Scared I'm dying

[gcalex]

Yes I understand and I am not a huge fan of doctors either, I can match you story for story, but the answer to that is to find one you trust, to get a second opinion, or to ask enough questions until you are satisfied -- not to let health anxiety destroy your life the way it's doing.  You are engaging in all or nothing thinking a cognitive distortion -- just because a few bad doctors made mistakes does not mean all doctors are bad and always make mistakes. 

[sassparella]

Thank you for your replies. I do know I have to change my thinking. It's hard as I can't get the what ifs out of my head. I worry that if I stop worrying then something even worse will happen, my psychologist calls it superstitious thinking and I am trying to work on that at the moment. I don't want to carry on like this as it's ruining my life but it's such a struggle to overcome it. I feel that if I could just know I was OK I'd feel better, but I also know that this will never happen and is in itself faulty thinking. I'm also struggling to come off one of my medications at the moment and it is awful to the point that my psychiatrist is trying to convince me to stay on it just to avoid the withdrawal symptoms so it's hard.

Thank you again for your input.

[gcalex]

What med, what dose, what taper schedule.

[sassparella]

Zyprexa (Olanzapine) it's an antipsychotic given to me for anxiety. I also take Luvox an SSRI which effectively doubles the dose in my bloodstream. I went from 10mg to 7.5 to 5 a year ago then recently 5 to 2.5 to 1.25mg which I'm on now and then in six weeks have to stop completely. The drops were fine until the last one to 1.25 (which is effectively 2.5mg as it's double in my blood) where I have insomnia, and for a week had the feeling like something was crawling in my brain and rebound anxiety. It's getting a bit better now the crawling feeling is gone and the insomnia isn't as bad but I'm dreading the final drop to nothing as i've read that that is the worst drop of all.

[gcalex]

Yes because even though you are dropping smaller increments in PERCENTAGE terms they are the same size and the last one will be 100 percent by definition.  Do you live someplace where there is a compounding pharmacy that can make pills smaller than the commercial ones, that would be an option to slow the last drop down a bit.  A compunding pharmacy can make any dose at all, and insurance will cover it.  That's how I got off klonopin years ago.  There should be no rush while getting off a drug, the goal is to get off as comfortably as possible.  I am glad you are getting off it as it's a really heavy drug from what I know.  But consider that option, you could take the last stretch real slow. 

Is Luvox next or will you stay on it?

[sassparella]

There is no compounding pharmacist as far as I know near us. My psychiatrist wants me to just stop from the 1.25 so I'll see how I go.

I want to come off the luvox eventually but it won't be in the near future as my psychiatrist feels I still need it, but once I'm off the zyprexa (assuming I can get off of it) and stable I'll push to start reducing it. A lot of people from what I have read have bad reactions to coming off zyprexa even at tiny doses with a long taper, it's the stopping it completely that causes the problem. The symptom that is rare but happens that worries me is uncontrollable vomiting that only seems to resolve by taking the drug again or toughing it out for four weeks which can't always be done as the vomiting can be too severe.

[gcalex]

I would look into compounding pharmacies, there are mail order ones too I believe.  Failing that i would ask if the drug can be made as a solution, and failing that I would look into something called the water titration method.  People getting off benzos are very resourceful so I have read a lot about this in the day, and there are many ways to work around the commerical pill size limitations.  I mean you could go 1.25 1.0  .75 .5 .25 or something like that with a workaround.  Be assertive with your doctor.  The last thing you need is a mega side effect of withdrawal.

[sassparella]

Unfortunately my doctor is one of the many that feel there are no withdrawal side effects from this drug apart from maybe the insomnia. He feels that any withdrawal is just your previous condition coming back and that the sickness some get is from anxiety. So I'll just have to tough it out and hope that I'm not one of the ones with the sickness.

[gcalex]

http://beyondmeds.com/2008/05/14/water-titration-for-slow-and-controlled-psychiatric-drug-withdrawal/

This sounds harder than it is, but with a compounding pharmacy they would do all the work for you and just make up whatever size pills you need.  If there's a will i bet there is a way.  I really urge you to discuss this with your doctor, with your anxiety already high you need a good plan here or at least a Plan B if the drop proves too difficult.

[gcalex]

Unfortunately my doctor is one of the many that feel there are no withdrawal side effects from this drug apart from maybe the insomnia. He feels that any withdrawal is just your previous condition coming back and that the sickness some get is from anxiety. So I'll just have to tough it out and hope that I'm not one of the ones with the sickness.

That is a crock, any psychiatric drug can be hellish to withdraw from and atypical antipsychotics like zyprexa can be particularly nasty.  So typical of doctors it infuriates me.  How realistic is it to look for another doctor, I would not tolerate that attitude if there was an alternative.

[sassparella]

It's not really practical for me to look for a new doctor so I'm kinda stuck with this one. I think I'm just going to have to see how it goes and hope for the best.

[sassparella]

it doesn't help that i am getting so worked up for this last drop. I don't want to be stuck on this stuff forever.

[gcalex]

It sounds that way.  I am sorry you don't have a more enlightened and understanding doctor.  If it gets really bad, be insistent though.  Hopefully it won't.  I've been through it and feel for you.

[gcalex]

it doesn't help that i am getting so worked up for this last drop. I don't want to be stuck on this stuff forever.

You don't have to be, but you may have to withdraw more slowly.  If you get to the point where you can't come off, you will have to reassess your options.  But maybe it will not be so bad, try not to anticipate the worst.

[sassparella]

Thank you

[vardnas]

I'm with gcalex. There's a way to go about doing this that will make things easier. Tapering should NEVER be forced or rushed, and to jump from 50% to now you're looking at a 100% drop—that's HUGE. Don't force yourself to do it all at once, and don't worry that you'll be on it forever. You're pushing yourself into a damned if you do, damned if you don't scenario and that is probably not helping your overall anxiety, I'd imagine, too.

Maybe you answered this already, but do you not reasonably think that maybe your night sweats are due to withdrawal of this drug? That sounds like the most obvious culprit to me.

[sassparella]

I had the sweats before I started withdrawing from the drug or yes I would have considered it.

My psychiatrist is happy for me to do this drop but then he doesn't think there are any withdrawal symptoms from the drug. I don't really have an option as there are no compounding pharmacies near me and my psych wouldn't support it anyway. I'm basically stuck taking the 100% drop or staying on the drug and I want to get off it. Also the max dose for this drug is 30mg so I'm on a very low dose now we'll just have to see how it goes I guess..

[gcalex]

I wish you the best, hopefully it will go OK despite your doctor who should do some reading.  Ask him if you on an SSRI which he presumably prescribed for anxiety why your symptoms such as insomnia are attributable to return of anxiety and not drug withdrawal.  Ask him what evidence he has that symptoms during drug withdrawal are not from withdrawal.  Did a drug company rep tell him that?

[sassparella]

He did concede that rebound insomnia may be due to stopping the drug but ruled out any other symptoms. I asked him about other people that had come off zyprexa and he said he didn't really prescribe it much now (Why the heck did he give it to me then? o_O). I've just got to cross my fingers and hope I can bear the withdrawal.

[gcalex]

Ask him how many times he has withdrawn from Zyprexa, and if he is willing to take it then withdraw from it since there aren't any withdrawal symptoms.  I am so sorry you have to face this unnecessary obstacle, a know it all doctor.

[sassparella]

Thank you, I just have to try and not get too worked up about stopping in six weeks, it doesn't help my anxiety.