Looking for research articles: Insomnia due to olanzapine withdrawal

hey,

I took 5mg of Olanzapine till February for a year. Then went off it. This caused me severe sleep problems for the first month or so. Now I still can’t sleep properly and wake up several times a night - but at least i sleep in between.

Although I find a lot of patients’ accounts of their suffering I found almost none scientific/research articles dealing w/ the issue. I’d like to read them for a potential outlook and treatment options for my insomnia. Can you help me out?

Cheers

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This has been the most helpful article I’ve found so far: https:// link.springer. com/article/10.1007/s40263-013-0079-5

I’ve been looking too, but can’t find any. I think the pharma industry is pretty much in denial about some of the side effects these drugs cause, including insomnia. My local pdoc team claims olanzapine does not cause dependency.

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I am so sorry about this. My psychiatrist is also in denial (she is very young and says at least it won’t be permanent).
Like wouldn’t it be logical it causes dependency or similiar things? It alters the brain efficiently in regards to positive symptoms, why shouldn’t it cause some rewiring of the ability to sleep, too?

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Ofcourse it does. There are very many stories online about people who struggle with sleep after olanzapine.

Doctors are taught to stick to their textbooks and not be biased by other information I guess. It’s ashame there aren’t good strategies in place in the medical community to come off drugs like olanzapine.

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@nowyoudo
I would say that it is unlikey that you insomnia 7 months later is caused by olanzapine. For the reason that 1 it has completely washed out of your system and 2 that you receptors would have acclimatised.

What your are talking about is permanent disruption to your sleep cycle from olanzapine. I would question whether antipsychotics do that.

The effects on positive symptoms flush out when you stop taking the medication. In that way by your own logic the effects on sleep should flush out also.

There is no research on this for several reasons.
1 You are being too specific looking at a single drug not antipsychotics in general
2 This area of research is under funded because it is a side effect. It is not life threatening and you don’t know the prevalence
3 You are looking at an area of research about withdrawal, it is not ethical to fund these studies in a scientific manner
4 You are looking for long term studies because you have to first build tolerance to build withdrawal. It isn’t financially possible to fund these studies.

Additionally treatment options only come after a long period of active research in the area. You’re only going to get user reports here.

In answering you questions treatment options are the same as for any other regular sleeping disorder. Circadian rhythms are highly disrupted in schizophernia, how can you delineate the two?

I think olanzapine is a exception. There are hundreds if not thousands of stories online about people who have trouble sleeping coming off olanzapine. It can take months, even years to recover. Some people may never recover. Long term use makes the situation worse. The olanzapine seems to make long lasting changes to brain chemistry which the body has trouble reversing after discontinuing.

I tried going off a couple of times before and literally had no sleep in 10-11 days. I ended up in the emregency room. I’m trying to go off again now, but the only way to do it in my case is to replace olanzapine with another AP that works on sleep like seroquel or nozinan. Or alternative use a benzo that’s good on sleep.

@Headspark Quit olanzapine like two years ago and has still not recovered fully. He’s using a benzo to help him sleep.

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Just wanted to say welcome back!

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Yeppers! Technically it’s been about 1.5 years, but you are absolutely correct in everything you wrote.

What’s worse is the medical establishment doesn’t recognize this as a problem, there are no scientific studies or articles about it, doctor’s don’t believe insomnia is caused by Olanzapine cessation, there is no one to help.

I was like you, but I went a month without sleep. I would just lay in my bed resting with my eyes closed for 8 hours every night. That was a brutal experience.

I had a choice. Go back to Olanzapine or try sleeping pills. I wanted off Olanzapine so I tried a bunch of stuff but 1.5mg of clonazepam was the only thing that worked satisfactorily.

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To clear things up.

My psychiatric team prescribed me the drug with the proclaimed intent to get rid of it after a certain time (but keep in mind that my PS weren’t about halloucinations, etc. but for example about endless pondering). The goal was “to rewire my brain” in certain ways (e.g. pondering, paranoias).

I got my diagnosis in 2016, I’ve never had any problem to sleep through the night, except from the day onward I went off olanzapine.

The definition of a withdrawal is that the substance isn’t there in its previous amount. The symptoms usually continue when the substance has left the body completely.

If anyone has intel about the same problem with other APs please let me know :slight_smile:

I am no psychiatrist, so I can’t say anything certain, but please if you contradict my claims, back them up.

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Thank you for your reply. That sounds horrifiying.
Do I understand it correctly that no professional ever consired Olanzapine as the cause of this? :frowning: How did they react when you confronted them about this?

Yes, I’ve heard about benzos but I’d rather not take them (and my situation seems a lot better than yours).
Will you have to take Clonazepam forever or do you hope to reduce it in the future?

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They said Olanzapine doesn’t do that when I told them what I was experiencing.

I realized I wasn’t going to convince the doc so I reacted by playing dumb and said something like “oh, must be Insomnia caused by my schizophrenia or something”

Then started trying different things for sleep and 1.5mg clonazepam worked best.

I don’t know. I can now fall to sleep without it, but only sleep 2-3 hours then I wake up. So I still need it to sleep 7+ hours. That is an improvement, before I couldn’t sleep at all without clonazepam.

I’m hoping maybe in a year or two my brain will have recovered from Olanzapine and I’ll be able to sleep without clonazepam.

However I’ve been on clonazepam for over a year so I’m almost certainly dependent on it now. If my brain does heal from Olanzapine I’ll have to go through benzo withdrawal.

I was on 40mg of Olanzapine for 17 years so my brain is f*cked, I think that’s why it’s taking so long to get back to normal …if it ever does.

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thats the main reason im back on olanzapine. when i switched to invega i would stay up all night like to 6am, sometimes even later like to 10am. i felt like ■■■■ due to my messed up sleep schedule. on olanzapine i sleep like 12 hours a night and go to sleep early

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Doctors do not know because they’ve never taken these medications that our brains become so dependent on. Secondly, they protect big pharma which is their meal ticket.
When I first went on olanzapine 4 years ago, initially it felt like a mild enough medication, but now when I come off it, I DO NOT SLEEP.
Yes I’m currently on 10mg but my goal is to come off in a month or 2 and switch to something else that makes weight loss easier……see my other thread.
It doesn’t surprise me that your sleep is still impacted 2 years off olanazapine. For me it works as a tranquilizer. Even stronger than benzodiazepines. This is real & not made up. One day their will be accountability for these dependable medications.

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@Mr_Hope @Headspark
I don’t dispute that you will get insomnia after discontinuation. I’m just skeptical it is something that would last for a period longer then a couple of months.
I haven’t read the volume of user reports you’re talking about. There are no verified reports in the literature.

Granted if you medication for that period of time anything is possible.

I don’t necessarily see why you wouldn’t see the same withdrawal syndrome in other heavily sedating aps like quetiapine

I slept perfectly fine before Olanzapine, even when I was Psychotic, I slept a lot while on Olanzapine. I couldn’t sleep at all after quitting.

I’ve been off it for 1.5 years. I can now sleep 2-3 hours without sleeping pills but that’s it. It brutal. You’ll understand when it happens to you @Gamma_Fox

I’ve become good friends with a forum lurker and her and I talk about our awful Olanzapine withdrawal experiences.

That’s what so frustrating! There is no help.

There are a done of user reports. Search more. Mental health forums are full of people complaining about protracted Insomnia if you take time to read all the threads on the various mental health forums out there.

18 months later
What I am left with:
Insomnia
Olanzapine Withdrawal | RxISK

My best friend was on 10 mg of Olanzapine for 25 years. He made the decision to get off of it with the Doctors’s guidance because it caused his diabetes and was making his diabetes worse. I am also on olanzapine and my friend told me he will be the guinea pig and get off of it first and if he is ok then I will know to get off of it. He got off of it 4 months ago and his insomnia was so bad that he went 4 months with hardly any sleep at all. Doctor prescribed hydroxyzine for his insomnia but it didn’t work. My friend could NOT sleep and got very very sick from not sleeping and was so confused. He took his life and died August 8, 2020 as a result. I lost my best friend due to olanzapine.
https://www.drugs.com/comments/olanzapine/for-insomnia.html

Insomnia may persist for quite some time after your last dose.
Zyprexa (Olanzapine) Withdrawal Symptoms + How Long Do They Last? - Mental Health Daily

I found a study! ↓

Coming off antipsychotics may take years: first paper on how to withdraw
Coming off antipsychotics may take years: first paper on how to withdraw | UCL News - UCL – University College London

I’ve taken Olanzapine for a month, now when I dont take it for a night I cant sleep at all.
Olanzapine withdrawal | Olanzapine | Forums | Patient

I could post more but you get the point.

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That’s really sad that story about him taking his life. I can understand how it happend too. I tried to quit for a period of four years. I was on 2.5mg with very poor sleep waiting for sleep to get better. It never did. And nobody in the medical community warned me this could happen. It almost ended me, but I recoverd some when I got a new GP that knew what to do. But my health has still deteriorated quite a bit, it wouldn’t surprise me if it’s permanent.

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@Headspark

Autonomic and somatic symptoms that occur on cessation generally start within days of dose reduction and resolve within weeks.

The persistence of TD, the most visible manifestation of dopaminergic hypersensitivity, for a considerable time following cessation of antipsychotics, provides evidence that neuro-adaptations to antipsychotics persist for many years and supports the need for long tapering. An early review of studies found that it took 2–5 years for 60%–90% of symptoms of TD to resolve following antipsychotic cessation (supplementary table S1). Another study found that 92.8% of patients achieved a 50% reduction in TD symptoms 46 weeks after discontinuing on average 10 years of antipsychotic treatment. A more recent study examined patients with 1 year of TD in whom dopamine antagonists (including metoclopramide) were ceased after 5 years of exposure: in 13% of the patients, symptoms resolved completely (taking 2–4 years, average 2.3), and the number defined as moderate or severe decreased from 63% to less than 20%. This suggests that TD (along with, presumably, dopaminergic hypersensitivity) can resolve when antipsychotics are discontinued but this process might, in some cases, take years and may be irreversible in some patients.

For people that have taken this drug for a long term, the withdrawal symptoms may linger for over 90 days.

I realise that you can get insomnia from stopping antipsychotics but also mainly what I was not convinced of was how long a withdrawal syndrome can last. Is it weeks, months, years? After reading a few of the anecdotes and the research paper you linked. I think it is be plausible that it could take years considering TD improves over that time period maybe other neuroadaptation might take as long to reverse. I think the duration of withdrawal effects is actually an open question and probably depends on a lot of factors, especially dosage and duration of treatment.

Thank your for sharing you changed my mind :slight_smile:

Definitely going to go more cautiously on my taper. A 3 year taper actually being the best evidence based practice. Not going to lie that sounds pretty rough by anyones standards.

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I took 4 years to go from 40mg to nothing with Olanzapine. I’m fine in every way except for the insomnia.

It has improved. The first I think 6ish months I couldn’t sleep at all without clonazepam. Now I can fall to sleep but only sleep about 3 hours then I wake up.

My last dose of Olanzapine was about 1.5 years ago.

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