hdmiTable: preparing to taper from Zyprexa / olanzapine

[hdmiTable]

Hi Everyone,

 

I have been taking Zyprexa 7.5mg for 60 days and made an attempt to decrease my dose to 5mg 3 days ago. I took the 5mg pill a single time and I could not sleep that night. The next day I went back and took the 7.5mg pill and I still only got about 0-3 hours sleep since then.

 

I'm seeking help for getting off this drug. I've read the Tips on withdrawing from Zyprexa thread many times over. My psychiatrist doesn't support me tapering so I don't think I have a chance to get the liquid form from a compounding pharmacy. I also can't afford an expensive scale. I was thinking about getting the orodispersible tablets and putting them into 7.5 ml-s of water. Then I would pull it up with a syringe and dispose 1ml every 2-3 weeks. Will this work? Has anyone succeeded in tapering Olanzapine this way? Any advice would be more than welcome. I'm very desperate to get off it and I'm really scared that I am having such horrible withdrawals even though I've only been on it for 2 months.

[Shep]

Hi, @hdmiTable.

 

Welcome to Surviving Antidepressants (SA).

 

I'm very glad that you're already reading the information on the forum. Before beginning your taper, please also have a read of these threads (or at least the first post in each thread):

 

Why taper by 10% of my dosage?

 

The Brassmonkey Slide Method of Micro-tapering

 

The Windows and Waves Pattern of Stabilization

 

On 6/23/2021 at 5:36 AM, hdmiTable said:

Has anyone succeeded in tapering Olanzapine this way?

 

 

Yes, many people come off antipsychotics of all varieties. You can read these posts for members who are using orodispersible:

 

SA Search for "orodispersible"

 

A tip - you may want to gradually transition over to liquid. Or you may wish to keep part of your dose in tablet and the rest in liquid. In the Tips for tapering off olanzapine thread, please note:

 

 

On 2/7/2013 at 10:00 PM, Altostrata said:

Using a combination of tablets or capsules and liquid
Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

Is your signature correct? You state that you've only been on Zyprexa for two months, but you have the year 2020 in your signature. Please verify how long you've been on this drug. Is this the first and only psychiatric drug you've taken? What date did you start this drug? 

 

Please continue to use this thread to document your taper and to ask questions. As you provide more information, we can help you set up a safe taper. 

 

 

[hdmiTable]

Hi @Shep

 

Thank you for the links I will have a look at them now.

 

My signature was incorrect and I have updated it with all the other meds I have been on. I hope it is in the correct format now.

 

 

[Shep]

Thanks, @hdmiTablethis is very helpful.

 

Although you've only been on Zyprexa for 2 months, your antipsychotic history is 6 months, so you likely are very dependent.

 

On 6/23/2021 at 5:36 AM, hdmiTable said:

I have been taking Zyprexa 7.5mg for 60 days and made an attempt to decrease my dose to 5mg 3 days ago. I took the 5mg pill a single time and I could not sleep that night. The next day I went back and took the 7.5mg pill and I still only got about 0-3 hours sleep since then.

 

How is your sleep now? Are there any improvements?

 

How did the switch from Aripiprazole to Zyprexa go? Did you have any changes of symptoms during that time? 

 

And one more question - was Aripiprazole more sedating than Zyprexa? 

 

[hdmiTable]

Hi @Shep

 

I have made some improvements and slept a couple of hours last night (not sure exactly how much) but I think I managed to sleep at least 4 hours.

 

I made the switch because I've had broken sleep and akathisia although I regret it so much as it would've been way easier to taper off from Aripriprazol imo but it's too late now.

I was slowly titrated over in two weeks, starting by taking 2.5mg Olanzapine whilst reducing Aripriprazol and eventually jumping to 7.5mg Olanzapine and quitting Aripriprazol.

I experienced no change in my symptoms.

 

It was not as sedating as Zyprexa I've had really bad sleep on it.

 

I may also go to the hospital next week to change from Zyprexa to something else. I think I would have a really difficult time tapering Zyprexa so it may be better to change to Seroquel and then start tapering Seroquel as soon as I'm on it. It is also one of the most sedating antipsychotics but it's histamine based. I expect to get at least 3 hours of sleep after the change and then lower my dose by 50mg every month and see how it goes. Hopefully I'll be still getting sleep even on 25 or 50mg and then I would hold for a little while before going completely off.

 

I expect at least a year of severe insomnia afterwards.. or maybe even two.. I'm feeling hopeless but I hope everything goes according to plan and I'll have an easier time reducing Seroquel.

[hdmiTable]

My sleep has almost fully stabilized. I've slept roughly 7-8 hours with vivid dreams. I've made myself a tea from a combination of filters, it's been succesful at making me feel drowsy and sleepy:

1. Liquorice Root Tea
2. St. John's Wort Tea
3. Lavender Tea
4. Hops Flowers Tea
5. Lemon Balm Tea
6. Camomille Tea
7. Roseship Tea

I'm still considering changing my medication to Seroquel. It would take months/years to taper from 7.5mg and over time I'd more and more dependent on it. I think Seroquel may be easier to taper.

 

 

[Shep]

On 6/26/2021 at 2:39 AM, hdmiTable said:

I've made myself a tea from a combination of filters, it's been succesful at making me feel drowsy and sleepy:

1. Liquorice Root Tea
2. St. John's Wort Tea
3. Lavender Tea
4. Hops Flowers Tea
5. Lemon Balm Tea
6. Camomille Tea
7. Roseship Tea

 

Please google here on Surviving Antidepressants or on the internet and learn more about what you are taking. A number of items here can cause dependency and other problems. This will get you started:

 

St. John's Wort (Hypericum Perforatum)

 

Lemon balm

 

On 6/26/2021 at 2:39 AM, hdmiTable said:

My sleep has almost fully stabilized. I've slept roughly 7-8 hours with vivid dreams. I've made myself a tea from a combination of filters, it's been succesful at making me feel drowsy and sleepy:

 

Having one good night of sleep - especially with taking tea full of herbs, which usually only is a temporary fix that likely won't last,  is not being "full stabilized." You posted in your earlier threads about sleeping 0 -3 hours a night, then getting a 4 hour night. I'm very glad you got some sleep, but I would research the items in that tea. I would be very cautious about using this mix of teas as a way of fixing a destabilized nervous system. This caution comes from watching many members here and on other withdrawal forums report problems, including paradoxical reactions and dependency issues. 

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

 King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

 

You may find some helpful information to handle your symptoms here: 

 

Non-drug techniques to cope with emotional symptoms

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

On 6/23/2021 at 5:36 AM, hdmiTable said:

My psychiatrist doesn't support me tapering so I don't think I have a chance to get the liquid form from a compounding pharmacy.

 

On 6/25/2021 at 7:29 AM, hdmiTable said:

I may also go to the hospital next week to change from Zyprexa to something else.

 

 

If your current psychiatrist doesn't support you tapering, how how will you be treated in a hospital? I don't know how mental facilities are set up where you live, but where I live, if you go on a psychiatric ward, you don't have control over the drugs you take and you may be subjected to forced treatment. Please keep yourself safe, hdmiTable. 

 

 

On 6/25/2021 at 7:29 AM, hdmiTable said:

I think I would have a really difficult time tapering Zyprexa so it may be better to change to Seroquel and then start tapering Seroquel as soon as I'm on it. It is also one of the most sedating antipsychotics but it's histamine based. I expect to get at least 3 hours of sleep after the change and then lower my dose by 50mg every month and see how it goes. Hopefully I'll be still getting sleep even on 25 or 50mg and then I would hold for a little while before going completely off.

 

I expect at least a year of severe insomnia afterwards.. or maybe even two.. I'm feeling hopeless but I hope everything goes according to plan and I'll have an easier time reducing Seroquel.

-----------------------------------------------------------------------------------------------------

Edit: the original doses here were based on an erroneous chart in the equivalency thread, which has now been updated. See the thread for the updated numbers. 

-----------------------------------------------------------------------------------------------------

You're currently on 7.5 mg Zyprexa. The equivalent dose of Seroquel is 562.5 mg (see the equivalency chart in the first post of this thread: Dose Equivalents / Equivalency for Antidepressants and Second-Generation Antipsychotics). 1 mg of Zyprexa (Olanzapine) is equivalent to 75 mg of Quetiapine (Seroquel).

 

(If you switch to 50 mg Seroquel, it's like going cold turkey off the Zyprexa because doses under about 150 mg Seroquel don't act on dopamine but as you noted, act on histamine. With your history of fast switches to multiple antipsychotics, your dopamine receptors are likely sensitive now, so making this type of abrupt switch could cause psychosis or other problems. 

 

If you continue to switch antipsychotics, you're going to continuously be on an antipsychotic. We don't know any short cuts. The best method of getting off an antipsychotic is to do a very slow taper. 

 

Recommendations:

• Stay on the 7.5 mg Zyprexa until you're more stable
• Minimize the use of herbal teas and instead, bring in a small bit of fish oil and magnesium, one at a time and at a low dose
• Work on non-drug coping skills

Please post your thoughts. 

Edited July 24, 2021 by Shep
added updated information

[hdmiTable]

Thank you for the links. My psychiatrist advised I should drink as much Lemon Balm tea as I can. I didn't know it can cause dependency.

 

I'm hopeful that I can convince my doctor about changing me to Seroquel. I know I would start on a higher dose and I would taper off by reducing 50mg every month.

 

I think by the time I would get down 50 mg I would still be having Zyprexa withdrawals. So I'd hold on 50mg until I'm able to get 8 hours of sleep then slowly taper the 50mg away.

 

I'm so afraid to stay on Zyprexa as I've read many stories where people failed to taper below half their original dose. I still don't know which route would be better. There's also a chance that I won't get to chose an AP in the hospital which would also be really bad.

[Greatful]

@hdmiTable  Please be careful.  Why do you think Seroquel will be a easier taper?  I know that people have also had a hard time getting off of Seroquel.  They would get horrible insomnia.  All the drugs can be hard to come off.  Changing drugs can make things worse.  I think it would be a good idea to listen to the advice of the mods here.  I wish I been advised through the mods here last winter.  It would have saved me from months of misery.  I even tried Seroquel. It really didn't help much with my sleep.   

 

Take care of yourself.  Try not to panic, which can lead to rash decisions.  

 

[hdmiTable]

Hi @Greatful

 

I can use Seroquel as a sleep aid. I think Olanzapine atrophies the brain and damages the ability to sleep indefinitely.

 

With Seroquel I can start from 500-600mg and slowly work my way down to 75mg - 50mg at low doses it's still effective as a sleep aid and at least I can get rid off the dopamine blocking properties of the AP-s. I'm too afraid to stay on Olanzapine as I've seen many people struggle to get lower than half their original dose.

 

I've had a very bad reaction when I lowered my dose to 5mg. Yesterday I was only drinking fruit tea and my sleep was terrible. I am not sure if I've slept more than 1-3 hours and I had very vivid dreams. Today I am also having some anxiety. I don't know what to do. I'm scared that I'll be stuck on Olanzapine if I stay on it. I've read a success story where someone was able to regain his sleep after 2 years.

[Shep]

4 hours ago, hdmiTable said:

I've had a very bad reaction when I lowered my dose to 5mg.

 

Please read the links that have been provided. I'll repost two of them here:

 

Why taper by 10% of my dosage?

 

Tips for tapering off olanzapine 

 

You'll need to decide if you wish to use a scale or make a liquid (you can make your own or use a compounding pharmacy). Here is the information for that:

 

Using a digital scale to measure doses

 

How to make a liquid from tablets or capsules

While Zyprexa is not very soluble in water, you can use a a suspension agent like Ora-Plus to make sure the crushed tablet is evenly suspended in water. Talk to your local pharmacist for what is available in your area. 

 

Compounding pharmacies (US, UK, and elsewhere)

I'm not sure there's information on compounding pharmacies in your area, so please use google and research if this is an option you'd like to use. 

 

22 hours ago, hdmiTable said:

I think by the time I would get down 50 mg I would still be having Zyprexa withdrawals. So I'd hold on 50mg until I'm able to get 8 hours of sleep then slowly taper the 50mg away.

 

You'll go into Zyprexa withdrawal as soon as you start crossing over to another drug. While Seroquel and Zyprexa are both antipsychotics, they are very different drugs. This is why we don't recommend switching to another antipsychotic to taper. 

 

Once you reduce under 200 mg Seroquel, you are moving toward a drug that works on dopamine to one that works on histamine. You still will be withdrawing from a dopamine drug. Seroquel does not bypass this. The histamine may or may not cover the withdrawals from the dopamine action. There is still the possibility of something called "dopamine super-sensitivity," meaning because the drug dampened down dopamine activity, after you remove the drug, the brain tries to compensate by becoming “supersensitive” to dopamine (see MiA - Antipsychotics). 

 

The best way to avoid this is to do a very slow taper and let your brain and body adjust slowly to the decrease. We don't know of any shortcuts by switching to another drug. 

 

As Greatful wisely noted, people struggle to get off Seroquel. My last antipsychotic was Seroquel and when I got down to 6.25 mg, it turned paradoxical, meaning instead of being sedating, it was stimulating. 

 

At these lower doses (100 mg or so of Seroquel), it's not much different than taking an anti-histamine such as Benadryl. Anti-histamine are also very problematic during withdrawal due to paradoxical reactions (see: Antihistamines for withdrawal insomnia (diphenhydramine, doxylamine, hydroxyzine as noted in that first post: The problem with  diphenhydramine is it's beneficial sleep effect can wear off and it can go paradoxical -- it will keep you awake instead.)

 

5 hours ago, hdmiTable said:

I've had a very bad reaction when I lowered my dose to 5mg.

 

Going from 7.5 mg to 5 mg is more than a 33% reduction. Again, we don't recommend going any faster than 10% off the previous dose. 

 

Please go back up to 7.5 mg Zyprexa and read the links that have been posted here on your thread. A slow taper is what separates those who are able to successfully get off this drug with fewer symptoms. Once you are more stable with sleep and anxiety, then we can help you set up a slow and careful taper and guide you through how to use a scale or make a liquid. 

 

But please first read and get informed on the best way to come off this drug. 

[Greatful]

@hdmiTable I know it is hard to work your way through all this when you don't feel good.  Try to stabilize before you make any decisions. 

 

I belong to Mayo connect form.   There were horror stories from people trying to come off their Seroquel. When I cold turkey my Seroquel after 5 weeks it was a horror story.  I started to become delusional.  I was sitting in my living room and heard the birds singing outside, I became paranoid that they could be trying to tell me something.  I was scared that people might be able to tell me something through their eye.  It was scary.  I have been off Seroquel now for 3 months, my symptoms are pretty much gone.  

 

 It is not FDA approved for a sleep aid.  The doctors are giving these strong, strong  drugs out like candy.  

You don't know how you will react to any med.  You can taper off of Zyprexa slowly.  You body all ready knows this med.

500mg to 600mg of Seroquel is a large dosage.  You may have to stabilize if you do make the switch, than start a taper.  Why would the doctor help you taper off of Seroquel and not Zyprexa?  

 

What ever you decide I wish you the best.  

We here at SA are here to help in anyway we can.

 

[hdmiTable]

Many thanks @Shep , @Grateful

 

My anxiety has eased up a lot this afternoon. I would like to ask a few questions.

 

Can I still do the liquid without Ora-Plus? It is not available in my country.

 

I've read a lot about dopamine supersensitivity and a while ago I have found a paper that gives instructions on how to taper off AP-s while minimizing the risk of dopamine supersensitivity psychosis. I am not sure if it is allowed to link the study but it is available here: https://academic.oup.com/schizophreniabulletin/advance-article/doi/10.1093/schbul/sbab017/6178746?searchresult=1

 

In the middle of the page there is a table (table 4) for reduction steps of popular AP-s. It is suggesting:

300 -> 240 -> 200 -> 160 -> 120 -> 90 -> 65 -> 40 -> 20mg for Seroquel, holding for about 3 months on each step.

 

This paper suggest that there is still dopamine blocking property even below 200mg but I am very confused as I've read elsewhere that it's only an antipsychotic over 200mg - 250mg?

 

This is a hyperbolic taper and not gradual. The paper says "Gradual reduction in antipsychotic dose leads to incrementally increased dopaminergic transmission, possibly associated with a smaller increase in the risk of relapse or temporary increase in symptoms."

 

I am still very tempted to make the change due to it's better side effect profile as well. For now I'm staying on 7.5mg Olanzapine until I feel better. I am trying to overcome my fear but I am still very scared to stay on it. This one-off reduction to 5mg was a little teaser of what is waiting for me. It was also an indicator that I cannot go fast. I've been on it for only 2 months and if I do a very slow taper I'll build more dependence to it over time.

 

[Greatful]

@hdmiTable I know what it feels like to want off and how hard it is to be patient.  I am on Lexapro that I think might be causing me adverse symptoms. 

I started it April 3rd  ( there is more to the story but I won't get into it here.  You can look at my introduction bio)  I  felt something was wrong within 48 hrs.  My anxiety ramped up and other symptoms.  I took the lowest dose 5mg Sat. morning by Sunday night I thought my head could roll off of my shoulders,  I was completely snowed, drugged, my speech was slow and I talked goofy.  Long story short my doc wanted me to keep titrating up to 10mg.  I was miserable through this process, but I did make it to 10mg.  I couldn't take it, talk to my doctor and he said to stop, by this time I knew I was in trouble,  I had already been on it for a month, so I knew had to stay on, told my doc. that I have been on it for a month already and my brain has started to make changes to work with the drug and that I will have to taper off, dropped down to 5mg fairly quickly, now I am stuck on this, and when I feel stable enough I will start a super slow taper.  Yes it is horrible what these drugs can do to your brain in such a short time and cause these kind of Withdrawals.  So I to am wondering how much of my misery is from the Lexapro and how much is from withdrawal.   So your brain is already adapted to Zyprexa,  now you have to deal with it as such, and taper as if you have been on it for a while.

 

Patience is very hard.  But the mods do know more about how this works even more than half the doctors.  So please take their advice and think it over long and hard.

Best of luck and know you are not alone....

[hdmiTable]

Hi @Grateful@Shep,

 

@Grateful I am sorry that this happened to you. These drugs are labelled safe when in reality they are not and can be very hard to get off. I refused any other medication apart from my AP-s and I'm sticking to that decision even though my shrink wants to prescribe me antidepressants. From what I've read on SA I agree that the mods know about these things more, doctors just prescribe meds but they never took them. I am trying to think this through over and over to come up with the best plan. Right now I am both trying to come off but also trying to minimize my chances of getting psychosis. Rather than going by the mg I try and go by considering how much dopamine they block and decrease my dose accordingly. Ultimately, Olanzapine won't work for me if I can't do a hyperbolic taper.

 

My plan so far is based on this:

 

Olanzapine 7.5mg corresponds to roughly 62.5% dopamine blockade. That's my starting point.

 

Olanzapine dose (mg)	D2 occupancy (%)
85.5	95
40.5	90
25.5	85
18	80
13.5	75
10.5	70
8.4	65
6.8	60
5.5	55
4.5	50
3.7	45
3	40
2.4	35
1.9	30
1.5	25
1.1	20
0.8	15
0.5	10
0.24	5
0	0

 

For Seroquel please see table below:
 

Quetiapine dose (mg)	D2 occupancy (%)
1200	38.0
1000	36.3
800	34.1
600	30.9
400	26.1
200	17.8
100	10.9
50	6.1
25	3.3
0	0

 

...and with 5% D2 intervals:

 

Quetiapine dose (mg)	D2 occupancy (%)
1547	40
874	35
553	30
365	25
242	20
155	15
90.0	10
39.9	5
0	0

 

Using this method tapering Olanzapine would take 12x6 weeks, roughly 1.5 years

 

while tapering Quetiapine would take roughly 6x6 weeks - assuming a starting point of 550mg, a little bit more than half a year.

 

When considering side effects and dopamine blockade it seems to me that hands down Seroquel is the lesser evil out of the two.

 

I think it was Robert Whitaker who has done an experiment on mice and they've found it takes 3 months for the receptors to recover for every month of a particular med.

 

If I apply this to Olanzapine, it would take a little bit more than 6 months to recover from it, but I'm not sure about this or if I could apply this logic the way I do to my situation.

 

I regret so much going on to Olanzapine and I'm trying very hard to find a solution.

 

There's very few success stories when it comes to Olanzapine. In most cases I find that people have been on it for years. I still feel like I have a slightly better chance of recovering if I come off now after 2 months. With a prolonged taper I'm also increasing my body's dependence to it. I am hoping I'd be having decent sleep with Seroquel for those allegedly 6 months that will take for me to recover from Olanzapine and in the meantime I could also taper Seroquel down to at least a minimal dose while evading dopamine supersensitivity psychosis with a hyperbolic taper.

 

I don't even know if this would work. Maybe once I stop Olanzapine I'll have really bad insomnia even if I take Seroquel.

 

 

 

 

[Shep]

22 hours ago, hdmiTable said:

In the middle of the page there is a table (table 4) for reduction steps of popular AP-s. It is suggesting:

300 -> 240 -> 200 -> 160 -> 120 -> 90 -> 65 -> 40 -> 20mg for Seroquel, holding for about 3 months on each step.

 

hdmi, these reducations are too much. Going from 300 to 240 is a 20% reduction. Going from 40 to 20 is a 50% reduction. 

 

Again, we don't recommend tapering faster than 10% per month off the previous month's dose. 

 

3 hours ago, hdmiTable said:

Using this method tapering Olanzapine would take 12x6 weeks, roughly 1.5 years

 

while tapering Quetiapine would take roughly 6x6 weeks - assuming a starting point of 550mg, a little bit more than half a year.

 

I have no idea what you are doing with your math here. 

 

At 10% reductions per month off the previous month's dose, you would only be down to 292.3 mg of this drug in half a year.  

 

3 hours ago, hdmiTable said:

I think it was Robert Whitaker who has done an experiment on mice and they've found it takes 3 months for the receptors to recover for every month of a particular med.

 

 

If that were true, it would have taken me 90 years to recover from 30 years of using antipsychotics (and a ton of other drugs). I recovered in 5 years. 

 

Robert Whitaker is a journalist, not a researcher or doctor. And he's reported on many studies and has many articles on his website written by different people, including those with lived experience, who state the benefit of the slow taper. 

 

 

 

3 hours ago, hdmiTable said:

There's very few success stories when it comes to Olanzapine. In most cases I find that people have been on it for years. I still feel like I have a slightly better chance of recovering if I come off now after 2 months. With a prolonged taper I'm also increasing my body's dependence to it. I am hoping I'd be having decent sleep with Seroquel for those allegedly 6 months that will take for me to recover from Olanzapine and in the meantime I could also taper Seroquel down to at least a minimal dose while evading dopamine supersensitivity psychosis with a hyperbolic taper.

 

There are plenty of success stories of people coming off not only olanzapine, but many antipsychotics. You can see them here - Success stories: Recovery from psychiatric drug withdrawal. There are overall fewer antipsychotic success stories in comparison to success stories from benzos and antidepressants because there have been withdrawal forums dedicated exclusively to benzos and then antidepressants. It's only a more recent phenomenon to see forums giving information on tapering off antipsychotic. As more people show up on these drugs and document their experiences, the more success stories will be posted. 

 

As I wrote earlier:  Although you've only been on Zyprexa for 2 months, your antipsychotic history is 6 months, so you likely are very dependent on a dopamine-reducing drug. 

 

And again: insomnia is a withdrawal symptom of Seroquel. 

 

The only way we know to reduce the changes of dopamine supersensitivity and other withdrawal symptoms is by a slow taper off your current drug. Continuing to switch antipsychotics and to make rapid reductions is only going to land you back into a doctor's office - or worse, on a locked psychiatric ward - and you'll continue on the drug merry-go-round. You also risk kindling your nervous system by continuing to switch drugs and make abrupt changes. Damage to the autonomic nervous system is also possible, not just dopamine supersensitivity. 

 

@hdmiTableI'm not going to continue debating this. This website offers help with doing a slow reduction. If you're not interested in our protocol, then please work with your doctor. We won't be able to help you here. From what you've written, what you propose doing is very dangerous. 

Edited June 28, 2021 by Shep
fixed typo

[BlondeAndDrugged]

I’m in the same boat as you but on risperidone instead (similar to zyprexa).  I was considering switching to seroquel also since like you noted it seems like an easier taper and a milder drug, but I know I’d still be essentially CT’ing what I’m currently on and I already had a taste of how awful that would be.  I’m no expert so I won’t give advice but I strongly relate to how you feel and our timelines are similar.  I hope things get better for you and that you keep updating.  
 

These drugs are the worst, it is hard to know what to do sometimes.  Wish you the best

[hdmiTable]

Hi @Shep

 

Thanks. I need a med that I'm able to function on and I can't function on Olanzapine and the side effects are less life changing on Seroquel. I honestly don't know what to do I'm about to start a new job next month.

 

I've done some further reading about others experiences and Seroquel doesn't seem to be that much different than Olanzapine, they're pretty much the same when it comes to withdrawals. I've thought it would be an esier ride on Seroquel but now I've read that there's withdrawals even with 50mg reductions.

 

You may be right I may be better off sticking to Olanzapine, I haven't read much about Seroquel withdrawals but now I've found a bunch of threads about it on another site.

 

Do you think I could still do the liquid taper without Ora-Plus - just to get me started? I guess I can order them from the US but it will take ages for it to arrive and I can't seem to be able to order them in large quantities.

 

 

 

 

 

 

[hdmiTable]

Hi @BlondeAndDrugged

 

I did some sniffing around about Seroquel withdrawals and found a bunch of threads on another site about difficulties withdrawing from Seroquel as well. People are struggling with withdrawals even with 50mg reductions.

 

Experiences mention these most commonly:

1. Depression
2. Nausea
3. Tinnitus
4. Insomnia
5. Anxiety
6. Headaches
7. Itchiness
8. Sweating
9. Restlessness
10. Issues urinating
11. Elevated heart rate
12. Loss of apetit

At this point I don't know if it's a good idea to change to Seroquel just for tapering. I've seen you are at 0.9mg of Risperidone which blocks about 40-45% dopamine. Seroquel is only slightly lighter than that, however it's better than Risperidone when it comes to prolactin levels.

 

I wish you the best of luck on your journey! Hopefully we can quit these nasty drugs for good.

 

 

 

 

[Shep]

20 hours ago, hdmiTable said:

Do you think I could still do the liquid taper without Ora-Plus - just to get me started? I guess I can order them from the US but it will take ages for it to arrive and I can't seem to be able to order them in large quantities.

 

You may want to talk to your doctor or pharmacist to see if there's something similar to Ora-Plus available in your area. 

 

If you aren't able to obtain this, you could simply crush the pill up and place it in water and shake it up really well. This is something another mod wrote:

 

 

On 2/27/2013 at 12:30 PM, Rhiannon said:

I personally don't worry about solubility.

 

None of the meds I'm tapering are actually soluble in water. But the pills dissolve into small enough particles that I can stir them up and keep them suspended in water while I measure them out, and that seems to work for me. I stir well before I measure, I stir a little while pipetting them up; I dissolve the pills in glass and pipette out of glass so that I can see visually how evenly everything is suspended, and that's good enough for me.

 

I use water as a medium because I like it that I can easily see for myself how evenly the little particles are suspended or if they seem to be settling out. Also because it's handy and cheap and I don't have to carry it with me if I travel.

 

Mostly I would just say, I don't think it really matters if the medication is soluble in whatever vehicle you're using, as long as it can be evenly distributed. What really matters is that it be evenly distributed and that your method be repeatable and consistent.

 

 

What she wrote about "your method be repeatable and consistent" is important. And I'll add - go slow, no faster than a 10% reduction off the prior month's dose. If you can do that, you'll have a much better outcome, regardless of whether or not you can get something Ora-Plus or you simply use water. 

 

The other option is to use a scale. A lot of people find the Gemini 20 scale to work well. You can find these scales on Amazon, ebay, and other online places. 

 

 

[hdmiTable]

Thank you @Shep

 

I did experiment with crushing the pill and putting it into water to see how it looks like but it's very murky and the yellow particles do settle on the bottom very rapidly. I couldn't see clearly how well they were suspended because of the whiteish mist. 

 

Update: Yesterday night I have slept solid 7-8 hours. I didn't feel rested early in the day but now I feel ok.

 

I have ordered some DMSO and will attempt to dissolve the Olanzapine for more precise tapering.

 

Someone mentioned elsewhere that they diluted 10ml DMSO/Olanzapine solution with 190ml of distilled water but the particles re-crystallized and settled at the bottom again ...so a super slow taper is probably not possible using this method.

 

To start off I will try dissolving the 7.5mg tablet in 7.5ml DMSO then drink it all to see if anything changes.

 

If it goes ok I will make a cut to 6.8mg and allow myself 6 weeks to stabilize.

 

So far that is the plan. In the meantime I'll keep taking my 7.5mg tablets. It's taken me 6-7 days to get back to sleeping 8 hours after reinstating my dose.

 

 

[Greatful]

@hdmiTable  I am so glad you are stabilizing.  You got 7-8 sleep, that is great.  I think you are on the right track.  Take it slow so you don't end up in a hard WD.  You know what happens to all of us when we don't feel good, are head is not working right, we get into a panic and want a quick fix.  Been there done that. 

 

You can do this!

Take care of yourself and keep us posted with the good and the hard times. 

[JohnBanes]

I am glad you are considering carefully whether an intermediate switch to Seroquel or another anti-psychotic is worth it.  I switched from Olanzapine to Latuda and went through almost three months of insomnia (with sleep supported by progressively lower doses of Ativan).  My sleep is still far from great with three awakenings a night (and 6-7 hours of sleep a night, which is a lot better than when I initially withdrew from Olanzapine).  However, now I have to face the difficulties of Latuda.  It has side effects.  And I get insomnia if I try to withdraw.  I suppose where I am is better than continuing to be on Olanzapine because of the terrible metabolic and other side-effects that it had, but still, it's a tough choice.

 

I would be cautious about anyone stating with too much certainty how much a particular dose translates into in terms of receptor occupancy, what the exact schedule for titrating down should be, etc.  As the survivingantidepressants website attests to quite well, people are very different and have different experiences on the same dosage.  I think you have to feel it out.  And generally speaking, I think the psychiatric profession does a bad job of attending to differences among patients.

 

It's good to see you here -- we met via Reddit, but I think this website offers better support.  I hope we both are living stable, happy lives without any antipsychotics in a few years.

[hdmiTable]

Hi @JohnBanes

 

It's good to see you too. As I was reading your post your story sounded more and more familiar and realized too that we have spoken on Reddit. Your story gives me hope that I'll have the oppurtunity to recover even if I end up with the worst case scenario - not being able to reduce or stuck on half my original dose - I can switch and sleep again given enough time and the right meds. You are right about dopamine occupancy the hyperbolic taper is useless if there are horrible withdrawals. I think the approximations are quite good, they were derived from pet scanning patients but it's true that everyone is different and dopamine is not the only variable in the equation as these drugs bind to various other receptors.

 

I'm following your thread to see how you are doing and I wish you the very best, we are going to break free from these drugs.

 

Hi @Grateful Thank you very much for the encouragement. 🦾 💪

 

Update: I slept 7-8 hours again and about an extra hour between 7am and 9am and I feel rested. The DMSO will arrive tomorrow. I couldn't find PBS anywhere so I bought a bottle of physiological saline solution they use the same thing in eyedrops and has a PH of around 7. I lost some weight last week which I attribute to the decreased appetite. I was only eating fruits, veg, yoghurt and some meat with no sides. Watermelons are really good because they are very filling and they're mostly water. I plan on keeping this diet going forward to see if I can keep my weight (143 lbs now and was 120 before Olanzapine)

 

 

 

 

[Shep]

Excellent update on the sleep, @hdmiTable

 

I see Brassmonkey has answered your DMSO question over on the Zyprexa "tips for tapering off" thread.

 

Brassmonkey responds to DSMO question

 

Are you having any other symptoms?  

 

[hdmiTable]

Thank you @Shep

 

The only other thing I noticed in the last week was that whenever I squat or lean down when I stand up I get this weird head rush and also my heart beats faster than usual.

 

I don't know if that's the Olanzapine could be because it's very hot here right now; 38 degrees celsius.

 

[Shep]

Sounds like it could very well be a combination of side effects of Zyprexa and withdrawal, made worse with the heat. Try to rest and stay as cool as you can. 

 

 

[hdmiTable]

Update:

 

So today I carried on with my diet only eating 2 chicken breasts, salad, 2 nectarines and some grapes. I was starving all day long.

 

My DMSO arrived and I filled up a glass with 7.5ml of  the DMSO. I took a piece of glossy paper, put the pill to the middle and then folded it in half. Then I put the paper with the pill inside a magazine and crushed the pill with a heavy hammer. I then took the paper unfolded it and slid the powder into the glass. I waited about 6 hours for it to dissolve, stirring occassionally every hour or so and I ended up with a yellow liquid. I then made my first cut; using a syringe I took out 0.3ml of the liquid which I disposed then drank the rest.

 

I was going to cut down to 6.8mg but decided that I'll be going slower.

 

The DMSO tastes 🤢🤮🤬🤯🥵 I am now going for a walk and hopefully I'll have no problems sleeping tonight. Keeping my fingers crossed hoping everything goes well 🤞

[Shep]

20 hours ago, hdmiTable said:

So today I carried on with my diet only eating 2 chicken breasts, salad, 2 nectarines and some grapes. I was starving all day long.

 

Please take time out to eat throughout the day. Starving yourself all day is very hard on your nervous system. That's a very healthy dinner. I hope all your meals are as healthy. 

 

Please let us know how you do with your reduction. 

 

 

[JohnBanes]

You are doing a great job eating healthy and finding a disciplined way of measuring reductions.  I'll keep my fingers crossed for you.  

[hdmiTable]

Hi @Shep

 

Unfortunately I'm not doing so well. Last night I had a really jittery, broken sleep with weird dreams. I fell asleep around 11PM and woke up 2AM for about an hour or two then went back to sleep until 7AM. I also experienced minor muscle twitches during the day. I only reduced by 0.3mg but my body definitely noticed the change. At this point I'm not sure anymore if I will be able to taper off this drug and I don't know where to go from here. Tonight I'm going to carry on taking 7.2mg and see if it gets better but I'm very demoralized by how I reacted to that tiny change.

 

Thank you @JohnBanes I'm keeping my fingers crossed for you as well 🤞

[JohnBanes]

The insomnia you are experiencing is almost identical to what I had when I tapered down Olanzapine (multiple times).  And 6 or so hours of sleep isn't terrible.  I hope you hang in there and get to the other side.  If you have the resources, Ativan can help with sleep (but comes with its own problems).

 

If this stays with you for the long term as it did with me, Mark Dunn on Quora claims that the insomnia gets better, year by year, with an additional hour or so of sleep after the initial rebalancing.

 

Out of curiosity, did you find your prior dosage of Olanzapine initially sedating but then no longer sedating (i.e., did you adjust to it)?  My theory is that if you adjust to the sedation, then your body comes to rely on Olanzapine for sleep, i.e., adjusting to the sedation side-effect while on the drug is not a good thing.

 

Even if your taper does not go well, there is still the backup option of what I did -- which is transitioning to a drug without the terrible metabolic, etc. side-effects.  Although you won't be off APs, your life will be a little better.  Don't give up.  And we'll keep supporting each other, at least with words.  It is terrible that psychiatry put us into these pharmaceutical prisons.   

[JohnBanes]

One other point.  Olanzapine has a long halflife, so the taper will become most intense about 72-96 hours out.  Keeping that in mind may help manage expectations.

[hdmiTable]

@JohnBanes I think your theory is correct. Initially when I was taking Olanzapine it was very sedating but the effect wore off over time and now I don't even feel it.

 

Last night I've slept much better, I fell asleep earlier as well but woke up 2-3 times during the night but fell asleep shortly after. My muscle twitches are gone which gave me a tiny glimmer of hope that my body is adopting 🐒 This morning I woke up feeling rested regardless.

 

Like you've said I'm still not at peak withdrawal but in a few nights it'll be clear if this is doable for me or not but I have a feeling my sleep will get progressively worse with each cut.

 

I feel so betrayed by my psychiatrist. I've read the horror stories online after we first talked about changing my med to Olanzapine and I asked her about it before we did the change. She said these things don't happen and it's a safe, non-addictive drug. Her plan was to keep me on 7.5mg until autumn then 5mg for a couple of months then 2.5mg for a couple of months then off. I experimented by taking the 5mg pill for one day and it messed me up for a whole week. She lied to me. If I did her schedule I'm sure I would've ended up in a hospital or the psych ward. In all honesty OZ should be banned but because it isn't it should atleast only be given as a last resort like Clozapine.

[Shep]

21 hours ago, hdmiTable said:

Unfortunately I'm not doing so well. Last night I had a really jittery, broken sleep with weird dreams. I fell asleep around 11PM and woke up 2AM for about an hour or two then went back to sleep until 7AM. I also experienced minor muscle twitches during the day. I only reduced by 0.3mg but my body definitely noticed the change. At this point I'm not sure anymore if I will be able to taper off this drug and I don't know where to go from here.

 

5 hours ago, hdmiTable said:

Last night I've slept much better, I fell asleep earlier as well but woke up 2-3 times during the night but fell asleep shortly after. My muscle twitches are gone which gave me a tiny glimmer of hope that my body is adopting 🐒 This morning I woke up feeling rested regardless.

 

Like you've said I'm still not at peak withdrawal but in a few nights it'll be clear if this is doable for me or not but I have a feeling my sleep will get progressively worse with each cut.

 

Just some thoughts: there's a lot of catastrophic thinking here. In that first quote, you mention sleeping from 11 PM to 2 AM and then from around 4 AM to 7 AM, which is 6 hours, so not restorative or long enough, but not a bad night, either, within the context of withdrawal. You also mention "minor muscle twitches during the day." Again, not a difficult symptom to manage, since it was minor. But then you go into the line you keep repeating - "I'm not sure anymore if I will be able to taper off this drug." 

 

And then in the second post I quoted, you state all of the improvements you just made, but instead of projecting a good outcome based on this, you state you feel that your sleep will get progressively worse. Why would you think that based on your own experience of it improving? 

 

Stop doing this! Everyone's experience is different. You're already showing a high level of resiliency, but I'm very concerned that your constant need to be negative is going to be a self-fulfilling prophecy. That this line of thinking is going to make it more difficult to sleep at night, as your thoughts of pessimism start to ruminate and your own thoughts keep you awake at night. 

 

Please work on some non-drug coping skills. These links will get you started:

 

Dealing With Emotional Spirals

 

Whenever you go into negative thinking, try this:

 

"Change the channel" -- dealing with cognitive symptoms

 

Perhaps try some guided meditations in the evening prior to bedtime. 

 

Guided Meditation Deep sleep | anxiety and insomnia relief | relaxation before bedtime  video (21 minutes)

 

This is just an example - there are thousands of guided sleep meditations out there for you to explore. Try to find ones that speak to letting go of negative thinking and calming the mind before bedtime. Build yourself up for success. 

 

If anxiety, worry, and insomnia were what led you to get on antipsychotics in the first place, learning to navigate through these emotions is vital in order to not only get off your current drug, but to ensure you don't end up back on them. 

 

The process of the slow taper allows you the opportunity to slowly bring in these non-drug coping skills and master them. By the time you complete your taper, you'll be a pro at handling anxiety and stress. But it does take time and practice. 

 

Please note it takes 4 days for your nervous system to register a change in dose and few weeks for your mind/body to adjust. Please let us now how you're doing over the coming days. 

 

[JohnBanes]

hdmiTable: I too tend to have negative expectations about possibilities, in part because of the unexpected difficulties Olanzapine caused and in part because I have already consistently experienced the difficulties of trying to move off antipsychotics.  The surprise followed by negative experiences has set me up for bad expectations.  

 

Psychiatrists simply do not recognize that for some people (probably a small minority), withdrawal from Olanzapine and other psychiatric drugs comes with tough, sometimes insurmountable, challenges.  They don't like to think that they are leaving some patients significantly worse off through their treatment.  Unfortunately, the weight of professional opinion is behind the idea that Olanzapine withdrawal does not cause long term insomnia.  Through experience, we know differently.  But psychiatrists can always say that these new symptoms are part of an emergent mood disorder -- and who would believe psychiatric patients?  My wife divorced me and took my son away in part because she thinks my arguments with the shrinks are my lack of insight.  And the effect of the antipsychotic + long term olanzapine withdrawal effects + depression make it difficult to work, and I may lose my job. 

 

We are in an incredibly difficult place not just because of the insomnia but also because our position is contrary to mainstream and authorities do not believe us.  I suppose that is why the survivor community is so important (although it certainly has its share of wacky people).  I hope you and I get through this.

 

John