Someday in the not-too-distant future, we hope med school will teach physicians how to help their patients with Zyprexa tapering. This alone could revolutionize the quality of mental health care.
There likely was a good reason for prescribing Zyprexa to a person mid-crisis. However, let’s now look at resolving the root causes that precipitated the crisis, and explore sane and non-toxic ways to regain mental health, beyond relying on harsh antipsychotic medications.
Does Your Diagnosis
Alternative to Meds has been successfully helping clients through antipsychotic withdrawal and tapering for about 20 years now. Our success is independently documented in published evidence. A client’s underlying issues can usually be sorted out without resorting to harmful prescription drugs. It may be found that some medical condition was not spotted and that contributing factors were not looked into at all before prescribing antipsychotic meds. Sometimes the diagnosis was not correct, and the person’s treatment plan lacked treatments that could have assisted the situation better.
This video details the journey of a young man diagnosed with bipolar and schizoaffective. His long spans of hospitalizations were dramatic and were leading towards institutionalization. His mom called ATMC, and we clearly heard the potential for a better outcome. We helped him get off of antipsychotics, get his diet adjusted, and get him physiologically cleaned out. He was stable and drug-free when he left and in the 10 years since has become an international speaker and author of multiple books
15 Years Experience by Professionals Who Understand Your Journey.
Zyprexa tapering (olanzapine) done properly aims to soften and largely eliminate troubling side effects of medication titration. Antipsychotic medications are considered some of the most challenging to stop. However, Alternative to Meds Center has found many effective treatments and strategies to help people feel good again, and become happily engaged in life, as a result of Zyprexa tapering done well. Please use the guidelines provided below as topics for discussion with your physician or other medical support and invite them to read the materials here which may be helpful. Nothing here is given as medical advice but only for the purposes of education and enlightenment about the protocols used at our center.
Zyprexa Tapering Guidelines and Schedule
Important note: Inpatient care is highly recommended for Zyprexa (olanzapine) tapering. Withdrawal management clinics, in the main, are not generally geared to this level of treatment and oversight. The Geneva Guidelines for Withdrawal Management in a Closed Setting, as set by the World Health Organization did not include protocols for withdrawal from psychiatric drugs such as atypical antipsychotics, antidepressants, benzodiazepines, et al. Their recommendations which are widely used across the world, have set out no specific or practical guidelines for coming off antipsychotic medications.9 So take time to locate an inpatient resource that understands the width and breadth of this subject and can offer the protocols you need for slow tapering and long-term care. If this resource is not available to you, find a prescriber to work with you out-patient, who you feel has the understanding, expertise, and compassion to help you.
Zyprexa tapering guidelines include:
Do not abruptly stop Zyprexa or begin tapering when unstable. The greatest success is achievable with preparatory steps that achieve some measure of stability first.29That would be the ideal point to begin tapering. (More on prep actions as outlined below.)
Draw up a clear contract for safety, sometimes called a “Ulysses contract” with a trusted family member or friend before you begin your taper — a caution to prevent sabotaging your own success in a transient moment of disordered thinking.20
Eliminate smoking marijuana and using other high-THC products as well as other recreational drugs.16,17
Eat breakfast and take a number of small protein-based meals and low-glycemic snacks throughout the day to keep blood sugar evened out.21,22
Eliminate sugar, and refined flour products such as pastries, doughnuts, etc. When you are hungry, eat. Have organic whole foods-based and protein-based snacks on hand to avoid sugar/carb impulsive binges.18,19
The human microbiome is an extremely key pillar in wellness, both physical and mental. Support your microbiome health by adding fermented foods and probiotics to your daily diet.32
Start a gradual physical exercise routine, building up to more vigorous cardio exercise.23,24
The smallest dose of Zyprexa (white round 2.5mg) will ease accurate measurement as the taper proceeds.1
For multiple medications, ask your prescribing doctor to help you plan the most workable sequence for tapering additional medications.11,25 (read more below)
Go slow, determining the percent of reduction and resting time between cuts on symptoms and tolerance, which you would discuss regularly with your prescriber.11,25
Let your prescriber know if you stop eating or sleeping well. These red flags may mean you are going down too fast or that you may need to reinstate at a higher dose and slowly taper down from there.11,25,26
Get adequate sleep. There are non-drug sleep aids that can help. In extreme cases of sleep deprivation, discuss the temporary use of a non-antipsychotic medication if needed.11,25,26
Be prepared that towards the end of a taper, the last reductions may take longer.26,27
Practice grounding activities such as pleasant walks, hobbies you can focus easily on, work of a non-stressful nature, avoid loud overly stimulating music, and avoid other sources of excitation. Practicing yoga and mindfulness have been shown in published studies as helpful in reducing stress and anxiety.30
CBT (cognitive behavioral counseling) also proved beneficial in improving mental wellness, with long-lasting effects.31
Aim to be at a stable point to begin your Zyprexa taper. This would generally mean eating and sleeping well and reasonably tolerating the medication. You may be experiencing some undesirable side effects, but you are not angry all the time, for example, or fighting with the people around you, and you are not experiencing psychosis or mania symptoms. Take time to prepare before beginning the taper, using the suggestions in this article, and on our antipsychotic alternatives page as guides to discuss with your medical oversight.
At Alternative to Meds Center, we consider these and other preparatory steps are absolutely essential before we would begin the actual taper. We attribute our clients’ successes to being thorough at each step of the process.
If you elect to do your taper in an outpatient setting, we recommend putting a good solid support team in place, consisting of trusted family and friends, as well as finding medical and nutritional oversight with which you are happy and confident. More information is given below on other preparatory steps that will assist your tapering journey.
Contracting for safety with a trusted person
Zyprexa tapering is best done in a team setting, certainly not on your own. There is great benefit in the concept of contracting for safety with one of your trusted team, whether a family member, friend or caregiver. During antipsychotic withdrawal, especially if the process is too rapid, there is an inherent risk of mania symptoms returning. The person may suddenly feel they don’t need to take these medications anymore, and they would rather just hop on a plane to an island getaway or some other fun activity. Rather than end up back in the hospital, which would be the usual result of such impulsive behavior, one can sign a contract for safety. The agreement says that if the person decides to stop treatment or not follow the prescriber’s medical direction, that hospitalization or police involvement will have to happen. Abrupt cessation of antipsychotic medication is not safe. Help yourself to stay safe with a contract for safety before beginning the taper process.20
Medical support for your Zyprexa taper
Most would agree that inpatient care is probably the most desirable route for antipsychotic titration. We know this is not always possible, and there are holistic medical practitioners who may be able to help you on an outpatient basis. Drug rehab centers, as excellent as most are, may not necessarily be the correct landing place for you as the mechanics and health aspects of coming off Zyprexa or even multiple medications may not adequately serve in addiction-based treatment centers. While Zyprexa addiction is not unheard of, it is not the prime problem in the vast majority of cases who are struggling with antipsychotic medications. Take some time to find medical assistance that you feel understands your predicament and has familiarity with helping those in your position.
Eliminate all forms of caffeine or other stimulants
The importance of this statement can’t be overstated. Caffeine in coffee, energy drinks or other sources may have provided a welcome jolt while medicated, but the flood of dopamine to the system may tip the scales enough to be medically catastrophic.18,19 Be safe and avoid stimulants during a Zyprexa taper.
Stop recreational marijuana use
Recreational marijuana use has landed some, especially with genetic profiles that inhibit the breakdown of THC, in the hospital with drug-induced psychosis.20,21 Even when marijuana was well tolerated while taking Zyprexa, the outcome could be very different when tapering a drug such as Zyprexa. Play it safe, and avoid the risk.
Eating breakfast and maintaining blood sugar
Blood sugar spikes and crashes can cause symptoms that mimic mental illness.22 You can use diet as a tool to stabilize blood sugar levels throughout the day by leaning towards protein and away from sugar and refined flour products.23 Don’t be afraid to eat abundantly and avoid periods of hunger by starting with a good breakfast and multiple small meals and snacks over the rest of the day.
Studies have suggested that oxygen is a co-factor in burning up excess dopamine. Cardio exercise is an excellent strategy, working up gently to comfortably increased respiration and heart rates. Along with the many other benefits of exercise, more specifically, cardio exercise can help mitigate the flood of dopamine that is expected to occur during antipsychotic tapering.23,24
Ask your prescriber for the smallest mg dose to configure doses accurately
Your physician may be amenable to prescribing you some 2.5mg pills, the smallest milligram versions along with your regular size dose.
(We are not suggesting an immediate drop to the lowest dose.)
Having both sizes would help in exactly configuring the various reduced dosages as your taper proceeds. As an example, to go from 20mg to 17.5, cutting the 20mg in half gives 10mg, then adding 3 x 2.5mg would add up to 17.5mg.
Handling multiple medications
Stimulant drugs are best reduced gradually before your antipsychotic tapering. Speak to your prescriber about getting off SNRIs, Provigil, or other similar drugs before addressing Zyprexa tapering.25,26
However, if you taking Lithium, Depakote, benzodiazepines, or other similar drugs, it may assist your Zyprexa taper to stay on these during the taper. They may provide something of a buffer. These are questions to discuss with your doctor before beginning to taper. Not everyone will necessarily be able to reduce Zyprexa to zero, but still, aim for the least amount with the least side effects, which will be a great improvement in quality of life even if you and your doctor elect to keep on the lowest possible dose of antipsychotic medication.
At a stable point, one may then wish to begin tapering off the Depakote or other medications, carefully and slowly, to as low a dose as is possible, or to zero in some cases, always staying in close contact with your medical support team.
How long is my Zyprexa taper going to last?
We have found that a person who is constantly suffering symptoms of psychosis even while medicated, may have much more difficulty getting their Zyprexa down to zero than persons whose symptoms are intermittent. This situation would require more time as the taper could be quite challenging. Many persons at the center have successfully tapered within a time frame of approximately one month for each year they were medicated, but each case is unique. The timeline for a taper would be unique to the person’s general health, length of time on medication, the severity and characteristics of symptoms, and other such factors.
Symptoms and”red flags” during the withdrawal
Symptoms can be signposts that inform whether the taper is going at a pace that is too accelerated. If you begin not sleeping or stop eating, or begin fighting with those around you or being consumed by ruminating thoughts, or signs of mania, these would be red flags. The mechanism of upregulation (increased dopamine and other receptor sensitivity) is understood to play a major role.26 If undesirable withdrawals emerge, your physician will know to slow the taper, possibly needing to reinstate at a higher dose, and then when stable, begin the slow reduction process from there. For more information on Zyprexa withdrawals generally, more information is provided below. You are also invited to visit our page specific to Zyprexa withdrawals.
Don’t rush the final steps of Zyprexa tapering
Generally, this holds true for all medication tapering, and we have observed it can be particularly true for antipsychotic tapering. The percentage of dose cuts near the end of a taper, as well as the resting time between dose reductions, may need to be considerably extended as you near the end of the process. Give the body enough time to adjust during this important time of healing.
There may be a dopamine surge near the end of a taper that could present as a return of manic or other symptoms. In certain cases, the use of a bridge medication can help to soften the impact of this phenomenon. Speak to your prescriber about whether it may be helpful to bridge over such an impasse in this way. You can read more about bridge medications on our medication tapering page.
Practice grounding activities during Zyprexa Tapering
As discussed above, Zyprexa is a drug that restricts dopamine expression. The body responds to this by creating new and highly sensitive dopamine receptors. The longer one has taken antipsychotic medication, the more prevalent this condition will become. This means that when reducing Zyprexa, the small amount of dopamine that can now get transported is going to have an extremely enhanced effect. To balance this one needs to be especially cautious about engaging in dopamine-triggering stimulation. One particular trigger could be exposure to loud sounds. Loud noise exposure was explored by Frenzilli et al in a study published in Frontiers in Neuroanatomy that showed long-lasting neurotransmitter alterations associated with noise exposure in both animal and human populations.12 Avoid loud music, traffic, or other disturbing noise, as these can be powerful stressors that are not useful during antipsychotic tapering. During Zyprexa tapering, this can be of particular concern. Stay safe by limiting exposure to loud noise or music, and sidestep diving into overly exciting religious, spiritual, political, or other stimulating media input. Instead, practice calming activities such as gardening, nature walks, yoga, mild exercise, light work to focus on, and hobbies you find pleasant, engaging, and relaxing to do. These can help keep things grounded and keep your taper balanced and moving forward.
A note on injectable Zyprexa
Speak with your doctor if you are currently on injectable olanzapine. A conversion to a tablet or wafer form is needed to enable tapering slowly and safely.11
Zyprexa warnings compare with those of virtually all antipsychotic medications – and they deserve careful consideration.
Zyprexa warnings issued by FDA:
Potentially fatal heart complications
NMS (neuroleptic malignant syndrome)*
Increased mortality in elderly dementia patients
*According to the FDA, swift emergency care can preserve the patient’s life, which may require the immediate cessation of the medication that caused the NMS.1,11
In addition to those risks, the FDA required the drugmaker, Eli Lilly, to issue a strong warning in 2007 for Zyprexa.1 As published in the Official Journal of the World Psychiatric Association, Corell et al established antipsychotic medications are associated with increased risk for several physical diseases, including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, hyponatremia; cardiovascular, respiratory tract, gastrointestinal, hematological, musculoskeletal and renal diseases, as well as movement and seizure disorders.9 Zyprexa causes high blood sugar, hyperglycemia, and dyslipidemia (elevated triglycerides and cholesterol levels), more than other antipsychotics. As a result, patients taking Zyprexa frequently gain excessive weight.10,13
Weighing Risks to Benefits of taking Zyprexa
Zyprexa does carry risks such as those mentioned above, but it also gives persons relief from symptoms of schizophrenia and acute psychotic episodes. Zyprexa can help dampen these. The problem here is that the longer a person stays on antipsychotic medication, the higher the likelihood of developing tolerance to the drug, at which point the drug can no longer reduce the psychiatric symptoms.6
Original symptoms may begin to re-surface along with newly developed side effects, a potentially very unpleasant combination that often leads to declining health and declining quality of life.7 One may well consider stopping the drug at this juncture, but it is very important never to do so abruptly as this can cause a cascade of undesirable and even dangerous consequences. Switching medications is an option but needs an extremely careful transition from one antipsychotic to another. Multiple medications carelessly introduced to avoid relapse, for example, can have disastrous consequences. The person’s neurology needs time to adjust and begin to function properly again. The abrupt stopping of antipsychotic medications is particularly risky for a pregnant woman.5
Problems and risks associated with long-term use of antipsychotics indicate that Zyprexa tapering may offer healthier outcomes. After considering the risks to benefits ratio, Zyprexa tapering may ultimately offer the best choice. But one must ensure it is done right, so as not to introduce rapid changes that the body cannot handle, especially with the person in a possibly already weakened state. Seek the best oversight, instruction, and attentive care that is available for ensuring your successful outcome.
Natural Mental Health Treatment
The psychiatric industry relies almost 100% on drugs for therapy. At the same time, medical consensus acknowledges drugs cannot heal — they only suppress symptoms.8 While Alternative to Meds Center acknowledges that drugs are certainly necessary in some cases, we also stress the proven efficacy of non-drug-based therapies to achieve bettered mental health.
A balance can be attained and that is the framework in which we aim to help our clients achieve natural mental health. According to Harvard Medical School studies, certain non-pharmacological treatments can be just as effective as drug treatment.3
Integrated Mental, Emotional, and Physical Healing
Mental health, emotional health, and physical health are three distinct subjects. Or are they? Does each of these subjects exist in a vacuum, or do they intersect? If one area is subjected to certain influences or impacts, might all 3 areas respond, to some degree, in tandem? 2 For example, if we are physically sick, how energetic and happy will we likely be? Lack of food and sleep are physical, but how does that cause hallucinations? A headache feels like physical pain, but can it also inflict emotional anguish?
In their 2010 Scientific Americanarticle, psychologists Ceddia and Coan asked “What Causes Chest Pain When Feelings are Hurt?” They observed an emotional impact, like an insult, can unleash a biological avalanche. Or, how a simple act of kindness, such as holding hands, can blunt the experience of physical pain. We are beautifully complex creatures, and with so many levels of healing that we still don’t fully understand, can we really expect true healing to come out of a pill bottle?
The dampening effect of drugs such as Zyprexa can numb a person’s emotions. That’s like being trapped under a dark, heavy cloud all the time. Blunted emotions, sometimes called “deadness” feelings are possibly the leading reason for deciding on Zyprexa tapering. We believe that tapering off Zyprexa, done carefully and well, can provide a new path leading to significant improvements in mental health and the resurgence of joyful living.
At Alternative to Meds Center, much work is done to discover root causes for a person’s original symptoms and instead of masking them, actually address and resolve them. This is the path to actual relief without drugs. We consider this approach conducive to natural mental health and is one of the fundamentals used in designing programs for our clients at the center.
Why Choose Inpatient Treatment for Zyprexa Tapering
Unfortunately, in an unsupportive or even negative environment, a person may be inclined to lose hope about recovery. Additionally, the struggles you go through may be difficult for your family to endure unsupported. In a positive supportive environment, a person may begin to feel more confident and hopeful, more responsive and engaged, and more willing to do the work necessary to get well. This can feel rewarding all in itself.
Alternative to Meds Center provides a nurturing, supportive atmosphere where clients feel cared for, attended to, and as comfortable as possible by offering many types of adjunct therapies for comfort and for the reduction of discomfort that may otherwise accompany Zyprexa tapering. Alternative to Meds Center provides a calming, well-staffed, and welcoming facility to give our clients the very best level of care.
For More Information
We invite you to contact us at Alternative to Meds Center to find out more about the science behind our programs, equine therapy, art therapy, and the many other therapies supportive to the Zyprexa tapering process that help our clients recover their natural mental health.
It is not just about getting off Zyprexa safely, although that is a major goal. Additionally, we seek overall health improvements based on non-pharmacological-based treatments. Long-term wellness permits drugs to tend to become unnecessary. Please ask us about insurance coverage as well, and how easy it may be for you or a loved one to enroll in our exceptional, world-class Zyprexa tapering program delivered at our inpatient center.
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Medical Disclaimer: Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.