simack: Trying to taper off antipsychotic's (saphris/zyprexa).

[Fresh]

Hiya Simack ,  good to hear things are finally stabilizing.  It takes a long time , hey?

  

As far as each symptom goes , it can be hard to tell what comes from what.   For me , Pristiq is very sedating , and I get clearer as the dose gets lower.

 

You've been playing around with the olanzapine and seroquel over the last few months - it sounds like a good plan to me to consider leaving them alone for 6 months and starting to taper the pristiq.  

They may help that taper go smoother than if you stop them first.

[simack]

I sure hope so fresh, I'm a tad anxious about tapering the pristiq though,  I've CT'd  it twice in the past long before this ordeal, and both times had to reinstate after about a month, my social anxiety became so bad it was a struggle to leave the house.   

[Fresh]

Tapering is very different to CT . . . the point is to go down slowly so that you don't get disabling symptoms.

You'll need a scale to start that measures to .000 grams -  jewellers scale on ebay.  So your dose will be consistent.

When you get to lower doses , you can get pristiq compounded in capsules with slow release additive.

 

Compared to CT , tapering will be a breeze , lol  

[simack]

Thanks fresh, the main thing that worries me is that it's not withdrawal but a reemergence of my original symptoms that led me to be hospitalized 11 years ago. Thanks to Yolande I'm fortunate enough to have compounded tablets all the way from 100mg right down to zero reducing at 5mg per week, I think it's over 600 tablets all up. I ordered them today so hopefully they arrive within the next two weeks. Makes the process a whole lot easier, very grateful for yours and yola's help through this.

[Fresh]

Ha , you're one step ahead of me  .

 

I didn't realize you've had a long history , could you add to your sig?    If going down 5mg a week is too fast (if you're

having bad symptoms) you can slow it down , sit on each level for 2 or 3 weeks.

When you go below 50mg you should rethink the plan going forward.  I think 5mg drops will be too much, even if they're

monthly.  Try and stick with the 10% rule.   

 

Delighted to be of service maaate!!

[simack]

Thanks Fresh updated my sig, I was starting to feel relatively good over the weekend so thought I might get away with a small drop on the olanzapine, I didn't, Had the usual symptoms, High anxiety, frequent urination and insomnia so I'm back at holding doses. 

[ang]

Hiya Simack ,  good to hear things are finally stabilizing.  It takes a long time , hey?

  

As far as each symptom goes , it can be hard to tell what comes from what.   For me , Pristiq is very sedating , and I get clearer as the dose gets lower.

 

You've been playing around with the olanzapine and seroquel over the last few months - it sounds like a good plan to me to consider leaving them alone for 6 months and starting to taper the pristiq.  

They may help that taper go smoother than if you stop them first.

Agree totally,   taper the seroquel last............  50mg is a dose used as a sedative........... you need your sleep,   I have been on so many damn meds, of course we all react totally differently....   I am on 75mg seroquel, and that is my last med.........  I do get a racing heart from it, before sleep takes over........... ....   (I do take St Johns Wort, but that is for a taper, much, much later).  And of course, dont trust GPs for any advice, to do with these meds.   Ask Yolande Lucire, for advice, if she is your doctor......

 

I am still in the realm, of I trust no doctors. If I did  I would skype Yolanda Lucire.

 

If you are managing to hold down a job, go sloooowwww....... hold your dosages, follow the advice here....  I found the site too late..                 however, saying that, I do know I will improve.   

[simack]

Thanks ang, think I may have destabilized my nervous system badly this Time though, only managing to get three hours sleep the last couple of nights, I should have known better but it's hard to resist the urge to rush things, just want this poison out of my body

[Fresh]

I want to come to Bendigo and put you over my knee and paddy-whack your bottom Simack! 

A couple of days of "starting to feel relatively good" is not the same as stable.   Apparently your cns agrees.

The more you mess with your doses the longer you'll take to recover.  Use your intellect to guide you , don't succumb

to impulsive urges to rush.

You might be surprised how good you feel after a month or two of holding.  Then you have a good baseline to start

tapering pristiq , although I imagine you'll start decreasing as soon as you can.  

 

Please be patient with yourself.  I know it's hard.  I did a bigger-than-recommended decrease and have been reminded

that it's just not worth the additional fallout.   I had my first w/d symptoms since March , so I'm going back to max. 10%

in future.

This is a time to focus on other areas that will support recovery - social connections , self-development , hobbies.

 

Sorry if I sound like a grumpy old Aunty Fresh today.

I just want you to get well.

[simack]

Yes I'm sorry, I'm definitely paying for it now,I promise no more impulse cuts from here on in.

[JanCarol]

Hey Simack - 

 

Think of the Saphris (or any drug for that matter) as a wolf or a bear.

 

When you are in the wild and you encounter one of these things, the FIRST thing you must do is: KEEP CALM.  (yeah, I know, the meme and all, but it's true)  The next thing you do is DON'T MOVE!

 

If it is a total standoff and you want to get away, you CANNOT run.  It's you and the bear.  If you run, the bear and wolf have a hard-wired instinct to chase, and you will lose.

 

The goal in a standoff with a bear is to sneak.

 

That's what a taper is.  Sneaking away from the wolf.  You've seen a cat stalk - it waits until the prey is not looking, then moves a bit (maybe 10%?)  then it waits.  And waits.  And waits.  Holding will save your life, when you are in a standoff with a bear.  And Saprhis and olanzapine are a bear and a wolf respectively!

 

Before, you dropped your berries and ran away, and the bear caught up to you.  Didn't work. 

 

The goal is to sneak the drug out of your system sooooooo slowly that your brain hardly notices it's gone.  And doesn't chuck a wobbly like before.

 

I've heard good things about Dr. Lucire - but I caution you - to listen to your own brain.  If you have a WHOLE WEEK of stability - then wait 2 weeks more before trying to sneak in another taper.  This gives any residual symptoms time to catch up. 

 

My favorite reference to this is by our own Rhiannon:  Rhis's Start Small Listen to Body Taper Plan

 

And I'm not a little jealous - I hear Dr. Lucire is a lovely woman!  Let us know how you are going, and tell us what *else* you can do while you are waiting to taper.  Maybe try a few  Non-drug techniques to cope with emotional symptoms and find out what you are happiest doing for yourself.

 

I hope you see the sun today!

[simack]

Thanks Jan, that's a great analogy I'll try and remember it when I have the urge to cut next. I'm travelling along ok at the moment, I wouldn't say I'm having windows or stabelizing yet, just less intense anxiety /insomnia, I'd say I'm just surviving not living at the moment.

The weekends are the worst for me, all the fatigue/sleep deprivation catches up with me and it's a battle getting out of bed, normally it wouldn't bother me too much, but that means my daughter misses out on going to the park with dad etc, which is really hard, it's half the reason I keep trying to rush.

Don't mean to make you jealous but yeah, Dr Lucire is fantastic, very grateful to have her help, and this site and everyone such as yourself for that matter.

[simack]

Hey all I was after some help with a bit of maths for future reference, I'm thinking about how I'm going to attempt the olanzapine taper and it's looking like I'm going to need to make my own liquid suspension,

ok this is where I need some help, I plan on taking a 5mg orodisperable wafer and dissolving it into 20ml of water, giving me a 1:4 ratio, so , would this then mean that for each 1ml of liquid I'm drawing out, it's equal to .25ml of olanzapine?.

If so, my current dose is 3.75mg, to get this is it 5mg - 3.75mg = 1.25mg, with the 1:4 ratio 4*1.25 =5ml ?. So to get the correct dose of 3.75mg from a 5mg wafer dissolved in 20ml of water I need to draw out 5ml of water, and then drink the remaining 15?.

Does this sound correct? Any help appreciated.

[simack]

I'm sorry but I've been feeling defeated these last few days, I'm coming up to six months off of saphris and I'm not seeing any signs of stabilizing. This constant fatigue is really becoming overwhelming, I can't tell if it's being caused by saphris withdrawal or side effect's from the zyprexa/seroquel.

My sleep is very fractured still, on average I'm managing about 4/7 hours of very broken sleep. I know I've been fluctuating my doses more than I should have been through this, but I thought I'd at least be starting to see some windows by now, I'm starting to wonder if I'm ever going to stabilize. Sorry for the rant but just wanted to get this off my chest.

[simack]

Hey all, Iv'e recently been kicking the idea around of switching my olanzapine dose over from tablet to liquid form, my main worry is, will this cause me any issues? .Is there a risk of reacting badly from making the switch? . I'm at a manageable place right now and dont want to risk upsetting my nervous system any further

[Gibby]

Hey all, Iv'e recently been kicking the idea around of switching my olanzapine dose over from tablet to liquid form, my main worry is, will this cause me any issues? .Is there a risk of reacting badly from making the switch? . I'm at a manageable place right now and dont want to risk upsetting my nervous system any further

 

One of the mods is probably more knowledgeable about this than I, but I also take olanzapine (though a lower dose, purely for sleep).

 

Compounding pharmacies have told me that olanzapine cannot be made into liquid form because of its chemical structure, so when I tried tapering (too fast!) the first time, I had a compounding pharmacy make custom tablets that contained the correct dose. 

 

Now, if you are referring to using the wafers to taper, I would still say that you should talk to a compounding pharmacist. They can do the math for you! 

 

They sure hand out antipsychotics like candy nowadays, don't they? I was put on olanzapine purely for sleep and boy would I like to strangle that psych sometimes (and myself for not questioning what the drug was). 

 

You can do it, though! There are success stories on here of people getting off antipsychotics, and I personally know a man who was forced to CT olanzapine because of TD and is still alive and functioning great after a pretty rough period (though CT is almost NEVER the right way to do it).

[Fresh]

Switching brands or going from tablets to liquid is known to destabilize some people.  It is

a risk.  Some people have no trouble.

 

I've read on here that one method of making the change is to keep your dose the same , but

take half your regular brand and half the new one for week or two to smooth over

any transfer issues.

Can you make your own liquid?    I don't know much about olanzapine , but you might find some

answers in the Tips for Tapering section. 

[simack]

Thanks Gibby and Fresh, Yeah I can make up my own liquid, I was planning on using Katy91's method of dissolving orodispersible wafers into water, but now im not so sure, I dont want to risk any further destabilisation at this time.

I have work holidays coming up over the Christmas period so I might just hold until then before making any changes. 

Yes I agree with you Gibby, Antipsychotic's are widely over prescribed these day's, in my opinion they should only be used in acute cases of psychosis, and even then only for a brief period of time. I was prescribed Saphris off label for social anxiety, what I wouldn't give to go back in time and change that.   

[Gibby]

Thanks Gibby and Fresh, Yeah I can make up my own liquid, I was planning on using Katy91's method of dissolving orodispersible wafers into water, but now im not so sure, I dont want to risk any further destabilisation at this time.

I have work holidays coming up over the Christmas period so I might just hold until then before making any changes. 

Yes I agree with you Gibby, Antipsychotic's are widely over prescribed these day's, in my opinion they should only be used in acute cases of psychosis, and even then only for a brief period of time. I was prescribed Saphris off label for social anxiety, what I wouldn't give to go back in time and change that.   

 

We all wish we could go back in time with what we know now and change things, but all that energy spent ruminating should be put into living the best life we can while we deal with withdrawing. 

 

Stay stable for now and just try to enjoy what you can. I've gone through at least three withdrawals from olanzapine and trust me, the slow, cautious way is the best way. 

[Fresh]

How have you been travelling Simack?   I hope you haven't fallen off any roofs lately.

 

[simack]

Hey fresh, yeah not traveling to bad at the moment, just holding hoping to stabilize, no roofing accidents yet thankfully:). I'm still having allot of trouble with insomnia and fatigue though, I've just ordered some l-theanine and taurine to try out, so hopefully It might get me a couple extra hours of sleep in at night.

I also have inositol and N-acetylcysteine on the list of supplements to try later.

I've decided to hold everything until the Christmas holiday period, might start my pristiq taper then and switch the olanzapine from tablets over to liquid.

So yeah still surviving hoping things stabilize soon, hope your doing well tootoo.

[Fresh]

Good plan.  Do remember to add just one new supplement at a  time. If you start 2 , you can't tell which is helping.

Same deal with olanzapine and pristiq - just change one at a time , so if there's a problem you know what it's from.

 

Re drug expiry dates:    The following article explores this issue and is an interesting read.

Exerpts:

 

"It’s not the first time I’ve thought about the meaningfulness of expiration dates on our medications. Frequently, I wonder, “Does it make any difference taking drugs that are far past their expiry? And is it harmful to be swallowing medications that were made in the last millennium?"

 

"From a merchant’s perspective, a short expiration date drives return customers. If your clients only use your product intermittently, expiry dates get them back to purchase more of the product. You often hear pharmacists and regulators hectoring about medication expiry dates, warning you in grave tones that you could be taking dangerous chances by swallowing expired drugs. Hmm, how true is that?"

 

"His study looked closely at 14 expired drugs, 12 of which were “present in concentrations at least 90 percent of the labelled amounts.” This is considered the minimum “acceptable potency.” Basically, these decades-old drugs were as potent as the day they were manufactured; in fact, he found that those 12 medications “retained full potency for at least 336 months, and eight of these for at least 480 months.”

 

Alan Cassels is a pharmaceutical policy researcher, an occasional swallower of expired acetaminophen and the author of a new book, The Cochrane Collaboration: Medicine’s Best Kept Secret. @AKECassels. You can read more of his writings at www.alancassels.com or follow him on twitter @akecassels

http://commonground.ca/2015/11/drug-expiry-dates-are-they-ever-too-old/

[simack]

Cheers thanks fresh, good to know that the compounded pristiq will remain potent for a while to come.

[simack]

Just a quick check in, I had my first wonderful window period of about there days last week, it was great, I wasn't completely back to myself but I actually managed to experience a sense of optimism for the first time in ages.

Unfortunately it didn't last long, and I'm back to feeling overwhelmed by withdrawal symptoms again. My Sleep is a little better, I'm managing about six/seven hours a night ,although I wake briefly every two hours. Better than nothing though I guess.

I've managed to get a hold of some orally disintegrating olanzapine tablets and am thinking of making the switch this coming weekend, I've decided I want to try a micro taper, I feel the olanzapine is doing me way more harm than good and want to target that first before the pristiq.

It's hard to tell what's withdrawal symptoms and what's side effects from the neuroleptic's

[simack]

Well I really don't know what to do from here, I tried unsuccessfully to switch over to liquid olanzapine this weekend and ended up with damn insomnia again. Friday night wasn't too bad but last night I only managed an hour tops. How am I ever going to taper off this poison if I can't even switch to liquid?

Feeling so frustrated at the moment, I'm going to take tablet form again tonight and hope that I haven't upset my nervous system too much, and manage a decent night's sleep for work.

The weird part of this was how great I felt Saturday, thought I'd be an anxious mess if I want going to be able to switch.

I'm going to wait until Xmas holidays and give it another shot then, hopefully the insomnia is only temporary and will resolve a bit after a week or so.

If that fails then I really have no hope left of ever getting off this junk.

[simack]

So I've been wondering since I've had such a hard time switching over to liquid olanzapine, if I need to increase the dose a bit. I'm currently on 3.75 with the tablet form which seems to hold me ok, I tried switching over to 3.75 in liquid which caused sleep problems, should I try again with a slightly higher dose say 4 mg and go from there?

[Fresh]

Hiya ,  when you say liquid , are you making it yourself with the orally disintegrating  tablets , or did you buy the liquid?

If you made it yourself , I'm wondering how you measured the amount of wafer to put in?

 

Hopefully someone who knows more will be along soon , or you might ask on the olanzapine thread

You may find  an answer there Tips for tapering off Zyprexa (olanzapine).  

[simack]

Hi fresh,

yeah I was making the liquid myself from the orodisperable tablets,

my method is dissolving a 5mg tablet into 20 ml of water then syringe out 5ml, to hopefully leave me with 15ml water with 3.75mg of olanzapine.

I measured the 20ml by syringing out 4x 5ml from a glass of water, and putting it into my mixing cup.

I don't know why but drinking the 15 ml definitely felt like I had made a cut, maybe there is a bit of discrepancy in the potency somewhere between the two forms?.

Thanks again fresh.

[Fresh]

Maybe the small amount that remains on the sides of the cup makes a difference?

You could try adding some water and swishing it round for a second swig after the main event.

 

I'm liking the new avatar  .

[JanCarol]

Hey Simack, I'm not the best one about solutions, solubility, or maths.

 

But many people report that switching from tablet to liquid can be traumatic.

 

Take it easy, and cross taper over - you can have withdrawal symptoms from changing brands, generics, and tablet/capsule to liquid.  But it will pass, as you body and brain get used to the new form.

 

It just drives home how crazy these drugs are!

 

And it does seem like you have a good system for measuring the liquid olanzapine.  It may not dissolve fully in water, but it will "suspend," so be sure and stir it vigorously with the pipette before drawing with the pipette - and draw it right away, while the liquid is still swirling.

 

I agree with Fresh, rinsing the glass with more water and drinking it might help, too.  Every little bit helps.

 

I hope you see the sun today!

[simack]

Thanks fresh and Jan, I'm going to try gradually cross tapering from solid to liquid, I have some 2.5 tablets left so I'll try that with 1.25ml liquid. Thanks again.

[simack]

Another update, all seems to be going well using a combination of 2.5mg tablet and 1.25ml liquid of olanzapine, however, last night after taking my dose and trying to sleep, I had the most unusual sense of tension in my legs, and a feeling of inner restlessness with an urge to get up and move. This restlessness was temporally relieved by turning over in bed only to have it occur again, ît happened about three times all up.

I'm a bit scared that I might be developing either akathisia or restless leg syndrome, I don't know if this is due to making the switch to liquid, but it seems that would be the case, now I'm not sure if I should continue what I'm doing, or go back to just using tablets, should I try liquid again tonight and see if it happens again? I'm pretty terrified of developing either akathisia or restless leg. Thanks

[Fresh]

What's been happening Simack?     I wish someone had an answer for you , I think if it were me I'd stay on the 

50/50 mix of tabs. and liquid and try again later.

Another option might be to just sit on the olanzapine for while and start tapering pristiq.  

?

[simack]

Hey fresh, I'm not doing all too bad at the moment, I think the restless leg/ akathisia worry was just that, it has settled down for now.

Medication wise I made a .1mg drop on the olanzapine over the weekend. Down to 3.65mg now. I slept well Friday night, had some higher anxiety Saturday afternoon, then slept like crap Saturday night, not sure if it's from the cut or the fact that it's summer. My anxiety has calmed down today and I'm going to try the 3.65mg again tonight and hope I get a decent sleep.

I know I should probably focus on the pristiq but I'm really struggling with the brain fog, memory issues and severe fatigue from the olanzapine/quetiapine, it's starting to really affect my work. Just wish I could be placed into a chemical coma for six months to get off these damn things

[Fresh]

I was just reading about tapering and someone brought up an interesting point about using

tap water . . . it may destabilize the medication.

Just a thought , probably best to use spring water. I'm wondering now if that's one of the

reasons people get symptoms when starting to make their own liquid.

[Fresh]

Missed the one hour EDIT deadline , grrr.

 

Distilled water is a more stable option than spring water   .