NNhope Tapering zyprexa/olanzapine help?

[NNhope]

So starting feb 2020 I was put on 20 mg paroxetine and 40 mg adderall. Around may or June I had a mental break and was hospitalized and was put on 30 mg paroxetine and 15 mg olanzapine and when out also taking 40 mg adderall. In dec 2020 decided to just quit taking everything. Did not feel much but was also using alot of cannabis and dxm so it might of mask the withdrawal. Until feb 10th where I used dxm on more time then decided to stop everything. For a while I was fine but on march 17th 2021 I crashed trying to harm myself and ended up in ICU then inpatient for a week. They put me back on 10 mg olanzapine with 150mg× 2 trileptal. I was also on trazadone for sleep nightly.

 

When I was out I took those for about a month until April 25th 2021 where I just wasnt feeling like myself so I tried to CT the olanzapine again. First 3 day was fine and I felt myself again but on the 4th day I had really bad anxiety that I tried to undure but only lasted till 3 pm or so before I took 5mg olanzapine but that didnt help so a few hours later I took 5 mg more. I did get to sleep that night but the restlessness and anxiety stayed with me. From that day I decided to just keep taking 5 mg instead of 10 mg. I also stopped taking the trazadone. Every morning or nearly 2 week I woke up to huge cortisol spike and for a while I couldnt sit still because it's too uncomfortable. So I kept pacing around the house. After 2 weeks on 5 mg things started to calm down a bit and I'm able to sit if I need to with less restlessness. 

 

Today is going into week 4 and I had a few day like yesterday with some bad anxiety for like a few hours but overall its tolerable.

 

My question is when should I start tapering as I'm feeling okay, still alot of discomfort but tolerable. 

[Altostrata]

Welcome, @NNhope

 

Cold turkey off psychiatric drugs often causes symptoms such as you described.

 

It sounds like your reinstatement of 5mg is gradually working to stabilize your nervous system after withdrawal. How have your symptoms changed in the last week?

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[NNhope]

Hi @Altostrata, thank you for the reply.

Symptom 2 weeks ago was lots of pacing, no appetite, restlessness, high anxiety, inability to relax and waking up with cortisol spike anxiety.

 This week appetite is back, low anxiety and able to relax. I do however have intrusive thought, fatigue while at work. Had 2 days with anxiety spike but seem to resolve after eating something. 

 

As for signature, I clicked on account but dont see where to add one. If you could point me in the right direction that would be much appreciated.

[Altostrata]

Your nervous system got shaken up badly, now it's settling down. Please be patient, 5mg may be enough.

 

To add your signature, edit your Profile fields.

[NNhope]

Thank you, I've updated my signature.

[Altostrata]

What effects have you felt from Trileptal? Please read up on Trileptal adverse effects on drugs.com (see Professional Information tab).

 

What times of day do you take your drugs, with their dosages?

[NNhope]

@Altostrata, I take trileptal twice a day, morning at 730am (150mg) and then again at 730pm (150mg) along with my dose of olanzapine(5mg) at night.

 

I dont really notice anything from the trileptal when I take them.

[NNhope]

I just checked the drugs.com adverse effect of trileptal. I think my vision is more blur then usual and I've been very fatigue/ tired at work. I thought it might be from olanzapine but could be from trileptal.

Should I stop taking it? I've only been on it almost 2 month.

[Altostrata]

Please update your signature with the date you started Trileptal.

 

How do you feel before and after taking Trileptal? Is the fatigue worse at any particular times of day?

[NNhope]

@Altostrata,I started trileptal on the 22nd of march. Till current. 

 

The physical symptoms have diminish alot but I feel like unable to relax mentally. Cant really enjoy watching a tv show etc. My emotion is very dull as well.

[NNhope]

I'm wondering if it's the trileptal or the olanzapine that is dulling my emotion. 

 

Also sleeping feels weird. I go to bed but dont really notice falling asleep and then its 5 30 am and lay there until 

7 30am.

 

Maybe I should do a quick taper of trileptal before the olanzapine?

[NNhope]

I take trileptal 7 30 am in morning. I wake up feeling like it's going to be another long day. After taking it I dont feel much different except my vision is a bit blurry. I get ready for work then pace around until it's time to go to work.

 

730 pm I take trileptal with my olanzapine then get ready for bed since it's the only mental break I get for the day.

 

 

Less physical symptom but still have this restless unease throughout the day, just waiting for the day to be over.

[NNhope]

The fatigue is just throughout the work day. My work is very physical so I notice it more. During the weekend I dont notice it as much.

[Altostrata]

It sounds like the Trileptal isn't doing anything useful.

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[NNhope]

Sunday May 30th

 

530am woke up stayed in bed anxious to start a new day

730am - got up to take 150 mg trileptal than back to laying in bed

930am- got up, feeling like its gonna be a long day

1000am- turn on hulu and have it in the background to distract from feeling unease, slight restlessness

1200pm- ate some food

200pm- feeling unease and restlessness just constant throughout day with thoughts of never getting better

530pm- feels a bit better now that day is about over

630pm- went for a walk with mom and sister than ate some food

700pm- pacing around 

730pm- took 150mg trileptal, 5 mg olanzapine 

830pm- lay in bed waiting to fall asleep 

930pm- turn off tv then fall asleep sometime after that

530am- wokeup

 

 

 

Throughout the day just have this inner restlessness.

 

 

 

[NNhope]

My symptom are constant throughout the day, its uncomfortable but tolerable atm. Feeling of unease and restlessness and dulling of emotion. 

[NNhope]

Saturday, May 29th

 

530am- woke up but stayed in bed

730am- got up to take 150mg trileptal back to laying in bed

930am- got up because it became too uncomfortable just laying there

1030am- turned on hulu for distraction from the constant unease

1100pm- ate food

1200pm-dental work with local anesthesia 

100pm- tried to take  nap to speed up the day.

130pm- open eyes and everything was disoriented for 20 second until things came back into focus. Scared me a bit.

300pm- pacing around the house a bit and on and off reading SA forums

500pm- ate food

730pm- took 150mg trileptal, 5mg olanzapine

800pm laying in bed wating to fall asleep

930pm turn off tv and sleep sometime after that

530am wokeup

 

Constant feeling of unease and restlessness throughout the day

 

[NNhope]

I just check my med. The trileptal is 300mg x 2 not 150 mg

[NNhope]

I means I take 600mg trileptal a day. Maybe I should taper that down a bit?

[Altostrata]

If I were you, I'd start tapering off Trileptal. Dullness and tiredness are adverse effects. See Tips for tapering off oxcarbazepine (Trileptal)

 

Please let us know how you're doing.

 

[NNhope]

@Altostrata, should I wait to stabilize since my recent reduction of olanzapine before I start tapering?

 

Also can you make your own liquid with trileptal or I'd have to get the liquid from pharmacy.  I read the link and it doesnt say anything about homemade suspension.

[NNhope]

I think I am going to hold for another month until I feel settled then start tapering the olanzapine. 

 

Tapering the AP first is what I feel like my body is telling me.

[NNhope]

Last two days the fatigue isnt as bad. I do have a bit of a headache though.

[NNhope]

I feel generally the same everyday the last few weeks. Not great but tolerable. I was wondering does that mean that I am stable?

[brassmonkey]

It's a really good indication that you are.

[NNhope]

Thank you for the reply.

 

So it's been about a month in a half since I reinstated and holding. I want to start tapering in 2 weeks. Do you think that's a good idea. 

 

So in 2 weeks I'm going to switch to liquid suspension and taking full 5mg dose for an extra week or two then if all goes well reduce by 5 % as a test reduction.

22 hours ago, brassmonkey said:

It's a really good indication that you are.

 

[brassmonkey]

Instead of switching directly to all liquid I would suggest doing a crossover. This would entail one week of 75% tablet 25%, a week at 50:50, a week at 25:75 and then finally all liquid. For some people a direct change can be s shock to the system. After a couple of weeks with the all liquid, if you are stable then you can start the taper.

[NNhope]

I will cross taper like you suggest and hopefully all goes well. Thank you.

 

Yesterday I had alot of neuro emotions. Today not so much but a bit fatigue at work. 2 more weeks hold on the solid form

Then I'll do 3 quarter tab and 1 quarter liquid and see how that goes.

 

[NNhope]

A question regarding akathisia. 

 

So when I tried to CT 10 mg about 2 months ago, by the 4th day I was having alot of anxiety and restlessness so I had to reinstate 5mg and it took about 3 weeks for the restlessness to settle enough to where I dont need to pace constantly.

 

Since stopping the meds cause this restlessness. Will I get it again everytime I reduce during my taper? It's really uncomfortable. If i taper slow enough, could this symptom be avoided?

 

[hayduke]

Hey @NNhope. 

 

Yes, I've definitely found tapering too fast or making too large a cut can induce akathisia.  It's a good sign to hold, and consider reducing your rate.

 

I've also found sometimes alcohol or weed can set it off, I'm guessing that's our old friend dopamine release.  Don't do much of those lately.

 

Cheers

[NNhope]

@hayduke does the akathisia settle pretty quickly for you? I remember you saying that when you made a cut from 5mg to 3.5mg, it was too fast and you were not functional for 2 week. What were the symptoms?

I'm going to transition to liquid in 2 weeks and then stay there for a while before starting my taper. I am really scared that I'll get akathisia again.

[hayduke]

Oh yeah 5 to 3 1/3 mg in one cut was way too much.  I hadn't read Breggin or SA here yet.  I felt so crap I just figured that was as low as I could go, and went back up to 5.  Anxiety probably the major symptom then but just everything felt bad, didn't want to be alone, wasn't good company, etc etc.

 

No telling how long akathisia sticks around, but it will more than likely tend to briefer spells the more gently you taper.

[NNhope]

I see, thank you for taking the time to answer my question. 

 

I am not sure If I should hold longer or not cause I have some of that anxiety and kinda feel blah overall.

 

Iam not sure If that's just because I'm on 5mg or if it's from WD. 

[hayduke]

Someone here once wisely said 'any reason to hold is a good one'.  If I'm not sure, I like to wait till I am. 

 

Looking at your drug signature, your body may well want more time to catch up the changes you've made.  10 -> 5 is a big drop in one go, if that was me I would stabilise for a good six months after that, then review how I felt.

 

[NNhope]

I just don't want to hold too long as I haven't been on it that long.  Hoping I can start tapering, because as I'm holding I don't feel like I'm making progress.

[hayduke]

You may as well say you’re tired of sitting around waiting for a sprained ankle to heal and are keen to start walking through the mountains.

 

We all understand that feeling…believe me we do.  It’s not a question of willpower though.
 

You are making progress during holds, your body is adapting to half what it was getting before.

 

You can’t sensibly fight what your body is telling you it needs.  If you ignore it it all just gets worse later on.

 

It sounds like you’re still having wd symptoms from your huge 50% cut.

 

The better way to see if you can go faster than 10%/mo is try 10% when you’re ready.  If you are peachy 4 weeks after your 10% cut, you could try 12.5.

 

The forum is full of posts from people who come here, sadly decide they will press on with a fast taper despite advice, and often worsening symptoms, and wind up set back worse than when they arrived.

 

It’s always up to you of course but it’s already trying enough doing a slow taper…why make it worse and court disaster just because you’re impatient?