Hopela: 10mg Zyprexa / olanzapine too fast taper

[DataGuy]

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.

 

 

[DataGuy]

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.

 

Cheers

 

@hayduke,

 

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.

 

[hayduke]

@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

[DataGuy]

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

[senseless]

How you doing hopela?

[Hopela]

Hi,

Thanks for all interesting discussions. Some bad news. I made a failed suicide attempt. Now I'm on forced Abilify injections since a few months and olanzapine tablets are back up to 2.5 mg. Not sure when I'll be able to taper. I've had troubling restlessness from Abilify making nights worse but I think I'm still healing from the cold turkey last december so nights are both better in terms of sleep ability and worse due to restlessness keeping me out of bed. Hopefully getting off abilify soon.

 

Thought I'd also tell about scihub.to, a project to make knowledge free. Full text articles about adverse effects of antipsychotics are hidden behind pay walls.
For example full text is hidden on this one: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2761879

But you can read that full article and many others on any subject for free on scihub.to:

https://scihub.to/10.1001/jamapsychiatry.2020.0036

 

[DataGuy]

Sorry to hear that @Hopela. Please reach out if you are feeling like that again. Someone will help you. 

 

I hope you are able to get back to sleeping normally. Then, if you still want to, you can do a very slow taper. No need to rush or worry though. Please feel better soon.

 

Sci-hub is great : )

[Hopela]

Thanks DataGuy. In short I made an error in judgement, might have been iatrogenic dopamin sensitivity playing a role, but anyhow I'm alive now and will reach out if I would ever perceive myself in a similar situation again.

[Hopela]

Good news. I was initially scheduled for 24 months of forced Abilify injections but was able to lie my way out of it totalling just two months. Truth has always been a goal of mine but when my health was attacked by a system filled with lies, cheating and force I made an exception. Had I not been able to do so I was considering using what force was available to me, ie leaving my country, to avoid the injections and save my health for the long term. I found one case study where one month of Abilify showed significant atrophy in the brain. I was forced on the chemicals to begin with, duped to stay on and duped to cold turkey by only being warned that the underlying condition could emerge, a condition I dont have, not of the damages that comes from withdrawing the chemical and nothing else. I made an error of judgement eventually but don't consider more chemicals the solution. I sneaked the olanzapine I was forced on this time lower too when possible and was able to avoid getting stuck at a higher level (just two-three weeks) so Ive actually been able to go down to 0.31 mg now and it's the only thing Im on. It's actually amazingly good news to me.

[Sunnyday]

 

On 10/3/2020 at 11:49 AM, Hopela said:

Hi,

Thanks for all interesting discussions. Some bad news. I made a failed suicide attempt. Now I'm on forced Abilify injections since a few months and olanzapine tablets are back up to 2.5 mg. Not sure when I'll be able to taper. I've had troubling restlessness from Abilify making nights worse but I think I'm still healing from the cold turkey last december so nights are both better in terms of sleep ability and worse due to restlessness keeping me out of bed. Hopefully getting off abilify soon.

 

Thought I'd also tell about scihub.to, a project to make knowledge free. Full text articles about adverse effects of antipsychotics are hidden behind pay walls.
For example full text is hidden on this one: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2761879

But you can read that full article and many others on any subject for free on scihub.to:

https://scihub.to/10.1001/jamapsychiatry.2020.0036

 

 

Hi @Hopela. I'm sorry to hear they forced Abilify injections on you (are they able to physically force someone to take them? In my country I don't think they are able to although I won't say with 100% certainty).

 

Very glad to see you are still with us, those dark thoughts can be terribly intrusive. Like DataGuy said I hope you will reach out in some way if they return, it can be very difficult to process them alone. 

How are the brain zaps lately? And how are you doing in general?

 

Take care

[BadMedicine]

@Hopela Sorry to hear about your suicide attempt but very glad you are still here. That’s great news you managed to get off the abilify injections. It is a horrible drug. I was on it for a bit - made me feel horrendous. I think that lying when your health depends on it is perfectly legitimate although it is a shame that the mental health system is so based on untruths and corrupt that this becomes necessary.

i wish you rapid healing from your drug withdrawal. It can only be ultimately a good thing to be off these poisons.

[DataGuy]

20 hours ago, Hopela said:

Good news. I was initially scheduled for 24 months of forced Abilify injections but was able to lie my way out of it totalling just two months. Truth has always been a goal of mine but when my health was attacked by a system filled with lies, cheating and force I made an exception. Had I not been able to do so I was considering using what force was available to me, ie leaving my country, to avoid the injections and save my health for the long term. I found one case study where one month of Abilify showed significant atrophy in the brain. I was forced on the chemicals to begin with, duped to stay on and duped to cold turkey by only being warned that the underlying condition could emerge, a condition I dont have, not of the damages that comes from withdrawing the chemical and nothing else. I made an error of judgement eventually but don't consider more chemicals the solution. I sneaked the olanzapine I was forced on this time lower too when possible and was able to avoid getting stuck at a higher level (just two-three weeks) so Ive actually been able to go down to 0.31 mg now and it's the only thing Im on. It's actually amazingly good news to me.

 

I don't think you are wrong to fear for your health when being forced APs, @Hopela. Glad you were able to use some of your craftiness to get out of it. How are you sleeping now?

 

Hope we can stabilize things. I was actually just looking at a study of adverse outcomes for antidepressants and found the hazard ratio for the first 28 days of withdrawal was 8.40 (!!). It was very statistically significant as well. I think they need to look at that with a much larger sample study, and they also need to study it in other psychotropics like APs. They hypothesize that the drugs may have been stopped around the time of a hospitalization, but not sure how much evidence there is for that. May only be a partial explanation. Here is the study I mentioned: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5842559/

 

Always happy to hear from you : )

[Hopela]

Hi Sunnyday,

Thanks for your post and concern. Yes they can physically force injections so it's better to accept them "voluntarily" if one wishes to be released. If one is problematic they can isolate you and strap you down. I accepted the injections because they said it would get me out of the lock up quicker. I thought one injection couldnt do too much damage and after that I could escape the country to avoid the rest. But they kept me locked up for two injections. If you deny sickness they can keep you locked up indefinitely. Resisting "treatment" is also cause for continued "care". Brain zaps are mostly gone. I only have occasional local muscle contractions over my body and face when trying to rest and some vibrations inside my stomach. Could be Abilify withdrawal coming on so things might get worse but I hope not. Injections make for a very smooth automatic tapering which is one good thing. But it might be too fast. I'll just have to see. I also contracted claustrophobia (panic feelings in the subway, elevators etc) since Abilfy so I'm working on releaving that with exercises of exposure to small rooms. Sleep has improved a lot and I'm getting around 5 hours usually just broken once during the night.

 

 

 

 

 

 

[Hopela]

Thanks BadMedicine for you post. Yes Abilify was much worse experience than I imagined. Made me unable to stay in bed,  had breathing attacks, muscle contractions in the legs and glutes and panic feeling forcing me up to walk and so on when trying to sleep which was a very bad combo with my previous sleeping problems. The whole nights were wrestling matches, trying to get myself to be able to stay in bed, leading to 0 sleep and also 0 rest some nights. I had to be quiet when walking about in darkness in my room in the ward during the nights and  fake sleeping when they checked on me every hour or I would get put on and made dependent on some sleeping chemical too. Once I got home at least I could walk around freely during the nights and then just wait the weeks out until the last injection subsided and sleep + restability returned. Abilify also gave a constantly elevated heart rate and made it feel difficult to do physical exercise.

[Hopela]

Hi DataGuy, thanks for your post. Sleep is around 5 hours. Broken once typically. I think im in the time frame of possible Abilify withdrawal, with 6 weeks since last injection, so I'll see how it progresses. So far okay.

[Hopela]

Went for a workout. I no longer push very hard. Felt some dyskinesias in the face while doing aerobics. Guess it's when I'm fatigued and relaxed it happens. It's not a major problem to have a face twitch occasionally, of course I never should have gotten these chemicals to start with and they've done nothing but torture me and destoy my health for 13 months. Dyskinesias are of course related to other unseen damages aswell though. It also worries me Im still not off the chemicals and what trajectory the dyskinesias will take.  This video about dyskinesias with Peter Gøtzsche I found disturbing, especially the children. It's hard to come to terms with the that they're knowingly doing this to children too. I found statistics that more than millions of children in the USA are on the lobotomizing toxins. If it wasn't your own but a foreign government calling the shots to inflict this on your population it would probably be called chemical warfare. A UN report says involuntary psychiatric interventions may amount to torture.

 

 

 

 

[hayduke]

Hey Hopela. 

 

I was quite worried about TD.  My symptoms were a bit of bruxism in the form of my jaw snapping shut while I was asleep during times of stress, often waking me up, and occasionally a small tremor in my hands, which could be a few things.  A bit of restlessness and akathisia sometimes had me pondering connections.  I think dopamine has a lot to do with all that kind of thing.

 

The jaw snapping is pretty much gone now.  I was worried about tooth damage and would sometimes wake up having bitten my tongue.  This was actually one of the factors in deciding I'd better work out how to get off the blasted drugs a few years ago - what else would get worse if I kept taking them?

 

I found a paper which reported good results in dyskinesia patients using niacin (in the form that gives you hot flushes) along with manganese supplements.

 

Not having much to lose, I went and got a blood test from my GP which showed that manganese wouldn't be harmful for me.

 

I took these supplements a few times a week for a while.  At times they seemed to help a little, and I'll still take them now and again.

 

Later I read Vitamin E can be helpful for dyskinesia, too.  I took 1500IU/day for some time, which is higher than recommended for long periods and am now at 1000IU.  This actually might work better for me than the niacin/manganese.

 

Altogether my impression is that these have helped fend off incipient problems for me, though I don't think my symptoms would be diagnosed as TD unless they worsened a lot.  The slow taper, the gradual reduction of the compound and having done most of the dopamine part of the taper has shown a gradual improvement.  I'm not out of the woods yet, but also I'm not seeing much to worry about for the moment.

 

Anyways none of that seems to be extensively studied for TD but if I was starting the taper over I'd take them again.  YMMV of course.

[Hopela]

Hi Hayduke,

Thanks for supplementation ideas. I supplement with a multivitamin tablet but will look into more manganese and vitamin E if the contractions become worse. So far I'm lucky I haven't had involuntary contractions in the jaw muscles. For me the muscle contractions began when tapering at low levels of Olanzapine, theoretically when no longer dopamine receptors were becoming free.

[ChessieCat]

Only start one new thing/make one change at a time and start with the small amount to see how you respond.

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable

 

[Hopela]

Hi ChessiCat, thanks for reminder. I've been on multivitamin continuously since february or so aswell as vitamin D and C. I'm not changing supplementation right now.

[hayduke]

19 hours ago, Hopela said:

For me the muscle contractions began when tapering at low levels of Olanzapine, theoretically when no longer dopamine receptors were becoming free.

 

Yes.  TD is sometimes reported as being unmasked when coming off the drugs.  Part of the reason I looked for supplements to help ameliorate that during a slow taper.

 

The _rate_ of change of dopamine levels is definitely implicated in akathisia.  I don't know whether it has a correlation with TD too.

[Hopela]

I don't recall precisely when but involuntary muscle movements increased for me when doing something like going from 0.12 to 0.00mg  or 0.31 to 0.25mg.  I didn't notice it when going from 5 mg to 2.5 mg, even though there should be significant amounts of dopamine receptors being unmasked during that drop, and not at the the low levels. My experience supports for example that there could be significant dopamine blockage even at low levels of olanzapine, or that histamine or serotonin plays a direct role in dyskinesias too, or that one or more unknown processes is taking place giving the result. Could speculate that worsened sleep, higher "stress", metabolic problems or something else all of which happens at low level drops makes for involuntary muscle contractions, perhaps predisposed by a latent already free but upregulated dopamine receptor density. Or any combination.

 

I had a few brain zaps this night. Sleep was light. Some people report permanent insomnia after olanzapine and needing to take a bit of it for life to sleep.

 

I read that Abilify injection 300mg had half-life of 30 days whereas a 400mg injection had a halflife of 46 days. If they are equally made, which they seem to be, the difference in half-life suggests a linear component in the withdrawal. That means two half-life periods could bring the concentration down closer to 0 than to 1/4, which could be good or bad but gives me an expectation of a shorter time until I'm free of it. Good unless withdrawal symptoms become bad.

 

 

[DataGuy]

 

@Hopela,

 

I think you are right. There is significant D2 blockage with Olanzapine at low levels of the drug, and the D2 occupancy curve looks something like this one for Risperidone (can't find an image like this for Olanzapine). Seems most psychotropic receptor occupancy curves look something like this. I don't know if they are 100% certain what the cause of TD is, but I think @Altostrata can confirm that most dyskinesias experienced as a result of withdrawal tend to disappear with sustained drug abstinence. They seem to strongly be associated with dopamine supersensitivity, so as the receptors become unblocked the TD can worse but then the nervous system eventually downregulates the dopamine receptors back to their normal state. I believe this is mentioned in the linked article above on Dopamine Supersensitivity Psychosis (really an excellent article). 

 

Hope you slept ok : ) How are you feeling? 

 

Edit: Whoops, not sure I had ever linked this article on your thread. Here is is just in case https://www.karger.com/Article/Abstract/477313

 

 

Edited October 28, 2020 by DataGuy
added link

[Hopela]

Hi Dataguy,

Interesting, the idea of affinity based priority (for Risperidone 5-HT2A filling up before D2 gets filled) seems to not have a significant impact on the curve.

 

I'm feeling okay today. Somewhat worried about sleep being so light. At least I got some hours and some rest. Hard to tell what was sleep and what was rest.

Will go subway riding as claustrophobic exposure practice.

[hayduke]

Cheers @DataGuy for that info.

 

I did a crude fit of a D2RO curve for olanzapine in my spreadsheet.  These numbers could be quite off, but until we get better data, here are a few extrapolated sample points:

 

NB:  You should probably take these about as seriously as a squiggle on a serviette!

 

Amount    D2RO

0.5mg   11%

0.75mg 16%

1mg       20%

1.5mg   26%

2mg      33%

2.5mg   37%

 

For reference, I spent hours searching but found nothing 'better' than this graph

 

I couldn't do anything useful with the serotonin curve, but inferred it will be quite steep even near 0mg

[Altostrata]

9 hours ago, DataGuy said:

I think @Altostrata can confirm that most dyskinesias experienced as a result of withdrawal tend to disappear with sustained drug abstinence.

 

It's my impression that withdrawal-induced movement disorders tend to fade along with other withdrawal symptoms. It's the movement disorders that occur while you're taking the drug that may lead to tardive dyskinesia. I don't know much about the neurobiology of TD, despite similarity in symptoms, withdrawal-induced movement disorders could be a different animal.

 

In general, my guess is adverse effects while you're taking the drug, such as TD or akathisia, are more persistent than if they appear only as withdrawal symptoms after you go off the drug, particularly if you keep on taking the drug despite these rather serious adverse effects. You might envision it as the drug making a deeper imprint on your nervous system, in a bad way.

[Jay78]

When it comes to TD, I have found these articles to be very helpful:

 

https://www.psychiatrictimes.com/view/tardive-dyskinesia-facts-and-figures

 

 

[Hopela]

Thanks for all replies on dyskinesias.

 

The abilify injections were horrible to be on but seems to have left without noticable withdrawal symptoms.

I've gone down to 0.21 mg olanzapine.

Had a nightmare this night. Waking up at least once and getting 2+3 hours sleep which is good.

A few dyskinesias per day, random locations but they are "benign" superficial twitches and not violently jerking whole body parts around.

A few sensations per day, random locations of being suddenly stabbed by a needle.

All in all feeling like no major problems. 

 

Im planning to go biweekly (unless feeling worse) from 0.21mg to 0.14mg to 0.08mg to 0.05mg to 0.03mg

 

 

 

 

[DataGuy]

Thanks for the update, @Hopela. I think you are sleeping too little to reduce this quickly. Here is @brassmonkey's thread on managing the endgame taper. He recommends holding for much longer, and you may want to avoid such sharp reductions. 

 

Edited November 2, 2020 by DataGuy

[Hopela]

Hi DataGuy,

Yes I will aim a bit slower. It's easy to make fantasy plans about getting off these chemicals.

[ChessieCat]

20 hours ago, Hopela said:

It's easy to make fantasy plans about getting off these chemicals.

 

When I first arrived here 5 years ago I was hoping to be off by my 60th birthday.  I'm about to turn 63 and I've still got about another year to go.  I added this to my drug signature just the other day:  REMINDER TO SELF:  I don't need the drug now, but my still brain does.

 

On 7/6/2020 at 5:49 AM, brassmonkey said:

During that waiting time people may think that they're not doing anything and want to get on with it.  When in fact doing nothing is very proactive.

[DataGuy]

On 10/28/2020 at 7:13 AM, hayduke said:

Cheers @DataGuy for that info.

 

I did a crude fit of a D2RO curve for olanzapine in my spreadsheet.  These numbers could be quite off, but until we get better data, here are a few extrapolated sample points:

 

NB:  You should probably take these about as seriously as a squiggle on a serviette!

 

Amount    D2RO

0.5mg   11%

0.75mg 16%

1mg       20%

1.5mg   26%

2mg      33%

2.5mg   37%

 

For reference, I spent hours searching but found nothing 'better' than this graph

 

I couldn't do anything useful with the serotonin curve, but inferred it will be quite steep even near 0mg

 

Very interesting @hayduke. How did you calculate the D2 occupancy by dosage? It looks pretty good, but we may be able to get it a bit more accurate. I found this article: https://pubmed.ncbi.nlm.nih.gov/23948784/ which estimates D2 occupancy by dosage for 8 antipsychotics. I don't really use any graphing software, but they give you an equation where you can calculate the approximate D2 occupancy if you plug in the dosage. The graph they give looks accurate but it is very hard to read, especially for olanzapine, because the dosages go way higher than normal and it is tough to estimate anything from the tiny part of the graph where they have realistic dosages. 

 

Edit: I have added a table where I plugged in various dosages of Olanzapine into the equation given in the article I linked. May not be completely accurate either, but it is a good rough guide and the general trend should be similar for most people. I can post it on the occupancy / dosage thread and link it on your thread @hayduke, if you like. Let me know if you think this is right. I can also try to graph it, but I am pretty clutzy with that software : )

 

 

Edited November 5, 2020 by DataGuy

[DataGuy]

On 11/2/2020 at 7:54 AM, Hopela said:

Hi DataGuy,

Yes I will aim a bit slower. It's easy to make fantasy plans about getting off these chemicals.

 

Good man, @Hopela. As I see it, you are effectively tapering the Abilify because of the long-lived injection, so we should ideally wait until that is out of your system before tackling the olanzapine. Have you calculated at what point you will reach a dose that will have trivial pharmacological effects?

 

I hope you are doing well. Always good to hear updates from you.

[hayduke]

1.  

13 hours ago, DataGuy said:

Very interesting @hayduke. How did you calculate the D2 occupancy by dosage? It looks pretty good, but we may be able to get it a bit more accurate. I found this article: https://pubmed.ncbi.nlm.nih.gov/23948784/ which estimates D2 occupancy by dosage for 8 antipsychotics. I don't really use any graphing software, but they give you an equation where you can calculate the approximate D2 occupancy if you plug in the dosage. The graph they give looks accurate but it is very hard to read, especially for olanzapine, because the dosages go way higher than normal and it is tough to estimate anything from the tiny part of the graph where they have realistic dosages. 

 

Nice work DataGuy!  I'll put that equation into my spreadsheet.  It suggests my D2RO is lower than my estimate at 0.5mg.  That graph you have there also shows a lot more individual spread.  (It's also terrifying to think of people being on more than 10mg of this compound, as if 10 isn't god-awful enough).  Ideally they'd be sampling beneath 2.5mg but it's much better data than before.

 

For the rough one I did I just tried to best fit the curve to the few sample points from the crappier graph I posted earlier.  There may also have been an equation given, I had 92 × ('BPL (ng/ml)' 'Thu, 5 Nov 2020'÷('BPL (ng/ml)' 'Thu, 5 Nov 2020'+11)) plugged into my spreadsheet, with a fudge for BPL too.

 

Appreciate it.  Also if you come across anything for serotonin as well, please let us know!  Cheers

[Hopela]

Hi Dataguy,

It's been 8 weeks since last abilify injection. I was scheduled for 400 mg but was able to negotiate 200mg + 2.5mg olanzapine instead due to bad reactions and I could feel abilify beginning to dissipate sharply (subsiding: akathisia, disorientation, high heart rate) after 3 weeks. Half-life durations are given for the injections but they are not exponential decay processes so I don't think it's right to extrapolate beyond the first half-life. Long story short I think I'm largely off abilify now but I could still get withdrawal symptoms. Given that I've had none so far (Based on time of appearance I attribute dyskinesias mostly to having been forced to jump around with olanzapine) I'm feeling quite optimistic.  

 

Last two nights I believe I had consecutive sleep for 5 - 6 hours which was a new record, but when I woke up I had 5 - 6 brain zaps as if my brain wasn't accustomed to much sleep. Some twitches remain. No feeling of needles. Mostly improvement I would say.

 

Interesting graph of dopamine occupancy. Looks like one person on 20 mg has 12.5% occupancy while another one on 2.5 mg has 62.5%. I hope the first one doesn't become a reason to put poeple on the 60 mg doses. Also I wonder what explanations are there for such diverse "efficacy" in terms of dopamine receptor occupancy?

 

 

 

 

[Hopela]

I'm dropping to 0.14 mg tonight after 14 days on 0.21mg with sleep improving.

 

Status before drop:

Sleep is 6 hours.

Waking up with a few brain zaps.

Rarely twitches.

I have some tinnitus (but I think it came from being on the chemical rather than tapering)

I feel like I've more difficulty keeping weight off (might be due to having gone off abilify on which I had constantly high heart rate)

I'm slightly weaker strengthwise (could be due to many things)

 

I'll extend holds more as dosages decrease