herewego: too large of a cut - should I go back up?

[herewego]

Hi all, I am happy to have found your site.

About 14 years ago, after my first child I had bad anxiety/insomnia (didn't sleep for 5 weeks) when my baby developed feeding/health issues. I stopped nursing and stopped domperidone (sp?) cold turkey after 2 months use(not sure if domperidone, meant to increase milk supply, can have withdrawal).

 

I was put on a regular AD (diagnosed with PPD) and had an immediate adverse reaction. Then I was put on an older more sedating antidepressant and was able to sleep. I gained weight on it and was not recommended to be pregnant while on it. After a couple years I tapered it wanting to have another baby, but then went off too fast at the end. I started it again at the last dose I was stable at but then developed hives. My doctor made me go CT from the lowered amount.

 

I had slowly reducing insomnia and anxiety that never completely went away until pregnant with my second child (it was like the pregnancy made my body do a re-set) about a year after going off the AD. After my third child, about 5 years ago, there were some very stressful circumstances/events within a few months of giving birth and during one of these events I stopped sleeping for a few days and had some paranoia. I was diagnosed as PP psychosis and put on olanzapine – I think because it was felt I did not tolerate AD.

 

But I wonder if they should have tried something else and for more short term since I was nursing full time and that was known. I was put on 10 mg. I stayed on that for 7 months then the doctor said I could go down to 5 mg for a couple months and then stop. I figured it was better to do a slower taper so was on 5 mg for 3 months and then went down to 2.5mg and slowly went down to less than .3 every few days.

 

I have tried to come off 4 times, each time getting down to less than .3 before having to go back on at 5mg or 2.5mg. I would cut by 50% each taper -  from Jan 2015 to June 2015 I reduced from about 5mg to .3 in about 6 months doing 50% cuts – didn’t know there was another way. This last time I went on 2.5 last June 2015 and stabilized and stayed there for a year before feeling it was time to come off - concerned about the risk of diabetes, high cholesterol, stroke, weight gain increasing, ect...

 

I had not found your site yet and made a 50% cut down to 1.25 about July 3 2016. I have had withdrawal since then and wonder if I came down too quickly especially once reading about your 10% reduction guideline. Within 2 days of stopping I had insomnia, daytime anxiety(lessoned after a few days but now slowly increasing again), headache in eve (gone after a few days) and sensitivity to light and sound.  I took some melatonin about a week in for a few days and that seemed to settle my sleep but now I am having insomnia again as of the last few days and last night I had anxiety as I tried to fall asleep.

 

I started having diahrea(sp?) today. I try to walk every day, in the afternoon for about 30 minutes. Before finding your site I started taking at the beginning of July 2016 calcium magnesium then switched to magnesium bisglycinate 200 mg with supper, and in the morning I take vitamin D 1000 IU, Vitamin C Calcium Ascorbate 1000 mg, Omega-3, and B12. I was going to start taking a B complex but after reading here won’t. I am wondering if the B12 is ok or not as well as the vitamin D.

 

I had a large glass of very concentrated ice tea (caffine) with supper yesterday which may have contributed to my bad sleep last night so I definitely won’t repeat that. I also plan to take some melatonin tonight if I don’t feel sleepy by midnight and keep taking it until I feel sleepy on my own. I am only taking .25 about of melatonin.

 

My big question is do you think I should go back to 2.5 mg Olanzapine since it has been only less than 3 weeks and try a 10% taper once stable or should I try to ride it out longer and see if I improve and then do a 10 or 5 % taper once I am stable again (if that happens). The insomnia is what really gets me as it makes coping with everything worse. Is it called re-instating if you haven’t gone CD, but made too large of a cut?

Thanks for any advice,

herewego

Edited July 24, 2016 by scallywag
Add paragraph breaks(kb) and tags(sw)

[herewego]

I forgot to say in my title in post above that I was also introducing myself - is there a way to edit my title?

[herewego]

So if I keep sleeping poorly (not sure how many days I should let myself keep having insomnia) and I decide to go back up to 2.5 olanzapine - I am wondering if I should kill 2 birds with one stone and keep taking the 1.25 in tablet and then add another 1.25 of liquid. I have read here that changing to a liquid is a decrease, so this might be the same as going on a slightly lower amount of 2.5 tablet. That way I can get my body to adjust to the liquid to prepare for the 10 or 5% monthly cuts (if that is what my body seems to tolerate). With my kids to look after every day I need to keep functioning and not get really bad. What are your thoughts on my idea for those of you who have been around this site for awhile?

[herewego]

On a side and hopeful note, one of my family members has successfully come off of Olanzapine - my 5 year old, who nursed for about 3 and half years. By the end he/she was only nursing once a day and weaned when I was down to .3 mg over a year and a half ago. I didn't know to look for signs of withdrawal, but he/she seemed ok and kept sleeping as far as I know. Children make more melatonin than adults so that may have aided. But now from what I have read online, as a nursing mom, I should never have been put on zyprexa/olanzapine to being with.

[herewego]

I noticed in my first post, last paragraph I put CD when I should have put CT

 

I also noticed I didn't really describe the side effects of olanzapine as reasons for wanting to come off, just the fears of the risks taking olanzapine carries - which are very real for some like diabetes - no thanks. Like most people on zyprexa, I gained extra weight - about 15 lbs and I was slowly continuing to gain more. I was also very unmotivated about life and would have about 7 hours of sleep but wake up feeling not rested and then until lunch time my body craved going back to sleep every day. I would get my kids breakfast in the morning and ready for the day and set them up with activities until lunch knowing I would be out of it.

[oops44]

hello herewego and welcome to the forum. while i am surprised your thread hasn't received a response yet i have no doubt that you have come to the right place for answers. there are a multitude of individuals here who know this stuff inside and out and have the life experience to back it up. unfortunately I'm not one of those people but if you hang on I'm sure a moderator will be by shortly to assist you. in the meantime you could check out the Tips for tapering off Zyprexa (olanzapine) thread on the tapering forum if you haven't already. you seem pretty knowledgeable so maybe you have. there is also a ton of helpful info on the Symptoms and self-care forum to read while you wait.

 

it sounds like you have a pretty good grasp of your situation and it could indeed be beneficial to go back to the last dosage you were stable on and hold for a spell, especial so considering you have so many motherly duties to attend to. however I'm not exactly ….equipped…. to give a mother any real advice concerning reinstatement, so please wait for someone more knowledgeable than i to chime in.

 

wishing you the best. hang in there, it gets better. 

 

if you have any questions for me (other than the ones i just avoided!) don't hesitate to ask them right here in your intro thread.

 

also, there is a way to edit your title but it means going through altostrata, and thats a bit like being dorothy asking the wizard of oz to go home. she's hard to get audience with and there will most likely be a lot of yelling and belittling. please don't tell her i said that :^)

 

but seriously i wouldn't fret over your intro title. you did just fine. it is implied that every thread on the intro forum is an intro after all.

[KarenB]

Hello herewego,

 

Your idea to up-dose is a good one.  However I wouldn't go right back to 2.5mg because it's been 3 weeks and you will have adjusted partially to the 1.25mg.  You could try a small up-dose, perhaps to 2mg, and then give yourself time to stabilise there.  When you have stabilised, we recommend a gentle taper, reducing by no more than 10% of your current dose each month.  This allows your brain time to adjust as you go, and lessens any withdrawal.  Keeping daily symptom notes will help a lot with decision making over the coming months.

 

(The term reinstatement is only used when a person has completely stopped their medication and decides to go back on).

 

Oops gave you some good links to start with.  You could also look at our insomnia threads. Lots of members struggle with it.  It tends to ease over time, but not quickly, so learning ways to improve or at least manage it is a good idea. 

 

Many people find Fish oil and Magnesium useful during withdrawal.   

 

Have a read of those and then you can come back to this thread to discuss things further.  This can be your journal to record your tapering and healing progress, and to ask questions. 

 

Welcome to SA,

Karen

[herewego]

Hi Oops44 and KarenB,

Thank you for the welcome and the advice on where to read and what dose to go down to. I will read and try that tonight.

I think with what I have read this far I am going to stop my vitamin D & B12. One quick question if you know - I couldn't find when I looked - is vitamin C and Advil thought to be ok during withdrawal?

Thanks again,

herewego

[KarenB]

I take vitamin C myself, and find it a good support.  As with any supplement, start at a low dose and increase gradually. 

 

I'm not sure about advil, but you might find something useful  here:  http://survivingantidepressants.org/index.php?/topic/1039-painkillers-in-withdrawal-aspirin-ibuprofen-paracetamol-acetaminophen-naproxen-codeine/

 

A little tip:  To find things on this site, google Surviving Antidepressants advil (or whatever you want to find).  Our search button isn't so great.

[herewego]

thanks :0)

[herewego]

So I took 2mg of olanzapine last night - at least I think I did. I had to crush my 5mg pills (I had been cutting them in half to take this past year) and then added 10ml of water then quickly stirred it up then withdrew about 4ml with a syringe from the middle and took that. However I am unsure of the quality of my syringe and little plastic graduated cylinder. They are the ones you get with children's Tylenol or other children's medicine. I am not sure how accurate I can be with those. Are the ones I have read you can order from amazon or get at your pharmacy more accurate than these kind?

 

I know you can get olanzapine that dissolves but I don't think my doctor will go for that - thinks I need to be on for life I think so wouldn't support me weaning myself in this more precise way (using the dissolving tablet). I also took about .25 of melatonin about an hour before I hoped to fall asleep - which seems to be the timeline that works for me. I slept a full 8 hrs and do not feel anxious today. I think I will make tapering a long long long term project as I don't think it's good for me to try to function on little sleep with looking after my family. Perhaps I'll try a 5% taper every 2 months and when I feel I am starting to sleep less go back up the last 5% up I was on that I didn't have sleep trouble with and stay there for a long time like 6 - 12 months before trying again. I know some people have learned to live with less sleep on a long term basis but I don't think that's a good idea for me. But I do think reducing this medicine as I can is a very good idea. I am thinking the risks of taking it long term will be diminished as I go down slowly. And I think I will be more alert for my family as time goes. I should notice an increase in alertness before lunch each day anyways at 2mg compared to 2.5mg I think. I certainly noticed it at 1.25mg but I think my body was saying it was way to big of a cut too.

[herewego]

One more quick question - I read that olanzapine is a 'thienobenzodiazapine'. Does that mean it is similar to or same as a 'benzodiazapine'? I would ask in the members only forum for benzodiazepine but don't want to intrude if it is not considered one.

[herewego]

So I took 2mg of olanzapine last night - at least I think I did. I had to crush my 5mg pills (I had been cutting them in half to take this past year) and then added 10ml of water then quickly stirred it up then withdrew about 4ml with a syringe from the middle and took that. However I am unsure of the quality of my syringe and little plastic graduated cylinder. They are the ones you get with children's Tylenol or other children's medicine. I am not sure how accurate I can be with those. Are the ones I have read you can order from amazon or get at your pharmacy more accurate than these kind?

 

The plastic syringe I am using has markings of 1, 2, 3, 4, and 5mL with 5 dividing marks between each mL. The little plastic graduated cylinder I am using has marks at 5, 10, 15, and 20mL.

Are the syringes and cylinders you can get from amazon or at pharmacy better quality than this? Should I ask this question somewhere else?

[herewego]

 

So I took 2mg of olanzapine last night - at least I think I did. I had to crush my 5mg pills (I had been cutting them in half to take this past year) and then added 10ml of water then quickly stirred it up then withdrew about 4ml with a syringe from the middle and took that. However I am unsure of the quality of my syringe and little plastic graduated cylinder. They are the ones you get with children's Tylenol or other children's medicine. I am not sure how accurate I can be with those. Are the ones I have read you can order from amazon or get at your pharmacy more accurate than these kind?

 

The plastic syringe I am using has markings of 1, 2, 3, 4, and 5mL with 5 dividing marks between each mL. The little plastic graduated cylinder I am using has marks at 5, 10, 15, and 20mL.

Are the syringes and cylinders you can get from amazon or at pharmacy better quality than this? Should I ask this question somewhere else?

 

so I was able to find the answer myself and order some different syringes/cylinders

[herewego]

Just wondering - if I am honest with the doctor about wanting to go on olanzapine orodisperable so I can slower taper - does anyone know in Canada if I can be made an involuntary patient (sectioned) just for being non-compliant even if my mood is fine? 

[scallywag]

The key on having these conversations with a doctor is to present your intention clearly, logically and with few if any emotions that are considered psychiatric symptoms.
 
How do you talk to your doctor about tapering and withdrawal

What to expect from your doctor about withdrawal symptoms  
 
The rules on involuntary hospitalization for mental health reasons are provincial.  It's extremely unlikely in your situation.  "Sectioning" usually requires being a danger to one's self, such as self-harm or a suicide attempt, or a danger to others. The probability is very, very close to zero but isn't 0, because it's difficult to predict with 100% certainty the outcome of any conversation. 
 
One advantage of a single-payer/government-funded health care is that there is more incentive is to keep people out of hospital than put them in and keep them there.

[herewego]

Thanks scallywag.

I have been spending some time today reading stories of others here coming off Zyprexa. Very scary to read about somes of the case of long term insomnia after jumping off or when trying to taper.

[scallywag]

Others' experiences are cautionary tales for sure.  All the more reason to keep things slow and steady.

[herewego]

Yeah - reading other people stories about Olanzapine & WD in general, can make me nervous but at the same time I want to learn as much as I can about how to get off this medication alright by finding out what worked for others.

 

I hope it is ok, but I wanted to ask a question here that I also asked in tips on tapering olanzapine/zyprexa. My reasons for doing so are that my question may not get seen enough to be answered there (and I am supposed to ask my questions here) but I thought if it ended up true, that would give everyone an excuse to tell their doctor, to ask for the orodisperable olanzapine (which may also be the same thing as ODT (orally disintegrating) Olanzapine).

 

So my question is: I have read in the tips for tapering olanzapine/zyprexa thread that orodisperable olanzapine(dissolved in liquid) is not the same thing as ODT (orally dissolving) Olanzapine, but I phoned 2 different pharmacists today in Canada who said it was the same thing. Can anyone confirm or not if this is true?

 

Perhaps the pharmacists were being lazy and not looking it up, or perhaps in countries other than Canada they are different things and orodispersable is not available in Canada, or perhaps in Canada the orodisperable pills are called ODT (orally dissolving) Olanzapine and are the same thing.

 

The good news is if they are the same thing, I have a very good excuse anyone can use to get the ODT Olanzapine - case studies have been done (you can find this online) showing that patients taking the ODT Olanzapine gain less weight than the ones who take the non dissolving tablets. Quote the doctors' info from the case study & the doctor's names if necessary and tell your doctor you are concerned about weight gain (who isn't on this med?) and then you don't have to try all the difficult conversations to get the dissolving kind of Olanzapine.   

 

So some nights ago we darkened our bedroom window but there is light shining around the door from the hallway. We put a towel down along the bottom of the door but light gets in the sides and the top of the door. So our room is not completely dark but it is fairly dark. My husband usually only gets 6 hrs sleep a night but since we darkened our room he has been sleeping between 6 1/2 - 8 hrs - so this has been a good thing for him too. My sleep is ok - better than before WD but not as good as I'd like. I went to sleep just after 1am and woke at 5:30am suddenly awake after dreaming I heard a door slam. It startled me. So not sure if that was morning cortisol or just my reaction to my dream. I was able to go back to sleep so I ended up with enough sleep enough for me. We'll see if I keep waking each morning at that time or not and if I can keep getting back to sleep.

[scallywag]

hwg: I don't know the answer.  Perhaps another member or moderator will.  Pharmacists are good people to ask these questions, as are the manufacturers' consumer info/help lines.

[herewego]

When I went thru withdrawal after taking an AD, I thought that the WD ended and what I experienced until my second pregnancy was my own brain imbalance. I thought WD did not last that long but in looking at your site it is obvious I had drawn out withdrawal.

 

The doctor who put me on olanzapine knew I was full time nursing and I asked if it was safe too. He said it was. When I was doing 50% cuts the first 4 times I tried to come off of olanzapine I was not aware of experiencing WD until I got down to .3 mg. In hind sight I think I was coming off too fast and it caught up with me. I had no idea WD could be so bad for some people and now that I have read here what people have gone thru I am horrified that my own child could have experienced WD and have read elsewhere of newborn babies going thru WD from this drug with mothers who take it during their pregnancy. I am so grateful we weaned our child when I was at my lowest dose of .3mg – that probably helped eased it if symptoms were felt. My child continued sleeping and eating fine and did not appear agitated and it has been over a year and a half since I weaned my now 5 year old – I am so glad my child seems to have escaped WD, or at least not severe. None of the doctors warned about the risk of diabetes on this medicine or the other risks – high cholesterol, stroke, weight gain ect... What a horrible drug.

 

Somewhere I have read that WD for benzo’s occurs within weeks, but for AD it can be months later. Does anyone know (when I finally jump off) how long I need to wait to see if I have WD that shows up after? I know Olanzapine is considered an anti-pscyotic but is it also classed as an benzodiazepine since it is classed a thienobenzodiazapine? So confusing.  

 

Thank you scallywag for the suggestion to call the manufacturers about my questions regarding olanzapine.

 

As far as I could find out the olanzapine that dissolves on your tongue (and can be put in liquids) is called olanzapine orodispersible (not orodisperable) (Eli Lilly calls them zyprexa zydis).

 

According to Eli Lilly, zyprexa comes in 4 forms – two oral, two injectable. Of the two oral forms one is swallowed, the other dissolves on the tongue.  The manufacturer in Canada for generic olanzapine did not get back to me, but according to the pharmacists in Canada there are only 2 oral forms – the one you swallow and the one that dissolves on your tongue which can also be put in liquid. I think the dissolving one is more expensive.

 

The instructions below say that the one that dissolves on your tongue can also be taken in liquid – see below.

 

Olanzapine Teva (in Canada called orally disintegrating or ODT olanzapine) tablets break easily, so you should handle the tablets carefully. Do not handle the tablets with wet hands as the tablets may break up.

1. Hold the blister strip at the edges and separate one blister cell from the rest of the strip by gently tearing along the perforations around it.

2. Carefully peel off the backing.

3. Gently push the tablet out.

4. Put the tablet in your mouth. It will dissolve directly in your mouth, so that it can be easily swallowed.

You can also place the tablet in a full glass or cup of water, orange juice, apple juice, milk or coffee, and stir. With some drinks, the mixture may change colour and possibly become cloudy. Drink it straight away.

 

For those wondering, zyprexa is the name brand form – while olanzapine is the cheaper generic form of zyprexa.

 

If it is ok I will post part of this post in the area for tapering olanzapine.

 

I had read online that Eli Lilly makes medicine to treat diabetes – which seems so odd since they created zyprexa which can cause diabetes. I wondered if it was really true or not that they make medicine to treat diabetes. When I phoned in to ask my questions I was asked a series of automated questions (answered by pushing numbers) and sure enough they asked if I was calling about their diabetes medications. It was true!

[scallywag]

hwg: Thanks for filling us in on your research!

[bromor]

Hi there. Just read through your thread. You've done a lot of research! I think WD is different for everyone. My hope is that when you taper very slow, you run a decreased risk of WD symptoms months after. For me, I felt great for the first 3 months after my first ct off Zoloft. Then all heck broke lose.

 

Sounds like you're on the right path. ????

[herewego]

Hi Bromor,

thanks for stopping by. Yes, I'm hoping a slow taper will minimize WD. How small of cuts can you make on your Gemini scale? I see you are down to .5 mg of Buspar. How low of an amount will your scale allow you to go? All the best to you and your taper :0)

[bromor]

I'm actually not sure how low the scale will let me go. It's getting hard though the smaller amounts I am tapering. All good though! I'm very ready to be off of the buspar & to start tapering the Zoloft.

Hope all is well with you ????

[herewego]

Thanks. It seems after the Gemini scale the next level up is the $500. dollar ones and after that the ones for over $1000. I read somewhere on this site that one guy who bought a scale in the $500. range did not find it helpful so sold that and bought one for $1200. He was wanting to get down to the smaller amounts and was making really small cuts as well. I am wondering if one in the $500. range would have been ok if he would have found one with low linearity(sp?). Anyways, I will find a way!Thanks for your encouragement and I am glad you are doing so well coming off buspar. Best to you too :0)

[scallywag]

just posted in the Zyprexa thread to you:
 

herewego -- Tell the pharmacist that you're having difficulty swallowing the capsules/tablets and that you were informed that Zyprexa can be dissolved in a liquid, e.g. OraPlus, and you want to know more about how that would work. If you're concerned about what they'll think of you, ask at a pharmacy you'll never go back to, e.g. in a mall the other side of town or in a big chain store (Loblaw, Walmart, etc.)

I had a chat with a pharmacist at a compounding pharmacy and he was really helpful. I've never spent a dime there, only went in to get answers to my questions.

[Evoldnahturt]

How small of cuts can you make on your Gemini scale?

 

10mg of powder from a 2.5 tablet of Zyprexa should be about 0.26mg.  I'm not sure how low would be too low.  The lower you go, the more variation in dosage you get.  I'm currently planning on getting down to 10mg on a scale, but I may switch to using scoops before then if I think they would be more accurate at that dose.  Unless I'm mistaken, the long-half life of Zyprexa may help differences in doses even out over a longer period of time.

[herewego]

Thanks for the info - if I decide that liquid olanzapine is inconsistent I will definitely switch to a scale/powder.

[herewego]

Hey just wondering if sometimes having constant muscle twitching (small not large twitches) is common as a withdrawal symptom?

[ChessieCat]

Use a search engine and type in:  survivingantidepressants.org twitch

 

This will return some topics.

[herewego]

Thanks

[Altostrata]

Hello, herewego. How are you doing?

[herewego]

I'm doing alright. However a little concerned about covid-19. With everything going on some officials are starting to recommend getting a good supply of prescription medications in case we need to stay home for a while to slow spread so as not to overwhelm hospitals with the 20% severe and critical cases. There may also be some supply issues due to various things. Also a good idea to stock up on non perishables such as a big bag of rice and dried beans which doesn't cost too much for the financially strapped. Pasta and spaghetti sauce also not too expensive. Anyways, something to consider. Take care everyone. Psalm 91

[Altostrata]

Hello, @herewego. How are you doing?

[Altostrata]

@herewego, please visit and update! We want to hear from you.