egmusician: drug induced psychosis and olanzapine

[egmusician]

hello guys,

 

 i should start by saying that i'm visually impaired which will be relevant as i go. it all started in january of 2019. i was 32 yrs. smoking hash (cooked with ketamine here in egypt) and meditating. this led me into an episode of psychosis which i mistook for a spiritual awakening back then. it was blissful and fearful with horrible feelings of guilt, paranoia, thinking of my mother as the devil, that my friends are pulling me down. i also had manic delusions, thought i and everything was god, other times a prophet with a mission to save the world and that i had miracles etc. it also brought about massive healing of past trauma and a lot of insight and deep understanding of self and others. this episode lasted nearly 45 days. i was smoking hash while it was happening and didn't take any medication...since then i would get smaller, more controllable manic episodes months after my first one was gone even without smoking.

 

fast forward to the 3d of february 2021. i was really abusing that same substance. it triggered a stronger epidose. i had a delusion that the girl i loved one sidedly really loved me and that she's waiting for me outside my building. i thought that the door men took her phone and ran to save her. then the prophet thing came again and i thought that many girls are waiting for me and called my friends and sister telling them my name was prophet muhammed and that my wives are here. she called my father and he came and took me to their house.

i saw everything as signs talking to me, tv shows, netflix, every word was magnified 100x. i spoke a lot about heaven and earth and thought that my parents are poisoning me, interpreting every attempt to help me as an attempt to harm me. i was smoking hash during all of this. long story short my father wanted me to sleep beside him, i did but while he talked about covid, i ran out of the room and out of the house taking nothing with me. i walked slowly in the street and felt VERY safe. my sister came after me and asked me to ride the car with her then they took me to a mental hospital on the 6th of february. it was an agonizing experience because i knew that they're putting me there and kept screaming and shouting begging them not to admit me there but they did.

 

i was diagnosed as having a drug induced psychosis. they started me on tegratol cr 400 and zyprexa. 5mg then raised the dose to 20mg after 2 days. trying to refuse taking the medicine went in vain. i spent a month at the hospital then i started following up with the psychiatrist. she reduced the dose to 10mg after another month (april) because i was sleeping 14 hours a day so that's 2 months on 20mg. i hated the medicine. it killed thoughts and would make me unbalanced and unable to do anything. weight gain wasn't an issue because i was skinny so everyone was happy that i 'm getting healthier  after 2 months (mid june) my psychiatrist dropped the dose to 5mg. this drop made me anxious and had a hard time communicating with my friends. i felt somehow depressed too. smoking weed would increase the anxiety and bring along very dark thought patterns. 

 

on the 10th of august i stopped tegratol cr cold turkey from 100mg. on the 12th i stopped zyprexa ct too and dropped the appointment with my psychiatrist because i couldn't take it all anymore

 

i wasn't aware that the withdrawal symptoms would be that strong and debilitating. i had no trouble sleeping since i quit and until now. the withdrawals started a week after quitting. deep depression, anhedonia, lethargy even my voice as i spoke sounds like an old man, strong headaches, obtrusive thoughts of killing my father i couldn't answer his calls. i spent a month in bed all alone, eating very very little. after that (september 10) i tried going to parties for relief. took MDMA and lsd but the lsd triggered the psychotic symptoms. they lasted for 3 hours but i managed to control them knowing that it was the trip. 

after that trip, the withdrawals worsened, tingling in my limbs, severe headache and symptoms of a heart attack occurred but they would subside if i ate a good meal. 

i kept bearing with the symptoms because i didn't want to return to zyprexa. i also began to notice that i couldn't hold cohesive thoughts and speak them out in a voice note on whatsapp. pre zyprexa, i could easily speak for 15 minutes non stop with all my thoughts organized. now i can hardly send a 2 minute voice note. even while texting i take a LOT of time to determine what i'll write and organize my thoughts...

 

after two months of stopping (october) the depression lifted a bit, the anhedonia remained. i'd still have headaches but they go away and stay gone for 7-8 hours which gave me hope that i'll be better. that hope did not last for long though. i went to a different psychiatrist because of the anhedonia and the decrease in cognitive functions. he advised me to take 3.75mg of zyprexa for 3 months then stop. and told me this is for protection of the nervous system but its not a treatment for the cognitive functions. i did not want to take that high of a dose because i thought my brain had sometime (2 months and 16 days) to adjust without zyprexa so on october 28th i reinstated. i now take 1.25mg and the depression and anhedonia are reduced to a good degree. i can listen to music and make myself something to drink and i eat more. the headaches are almost gone as well. i still have obtrusive thoughts but not as harsh as they were without the olanzapine.

 

i have some questions for you to kindly help me with my situation:

 

1. are the cognitive functions recoverable given that i only took olanzapine for six months 2 months of which were on 10mg and 2 were on 5mg?

 

2. please help me with my situation. what should i do? how to proceed from here? should i raise the dose? if not, how long should i be taking it? and is it ok to go off the olanzapine from 1.25mg?

 

3. i haven't talked a lot about tegratol because i don't think it has any dangerous withdrawals but please correct me if i'm wrong

 

thank you for being here for us.

 

 

 

 

 

 

[hayduke]

Hi @egmusician.  Sorry to hear about your hard times.

 

First, you don't need me to tell you that you've been on quite the roller coaster ride!  What I would be looking for if I was in your situation is stabilising, and coming to a steady place where you can plan your taper and healing.

 

Now that you've reinstated at 1.25mg, best to hold there for a good 6-12 months and see if you can ride it out.  Your nervous system and the rest of your physical body will need to catch up on all the chemical changes it's had to deal with over the last while.  5 down to 0mg is a big drop, and it will take your physiology some time to process it, along with the reinstatement.  You might not be very comfy for a while, but if you can stay safe and keep your relationships and health on track it should resolve eventually.  Hopefully you won't have to updose more.

 

Others here can advise on the tegretol.

 

MDMA and LSD can have therapeutic uses, but unless used with a qualified therapist, are just likely to release a whole bunch of trauma that you already weren't prepared to process.  And just from a physiology point of view, your dopamine, serotonin systems etc are already messed up from the prescriptions you were on, so you were giving yourself a lot more stress.  I do understand the instinct to use these drugs, since you can intuit that they can help you release the trauma, but without the support, you won't be ready to actually process it, and people like parents, police, startled shopkeepers etc can get quite upset and all they know is drugging people in that condition.

 

While you are stabilising, if you can read, I would suggest getting hold of Bessel van der Kolk's book The Body Keeps The Score.  It will give you some useful tools to address your difficulties that you would probably not be offered through most of the mainstream health services (yet).

 

It sounds like you've been self medicating prior to this prescribed drugging for various traumas.  Nuclear families are complex and imperfect things, and in your shoes I would be looking for a supportive clinical psychologist, ideally one specialising in trauma, to support you through your healing.  They will be able to help you with things the typical family simply can't.

 

Doing this kind of therapy makes it possible to resolve the underlying issues that lead to bad recreational drug decisions, emotional and other difficulties, problematic family / work / school interactions etc.

 

So yes, you should be able to restore your health with good self care and careful choices here.

 

I will post some links for you shortly.

[hayduke]

I would not plan to taper further for a good 6-12 months, once you know you've been steady for a fair while.  In the meantime here are a bunch of topics for you to review and prepare.

 

 

 

 

 

 

 

[egmusician]

hayduke: thanks for replying

 

i have to tell you that i can't taper off below 1.25mg. here in egypt the minimum dose we have is 5mg. so i can barely cut the pills in quarters. cutting them further breaks the pill. i even can't say that i'm consistent with my dose because of the cutting (i'm visually empaired). so is it okay to go off from 1.25 to 0? or will it be hell again?

 

regarding cognitive functions, i've read on reddit and quora that they're permanent and never return to normal. in your experience and seeing a lot of others like us do you think otherwise? 

 

thank you for the links book recommendation. i have that book in audiobook form and i was planning to read it.

[hayduke]

11 minutes ago, egmusician said:

i have to tell you that i can't taper off below 1.25mg. here in egypt the minimum dose we have is 5mg. so i can barely cut the pills in quarters. cutting them further breaks the pill. i even can't say that i'm consistent with my dose because of the cutting (i'm visually empaired). so is it okay to go off from 1.25 to 0? or will it be hell again?

 

This is how you do it.  You will get a more consistent at your 1.25mg doing it this way than cutting pills, even before you start your taper.  It's not very difficult to use a syringe, or later a pipette once you get the hang of it.

 

13 minutes ago, egmusician said:

regarding cognitive functions, i've read on reddit and quora that they're permanent and never return to normal. in your experience and seeing a lot of others like us do you think otherwise?

 

Well it won't be 100% identical to as if none of this ever happened, but that would be true for any kind of significant experience.  There's always tons of crap people post on the net, the trick is knowing what to discard (probably most of it these days :P)  There will likely be grieving for lost time, anger and many many other emotions to deal with. 

 

But the main thing is that yes, you can heal and recover your life path. 

 

18 minutes ago, egmusician said:

thank you for the links book recommendation. i have that book in audiobook form and i was planning to read it.

 

Good work :-)

[egmusician]

i might be doing this to taper

 

what if i cut the crap and stop taking the olanzapine altogether? will my nervous system and brain take its time and recover itself? i mean i waited two and a half months and could've waited more but i was afraid that the symptoms may get worse and unpredictable....now i've only reinstated two weeks ago so...

[hayduke]

11 hours ago, egmusician said:

i might be doing this to taper

 

what if i cut the crap and stop taking the olanzapine altogether? will my nervous system and brain take its time and recover itself? i mean i waited two and a half months and could've waited more but i was afraid that the symptoms may get worse and unpredictable....now i've only reinstated two weeks ago so...

 

If you were uncomfortable enough at zero that you reinstated, that's a fair sign that it has probably helped.  You can't just go making big changes all the time like this, they add up and eventually tend to really clobber you otherwise.

 

It's likely that your body still has a lot of catching up to do, and at 1.25mg it doesn't have as far to go, and your wd symptoms should be milder.  Anything you can do to make wd milder is worth your while.

 

I think if you stopped taking it altogether again, you would be inviting more instability and discomfort.  As I suggested before, I would be looking to review how I felt after 6 months at 1.25mg.  It's not a huge dose anyway, it won't be getting in your way that much unlike 5mg etc.

[egmusician]

 

your input is really appreciated. i felt more compassion from reading your posts then from anyone around me. 

i'm thinking of adding an antidepressant in. i've read that cymbalta improves cognitive function and helps with limb pain so it can reduce the WD of olanzapine. what do you think?

[hayduke]

Cheers. We're all very fortunate the forums are here. 

 

It's important to say that we are here to help people get off these drugs. We don't support or advise on adding them.

 

It would almost certainly complicate your already difficult health situation, induce more instability in your nervous system, and add years and pain to your taper.

[hayduke]

 

Have a read about the complications of polydrugging, and also others' stories of duloxetine withdrawals.