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Hopela: 10mg Zyprexa / olanzapine too fast taper

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Hi @hayduke,


I've written a response much longer than I initially intended. Please skip through to relevant points if you don't want to listen to me drone on for too long : )


Regarding the risk of lack of sleep: 

They don't actually know much about sleep, but what they do know is that the risks of sleep deprivation can only be described as trivial. The mortality risk of even long term sleep deprivation is surprisingly low (1.07 hazard ratio for all cause mortality for 4 hours per night sleep), lower than the risk of a sedentary lifestyle (hazard ratio of 1.479 here). Here is a graph from a meta-analysis showing the hazards of lack of sleep vs more sleep than average. You can see that it is much more dangerous to sleep 9 or 10 hours per night than 4 hours per night. https://pubmed.ncbi.nlm.nih.gov/26900147/










Supplements: Note that the article I initially posted merely said “activation of GABA-A receptors”. I agree that amino acid type supplements are likely close to harmless, but they can have drug-like effects on medical conditions. Ask anyone on the forums who has had adverse reactions to 5-HTP, tryptophan, magnesium or even experiences worsening symptoms due to their menstrual cycle. I believe a pharmaceutical company has even patented a “pharmaceutical grade” form of glutamine to sell at exorbitant prices for people with sickle cell anemia. https://academic.oup.com/ajhp/article-abstract/74/16/1206/5102824?redirectedFrom=fulltext


It helps to remember that there isn't much preventing pharmaceutical companies from slightly altering a natural product and selling it for profit if it can be shown to help with some condition. They test thousands of compounds and very few ever make it to market. All of the compounds they test are tested because they can reasonably be expected to help a condition based on how they interact with biology (bioplausible), but few actually do. Even the drugs approved for particular conditions like antidepressants, antipsychotics etc. usually only improve some aspect of that condition (psychotic symptoms, performance on the Hamilton depression scale) but do not necessarily improve health. Neither have been shown to reduce the risk of all-cause mortality and there are some indications they may increase it even when prescribed appropriately under ideal conditions. Drugs that improve all-cause mortality for even one condition are fairly rare, and drugs that are relatively safe and do this are even rarer. Statins are a pretty good example, but some people cannot even tolerate these. After statins were shown to reduce all-cause mortality in a long randomized, placebo controlled trial, they became the best-selling drugs on the planet. This type of research provides the best fodder for drug sales.


In any case, I think the strongest argument against supplement use is that 1) thousands of compounds are tested and fail to improve even one medical condition 2) even drugs that reach the market and improve some aspect of some medical condition don't necessarily improve health (none of the psychotropics as far as I know) 3) Therefore, the probability that a random untested supplement or drug will improve a given medical condition (acute withdrawal or PAWS) is pretty close to zero. And the likelihood that it improves health is even worse.


Simply because a given supplement relieves symptoms temporarily, this is not necessarily an indication it is improving health (antidepressants and benzos can do this). I think it may just be best to accept that your body – for its own reasons - just doesn't want to sleep, as painful as that may be. Medical science oversells how much it understands about human biology (as evidenced by how difficult it is to develop a drug or treatment that improves health), and many medical treatments are more harmful than helpful as a result. It's difficult to improve on millions of iterations of evolution for obvious reasons. The body is a complex system, and any attempt at interfering with its biology is usually very clumsy and seems much more likely to throw things out of kilter than improve upon its current state. You have your unique biology because its design was able to survive thousands of challenges to survival and reproduction. It most definitely didn't need the help of a drug or supplement to pass its genetic material on to multiple generations. Discomfort is a part of life and alleviating it can be dangerous. Opioids, for example, have resulted in hundreds of thousands of deaths in the US alone. I think you get my point. Drugs and supplements can be dangerous. Supplements that are closest to food taken in its natural form are likely safest, but you should still be careful to avoid taking them every day or at high doses. Remember that the body adjusts to accommodate disturbances to its equilibrium. Benzos (PAM of GABA-A) cause the downregulation of GABA-A receptors, antipsychotics (D2 blockers) cause the dopamine receptors to become supersensitized etc. If getting better requires the receptors to return to their normal conformation, then drugs which activate those receptors over and above the way they are normally active in daily life may delay their return to their normal state. But this is all theoretical. It needs to be demonstrated in a randomized controlled trial, which I doubt we'll ever see. There is not much profit in demonstrating that drugs or supplements slow healing from drug injury. Since this condition is little studied, the best we can do is guess at what is healthy and harmful for us based on the balance of probabilities.



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4 hours ago, hayduke said:

Thanks @DataGuy


I would generally agree with minimising intake of any supplement.


The study you linked to there shows a neuroprotective effect.  I see theanine as having a lot of the benefits of green tea (widely known to be healthy) without the activating caffeine which is undesirable in wds.


Olanzapine is such a pig of a drug that I think anyone dealing with too rapid a taper has more to gain from moderate use of green tea extract than suffering the trials of a steep withdrawal unabated.  Even the risks you posit pale next to the cumulative effects of no sleep and no rest, at least until equilibrium is attained.


I would agree with the severity of your warning if you were talking about regular benzo use, but I don't believe theanine is close to the potential risk of those (speaking as someone who might use a prescribed benzo a few times a year).  Again, I'd agree with minimising usage.

If I wasn't sleeping, and theanine let me have a few hours of kip, it's worth it.  It's probably a lot safer than alcohol and I'd still take that over no sleep.






I realize I didn't address all your points in my earlier response. So I will just do a short reply here.


I think "neuroprotective" is often just a marketing term. As an example, if you go to google scholar and search "olanzapine neurotoxicity", you will find plenty of articles claiming olanzapine is "neuroprotective". But we know it results in brain atrophy. 


Agreed that theanine is likely safer than most drugs. Whether taking theanine to sleep vs whatever sleep you'd get without theanine is better for your health or better for healing would have to be tested in a trial (the best medical evidence is empirical evidence rather than theorizing based on biology, which is close to worthless). 


I agree again that caffeine might be harmful in withdrawal. It does seem to increase neuroapoptosis, but as far as I know it is actually associated with reduced risk of mortality in regular people when it is consumed with coffee. However, I don't think many people in withdrawal could drink caffeinated coffee every day even if they wanted to : )


In conclusion, I think we are mostly in agreement : )


Sorry for cluttering up your thread, @Hopela!


Happy healing to all.


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@DataGuy thanks for sharing your research.  To sum up, we haven't identified any concrete issues with the green tea extract, we know it doesn't hit the receptor directly like alcohol or benzos so isn't directly comparable.  It's not a sedative - it's calming, but doesn't induce drowsiness itself.  If your body is ready for sleep, it can allow it to.  We know green tea has been used in Asia safely for a very long time.  So I'm content to take it for this stage of my withdrawals without waiting for studies to be done, as I can see it's helping first hand.


I think to look at the risks of no sleep you need to look at more than mortality rate.  For people who were put on olanzapine it could land them in psych ward.  It could lead to loss of employment, or a motor accident.  And in any case considerable discomfort which I don't agree one need suffer through unaided.


And back to agreeing with you on minimising the use of supplements.  5-HTP, tea or coffee is probably a reasonable comparison here.  I don't tolerate 5-HTP well on olanzapine (it's actually contraindicated), while the L-Theanine is making life easier.  I don't take it every day but find 100-200mg some days helps.


Ditto @Hopela, sorry for adding noise in your thread.  I can only imagine how debilitating CT of olanzapine is, and if green tea extract helps, well I just wanted to say that it was working for me in a slow taper and I'm personally comfortable with the amount I'm taking (100-200mg/day) and the nature of the amino acid.  To be clear, this is not a general recommendation.  Thanks

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@hayduke, excellent points! Fully respect your decision. I hope both you and @Hopela have gotten some decent sleep lately. 

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