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JandD: weeks on sertraline - extreme head pressure and suicide thoughts


JandD

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Hello to all users of this forum!

This is Jan - husband of Dominique and father of a 4.5-month old son. I am currently writing here for my wife, who is lying in bed next to me and is of course aware of this forum and my contribution.
 

My wife gave birth to our son in July. A lack of postpartum and a few other things led to her getting postpartum depression in August with difficulty sleeping through the night (only 3-4 hours a day). At first we couldn't really place it and for a few weeks we suspected other things as the cause. I tried to support her where I could, but the sleep problems (depression) continued.
 

That's why we had a blood test done at the hospital at the beginning of October to check whether the pituitary gland was damaged. According to the test results and the doctor, there was nothing wrong with the gland. However, she informed the psychiatrists at the hospital who asked us to come for an appointment. They told us that my wife suffers from depression and that she urgently needs antidepressants. 50mg Sertraline and 5mg Diazepham at the beginning. There could be side effects at the beginning (which exactly were not said), but these would soon disappear. My wife would soon feel better. One of the health officers told us that she might have suicidal thoughts at the beginning, so it was important to watch her intake very closely.

We have always lived a very healthy life and have not taken any medication so far. I consulted a few friends and the unanimous opinion was "Antidepressants are not good, but a short-term crutch. Once the depression / sleep problems are better, stop it again". Already very exhausted by the last few weeks and encouraged by the doctors' and friends' assessment, I did not consult further and persuaded my wife to take the antidepressants. A terrible mistake!
 

Taking the medication over time like this:
13.10.21 - 50mg Sertraline + 2mg Diazepam (doctors suggested 5mg, stop after 7 days).
13.11.21 - 75mg Sertraline (doctors suggested 100mg)
14.11.21 - 50mg Sertraline (reduction because side effects)
15.11.21 - 10mg (decission to stop sertraline)
16.11.21 - 20mg
17.11.21 - 20mg
18.11.21 - no more Sertraline since then


The side effects:
The first few days went relatively well. My wife was able to sleep a little more (6.5 hours - thanks to Diazepham?). Strong side effects were not noticeable at the beginning. Weaning off the diazepham after a few days was uncomplicated. After we had a conversation with a doctor every 2-3 days at the beginning, the critical initial phase seemed to be over. After some time, my wife noticed slight hair loss and increased bruising. However, she could not pinpoint the cause. A lot of cortisol from the depression could also have been a reason. A head pressure, especially in the morning, was noticeable and slowly became stronger.
 

About 4 weeks later, my wife told me that she was having suicidal thoughts and that I had better lock the front door.
I was surprised and shocked. I had the feeling that the anti-depressants had made the anxiety disappear and that there were no more panic attacks.
Of course, I was in an absolute alarm mood and took my wife's statement very seriously. I started to inform myself about Sertraline.
2 days later I had another appointment with a psychiatrist and my wife also had to pick up a new pack of Sertraline from her doctor.
Both advised to increase the dose to 100mg after one month. However, my wife did not mention her suspected side effects and suicidal thoughts at the appointments.
Instead of 100mg, we only increased to 75mg. The side effects after taking it, especially the suicidal thoughts became even more intense.
For us, there was now a clear connection between the side effects and Sertraline.
 

Stop Sertraline:
Suicidal thoughts as side effects are gross. That's why we wanted the stuff out of my wife's body as soon as possible.

A doctor's appointment was imminent. Here I dealt more comprehensively with the subject of antidepressants. A change to another class (tricyclic?), additional drugs to tide her over until she was adjusted to the new antidepressant. In forums I have seen how one gets more and more dependent and how it becomes more and more difficult to stop.

We no longer had confidence in the doctors who surprised us with the diagnosis of depression and the immediate prescription of antidepressants (we were there for an examination of the pituitary gland). Doctors who had not informed us about the blatant side effects. In my opinion, they also started us on too high a dose and recommended increasing it to 100mg. Hence the decision to continue without doctors / psychiatrists from now on.
 

My assessment was that the intake period of 31 days at 50mg is relatively short and low. A very short intermediate step (3 days with 20/10mg Sertraline) would hopefully be sufficient.
The side effects with suicide thoughts extreme. I thought it would be dangerous to stop for weeks/months. Since 18.11. my wife has stopped taking Sertraline.


Current status:
The time after stopping Sertraline was / is really intense! I don't feel it myself, but as a husband and father I am with my wife 24 hours / 7 days a week. Look after her and take care of her.
Shortly after coming off the suicidal thoughts became very strong. I have locked away dangerous objects from the flat and sleep with my mattress outside her door (so I can also look after our son who sleeps in the next room without waking my wife like that). The suicidal thoughts have decreased now, but I am still extremely mindful.
 

The worst side effect / withdrawal symptom for my wife is the head pressure. This head pressure started insidiously when she started taking Sertraline. However, it still persists and is consistently at a very high level. From 6 - 10 am in the morning this time is extreme. She then takes high doses of vitamin C and I have to stroke and comfort her. But the head pressure is really very extreme. My wife says "head pressure of death", "I'm losing my mind" and says I don't want to go on living like this. Cries, screams and is desperate. From midday onwards, a kind of "switch" seems to be flipped, even though the head pressure is still there. Luckily we can usually go for a walk then and have been to cafes / restaurants. We hope that this really blatant side effect will diminish over time.
 

The sympthoms of depression have now returned. My wife sees a lot of things negatively, thinks of the good times during pregnancy and blames herself. Fear of little sleep and headaches in the morning has returned. There have also been three mild panic attacks since then. These things are ok and we are looking at different ways to get better. With the "anxiety" coming back, other feelings are coming back too, which is nice. After 4 weeks of Sertraline, I have found my wife to be an emotionless robot.

There are no other side effects. The bruises on the legs have decreased significantly, the hair loss has decreased.


What we do to alleviate the side effects / withdrawal / depression:
- Freshly squeezed juices
- Only raw vegetables and nuts if possible
- Vitamin C in high doses (especially in the morning)
- Vitamin B complex (very cautious, as it may increase headaches in the short term)
- Vitamin D (very cautious)
- Omega 3 (very cautious, as it may aggravate headaches)
- Drink a lot (water, lemon juice + Himalayan salt)
- Walk every day if possible
- Meditation / positive visualisation if possible
- Epsom / magnesium bath
- Sleep goggles
- Daylight lamp (still cautious, as it may increase headaches)
- Towards evening, if possible, "normality" (watch travel reports)
- NO sugar or bread etc.


Our contribution may read simple and not serious.
But I can say that the last 5 weeks on Sertraline were really physically and mentally extremely exhausting - first of all for my wife, but also for me.
Since the months before were also very exhausting for various reasons and with a baby, we are really at the limit.
I am of course aware that most people on this forum have had much longer and more gruelling experiences with antidepressants.
I have an inkling of what this may mean and what strong personalities are on this forum, but certainly tragic fates as well. 
It saddens me that people can be so destroyed by antidepressants in the hope of help.


My wife and I would be very happy to receive assessments, perhaps valuable tips and an exchange of experiences with people who also have extreme head pressure due to Sertraline / Zoloft.

Jan & Dominique

 

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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  • ChessieCat changed the title to JandD: weeks on sertraline - extreme head pressure and suicide thoughts
  • Moderator

Welcome @JandD

I'm sorry your wife experienced these scary side effects and all it has put your family through. I will never understand why a pill that can do this to people is legal and given to so many.

 

Can you put this information in your signature here. We ask all members to do this so it’s easy for anyone reading your posts to get a quick overview of your situation.

13.10.21 - 50mg Sertraline + 2mg Diazepam (doctors suggested 5mg, stop after 7 days).
13.11.21 - 75mg Sertraline (doctors suggested 100mg)
14.11.21 - 50mg Sertraline (reduction because side effects)
15.11.21 - 10mg (decission to stop sertraline)
16.11.21 - 20mg
17.11.21 - 20mg
18.11.21 - no more Sertraline since then

 

Unfortunately medical professionals have a poor understanding of how these drugs affect people. I found this post helpful to understand how these drugs actually work and why it's not just a matter of getting the drug out of your system:

How Psychiatric Drugs Remodel Your Brain  

 

This explains more about what happened to your wife:

Adverse reactions to an antidepressant within a few doses -- how long for recovery?

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

The Windows and Waves Pattern of Stabilization  

 

Aside from a high quality fish oil and magnesium, be careful with supplements. Her central nervous system (CNS) has become sensitized from psychiatric drug use and can react unpredictably. Alcohol, caffeine, nicotine and other mind altering substances can make the condition worse.

Important topics about tests, supplements, treatments, diet

 

Here is our symptoms and self care section, she may find some useful ideas to help manage symptoms as she recovers. 

Symptoms and self care topics  

Migraines, Headaches, Neck Ache and Head Pressure

 

The search function on this site doesn't work very well.  The best way to search this site for specific information is to use your favorite search engine. Type in survivingantidepressants.org then the symptom, treatment, supplement or information you wish to search for.

 

I highly recommend reading  Anatomy of an Epidemic by Robert Whitaker as well as A straight talking introduction to psychiatric drugs by Joanna Moncrieff to better understand these drugs and their effects. The Council for Evidence based Psychiatry also has a lot of good information.

 

This is your Introductory topic, where you can ask questions and connect with other members. If you need any advice specific to you and your situation, please ask it here. Otherwise, feel free to join discussions on other threads. To make sure I or someone sees your question, tag them by writing @ and then start typing their username. A drop down menu will appear. Click on their username and it will turn blue.

 

Please stay in touch and let us know how your wife is doing.

Edited by Kiasofia

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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I am currently soaking up all the information on the subject. Kiasofia's tips and advice on this have been very helpful. Many thanks for that!
 

Dominique continues to feel very bad. The head pressure is almost unchanged. Somewhat new sympthoms are speech difficulties (yesterday morning & evening for a short time => is this "normal" or dangerous?) and she feels she is almost losing her mind due to the strong head pressure. She also has no appetite. However, she drinks enough juices and water. Juice fasting is generally a good way to get rid of toxins and not burden the body with digestive work. Therefore it seems to me that this is ok for the time being. She almost despairs and thinks about going to a clinic. But she also knows that she can't really be helped there. 
 

New findings for us:

  • She tolerates magnesium well so far.
  • We have to be very careful with food supplements. The one tablet of vitamin B complex seems to be too high (1/10 seems to be enough) and B vitamins (even if important) stimulate the nervous system strongly. 
  • We have to be careful with vitamin K (often included with vitamin D) - "make sure that it doesn't contain vitamin K. Vitamin K plays a role in the manufacture of blood clotting. Too much of this vitamin might interact with plasma serotonin which is also known to make blood form cloth".
  • Is ginger good or bad? I read in one source that one should be careful when taking SSRI's because of serotonin. Another source said it can reduce the side effects! 
  • The intestine seems to play a very important role. (gut-brain axis) and also very important for the immune system and most of the serotonin is probably produced in the gut. Many bacteria in the intestine are probably damaged by antidepressants. That is why we hope to have found a possible starting point here. Yesterday I bought psyllium (intestinal cleansing) and probiotics for the intestinal structure. Yesterday she took the first capsule of probiotics. No negative reaction. So she will take one again tonight.
  • For us, a good site/tips for dealing with negative reactions to SSRI's (I think the link was posted here somewhere in the forum): http://www.antidepressantsfacts.com/reaction.htm
     

Really appreciate any feedback!

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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  • Moderator

I'm glad the links were helpful. And sorry your wife is not well. It is good that she has you at least. It is so important to have someone who knows that Sertraline caused these symptoms. Otherwise people are written off as severely mentally ill and drugged even more.

 

What do you mean by speech difficulties? Here are some threads that might be relevant:

 

Problems with speech or communicating

language-problems

 

I personally find ginger calming, but I have to be careful with juice (sugar) since it can make me more anxious.

Gut health influences emotions, thinking

Probiotics and gut health

 

I hope you can make some connections, keep learning and find support here. Best wishes for your wife's recovery❤️

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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  • 1 month later...

The time since the last entry was very exhausting. 

 

The good:
My wife is still not taking any antidepressants
 

This was her course until 4 days ago:
The side effects, especially the head pressure, have improved only slightly in the last few weeks. At the end of the year, we had a CT scan of her head done in hospital to rule out things like "brain haemorrhage due to SSRI", "enlarged pituitary gland" or other physical causes. Nothing could be found. Everything was fine said the doctor. The headaches come from the depression. She should take another antidepressant and/or painkillers. We got the painkiller (co-codamol - paracetamol and codeine) but have not taken it yet because of concerns about disturbing the healing process. 
 

After the CT, I had hoped that my wife would become more confident. However, in my eyes, my wife's "agitated depression" has increased since then. Possibly this is the rebound effect from the Sertraline. She is very agitated and has started to get new symptoms. However, in my eyes these are not symptoms, but negative beliefs that were created by the depression and are not real. 
 

The feeling that she can't eat any more because otherwise the head pressure will rise even more / The feeling that she can't drink any more because otherwise the head pressure will rise even more and she won't be able to breathe. 
 

Every sip of water and every meal took a lot of convincing. I told my wife that she can't live like this and that she has to go to a clinic like this. Unfortunately, my wife was totally passive, so she didn't care and said, "Then let me in". Hours of discussions about the correlations, side effects of Setraline and the prospect of recovery were of no avail.  I tried everything to convince her that she was harming herself. I was very frustrated and didn't know what to do. I wanted to get a sign of life out of her. That's why I told her that I couldn't go on living like this and that our marriage could be over.
 

The last three days:
In the morning when I briefly took care of our baby, my wife attempted suicide. It was real but thank god not successful, even though she suffered injuries. Fortunately, these will heal and not be permanent. 

We had my wife checked in hospital (said it was an accident) and since then she has mainly been in bed because she finds it very difficult to move. Painkillers paracetamol / ibuprophen had little effect on the head pressure, just reduced the pain in the body.

We had a video call with a psychiatrist yesterday. He said that my wife needs to go to a clinic and it won't work without antidepressants. He gave the very blatant example of a woman who burnt herself and her two children in the car after several attempts to stop taking them. For me, this is more of a reason against antidepressants. However, I also have to say that until then all other attempts to do something naturally against depression were unsuccessful. However, the psychiatrist also mentioned another case - a failed suicide attempt by another woman, whose depression was gone 3 weeks later.
 

Current:
Actually, my wife is doing quite well now. She is still in pain, of course, but notices how her body is healing. She wonders how this could happen, feels ashamed and is happy to be alive. She is much calmer and has overcome two negative beliefs and is eating and drinking again. She also made a joke and laughed today, which hasn't been the case for a long time. We are trying - as far as possible - to get some normality back.
 

However, I am now wondering how to proceed. I wonder if my wife has now taken the "path of healing and self-love" after the "path of self-destruction"?

I want to support my wife where I can and at the same time avoid antidepressants. I would like to ask in the forum (new post) if there are any recommendable facilities in Europe where we can live as a small family for a while and my wife can get the help to get rid of her depression.

But I am also grateful for any other opinion on my description! Anything helps!

 

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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  • Moderator

I'm sorry to hear of your wife's suicide attempt and relieved she has pulled through. I'm afraid I don't know of any facilities like you describe. The only real "help" to get rid of her depression, is for her brain to heal from the shock of Sertraline. Have you explored our topics about fish oil and magnesium?

Magnesium 

Omega 3 Fish Oil

 

I know you have tried many things already. The main cure is time, time and more time. This is hard to accept when we are programmed to "do" something to fix a situation.

 

On 1/15/2022 at 5:28 PM, JandD said:

We had a video call with a psychiatrist yesterday. He said that my wife needs to go to a clinic and it won't work without antidepressants. He gave the very blatant example of a woman who burnt herself and her two children in the car after several attempts to stop taking them. For me, this is more of a reason against antidepressants.

I'm sorry the psychiatrist is so clueless. But not surprised. Antidepressants will, of course, make her worse. The example he gives is, as you say, an example of someone reacting to coming off drugs and shows why they should never be given in the first place. There are some initiatives to get out the word about the dangers of these drugs. Not sure how helpful that is though. But know that you are not alone in your struggles.

https://www.madintheuk.com/

http://cepuk.org/

https://www.antidepressantrisks.org/

https://medicatingnormal.com/

 

 

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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Brain feels cut off - maybe someone can help?

 

Hello,

I am Dominique. I gave birth 6 months ago to a beautiful baby boy. My husband Jan already wrote some posts here.

2 weeks later I took a supplement for the pituitary gland - extracts from the pituitary glands of cows with the wish to improve my breast milk. Since then things are going downhill. I am only sleeping 4 hours a night. I am having panic attacks. And I have severe depression.


After some tests at the endocrinologist it was said that the pills didn´t have an impact. I didn´t have extra breast milk. And I do have my period again. But I still think that the pills put my system off.


Then I was described antidepressants (Sertraline) against postpartum depression. These made things even worse. I lost basically all of my collagen in the body and got thin hair.


Even worse: I got major pressure in my brain.


Apparently it was an adverse reaction so I stopped the Setraline after 4 weeks.
We did an CT to see if there was something off in the brain but it seemed okay.

And my depression still didn´t lift - to the contrary. I even attempted suicide - I jumped off a 3 m high wall and took toilet cleaner - I know, totally insane. Now my brain feels cut off. I have major pain behind my nose. And I react to any kind of food. My body, especially my brain seems to be full of cortisol. Does anybody know of such a symptom? I feels as if my longterm memory has vanished.

And I have major pressure and pain in the brain that gives me the feeling that I can only eat and drink a little only a certain amount of breathings during the day. I know it sounds crazy but that´s what I am feeling.


I was wondering if I am suffering from hypercortisolism, depression or still the side-effects of Sertraline?

Many greetings.
Dominique

 

Edited by ChessieCat
reformatted to remove background grey & added topic title before merging with intro

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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  • Administrator

Hello, Dominique

 

I am sorry you are going through this. First, not being able to sleep after giving birth is normal very common among new mothers (and fathers). This alone is not any kind of depression or post partum psychiatric disorder. It is normal, though not being able to sleep and feeling the pressure of having to care for a tiny baby can affect anyone's mood for the worse.

 

It also sounds like you might have had an adverse reaction to a hormonal supplement. This is not unusual, either.

 

Sertraline is known to cause adverse effects such as mood changes, depression, agitation, and suicidality, as well as insomnia, particularly if the starting dose is too high. You were also taking a benzo, which may cause odd symptoms, too. Getting withdrawal symptoms after going off a rocky month of sertraline is to be expected -- but few psychiatrists understand this.

 

It is unfortunate that you started to think of yourself as a psychiatric patient with a broken brain and became so distressed at all these iatrogenic effects.

 

Head pressure, etc. is a common withdrawal symptom. Here are more 

 

Papers on diagnosis of antidepressant withdrawal syndrome

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Dysautonomia (autonomic dysregulation)

 

22 hours ago, JandD said:

I was wondering if I am suffering from hypercortisolism, depression or still the side-effects of Sertraline?

 

Unlikely you have any of the above, though you might have some after-effects from the cleaning fluid.

 

What we see is that withdrawal syndrome very slowly goes away over many months if you don't do anything to make it worse. What are your current most prominent withdrawal-related symptoms? Depending on their severity, you may want to try a very low dose reinstatement of sertraline or other SSRI, this can stop withdrawal symptoms.

 

 

 

Edited by Kiasofia
removed tag (Dominique is a different member)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 weeks later...




Hello - this is the husband again.

In the last three weeks my wife has refused more to eat and drink. Then yesterday morning my wife jumped off the approx. 3.5 metre high wall again. Probably not a suicide attempt as she landed on her feet again. I guess she doesn't want to take any responsibility or make any decisions anymore.


She was taken to the clinic yesterday morning by ambulance. Both feet broken. Possible consequential damage. Apart from that, fortunately nothing. 

However, she also had an appointment with the Mental Health people. Unfortunately I couldn't be present at the appointment as I hadn't slept for 28 hours (went with her and the ambulance to the hospital) and wanted to look after our little baby (luckily someone else here was looking after it). I demanded to be asked beforehand if any medication was given. I was not called and in the evening I found out that my wife probably also agreed to take medication (which she actually refuses).

 

Today I wanted to visit my wife in hospital. The nurses at the phone at arround 1 pm said she was fine. She wanted me to bring underwear, books, etc.
 

Before that, I had a conversation with a mental health worker. 

My wife was given 5mg Olanzapine and 20mg Fluoxetine.
As she had previously refused to drink.

After the interview, I wanted to go on and visit my wife with our baby.
 

When I got there at about 5 pm, the nurse said my wife was very unwell. She didn't want to see us!
 

I am now very worried that this is because of the medication. She has already had an Adverse Reaction on Sertraline (possibly as she has agitated depression) with hair loss, bruising, head pressure and suicidal thoughts.

Now there seems to be another SSRI medication (fluoxetine).
 

The mental healt worker said a decision will be made on Friday whether my wife will be compulsorily admitted, as she could be a danger to herself and/or others.

Can I influence the medication here? What should / can I do? 
I would like to write something more present, because I fear this post will hardly find attention...

Please help me!!!

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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I used the wrong word for the medication - Fluoxentine (german) is Prozac in english..

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

Link to comment
  • Administrator

@JandD This must be very difficult for you. Is your wife convinced she needs psychiatric drug treatment? If so, we cannot recommend anything against her will.

 

A suicide attempt or going to the hospital saying one is suicidal is almost guaranteed to result in drug treatment. She's done this twice, perhaps her preference is the treatment.

 

Other than that, 20mg Prozac seems excessive to start. She might do better with 5mg. The olanzapine should help her sleep, but has other adverse effects. Too much olanzapine may not help sleep. If she is interested in minimizing the drugs, please let us know.

 

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you very much @Altostrata for your response! I appreciate you answering me very much!

"Is your wife convinced she needs psychiatric drug treatment?"
=> No my wife is very reserved and cautious because of her negative experience with Sertraline. She is afraid that she will lose her feelings again and become a different person. But it might not work without medical treatment at this stage any more. She is desperate and no longer amenable to arguments as to why it is probably a mental block that tells her she can no longer drink or eat.

Yes of course she is interested in minimizing the drugs! She is a very sensible person.
I would be very grateful for a recommendation!

 

I am worried about Prozac as an SSRI in the case of agitated depression. Do you think she will tolerate it better than Sertraline and not have suicidal thoughts again? Wouldn't a trycyclic antidepressant be more suitable here?
 

PS: Is there a donation address for SA? 

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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3 minutes ago, JandD said:

Do you think she will tolerate it better than Sertraline and not have suicidal thoughts again? Wouldn't a trycyclic antidepressant be more suitable here?

 

I don't know, sorry. You'd have to find out how she's feeling on fluoxetine. Be aware its effect will get stronger over the next few weeks.

 

Our Paypal for gifts survivingads at gmail com. Thank you.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 months later...

Hello again!

My wife is out of hospital since 4 weeks now and is sitting next to me.
She and I are very happy, that she is at home again, but she is still suffering from head pressure.

Please see our updated signature for the current medication.

She would like to slowly phase out these drugs, but the question is when and how.
The doctors said she should take 20mg Olanzapin for at least 6 months and treat the psychosis "as aggressively as cancer" and then maybe think about a slow reduction.

However, she would like to start weaning herself off in small steps now, as the medication makes her incredibly tired and lethargic.
The planned procedure now would be a reduction of 10% of the previous dose every month. Later, with a lower dosage, possibly a slower reduction.

Would a faster reduction be possible in a clinic? Is there a possibility to reduce the withdrawal symptoms with e.g. bupropion (nicotine withdrawal medication)?

We are grateful for any answer / opinion! 

Best wishes and a happy Easter!
J&D

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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@JandD

 

I am not a mod and therefore am reluctant to contribute except to wish you well. 


Having been on antipsychotics and mirtazipine I am only too aware of your desire to get off them. And it is possible in due course. 

However post partum psychosis is an exhausting thing to suffer and I sympathise. 
 

Wishing you well. 
 

OldDodgy 

 

 

My Intro topic.  Was Dickie in FB gabapentinoids 

2020 January Stopped Quetiapine 150 at night in a fairly chaotic fashion with holds, jumping at 6mg 

2020 June Stopped Pregabalin 150 at night using Ashton Method Some holds. 

2021 December Stopped Mirtazipine 15 using Ashton Method. (Slower at end). 

Nov 21 - Given Quetiapine 12.5 for sleep. Reduced mid March 2022 to 6mg - Off 30/5/22

Feb 2022 Ongoing Diazepam 17.5, Blip at Christmas when took 22.5mg for a few days, now 24 FEB Stable 17.5 as advised. Had long covid. Now going to 16.25 from 8/7/22. 7% drop 

Oxazepam 10mg.STOPPED 10th FEB 2022  “Rescue dose x 2 in 2 months. 

Buccastem 3mg less than 1 a month for nausea. 

Past meds since 1969 -Approx dates only available. Tranxene 15, Clomipramine 150 for about 25 years. 1993 Paroxetine 20 AD change. Diazepam 20mg swap from Tranxene.

Oxazepam 10mg Prn since 1990's  1995 Trial of MAOIS. 2000 Escitaopram 10mg. 2015 trial of Trazadone. 2004 Pregabalin 150 at night.

2015 Started on Quetiapine 150 note, Mirtazipine 15 note. Diazepam increased to 30mg split dosing. 

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@JandD Here are our Tips for tapering off olanzapine (Zyprexa)

 

Please be aware that if your wife attempts suicide again, she will certainly be hospitalized again, and most likely be put on even more drugs. We're just a peer support site, we cannot resolve situations where people cycle in and out of the hospital. 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you OldDodgy!

@Altostrata Thank you for the link.

My wife has been to hospital only once. We absolutly want to avoid her being in hospital again.
Thats why we want to be very carefull with tapering off.

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

Link to comment
  • 4 weeks later...

Hello - a short feedback on the current status.
 

After an intensive study of the various posts here in the forum on reducing medication and olanzapine, we have decided on the following course of action.

  • Wait for 4 weeks after discontinuation of benzodiazephines.
  • Start the reduction of Olanzapine quite soon, because unfortunately the dosage is quite high.
  • Concentration on only one medication. Continue taking the antidepressant "Mirtazaphin" in unchanged dosage of 30mg.
  • Purchase of tablet splitters and two scales to reduce the risk of measurement errors
  • One-time reduction from 20mg to 19mg (5%) to get to know the pattern / possible discontinuation symptoms => slight sleep problems, slightly more anxiety (approx. 2-4 days after the reduction) and slight (other) headaches, in addition to the strong general head pressure which has existed for approx. 6 months. Possibly also sweating, although this can also be a general side effect of Olanzaphin / Mirtzaphin. 
  • Waiting 10 days without further reduction. The described sympthoms disappeared again (sleep problems, mild headache, anxiety). There were no further symphtoms.
  • After that we started Microtapering. Small reduction steps of 0.2 or 0.1 based on how my wife feels. Some days no reduction at all.
  • The model for the reduction steps are the so-called tapering strips. Here are also exact dosage schedules for Olanzapine (https://www.taperingstrip.com/prescribing-and-ordering/). But we do the reduction by ourself with a pillcutter and the two scales.
  • So far everything works quite well. After 20 days of reduction, we have now gone from 20mg to 17.5mg. My wife is doing well. She has no tapering symptoms. 
  • We are also trying to have as positive an influence as possible in other areas. Exercise, going out to eat, fresh juices, nice experiences. 
  • In terms of supplements, fish oil, magnesium and also NAC (N-acetyl cysteine - there are some studies which show that the brain recovers better from olanzaphine and at the same time anxiety is reduced) seem to have a small positive impact. 


From time to time there is also an appointment with the psychiatrist.
I briefly described the last appointment in my last post. 

There are also meetings with a nurse in charge, who looks how my wife is doing. At the last two meetings, my wife remarked how tired and listless the medication makes her. 

Actually, today should be another visit from the doctor with us. Since we had another appointment in the afternoon, we scheduled this appointment for next week with the responsible secretary.
Apparently the secretary made a mistake and the psychiatrist came by today with an assistant while we were putting on our clothes in the hallway and were on our way out of the house.

Here the psychiatrist asked my wife how she felt. When she said she felt relatively well, he said she could then reduce the olanzaphin from 20mg to 15mg starting today.
 

In general we think the reduction is good, but we are surprised about the procedure, size of the reduction step and no further information about the procedure (dividing the tablet by knife and by feeling?!). 

We want to continue our previous reduction path in the smallest steps. Depending on the condition of my wife, we also want to maintain the level once for the required period.
With the doctor we want to talk then next week and tell him that we do not want to reduce the olanzapine in such large steps.

We are grateful for any kind of feedback!

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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On 5/10/2022 at 7:20 PM, JandD said:

Here the psychiatrist asked my wife how she felt. When she said she felt relatively well, he said she could then reduce the olanzaphin from 20mg to 15mg starting today.

 

How long has she been stable or free of withdrawal symptoms? It's best to allow the system to rest before making more drug changes. 

 

It would not be unusual for a psychiatrist not to know this.

 

It seems to me you made a good plan yourself for gradual reduction of olanzapine.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you Altostrata for your message.

My wife has been stable for about an month after stopping the benzodiazephines (on for 6 weeks).
Until now, we can not see any withdrawal symptoms of Olanzapine except for a little more sweating, but this probably comes from the mirtazapine.

 

The trade-off between taking a longer break to recover was to start tapering relatively early to 

a) keep the side effects of the high dose of olanzapine as low as possible and 
b) so that my wife's body would not get used to the olanzapine for too long and start making adjustments that would make the reduction more difficult later (reduction of dophamine production / formation of more receptors). 

 

I am not quite sure if b) is so correct and if there is really a temporal advantage?

I think longer stabilization periods seem to be very important especially at low dosages (from about 2.5 mg) when the percentage of receptors affected is relatively high.
And at the same time, the side effects of olanzapine are not quite as high anymore because of the lower dosage. 

 

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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  • Administrator

Your wife has already been taking 20mg olanzapine for more than 3 months. Adaptation has already occurred. 

 

What olanzapine adverse effects does she feel?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

Thanks for the assessment on the adaptation of Olanzapine, although of course I hoped that it would have lasted a little longer.
 

My wife has no feelings and feels like a zombie.
Especially in the morning hours she is very tired and she has no motivation to do things. It is always a big overcoming for her.
 

We stopped the very small reduction steps now yesterday at 16.7 mg. This is a 16.5% reduction within one month. My wife seems a bit more tense and feels it is all getting too much for her.

The severe head pressure that started in my wife about 6 months ago (very likely triggered by the Adverse Reaction to Sertraline - also at that time lots of bruising on the legs, hair loss, suicidal thoughts) has become a bit more present in the last few days. 

We stopped microtapering yesterday and now want to take a break for the time being so that my wife's nervous system can calm down.
Because of the longer half-life, we expect stabilization in the next few days. It is learning process that I am closely monitoring and also documenting.
 

We met with the psychiatrist earlier. He seems to be in favor of smaller reduction steps now.

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

Link to comment

@JandD

 

It seems that you are heading in the right direction and I wish you well during this difficult time. 
 

I bled more on Ssri meds and a bit on mirtazipine but the haematology consultant was not concerned after weeks of tests. 
 

OD 

My Intro topic.  Was Dickie in FB gabapentinoids 

2020 January Stopped Quetiapine 150 at night in a fairly chaotic fashion with holds, jumping at 6mg 

2020 June Stopped Pregabalin 150 at night using Ashton Method Some holds. 

2021 December Stopped Mirtazipine 15 using Ashton Method. (Slower at end). 

Nov 21 - Given Quetiapine 12.5 for sleep. Reduced mid March 2022 to 6mg - Off 30/5/22

Feb 2022 Ongoing Diazepam 17.5, Blip at Christmas when took 22.5mg for a few days, now 24 FEB Stable 17.5 as advised. Had long covid. Now going to 16.25 from 8/7/22. 7% drop 

Oxazepam 10mg.STOPPED 10th FEB 2022  “Rescue dose x 2 in 2 months. 

Buccastem 3mg less than 1 a month for nausea. 

Past meds since 1969 -Approx dates only available. Tranxene 15, Clomipramine 150 for about 25 years. 1993 Paroxetine 20 AD change. Diazepam 20mg swap from Tranxene.

Oxazepam 10mg Prn since 1990's  1995 Trial of MAOIS. 2000 Escitaopram 10mg. 2015 trial of Trazadone. 2004 Pregabalin 150 at night.

2015 Started on Quetiapine 150 note, Mirtazipine 15 note. Diazepam increased to 30mg split dosing. 

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On 5/17/2022 at 4:08 PM, JandD said:

My wife has no feelings and feels like a zombie.
Especially in the morning hours she is very tired and she has no motivation to do things. It is always a big overcoming for her.

 

This is the typical effect of olanzapine.

 

On 5/17/2022 at 4:08 PM, JandD said:

We stopped the very small reduction steps now yesterday at 16.7 mg. This is a 16.5% reduction within one month. My wife seems a bit more tense and feels it is all getting too much for her.

 

Good idea to let the changes settle. You may be micro-tapering but a cumulative reduction of 16.5% in a month appears to be too much for your wife. Suggest you taper less aggressively when you start again.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 1 month later...

Tapering of Olanzapine (20mg) and Mirtazapine (30mg)

 

I would like to write an update on the tapering process so far. Unfortunately, the previous thread ("weeks on sertraline - extreme headpressure and suicide thoughts") no longer fits the title and content.
Therefore, I would like to open this new topic, which is only about the tapering of Olanzapine and later Mirtazapine. 


Perhaps a short note about my wife's head pressure. When she started taking Sertaline she had an adverse reaction (hair loss, bruising, suicidal thoughts and severe head pressure). It now appears that the head pressure can be significantly reduced for her by chewing gum or wearing a mouth guard / dental splint. Doctors or osteopaths have no explanation for this yet. If anyone knows more about this or has had similar experiences, I would be very happy to hear from you!


Now to the tapering of Olanzapine (20mg) and Mirtazapine (30mg):
The beginning of tapering (may 10th) is described here:
 

Quote

After an intensive study of the various posts here in the forum on reducing medication and olanzapine, we have decided on the following course of action.

  • Wait for 4 weeks after discontinuation of benzodiazephines.
  • Start the reduction of Olanzapine quite soon, because unfortunately the dosage is quite high.
  • Concentration on only one medication. Continue taking the antidepressant "Mirtazaphin" in unchanged dosage of 30mg.
  • Purchase of tablet splitters and two scales to reduce the risk of measurement errors
  • One-time reduction from 20mg to 19mg (5%) to get to know the pattern / possible discontinuation symptoms => slight sleep problems, slightly more anxiety (approx. 2-4 days after the reduction) and slight (other) headaches, in addition to the strong general head pressure which has existed for approx. 6 months. Possibly also sweating, although this can also be a general side effect of Olanzaphin / Mirtzaphin. 
  • Waiting 10 days without further reduction. The described sympthoms disappeared again (sleep problems, mild headache, anxiety). There were no further symphtoms.
  • After that we started Microtapering. Small reduction steps of 0.2 or 0.1 based on how my wife feels. Some days no reduction at all.
  • The model for the reduction steps are the so-called tapering strips. Here are also exact dosage schedules for Olanzapine (https://www.taperingstrip.com/prescribing-and-ordering/). But we do the reduction by ourself with a pillcutter and the two scales.
  • So far everything works quite well. After 20 days of reduction, we have now gone from 20mg to 17.5mg. My wife is doing well. She has no tapering symptoms. 
  • We are also trying to have as positive an influence as possible in other areas. Exercise, going out to eat, fresh juices, nice experiences. 
  • In terms of supplements, fish oil, magnesium and also NAC (N-acetyl cysteine - there are some studies which show that the brain recovers better from olanzaphine and at the same time anxiety is reduced) seem to have a small positive impact.



Current status:

  • My wife is currently at 13.7mg of Olanzapine.
  • The reduction steps were very small, fortunately she has not had any major witdrawal symptoms yet. Some days the anxiety is more present, my wife sweats a little more and sleep is shorter/worse. We than stay at the current dose until those symptoms get better.

 

Experiences:

  • Microtapering with one scale / or an additional scale for checks is already demanding, as the respective quantities are calculated and the actual dosage must be correct. 
  • We do a certain amount of advance planning of the dosage level to take into account stressful appointments such as dentist/periods and to be as stable as possible here. 
  • It is very helpful to record sleep duration, mental and physical symptoms on a daily basis. In this way, a break can be taken in good time.
  • NAC seems to be very good for my wife. In the phases where we stopped it (dentist appointment), sleep was a little worse and anxiety a little greater.
  • The reduction is already somewhat noticeable in my wife. She no longer feels quite so sedated and cut off from her feelings. Although the dose is still very high and it is only a slight improvement.
     

Further procedure:

  • We are aware that we are now still in a high-dose range where the reduction steps are easier. 
  • I have the feeling that there are always certain inaccuracies with the scales. The liquid method seems to me to be much more accurate here. We would therefore switch to one part solid (10mg) and one part liquid (2.5mg) from 12.5mg. The reductions would then be from the liquid portion.
  • The goal is to get to 2.5mg by the end of next year and perhaps plan a somewhat longer stabilisation phase so that the brain, nervous system and body can adjust.
     

Thoughts / questions:

  • Does it make sense to reduce mirtazapine to e.g. 15mg during the planned stabilisation phase (6 months), so that the ratio of the two drugs is not reduced too one-sidedly and / or no poop-out might occure with mirtazapine?
  • We always receive the medication very close to the end of the last available dose (5 days before). Can there ever be delivery problems here? I always find it a bit stressful and would like a bit more buffer here. Is it usual to receive only 28 days of medication?
  • It is quite likely that my wife does not have psychosis. She has atypical face pain and this can indeed be triggered by eating and drinking. The use of Olanzapine has probably not had any positive effect on her, as the pressure is still there. I have read that there are reports in some forums about switching from Olanzapine to Abilify. Would this possibly be a worthwhile change because the side effects are less and tapering is easier?
  • To alleviate the head pressure / atypical facepain, one recommendation of the doctors could be to take "gabapentin". As can be seen from the posts here in the forum, this would only suppress the symptoms and lead to a further long tapering process.

 

We are always grateful for comments of any kind!


 

Edited by ChessieCat
added Intro topic title before merging with intro topic

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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On 7/19/2022 at 4:02 PM, JandD said:

It now appears that the head pressure can be significantly reduced for her by chewing gum or wearing a mouth guard / dental splint.

 

She is probably clenching her teeth, causing some kind of circulation or nerve blockage.

 

On 7/19/2022 at 4:02 PM, JandD said:

 

  • My wife is currently at 13.7mg of Olanzapine.
  • The reduction steps were very small, fortunately she has not had any major witdrawal symptoms yet. Some days the anxiety is more present, my wife sweats a little more and sleep is shorter/worse. We than stay at the current dose until those symptoms get better.

 

Good to hear this. What drugs are she taking now, at what times o'clock?

 

On 7/19/2022 at 4:02 PM, JandD said:

The liquid method seems to me to be much more accurate here. We would therefore switch to one part solid (10mg) and one part liquid (2.5mg) from 12.5mg. The reductions would then be from the liquid portion.

 

Tapering with a liquid is preferable. Taking part of the dose in tablet form is a good idea, since her body is used to it.

 

On 7/19/2022 at 4:02 PM, JandD said:

Does it make sense to reduce mirtazapine to e.g. 15mg during the planned stabilisation phase (6 months), so that the ratio of the two drugs is not reduced too one-sidedly and / or no poop-out might occure with mirtazapine?

 

What stabilization phase?

 

On 7/19/2022 at 4:02 PM, JandD said:

We always receive the medication very close to the end of the last available dose (5 days before). Can there ever be delivery problems here? I always find it a bit stressful and would like a bit more buffer here. Is it usual to receive only 28 days of medication?

 

Are you in Europe? You'd have to see if your health system allows more frequent or large prescription refills.

 

On 7/19/2022 at 4:02 PM, JandD said:

She has atypical face pain and this can indeed be triggered by eating and drinking.

 

This is probably related to her bruxism. She might do better with acupuncture, massage, chiropractic, jaw stretching exercises, etc. Could be related to a dental problem.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thanks for the opinions!

Maybe my wife's head pressure is related to her jaw and stress here. She doesn't grind her teeth or clench them, but maybe she does it unconsciously. The head pressure does coincide with the adverse reaction to the Sertraline, but perhaps extreme stress was the trigger. We will observe it and do exactly such things that reduce stress (chiropractor, osteopathy, massage, meditation,...) regularly. 

My wife currently takes 13.4mg Olanzapine and 30mg Mirtazapine every day at 21:30, about 1.5 hours before sleep. This seems to be a good time as she is not quite so sedated in the morning or during the day.

"What stabilization phase?"
A slightly longer stabilisation phase (6 months) without reductions, in which the receptors are given more time to adapt due to the previous olanzapine reduction (10% per month /microtapering). 

Does it then make sense to reduce the mirtazapine to maybe 15 mg then in order to keep the balance (interaction of mirtazapine and olanzapine) somewhat in equilibrium / avoid mirtazapine poop out / reduce sedation - or should the olanzapine first be completely reduced? (which would take 1-2 years)

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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  • Administrator

We have seen that bruxism is common in antidepressant withdrawal syndrome. I broke a filling! She may be clenching at night. I had to use a night guard for a long time until my jaw relaxed.

 

On 7/25/2022 at 5:52 AM, JandD said:

Does it then make sense to reduce the mirtazapine to maybe 15 mg then in order to keep the balance (interaction of mirtazapine and olanzapine) somewhat in equilibrium / avoid mirtazapine poop out / reduce sedation - or should the olanzapine first be completely reduced? (which would take 1-2 years)

 

What happens after your wife takes these 2 drugs at night? How long does it take for her to fall asleep? What is her sleep pattern?

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

We're not concerned about balancing the drugs, but minimizing withdrawal effects. She's been taking 30mg mirtazapine for about 4 months. This is enough time for withdrawal symptoms to become a concern, if she reduces mirtazapine.

 

However, the combination of drugs is quite sedating, and it may be that the effect of the quetiapine will compensate for mirtazapine withdrawal effects, often insomnia. OTOH, quetiapine is a more destructive drug than mirtazapine, so it may make sense to reduce the quetiapine more with mirtazapine compensating for withdrawal effects.

 

Timing of reductions depends on her current symptom pattern. 

 

On 7/19/2022 at 4:02 PM, JandD said:
  • The reduction steps were very small, fortunately she has not had any major witdrawal symptoms yet. Some days the anxiety is more present, my wife sweats a little more and sleep is shorter/worse. We than stay at the current dose until those symptoms get better.

....

  • The reduction is already somewhat noticeable in my wife. She no longer feels quite so sedated and cut off from her feelings. Although the dose is still very high and it is only a slight improvement.

 

Since it appears your wife is doing fairly well with olanzapine reduction, if I were she, I would continue olanzapine tapering as long as withdrawal symptoms are minimal, then hold on olanzapine and consider reducing mirtazapine.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 1 month later...
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Hello, @JandD, how are you doing?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hello Altostrata - thank you very much for asking and thank you for your last post and valuable advice on how you would go about reducing the two medications!
Olanazpine has now been reduced with microtapering from 20mg to 11.2mg in about 6 months. We also started giving some (10mg + 2.5mg) as liquid three weeks ago and reduce the liquid part now. Mirtrazapine is unchanged at 30mg.
Despite the difficult circumstances and many things to care about, we can live halfway "normally" with our baby and sometimes have nice moments. I think my wife is making slow but good progress with normal fluctuations as it goes.

 

Quote

We have seen that bruxism is common in antidepressant withdrawal syndrome. 


Your reference to bruxism has given us a lot to think about. It seems that this is also quite common, especially with Sertraline (where my wife had the adverse reaction) and in women.

One possible impact of bruxism also seems to be swallowing difficulties. My wife's jaw also makes slight grinding noises when she moves it. She still wears the mouthguard often during the day because it reduces the pressure on her head. Another point for bruxism is stress, tension and anxiety. All things she had and has due to postpartum depression. We have an appointment with a specialist dentist soon and are trying to do everything about the depression in different ways.

The thought that my wife has been diagnosed (possibly to quite likely) as psychotic due to the side effects of the sertraline or bruxism ("I can't drink/eat, I'm in pain doing it") is very difficult for me.  I can't think about this for long or I get sad and angry. But it would also explain why the Olanzapine even at a very high dosage (20mg) had no effect. The problems with head pressure and eating/drinking are still there now. In the beginning, relief came from the diazepham in the clinic, which relaxes and relieves anxiety. 
 

 

Quote

What happens after your wife takes these 2 drugs at night? How long does it take for her to fall asleep? What is her sleep pattern?


My wife is taking olanzapine and mirtazapine about 1 hour before going to bed.
She feels tired afterwards. When we turn off the light to sleep, she usually falls asleep very quickly.
For the sleep pattern, I have attached a file to this post. It shows the pattern best.

 

Quote

Please put ALL your drugs in this Interaction Checker and post the report or a link to it in this topic.


https://www.drugs.com/interactions-check.php?drug_list=1640-0,1744-0

There was a blood test done by the doctors on my wife three weeks ago.
However, it seemed to be more about checking the medication dosage and relatively banal things like pulse, weight and blood values.
According to the doctors, everything was fine. We requested the report but have not yet received it. The heart rate was not checked.


It seems to me that we should now microtape a little more slowly for 1-2 weeks, as my wife has been sleeping a little less again in the last two weeks (here was also the change to 10mg Olanzapine fixed + 2.5mg liquid).
She also told me today that she hears a slight rushing in one ear.

Thank you & best regards!


 

 

tapering-sleep-2.pdf

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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2 hours ago, JandD said:

relief came from the diazepham in the clinic, which relaxes and relieves anxiety. 

 

Diazepam is also a muscle relaxant. Your wife may benefit from gentle stretching exercises and self-massage for her jaw. There are instructional videos from physical therapists on the Web.

 

It appears your wife gets a good amount of sleep with the drug schedule as is, and taper is going well.

 

Yes, sadly, her original problems might have been an adverse drug reaction. You might bring this up with your doctors to educate them.

 

In the future, please embed files or link to an external drive such as Google Drive so downloads are not required.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 months later...

Hello - I just want to give a short update ;-)

Current status:

  • My wife is currently at 9mg (coming from 20mg) of Olanzapine and 30mg Mirtazapine (no reduction).
  • The larger part of the medication is a tablet (now 7.5mg), the reduction part is liquid.
  • The reduction steps were very small, fortunately my wife has not had any major withdrawal symptoms yet. 
  • Head pressure: The bruxism was confirmed by the dentist. Jaw crooked and teeth slightly ground down. My wife now wears braces at night. So far, however, there has only been a very slight improvement in terms of head pressure.
  • The psychiatrist in charge is very satisfied with the course of treatment so far and with my wife's current condition. He is letting her continue with the reduction and the intervals for the next meetings have been increased to 2-3 months. I still don't think he is very competent in the field and is strongly influenced by the pharmaceutical industry, but I am happy that we can continue to reduce slowly and calmly. 
  • The psychiatrist and two other people were a bit surprised when I told them that I thought the head pressure could be due to bruxism (and depression). And with it the pain when drinking. And this pain was real and not due to a psychosis. And that the bruxism was most likely due to the adverse reaction from the Sertraline. They have listened to it, but I don't think it will change much.
  • We are holding at 9mg since 10 days and plan to do this the whole December.

 

Experiences:

  • Reduction becomes a little harder (probably because we have been reducing continuously for 6 months now with only two short breaks of max. 10 days.)
  • The menstrual period is a greater stress level for my wife. A few days before and after, her symptoms such as anxiety and feeling overwhelmed are stronger. I consciously plan these times very sensitively for reduction (microtapering).
  • Cold / flu is an additional stress
  • The stress (reduction speed, length of reduction without major breaks, menstrual period, cold / flu, unpleasant appointments / meetings,...) adds up and leads to greater sympthoms. Microtapering helps us to plan ahead and to be able to react to such things.
  • Coming under 10mg Olanzapine, my wife shows more feelings (she has been laughing two weeks ago for the first time since a year now).
  • The reduction by liquid feels much more accurate than when I do it by scale (+ a control scale).
  • The way I read it here in the forum and the way I think now, a slightly longer period (1 month or more) without reduction seems to be very helpful, especially when things are actually going well and a break does not seem absolutely necessary.
  • After stopping the reduction (microtapering) for 7 days, my wife stops sweating in the morning.
  • The dosage of liquid is a bit tricky with olanzapine because it is not water-soluble (only many small parts) and here an even distribution is very important.
     

Further procedure:

  • Now we will keep the dose constant until the beginning of January.
  • After that, the reduction will continue in small steps (one part solid and one part liquid). 
     

Thoughts / questions:

  • Could it be that with a lower dosage (olanzapine) the effect is possibly lower and therefore, for example, the anxiety is greater?
  • Is there another antioxidant (NAC is already very helpful for us) that can help reduce the side effects of Olanzapine?

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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1 hour ago, JandD said:

Thoughts / questions:

  • Could it be that with a lower dosage (olanzapine) the effect is possibly lower and therefore, for example, the anxiety is greater?

 

Anxiety can be the result of the withdrawal itself especially if your wife didn't have anxiety prior to this medication. It was my strongest withdrawal symptom from Latuda and imagine I will experience it again, hopefully to a lesser degree with a slow taper, when I start to come off of Olanzapine.

 

Pre- October 2022: Wellbutrin, Escitalopram, CitalopramSertraline, Adderall IR, Vyvanse, Propranolol, Buspar, Ativan, and Latuda

Oct 13, 2022 - Oct 24, 2022 and Oct 31, 2022 - Present: Zyprexa (2.5 mg). Jan 14, 2023 -> Began transition to liquid suspension. Jan 29, 2023 -> 2.375mg

Oct 14, 2022 - Present: Prozac (40mg) upped from 20mg on Nov 1, 2022.

Oct 31, 2022 - Present: Gabapentin (300mg 3x day)

Supplements: Omega-3 Fish Oil (1,250mg) & Magnesium Glycinate (200mg 2x day)

 

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2 hours ago, JandD said:

Thoughts / questions:

  • Could it be that with a lower dosage (olanzapine) the effect is possibly lower and therefore, for example, the anxiety is greater?
  • Is there another antioxidant (NAC is already very helpful for us) that can help reduce the side effects of Olanzapine?

 

As @FireflyFyte said, increased anxiety is more likely a withdrawal symptom. This should fade as she holds on the dosage. You may wish to extend the hold through February, allow her nervous system to stabilize before the next leg of reductions.

 

It's very common that women will have worse withdrawal symptoms during withdrawal.

 

Which side effects of olanzapine do you want to address?

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thank you FireflyFyte and Altostrata for your thoughts.

I was already generally aware that anxiety and depressive thoughts can be a consequence of reduction. My wife never had this before the medication, but now it is more likely on individual days, especially during menstrual periods. However, it is possible that this is exactly the point where it first shows up before it spreads to other time periods during further reductions (and no hold of reduction). After your comments I will see this as new "early warning indicator", as well as sleep duration. 
 

Of course, it is hard to force yourself to take breaks when you know about the side effects, get more feelings the lower the dose gets and want to reduce the dose further as soon as possible. But it is true that the slow way is probably the faster way in the end. In addition, when she is well, she can meditate better and do other things that are generally good for her - which also makes the reduction easier.
 

Olanzapine also seems to cause physical changes in the brain, such as a decrease in grey matter. I would like to prevent such damage as much as possible, e.g. by taking antioxidants. The NAC seems to be really good for my wife. Sleep is better and repair work seems to be going on at the cellular level (not noticeable to us). Are there other things here that we could try at a lower dose, also to get a break from the NAC for once?

 

13.10.21 - 50mg Sertraline + 2mg Diazepam (stop after 7 days).
15.11.21 - 10mg (decission to stop sertraline, because of adverse reaction, no more Sertraline since 18.11.21)
03.02.22 - 15mg Olanzapine / 20mg Mirtazapine / 3x1mg Lorazepam (hospital)
16.03.22 - 20mg Olanzapine / 30mg Mirtazapine / 2.5mg Diazepam (last day of hospital and Diazepam)
17.04.22 - started microtapering Olanzapine (22.10.22 - 10mg)

Current - 9.00mg Olanzapine / 30mg Mirtazapine

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I just want to say that your wife is so blessed to have such a wonderful, caring, and attentive husband!  You obviously love her very much.  I hope that things eventually get much better for your dear wife. 💜

1994 - 2017:  Prozac, Cymbalta, Celexa, Paxil, Wellbutrin, Zoloft, Seroquel, Buspirone, Lorazepam.

2005: Trazodone 50 mg (due to insomnia from Cymbalta)

2017:  Effexor XR 75 mg (Gee, let's try THIS one!  Biggest mistake of my life.)

2019:  Missed one dose and had WD symptoms for three months straight...complete nightmare

2020 (March):  Began 10% monthly taper of Effexor XR (got down to 12 mg)

2021 (September):  Hit a brick wall.  Became suicidal from severe panic and insomnia.  Went back up to 37.5 mg

Currently experiencing waves of WD symptoms (anxiety/insomnia/headaches/nausea) and cannot titrate any further until they resolve.  

 

Reasons for starting psych meds:  PMDD/Depression (resolved with menopause & ketogenic diet), Generalized/Social Anxiety Disorders

Other medications:  Levothyroxine 75 mcg

Supplements:  Vitamin D3, Probiotic, Cod Liver Oil,  Turmeric, Ginger, Magnesium Glycinate.

 

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