Posted by SLS on November 4, 2005, at 8:41:16
In reply to Weaning off zyprexa is aweful, posted by blueberry on November 3, 2005, at 3:54:42
I have had success discontinuing both SRI antidepressants and benzodiazepines using what has come to be called (by me :-)) a flexible-dosing strategy. However, I don't know with certainty that it would work when attempting to discontinue Zyprexa.
Before describing this silly idea of mine, let me pass on to you another idea that has been contributed by others. You can try using diphenhydramine, hydroxyzine, or promethazine to mitigate the withdrawal symptoms. These drugs have strong antihistaminic and anticholinergic effects. They should help.
For me, I would experiment and try a flexible dosing strategy. In short, it involves taking very small doses of Zyprexa several times a day. Once you feel the withdrawal symptoms appear, you simply take a small dose as if you were taking aspirin for a headache - sort of a PRN. You are better off taking smaller and smaller doses rather than fewer and fewer. This will happen automatically. Optimally, you choose to take the minimum amount of Zyprexa that will allow you to go perhaps 6-8 hours without withdrawal symptoms. Then, once the symptoms reappear, you take your next dose. You don't have to be precise with measurement. Any difference in dose amount will simply change the time until your next withdrawal episode. Flexibility allows for this. When you reach the point that no further reduction in dose amount is possible; that dose that will not allow you to go 4 hours until withdrawal symptoms reappear, you can discontinue the drug completely at this point. I have managed to discontinue Effexor 300mg in less than two weeks this way - more than once. I've also used it for other SRI antidepressants and the benzodiazepines lorazepam and clonazepam. Others have had success with this method.
You can find better explanations of flexible-dosing in the archives. Zyprexa does have a longer and more variable half-life than Effexor. You might want to experiment with the inter-withdrawal dosing periods by using slightly higher doses. However, I don't think that allowing more than 12 hours before withdrawal symptoms reappear would be optimal. I think you should dose at least 3 times a day. NO GUARANTEES. It couldn't hurt, though. Whatever you do, try not to allow the withdrawal syndrome to persist for more than an hour. I think that by doing so, it intensifies the withdrawal symptoms and extends the withdrawal period. I believe that kindling might be involved with this phenomenon.
I would try the symptom management approach first using one of the three drugs mentioned. Then, if you still feel the need to progressively taper your dosage, I would recommend using a flexible-dosing strategy.
I didn't mean to write so much. Forget the archives. If you have any questions, I'll try to answer them here.
Please let me know how you do.
Good luck.
:-)
- Scott
poster:SLS
thread:574817
URL: http://www.dr-bob.org/babble/wdrawl/20051018/msgs/575298.html