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Tried to come off olanzapine


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I've been on olanzapine (10mg) and sertraline for ten years. I decided to try and come off olanzapine because of the weight gain and basically felt chemically lobotomised. I reduced my dose to 7.5mg for four months and was fine (more energy and not hungry constantly). Then I went down to 5mg last November. But at the end of January I started to feel very unusual. I was having lots of flashbacks and finding it very hard to sleep.

Last month I went back to my GP and she wanted me to go back on 10mg but we compromised at 7.5mg.

Feeling a little better but having one or two rough days. Curiously on those days I'll be in pain for three to four hours with abdominal cramps. Bizarrely I'll feel like crying, start yawning and the pain passes which seems to repeat. Probably sounds ridiculous.

Tempted to go back on 10mg but heck it would feel like a defeat.
Antipsychotics have some really awesome off label benefits for a range of mental health issues. I’ve been on one myself for a long long time. Changing doses, or trying alternatives, is very often committing to a significant period of nasty side effects and intrusive symptoms.

And yeah, even at moderate doses, they can definitely make you feel like the walking dead!

That’s both a benefit and a problem. The same reason they help blunt emotions and make overwhelming emotions much more manageable, means that very often we spend a lot of time feeling nothing at all.

For disorders like ptsd, they can be helpful to get a person stable enough to do therapy, and spend some time learning skills to manage those overwhelming symptoms. Once you’ve learned those skills, then you’d start to slowly decrease the dose to switch from a medicated-holding pattern, to something much more functional, sustainable and med-free.

There’s a range of different antipsychotics that can help you achieve similar benefits (emotional blunting being a big one), and while your body may not tolerate the side effects so well with one type, you may find a different type gives the you benefits without the substantial side effects.

Your GP should be able to refer you for a blood test to test you genetically to find the types of antipsychotics that you personally should steer clear of, because of the likely high level of side effects they’ll give you. This has been available widely for a while now, and is very helpful for narrowing down the list of antipsychotics that you’re going to tolerate well.

Olanzapine was one of the ones I tried, and yeah, the weight gain for me was frightening! I did a blood test some years later and could have avoided that chapter altogether, because genetically, there was no way I would have avoided those side effects.

I now use quietiapine, on an extended release dose to help keep the side effects to a minimum. Which I tolerate really well.

This can start to become a bit outside a GPs expertise, so you might consider asking for a referral to a psychiatrist for the sole purpose of managing your medication.