Paul2014: Zyprexa withdrawal insomnia - looking for help

[Paul2014]

Meimeiquest.  Thank you so much for your comments.  I have been taking a supplement made of calcium 500 mg, magnesium 200 mg, vit D 200 iu an hour before bed.  I am not sure if this is helping but I am still taking it.  I am going to get Epsom salts today to try the bath tonight.

 

Last night I was able to get a few hours of sleep.  This is good because some nights I get no sleep at all.  Last night I was able to sleep a few hours but I am taking a cocktail of drugs for this.  I am taking Xanax, Neurontin, Doxepin and melatonin and

now 0.1 mg of Olanzapine.  I know this is no good for the long term.  I don't want to fall

into additional addictions that would further complicate my situation.

 

"One reason Zyprexa is so nasty is that it is a strong anti-histamine"  Can you help me find where can I read some more about this?

 

Is there information somewhere about how long can the sleep withdrawal from Ziprexa last?

[Altostrata]

Paul --

 

Withdrawal symptoms from any psychiatric drug can last a long time. But -- it sounds like a tiny bit of Zyprexa is helping.

 

Meimeiquest.  Thank you so much for your comments.  I have been taking a supplement made of calcium 500 mg, magnesium 200 mg, vit D 200 iu an hour before bed.  I am not sure if this is helping but I am still taking it.  I am going to get Epsom salts today to try the bath tonight.

 

Last night I was able to get a few hours of sleep.  This is good because some nights I get no sleep at all.  Last night I was able to sleep a few hours but I am taking a cocktail of drugs for this.  I am taking Xanax, Neurontin, Doxepin and melatonin and

now 0.1 mg of Olanzapine.  I know this is no good for the long term.  I don't want to fall

into additional addictions that would further complicate my situation.

 

"One reason Zyprexa is so nasty is that it is a strong anti-histamine"  Can you help me find where can I read some more about this?

 

Is there information somewhere about how long can the sleep withdrawal from Ziprexa last?

 

Vitamin D is a daytime hormone. You might take that supplement in the morning rather than evening.

 

When you take calcium and magnesium together, the calcium cancels out the calming effect of the magnesium. If you want a calming effect, take magnesium (mag glycinate is best, mag citrate is okay) by itself. Epsom salts baths are a good way to absorb magnesium.

 

You are taking a lot of drugs. If I were you, I might taper doxepin next, to preserve your sleep.

 

You might see your friend's neurologist/psychiatrist to see what he or she says about your situation. Please don't expect much. There are very few doctors who understand even how to taper people off these drugs. This doctor might be the rare exception -- but that would be a long shot.

[Paul2014]

Thank you Altos.

 

I agree, the tiny bit of Ziprexa seems to be helping and I hope it will continue to get better as days go by.

 

The though that this withdrawal may last a very long time frightens me very much.  I need to get well enough so that I can get a job as soon as possible.  I have no one that I can depend on financially.

[Rhiannon]

 

 

 

I have a question, can you clarify for me what do you mean by "Eyeball" cutting tablets? (sorry English is not my native language and I am not sure)  Do you mean like cutting a pill into quarters with a pill cutter?  and then using a quarter to make the preparation?   I was thinking of precisely doing this.  This is why I need to confirm.

 

 

 

Sorry, your English is so good I didn't realize it wasn't your first language! :-)

 

I mean, yes, cutting with a pill cutter what looks, to your "eyeballs", like approximately a half or quarter of a pill, allows too much actual variation of dosage. Depending on the pill and the amount you want to get. If you want to get a very small amount from a large pill, you're not going to be able to get enough accuracy "by eye" and your dosages will vary too much.

 

With the milligram scale: You will take your pill and measure the average weight of each pill and use percentages to figure out the weight of the piece of pill that you are trying to get. You'll cut the pill and weigh the piece. It will be a little high or a little low. If it's high you'll need to shave off a bit (I use a nail file). If it's low, you'll break off a little more and add crumbs until you get the right weight. With all this shaving and crumbling, you won't end up with four usable equal pieces, but you can probably get three. Does that make any more sense? If you do it you will quickly see what I'm talking about.

 

But I would say focus on either liquid or dry, learn one or the other, to start with. 

[Meimeiquest]

The other thing about Zyprexa is that the tablets are tiny and really, really hard.

[Paul2014]

I didn't get much sleep last night.  I saw a DR today.  She was not receptive to the ideas I've got on this site.  However I did get the prescription for Ziprexa but new time she may not give it to me.  She said in summary to go to a siquiatrist or to start taking the Ziprexa again.

 

I am tempted to try a more aggressive reinstatement.  I am desperate.  What do you guys think?

[bubble]

Thank you Altos.

 

I agree, the tiny bit of Ziprexa seems to be helping and I hope it will continue to get better as days go by.

 

The though that this withdrawal may last a very long time frightens me very much.  I need to get well enough so that I can get a job as soon as possible.  I have no one that I can depend on financially.

 

Hi,

 

I understand how  hard things are for you... Were you able to get hold of that magnesium Alto mentioned? I bought mine online via iherbs. Maybe it could help you with the sleep.

 

In response to the question of increasing the dose, I'm quoting this post where you wrote you felt improvements. This is a big thing since it means reinstating is working. I'm personally a big proponent of the school of thought that claims it's not the dose but stability that heals (and time). In accordance with that theory even updosing could potentially have a negative impact on healing because it's impacting stability. It seems that it hasn't even been 4 days since the reinstatement?

 

I totally understand how important it is for you to be functional enough to work so I want to add that the duration of WD shouldn't worry you. Are you familiar with the windows and waves concept of recovery? (posting the link just in case). This concept helped me to survive. It basically says WD is not only a period of sheer horror. There are periods when the symptoms abate (windows) and then you can function. Unfortunately periods of waves are always there with us when the original symptoms return with all their ferocity. And then pass. Gradually and almost imperceptibly windows get longer and waves shorter and less fierce. The link describes it better, that was my personal experience of them  

 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

 

try to focus on those however initially short periods of feeling a little better and just repeat that the rest will pass. Because it will. And try to explore the symptoms and self-care section for all the ideas that could make your suffering less. It's a slow process and rushing it backfires. This improvement is a sign that you are on the right track and you will get there. (unfortunately doctors won't be much if any help i that process ;(

 

hope this night was  better for you.

 

best,

 

bubble

[Paul2014]

Hi

 

I appreciate your comments.  I am doing the Epsom salts.  I started doing this two nights ago.  I also listen to some relaxation tapes.  I am looking to buy the magnesium glicinate or citrate.  I am not sure how much to take.

 

What happened is that for 2 nights in a row I started sleeping a bit more (to around 3 AM) In addition to 0.1 mg Ziprexa, I am taking a lot of pills to do this. but then the last two night I am back to waking up at 1 AM and not being able to go back to sleep even taking more pills (mostly Xanax and I have added a natural pill called Sleep Tonight that says that reduces the level of cortisol) at 1:00 doesn't help.

 

I had seen the terms windows and waves in some posts I've read but I didn't really know what they meant.  Thanks for  bringing this to my attention.

 

I'll do more reading on symptoms and self care section.  I have been reading a lot on the sleep links.

 

Thanks so much for replying to me.  It also helps me feel less alone on this mess I'm in.

 

Rhi, thanks for your reply to me.  It did clarify things for me.  I will be buying a milligram scale since I need the pills to last me as much as possible.  Using a nail file to shave off a bit, I'll try to find a metal one to do this.  Also, I wonder, does anybody know is the Ziprexa evenly distributed throughout the pill? I mean, if I shave off a bit, will I be shaving off filler?

[Altostrata]

When you say you're taking a lot of pills, what are you taking?

 

Shaving a pill is a very inexact way to titrate. See these ways to take a small amount of Zyprexa http://survivingantidepressants.org/index.php?/topic/3743-tips-for-tapering-off-zyprexa-olanzapine/

 

If you have difficulty understanding it, please find someone to help you translate.

 

Please be patient and allow the small amount of Zyprexa to work for a while. It may take some time for your nervous system to settle down. You may suffer bad waves and better windows during this time.

[Paul2014]

Altos,

 

Thanks for your reply.  I am very grateful I found your forum and that you people are taking time to work with me.

 

Xanax 0.5 mg, Neurontin 300 mg, doxepin 25 mg, Melatonin and now I have added a natural pill called Sleep tonight that lowers cortisol levels.  I am also doing the Epsom salts bath at night.

 

"Shaving a pill is a very inexact way to titrate.  See these ways..."

 

I am confused about this.  I have read over that link many times.  It says that initially splitting tablets is OK.  Then it talks about making your own liquid which is what I have been doing.  I have been crushing a quarter pill and then adding water in the right proportion and then drawing 0.1 mg with a syringe which in my case equals to 1 ml=0.1 ml

 

Rhi explained to me that quarter pills are not accurate for small dose and showed me the way to use a milligram scale in which I have to weight the piece and add to it or remove from it by "shaving" until I get the right weight.  I though I would use the milligram scale method to get the quarter to the right weight and then prepare my liquid with it.  Is this wrong?

 

Sorry

[Altostrata]

Oh, I misunderstood. I thought you were shaving pills in a different way. What you're doing is okay.

 

You're taking all those drugs to sleep? Which one did you start first?

[Rhiannon]

Be careful with the Xanax. It only works for a short time and then tends to rebound in the other direction. Blood levels peak out in less than two hours and then begin to drop. So it can actually make problems worse as it wears off.

 

It's also extremely addictive if you take it every day, so you will have to taper it as well.

 

Do you qualify for Medicaid? If you could get insurance it might be easier to afford your meds and then you could do the liquid, which is the best way. (I can't remember if Florida turned down the Medicaid expansion or if they changed their minds and accepted it.)

[Paul2014]

Yes I am taking all those to sleep, the Neurontin I started about 7 weeks ago.  The Doxepin about 4 weeks ago,  The Xanax about 4 weeks ago.  I am actually talking about 2 Xanax a night of 0.5 mg each.

[Paul2014]

Rhi,  thanks for the advice on Xanax.  What would be better to take in its place?  are all benzodiazepines the same?  Would I be better off taking Temazepan or bromazepan? or perhaps Ambien?  I would really like some feedback on this.

 

Unfortunately Florida turned down the Medicaid expansion.

[Altostrata]

Did the Neurontin help? How about the doxepin?

[Paul2014]

The Neurontin helped in the beginning (instead of waking up at 3 I would sleep until 4 or 5 AM) but now it doesn't seem to be helping.

 

What has happened is that as time has gone by I am sleeping less and less.  When my insomnia started I was waking up at around 3 to 3:30 AM.  I wasn't taking any sleeping pills at the time.  As I began to get more and more tired from the cumulative lack of sleep I started trying the Neurontin and I was getting to sleep to around 4 or 5 AM but after a couple of weeks the Neurontin started to not work anymore and I started sleeping less and less until some nights I wasn't getting any sleep at all.  In this spiral down I started feeling worse and worse I think mostly from the lack of sleep.  So I have been trying different things in attempts to get some sleep.  I tried Ambien for a couple of night and got no sleep.  Then I tried Xanax (a friend gave me some pills to try) and it kind of worked for a couple of nights but then again it doesn't work as well anymore.  I have tried not taking the Xanax and I did not sleep all night.  The following night a took 2 Xanax and I slept a few hours.  The Doxepin seems to help me fall asleep faster but that's it.  I don't think it helps me stay asleep.

[Altostrata]

How long have you been taking the Neurontin? Do you take it every night?

 

Please put your drug situation in your signature, instructions here http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

[Mario]

I would also suggest to go immediately to 5mg of Olanzapine (i.e. Zyprexa).

 

 

the Xanax acts on similar receptors than the Olanzapine (that is why you may have felt an improvement when you have taken it).  However the Xanax is a drug that cannot be taken for a very long term.  

If you don't go back to 5mg you clearly risk to not be able to remove the xanax (because in part they act on the same receptor).

This is basically the technical explanation (I hope you can understand it !)

 

 

Other suggestions:

- buy the liquid form of all the other drugs that you are taking 

- try to taper all the other drugs gradually in 1 month (because you could have acquired dependence to those as well)

- keep a clinical record (an excel table) where you sign everything that you are taking every day and you also report the symptoms (e.g. able to sleep or not, anxiety, concentration etc...)

- try to reach a psychiatrist (it is safer if somebody is ready to act in the case something goes wrong)

 

Don't worry for the final outcome. If you are able to cure yourself this crisis than it will be very easy to reorganize a safe gradual reduction of olanzapine in about 1 or 2 years maximum.

 

My sincere best wishes 

[Meimeiquest]

What are your thoughts about how the insomnia started in the first place?

[Paul2014]

I would go on 5mg zyprexa with clonezipam and then consult a Dr. before making any decisions. 

 

Read my post : ts

Thanks ts.  How much clonazepam should I take? can I take it instead of the Xanax?  What can I use to sleep in the meantime until the Ziprexa starts kicking in?

[Paul2014]

I would also suggest to go immediately to 5mg of Olanzapine (i.e. Zyprexa).

 

 

the Xanax acts on similar receptors than the Olanzapine (that is why you may have felt an improvement when you have taken it).  However the Xanax is a drug that cannot be taken for a very long term.  

If you don't go back to 5mg you clearly risk to not be able to remove the xanax (because in part they act on the same receptor).

This is basically the technical explanation (I hope you can understand it !)

 

 

Other suggestions:

 

- buy the liquid form of all the other drugs that you are taking 

- try to taper all the other drugs gradually in 1 month (because you could have acquired dependence to those as well)

- keep a clinical record (an excel table) where you sign everything that you are taking every day and you also report the symptoms (e.g. able to sleep or not, anxiety, concentration etc...)

- try to reach a psychiatrist (it is safer if somebody is ready to act in the case something goes wrong)

 

Don't worry for the final outcome. If you are able to cure yourself this crisis than it will be very easy to reorganize a safe gradual reduction of olanzapine in about 1 or 2 years maximum.

 

My sincere best wishes

Thanks Mario and ts.  I think l am going to follow your recommendation and go back to the ziprexa starting tonight.  I can not stand the condition I'm in and I've seen my insomnia getting worse over time not better so I don't see other way out. 

 

I understand it can take a while (maybe several weeks, a month or two) before the Ziprexa works again.  What can I do in the meantime to safely get some sleep at night? 

 

As you point out, I want to start reducing the Xanax to avoid further dependencies but what can I take in its place for the next couple of months?

 

Is clonazepam a better choice?

 

Thanks again

[Petunia]

Hi Paul,

How are you doing now?  Did you increase your dose of Zyprexa to 5mg?  Please let us know how your are.

 

I wanted to point out that when reading the advice and suggestions on this forum about reinstating medications and what dose to try, its best to pay most attention to the suggestions of members who have 'staff' badge or 'administrator' badge under their name, on the left, this way you will benefit from the advice of members with experience of helping many people taper off medications.

 

None of us are medical professionals, so you have to make your own decisions about what to do, but suggestions from staff/administrators are more likely to prove helpful in your goal of safely tapering off medication.

 

I know that not being able to sleep can make you miserable, but often, if you can just rest, in the dark and relax, it can be enough, until sleep starts to come back more naturally.  Have a look at our thread about sleep here:

 

http://survivingantidepressants.org/index.php?/topic/604-important-topics-about-symptoms-including-sleep-problems/

 

You will need to scroll down to get to the sleep section.

 

Petu.

[Altostrata]

ts, please stop making drug recommendations on this site. See What will get you warned or banned

[Altostrata]

Sorry, folks -- no recommendations about what specific drugs to take unless you're a doctor and identify yourself as such publicly, with complete contact information for legal liability.

[Altostrata]

Thank you Altos.

 

I agree, the tiny bit of Ziprexa seems to be helping and I hope it will continue to get better as days go by.

 

The though that this withdrawal may last a very long time frightens me very much.  I need to get well enough so that I can get a job as soon as possible.  I have no one that I can depend on financially.

 

This is good news, Paul. Are you taking 0.01mg Zyprexa?

 

....

Xanax 0.5 mg, Neurontin 300 mg, doxepin 25 mg, Melatonin and now I have added a natural pill called Sleep tonight that lowers cortisol levels.  I am also doing the Epsom salts bath at night.

....

 

I would go on 5mg zyprexa with clonezipam and then consult a Dr. before making any decisions. 

 

Read my post : ts

 

ts, no more of this, please. Paul is not presently taking clonazepam. It could conflict with the drugs he is taking and make him very sick. Do not recommend drugs on this site unless you are a doctor and you identify yourself as such.

 

I would also suggest to go immediately to 5mg of Olanzapine (i.e. Zyprexa).

 

 

the Xanax acts on similar receptors than the Olanzapine (that is why you may have felt an improvement when you have taken it).  However the Xanax is a drug that cannot be taken for a very long term.  

If you don't go back to 5mg you clearly risk to not be able to remove the xanax (because in part they act on the same receptor).

This is basically the technical explanation (I hope you can understand it !)

 

 

Other suggestions:

 

- buy the liquid form of all the other drugs that you are taking 

- try to taper all the other drugs gradually in 1 month (because you could have acquired dependence to those as well)

- keep a clinical record (an excel table) where you sign everything that you are taking every day and you also report the symptoms (e.g. able to sleep or not, anxiety, concentration etc...)

- try to reach a psychiatrist (it is safer if somebody is ready to act in the case something goes wrong)

 

Don't worry for the final outcome. If you are able to cure yourself this crisis than it will be very easy to reorganize a safe gradual reduction of olanzapine in about 1 or 2 years maximum.

 

My sincere best wishes

 

Mario, please do not give Paul instructions like this one.

 

Paul's nervous system might be sensitized to 5mg Zyprexa now. This happens often when people suffer withdrawal syndrome. He might only be able to take a small amount. This is what we're trying to find out.

 

We also advocate adjusting one drug at a time. If you make changes in 2 drugs or more and you develop bad symptoms, you won't know which caused the symptoms. This greatly complicates the process.

 

The reason this site exists is because people cannot get good tapering advice from psychiatrists. If they could, I would be happy to send them all to psychiatrists and close this site up tomorrow. What we offer here are suggestions people can discuss with their doctors, and self-help tips.

[Paul2014]

For the first couple of nights I thought the 0.1 mg could be helping but as days have gone by there's not really improvement.  Last night I took 1.25 mg.  No improvement either but not bad reaction either.

 

I have stopped the doxepin with no side effects ( I only took it for a short time)  I also reduced the Neurontin with no side effects. 

  I did this because they do not seem to be helping.  The only thing that is doing something is the Xanax.  Unfortunately it is so addictive but what am I to do?  At this point is either Xanax or no sleep at all.  I am so sorry.

 

Altos I am confused by something, you suggested 0.1 mg to me but then to Omorfi you suggested 0.5 mg.  Why the difference?

 

Petu, thank you for your message.  I did increase and I strongly feel inclined to continue trying a higher dose since the 0.1 mg is not working.

[Meimeiquest]

Paul, again, how do you think this insomnia got started?

[Paul2014]

withdrawal from Ziprexa.  What's your point?

[tezza]

Hi Paul, Welcome to the group, I'm sorry you have a need to be here.

 

When I was in very harsh withdrawal, nothing really helped other than stabilizing on the drug that had caused the WD. You will eventually stabilize but give yourself some time and don't change a lot. By that I mean too many dose changes and/or starting/stopping drugs. When people do that, they usually end up destabilizing the already delicate CNS further.

 

If I were you, I'd titrate slowly up to the lowest and most comfortable dose of Zyprexa, stabilize and then slowly taper off.

 

Warmest wishes!

[Altostrata]

Paul, the reason I suggested such a small amount of Zyprexa is that I thought your nervous system might be sensitized by the harsh withdrawal you experienced. It's good you did not have a bad reaction to the small amount of Zyprexa you did try.

 

But -- changing the doxepin and Neurontin at the same time might have affected your sleep. If I were you, I might go up to .5mg Zyprexa, but hold there for a good while to make sure everything has settled down.

 

Are you taking Xanax regularly or does your schedule vary? If you're taking it regularly, I would not change your schedule with Xanax at all. Take it as close as you can to the same time each day. You may become physically dependent on it, many do, but you can taper it later.

[Paul2014]

Hi Paul, Welcome to the group, I'm sorry you have a need to be here.

 

When I was in very harsh withdrawal, nothing really helped other than stabilizing on the drug that had caused the WD. You will eventually stabilize but give yourself some time and don't change a lot. By that I mean too many dose changes and/or starting/stopping drugs. When people do that, they usually end up destabilizing the already delicate CNS further.

 

If I were you, I'd titrate slowly up to the lowest and most comfortable dose of Zyprexa, stabilize and then slowly taper off.

 

Warmest wishes!

 

 Tezza,

 

Thank you so much for writing to me. I appreciate so much what you've shared.  I feel I needed to hear something like this.

 

It is re assuring hearing your words.

[Paul2014]

Altos,

 

Yes, I am taking the Xanax every night and I have been doing this for about a month.  Unfortunately it's the only way I get a few hours of sleep.  I have been reading a good deal about benzodiazepines and the clinical duration of action for Xanax is 3 -4 hours while the clinical duration of action for Clonazepam is 6 - 8 hours.  I've also learned that the equivalent dose of 0.5 mg of Xanax is equal to 0.5 mg of Clonazepam.  I am thinking, would it make sense to take clonazepam in place of the Xanax?  and I would like your feedback on this one.  Hear what you think about it  I figure 6-8 hours of action vs. 3-4 hours of action.  Perhaps the reason with Xanax I only sleep about 3 to 4 hours is because the action of the pill wears out in that time.  Then I am thinking if clonazepam's action last for 6-8 hours I may get more hours of sleep with 0.5 mg Clonazepam than with 0.5 mg Xanax.  I hope I am making sense.

 

I know benzodiazepines are very addictive so I may have to taper this one as well as you point out but as long as I am taking it I think, why not take the one that gives me more sleep?  I would like to hear your input on this one.

 

One other thing, the cost of Olanzapine without insurance is extremely expensive.  I have been suggested to look into ordering from a Canadian pharmacy.  Anyone on this forum has any experience with this?  The hard part is to find a reputable pharmacy so you don't end up getting a fake instead of the real medicine.  This would be disastrous. Can anyone point me out to a reputable one?  This information would help others on this forum as well with drug affordability issues.

[Meimeiquest]

Hi Paul, I don't know the answer to most of your questions, but I did have the thought that compounded olanzepine might be less than buying individual tablets since you are throwing so much away. In 2013 it cost me $1 per milligram. Best!

[Altostrata]

Sorry, I don't know of a reputable Canadian online pharmacy, perhaps our Canadian members would know.

 

This is the best online pharmacy I know of https://www.healthwarehouse.com/solr/result/?q=Olanzapine

 

Please visit this forum for benzo questions http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-tapering-discussion/

[Paul2014]

Thank you Altos.  I just checked the link of the pharmacy and I can not believe the prices.  90 tabs of Olanzapine 2.5 mg $29.  I checked my local pharmacies and the cheapest price I found was over $300 for the same. 

 

How can they do it?  Sorry to ask.  Are they legit?  Can I buy from them with confidence?

 

Do you have any information on GABA supplementation.  you can buy it in places like Vitamin Shoppe, iherb, etc.  I have read an article that GABA supplementation is good for avoiding Ziprexa withdrawal insomnia while tapering.  I can post the link to the article if it is okay with the forum rules. I would like to know if you guys have any information on this.

[Petunia]

Hi Paul,

GABA does seem to help some people, we have a topic on it here:

 

http://survivingantidepressants.org/index.php?/topic/5567-gaba-gamma-aminobutyric-acid-tablets-capsules-liquid/?hl=gaba

 

I know you can get it from iHerb.

 

Petu.