Initially when I took my medication I was out like a light. The sedation just doesn’t hit me the same to the point where it doesn’t make me feel tired at all. I spoke to my doctor and told him I felt like I was still building tolerance to the medication after being on it for over a year. When I asked him if it was possible he didn’t my experience. I don’t imagine there are any studies on this.
As a counter example clinical experience would also say that there are some people who have been stable on the same antipsychotics for over 20-30 years now.
What has been your experience with taking medication long term, do you feel it sedates you less overtime? Or did you feel the need to increase dosage?
I am much less tired than i used to be. When i first started meds i was sleeping 22 hours a day. Id only be out of my room for a couple hours. Now i sleep 10-11 hours and am up the rest of the day. I dont do much but thats kind of my depression…
On olanzapine I got sedation for the first seven years i took it, but then it stopped working as effective and I got poor sleep even on 10mg which is supposed to be a standard dose. I couldn’t take 10mg because that’s too much for me to stay active at work. So I took about 5mg which was enough symptom wise but not enough to take away the insomnia.
Am currently attempting a switch from olanzapine to Latuda. I feel olanzapine doesen’t have anything more to offer me.
@Voeal_Cat
Sedation has been linked to antihistamine effects of antipsychotics. However as dopamine is stimulanting, dopamine antagonists/modulators (Antipsychotics) would have a sedating effect. Therefore it is unlikely that you would build tolerance to one and not the other.
Just thinking about it now because you can have rebound psychosis there would upregulation of the dopamine receptors. Upregulation is a form of acclimatisation and I think it would be correlated with tolerance. Like how addiction is correlated with tolerance.
These things are relative. It is entirely possible in the real world. The therapeutic window for antipsychotics large so it might be the case that you build tolerance to dopamine antagonism but because you don’t any difference in positive symptoms you don’t realise. In that sense you really would build tolerance to sedation without experiencing increased symptoms overtime.
@pasteyface
Bro yes, I remember how bad it was at the start I slept 18 hours a day for like more then a month at the start. But that could have been the harsh meds they gave me at the start in my case.
@Mr_Hope
Interesting anecdote, were you on the same 5mg dose for several years before it stopped working for sleep?
@LilyoftheValley
Yeah this has been my general experience starting a new med at least in the short term. Did you experience them still becoming less sedating after taking the same thing for a period of months?
As I recall I had come down from 10mg to 5mg which worked fine for maybe 6 months. Then the sleep issues came. Before this I was able to skip a dose and still get sleep, but suddenly it was impossible to skip a dose because then I would get total insomnia. I have been dependent on olanzapine for poor sleep the last 7-8 years.
I guess I should have given them up sooner, but my gp wouldn’t have it. When I brought up that the meds were troubling me he would just say that it wasn’t beneficial switching because olanzapine took care of my symptoms. He wouldn’t give me any sleep aid either. And referral to pdoc was denied. I switched gp about 4 years ago and am being taken seriously now. Finally got arranged a med switch and a sleep aid.
Part of the listlessness comes from the sedating effects of the meds. Part of it comes from bad habits we build around our meds. I’ve been able to deal with the bad habits the meds caused me to form. That removes enough of the roadblock that I can push past the sedation and do things that help, like regular bursts of exercise throughout the day to help bump my energy level.
@LilyoftheValley@Joker
This was the case for me as well I did like 4 antipsychotics and like 5 or 6 antidepressants before I found a combination that that worked. That was a process for the first 4 years after my initial admission.
@Mr_Hope
I think it is a somewhat common experience that people become dependant upon APs for sleep! Maybe that’s part of the tolerance
Doctors are reluctant to switch as long as your symptoms are under control even if you experience side effects. This is especially the case if you have been stable on the same medication for years
@shutterbug
I also feel like the medication promotes bad habits with sleep hygiene, that’s something I’m guilty of. I think it is true that a lot of the work you have to do yourself and that the meds can only help you so much
It would be nice if the doctors really knew their meds though. I suggested in a letter to a pdoc team that olanzapine had caused sleep dependency.
In their reply they wrote: Olanzapine does NOT cause dependency. They actually wrote it like that with not highlighted. In a previous letter they offered me a sleep aid when I said I wanted to go off olanzapine. Why would they offer a sleep aid if it didn’t cause dependency?
It would be better if the doctors knew what they were talking about. Like: “Oh, and one more thing. It’s impossible to quit olanzapine on your own. Have a nice day”.
Yeah gp’s don’t know these meds well. You really need a psychiatrist if it is possible to see one. It’s pretty self evident if you miss a dosage that you’re not going to sleep. That’s dependance on medication for sleep.
I have had multiple doctors tell me similar things about side effects. Which is ultimately the most frustrating when they control which medications you take.
Side effects in general are a bit of a wild card. From a financial view point it’s really in no one’s interest to fund side effects studies. The pharmaceutical company doesn’t have a great deal of onus to report benign side effects that become apparent post approval trials. Consequently no one is actively invested in fully illiciting research outcomes on drug side effects. Not the best use of limited research funding anyway. My experience tells me is likey that there are gaps in the literature regarding side effects. Additionally side effects tend to come through case reports first and they again mainly only get a write up if they are serious/life threatening.
For a sleep dependance side effect to come through the literature you would have to be doing a study with reducing or removing antipsychotic medication. Which is not a study that would be funded for ethical reasons. The medical establishment as it stands aren’t huge proponents of dosage reductions in general. If you doctor has no knowledge or experience of tapering antipsychotics then they might not be aware. Doctors are people too they are not infallible.
I always trust the user experience. Even if it makes no sense in the context of the available literature if someone is complaining you’d think it best to exercise caution. As far as I’m concerned anything is possible as a side effect. And why wouldn’t it be, no one fully understands how chemcials interact in complex biological systems. To declare otherwise is wishful thinking.
Antipsychotics are well know to be ‘dirty drugs’ targeting multiple receptors and creating many off target effect. Olanzapine is also prescribed as a sleeping agent so it’s not a great leap in thought that you can become dependent on it for sleep. I can not recommend enough that everyone put faith in their personal experience when it comes to side effects. Like obviously always listen to medical advice but actually side effects are a subjective and personal experience. I think it is not the best to discount something which is unlikely to appear in the literature. Doctor and patient can still disagree but it is bad clinical practice to not acknowledge the possibility in absence of evidence. I would agrue side effects are essential unknown unkowns. Unless you see a large amount of patients in clincal practice taking the same medication then you won’t understand these drugs well. Psychatry is a bit of a dark art as it is.
I was on Geodon over three years, at first it made me sleepy during the day, then that effect wore off. Now I’m on Loxapine and that makes me sleepy during the day. Loxapine I’ve found to be very sedating even long term use
