hdmiTable: preparing to taper from Zyprexa / olanzapine

[hdmiTable]

Thanks @Shep I think you are right. I need to stop worrying about how it will end up and instead focus on getting it done with much more positivity.

 

I'm so sorry that this has happened to you @JohnBanes. I'm back living with my parents and I get the same from my family. Each time we visit my psychiatrist she would ask me about the problems I'm having and then would blame me for them. She kept me on a med that was causing akathisia for 3 months because she didn't believe it was the med causing it. I asked her why I'm feeling dumbed down and having cognitive problems she said it was because I used cannabis in the past. I asked her about motivational problems she said people take this med and feel normal and it's just me being lazy and she's not going to reduce my dose until I start a daily routine. My family believes everything she says. 🤷‍♂️🤦‍♂️ I think she is proper evil.

 

Luckily, over time I learned not to trust her and now I do my own research about everything. I believe patient testimonies and try to learn from the experiences of others, I read studies and also sites like SA. I'm sure we'll get through this and may be even better off in the end. Extreme hardships build character and we'll be much wiser and more resilient and appreciative in the future.

 

 

 

[JohnBanes]

It can be very difficult when your psychiatrist is gaslighting you, and your family believes the psychiatrist.  Try to stay strong.  There is almost no chance that some pot smoking a while back has had any serious long term effects.  And websites are a good resource for corroborating side-effects.

 

All of that said, a daily routine may be helpful.  It doesn't have to be demanding or elaborate.  But may help you recover mentally as you see yourself gaining physical health and being somewhat productive.

[Shep]

On 7/4/2021 at 10:06 AM, hdmiTable said:

Luckily, over time I learned not to trust her and now I do my own research about everything. I believe patient testimonies and try to learn from the experiences of others, I read studies and also sites like SA. I'm sure we'll get through this and may be even better off in the end. Extreme hardships build character and we'll be much wiser and more resilient and appreciative in the future.

 

Thank you for your last post, hdmi. So much wisdom in what you wrote. 

 

16 hours ago, JohnBanes said:

All of that said, a daily routine may be helpful.  It doesn't have to be demanding or elaborate.  But may help you recover mentally as you see yourself gaining physical health and being somewhat productive.

 

Excellent advice, John. With the nervous system fighting for stability, it's not only having a consistent drug schedule, but also keeping everyday life as predictable and orderly as possible is good for the nervous system. 

[Bobblehead]

I bought a jewellers scale off amazon but ended up not reducing by 10%, too hard and confusing to weigh it out, I reduced by a 1/4 pill at a time every 4 weeks. First with 5mg pills, then with 2.5mg pills.

 

I was on 40mg of olanzapine, dropping about the first 20mg was easy, the next 10 more difficult, the last 5 very hard. I've had all kinds of weird withdrawal symptoms. Insomnia being the worst and I haven't recovered from it, I'm on 1mg of clonazepam to sleep now.

 

I wish you the best of luck trying to come off this drug.

 

[hdmiTable]

Hi @Bobblehead Thanks for stopping by. I'm sorry that you have had a bad experience with Olanzapine. I think we are in the same boat. I'll wait a couple of days to see if things even out but so far things aren't going great.

 

 

[JohnBanes]

Bobblehead's signature speaks to a difficult struggle with this drug that is so terrible for some people.  I am in the same boat, and I wish both of you at least gradual improvement in your challenging journey.

[hdmiTable]

Update:

 

I've been tapering for 10 days so I've thought it's time to give you all an update.

 

7.5mg -> 7.2mg:

Day 1: 11PM to 7AM sleep, bad quality sleep, woke up multiple times, muscle twitches

Day 2: 10PM to 7AM sleep, good quality sleep, woke up 1 time, muscle twitches faded

Day 3: 10PM to 7AM sleep, good quality sleep, woke up 1 time, muscle twitches faded more

Day 4: 10PM to 7AM sleep, good quality sleep, woke up 1 time, waves of easy depression, muscle twitches gone

Day 5: 10PM to 7AM sleep, ok quality sleep, woke up 2 times, waves of medium depression

 

7.2mg -> 6.9mg:

Day 1: 10PM to 7AM sleep, but woke up at 11:20PM for a few minutes, high heart rate (avg 92 bpm)

Day 2: 11PM to 7AM sleep, woke up multiple times, high heart rate (avg 94 bpm)

Day 3: 10PM to 7AM sleep, woke up 2-3 times, high heart rate (avg 98 bpm)

Day 4: 11PM to 7AM sleep, woke up at 3:30AM for about 20 minutes, high heart rate (avg 91 bpm)

Day 5: 10PM to 6:45AM sleep, but then slept an extra hour until 7:50AM, woke up 2-3 times, high heart rate (avg 90bpm)

 

I was about to make another cut today to 6.6mg but I'm still undecided whether I should go with it or hold. Things have gotten slightly worse sleep wise. I'm now waking up a few times at night and then fall back asleep. Overall, I'm still sleeping enough and feel rested the day after the sleep quality has still gotten worse with each drop and I'm concerned about this trend. I don't know if I should keep going and potentially hold longer at a lower dose or hold now.

 

I also started taking my dose earlier and earlier (moved it back 15 minutes every 2 days) in the last couple of days. I'm now taking it at 17:30.

 

 

[Shep]

1 hour ago, hdmiTable said:

7.5mg -> 7.2mg:

 

1 hour ago, hdmiTable said:

7.2mg -> 6.9mg:

 

1 hour ago, hdmiTable said:

I was about to make another cut today to 6.6mg but I'm still undecided whether I should go with it or hold.

 

Please add these reductions to your signature along with the exact days (right now, you just have the month and year in your signature). It will help the moderators guide you in your taper by knowing the day and month of your reductions. A direct link to your signature is here:

 

Account Settings - Create or Update Your Signature

 

You were at 7.5 mg Zyprexa some time in June (per your signature). Going from 7.5 mg down to 6.6 mg would be a 12% reduction within a month's time (or less, depending on what day in June were you last at 7.5 mg). Please note we don't recommend reducing by more than 10% off the prior month's dose. Please see:

 

Why taper by 10% of my dosage?

 

I would not decrease any more at this point, but simply hold and give your nervous system time to catch up with the decreases. Perhaps spend some time working on learning more non-drug coping skills. That will give you the feeling of making progress as you hold. One of the beautifies of the slow taper is it allows you to explore alternative ways of handling anxiety, insomnia, worry, etc. so by the time you're completely off the drug, you'll have all the skills you need to navigate through life without needing drugs. 

[JohnBanes]

You are making great progress.  While it is disturbing to see oneself lose normal sleep, the extent of interference with your sleep is not great and you appear to be getting an amount sufficient for functioning fine.  I would take encouragement from the relatively good results, and slow down.  It does take at least 3-4 weeks for your receptors to adjust to the new level.    

[hdmiTable]

Update:

 

Since I was feeling relatively well on 6.9mg I've thought I could take one more hit and reduced my dose to 6.6mg. Big mistake I should've listened to you guys. I was expecting to sleep a little bit less or wake up more frequently instead I didn't fall asleep at all so at midnight I took 1mg Xanax which knocked me out for 8 hours. The next day I updosed back to 6.9mg but my sleep is still much worse than it was. It's a shame because the day I was on 6.6 I felt a bit more alive and laughed for the first time in 6 months.

 

I also wanted to get off quickly from this poison because I'm having the most disturbing dreams ever. Last night I dreamt that my former boss is molesting me and in another dream my ex girlfriend from 10+ years ago broke up with me. I don't understand why I'm having these bizarre nightmares constantly I think my shrink is a psychopath and a horrible person for prescribing me this med and the people who've let this cr*p land on the market without properly studying it are criminals.

 

I'm also considering going to a detox clinic where they can get me off as I don't care much about sleeping anymore I'd rather not sleep for months than to have these awful dreams. Anyway I'm holding now at 6.9mg waiting to sleep better until I decide.

[JohnBanes]

Psychiatrists and the mental-health pharma industry inflict a lot of needless suffering.

 

I am sorry you ran into insomnia. A lot of people withdrawing have concerns about dreams, but I try to remember, dreams are just that and what's important is how much sleep we are getting (and not having bad effects from sedatives).  

 

I don't think a detox clinic can help you.  They won't know how to deal with antipsychotic withdrawal, and the process lasts too long for you to spend it in a clinic.  Sleep deprivation is torture.  Literally.  Countries use it on terrorists and other nogoodniks.  You won't last long if you aren't getting 5+ hours of sleep, and then you will just backslide and reinstate.  I would go slow.

[NNhope]

Hi hdmitable,

 

Hope you are feeling better.

[Shep]

21 hours ago, JohnBanes said:

I don't think a detox clinic can help you.  They won't know how to deal with antipsychotic withdrawal, and the process lasts too long for you to spend it in a clinic. 

 

@hdmiTable What John wrote is very true. Detox centers almost always taper people too fast, and when withdrawal symptom appear, will place them on other drugs, usually with a more severe psychiatric diagnosis. You may end up on an injectable form of an antipsychotic by forced treatment. You mentioned this earlier:

 

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.

 

Please stay safe, hdmi. If your psychiatrist doesn't support your taper, I would be hesitant to turn yourself into a psychiatric or detox facility and expect better treatment than you're now getting. The goal of psychiatry isn't to heal you, it's to control you. You're very intelligent and quite capable of doing a slow taper yourself in your own home. 

 

On 7/14/2021 at 5:59 AM, hdmiTable said:

Since I was feeling relatively well on 6.9mg I've thought I could take one more hit and reduced my dose to 6.6mg. Big mistake I should've listened to you guys. I was expecting to sleep a little bit less or wake up more frequently instead I didn't fall asleep at all so at midnight I took 1mg Xanax which knocked me out for 8 hours.

 

Please let us know your history with Xanax and any other benzodiazepine. We're giving you tapering advice based on the drugs you've told us you're taking, but this is the first time you mentioned taking Xanax. To make sure we're giving you the right information, please list all psychiatric drugs you've been on and are currently taking. 

 

[hdmiTable]

You're right. A detox clinic might be a bad idea. The xanax was a one-off I don't use it but I've got some from my mom.

 

Hi @NNhope I'm feeling a lot better thank you. 🙏

 

My sleep is getting there, now I'm only waking up at around 5-6AM in the morning and then fall back asleep for another hour getting around 9 hours of sleep in total. I was just about to try making another cut but yesterday I've accidentally updosed to 7.5mg. Hopefully I haven't undone the progress I made so far.

 

Today I'm taking the 6.9mg again to see if my sleep changes and if it doesn't than tomorrow I'll cut down to 6.6mg. It took about 10 days on 6.9mg for my sleep to become as good as it was on 7.5mg.

 

 

 

[Shep]

35 minutes ago, hdmiTable said:

The xanax was a one-off I don't use it but I've got some from my mom.

 

That's good it was a one-off. Just so you have the information, dependency on a benzo generally develops in 2 - 4 weeks, but some people become dependent in only a few days. New information from the FDA is here about that and other issues - FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class.

 

38 minutes ago, hdmiTable said:

Today I'm taking the 6.9mg again to see if my sleep changes and if it doesn't than tomorrow I'll cut down to 6.6mg. It took about 10 days on 6.9mg for my sleep to become as good as it was on 7.5mg.

 

 

Just a few days ago you reported this: 

 

On 7/14/2021 at 5:59 AM, hdmiTable said:

Since I was feeling relatively well on 6.9mg I've thought I could take one more hit and reduced my dose to 6.6mg. Big mistake I should've listened to you guys. I was expecting to sleep a little bit less or wake up more frequently instead I didn't fall asleep at all so at midnight I took 1mg Xanax which knocked me out for 8 hours. The next day I updosed back to 6.9mg but my sleep is still much worse than it was.

 

 

I'm glad your sleep has improved since you posted this on July 14, but I would hold until August before making any more reductions. You were at 7.5 mg in June and now you're at 6.9 mg, which is an 8% reduction. You're making progress. Please don't rush this. Reducing down again (to 6.6 mg) within a month of being on 7.5 mg is a 12% reduction. Your nervous system couldn't handle it a few days ago, it's likely not going to now. 

 

The goal is to be functional, even while on the drug. 

[hdmiTable]

I'm seriously re-considering the change to a low dose Seroquel. Last night I've only had about 4-5 hours of sleep and with 3 awakenings. I think it may have been because of the accidental updose. I haven't found a single case online where somebody was struggling going from 7.5 to 5mg. People usually drop it all the way down to 2.5mg without a fuss. I think it's pretty much unheard of that somebody would already struggle at the doses I'm at. There's many people who gut stuck on Olanzapine even after 5 years of tapering they just can't go any further than half their original dose. I've only been on it for 3 months. I don't know if I still have the chance to recover if I quit it now. Much better than struggling for years just to find out I can't go any further. Seroquel only binds to 7 receptors. I've heard Olanzapine binds to 17. The progress I've made so far is really bad. It's supposed to get hard below 2.5/1.25. I don't know what to do really. I feel like it's so risky to stay on it and it's crazy that at this speed I'll be tapering for years while I was on it for 3 months only.

 

[JohnBanes]

I had severe insomnia when I tried to go from 7.5mg Olanzapine to 6.875mg.  People react differently to the taper.  Seroquel may be better than Olanzapine, but it's still poison (even relatively to other APs).  But of course the choice is yours.  

 

It's hard to be patient and treat the taper as what it is: a marathon battle to recover a major part of your life.  Sadly, there are no quick fixes.

[hdmiTable]

@JohnBanes I think the problem with Olanzapine is that it's too strong / heavy for us with fragile nervous systems. I still wonder a lot about what you said about not feeling the sedation effect any longer. In the beginning it used to knock me out and I felt drowsy the next day. After a couple of days, I took it and felt nothing as if it wasn't a sedative drug at all.

 

Where did the sedation go I have no idea and I can't find anything about it on the internet. A lot of people still get sedation even from low doses and this helps them to move the dose down nicely. The lack of sleep cannot be from the dopamine. 7.5 to 6.8 is a 2.5% jump down in dopamine occupancy. How long did you try to endure the insomnia? Were there any signs of it getting any better?

 

 

 

[JohnBanes]

The insomnia lasted about a month, and I got through it with the help of Ativan.  But be careful with benzos.  There are plenty of people on this site who are here because they had trouble with Ativan or similar drugs (but for me, it worked great to relieve the insomnia when nothing else would).

 

And yes, I think people respond very differently to Olanzapine.  And for whatever reason, we got very unlucky.

[hdmiTable]

Thank you for the heads up. If I'll have to use benzos I'll use them once a week at most so I don't develop a dependency.

[Shep]

18 hours ago, hdmiTable said:

Where did the sedation go I have no idea and I can't find anything about it on the internet. A lot of people still get sedation even from low doses and this helps them to move the dose down nicely. The lack of sleep cannot be from the dopamine. 7.5 to 6.8 is a 2.5% jump down in dopamine occupancy. How long did you try to endure the insomnia? Were there any signs of it getting any better?

 

My best guess would be overall nervous system destabilization from multiple antipsychotic switches over the past 6 months and several dose changes of your current drug over the past few weeks. You may have kindled your nervous system from all of the changes.  I doubt you'll find many people who have travelled your exact path, which is one reason this experience is so individual. Also, outside stressors add even more variables to how people manage during their taper.

 

A lot of very analytical people will wrap themselves up in knots trying to figure it out. Perhaps practice letting go of the need to know exactly what is happening and aim for acceptance. By continuing to worry and fret and search the internet for people who have had your exact experiences, you are expending a lot of energy for something, in my view, you'll likely never find. 

 

Acceptance is a lot easier once you let go of feeling you need to control every aspect of this journey, including having to know the "why" and the "who else has this symptom" aspect, trying to pattern your taper after a random person on the internet whose external stressors (or lack of external stressors) may be completely different than your own. 

 

That's a lot of extra weight to carry when in the end, it won't give you any better answers than to taper slowly and do a lot of self-care. 

 

A great thread on acceptance is here:

 

Acceptance and Hope

 

 

12 hours ago, JohnBanes said:

But be careful with benzos.  There are plenty of people on this site who are here because they had trouble with Ativan or similar drugs (but for me, it worked great to relieve the insomnia when nothing else would).

 

1 hour ago, hdmiTable said:

Thank you for the heads up. If I'll have to use benzos I'll use them once a week at most so I don't develop a dependency.

 

I'm going to add onto what JohnBanes wisely noted about dependency with benzos.  We've seen a number of people add in a periodic benzo to help with a taper and three main problems come up. Not only the problem of developing a dependency on the benzo, but also, the use of benzos to mask withdrawal symptoms, leading people to think they can taper faster than their nervous system can handle. When the taper speed finally catches up more than the benzo can help with, the damage can be severe, even leading to more and more benzo use. A third problem we see is interdose withdrawal and / or rebound anxiety. Benzos are slippery drugs with unpredictable results that can complicate a taper. 

 

It's highly individual, and some benzos have longer half-lives than others (Valium, for example, has a half-life of up to 200 hours, or 8 days). So it's possible to develop a dependency even with periodic use. 

 

Benzos are great for a crisis state that might otherwise land someone in the hospital, but for general use - even periodic use - please use with caution. When you start having an uptick of symptoms, your mind/body is telling you something, such as the need to hold longer or taper at less than the usual 10% rate. 

 

[Hopela]

Hi hdmiTable,

Relevant to your comment on interindividual differences in difficulty to pass certain doses a while back DataGuy posted in my thread an article link with an image:

I'm reposting the article link here as scihub link so it's not behind paywall:

https://sci-hub.st/10.1097/JCP.0b013e3182983ffa

 

You find the image on page 5. A key take away is that one person on 2.5mg Olanzapine may have 62% D2-occupancy while another on 20mg Olanzapin can be on 12% occupancy. An apparent (62/2.5)/(12/20) approximately 40 times difference in efficacy of the drug with regard to D2-occupancy. Controlling for dose there is still a factor above 10 of individual difference. To conclude a doctor has no idea what D2-occupancy a typical prescribed dose will result in, it's a shot in the dark, and when trying to come off the drug we need to have as much of an individual approach as possible because noone has any clue where our system is at. Formulas of mean occupancy per dose are very misleading for individuals. We need to follow our own individual senses and observations. It reminds me of max heart rate formulas per age that people use to set workout intensity zones, a very bad practice too due to individual differences. 

[Gibby]

For us analytical people who are always seeking a pattern, a number, a straight answer...these experiences are so frustrating because often there isn't any of those things. And accepting that is even harder, I struggle with that. But you can do it. 

[hdmiTable]

Thanks for posting this, @Hopela. Now it makes sense why I already felt so much better on 6.6mg. I can see how with such high variance it's impossible to even approximate where someone is at. When I dropped to 5mg for a day I couldn't sleep at all. Seems like changing to Seroquel would already be a big drop regardless probably resulting in insomnia. Fortunately, Seroquel can also be dissolved in DMSO. I could do 12ml-s of 300mg and get rid off 1ml each month and see how it goes.

[Altostrata]

@hdmiTable it's entirely possible to taper directly from Zyprexa, which you've been taking for nearly 3 months. We do not see the advantage in risking a drug switch to quetiapine.

 

However, you have your theories, and it seems you are set on your experiment no matter what. We may not be able to help you if you destabilize your nervous system further. Once the egg is broken, we don't have any magic to put it back together again.

[DataGuy]

Hi @hdmiTable,

 

I would advise you strongly to avoid switching to seroquel. Seroquel, along with clozapine, are listed by Chouinard in his paper Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy as being particularly difficult to taper off because of their penchant for causing dopamine supersensitivity psychosis, a result of the pharmacological properties that are peculiar to those drugs.

 

In addition, there is the difficulty that the two drugs (olanzapine and seroquel) have vastly different receptor profiles and may differ further in their actions depending on dosages (linear equivalencies between them may not be possible due to the pharmacology of both drugs). So switching to Seroquel may make things harder for you, not easier, by 1) inducing withdrawal from olanzapine  2) increasing the probability that you develop supersensitivity psychosis, something very undesirable when it comes to tapering the drug, not to mention quality of life. Please see this blog post by a psychiatrist explaining the pharmacology of seroquel, and note the different receptor profiles in the diagram near the beginning of the post. Apologies for any non-PC analogies the blog poster uses that some may find offensive, but it is an instructive, colorful explanation. 

[hdmiTable]

Hi all,

 

Many thanks @Altostrata, @DataGuy for the heads up. Olanzapine, Seroquel and Clozapine are one family of drugs and it seems like I should avoid that branch altogether.

 

I don't know what to do really. I don't want to be stuck on Olanzapine for years.

 

 

[Shep]

1 hour ago, hdmiTable said:

I don't know what to do really.

 

Taper no faster than 10% per month, learn non-drug coping skills, and live your life as much as possible. 

 

It's really that simple. If you have some free time, perhaps pick up a hobby that will allow you to relax and also serve as a distraction to keep from endlessly researching this online.  Art, photography with a cellphone, music, etc. are all great during withdrawal. And there's lots of free information online. We have a number of free resources linked in the non-drug coping skills section as well as tons of information on YouTube for learning new skills. 

 

The "I don't know what to do really" is a path toward learned helplessness. And it's more needless weigh to carry. Find ways of dealing with withdrawal that will ensure whatever landed you on these drugs is something you can handle as you come off them. Otherwise, you may spend a lifetime bouncing from psych drug to psych drug. Getting off the drug is only part of the journey, staying off them is another. 

[DataGuy]

@hdmiTable, I don't really see any reason that olanzapine would be more difficult to taper than other drugs. It has a long half-life and doesn't have the bothersome properties of clozapine or seroquel in producing increased risk of supersensitivity psychosis. I'm not really sure what the basis of your worry about olanzapine in particular is. 

 

You are probably experiencing adverse effects from all the drug switching in the past few months. These can last quite a long time. I would simply hold the olanzapine dose for now until your symptoms fade. Then you can taper the olanzapine very slowly. It can be difficult to taper if you are still experiencing adverse withdrawal effects from a previous taper/drug switch. 

[hdmiTable]

Okay you convinced me. I'm going to hold 🙌 until I stabilize.

 

Last night I woke up 4 times during the night but I've slept well for the 2 days before. I hope I can make another reduction in August. I'll start with a 0.3mg cut and if it goes well I'll do another 0.3mg just like I did this month.

 

My Olanzapine appetite came back already which is unfortunate but I'm trying to stay healthy by eating less but mostly fruits, veg and meat.

 

When I quit Aripriprazole the only symptom I've had was akathisia. It used to start every day at around 8PM and lasted until 9PM. In the beginning it was super annoying but it's gradually fading away. Now it's only for a couple of minutes and oddly I only feel it in my left leg. I suppose my CNS is not fully over quitting that med yet.

[JohnBanes]

I am glad you aren't switching to seroquel.  When I was coming off olanzapine, I thought of following Dr. Alice Lee's recommendation of switching to seroquel to make the switch more gradual.  This idea was introduced by Dr. C U Correll in an earlier article.  But seroquel is also a beast -- not as great of a beast as clozapine and olanzapine, generally speaking, but still a beast.  I hope you manage your slow titration.  I fully understand the frustrations of being stuck on olanzapine and other antipsychotics. 

[hdmiTable]

@JohnBanes I think that's a very creative strategy to come off Zyprexa. To be honest I'd try this if I had some Seroquel at home. I have Abilify and Haldol the only thing I'm missing is Seroquel. Would be nice to know a little bit more about how this should be done. Another problem is that I've had severe side effects on Haldol like drooling, blurred vision and restless legs so it wouldn't be a pleasant experience.

 

It sucks to be on them but hopefully by some time we'll be more and more like ourselves again. When I reduced to 6.6mg for a day I felt so much better. I wish I didn't have to updose but at least I saw some light at the end of the tunnel and this keeps me going.

 

 

[JohnBanes]

After reading these and working with my psychiatrist, I had several medications prescribed that worked like Olanzapine on the muscarinic and histaminic channels.  But that didn't help the cross-taper to Latuda (and did carry its own side effects).  I did not try something for the cholinergic channel, but those tend to be other heavy hitting meds.  

 

I am glad you saw some light and remain hopeful this is a tunnel with some way out.  I am sometimes not sure if it's a tunnel or just a hole I'm descending into 

 

I wish this forum allowed sharing of larger attachments so I could post some of the medical literature on tapering.  

[hdmiTable]

Sometimes I panic too. Last few days have been really hard because my sleep started to get worse so sometimes I feel like not even a very slow taper will work. It's not a good sign that even on the most sedating drug I'm waking up a few times at night. If things don't improve much until September I think I'm going to try a more aggressive taper and see if my body has the ability to heal naturally. I'm sure we'll get out one way or the other but maybe sacrifices will have to be made it's definitely not going to be easy.

[JohnBanes]

I think I am like you in that I like to think through things and have a sense of agency.  The severe and unpredictable effects of these drugs (including on discontinuation) undermine my sense of control, and leave me feeling helpless.  If you do go the aggressive route, I would have plenty of benzos on hand and use them to get steady sleep.  I hear benzo withdrawal can be its own terror, but Ativan worked to calm the insomnia for me as I switched to Latuda and I had a fairly easy time coming off Ativan.  I say this knowing that many a moderator will disagree

 

It is very scary how the sedative effect does not seem to be enough to counteract insomnia from even a small decrement.  Olanzapine really messed me up, and although I've been off that drug for a while, the effects on sleep continue.  

 

I wish you luck.  This is not an easy process.  It is the most difficult problem I've encountered in my life.

[Hopela]

I would advice against benzo supplementation. It increases risks, uncertainty, complexity and potentially duration of meds/withdrawals. And even no sleep does not kill you in itself (although avoid if you can). I had some months with no sleep at all as far as I could detect after my initial failed doctor supervised fast taper from 10mg with cold turkey from 2.5 mg. Gradually I became more recovered in the morning with just resting. I actually eventually dreaded going to bed because I knew I would just lay there awake for a very long time, turning and turning and turning and turning, checking the clock, and turning and turning and turning and so on, but resting as much as possible. After a while you just have to turn, try lying completely still for 8 hours! I was using sleep support methods just to enhance rest (cold, very quiet, very dark, same time, warm shower before, etc). What stopped me from resting (avoid strongly these) was involuntary muscle contractions, rushes of anxiety/panic feelings and akathisia which was also brought on by withdrawal and meds. Having observed that I wasn't dead yet without sleeping I was not alarmed by the circumstance in itself of having become an organism that could not sleep. Diet, supplementation, exercise, positive social interactions and avoiding external stressors are avenues to support rest. Not sleeping is one problem not resting another. If you can manage to just not sleep it seemed for me at least that my brain was able to last. Docs wanted me to use more meds to aid sleep but I did not want more of their poisons to mess me up further than they already had. Also I tried some meds that didn't work, including updosing. And they forced one on me that gave me akathisia. And the one I used a few times voluntary that did knock me out does not really make you sleep and recover deeply it just makes you unconscious. So to conclude you will probably have to accept less sleep as you come off but that is not to be too alarmed by, just managed, but avoid more strongly the unability to rest and support with natural methods.