Mahadeva: Olanzapine and Lithium tapering, after 13 years of meds

[Mahadeva]

Hi everyone, i think this is not the right forum to post this question, but i could not post it on tapering section so i ask the mods to move it to the right section of this forum.

 

I went trough severe psychosis after the use of marijuana, they placed me on wards, docs, and they put me mostly on antipsychotics and few others meds (benzos, mood stabilizers).

 

I had 5-6 relapses on marijuana in the past 12 years and they all made me went psychotic, docs think i could be bipolar but i do not, i think my problem is marijuana and the side effects of the meds.

 

I have been following this website for 2 years and my doubt is the follow:

 

The last psychosis got me in a psych ward for 6 months, they put me on Olanzapine, Lithium and 2 others meds, i got there in november 2019 and got out 8 months ago.

 

I was able to taper off clonazepam and depakene without problems. I'm now tapering off lithium and doing ok so far. My problem is that i never took Olanzapine(zyprexa) for so long, once a doc put me on it for 1 month and i felt awful. He than put me back on aripiprazole (abilify) which i took for 5-6 years. On aripirazol i had bad side effects that annoyed me but far less worse than olazapine, I'm feeling totally awful on olanzapine, i feel completely afraid, unsecure, weak, depressed, unable to function, no motivation, brain fog, flat emotions, and this is much worse than when i was on aripiprazol for several years.

 

As i'm tapering of lithium, the plan is to start tapering of olanzapine in the next few months, but as i"m feeling totally hell on it, and will take at least 1 year to tapper it safely i was considering going back to aripiprazol 10mg (minimum dosage they sell), and procced to tapper it instead of olanzapine in the future.

 

I take 5mg of olanzapine and I'm afraid if changing to aripiprazol now may affect my brain,etc. and make harder to taper it in the same timeline i would do with olanzapine which my body is used to, besides being a nightmare.

 

I don't know if i formulated my question right, but i would like to know if changing now the med and procced to tapper it in the next months could be worse then keeping on the med that I'm already taking for 1 year, and tapper it instead.

 

I think the tapper period which is long could be much more easy on aripiprazol, as i took it for 6 years and never felt soo bad like now on olanzapine.

Edited November 28, 2020 by Gridley

[Gridley]

Welcome to SA, Mahadeva.  This Introduction forum is the correct place for your question and for any further posts you have about your situation.

 

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. Please include your taper rate for the lithium as well as the pervious drugs your tapered.  Most of the information is in your post, but it is very helpful to the moderators for you to put it in a drug signature, which will appear beneath all your posts.  A list format is best.

 

Account Settings – Create or Edit a signature.

 

The question you pose -- switching drugs for an easier taper -- is a complex one.  Basically, because of the risks involved in switching, our answer is that, generally, it's better to taper your current drug than to switch.  Among the risks is the shock to your system of switching drugs.  Another factor is that your current nervous system is not the same nervous system as when you were on the Abilify previously, and your response to Abilify might  not be the same as before.  The following link, about switching to Prozac from another antidepressant, applies to any drug switch, including the one you're asking about.  Once you've read the link and the issues it raises, you should be in a better position to make a decision.  

 

The Prozac switch or "bridging" with fluoxetine

 

As you may be aware, we recommend tapering by no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

The following link is specifically about tapering Olanzapine, including how to get the nonstandard doses you'll need for a 10% taper.

 

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. Get supplements that are single ingredient (not mixed with other types of supplements).

 

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.

 

 

 

 

 

 

 

 

[Mahadeva]

Thank you Gridley

 

Indeed you seem right, reading few more posts here and thinking about it, i will not switch olanzapine for another med and i will procced to taper it after lithium tapers ends.

 

I will put more info here below:

 

After my first mania episode, which as very mild comparing to the following ones,i was put by a doc on lithium,clonazepan and alprazolam, which messed my sleep quality till nowadays, i took them for 1 year, this was in 2007.

 

One year after i had a bad experience under the use of mushrooms in my bedroom, i woke in psychiatric hospital feeling ok, but my parents were scared about drug usage and took me by force to a drug clinic.

The experience of being locked up there brought out a psychotic paranoid episode, received a strong injection and was under care locked in a room for 7 days, then the mess began, the doctor there put me on 5 meds, Haldol,alprazolam,trileptal and two more, than i started to feel pretty bad, psychosis was gone but i was having tons of bad sensations, feelings, mind and thought process was weird and awful, akhatisia,etc.

I took these meds for about 7 months, 2008. I don't remember well but i stop tooking them, its not clear, but i was not taking them after this period, and i got back on smoking weed again and had a mild psychosis outbreak, a new doc put me on Risperidone for 2 years (2008-2010). In 2010 i met a new psychiatric and he changed Risperidone for Seroquel (400mg) for 1 year, 2010, and i got back to weed again and in the ends of 2010 i had a mild psychosic outbreak, i stopped with weed, kept on seroquel. I usually recovered fast and improved in the forward months after the outbreak, but felt some side effects, but i was fine, doing university well and living alone, but i know for sure that antipsychotics alters conciousness, the way your perceive things. In the end of 2012 i got back to weed and also few lsd and mushroom trips too and in May 2013 i had a hardcore psychosis crisis, really hardcore, all kind of crazy toughts and beliefs, a lot of suffering to, i was hospitalized in a drug clinic for 2 months, and i was then put on Aripirazol for the next 6-7 years. I recovered like always but the firsts 4-5 months after psychosis was really hard for me.

 

2013-2016 i was not smoking weed, i spent 3 years doing ok, i had weakness, muscle tension, fatigue, anxiety, some low moods but i was working and managing fine, as i was not smoking weed, no psychosis came about.

But i was also researching about the meds, their side effects, others users experience, and i was pretty afraid of developing extrapiramidal side effects, like disknesia,etc. Then i did a tapper ofr 6 months spliting tablets, firts 10mg to 5mg, half pill than i started to break half pill, 5mg, in smaller sizes like 2.5 and went going like that. I don't remember experiencing any kind of side effect, i was actually feeling better as the dosage was going lower. 6 months passed by (2015) and i was free of aripirazol, feeling good actually, but then in the next 2 months is started to go maniac, euphoric, and i had a strong psychosic outbreak that put me on hospitalizationg again. There i took 2-3 meds on higher dosage which i don't remember, but i asked the doc to put me on Aripiprazol again as i felt not so bad on it, than in 2017-2018-2019 at the end of each year i came back to the use of marijuana for couple months, in those 3 years i was hospitalized for 2 month period,left them with one med, which was Aripirazol. In this point, fatigue, muscle weakness, tension, difficult thinking, obscure toughts, lack of motivation, braing fog,low pleasure in all things was pretty present.

 

In the end of 2018 to 2019 after an hospitalization my father and i was very upset with the treatment, the psychiatric care, and the meds. We thought going of the med (aripiprazol) was a good move,as i was alredy in a hell situation what could be worse.

 

I got cold turkey on aripirazol on june 5 of 2019, what followed up was not psychosis, but 4 months of intense hell of depression, anguish, extreme anxiety and 100% negative mind,fear all the time. But i hold on, my father taking care of me as my mother we had the idea it was worth doing. On the fourth month i started taking magnesium and valeriana (i took magnesium,iodine,selenium,niacin for many years,but stopped after hospitalization) and i went 50% better just on magnesium and valerian, i saw some hope, then the next months i improved alot each month and finally on 6-7 month i was feeling great, really good, body was free of tension, i had strenght, motivation came back, toughts were light, alot of mental noise and negative (braing fog and some kind of negative mass in thoughts) were gone, i was pretty happy. But being stupid as the same i came back to smoking cannabis, 3 months and boom, hardcore psychosis and 6 months jailed in a drug clinic, the put me there on lithium,olanzapine,clonazepan,depakene,and another one for the firsts months) all stuff that i was free came back after being put on these meds again, the psychosis were gone, but all my problems came back.

 

I left it out on april 2020, in june the doc said i could taper clonazapam, i did it by 1/4 doses, first 2 weeks 3/4, next 2 weeks 2/4 one month with 1/4 and stopped, no problems felt, just my sleep take longer to engage( which happens for the past 8 years....) one month after she aggreed we could remove depakene, i was toking two pills of 350mg,morning and night, i removed one from the morning for 3 weeks and quitted the last pill after it. I felt good for 3 days, than not so well, but not differently then before, so was quit easly to taper depakene too.

 

Now i've started lithium tapper:  i was taking 2 300mg pills in morning and 2 300mg at night, on 19/10 i was on 1 pill morning (300mg) and 2 at night (600mg), at 26/10 1 pill morning(300mg) 1 pill night (300mg) and recently 30/11  half pill morning (150mg) and 1 pill night (300mg)

 

I know that i'm being kind fast on these tappers, the first 2 ones were ok, with lithium i feel some improvements and some problems at same time, but nothing severe, but i'm thinking i will do 2 more reductions in dose by a month span (300mg,150mg).

 

With Olanzapine for sure i will do the 10% liquid tapper, but i'm thinking i will follow the same dosage reduction and not 10% from the last dosage, whitch will take 10 months to happen....i don't want to suffer for more time, this time, with olanzapine things are pretty heavy and maybe 10% reduction each month for 10 months may be safe for me.

[Gridley]

4 hours ago, Mahadeva said:

i'm thinking i will follow the same dosage reduction and not 10% from the last dosage, whitch will take 10 months to happen....i don't want to suffer for more time, this time, with olanzapine things are pretty heavy and maybe 10% reduction each month for 10 months may be safe for me.

I'm glad you've decided not to switch to another drug.

 

The reason why we recommend tapering 10% from your current (last) dose as opposed to 10% of original dose is that if you reduce 10% of the original dose, the percentage you're reducing with be increasing as you get lower and lower.  At the low doses is when the drug is at its most potent, which means it's time to slow down, not speed up.  I know  you want to be off the drug, but if you taper too fast you could end up with withdrawal symptoms that force you to hold or updose.  This will make your taper longer, not shorter.  My recommendation would be to taper by 10% of your current dose, not original dose. 

[ChessieCat]

Putting this here for member:

 

  

25 minutes ago, Mahadeva said:

Hi, i'm doing a standart liquid suspension tapper with a generic brand of olanzapine and its working well.

 

I just measure 20ml of filtered water with a syringe and pour in a small glass container with a plastic lid, i place my pill there and wait to dissolve for about half n hour, then i stirr very well with the syringer and take the right dose in mls following the sheet calculator for my current dose, now im removing 7.4mls out of 20, and it works, i was doing very good till now, not much side effects and improvements on my mood/mind, but lately the last reduction gave me insomnia so i cut back the dose a bit and tonight i will check if i can sleep.

 

[ChessieCat]

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