Musiclover: would really like to find my way off meds but hard to imagine it

May 8

Hi everyone. I'm really glad to have found this site as I have been feeling very alone in my longing to get free of the trap of medication. So it's great to find a place where people are likely to understand. Here is my story:

I have been a relatively high-functioning person all my adult life. However at about age 61 I experienced the resurgence of a health phobia that had plagued me in my late teens but which I had somehow managed on my own to the point where it had ceased to be a problem, although it always lurked under the surface. For whatever reason, and there were probably several factors contributing including Covid and career/time of life issues, it came back with particular ferocity so that I was desperately anxious most of the time and not sleeping, which in turn led to feeling depressed and at times almost suicidal. The depression then took hold and affected all aspects of my life so that I was living in a nightmare most of the time, although I still managed to work and function somehow.

During this time I made several visits to my GP, with whom I had a good relationship, and he prescribed 30 mgs of Mirtazapine. I was very reluctant to go down the medication route as I've always been into alternative approaches and healthy eating/lifestyle but I was so desperate that I agreed to try it. It helped a bit but I still felt awful and wasn't sleeping properly. This went on for ages until another doctor referred me to the community psychiatric service and I saw a really nice psychiatrist there who put the dose of Mirt. up to 40 mg and also prescribed 2.5 mg of Olanzapine. She tried to put that up to 5 mg later on but I had a reaction to it so I stayed on the 2.5. This helped a little but it wasn't until her senior, again a really lovely man and very empathic and helpful, prescribed first Lexapro, which I had a fairly strong reaction to, and then Venlafaxine, that things started to improve.

The first psychiatrist had tried to get me to go on Lexapro but I was very afraid of Serotonin syndrome given I was also taking Mirtazapine. However again I was pretty desperate later on so I decided to try the Venlafaxine despite the risk, after holding out for a good few months. I have to say that it made a huge difference and I have been much better since going on it. in fact the combination of the 3 meds has worked well for me and has enabled me to sleep, to go away on holidays and generally to get back to enjoying my life. The problem is I am now dependent on them.

I am very health-conscious and hate being dependent on medication, mainly because of the side-effects. So last August I tried to come off the Olanzapine because I was worried about the potential of raising my cholesterol. I did this in consultation with the psychiatrist and he suggested going on half the dose for a week and then stopping. That was no doubt too abrupt (even though it is a small dose) because I started to feel anxious and depressed again with very negative thoughts so I went back on it.

I recently had routine blood tests done and all was well apart from the fact that there has been an increase in my cholesterol, which is not about what I eat because I am a vegan and very much on the 'Mediterranean diet' minus the meat, so I put it down to the Olanzapine. Again I would very much like to come off it and eventually to come off all the meds because I really don't want to be on them long-term, mainly because of the physical side-effects, which I haven't researched too much as that would set off my health anxiety - I tend to avoid Dr. Google as much as possible! I am no longer under the psychiatrist as I have been feeling so much better but neither he nor my GP (a new one, competent but young) has talked about coming off the meds at any stage. They probably see it as long-term or perhaps even for life! I really hope not..

So to wind up this possibly over-long post (sorry mods!), I am conflicted about tapering off. On the one hand I would dearly love to but on the other hand I am afraid of a resurgence of the depression and the horrible symptoms associated with that. Medication has really worked for me and I am afraid of losing the ground I have gained. On balance though, I do want to begin the tapering journey at some point because I want to re-claim my health and my body, and primarily at the moment, to get my cholesterol back to where it was prior to going on Olanzapine.

Many thanks for reading this!

May 9

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

This topic is for anything relating to you, and any questions you have. Please do not start another topic.

We recommend tapering by no more than 10% of your CURRENT dose each month, to limit withdrawal symptoms. E.g. 10mg --> 9mg --> 8.1mg --> 7.29mg

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

Here are a few of the most useful links:

--------Important topics in the Tapering forum and FAQ--------

Micro tapering

Why taper by 10% of my dosage?

Taking multiple psych drugs? Which drug to taper first?

How to make a liquid from tablets or capsules

Using a scale to weigh and measure doses

--------From the Symptoms and Self-Care Forums--------

What is withdrawal syndrome?

About reinstating and stabilizing to reduce withdrawal symptoms

The Windows and Waves Pattern of Stabilization

Hypersensitivity and Kindling

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

Regards

Erimus

May 9

You are on quite the cocktail of medication at the moment, which is completely overkill for anyone. It appears your psychiatrist has been practicing polypharmacy, which is unforunately all too common here. I would suggest you start by tapering the olanzapine.

Please read these topics, as well as the ones I posted above:

Tips for tapering off olanzapine (Zyprexa)

About going off mirtazapine plus venlafaxine (Effexor) aka "California rocket fuel"

Edited May 9 by Erimus

May 9

As far as I know there are no scientific studies showing that those drugs are beneficial in the long run. I am on Venlafaxine for over 18 years now and had last year a severe relapse of anxiety and depression (while not touching my dose). This should not be possible, if Venlafaxine was "the cure" to all my problems.

Another problem is that it is tremendously difficult to assess any positive effects of those drugs if you cannot simply quit them and thus have a "before and after" comparison several times. I am severely dependent on Venlafaxine and missing it for only 3 days sends me down to hell, while retaking it immediately restores me in a matter of several hours.

Furthermore Venlafaxine has nasty side effects in my case, numbing my senses and impeding my sleep. When I was off Venlafaxine for about 4 weeks lately, I slept like a baby and felt how my taste and other senses were returning.

If you should decide to try a taper, you should proceed slowly and carefully and always only reduce one drug at a time. Tapering carefully means trying little steps and seeing where they take you instead of sticking to some mathematically calculated plan. For example you could try in a first step to slowly get down to 0mg Olanzepine, 37.5mg Venlafaxine and 7.5mg Mirtazapine. This would already take quite a lot of time, probably years if you proceed carefully. Mirtazapine is a sedative drug and might help you protect your sleep during tapering and withdrawal. It might be helpful to tackle Mirtazapine last. Venlafaxine is very activating and it's hard to understand why doctors prescribe you one drug to get you "up" and at the same time one that gets you "down". Since Olanzepine seems to have serious adverse effects on you, it might be your tapering priority.

May 9

Thanks very much folks for your helpful posts. Lots to think about and read. Yes, starting with the Olanzapine makes a lot of sense and making my way down with the other two, eventually. I told my partner last night about my intention to come off the meds over time and she was worried because the worst of what I went through was highly traumatic for her as well as for me. She stood by me through it for which I will be eternally grateful but it was a living hell for both of us. I really don't want to go back to that.

No guarantees on the Venlafaxine I know. Still, I have no doubt that it has worked for me and has literally given me my life back. Sure, that could probably all dissolve if I was hit by another episode but I am grateful for its help thus far. Sorry that you had such a nasty relapse last year Alfred1977 but also interesting to hear that there is no real evidence of long term benefits. Thankfully my sleep is ok on it but I have completely lost any interest in sex and I also get some pretty bad night sweats, and extremely vivid dreams. What it's doing to my poor old brain, aside from keeping the depths of depression/anxiety at bay, I dare not think about..

Polypharmacy, yes indeed but he came into the picture long after I was already well established on the Mirtazapine and Olanzapine and felt that an SSRI or SNRI would be more helpful. He has suggested coming off the Mirt. but was worried about my reaction to coming off Olan. So he suggested I go back on it. The combination of M. and V. (my abbreviations are getting shorter!) is quite well known I think - 'California rocket fuel', the upper to ward off depression and anxiety and the downer mostly to help with sleep, in my case anyway.

Anyway, it's all a bit of a mess and I think once I do decide to taper I will be on my own with it because everyone around me thinks I should stay on the meds, given how abominable my life had become without them. Still, I could do with some support in this endeavour.

Thanks again for the advice and links. I will peruse all over the next while.

Just one thing - so if I do start to taper I should still post everything in this thread rather than in the tapering forum?

May 10

22 hours ago, Musiclover said:

Just one thing - so if I do start to taper I should still post everything in this thread rather than in the tapering forum?

Yes, this is the thread for you to post about yourself. The tapering thread is orientated around guides for tapering.

May 10

20 minutes ago, Erimus said:

Yes, this is the thread for you to post about yourself. The tapering thread is orientated around guides for tapering.

Ok thanks for that.

Just one more question at the moment. When I tried to come off Olanzapine last August I seemed to be fine on half the dose, i.e. 1.25 mg, which I went down to straight away and was on for a week before stopping completely. It was only then that I started to feel bad. Would it be ok to start with the same reduction again and then slowly taper from there? Or am I asking for trouble that way?

May 10

1 hour ago, Musiclover said:

Just one more question at the moment. When I tried to come off Olanzapine last August I seemed to be fine on half the dose, i.e. 1.25 mg, which I went down to straight away and was on for a week before stopping completely. It was only then that I started to feel bad. Would it be ok to start with the same reduction again and then slowly taper from there? Or am I asking for trouble that way?

There is no tapering plan or rule that applies to everybody. Some people cold turkey a drug and are perfectly fine, others reduce by 15% and get trouble. You need to try, observe yourself (and give time for this observation) and find your own way. Two things however are important to know, I think:

1) Some unlucky folks experience a delayed onset of withdrawal when they reduce their dose. For example, they cold turkey, think they are fine and 3 months later withdrawal kicks their door in. I guess this is rather the exception and not the rule. But it is a good reason not to go overboard with speed.

2) At lower doses small changes of dose cause large changes of effect. This is supposed to apply to almost all psychotropic drugs. For example, 75mg Venlafaxine cause around 80-85% receptor occupancy in your brain, 25mg Venlafaxine cause around 70% receptor occupancy and at 5mg you still got around 40% receptor occupancy. Those numbers vary individually, but you get the picture. Handling the low doses is key to get off those drugs smoothly.

May 10

23 minutes ago, Alfred1977 said:

There is no tapering plan or rule that applies to everybody. Some people cold turkey a drug and are perfectly fine, others reduce by 15% and get trouble. You need to try, observe yourself (and give time for this observation) and find your own way. Two things however are important to know, I think:

1) Some unlucky folks experience a delayed onset of withdrawal when they reduce their dose. For example, they cold turkey, think they are fine and 3 months later withdrawal kicks their door in. I guess this is rather the exception and not the rule. But it is a good reason not to go overboard with speed.

2) At lower doses small changes of dose cause large changes of effect. This is supposed to apply for almost all psychotropic drugs. For example, 75mg Venlafaxine cause around 80-85% receptor occupancy in your brain, 25mg Venlafaxine cause around 70% receptor occupancy and at 5mg you still got around 40% receptor occupancy. Those numbers vary individually, but you get the picture. Handling the low doses is key to get off those drugs smoothly.

Ok great, thank you. Given what you say it's possible that what I experienced was a slightly delayed withdrawal to coming down the half dose rather than when I stopped completely. No way of knowing for sure though. I guess I'll have to see what happens but I won't be doing anything until I discuss it with my GP, although he may or may not know about, or have any sympathy with, the whole notion of tapering.

May 10

2 hours ago, Musiclover said:

Ok thanks for that.

Just one more question at the moment. When I tried to come off Olanzapine last August I seemed to be fine on half the dose, i.e. 1.25 mg, which I went down to straight away and was on for a week before stopping completely. It was only then that I started to feel bad. Would it be ok to start with the same reduction again and then slowly taper from there? Or am I asking for trouble that way?

We suggest no more than 10% of your current dose a month. It's better to reduce by smaller amounts in order to see how your body reacts. Please read all the links I posted above about tapering, and how to prepare custom doses. I would suggest your first reduction is 10% down to 2.25mg.

May 10

Yes I understood that about the 10% and I have been reading through the links. It was just that I seemed to manage the half-dose ok before so I was wondering about it in my case. However, better to be safe than sorry I suppose. It's just that I would really like to get off Olan. soon and re-gain control over my cholesterol levels, though I must say they are only a little above what they should be but still going in the wrong direction!

May 10

On 5/8/2024 at 4:03 PM, Musiclover said:

Hi everyone. I'm really glad to have found this site as I have been feeling very alone in my longing to get free of the trap of medication. So it's great to find a place where people are likely to understand. Here is my story:

I have been a relatively high-functioning person all my adult life. However at about age 61 I experienced the resurgence of a health phobia that had plagued me in my late teens but which I had somehow managed on my own to the point where it had ceased to be a problem, although it always lurked under the surface. For whatever reason, and there were probably several factors contributing including Covid and career/time of life issues, it came back with particular ferocity so that I was desperately anxious most of the time and not sleeping, which in turn led to feeling depressed and at times almost suicidal. The depression then took hold and affected all aspects of my life so that I was living in a nightmare most of the time, although I still managed to work and function somehow.

During this time I made several visits to my GP, with whom I had a good relationship, and he prescribed 30 mgs of Mirtazapine. I was very reluctant to go down the medication route as I've always been into alternative approaches and healthy eating/lifestyle but I was so desperate that I agreed to try it. It helped a bit but I still felt awful and wasn't sleeping properly. This went on for ages until another doctor referred me to the community psychiatric service and I saw a really nice psychiatrist there who put the dose of Mirt. up to 40 mg and also prescribed 2.5 mg of Olanzapine. She tried to put that up to 5 mg later on but I had a reaction to it so I stayed on the 2.5. This helped a little but it wasn't until her senior, again a really lovely man and very empathic and helpful, prescribed first Lexapro, which I had a fairly strong reaction to, and then Venlafaxine, that things started to improve.

The first psychiatrist had tried to get me to go on Lexapro but I was very afraid of Serotonin syndrome given I was also taking Mirtazapine. However again I was pretty desperate later on so I decided to try the Venlafaxine despite the risk, after holding out for a good few months. I have to say that it made a huge difference and I have been much better since going on it. in fact the combination of the 3 meds has worked well for me and has enabled me to sleep, to go away on holidays and generally to get back to enjoying my life. The problem is I am now dependent on them.

I am very health-conscious and hate being dependent on medication, mainly because of the side-effects. So last August I tried to come off the Olanzapine because I was worried about the potential of raising my cholesterol. I did this in consultation with the psychiatrist and he suggested going on half the dose for a week and then stopping. That was no doubt too abrupt (even though it is a small dose) because I started to feel anxious and depressed again with very negative thoughts so I went back on it.

I recently had routine blood tests done and all was well apart from the fact that there has been an increase in my cholesterol, which is not about what I eat because I am a vegan and very much on the 'Mediterranean diet' minus the meat, so I put it down to the Olanzapine. Again I would very much like to come off it and eventually to come off all the meds because I really don't want to be on them long-term, mainly because of the physical side-effects, which I haven't researched too much as that would set off my health anxiety - I tend to avoid Dr. Google as much as possible! I am no longer under the psychiatrist as I have been feeling so much better but neither he nor my GP (a new one, competent but young) has talked about coming off the meds at any stage. They probably see it as long-term or perhaps even for life! I really hope not..

So to wind up this possibly over-long post (sorry mods!), I am conflicted about tapering off. On the one hand I would dearly love to but on the other hand I am afraid of a resurgence of the depression and the horrible symptoms associated with that. Medication has really worked for me and I am afraid of losing the ground I have gained. On balance though, I do want to begin the tapering journey at some point because I want to re-claim my health and my body, and primarily at the moment, to get my cholesterol back to where it was prior to going on Olanzapine.

Many thanks for reading this!

Hi @Musiclover... I am a music lover myself! My husband is a musician, and I have been playing the piano since my teen years. It's very therapeutic!

Only you can decide whether or not to taper your meds, and only you can decide when the time is right. I would suggest taking a very hard look at why you ended up on them in the first place, deeply examine and deal with any issues that pop up, and to develop some non-drug methods of coping with stress and anxiety before starting your taper, if you can. I started that process about 6 months before I started my taper, and it has been extremely helpful to have those tools to call on during the tough times. If we don't examine what got us here in the first place, I think we are putting ourselves at risk of ending up back on the drugs, and that's not something we want, given the effort it takes to safely discontinue them. In my case, I have a lot of unresolved trauma. I don't think I was ever depressed in the classical sense- I just had trauma, and very poor coping skills. I'm working hard to resolve these issues.

I, too, am a very health conscious vegan. My concern for my long term health is one of the reasons that I have decided to do a proper slow taper, and get off of these drugs for good. I started seeing some odd things in my bloodwork over the last couple of years- elevated cholesterol and liver enzymes, when there is absolutely no reason for it, given my lifestyle and family history. My doctor is not concerned, but I was concerned enough to look into it a bit more. After some research, I'm starting to see that these drugs affect ALL body systems, not just the brain, and they could be responsible for the changes I have observed. I also have long covid, and truly believe that my nervous system will never fully heal from that as long as these drugs are in my system. Scientifically, there is no evidence of this, but given the overlap between long covid symptoms and withdrawal symptoms, it does make sense on some level. I, too have unpleasant side effects that I have been experiencing for 30 years, and I just want my body to have a chance to heal.

I know you don't like consulting Dr. Google, but there are great articles linked on this site to help you understand how these drugs are affecting you. Make sure you are fully informed in order to make the best decision for yourself. Wishing you happiness and healing! ❤️‍🩹

May 10

1 hour ago, Musiclover said:

It's just that I would really like to get off Olan. soon and re-gain control over my cholesterol levels, though I must say they are only a little above what they should be but still going in the wrong direction!

Some adverse effects of drugs can require urgent action and a fast or immediate quitting. You or your GP will have to decide how urgent and important reducing your cholesterol is. Maybe there are other things you can do for your cholesterol to buy you time (diet change, exercise)? Maybe only reducing Olan will already help with the cholesterol. There are a lot of variables to consider when making such decisions...and in the end only you can decide. Regardless of all other things, if tapering a psychotropic drug is your only concern, it's best to keep it slow.

May 11

Thank you Catwoman73 for sharing your story and for your suggestions. I am actually a guitarist and composer, although I make my living in the mental health field - soon to retire! I hear what you say about looking at the issues that led us into the vicious circle of medication in the first place. I have been in various forms of therapy many times, though I am not currently in it. When things were at their worst I tried a couple of approaches, both for quite a long time, and although the therapists were lovely and very skilled, it didn't help with the anxiety and physical symptoms I was getting. That's not to say that it wouldn't be useful to talk to someone again, I may take that step at some point. However I would say I am fairly self-aware and have worked a lot on my own childhood trauma, though of course there could always be more. This depression was like a physiological attack though, as if my brain went into overdrive somehow. Hard to explain it though I'm not sure it was accessible through talk therapy and yes I know there are approaches which are not about talk.

Good to hear from another 'health-conscious vegan' and to hear how the drugs really can affect our bodies' various systems in undesirable ways. A rise in cholesterol is a known side-effect of Olanzapine of course but I have no doubt there are many others, especially being on this cocktail of 3 medications. I have not read the PILs that go with them, nor have I researched the side-effects online as that would only ramp up my health anxiety which is why I have to be careful about Dr. Google. It is enough to know that the side effects are numerous and can be egregious. However I will read the articles and resources here, albeit judiciously.

Good advice again thank you Alfred1977. Yes I am waiting for a call-back from my GP to discuss the blood results and to what extent I need to be concerned about the cholesterol. All he said in his text about the results was that it was 'slightly raised' and that I should consider going on the Mediterranean diet. He doesn't realise that I already eat that way, for the most part anyway. I need to ask his advice given that scenario, i.e. as Catwoman73 says given the fact that the rising levels do not make sense given my lifestyle. Bloods from the years before I started on meds always showed a low total with a good balance between LDL and HDL. Now the LDL and total number are on the rise.

Yes I would hope that reducing the dosage of Olan. might positively impact the cholesterol although what little research I have done suggests that any dose can have the opposite effect, even a very small one. I am taking plant sterols, green tea etc. to try and mitigate the increase and I also take daily exercise but I think ultimately stopping is the best way forward. I get that doing it slowly is what everyone here advises.

Thanks again folks for your very helpful input!

May 13

On 5/10/2024 at 8:56 PM, Musiclover said:

Yes I understood that about the 10% and I have been reading through the links. It was just that I seemed to manage the half-dose ok before so I was wondering about it in my case. However, better to be safe than sorry I suppose. It's just that I would really like to get off Olan. soon and re-gain control over my cholesterol levels, though I must say they are only a little above what they should be but still going in the wrong direction!

It will be just as quick, and less painful, to taper following the guidelines set out here. Antipsychotics are very strong drugs and need to be tapered with upmost care and caution.

May 13

2 hours ago, Erimus said:

It will be just as quick, and less painful, to taper following the guidelines set out here. Antipsychotics are very strong drugs and need to be tapered with upmost care and caution.

Ok, that's good to know. Would you say that even 2.5 mg is very strong?

I have been reading through all your links and articles and getting ready to launch a careful taper. Hopefully I will be informed enough to do it 'right', if there is such a thing.

Thanks again.

May 13

Hi, @Musiclover!

I going through all your posts since I recieved my last blood panel last saturday and I found my LDL is on the rise. I not sure if the measure units are the same worldwide, but here the limit are 130 for people with good heart condition, mine is at 137. Before that, my LDL was at around 120. Considering the polypharmacy with three antipsychotics, it was pretty good. Ten years ago it was as low as 50. I'm not sure why it is on the rise even now that I'm tapering my last drug (at the moment I'm down to 18mg of quetiapine, from 50mg ). It has some similarities with olanzapine, but why when I was in both my LDL was "good"? Maybe cumulative time of exposure? Another theory is the change from XR to IR, maybe it "shifted" something in the receptors.

Yesterday I was talking to my wife and remembering of a bad side effect of amisulpride (socian) and we checked out my old prolactine levels (a well know side effect). I'm sharing with you the graph of the evolution, just to explain our theory (I know is totally anecdotal). The first dot shows when I was on 100 mg, then I was downed to 50 mg and my ex-doc put me on some kind of drug to counteract the side effect. Between the last two results, in January-2020, I had a result of 38.40, which I don't know why is not appering in the graph of the lab app. This was my result when I was on only half of the tiniest pill (25mg). My ex-doc even made me go through an MRI to check for some "cancer", since even below the tiniest pill available, I was with the results, and of course feeling what it causes on our body. At some moment by the end of 2020 amisulpride was discontinued. And the last result shows a normal result. What I want to explain here is that even at lowest dose, some side effects can persist. If we check the hyperbolic curve, maybe we can kind of understand why. Even at lower doses, the concentration of the drug on our body is high, specially at certain receptors, in the caso of drugs like quetiapine and olanzapine.

I know it's kind of 'bro-science', but I'm trying to use this to make me more calm since I'm afraid of taking any new drug due to all side effects I always had in my life with almost any drug.

Another thing is that last month I had some bad viral infection that wife brought home from her job. Maybe infection could led to raise of cholesterol levels? On the other hand, my blood sugar level is fine in the last three tests I had in the last year.

May 13

2 hours ago, Musiclover said:

Ok, that's good to know. Would you say that even 2.5 mg is very strong?

Yes. Just because the number is small it does not mean the drug is not strong.

May 13

Hello, just having a little browse of your thread. It’s good that you are learning all about tapering before trying again. Your system will already be sensitised because of the previous failed taper so it is most important you follow the SA guidelines if you want to stay well.

I suggest you print off and take a copy of these guidelines about tapering when you go to see your GP. He will most likely be completely unaware of them and since he’s young he may well be very interested in learning about them.

Take it slowly and you will most likely stay well, do anything faster and all bets are off, you risk getting very ill. When I first started my taper (after a few failed attempts) I used to read many distressing thread on here (sadly so many are) and it really helped me to stick to the plan. After 3 years the end is nearly in sight, about 18 months to go (I only have mirtazepine to do thank god!) and things get better every week.

You will need to address the issues that caused you to be prescribed this medication in the first place, if you haven’t already done so. I have found this whole process of taking and trying to get off mirtazepine has finally taught me what looking after myself means. I do now feel confident I can stay well ☺️

May 13

4 hours ago, Erimus said:

Yes. Just because the number is small it does not mean the drug is not strong.

I suppose I meant the dose is relatively small so I thought that might translate to the overall 'strength' of the medication in terms of its effect on my system but I get what you are saying and you have answered my question thanks.

Thank you snowdog for the 'bro-science'! Very interesting and it does support your point about small doses still having a strong impact. My LDL is 3.11 mmol/L which is under 130 so it's ok but borderline. However I want to take action before it goes any higher because that has been the trend over the last few years. I'm sure there are several factors that influence the levels, including age in my case, but I have little doubt that the Olanzapine is the culprit. My doctor is ill himself at the moment so I am still waiting to talk to him. Hopefully he will have some advice on the best way to proceed in terms of managing the chol. anyway while I (hopefully) go through my taper.

Thanks for the link Faure, yes I think he may well be interested as he seems quite receptive and 'into' the science but I will have to see how he responds to the whole idea of coming off the meds. I don't necessarily need him to be on board but it would certainly help if he was. Good to hear that things are going well for you and that the end is in sight. If I had known how difficult it would be to come off these medications I would have been much more reticent to go on them in the first place, though I'm not sure I really had much choice as things were extremely dark. Yes I will be careful and will take it slowly and listen to my system as I go. I am putting off starting until I have read through the materials here so that I am as informed as I need to be. There's a lot to get through and fitting it around work etc. is taking some time!

I would address the underlying issues if I knew how but I've done literally years of therapy in the past and as I said the therapy I had during the worst of this episode didn't help, apart from having a listening ear. I think it was a mix of unresolved past trauma and time of life / career issues but I don't really know. I too know how to look after myself and have left no stone unturned in that regard, as far as I am aware anyway. Of course my psychiatrist's response when I said to him that I probably still needed to deal with the underlying issues was "maybe you just have a tendency towards depression". He meant it well, to make me feel less self-blaming and he is a good guy but it was the medical model talking - i.e. just my 'condition'!

May 13

48 minutes ago, Musiclover said:

I suppose I meant the dose is relatively small so I thought that might translate to the overall 'strength' of the medication in terms of its effect on my system but I get what you are saying and you have answered my question thanks.

Thank you snowdog for the 'bro-science'! Very interesting and it does support your point about small doses still having a strong impact. My LDL is 3.11 mmol/L which is under 130 so it's ok but borderline. However I want to take action before it goes any higher because that has been the trend over the last few years. I'm sure there are several factors that influence the levels, including age in my case, but I have little doubt that the Olanzapine is the culprit. My doctor is ill himself at the moment so I am still waiting to talk to him. Hopefully he will have some advice on the best way to proceed in terms of managing the chol. anyway while I (hopefully) go through my taper.

Thanks for the link Faure, yes I think he may well be interested as he seems quite receptive and 'into' the science but I will have to see how he responds to the whole idea of coming off the meds. I don't necessarily need him to be on board but it would certainly help if he was. Good to hear that things are going well for you and that the end is in sight. If I had known how difficult it would be to come off these medications I would have been much more reticent to go on them in the first place, though I'm not sure I really had much choice as things were extremely dark. Yes I will be careful and will take it slowly and listen to my system as I go. I am putting off starting until I have read through the materials here so that I am as informed as I need to be. There's a lot to get through and fitting it around work etc. is taking some time!

I would address the underlying issues if I knew how but I've done literally years of therapy in the past and as I said the therapy I had during the worst of this episode didn't help, apart from having a listening ear. I think it was a mix of unresolved past trauma and time of life / career issues but I don't really know. I too know how to look after myself and have left no stone unturned in that regard, as far as I am aware anyway. Of course my psychiatrist's response when I said to him that I probably still needed to deal with the underlying issues was "maybe you just have a tendency towards depression". He meant it well, to make me feel less self-blaming and he is a good guy but it was the medical model talking - i.e. just my 'condition'!

The numbers are arbitrary, in the sense that 2.5mg of olanzapine could be equal in strength to 100mg of sertraline.

Like how the starting dose of sertraline in the UK is 50mg, fluoxetine is 20mg, citalopram is 10mg, and so on. Each of those SSRIs are expected to have similar strength at their start dose, but the numbers are all different.

May 13

Yes I am aware that Olanzapine only goes up to 20mg and I am on 150mg of Venlafaxine so I understand that they are all different in terms of how their potency is measured. Still, I am on the lowest/starting dose of Olan. Which doesn’t mean it isn’t having a strong effect at the same time.

May 13

You might like to read this user's thread. They have also tapered from a multi drug cocktail using the advice here, with great success.

May 13

The relation between dose and effect for psychotropic drugs is supposed to be nearly always hyperbolic - as explained for example in this paper for antidepressants:

https://markhorowitz.org/academic-paper/tapering-of-ssri-treatment-to-mitigate-withdrawal-symptoms/

This means that psychotropic drugs are disproportionately stronger at lower doses. We tend to think the drugs effect decreases linearly with dose, but it doesn't.

On 5/10/2024 at 7:51 PM, Alfred1977 said:

At lower doses small changes of dose cause large changes of effect. This is supposed to apply to almost all psychotropic drugs. For example, 75mg Venlafaxine cause around 80-85% receptor occupancy in your brain, 25mg Venlafaxine cause around 70% receptor occupancy and at 5mg you still got around 40% receptor occupancy. Those numbers vary individually, but you get the picture. Handling the low doses is key to get off those drugs smoothly.

That's what I tried to explain here. Many people fail at the low doses because they seem easy to quit and are in fact hard.

May 13

10 minutes ago, Erimus said:

You might like to read this user's thread. They have also tapered from a multi drug cocktail using the advice here, with great success.

Excellent thank you. I really appreciate all your help and input.

5 minutes ago, Alfred1977 said:

The relation between dose and effect for psychotropic drugs is supposed to be nearly always hyperbolic - as explained for example in this paper for antidepressants:

https://markhorowitz.org/academic-paper/tapering-of-ssri-treatment-to-mitigate-withdrawal-symptoms/

This means that psychotropic drugs are disproportionately stronger at lower doses. We tend to think the drugs effect decreases linearly with dose, but it doesn't.

That's what I tried to explain here. Many people fail at the low doses because they seem easy to quit and are in fact hard.

Again, many thanks. Yes that makes sense and it is good to be forewarned. Hopefully the guidelines address how to manage the taper at the lower doses.

May 13

Just now, Musiclover said:

Again, many thanks. Yes that makes sense and it is good to be forewarned. Hopefully the guidelines address how to manage the taper at the lower doses.

The basic principle is as follows: In order to decrease the drugs effect linearly (and thus smoothly), the dose changes need to decrease "exponentially". This means with each and every step your reduction is getting smaller. For example with the recommended 10% reductions: 2.5 -> 2.25 -> 2.025 -> 1.8225 -> ...

If you assume a holding time of a month for each step you would be at about 0.7 after 1 year.

But as I said, you can't plan it mathematically like that ahead of time. You will have to evaluate every single step and possibly adjust afterwards.

May 13

For the "endgame", see also here:

https://www.survivingantidepressants.org/forums/topic/27067-managing-the-endgame-taper/

May 13

Ok, great. I am getting the principle of this. Thanks for the link. What a mine of information this site is. I have only been a member for a few days and already I feel much more supported both by that information and by all the helpful input. 🙂

May 14

Sorry that I am behaving teacher-like. I probably somehow try to make something good out of my own chaotic situation and painful experience. Maybe I also feel people should get "educated" about those things since there is so little support and understanding "out there".

May 14

You have been given a whole boatload of valuable information above. It’s good to see so many members responding to your thread. This is somewhat unusual, especially so early on after your original post. I believe the reason for this great response is that it is rare to have someone come to this sight with so few years of being on these drugs and relatively little harm done from too fast tapering. You would be very wise to heed the warnings you have been given.

About Venlafaxine: 1) it is well-known to cause high-cholesterol and is one reason why some of us above 60 were told by our doctors to come off it. 2) It’s also well-known to cause high blood pressure and increased heart rate. This is one reason my cardiologist and heart surgeon suggested I lower my dose. I was on 75mg at the time. Your 150mg is a very large dose. Venlafaxine is one of the most potent antidepressants out there. 3) It is also well-known to be one of the hardest 2 antidepressants to withdraw from, if not the hardest.

Even though you may be triggered by reading about the side-effects of these medications, not reading the information could do you more harm.

@Erimus gave you some great links in the beginning of this thread regarding California Rocket Fuel along with tapering threads on your specific drugs. Please read these so you can make an informed decision. They are very important. Tapering mirt + ven can be very tricky since they affect one another.

I too am stunned that any doctor would prescribe any part of this drug cocktail to a 60+ year old person who has never been on antidepressants before … or even to a 60+ y/o in general. California Rocket Fuel is usually reserved as a last resort. Then an antipsychotic in the mix as well. You are on a very strong cocktail. At 60+, our liver, kidneys, and heart don’t function as efficiently as when we were younger. Sadly, all of these medications individually take a big toll on these organs, and even more so when combined with each other.

I’m sorry if this comes across as being too frank, but it makes me sick when doctors we trusted do something like this. I’m sorry this has happened to you. The good thing is that you are in a stable spot right now and can make a decision knowing what many of us didn’t know until it was too late.

Edited May 14 by FindRest

May 14

11 hours ago, Alfred1977 said:

Sorry that I am behaving teacher-like. I probably somehow try to make something good out of my own chaotic situation and painful experience. Maybe I also feel people should get "educated" about those things since there is so little support and understanding "out there".

You're not behaving 'teacher-like' - I have really appreciated your input. I also need to be judicious about how I educate myself around this issue. My health anxiety can easily get triggered by certain information, which is why I tend not to read the PILs nor research the ins and outs of the drugs on the internet. This may seem foolish to some but I know myself enough to realise I have to be careful. What is meant to inform can simply lead to an increase in distress.

FindRest, thank you for your frank post. I will reply in more detail later on when I am finished work.

May 14

11 hours ago, FindRest said:

You have been given a whole boatload of valuable information above. It’s good to see so many members responding to your thread. This is somewhat unusual, especially so early on after your original post. I believe the reason for this great response is that it is rare to have someone come to this sight with so few years of being on these drugs and relatively little harm done from too fast tapering. You would be very wise to heed the warnings you have been given.

About Venlafaxine: 1) it is well-known to cause high-cholesterol and is one reason why some of us above 60 were told by our doctors to come off it. 2) It’s also well-known to cause high blood pressure and increased heart rate. This is one reason my cardiologist and heart surgeon suggested I lower my dose. I was on 75mg at the time. Your 150mg is a very large dose. Venlafaxine is one of the most potent antidepressants out there. 3) It is also well-known to be one of the hardest 2 antidepressants to withdraw from, if not the hardest.

Even though you may be triggered by reading about the side-effects of these medications, not reading the information could do you more harm.

@Erimus gave you some great links in the beginning of this thread regarding California Rocket Fuel along with tapering threads on your specific drugs. Please read these so you can make an informed decision. They are very important. Tapering mirt + ven can be very tricky since they affect one another.

I too am stunned that any doctor would prescribe any part of this drug cocktail to a 60+ year old person who has never been on antidepressants before … or even to a 60+ y/o in general. California Rocket Fuel is usually reserved as a last resort. Then an antipsychotic in the mix as well. You are on a very strong cocktail. At 60+, our liver, kidneys, and heart don’t function as efficiently as when we were younger. Sadly, all of these medications individually take a big toll on these organs, and even more so when combined with each other.

I’m sorry if this comes across as being too frank, but it makes me sick when doctors we trusted do something like this. I’m sorry this has happened to you. The good thing is that you are in a stable spot right now and can make a decision knowing what many of us didn’t know until it was too late.

Ok so a lot to think about here and not an easy read, for me especially. That's not to say I don't appreciate your help - I absolutely do.

There's a trade-off between knowledge and sanity for those of us who suffer from health anxiety, and in my case the very real physical symptoms that go with the syndrome. The information that most people can appraise and digest constructively can all too easily lead to greater distress and obsessive worry, a downward spiral that leads to a very real place of despair. When I was really bad a few years ago, something simply had to be done. And no therapy or natural approach was going to cut it as I was extremely close to the edge. My family were very worried about me and I was in hell. So the meds seemed the only option, otherwise I was going to fall off the cliff. My doctors knew that and believe me they had to deal with my constant doubting and questioning regarding side-effects, combinations etc. Finally I gave in through sheer desperation and as I have said before the meds really did help and continue to.

I am not anti-medication however I am very aware of the harmful side-effects, I just don't go into the details for the reason I have already given. My GP and the few psychiatrists I have seen all advised me not to peruse leaflets or to consult Dr. Google, not out of a defensive position in relation the often-maligned medical approach but out of an awareness of where that could potentially take me.

So the 'frank' and alarming details of the possible harm to my body and organs - I need not to go there because I am stuck on these medications for a long time to come so it seems as tapering off them will be a very protracted process. Nothing I can do about that and if I dwell on the damage they're doing meanwhile, I'll be in trouble. Of course on the other hand I absolutely do need to go there as I need to be aware of the reality of what these drugs are doing and make informed decisions, so from that point of view I simply need to 'man up' and deal with the harsh and scary facts. Well in a sense that is what brought me to this site in the first place - a very real awareness that although I feel much much better on the meds and have been able to pick up and live my life again, staying on them is just too risky.

So I will try to find a way to deal with the anxiety that some of this information causes while at the same time not taking it all on. As I said in a previous post, it is enough to know that the effects can be egregious and that I need to start tapering and soon.

Once I get through that boatload of articles and threads that is.. 🤔 And of course after I have a chance to discuss with my young but kind and sincere new GP what he and I are going to do about the fact that the 'life-saving' drugs I am taking are probably slowly killing me.

May 14

@Musiclover

I am sorry that you are suffering so much from health anxiety. I was not aware of the extent of your problem.

10 minutes ago, Musiclover said:

fact that the 'life-saving' drugs I am taking are probably slowly killing me.

I am for over 18 years now on Venlafaxine... I feel totally dependent, my smell, taste and other senses are numbing, I have sleep issues and I think it rather destabilizes me mentally than doing any good...however... I don't think its killing me. My mother takes ADs for over 40 years now (not going into that, it's not been great either) and it didn't kill her.

I think there is a lot to gain by getting off that s**t...for example feeling, smelling and tasting normally again and not being afraid to travel since losing those capsules would send me down to hell within 3 days time...but if I am not able to come off, it won't kill me. I used to be happy during those 18 years and I will be happy again.

You will also be alright...it may take time, but somehow everything will be fine...

May 14

1 hour ago, Musiclover said:

And of course after I have a chance to discuss with my young but kind and sincere new GP what he and I are going to do about the fact that the 'life-saving' drugs I am taking are probably slowly killing me.

Technically we are all slowly dying. Don't fret about what harm the drugs might be doing. The reality is you are on them, but now you have the information to take back control of your health.

May 14

Thank you both for your kind reassurances. Most welcome. One thing I have learned from that dreadful few years is how to manage my mind and those obsessive thoughts better - I simply don't feed them with attention so I can stay 'on top' most of the time. Mindfulness I suppose. So although I do suffer from health anxiety, and one phobia in particular, it does not control my life anymore in the way it sometimes has. in fact I would say that these days I am living and functioning well and enjoying my life for the most part. I feel immensely grateful for this. Notwithstanding the fact that my healthier mental state is no doubt mostly due to the meds, which is why I do fear coming off them in case I go back to how it was. Yes I know I need to tackle the problems that brought me there in the first place in order to mitigate that possibility but that is far easier said than done as I don't think the problem is accessible to most forms of therapy.

I suppose I was being a bit dramatic before, although these medications and their side-effects could be described as potentially life-threatening. However I am very glad that I found this site and all the information available here as I sense it is going to enable me to take back some control as you say Erimus. I knew the time would come when I would have to look properly at the reality of taking the meds and find some way to get off them, even if it takes at least as long again as I have been on them.

Sorry to hear about your symptoms and loss of senses etc. Alfred1977 - that sounds rough. For me it has been mostly some bad night sweats, vivid dreams (which I quite enjoy actually) and a complete loss of sexual desire, which I don't enjoy at all! Thank you again for your kind words and I really hope you too find your way to that happiness you know you can experience.

Very best wishes to all. 😊

May 14

@Musiclover Thank you for your very thoughtful and eloquent response to my comments above. I appreciate you not going off on me when you very well could have, and maybe rightfully so. I too have health anxiety and I do relate to what you’re saying. You have some very valid points. I knew I was taking a risk of upsetting you, but like others here can attest to, trying to save someone from this hell seems to outweigh everything else. Not saying that is right. It’s just how this hard road leaves us, trying to protect others from going down the same path.

I’ve been on these drugs for over 35 years, Effexor XR since it came out on the market over 25 years ago. I had been told my brain wasn’t producing enough serotonin and , “like a diabetic needing insulin”, I needed antidepressants. They ruined my life. They saved me in the first few months, but after that I saw few benefits as they no longer worked. This led to increases in dosages, then changes back and forth, one antidepressant after another, antipsychotics added in here and there as well. Fast forward to 2019 when a psych CT’d me off Effexor after being on it over 20 years. I almost didn’t survive and don’t wish this hell on anyone.

You will be in a good position should you ever choose to come off of them. At a minimum, you know that if/when that time comes, there are safer ways to taper than going down to the minimum pharmaceutical dose produced or skipping days and the like.

I’m sorry if my words above harmed you in any way. I sincerely wish you the best, no matter what you decide to do.

FR

Musiclover: would really like to find my way off meds but hard to imagine it

Recommended Posts

Musiclover

Link to comment

Top Posters In This Topic

Top Posters In This Topic

Popular Posts

Alfred1977

Erimus

Erimus

Erimus

Link to comment

Erimus

Link to comment

Alfred1977

Link to comment

Musiclover

Link to comment

Erimus

Link to comment

Musiclover

Link to comment

Alfred1977

Link to comment

Musiclover

Link to comment

Erimus

Link to comment

Musiclover

Link to comment

Catwoman73

Link to comment

Alfred1977

Link to comment

Musiclover

Link to comment

Erimus

Link to comment

Musiclover

Link to comment

snowdog

Link to comment

Erimus

Link to comment

Faure

Link to comment

Musiclover

Link to comment

Erimus

Link to comment

Musiclover

Link to comment

Erimus

Link to comment

Alfred1977

Link to comment

Musiclover

Link to comment

Alfred1977

Link to comment

Alfred1977

Link to comment

Musiclover

Link to comment

Alfred1977

Link to comment

FindRest

Link to comment

Musiclover

Link to comment

Musiclover

Link to comment

Alfred1977

Link to comment

Erimus

Link to comment

Musiclover

Link to comment

FindRest

Link to comment