Emily02: Zyprexa / olanzapine

[Emily02]

Dear All,

 

I wish I found this website before. 
I had a psychotic break November 2019, I was put on 5 mg Olanzapine. It was reduced to 2,5 January 2020. I started to become anxious and in March I had a night when I couldn’t sleep and was shaky. I was put on 5mg again. It solved the problem immediately.

 

In August it was reduced again to 2,5mg. First two weeks I was feeling fine, after that I couldn’t sleep and was restless. I didn’t know anything about withdrawal. I slept only a little for weeks. I really wanted to reduce the drug so I was holding on waiting for a relief. After a while I couldn’t take it any longer. I needed sleep so I agreed to go back to 5mg again.

Now I’m back to 5mg again for five days but I’m still shaky and sleep badly.

What should I do?

Please give me advice 

many thanks 

[Gridley]

Welcome to SA, Emily02.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  A list format is best.  Please include the dates of your dose changes.

 

Account Settings – Create or Edit a signature.

 

Your nervous system is destabilized and you are in withdrawal caused by your many dose changes.  Your brain needs stability. 

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

What is withdrawal syndrome.

 

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

 

Why taper by 10% of my dosage?

 

If a person needs to increase a dose (updosing) we recommend updosing by a very small amount.  Your decrease from 5mg to 2.5 was 50% and your increases were also 50%.  I imagine you did this using 2.5mg and 5mg pills or by splitting a 5mg pill.  I understand why you did this, but there are much better and more gradual ways to reduce (or increase) your dose, as I'll explain.

 

I recommend you hold at 5mg until you stabilize.  This may take several months.  Then you can begin a slow 10% taper down to zero.  The following link is specifically about tapering Zyprexa, including how to get the nonstandard doses you'll need for a 10% taper.  Your choices, as explained in the link, are using a digital scale to weigh doses, making your own liquid and having a liquid compounded.

 

Tips for tapering off olanzapine (Zyprexa)

 

But for now just hold at 5mg until your system stabilizes.  Make no further changes.

 

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 complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Emily02]

I’m really happy that you answered Gridley, thank you!

 I understand the my nervous system needs time to stabilize, but what can I do with my insomnia and anxiety? I’m really suffering right now.

Can you give me any ideas?

[Emily02]

Yesterday night I couldn’t sleep and was shaky all over my body. I didn’t know what to do so I took a quarter of a Xanax. I know it’s not good but I was absolutely clueless what I could do.

Please give me advice

many thanks 

[Gridley]

19 hours ago, Emily02 said:

my insomnia and anxiety

I'm going to give you some links to help you with the insomnia and anxiety.

 

Regarding insomnia:

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosi

 

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 problem

 

Some members have found Melatonin helpful with insomnia.   

 

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.  

 

This link is to a Melatonin product on Amazon that's .3mg, which some say is an ideal dose.  It's what I take.

I trust NootropicsDepot for things like this – and sure enough their melatonin (available on Amazon) is exactly 0.3 mg. 

 

The following post about sleep is from Apace41, one of our moderators.  I found it helpful.

 

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."

 

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.

----

Regarding anxiety, here are some tips.  I've found the last link about the restorative yoga pose to be very helpful with anxiety.

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help …

 

10 minute Restorative Yoga for Relaxation | Up the wall

---

Please be very careful with the Xanax.  Physiological dependence can result from 2 to 4 weeks of regular use and also from intermittent use.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited September 27, 2020 by Gridley

[Emily02]

Dear Gridley

 

I cannot tell you how grateful I am for your answer and for the lots of information.

When I was talking to my doctor I just felt that they don’t listen to me and don’t share any information, the only thing they said was to ‘go back on 5mg because your mental health is deteriorating’ 

Many Thanks for taking your time and sending the links to me.

 

I read somewhere about GABA supplement for withdrawal. I actually ordered one. What do you think about it?

[Gridley]

@Emily02

Here's a link so you can see what you think.  If you do take it, start at a small dose in case it has a negative effect.  In withdrawal we can be very sensitive to supplements and even foods.

GABA (gamma-aminobutyric acid) tablets, capsules, liquid ...

[hayduke]

Hi Emily02.  Sorry to hear you've been having a rough time of it.  Not surprised with that yo-yo dosing.

 

It took me 5 months to gradually taper from 5 to 2.5mg and I did a six month hold after that.  Slow and steady wins the race

 

Cheers,

Hayduke

[Emily02]

Hello Hayduke

 

Thanks for your reply!

Yes, you’re absolutely right that it’s yo-yo dosing. I just didn’t know what to do you know. Here the docs take you from 5 to 2,5 mg and if you’re unwell than they put you back on 5 again. It’s the second time it happened to me.

I’m glad I found this page.

It’s been a week now that I’m back on 5mg and my sleep is getting better and almost no anxiety.

When do you think I’m ready for the 10% slow taper?

[ChessieCat]

7 minutes ago, Emily02 said:

When do you think I’m ready for the 10% slow taper?

 

It's better to hold for longer than to risk tapering too soon.  You will need to listen to your body/symptoms.  Once you reach withdrawal normal (link below) it's a good idea to hold for a bit longer after that.  When you do make your first reduction you might consider doing a test reduction of a small amount to see how you respond.  You could try a 1% reduction.  If that goes okay then you can reduce by a larger amount the next time.

 

Stability

 

WDnormal

[hayduke]

Emily02 yes the prescribers often give us very irresponsible directions.  I'm glad you got here too, a lot of people show up cold turkey - that's way harder to traverse.

 

ChessieCat's spot on, best give your body some time to catch up with the recent changes.  Once you're feeling settled again you have a good baseline to work with for a taper.

Cheers

[Emily02]

Many of thanks for your answers!

 

ChessieCat, how do I make such a small cut as 1%?

 

hayduke, how do you make such accrue cuts as 1,825 for example?

As I see from your signature, you go really slow and steady with your tapering. Do you or did you have any withdrawal symptoms? How easy or difficult was it for you?

[hayduke]

14 hours ago, Emily02 said:

hayduke, how do you make such accrue cuts as 1,825 for example?

As I see from your signature, you go really slow and steady with your tapering. Do you or did you have any withdrawal symptoms? How easy or difficult was it for you?

 

Hey Emily02.  I use a spreadsheet to calculate my cuts.  There are some you can download from the forums that you can use as templates if you want.

 

The basic idea is that cutting 10% (of the previous dose) a month will give you some fraction of the full dosage of the tablet you start with.  So 2.5mg - (2.5/10 = .25) = 2.25mg.  Next month, 2.25 - (2.25/10 = .225) = 2.275mg and so on.

 

I'm a big fan of liquid titration, I find it's way better than trying to weigh solids with these small olanzapine tablets.  While these tablets don't dissolve in water, they do disintegrate, and you can make a suspension that is fine for our purposes.  More here.

 

It looks like my taper is slow some days, other days quite rapid :-)  There are definitely withdrawal symptoms.  Low mood, irritability, fatigue, headaches and mild derealisation are the ones off the top of my head.  This week my cut was a bit ambitious and I found myself getting a bit snappy with cow-orkers and not concentrating much on work - a sure sign I should keep my head down there and hold the current amount til I feel more settled.  Even if part of that is due to external stresses.

 

So basically I use my comfort and monitor my ability to function socially as yardsticks for how a cut is going.  I usually notice how a cut feels around 4 days after making it.  If you start having more serious symptoms you should generally hold until they abate, and consider a smaller cut next time.  Any time it feels too uncomfortable, or you're stressed out, etc just hold.  It's always good to take a break and let your body catch up and find some comfort before making more cuts.

 

I'm in the general pattern of making a set of four weekly cuts of 2.5% each, then a two week hold before the next.  It's a bit slower, but gentler.  Having taken these drugs for years, that helps. 

 

It does take some time this way but it really minimises the risk of having bad flare-ups, jeopardising work or relationships etc and means life can often be enjoyable on the way.  Otherwise it's very easy to ask more of your body than it can handle with big and/or fast cuts.  You can see a lot of people who've posted on the forum here who've gone too fast and have had to start the whole thing over or had some other trouble.

 

 

[Emily02]

Hello hayduke

 

Since I’m back to 5mg I feel most of the time really drowsy, lack of motivation and concentration. When I read something I forget what I just read. I don’t have real feelings either. This makes me worried if I’ll ever be back to normal again.

 

How did you feel when you were on Olanzapine and how do you feel now that your on a very low dose (as I see from your signature)? When do you plant to jump off?

 

many thanks!

Emily

[hayduke]

Hey Emily02.  I was started on 10mg which was pretty chunky.  Sleeping 11-12 hrs a day, felt kind of numb and stupid.  My emotions were heavily subdued and in hindsight I feel like I'd lost much attunement to subtlety, which made conversation more awkward than it ought to be.  I stepped down to 5mg before long which was a bit better, but similar effects. 

 

After reaching 2.5mg and settling there for a while I found I was connecting with my close friends a lot better and the feeling that I was in a room next to the party instead of at it had faded and I felt more present.  Around 2.1mg I was able to do EMDR and we unearthed the root trauma from early childhood which had originally got me sat in front of the quack who drugged me long ago and had been messing up my life.  Since then I feel like I'm on my way down the mountain instead of up it and life keeps improving.

 

I'm not sure when I'll end the taper yet.  Given that I still feel each cut, it might be another 6-12 months?  Just won't know till I feel ready.  The body sets the pace not the calendar :-)

[Emily02]

Thanks very much for you reply hayduke!

I find it really informative. I know that everyone is different but it’s good to know what others experience.

I wish you a lovely day!

Emily

[hayduke]

For sure, everyone seems to have a different time on these chemicals.  You have a great day too!

[Emily02]

Hello Everyone!

Two weeks ago I started a 10%taper which doesn’t go well . I have too intense withdrawal symptoms, intense anxiety and insomnia . Previously I  had a quick taper in August when I had to reinstate the original dose, it resolved my problem at that time. I waited six weeks to stabilise and I started this taper. Now I know I should have waited more but it’s so horrible to be on Olanzapine. What shall I do now to feel better? Shall I go back to the original dose again?

[hayduke]

Hi Emily.  Sorry to hear you're having a lot of discomfort.

 

So you've gone from 5 mg to 4.5mg two weeks ago, and are still feeling unsettled?

 

If it's something you feel you can put up with for a bit longer yet, you can just hold till you feel ok again.  Has your sleep been improving at all?

 

I don't think this is the usual forum advice, but when I've made a cut and still felt too dysfunctional to avoid problems after a few weeks, once or twice I've added a very small updose and it seems to even out quicker.  For instance, I just wasn't settling at 1.2mg so I went up to 1.25mg and it really helped.  I didn't feel weirded out any more, just held there till it was all peachy again.

 

My strong preference would be to just hold if I could deal with it.  Otherwise if it was looking like trouble, you could try say 4.55mg and see how you feel after a week or so?  I probably wouldn't updose beyond that.  From what others on here have learnt, there's no guarantee going further will improve your sleep and you'll be stressing out your body in the opposite direction.

 

When you're ready to taper again I suggest looking at a much gentler taper

 

Let us know how you get on

 

Cheers

[Venkat]

Hi Emily 

 

Sorry to hear about what you are going through. Just wanted to share my experience which was a bit similar. I too am now on 5mg of olanzapine from 6.25mg. Reduction by 10% of the previous dose per month did not go well with me either.So I switched to 2.5% of the previous dose every 2 weeks, which amounts to reduction by 5% of the previous dose every month. It does take a bit longer but I have no alternative. As hayduke said, a gentle taper helps and like hayduke I am following the water titration method. 

Wishing us all a safe journey. 

 

Regards, venkat 

[ChessieCat]

  

11 hours ago, hayduke said:

When you're ready to taper again I suggest looking at a much gentler taper

 

The BrassMonkey Slide Is a slower taper, by it gives you more control over your taper.  The main thing is to be heading in the right direction, ie lower dose, but to do it so as not to cause withdrawal symptoms which are more than mild.

 

Edited November 13, 2020 by ChessieCat

[Emily02]

13 hours ago, hayduke said:

So you've gone from 5 mg to 4.5mg two weeks ago, and are still feeling unsettled?

I measure my pill on a scale, it weighs 0,124 g and I take away 10% so I took 0.111g. I don’t know how much active ingredient it is.

 

You told me before that you dissolve the pill in water, but I don’t understand how you know how much mg active ingredient you take. Could you please tell me?

 

I had really bad symptoms, I was shaking for hours, unable to sleep. It was very bad. Absolutely not something I can put up with.

 

First I updosed it to -5% but because the symptoms were still very bad, last night I took whole 5mg and managed to sleep. Still anxious but it’s better than a few days ago.

 

It it’s the fourth time this year that I try to decrease my dose. On the first three occasions it was a 50% cut, it was the first 10% cut.

What shall I do now? Shall I make a 2,5% cut?

 

[Emily02]

2 hours ago, ChessieCat said:

  

 

The BrassMonkey Slide Is a slower taper, by it gives you more control over your taper.  The main thing is to be heading in the right direction, ie lower dose, but to do it so as not to cause withdrawal symptoms which are more than mild.

 

Thanks ChessieCat!

First i updosed to -5% cut but things were still really bad so last night I went back to the whole 5mg. What shall I do know? Can I try a 2,5% cut tonight?

[Emily02]

3 hours ago, Venkat said:

Hi Emily 

 

Sorry to hear about what you are going through. Just wanted to share my experience which was a bit similar. I too am now on 5mg of olanzapine from 6.25mg. Reduction by 10% of the previous dose per month did not go well with me either.So I switched to 2.5% of the previous dose every 2 weeks, which amounts to reduction by 5% of the previous dose every month. It does take a bit longer but I have no alternative. As hayduke said, a gentle taper helps and like hayduke I am following the water titration method. 

Wishing us all a safe journey. 

 

Regards, venkat 

Hi Venkat!

I’m glad you already managed to decrease your Olanzapine. Well done. Do you have withdrawal symptoms this way? How’s your sleep? Speaking about water titration. Do you just dissolve the pill in water and syringe it up? 

[Emily02]

Does anyone know how I can update my signature? I don’t seem to find the way.

[Venkat]

Hi Emily 

Please wait for the moderators to tell you if you should start tapering or not as of now.

 

Please visit hayduke 's thread to learn about water titration, where he has explained clearly how to do it including the calculations.If you don't find it there please reach out to him.

 

Insomnia was the main withdrawal symptom I was going through, I am managing to get some good sleep with a cup of warm milk mixed with one spoon of fried and grounded poppy seeds, before going to bed. I don't know if I am allowed to suggest this on the site.

 

Also please remember, while tapering, it is the percentage of the previous dose and not of the original dose. 

 

Regards, venkat 

[Emily02]

thanks Verkat! All the bests for you too!

[Venkat]

Thanks Emily, 

 

With smaller dose reductions withdrawal symptoms are minimized and better tolerated as I have found out the hard way.

 

I am going through a lot of side effects of olanzapine like blunted emotions, memory issues , loss of focus , diminished intelligence etc...

 

Regards, venkat 

 

 

 

 

[Emily02]

Hi Venkat!

 

I’ve got the same problem with Olanzapine. Especially the blunted emotions and cognitive ability disturb me a lot.
I’ll try this 2,5% reduction.

I’ve done big reductions before than updosing again.

Does your psychiatrist support you with your taper?

 

Regards,

Emily

[Venkat]

Hi Emily 

 

My psychiatrist does support tapering but he has no idea of this kind of slow taper and he won't listen to me even if I told him about it, so I am doing it on my own following this site.

 

I am holding on to 5mg of olanzapine for a month before starting to taper again. 

 

Regards, venkat 

[Emily02]

My psychiatrist is the same, they don’t believe in slow taper. They use only the conventional pill sizes.

I hope your taper will go well

[Venkat]

Thanks Emily 

 

Yours too should go well , I pray for all of us going through this process. 

 

Regards, venkat 

 

 

[hayduke]

I'd encourage everyone to shop around for better support if they aren't getting it.  If your psychiatrist doesn't understand tapering, what good are they doing you at all?

 

I was able to find a clinical psychologist who is also a trauma expert - exactly what I needed.  Two months of visiting her turned my life around.  She is extremely critical of the medical model, because she sees people healing without the drugs.  And my reasonably sympathetic GP prescribes during the taper.  As part of my WD plan a psychiatrist would be available if needed, but that hasn't been necessary to date, and in all honesty I'd be chuffed never to see one again.

 

Compare with two decades of the awful psychiatrist my mother found long ago, who drugged me in the first place, after steering me away from any sensible options. 

 

Keep looking if you haven't found a good support team yet.  Even if you go through a fair few candidates.  You wouldn't go back to a salon that doesn't cut your hair properly - same thing with your brain and mind 🙂

[Emily02]

You’re absolutely right Hayduke!

I think need to find a psychiatrist who can actually help me.

[Emily02]

6 hours ago, Venkat said:

I pray for all of us going through this process. 

Many thanks Venkat!

[Emily02]

Did anyone suffered from low mood or depression while on Olanzapine?

I have low mood ever since I’ve been put on it and last few weeks are really bad. 
How can you get out of depression?