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Tips for tapering off Zyprexa (olanzapine)

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Altostrata

ADMIN NOTE Also see Dose Equivalents for Second-Generation Antipsychotics


 

Olanzapine is an atypical antipsychotic with a number of serious drug interactions and side effects, weight gain, blood sugar elevation, and movement disorders among them.

Official FDA information at http://www.drugs.com/pro/olanzapine-tablets.html

To minimize the risk of withdrawal symptoms, we recommend a conservative taper of 10% from the previous dosage every few weeks. The amount of the decrease keeps getting smaller. Some people find they can go faster and some people find they have to go slower -- they can only tolerate decreases of a fraction of a milligram at a time. See Why taper by 10% of my dosage?
 
Very careful tapering is necessary when you have had psychotic symptoms. Such symptoms can appear as withdrawal symptoms; that will cause you to become diagnosed as relapsed and re-medicated. Read Psychiatrist: Some patients are better off without antipsychotics...

Fortunately, olanzapine comes in a range of dosages for tapering, from http://www.drugs.com/ppa/olanzapine.html

Quote

Zyprexa
- Tablets 2.5 mg
- Tablets 5 mg
- Tablets 7.5 mg
- Tablets 10 mg
- Tablets 15 mg
- Tablets 20 mg
- Injection, powder for solution 10 mg

Zyprexa Relprevv
- Injection, powder for suspension, ER 210 mg
- Injection, powder for suspension, ER 300 mg
- Injection, powder for suspension, ER 405 mg

Zyprexa Zydis [wafers]
- Tablets, orally disintegrating 5 mg
- Tablets, orally disintegrating 10 mg
- Tablets, orally disintegrating 15 mg
- Tablets, orally disintegrating 20 mg

Novo-Olanzapine (Canada)

 
Olanzapine has a fairly long half-life; in people who are not elderly, it ranges from 32-37 hours  -- from http://www.medicines.org.uk/emc/medicine/614

Quote

....After oral administration, the mean terminal elimination half-life of olanzapine in healthy subjects varied on the basis of age and gender.

In healthy elderly (65 and over) versus non-elderly subjects, the mean elimination half-life was prolonged (51.8 versus 33.8 hours) and the clearance was reduced (17.5 versus 18.2 l/hr). The pharmacokinetic variability observed in the elderly is within the range for the non-elderly. In 44 patients with schizophrenia >65 years of age, dosing from 5 to 20 mg/day was not associated with any distinguishing profile of adverse events.

In female versus male subjects, the mean elimination half-life was somewhat prolonged (36.7 versus 32.3 hours) and the clearance was reduced (18.9 versus 27.3 l/hr)....

 
Using tablets to taper
Since olanzapine comes in many dosages, at least initially, tapering can take place using tablets and splitting them. Plan your taper and, via prescription, convert any dosage to some number of lower-dosage tablets.

Zyprexa tablets can be safely split, according to http://ps.psychiatryonline.org/article.aspx?articleID=84368
 

Quote

patients should be cautioned that because of the coating of Zyprexa, split tablets must be used within seven days.

summed up at http://depression.about.com/od/depressionmedication1/a/savemoneyonmeds.htm
and Consumer Reports http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/PillSplitting-FINAL.pdf
 

However, the tablets can be difficult to split because they tend to be very small.


Use a digital scale to weigh tablet fragments
To control your dosage more exactly, you may wish to weigh tablet fragments, see Using a digital scale to measure doses
 
Using a liquid to taper: Pharmacy compounding
At a very low dose of olanzapine, if you are sensitive to dosage reductions, you may wish to request a prescription for a liquid from a compounding pharmacy. This will enable tapering by a fraction of a milligram.

A pharmacy compounding formula using crushed tablets is here http://www.pharminfotech.co.nz/manual/Formulation/mixtures/olanzapine.html
It is also attached to this post. (It notes olanzapine is "practically insoluble in water.") This formula says the suspension will expire in 14 days.
 
You will need a prescription written for the custom-compounded liquid. The only drawback is this can be quite expensive.
 
Using a liquid to taper: Make your own liquid
However, like other drugs that are not particularly soluble, you can make a suspension, as our member Rhi explains. Also see http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/


According to http://www.pharminfotech.co.nz/manual/Formulation/mixtures/olanzapine.html

Quote

Olanzapine (as crushed Zyprexa® tablets) is stable for up to 6 hours at room temperature and up to 48 hours refrigerated in water and the following beverages; orange juice, apple juice, cola and milk.

 

The preparation and stability of a liquid olanzapine preparation for oral administration in hospitals

The Pharmaceutical Journal Vol 265 No 7110 p275-276 August 19, 2000

 

Quote

 

....We have found that Zyprexa tablets 10mg, crushed and suspended in Guy's hospital "paediatric base", provides a more palatable liquid oral olanzapine preparation than crushed tablets suspended in water.

....

Zyprexa tablets (3 x 10mg) were halved and then crushed using a mortar and pestle and the powder suspended in 30ml Guy's hospital formula base for paediatric mixtures (paediatric base), a syrup-based mixture containing carboxymethylcellulose BP, methylhydroxybenzoate BP and propylhydroxybenzoate BP.3 Each batch of olanzapine suspension was stored at 2?8C in a 50ml amber glass bottle in the dark.

....

The suspension settled quickly and powdered tablet fragments formed a visible layer on the bottom of the glass bottle. Experience with the analogous clozapine suspension3 has shown that the need for vigorous shaking must be emphasised to nursing staff who may be asked to administer the suspension to patients. As with the clozapine suspension, informal assessment of the palatability of the olanzapine suspension has shown it to be well tolerated, some patients in fact preferring it to tablets.

....
No tests of microbiological stability have been performed although paediatric base is preserved. It therefore seems prudent to recommend a shelf-life of two weeks when the product is stored in a refrigerator. Such a shelf-life is adequate for hospital use. We have no information on the bioavailability of olanzapine from the suspension, although it seems unlikely that olanzapine bioavailabilty will prove to be less than that from Zyprexa tablets.

 

 

Guy's hospital "paediatric base" appears similar to Ora-Plus suspension base, which is commercially available:

 

http://www.perrigo.com/files/rx/pdfs/pds173-ORA-Plus.pdf

 

Quote
....ORA-Plus is an aqueous-based vehicle consisting of a synergistic blend of suspending agents that have a high degree of colloidal activity. The suspending agents form a structured, gel-like matrix which suspends particles and allow for little settling. ORA-Plus is buffered to a slightly acidic pH to help reduce degradation of medicinal agents through oxidation. An anti-foam agent is incorporated in ORA-Plus to allow for vigorous shaking with minimal foam.
 

Ingredients

Purified water, microcrystalline cellulose, carboxymethylcellulose sodium, xanthan gum, carrageenan, calcium sulfate, trisodium phosphate, citric acid and sodium phosphate as buffers, dimethicone antifoam emulsion. Preserved with methylparaben and potassium sorbate.....


If you want to experiment further with dissolving the tablet:
 
https://www.caymanchem.com/pdfs/11937.pdf

 

Quote
Olanzapine is sparingly soluble in aqueous buffers. For maximum solubility in aqueous buffers, olanzapine should first
be dissolved in DMSO and then diluted with the aqueous buffer of choice. Olanzapine has a solubility of approximately
0.5 mg/ml in a 1:1 solution of DMSO:PBS (pH 7.2) using this method. We do not recommend storing the aqueous
solution for more than one day.

 

Using orally disintegrating Zyprexa tablets or wafers to taper
Orally disintegrating tablets (ODT) or wafers, which dissolve in the mouth, come in a range of dosages (see above). Conceivably, one might very carefully cut up the wafers to taper, but they may be difficult to cut accurately. (I haven't done this and don't know of anyone who has, please let us know if you try this.)
 
Making a liquid with water would seem to be a better way to taper utilizing these tablets or wafers. In fact, in Europe, patient instructions for the orally disintegrating tablets state

 

Quote

it may be dispersed in a full glass of water or other suitable beverage (orange juice, apple juice, milk or coffee) immediately before administration

 

Also see http://www.medicines.org.uk/emc/medicine/25020/spc
 
One of our members has tapered successfully by making a liquid with the orodispersible wafers, see http://survivingantidepressants.org/index.php?/topic/3743-tips-for-tapering-off-zyprexa-olanzapine/?p=163188
 
I would dispose of any homemade liquid left over from a dose -- do not save for another dose.
 
Using a combination of tablets or capsules and liquid
Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.
 
If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

 

Attachments:

 

180329 Formulation_mixtures_olanzapine.pdf

 

 

Edited by Altostrata
Updated

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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Jerome

Hi, Alto: Looking at the "Formulation in Pharmacy Practice" prep, these are directions for making a suspension, probably because olanzapine is not very soluble. It is quite soluble in DMSO (15 mg/mL, Sigma-Aldrich) and that's probably the only direction to go in if you need a solution. DMSO is regularly taken safely in oral solution. However, I suspect many people will prefer an alternative, if one is available. :unsure:

 

These directions are similar to the ones given in the APhA Handbook for clonazepam--the benzo is suspended in a very viscous syrup to keep the particles evenly distributed, the same basic thing that Ora-Plus does. I'm not familiar with carboxymethylcellulose or with preparing syrups, but I assume that the medium they describe here would keep the drug evenly suspended so that it's distribution would be homogeneous and it could then be measured accurately. I hope this helps. Aweigh


No history of AD meds. Single dose 6-8 mg/day of Ativan (9 mg/d max!) for 7 years. Summer of 2012 I learned about IW sx and began the change to 3X day dosing, finishing in October. Big improvement in sx. Finally got under way with a hybrid [wet/dry] daily cut taper in Dec. 2012, at 0.0125 mg/day. I also take 5 mg/day of Valium and opiate pain meds. On medical hold, re-started taper 5/13. Cardiac sx {heart block) put taper on hold for summer of 2013. Some of what I thought were wd sx remitted when I had the heart problem corrected. > IW sx led to 4X/day dosing, again helpful. Fractured my left wrist in April, 2014, taper on hold again. Restarting 12/2016, at 1 mg 4 X day, ramping to a projected reduction rate of ~ 10 µg per day. Taper stopped again for increasing sx: insomnia, cognitive deficits, mood swings, severe fatigue. A testosterone level was very low. Tx with transdermal patches caused remission of many symptoms; many are still present but not as severe. I think they may be benzo-related. I'm looking for a doctor who will prescribe a small amount of liquid Ativan. This will make my taper faster and more accurate. I took my first reduced dose today, 2/2019; I'm under way, anchors aweigh! Reduction starting at 0.01 mg/day, hoping to ramp up.

My taper method, which will soon be further simplified and contain corrected information, is linked here: http://survivingantidepressants.org/index.php?/topic/5037-jeromes-wetdry-taper-revised/?hl=jerome

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Altostrata

Wow, thanks, Jerome. That will help many people figure out how to taper olanzapine.

 

Do you think the suspension in water would be even enough for tapering?


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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Jerome

Hi: You're welcome. I hope it does help people taper from Zyprexa, and suggest that the same methods might be applicable to clonazepam, another benzo that has solubility issues.

 

At the bottom of the linked suspension prep there are two references. The first one, from which the prep is probably taken, has a link to the full article. It looks to me like you can pay to get it on line or go to the library and copy it from the Royal Journal of Pharmacy. I'd want to read the full article before preparing and swallowing the syrup. The article is titled "The preparation and stability of a liquid olanzapine preparation for oral administration in hospitals", so I think it should be suitable for tapering as long as the viscosity doesn't cause measuring problems. If it does, they can be overcome.

 

 

Aweigh


No history of AD meds. Single dose 6-8 mg/day of Ativan (9 mg/d max!) for 7 years. Summer of 2012 I learned about IW sx and began the change to 3X day dosing, finishing in October. Big improvement in sx. Finally got under way with a hybrid [wet/dry] daily cut taper in Dec. 2012, at 0.0125 mg/day. I also take 5 mg/day of Valium and opiate pain meds. On medical hold, re-started taper 5/13. Cardiac sx {heart block) put taper on hold for summer of 2013. Some of what I thought were wd sx remitted when I had the heart problem corrected. > IW sx led to 4X/day dosing, again helpful. Fractured my left wrist in April, 2014, taper on hold again. Restarting 12/2016, at 1 mg 4 X day, ramping to a projected reduction rate of ~ 10 µg per day. Taper stopped again for increasing sx: insomnia, cognitive deficits, mood swings, severe fatigue. A testosterone level was very low. Tx with transdermal patches caused remission of many symptoms; many are still present but not as severe. I think they may be benzo-related. I'm looking for a doctor who will prescribe a small amount of liquid Ativan. This will make my taper faster and more accurate. I took my first reduced dose today, 2/2019; I'm under way, anchors aweigh! Reduction starting at 0.01 mg/day, hoping to ramp up.

My taper method, which will soon be further simplified and contain corrected information, is linked here: http://survivingantidepressants.org/index.php?/topic/5037-jeromes-wetdry-taper-revised/?hl=jerome

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Rhiannon

I'm kind of out of it right now and need to go to bed, but I just wanted to toss in my usual bit on the subject of making preparations for liquid tapering, which is: I personally don't worry about solubility.

 

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

 

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

 

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


Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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Altostrata

Thank you for that excellent advice, Rhi.


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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Jerome

Hi, Rhi:

And thank you, Altostrata. Rhi, I still don't have the hang of following threads and how notification works [maybe I have to set them?], so I didn't see your reply until just now. It's very amusing, to my <_< sense of humor, that our first conversation was about this very subject on BB last Sept. I would like to have a go at solutions, suspensions, dispersions and their ilk...some other evening. My lack of faith in my own ability [dexterity] to consistantly titrate in a water suspension as you describe so well may have lead me to...alcohol :P I did try milk first, but I think it didn't work for me 'cause I didn't believe in it. Reverse placebo effect.

 

Right now, my taper seems to feature sleepiness as the most prominent sx, along with mood changes. Is there any way that could be an ID w/d effect? Because I think the IDW may be happening, but sedation seems counter-intuitive.

 

And a good night's sleep to all,

 

Jerome


No history of AD meds. Single dose 6-8 mg/day of Ativan (9 mg/d max!) for 7 years. Summer of 2012 I learned about IW sx and began the change to 3X day dosing, finishing in October. Big improvement in sx. Finally got under way with a hybrid [wet/dry] daily cut taper in Dec. 2012, at 0.0125 mg/day. I also take 5 mg/day of Valium and opiate pain meds. On medical hold, re-started taper 5/13. Cardiac sx {heart block) put taper on hold for summer of 2013. Some of what I thought were wd sx remitted when I had the heart problem corrected. > IW sx led to 4X/day dosing, again helpful. Fractured my left wrist in April, 2014, taper on hold again. Restarting 12/2016, at 1 mg 4 X day, ramping to a projected reduction rate of ~ 10 µg per day. Taper stopped again for increasing sx: insomnia, cognitive deficits, mood swings, severe fatigue. A testosterone level was very low. Tx with transdermal patches caused remission of many symptoms; many are still present but not as severe. I think they may be benzo-related. I'm looking for a doctor who will prescribe a small amount of liquid Ativan. This will make my taper faster and more accurate. I took my first reduced dose today, 2/2019; I'm under way, anchors aweigh! Reduction starting at 0.01 mg/day, hoping to ramp up.

My taper method, which will soon be further simplified and contain corrected information, is linked here: http://survivingantidepressants.org/index.php?/topic/5037-jeromes-wetdry-taper-revised/?hl=jerome

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Altostrata

Good for you that you're sleepy instead of the opposite. I'd view that as your body's restorative functions kicking in.

 

To follow a topic, click on the big blue Watch Topic button at the top of the topic. Make sure your Settings allow e-mail notifications.


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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Tuskentank

Does anyone know if the orodispersible wafers would allow for a liquid solution with water. These are designed to dissolve on the tongue so I'm figuring this would work with water?


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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Altostrata

Is this what your wife has been putting in your tea?


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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Tuskentank

Hi Alto, no she's been dissolving the ordinary tablets. 5mg over 5 weeks to date. I tried this myself with one last night and it seemed to dissolve reasonably well. I'm so scared right now. I was going to do a micro taper each day over 3 months given the short spell I've been on them.


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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Altostrata

How short a spell and what kind of dosage?


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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Tuskentank

HI Alto, it's been 5 weeks at 5mg a night. My family expect me to just get over this and keep threatening that my wife will leave me and take the kids. They think my reactions to this are a sign of psychosis. When I confided that the diazepam withdrawals were making me suicidal, and told my mother that I had phoned a helpline, she told me to get a life. This is all so ludicrous, but true that it is killing me. I am fighting this on my own. I spent the entire summer being tried on different anti-psychotics against a backdrop of my wife threatening to leave me and take our kids, and the deterioration this caused to me, and then been told they slipped the olanzipine in there because my way hadn't worked. I wish I didn't hate them so much right now.


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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Altostrata

I'm sorry you're having such a bad time with your family. I would be very angry with anyone who thought I was deluded.

 

If you've been taking any psychiatric drug for more than a month, you're at risk for withdrawal syndrome, and you'll want to reduce very carefully until you find your tolerance for dosage reduction.

 

I updated the first post in this topic to include the orodispersible wafers.


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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LaurensOn

Hello. My name is Lauren and I'm looking for a little help. I have been taking 2.5 mg of zyprexa for one year now. I want off it so badly. I've tried twice but once I start to feel funny I immediately go Back to taking it regularly. I'm in the middle of trying again this week and came across this site today and it looks as if I'm doing things all wrong. I've been taking the 2.5 every other night instead of every night for one week now. I'm not sure what to do next. Today, I don't feel well. I feel agitated, foggy, and nervous.

 

Since it's only 2.5 the pills are already quite small. In addition, they are not flat, round pills. They have a bit if a circular shape to them.

 

Since taking zyprexa, I've gained a lot of weight and my cholesterol has become borderline high.

 

I just don't know what to do anymore, this is very difficult! Any help or advice is appreciated. :)


~Lauren, 38 years old~

Past:

Zoloft, 50 mg 2008-2012 for general anxiety, worked well for that time period.

 

Presesnt Day:

Zyprexa, 2.5 mg Nov 2012 - present for severe anxiety, worked instantaneously but gained lots of weight and elevated cholesterol (Zoloft didn't help with this anxiety so dr. switched me to zyprexa)

 

Klonopin, .5 mg 2008 - present for general anxiety and help with sleep

 

Effexor, 75 mg Sept 2013 - present for depression and something to replace the zyprexa

 

Struggling with getting off zyprexa. Causing fatigue, weight gain, and high cholesterol.

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Meimeiquest

Hi Lauren,

 

I'm a Zyprexa survivor...it can be done! Why don't you write a full intro with signature in the intro and update forum, especially if you are on other meds. I've made a lot of mistakes along the way, but tapering Zyprexa first was, for me, the most serious of them. I'm assuming you read this thread on Zyprexa tapering?


1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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LaurensOn

Hi Meimeiquest!

 

Thank you SO much for replying to me, it meant the world to me tonight!

I'm so happy to hear that it can be done, thanks for sharing that.

As I sit here and not feel well I simply cannot tell if it's a withdrawal symptom.

 

I will do what you said about writing an intro and signature as soon as I get my son to bed.

 

I read enough of the zyprexa tapering instructions to know I am doing it wrong, but I need to read it more closely this time.

 

:) Lauren


~Lauren, 38 years old~

Past:

Zoloft, 50 mg 2008-2012 for general anxiety, worked well for that time period.

 

Presesnt Day:

Zyprexa, 2.5 mg Nov 2012 - present for severe anxiety, worked instantaneously but gained lots of weight and elevated cholesterol (Zoloft didn't help with this anxiety so dr. switched me to zyprexa)

 

Klonopin, .5 mg 2008 - present for general anxiety and help with sleep

 

Effexor, 75 mg Sept 2013 - present for depression and something to replace the zyprexa

 

Struggling with getting off zyprexa. Causing fatigue, weight gain, and high cholesterol.

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Tuskentank

HI Meimequest, do you mean it would be better to taper zyprexa after other meds? I was thinking of a daily taper with minute reductions each day.


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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Meimeiquest

Generally it is best to taper from most activating to most sedating. But given the short time you've been on Zyprexa, I think it is an Alto question. I have never heard of a micro taper for Zyprexa, but that doesn't mean it couldn't be done.


1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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Tuskentank

Hi folks, I'm thinking a daily microtaper might be easier on the CNS? Given olanzipine's 17 receptor hits I was thinking this might make for an easier taper. Is there anyone who does microtapering? Looking for some encouragement to get off this junk.


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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Laqiya

The orodispersible wafers were the ones I was on, not the Olanzapine tablets. (Was confused about this before) The lowest available dose to be found was 5mg and had to halve it further to 2.5mg. Although I couldn’t really get it cut accurately since it disintegrates easily when breaking it in half so maybe the dosage would vary each time.

 

I suppose you could do the same microtaper with wafers just like tablets?

 

Since it can be easily made into a fine power, it‘s better dissolved than the tablets, I guess. Does that mean it’s more soluble in a liquid like water for the purpose of tapering minute amounts, though? I don’t know.

 

I’m interested in learning how to taper this drug as well. Thanks for adding in the new info.

 


<p>Quit Olanzapine 2.5 mg cold turkey. (by the way I do not recommend c/t, but an appropriate safe taper instead)

April 2013: 18 months drug free yet suffering protracted withdrawal.

On no medications except: 360mg Omega 3 cod liver oil daily and epsom salt spray for magnesium.

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Altostrata

Tuskentank -- yes, you might try a microtaper.

 

Laqiya -- making a liquid from the wafers seems to be a good way to taper. Instructions for doing this are in the first post.


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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Tuskentank

Just an update. I made a liquid solution with water and the orodispersible tablet. It forms a perfectly even solution so a daily taper should be accurate.


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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mammaP

I'm glad you found the wafers are good for your taper, and hope it goes smoothly for you. 


**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Meimeiquest

Is it confirmed that the dissolved wafer and dissolved tablet bioavailability are the same? I'm not saying it's not, I just think we need to be sure.


1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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Altostrata

You'd have to ask a pharmacist about that one. It's pretty clear being put in water doesn't affect wafer bioavailability. People seem to be doing fine making suspensions of other drugs with water.


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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Meimeiquest

My concern is that the wafer is made to pass directly through the mucous membranes into the blood, whereas the tablet is meant to undergo first pass metabolism by the liver. If you swallow the wafer in water, theoretically it will not be absorbed till it hits the GI tract. Which may or may not matter.


1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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Altostrata

The mouth, throat, stomach, etc. are all lined with mucus membrane. You're right, the direct absorption through mucus membrane is faster, which is why sometimes when switching from tablets to liquid, the dosage of liquid preparations needs to be adjusted downward slightly.

Olanzapine orodispersible tablet is bioequivalent to olanzapine conventional tablets, with a similar rate and extent of absorption. It has the same dosage and frequency of administration as olanzapine conventional tablets. Olanzapine orodispersible tablets may be used as an alternative to olanzapine conventional tablets.


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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Tuskentank

HI all, I'm confused. Does this mean that by dissolving the wafers I've effectively already taken a cut?

 

I tried the traditional 10% cut and things have been pretty bad in terms of anxiety, but a bit better today, although not great. Going to hold my diazepam, fluoxetine and olanzapine for a few weeks at least at the current doses, then look at daily tapering of the wafers. My only concern is that diazepam lowers serotonin, so would leaving this to last mean my receptors wouldn't grow back properly? I'd love Rhi to advise on this as she's  been tapering citalopram and diazepam.


Update 05/10/14: 11mg fluoxetine, 1.3mg diazepam (slow microtaper of both). Off olanzapine about 6-8 months?

Currently taking: histamine degrading probiotics, a glass of milk kefir mixed with natural yoghurt, flaxseed and slippery elm (split into two doses, one AM & one PM), butyric acid, high dose b vitamins, additional panthenine & a very healthy diet (no grains at all).

 

I believe that the answers to healing are in the gut. God bless you all.

 

 

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Altostrata

No, the wafers are equivalent to the tablets.

 

Do you feel any differently?

 

Don't worry about your serotonin receptors. All receptors tend to self-correct over time.


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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LongJohn

10% reduction/month seems like a good starting rule.  At what level might it make sense to "jump" off?


switched from clonazepam to diazepam, per Ashton 9/14

was tapering diazepam, feeling optimistic when unexpectedly sectioned as "suicidal" 11/14/14

rapidly withdrawn from diazepam

insomnia

placed on olanzapine 7.5mg, gabapentin 300mg

worked at first, then insomnia

olanzapine 5mg, gabapentin 200mg, baclofen 10mg 12/14

worked at first, then insomnia 

tapered off gabapentin, baclofen

went back on diazepam 3mg for insomnia, tension 

olanzapine 2.5mg 1/15

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Meimeiquest

I think you will know when you are ready to "jump." You can read Hudgen's thread on how he went off an AD at the end. I went off at 0.6mg before I came here...that was way early. But I lived :). Rhi is having good success with dropping several together in tiny amounts, Rhiannon is the name of her introduction.


1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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Katy91

I am using orodispersible  olanzapine to taper.  In the UK it is available in 5mg, 10mg, 15mg and 20mg tablets.  

 

I dissolve 5mg in 100ml of water in a measuring jug then syringe out what I'm reducing by.  The syringes are available free from the pharmacy.  I let the tablet dissolve for a minute then I stir with a teaspoon, as though it dissolves well the particles tend to gather at the bottom, then I quickly syringe out what I what to get rid of.  At the moment I'm syringing out 11ml of liquid meaning I'm on a dose of 4.45mg.

 

I wish that more people knew about orodispersible olanzapine as I only found it after much research.   Trying to accurately cut the tiny regular olanzapine tablets is really impossible whereas using the orodispersible tablets is a very easy and accurate way to taper. I use a 5ml syringe which has measurements of 0.5ml on it, meaning I could taper by as little as 0.025mg if I liked.  I am actually tapering by 0.1mg a week and so far so good.

 

I must point out that the orodisperable tablet is not the same as the velotab/wafer.  The velotab is designed to dissolve on the tongue whereas the orodisperable tablet is designed to dissolve in a liquid and be drank.


Olanzapine 10mg  Dec 2007 - Jun 2008

Olanzapine 10mg Sep 2009 - Apr 2010

Olanzapine 10mg Aug 2010 - April 2011

Olanzapine 10mg Jan 2012 - Jun 2012

Lithium 800mg Jun 2012 - Dec 2013

Lorazapam 1mg Nov 2012 - Dec 2013

Diazepam 2mg Nov 2012 - Dec 2013

Olanzapine 20mg Jan 2014 to May 2014

Olanzapine 5mg May 2014 - May 2015

tapering 0.1mg every 7 days

 

1mg melatonin

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Gibby

My first taper was conducted with a compounding pharmacy making custom capsules. I made a mistake in making it a ten percent reduction from the ORIGINAL dose rather than from the current dose each time, so it went too fast and when I got down to about 1.5mg things got a little hairy.

 

I'm planning a new taper that will be MUCH longer. I know I'm sensitive enough that the long way is probably the only way. 


-Started on Citalopram 20mg & Zopiclone 7.5mg in August 2010

-Given olanzapine 2.5mg due to not sleeping through the night with zopiclone

-Went up to 40mg Citalopram sometime in 2011 after disastrous flirtation with Wellbutrin

-Tapered off zopiclone by January 2013 (take as PRN sometimes)

-Went up to 5mg olanzapine for one day due to a weird crash in June 2013, could not taper down past 1.85mg subsequent to that

-Latest CT of olanzapine Aug 31st-September 4th 2015, went back on, re-evaluating everything

-Late Nov 2015: Dropped from 5ml liquid citalopram to 4.875ml. 

-Jan 10/2016: Back up to full dose of citalopram. Not tapering anything at the moment

-Jan 2018: Cut to 1.8mg of olanzapine from 1.825

-Mid-August 2018: Cut from 1.8mg olanzapine to 1.76mg. Probably withdrawal symptoms emerged about ten days later. 

 

 

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simack

Hey all, I was looking for a bit of help switching from tablet form olanzapine, to a liquid suspension form made from orodisperable tablets. I tried switching over on the weekend, and ran into trouble with insomnia on the second night. My current dose is 3.75mg tablet form, so I mixed a 5 mg orodisperable tablet into 20ml of water, then cut 5ml out, hopefully giving me 3.75mg liquid form. This didn't seem to work for me should I try increasing the dose slightly to say 4mg and see if that works?


MEDS HISTORY

2004 hospitalized for acute alcohol induced psychosis and started on my psych drug merry-go-round.2004-2006 SSRI > SNRI Merry-go-round finally settled on Effexor. Also was started on Risperdal in 2004 but switched to seroquell after I had a bad reaction to it.2008. Was switched from Effexor to pristiq, Also managed to successfully Quit Seroquel Cold Turkey.Asenapine- 5mg- August 2014 ~ May 2015. Was put on for Social Anxiety, was great at first then started developing disabling side effects, did a rapid taper and so started my withdrawal nightmare...

MEDS CURRENT

Pristiq-100mg ~ Currently holding

Olanzapine- 3.75mg May 2015 ~ Currently tapering by -.06mg per week (Jan 2016, 3.5mg  ~Feb 2016 intractable insomnia updose to 3.75mg)

Quetiapine- 50mg June 2015  ~Dec 25 2015 Quit cold turkey. ~(Feb 6 2016 hit with intractable insomnia - reinstated 50mg.)

August 2016 : Became destabilised after messing around with cutting doses, trying THC oil etc, Holding on for dear life hoping to stabilise again someday.. 

Supplements Ashwaghanda,  melatonin 2mg, fish oil, Magnesium.

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erer

Hey all, I was looking for a bit of help switching from tablet form olanzapine, to a liquid suspension form made from orodisperable tablets. I tried switching over on the weekend, and ran into trouble with insomnia on the second night. My current dose is 3.75mg tablet form, so I mixed a 5 mg orodisperable tablet into 20ml of water, then cut 5ml out, hopefully giving me 3.75mg liquid form. This didn't seem to work for me should I try increasing the dose slightly to say 4mg and see if that works?

 

It seems you did everything correctly. Could it be that it is the change from the regular pills to the orodispersible ones that is doing this? Because there are different additives in the pills. It could be like it is when changing from one brand name to another.


  • 2,5 years of slowly tapering down Cymbalta from 60 mg. Then tried going from 8,44 mg to 1 mg in 8 days. (April 1st 2015). That's when the real hell started. Reinstated. Didn't help. I was added Ativan (2 mg 2 times a day for relentless akathisia that started with jumping Cymbalta). For years had been taking Zopitin 7,5 mg and Stilnox 10 mg for I had not been able to sleep naturally since the 1st day I started Cymbalta). Used to take Xanax occasionally.
  • All of the above were stopped cold turkey when I was hospitalized in the beginning of May 2015.
  • Prior to that I have been on and off the whole spectrum of different AD-s for 15 years (since I was 17).

My introduction.

 

Tapering:

  • Olanzapine (starting point 2,1 mg): Jan 2016  /---/ April 2018 0 mg. (From 2,1 mg to 0 mg in 1y 3mo).
  • Diazepam (starting at 5 mg) : switching to liquid May 2018;  4,6 mg (June 2018) /---/ 0 mg (Feb 2020) (From 10 to 5 - nobody knows, from 5 to 0 in 1 y 10 mo)
  • Valdoxan (starting at 25 mg): switching to liquid (Feb 2019) /---/ 12,5 mg (Feb 2020)

 

Supplements: D3, turmeric, probiotics, magnesium threonate + glycinate, B12+folate, omega 3.

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