Kevin1: seeking advice to taper olanzapine / Zyprexa

[Kevin1]

 

Seeking advice to taper Olanzapine after two failed attempts

Dear forum

 

First of all, and after spending some hours browsing this forum, I'd like to congratulate you for the support you have given to so many of people in need. Please keep it up and God bless.

 

To my story:

 

After a breakdown following both work and marriage issues at the same time, I found myself in a psychiatry ward here in Germany beginning of June 2022. As I couldn't sleep due to trauma and compulsive thoughts, I was first put on quetiapine (dose unknown). I did sleep for a couple of hours, but after waking, my thoughts would be racing even faster compared to when I fell asleep. After discussing this with the responsible doctor, I was switched to olanzapine 10 mg. I left the ward with this dose beginning of July 2022.

 

I was suffering from muscle weakness at that point (my only symptom as far as I can remember), but as I learned more and more about the long term effects of olanzapine, I decided to start tapering, always discussing this with a psychiatrist. September 2022 I went 10>7,5>5>2,5>0 in a weekly rythm.

It all went smoothly until 2,5 mg, but 5 days after the last 2,5mg dose that I started feeling strange. Bouts of anxiety, chills, poor sleep, and finally, I stopped eating. Couldn't even force myself to eat. Eventually, I discerned that it must be withdrawal symptoms, and went back to the doctor. He confirmed, put me back at 2,5mg, and told me to hold for a month. Which I did, and I felt ok again.

 

End of October 2022 I started the second attempt. I was to do a week alternating the 2,5mg every other day, then stop. Well, 3 days after stopping the last dose I started noticing my hunger go away again, as well as my sleep. I immediately went back to the doc, that gave me the option to go back to olanzapine, or take promethazine for the sleep issues. I first agreed to the promethzine and went home.

 

However, I then decided to hold off for another two days, to see how things went, but well, things went down the drain. Acathisia, suicidal thoughts and a general sensation of doom came into the mix. I reconsidered taking the promethazine, as sleep was the least of my problems by now, reinstated the 2,5 mg olanzapine, this last week, which is where I am now.

I don't think this second attempt went without leaving a mark tough. Before, I would go to bed at 9pm and fall asleep like a rock and slept through 6am. Now, I struggle to do so before 11pm and wake some time around 5 am, struggling to find rest again until 6am. I've also noticed something like I would describe as anhedonia for the first time, which I didn't have before.

 

So, I would kindly ask for your support answering the following questions:

 

1. Have I sensitized myself already, given the new symptoms? What do you reckon?

2. How long should I at least wait until my next tappering attempt? 

3. I understand the concept of a 10% taper by now, but would a 25% taper be totally off the charts, by cutting the tablets? I'm struggling the whole time thinking about the process of crushing tablets and making suspensions

4. To support the tapers, I started myself on 440mg valerian each night two weeks ago, as well as 30 drops 3x a day of passionflower. I had some heart rhythm issues that seemed to go away with this. How should I proceed with these two in your opinion?

 

Hoping to hear from you soon.

Kevin

 

 

Edited November 8, 2022 by ChessieCat
added topic title before shortening

[Shep]

HI, @Kevin1. Welcome to Surviving Antidepressants.

 

On 11/8/2022 at 2:10 PM, Kevin1 said:

So, I would kindly ask for your support answering the following questions:

 

1. Have I sensitized myself already, given the new symptoms? What do you reckon?

 

Yes, it does sound like these previous withdrawals have rattled your nervous system. So please do as much self-care as you can until you recover and heal the damage. 

 

On 11/8/2022 at 2:10 PM, Kevin1 said:

2. How long should I at least wait until my next tappering attempt? 

 

This is a great post to help gauge when it's time to taper again:

 

Withdrawal Normal

 

On 11/8/2022 at 2:10 PM, Kevin1 said:

3. I understand the concept of a 10% taper by now, but would a 25% taper be totally off the charts, by cutting the tablets? I'm struggling the whole time thinking about the process of crushing tablets and making suspensions

 

No, I definitely wouldn't do 25% reductions. Your nervous system needs to be treated like fine crystal. You may have already seen some of these threads, but just to be sure, please have a read:

 

Tips for tapering off olanzapine (Zyprexa)

Why taper by 10% of my dosage?

 

How about taking my medication every other day to reduce my dosage?

 

The Windows and Waves Pattern of Stabilization

 

Hypersensitivity and Kindling

 

On 11/8/2022 at 2:10 PM, Kevin1 said:

4. To support the tapers, I started myself on 440mg valerian each night two weeks ago, as well as 30 drops 3x a day of passionflower. I had some heart rhythm issues that seemed to go away with this. How should I proceed with these two in your opinion?

 

Quote

October 2022 - Second taper attempt. A month with 2,5mg, the one week alternating 2,5 mg, then 0 -> failed! Reinstated at 2,5 mg. Also taking valerian 440mg every night, and 30 drops of passionflower 3x a day.

 

 

Questions needed to answer your fourth question:

 

• Did you start the Valerian and passionflower before or after this latest taper attempt? 
• What time(s) of the day do you take the olanzapine and each of these supplements? Do you take any other drugs or supplements? If so, please list the names, doses, and time(s) of day taken.
• How many hours do you sleep at night? 

 

Please continue to post here in your intro thread to ask questions, receive support, and to document your taper and recovery. 

 

[Kevin1]

Shep, nice meeting you and thank you for the reply!

 

I did start the valerian and passionflower after my second failed attempt to taper, to prepare a third taper. That was the intention. But I'm definitely holding for another couple of weeks at least.

 

This is my current medication regimen:

 

Morning: 30 drops passionflower, 100mg magnesium glycinate

Afternoon: 30 drops passionflower, 100mg magnesium

Evening: 30 drops passionflower, 100mg magnesium, 440 mg valerian an hour before bedtime, 10.000 IU Vit D., 10 ml Omega 3 fish oil since 2 days ago to support brain healing

 

In terms of sleep it's hard to tell. I'm in bed for 7-8 hours, but since my last taper attempt i'm finding it difficult to fall asleep and I'm waking up a couple of times a night. It's difficult to tell how much sleep I exactly get, but I do get some sleep. I've heard of worse stories!

 

 

[Shep]

13 hours ago, Kevin1 said:

Morning: 30 drops passionflower, 100mg magnesium glycinate

Afternoon: 30 drops passionflower, 100mg magnesium

Evening: 30 drops passionflower, 100mg magnesium, 440 mg valerian an hour before bedtime, 10.000 IU Vit D., 10 ml Omega 3 fish oil since 2 days ago to support brain healing

 

In terms of sleep it's hard to tell. I'm in bed for 7-8 hours, but since my last taper attempt i'm finding it difficult to fall asleep and I'm waking up a couple of times a night. It's difficult to tell how much sleep I exactly get, but I do get some sleep. I've heard of worse stories!

 

 

Since you just started these supplements, please research them to see if you wish to stay on them. Some of these may interfere with your taper and recovery. 

 

We do recommend magnesium and fish oil,  so those are good ones to keep in your supplement toolkit. For more, see:

 

Magnesium, nature's calcium channel blocker

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

 

Valerian may be problematic and it definitely will need to be tapered if you stay on it for your olanzapine taper and then wish to come off it later. 

 

Valerian Root

 

Here is information on passionflower:

 

Passionflower

 

Your vitamin D dosage is extremely high. Please read at least the first post in this thread:

 

Vitamin D3 (cholecalciferol or calcitriol)

 

Some things to consider:

 

From the vitamin D3 thread I just linked:

 

On 3/13/2011 at 10:33 PM, Altostrata said:

NOTE: Vitamin D is a daytime vitamin. Even if you take it in the morning, it can keep you awake at night. Be sure to start low and don't take too much.
 

 

Also, when you take a lot of or a high dose of sedating drugs and / or supplements, you may experience paradoxical reactions. So instead of being sedated, your brain and nervous system are alerted. 

 

13 hours ago, Kevin1 said:

In terms of sleep it's hard to tell. I'm in bed for 7-8 hours, but since my last taper attempt i'm finding it difficult to fall asleep and I'm waking up a couple of times a night. It's difficult to tell how much sleep I exactly get, but I do get some sleep. I've heard of worse stories!

 

 

It sounds like you may be experiencing some paradoxical effects from your drug and supplement cocktail. 

 

Please post your thoughts after you have a chance to read these links. Do you think you may be getting an alerting reaction from what you're taking? 

[Kevin1]

Hey everyone,

 

It's a while since I've posted, but at least I have some positive news, that I would like to share. I know it helped me to read some of your success stories, to keep me going. 

 

November 2022, my last post, I decided to hold on my withdrawal attempts until March 2023, 4 months give or take. In the mean time, since the whole water titration business seemed to overwhelm me at the time, I researched compounding pharmacies here in Germany. 1 or 2 two said they would fabricate the required pills, but they weren't very clear about it. And they demanded a doctors prescription of course, which I never got from my psychiatrist. The answer was: cut the pills...

That wasn't going to work. So one day I was talking to a family member back in Portugal, and she decided to ask around and eventually found a pharmacy and a doctor that would prescribe the required doses.

And so I started.

Now, as many of us, I was impatient, and decided to go 10% original dose all the way down, in 4 to 6 weeks gaps depending how soon I could get a hold of the medication. 2,25 - 2 - 1,75 - 1,5 - 1,25 - 1 - 0,75 - 0,5 - 0,25 - 0

I stopped about two months ago. And I haven't experienced any withdrawal symptoms since, but the whole process wasn't completely smooth.

 

About a 1 week into the compounding pills at 2,25mg, I started developing severe arrhythmia, in the form of multiple chained PACs or PVCs (don't know which to this day), that wouldn't stop for an hour. Unfortunately, I only made the connection to the compounded olanzapine 4 weeks later, after a couple trips to the ER. And so I faced a choice: continue, or take beta blockers after a visit to my GP. I wasn't going to stop now, so I went for the beta blocker, bisoprolol 1,25 mg. And the arrhythmias went away 90%, even though I still had the occasional, single palpitation.  

 

After that, things went smoothly until I went from 0,5 to 0,25 in November 2023. It was the first time I experienced withdrawal symptoms again. My sleep deteriorated, I started having crying spells and went completely apathetic. I also developed tremors, that would hit different muscles of my body. Each day a new one it seems. That scared me a lot, as I feared they might become tardive, so I decided to hold 0,25 mg until they had passed,and my sleep stabilized. And so I did, until the end of January 2024, when I decided to jump off. 

 

And so, how am I now?

 

Well, I'm still on 1,25 bisopolol and kind of weary of going off it. I still have the occasional PVC/PAC and I kind of think I might have done my heart some damage from the compounded olanzapine. My lesson here, which I learned first thing when I left the psychiatry ward in July 2022, is that the same molecules aren't created equal. Back then, the generic olanzapine I got gave me severe akathisia and I needed to go back on the branded pill, called Zalasta here in Germany. Same thing with the compounded pill, which ended up giving me the heart issues. 

 

My sleep never returned to normal. I can sleep, but there are nights where I'm waking up every hour it seems...

 

And please, go slow and reduce 10% last dose! This is still the safest method. These drugs are dangerous and can leave life long scars if you're not careful.

 

Hopefully my sleep will get better with time, and I my heart didn't catch any severe damage in the process.

 

Thank you to all involved in this forum, I wouldn't have made it without the valuable information provided here!

 

All the best to everyone still on the journey. Support is everything: doctors, therapists, family, friends, people on this forum... Never lose hope, things will get better eventually and time will pass fast enough, just don't rush it!

 

 

[JandD]

Thank you for taking the time to write a positive report and share your experiences here to encourage others! It helps! 

You have reduced faster and more linearly than the recommendations here in the forum. But still much better and more cautious than suggested by doctors (probably last dose 2.5mg...). 

Alles Gute und lass uns andere Menschen (wenn passend) im Gespräch über dieses Tabuthema "Psychopharmaka" und die korrekte Art der Reduzierung aufklären. Es herrscht leider noch zu viel Unwissenheit, was viel Leid verursacht.

(All the best and let's educate other people (when appropriate) in conversation about this taboo subject of "psychotropic drugs" and the correct way to reduce. Unfortunately there is still too much ignorance, which causes a lot of suffering.)

[Kevin1]

Thank you JandD for your reply. 

 

Yes, the fact that I wasn't grinding the pills or water titrating myself influenced the decision to go in bigger steps, but I should have at least gone with the recommendation of the Icarus Project, which is to half the dose again once you're half way down.

 

For me it would have been 1,5 then 1,35 - 1,1  and so on... But again, the parabolic reduction is still better for those who don't mind doing the work of weighing the dosage themselves. It has the advantage, that you use the same compound as you've taking before, which, as I found out on two occasions, might make a major difference. Always be mindful of new symptoms when you change medications, even if its the same molecule. And you have greater control of the reductions, time and dosage, as you don't have to wait for prescriptions and buy the compounded pills. 

 

Auch Dir alles Gute!