about 20-30% better of at my current dose than the whole year @ 1/3. I´m very certain that if I had stayed on 1/3 until today and not raise, I´d be of much worse. Seeing that I didn´t feel any improvement the last 7-8 months that year, I continued to feel worse. 

 

What I care about is stopping the panic attacks. I just need to know the best way, however those too, has improved a lot since raising.

 

Updated now

 

Thank you again  

[Gridley]

1 hour ago, Svie said:

But what I can´t wrap my head around is the fact that I do get more stable each time I raise.

Thank you for updating your signature.

 

You are the best judge of what will work for you.  I can only give you information based on our experience.  The decision of what to do is yours.  

[Svie]

On 7/9/2021 at 3:50 PM, Gridley said:

Thank you for updating your signature.

 

You are the best judge of what will work for you.  I can only give you information based on our experience.  The decision of what to do is yours.  

That´s the information I wanted. I´ll continue hold. Thanks @Gridley

Is it safe to switch to a water solution according to this? https://www.survivingantidepressants.org/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

If I´m right then 1100mg (44% out of 2500mg) would be 8.8ml in water out of 20ml?

[Gridley]

1 hour ago, Svie said:

Is it safe to switch to a water solution according to this? https://www.survivingantidepressants.org/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

If I´m right then 1100mg (44% out of 2500mg) would be 8.8ml in water out of 20ml?

Many members use a water solution.  I'm not knowledgeable about water solution calculations.  You'd need to ask another staff member about your calculation.  Manymoretodays and Brassmonkey are both good at this.

 

Here is the information about making your own liquid from the link

Tips for tapering off olanzapine (Zyprexa)

 

Using a liquid to taper: Make your own liquid
However, like other drugs that are not particularly soluble, you can make a suspension, as our member Rhi explains. Also see http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

According to http://www.pharminfotech.co.nz/manual/Formulation/mixtures/olanzapine.html

  Quote

Olanzapine (as crushed Zyprexa^® tablets) is stable for up to 6 hours at room temperature and up to 48 hours refrigerated in water and the following beverages; orange juice, apple juice, cola and milk.

 

The preparation and stability of a liquid olanzapine preparation for oral administration in hospitals

The Pharmaceutical Journal Vol 265 No 7110 p275-276 August 19, 2000

 

  Quote

 

....We have found that Zyprexa tablets 10mg, crushed and suspended in Guy's hospital "paediatric base", provides a more palatable liquid oral olanzapine preparation than crushed tablets suspended in water.

....

Zyprexa tablets (3 x 10mg) were halved and then crushed using a mortar and pestle and the powder suspended in 30ml Guy's hospital formula base for paediatric mixtures (paediatric base), a syrup-based mixture containing carboxymethylcellulose BP, methylhydroxybenzoate BP and propylhydroxybenzoate BP.3 Each batch of olanzapine suspension was stored at 2?8C in a 50ml amber glass bottle in the dark.

....

The suspension settled quickly and powdered tablet fragments formed a visible layer on the bottom of the glass bottle. Experience with the analogous clozapine suspension3 has shown that the need for vigorous shaking must be emphasised to nursing staff who may be asked to administer the suspension to patients. As with the clozapine suspension, informal assessment of the palatability of the olanzapine suspension has shown it to be well tolerated, some patients in fact preferring it to tablets.

....
No tests of microbiological stability have been performed although paediatric base is preserved. It therefore seems prudent to recommend a shelf-life of two weeks when the product is stored in a refrigerator. Such a shelf-life is adequate for hospital use. We have no information on the bioavailability of olanzapine from the suspension, although it seems unlikely that olanzapine bioavailabilty will prove to be less than that from Zyprexa tablets.

 

Expand  

 

Guy's hospital "paediatric base" appears similar to Ora-Plus suspension base, which is commercially available:

 

http://www.perrigo.com/files/rx/pdfs/pds173-ORA-Plus.pdf

 

  Quote

....ORA-Plus is an aqueous-based vehicle consisting of a synergistic blend of suspending agents that have a high degree of colloidal activity. The suspending agents form a structured, gel-like matrix which suspends particles and allow for little settling. ORA-Plus is buffered to a slightly acidic pH to help reduce degradation of medicinal agents through oxidation. An anti-foam agent is incorporated in ORA-Plus to allow for vigorous shaking with minimal foam.

 

Ingredients

Purified water, microcrystalline cellulose, carboxymethylcellulose sodium, xanthan gum, carrageenan, calcium sulfate, trisodium phosphate, citric acid and sodium phosphate as buffers, dimethicone antifoam emulsion. Preserved with methylparaben and potassium sorbate.....

Expand  

If you want to experiment further with dissolving the tablet:
 
https://www.caymanchem.com/pdfs/11937.pdf

 

  Quote

Olanzapine is sparingly soluble in aqueous buffers. For maximum solubility in aqueous buffers, olanzapine should first
be dissolved in DMSO and then diluted with the aqueous buffer of choice. Olanzapine has a solubility of approximately
0.5 mg/ml in a 1:1 solution of DMSO:PBS (pH 7.2) using this method. We do not recommend storing the aqueous
solution for more than one day.

Expand  

 

Edited July 11, 2021 by Gridley

[Svie]

21 hours ago, Gridley said:

Many members use a water solution.  I'm not knowledgeable about water solution calculations.  You'd need to ask another staff member about your calculation.  Manymoretodays and Brassmonkey are both good at this.

 

Here is the information about making your own liquid from the link

Tips for tapering off olanzapine (Zyprexa)

 

Using a liquid to taper: Make your own liquid
However, like other drugs that are not particularly soluble, you can make a suspension, as our member Rhi explains. Also see http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

According to http://www.pharminfotech.co.nz/manual/Formulation/mixtures/olanzapine.html

  Quote

Olanzapine (as crushed Zyprexa^® tablets) is stable for up to 6 hours at room temperature and up to 48 hours refrigerated in water and the following beverages; orange juice, apple juice, cola and milk.

 

The preparation and stability of a liquid olanzapine preparation for oral administration in hospitals

The Pharmaceutical Journal Vol 265 No 7110 p275-276 August 19, 2000

 

  Quote

 

....We have found that Zyprexa tablets 10mg, crushed and suspended in Guy's hospital "paediatric base", provides a more palatable liquid oral olanzapine preparation than crushed tablets suspended in water.

....

Zyprexa tablets (3 x 10mg) were halved and then crushed using a mortar and pestle and the powder suspended in 30ml Guy's hospital formula base for paediatric mixtures (paediatric base), a syrup-based mixture containing carboxymethylcellulose BP, methylhydroxybenzoate BP and propylhydroxybenzoate BP.3 Each batch of olanzapine suspension was stored at 2?8C in a 50ml amber glass bottle in the dark.

....

The suspension settled quickly and powdered tablet fragments formed a visible layer on the bottom of the glass bottle. Experience with the analogous clozapine suspension3 has shown that the need for vigorous shaking must be emphasised to nursing staff who may be asked to administer the suspension to patients. As with the clozapine suspension, informal assessment of the palatability of the olanzapine suspension has shown it to be well tolerated, some patients in fact preferring it to tablets.

....
No tests of microbiological stability have been performed although paediatric base is preserved. It therefore seems prudent to recommend a shelf-life of two weeks when the product is stored in a refrigerator. Such a shelf-life is adequate for hospital use. We have no information on the bioavailability of olanzapine from the suspension, although it seems unlikely that olanzapine bioavailabilty will prove to be less than that from Zyprexa tablets.

 

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Guy's hospital "paediatric base" appears similar to Ora-Plus suspension base, which is commercially available:

 

http://www.perrigo.com/files/rx/pdfs/pds173-ORA-Plus.pdf

 

  Quote

....ORA-Plus is an aqueous-based vehicle consisting of a synergistic blend of suspending agents that have a high degree of colloidal activity. The suspending agents form a structured, gel-like matrix which suspends particles and allow for little settling. ORA-Plus is buffered to a slightly acidic pH to help reduce degradation of medicinal agents through oxidation. An anti-foam agent is incorporated in ORA-Plus to allow for vigorous shaking with minimal foam.

 

Ingredients

Purified water, microcrystalline cellulose, carboxymethylcellulose sodium, xanthan gum, carrageenan, calcium sulfate, trisodium phosphate, citric acid and sodium phosphate as buffers, dimethicone antifoam emulsion. Preserved with methylparaben and potassium sorbate.....

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If you want to experiment further with dissolving the tablet:
 
https://www.caymanchem.com/pdfs/11937.pdf

 

  Quote

Olanzapine is sparingly soluble in aqueous buffers. For maximum solubility in aqueous buffers, olanzapine should first
be dissolved in DMSO and then diluted with the aqueous buffer of choice. Olanzapine has a solubility of approximately
0.5 mg/ml in a 1:1 solution of DMSO:PBS (pH 7.2) using this method. We do not recommend storing the aqueous
solution for more than one day.

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Thanks for the information @GridleyIt would make things easier if I could make it work.

@brassmonkeyHello.  I would highly appreciate your input on this. I´m thinking of switching Olanzapine from weighting tablets into a liquid solution instead. Is it correct that one can simply dissolve an coated tablet into 20ml water then measure out the percentage?

Is it fine to do a switch even when i´m unstable? The current dose is 1100mg. This is 44% of a whole tablet @2500mg, if counted correct. 44% out of 20ml water should be 8.8ml. So the dose should be 8.8ml?

 

Thank you

[brassmonkey]

Yes that would be the dose you would start with.

 

Now the tricky part, Olanzapine does not dissolve in water. So you would not be working with a true solution. Rather the small particles of powder float in the liquid in what is referred to as a "suspension".  This medication tends to settle out of water quite quickly so the suspension needs to be mixed before drawing up the dose.  This is where using a suspension media like ora-plus comes into play.

[Svie]

17 hours ago, brassmonkey said:

Yes that would be the dose you would start with.

 

Now the tricky part, Olanzapine does not dissolve in water. So you would not be working with a true solution. Rather the small particles of powder float in the liquid in what is referred to as a "suspension".  This medication tends to settle out of water quite quickly so the suspension needs to be mixed before drawing up the dose.  This is where using a suspension media like ora-plus comes into play.

Thank you for the confirmation. 

 

Good to know. Are there any alternatives to Ora-Plus that are more available in Europe?

 

Thanks again @brassmonkey

[Greatful]

@Svie  How are you doing?  It had been pretty quite over here.

[Svie]

Hello. It´s been a while. Shortly after my last post, 6 months ago, i upped to dose slightly, now i´m just about under a half tablet. It did help slightly. However I´m still not nearly stable. Not really doing very well at all. My body is just getting more tired, I don´t digest food very well and I can´t relax. The last months I´ve been pretty much isolated except going to the nearest grocery store and short walks to keep me going. Due to energy level and fear of getting panic attack.

 

This situation isn´t working it and it isn´t worth doing this anymore. I need improvements which just isn´t happening. I feel like that I don´t have any choice rather than go back to the  last stable dose at 1 tablet. It´s been more than 3 years now and i´m tired to my bones. This is just way beyond what any human body should handle for such a long period of time.

@Gridley what do you suggest? I know you advocate to hold but for me and my body i just feel the current dose isn´t enough to sustain my nervous system and the heart, which i still have trouble with and is growing worse especially this last month. Due to nutritional deficiencies I´m getting osteoporosis and grey beard due to stress. To get the idea, imagine a delicate nervous system then multiply that with 5 and you get me.

 

What if a dose under 1 tablet does not have enough medicine in it to stabilize my system, no matter what dosage or how long i hold?

That´s what i feel like.
I know in the end it´s my decision but i´m just terrified of making anything worse, but as it is now, i´m getting less and less to lose.

 

Appreciate any input

 

 

 

 

On 7/27/2021 at 1:09 AM, Greatful said:

@Svie  How are you doing?  It had been pretty quite over here.

Hello. Thanks for asking. I´m holding on but under strain. Hope you´re doing well yourself.

[Svie]

And to clarify. By 1 tablet I mean 2.5mg. Not 10mg.

[Svie]

Hello. It´s been a while since I´ve posted. I´ve been increasing, very slowly, and the goal is 2.5mg. I increase because i need a stable dose for the moment, due to PTSD. Plan is to stay on 2.5mg, ie. 1 tablett for a while, a year maybe, and then decrease very slowly and correctly from the start (which I didn´t do previously)

 

Anyway my question is that last night I went from 75% (of a 2.5mg tablet) to the whole 2.5mg tablet. The reason I did make that jump is that I felt somewhat stable and until now I´ve increased the dose ridiculously slowly and got impatient. And my doctor keeps telling me it´s such a smal dose to begin with so it doesn´t matter. However last night I got a very bad experience. First off, the effect was way less than normally, which is strange because it´s a 25% increase. I got almost the same reaction as I would if I had DECREASED 25%. I did not sleep and felt feverish and shaky all night. Why is this? Is it because of the coating? My doctor says that these pills are not ment to be splitted, due to the coating and makes the effect of the medicin uneven throughout the day. Ie. big spike at first- then slowly decrease. Or was yesterdays experience because it was just a too big of a increase and nervous system was not ready for it?

 

My plan is to go back to 75% and then increase 5% or so, every week. Or is it better to keep at it at a whole tablet and hope it gets better?

 

Thanks in advance

[Ariel]

Hello @Svie

 

I don't know the answer to your questions, but you may find some useful information in this help topic:

 

 

[Altostrata]

Hello, @Svie It's been a long time since we've seen you. Last year, you were decreasing olanzapine, now you're increasing it?

 

This is a site for going off drugs, we can't advise you about increasing dosage to treat PTSD, we don't know anything about it. It's your doctor's job to address adverse effects from his or her treatment.

 

Personally, I would not take a dose of a psychiatric drug so high that it makes me feel ill.

[Svie]

Hi.

I have a question about the coating on Olanzapine/Zyprexa. My tablets have a smooth white coating, not a yellow-ish inside. They are round and rather flat. Standard form i guess. My doctor insist that cutting these may cause a different effect in the body because of the coating and that the coating makes the absorption more even and steady throughout the day. Hence saying that cutting them makes the the effect much unstable.

Is this true? I can see that it´s true when it comes to very hard surfaced yellow-ish insides.

 

Thanks for reading and please move this post to where it belongs if it doesn´t fit

 

Mod note: Moved this post to Svie Intro thread from tapering forum on 10/1/22.  

Edited October 1, 2022 by getofflex

[ChessieCat]

Please read Post #1 of this topic:

 

Tips for tapering off olanzapine (Zyprexa)

 

Please also read other posts in that topic.  If you cannot find the answer to your question in that topic, I suggest that you post your question there; other members taking the same drug are more likely to see it.