65 replies to this topic

[invalidusername]

I am with Hat on this one - that was the train of thought as Olanzapine has the benefit of the longer half life. But I need to do some maths to work out the doses... This should be fun!

 

BRB

[invalidusername]

WHERE WORTHY IS NOW

cymbalta 13.2 mg of dose from 60mg

mirtazapine 3.2 mg of dose from 15mg

zyprexa .72 mg of dose from 5 mg

 

WHAT WORTHY HAS LEFT

180 cymbalta left @ 60mg = 10800mg

100 mirtazapine left @ 15mg = 1500mg

90 zyprexa left @ 5mg = 450mg

 

PROPOSED WITHDRAWAL PLAN

Zyprexa 2 month withdrawal @ 0.72mg = 43.2mg, thus leaving 406.8mg

Mirtazapine 2 months hold, 4 months taper @ 3.2mg = 384mg, thus leaving 1116mg 

Cymbalta  6 month hold - 6 months taper @ 13.2mg = 2402mg, thus leaving 8398mg 

 

You have a lot more time to play with given the amount of meds you have left. As Hat has suggested, you should stay where you are until stable, so I would suggest that be a good 2 months - don't worry, you have time for this. But we also need to leave some of the meds left over in case they are needed to go back a little if you hit a tough spot, so creating a taper plan to run out at the end is not what is done. You need to allow for issues along the way. 

 

Hope you are with me so far.

 

If we stick to the doses we have and work it out based on taking the same amount each day (ignoring the 3% drop, that will mean we have plenty of our "rescue supply". Even with that, we can lengthen your withdrawal somewhat.

 

FINAL PROPOSED PLAN

2 months to stabalise with 10% increase across all.

Cymbalta to 14.5mg (870mg)

Mirtazapine to 3.5mg (210mg)

Zyprexa to .80mg (48mg)

 

After 2 months this will leave you with;

Cymbalta = 9930mg

Mirtazapine = 1290mg

Zyprexa = 402mg

 

Then withdraw Zyprexa over 4 months (assuming no taper) = 96mg... still leaves 300mg rescue.

Then withdraw Mirtazapine (4 months during above taper = 420mg, thus leaving 870mg), then 6 months withdrawal 

 

(assuming no taper) = 637mg, still leaves you 233mg rescue.

The withdraw Cymbalta (8 months during above taper = 3523mg, thus leaving 6406mg), then 8 months withdrawal 

 

(assuming no taper) = 3523mg, thus leaving 2883mg rescue (which you will probably need)

 

IN SUM

1. Increase doses by 10%

2. Stabalise for 2 months

3. Withdraw Zyprexa for 4 months

4. Then withdraw Mirtazapine for 6 months

5. Then withdraw Cymbalta for 8 months - but expect 12 months

 

You wouldn't get that from a doctor!!

 

PHEW!!!! You want to check that Hat

[fishinghat]

IUN - Absolutely a great job. Perfect. That gives her plenty of time to hold every now and then if things get too bad. Super job.

[invalidusername]

Thanks Hat. Always need a second look over...

 

Let the fun commence!

[Wagtail]

OK, worthy, I have posted information on the PM you sent me but for the purposes of helping others in the future I will copy that info to this thread so it can possibly help others. We can then do our communications on this thread for all to see. 

Thank you so much Fishinghat, this poor person needed expert advice & this group & you were my first thought .

Hopefully we can help . 
your advice is excellent...

[invalidusername]

Hi Wagtail - good to see you again...

 

Did you recommend Worthy to speak with us? So glad that you did. What they have been through is nothing short of horrific. But the plan we have put together along with supplementation should see them through.

 

It is shocking how little support there is available to most...

[worthy]

Thank you so much for this. It is going to be a lot quicker than I expected which is really good news. I am pretty suicidal at the moment so not sure if I should start the olanzapine taper straight away. My little grandson has had major surgery (liver transplant) a few days ago so I am also hugely stressed. You do say slower is best and this is the fastest you would even try. How will I know if I am going too fast? My symptoms are pretty severe now so I hope they will not get worse. I will do my best to get one of the prescription drugs you mention but don’t know if they will be available in Zimbabwe. Can you explain why these could help?

I sincerely hope I won’t have to re instate any of these drugs at a later stage but will be sure not to throw anything away.

[worthy]

Sorry I did not read invalid usernames post before replying. I see younrecommend holding for 2 months and then start tapering. I will do this. I really do appreciate your help and look forward to working with both of you on this difficult journey.

[fishinghat]

Glad to help Worthy. IUN also suggested to go back up a little on each dose so you would stabilize quicker and that would be fine. I suggested just waiting wait 2 months and and letting yourself settle down before starting your olanzapine wean.  Either way is good.

 

Clonidine blocks the signal from the brain telling the adrenal gland to produce less adrenaline. thus your anxiety decreases. The hydroxyzine is an antihistamine that effects the histamine 1 receptors and that produces the calming effect. Neither has a withdrawal. 

L-theanine is converted to glutamate (involved in the synthesis of GABA) and glutamine. It can cross the blood brain barrier. Both are used by our bodies to stabilize the receptors on our nerves.

 

You might want to look over our ebook at this link.

 

https://www.cymbalta...tion-the-ebook/

 

It contains what people have tried, their comments, medical research, diet, treatments. and much more. Feel free to ask any questions. we are here to help.

[invalidusername]

Worthy...

 

Glad we could help to get you this far... and yes, please increase your doses by 10% (but no more). Going up too much can have the same effect as going down too much. But at the moment, your system can't deal too well with the speed at which you are going, so a little increase will help. It might take about 5-7 days to see the difference considering the longer half-lives, but you should start to feel better by next weekend. 

 

Once you have stabalised, we can consider some supplementation to help the journey too. But for now, let's get you through this first week and see how you go with the +10%.

 

Once change at a time so we can monitor.

 

Don't worry about what might or might now happen until its happened. You have a lot of stress (of which I am sorry to hear) - you don't need to increase it. Hat and I have been here years - we're not going anywhere!! We'll be here to help you all the way through.

 

IUN

[worthy]

Hi. Just a check,in. I am still feeling very suicidal and really have not noticed any relief. Finding this very hard and wondering if there is any hope for me. Would it be a very bad idea to take zopiclone sleeping tablets for try and help,me through the difficult weeks till I stabilize.

[fishinghat]

Zopiclone sure wouldn't be my first choice. It only works for a day or two, when it wears off you usually have a bad bout of anxiety and shouldn't be used if you are depressed. I would try a couple drops of liquid melatonin instead. If you decide to go this route then let me know the strength of it and I can recommend a dose to try.

[worthy]

I have tried melatonin before and it has not helped me. I went CT off zopiclone last year and that is why they thought I had depression and anxiety and put me on all these drugs. Would it help to increase the Ativan dose or would that just make it worse later

[fishinghat]

That would make it worse later. there is an important factor with melatonin. Any dose over 1 mg will make you sleep worse. A successful dose should be 0.7 mg or less. Melatonin like most sleep aides only work for a few days (usually 4 or 5) before your body adapts. You then come off it for a few days and it can be used successfully. Another important thing is that when one takes the right dose but in an extended release it will work but usually you are very groggy the next morning. The best use is the 0.7 mg or less dose placed under the tongue (called sublingual). It is held there until it is absorbed directly into the blood (usually 3 or 4 minutes). This gets it into the blood stream rapidly so you can go asleep and by the time you wake up it is out of your system and there is no remnant grogginess. 

 

If you can get access to clonidine or hydroxyzine they also work well for getting you to sleep.

[worthy]

Thanks so much. I have tried to get melatonin but no luck and can’t get clonidine or hydroxide either. Drugs are in very short supply in Zimbabwe. So will just have to persevere and hope it gets better. My family are wanting me to stop the olanzapine at my current dose as they believe it is causing my problems?? They say I am on such a low dose it should not make a difference.

[invalidusername]

Hat has steering you in the right direction with melatonin, but such a shame you don't have access to it.

 

People often misrepresent a low dose as not making much difference but they don't think in logarithmic terms. This is why we drop in % rather than mg. 

 

Do they have reasoning for their claim? 

[worthy]

They believe .68mg is a very low dose and not doing much. I have been tapering slowly all along. They believe zyprexa may be causing akasthisia. Apparently the drug was originally prescribed to boost the cymbalta.

[fishinghat]

They are right in the aspect that that low of a dose isn't helping but that is not the issue. The drop in olanzapine causes withdrawal, which is due to the lack of olanzapine in the body. Stopping now would only worsen your withdrawal. 

[invalidusername]

I'm with Hat on this one. Unless there is proof to the contrary, it wouldn't be wise to stop from that point.

[Wagtail]

Hi Wagtail - good to see you again...

 

Did you recommend Worthy to speak with us? So glad that you did. What they have been through is nothing short of horrific. But the plan we have put together along with supplementation should see them through.

 

It is shocking how little support there is available to most...

 

IUN , it’s wonderful to see all you regular angels still here helping the unfortunate victims of Drug Companies. 
IUN , you have given sound advice here & I thank you so much , it’s great to know that FH has someone else to help him after all these years .

yes , I did recommend this caring group to Worthy , there was no way that I had the expertise to help her so I told her to seek out FH which thankfully she has done . I will watch her progress with much interest. I’m still shocked at the mix of drugs that she was given ,it’s truly a crime . Hopefully with all the information you guys have given her , her withdrawal will be somewhat bearable .

Stay well all of you , you truly are all Gods Angels ...❤❤

[Wagtail]

They believe .68mg is a very low dose and not doing much. I have been tapering slowly all along. They believe zyprexa may be causing akasthisia. Apparently the drug was originally prescribed to boost the cymbalta.

Worthy , I’m so glad you’ve found the help you desperately needed . Follow their advice & they will get you through this , there are no better & more experienced people than this group .

Thinking of you & will watch your progress ....Good Luck ❤️

[worthy]

Thank you all. Advice taken and really hope I find some relief soon as going through really tough time at the moment

[fishinghat]

It is a shame you can't get ahold of any of those things we recommended. They are not cures but do usually help. Do try and focus on some of the do's and don't on that list, eg. no caffeine, low/no sugar, etc.

 

If you do have access to some cold medicines you might send me a list and I might be able to find something you can try. All I need is the brand name and its active ingredients. Do you have any access to supplements at all?

[worthy]

Sorry to post again but I have really deteriorated in the last few days. Have you heard of akasthisia. I am having all the symptoms of it and just don’t know what to do. Are you able to give me any advice on how to cope with it.

[fishinghat]

Akathisia and Tardive Dyskinesia are similar neurological syndromes. 

 

Considerable study has went into the cause and treatment of these conditions with few answers. Treatments are minimal at best. The strongest evidence is that it is typically a side effect of medication, especially antidepressants, antipsychotics, etc. The good news is that for most, but not all,  the symptoms disappear shortly after stopping the medication. There aren't any treatments that I can really recommend. There is a lot of information in the ebook on this as well as a review of some of the treatments.

[invalidusername]

Yes, as Hat says, there is a LOT of information in the eBook collated from the site and Hat's own research into ad-related movement disorders.

 

Odds are in your favour that it will pass in due course, but I know only too well how difficult it can be when you are in the thick of it. 

 

My depression has come back with a vengeance over the last 24 hours after significant stress. I know it will pass but right here, right now, I feel like a mess. You are never alone, worthy. 

[worthy]

I don’t think I can carry on with this akasthisia. It is destroying me. Is it likely to carry on till I have finished tapering. That will be at least 3 years on my current taper plan. I just don’t know what to do as feel like ending it all. Is there light at the end of this very long dark tunnel. Sorry to,post like this but I am feeling desperate

[fishinghat]

The akathisia would normally fade in an out as long as you are on an antidepressant and then for a few months afterward but it does vary. You really need to get some help with these symptoms from a dr. Some of the meds and supplements we mentioned could be significant help. I wish you had access to them.

[invalidusername]

I don’t think I can carry on with this akasthisia. It is destroying me. Is it likely to carry on till I have finished tapering. That will be at least 3 years on my current taper plan. I just don’t know what to do as feel like ending it all. Is there light at the end of this very long dark tunnel. Sorry to,post like this but I am feeling desperate

 

Worthy,

 

I want to share something with you after reading what you have said. I have had over three days of non-stop shaking, my legs are in so much pain from the muscle assertion. My breathing has been so shallow that my lungs are in equal levels of pain. Much like you, this bought back very dark times for me yesterday. I knew what I needed, but the ER wouldn't give me the drugs. I made it through the night by God's own intervention and got to my GP who let me self-prescribe what I needed. I know just how bad these things can be in just the shortest amount of time. But the right drugs WILL get you there, and akasthisia will come and go. 

 

What is the policy on importing supplements into your country? Is there no hope for you this route??

 

My thoughts are with you - come back as often as you need. We are always here for you.

[worthy]

So sorry to hear you are having such a hard time. I know just how awful it is and I really understand how you are feeling. Does this ever really go away even years after stopping the drugs. Can I ask what drugs you took or are taking.

It is not possible to import drugs into our country unless you are a licensed medical practitioner or pharmacist. Our country is ruled by a military dictator and it is not easy living here. It used to be a paradise but unfortunately was overrun 40years ago and has deteriorated ever since. It is our home and we have no claim or money to move anywhere else. It’s such a stressful,life here which does not help my symptoms.

When you are feeling a bit better I would like to ask a few questions on the tapering plan you worked out for me.

Sending good wishes for your healing