Posted by ed_uk on November 9, 2006, at 16:07:59
In reply to Re: Has anyone ever heard.....? » ed_uk, posted by ronaldo on November 9, 2006, at 10:18:47
Hi Ronaldo
Was the sole purpose of the olanzapine to help you sleep? After withdrawal from olanzapine, you may need addional medication to treat your condition. Symptoms appearing on withdrawal may fall into two categories.......
1. Withdrawal symptoms
2. Relapse of your underlying condition>I came off a course of 5 mg Olanzapine that I had been taking for just under 4 years in a matter of 4 weeks. Was this too hasty?
Yes, I think it was. The severe insomnia you suffered on withdrawal is evidence of this. It would almost certainly have been better to withdraw over a period of several months.
>Is the latter problem with the Seroquel and Zopiclone d/t coming off the Olanzapine too quickly?
When withdrawing from one drug, other drugs are not generally able to treat the withdrawal symptoms effectively unless they are very closely related to the drug from which you are withdrawing. The best solution is normally to taper more gradually. Of course, if your original condition recurs on withdrawal, it may not be possible to withdraw.
>Now, for my sins, I am on 10 mg of Olanzapine which gives me a dull depressed feeling so that I am once again anxious to come off it. How long should I take to do so?
I think you will be able to reduce your dose from 10mg to 7.5mg and then 5mg over the next few weeks. Once you are on 5mg, withdrawal may need to be much more gradual. I cannot predict a 'time scale' for your withdrawal because you will have to adjust your schedule depending on how you are feeling eg. withdraw more gradually if unpleasant symptoms appear. Do not force yourself to adhere to a strict withdrawal plan. You will need to adjust the rate of your withdrawal according to your symptoms.........both subjective symptoms and symptoms observed by others eg. unusual behaviour, hypomanic symptoms.
>Maudsley Psych. Pharm. Helpline, (0207 919 2999) told me (when I was on the 5 mg) that I should reduce to 2.5 mg for 2 to 4 weeks and then STOP.
Going from 2.5mg to zero is likely to be the most difficult step. You can cut the 2.5mg tablets in order to reduce your dose more gradually. I think it would be helpful to buy a tablet cutter. Olanzapine is very sensitive to light - tablets which have been cut must always be kept in the dark or else the olanzapine will degenerate.
>How would you recommend I should come off the 10 mg Olanzapine?
Get a prescription for a box of 7.5mg tabs, a box of 5mg tabs and a box of 2.5mg tabs. First, take 7.5mg in the evening. Stay on 7.5mg for a minimum of two weeks. Do not reduce your dose to 5mg unless you feel ok. If you do not feel ok, keep taking 7.5mg for a few more weeks until you *do* feel ok. At this point, you can reduce to 5mg. Again, stay on 5mg for at least two weeks. Do not attempt to reduce to 2.5mg until you feel ok on 5mg. If withdrawal symptoms appear, maintain the dose at 5mg until you feel normal again. This may take a few weeks. Once you are feeling OK, you can reduce to 2.5mg. Repeat the above process ie. not reducing your dose until you have been stable for a couple of weeks. From this point on, you will need to experiment a bit. You could try reducing to 3/4 of a 2.5mg tab, or maybe to 1/2 a tablet. It's up to you, and depends a lot on how easy or hard you have found the withdrawal so far. It also depends on how easy the tablets are to cut. Is it possible to cut the tablets into quarters? I don't know. I've never tried. You will need to practice! Whatever you do, do not attempt to rush the withdrawal. Rapid withdrawal never did anyone any good. Wanting to 'get the drug out of your system' is not an excuse to withdraw rapidly!
>They weren't wrong though the anxiety only appeared when I was off the Olanz. completely. Is this what they call 'rebound anxiety' and also 'rebound insomnia'?
Yes. Your original anxiety and insomnia are magnified on withdrawal, and can be worse than they were before you first started the drug. This is called a rebound.
>I have chronic flat affect or is it chronic mild depression?
The episode you described earlier (hallucinating and breaking into your neighbour's house) is evidence that your condition is more that 'just' depression. You may never receive a 'precise' diagnosis but I do think it would be helpful to concentrate on 'mood stabilisers' rather than antidepressants. I also think it is very important that you are monitered very regularly by your doctor during olanzapine withdrawal because if psychotic or manic symptoms appear, you may loose insight into your condition and require additional treatment. Before each dose reduction (of olanzapine), you should gain the advice of your doctor to ensure that you are OK to reduce further. If hypomania was to appear, you might be tempted to abrupty discontinue olazapine with potentially disasterous consequences.
Take care
Ed
poster:ed_uk
thread:700518
URL: http://www.dr-bob.org/babble/20061104/msgs/702078.html