Long term Effects of Olanzapine

[Julianb]

I was prescribed Olanzapine as the next stage of dealing with what was diagnosed as TRD.

Howerver my depressive symptoms got a lot worse after an initial improvement as well as additional side effects. I developed all sort of symptoms at different times: Restless leg syndrome, pacing, dyskinesia, severe stomach pain, hypotension,..

I became extremely apathetic to the extent that even walking became too much. I couldn't even leave the house to buy food. I was found starving in my bed by social services which lead to reducing the dose from 5mg to 2.5mg. My symptoms didn't get much better but no notice was taken of that.

I only continued to take it because at least it made me sleep which was the only relief I had from the hell I was in. Meanwhile my GP kept giving me stronger and stronger pain killers to deal with this crazy stomach pain, until it got to morphine sulphate to which I became addicted. It wasn't helped by the fact that I couldn't judge distances very well and I kept having driving accidents, the last of which put me in ICU with broken ribs, both hands, legs and then for three weeks on morphine drip.

This situation went on for five years. I was denied morphine and therefore I was put on Methadone. But I kept getting worse, until I couldn't leave my bed.

That was when I figured out that the only thing that hadn't been changed in the previous five years was Olanzapine. So I stopped taking it and after a few days I started feeling better. I couldn't believe it. So after a few weeks, I started taking Olanzapine again and within 48 hours, my symptoms returned. So, it was undisputable that it was Olanzapine that was the cause of all my symptoms. I just couldn't believe that none of the psychiatrists (doctors) throughout those five years hadn't figured it out.

However by then I was dependent on Methadone and still depressed which became intolerable every time I tried to come off Methadone or even below 12 mg per day. So I was switched to Buprenorphine. Buprenorphine turned out to be a fantastic antidepressants.

However, although my depression had completely disappeared, for longer than a month at a time probably for the 1st time since the age of 16 , I had all sorts of other symptoms, daytime sleeping attacks, forgetfulness, inability to focus and lack of motivation.

Finally, I was diagnosed with ADHD which I realized really did fit the problems I had had since childhood except hyperactivity. Once I was prescribed concerta, I kind of started feeling normal.

However I still have major problems with motivation which was not there before I was put on Olanzapine. I am also finding it difficult to come off the last 2 mg of Subutex (been trying for the last six months).

So, here is my question: could it be that Olanzapine has had a permanent effect on my brain (it also damaged my teeth and my heart)? Because, I am just not the same person. I am not saying that I didn't have motivational issues before taking Olanzapine but it didn't feel like an illness.

I am really fed up with myself. I used to get bored with thing easily but that was after getting interested for a while at least. Now, I just can't be bothered with anything and it really feels like a sickness. I can't be bothered to take showers regularly, go out, socialize and have no sex drive what so ever and lots of other things that I thought was just normal to do, before I took Olanzapine.

What is going one and what can I do about this? It has been six years now that I have been off that damn stuff. I don't feel depressed. So what has happened to me?

As I said, I am fed-up with myself.

 

[Larc]

If you had stopped 6 months or a year ago, I would say give it time. 6 years though? You need to start forcing yourself to do things. Slowly, but surely, things will be second nature again and not seem like such a daunting task.

Are you currently stable on your buprenorphine dose or are you still trying to taper?

 

[Julianb]

First of all I reduced my buprenorphine from 8 mg to 2 mg quite easily over a period of couple of months and stayed on 2mg for several months. I have been trying to taper off but without much success. As soon as I get to 1.5mg, my exacerbated lack of motivation turns into blankness and depression.

Secondly I remember people saying that I needed to force myself to do things when I was on Olanzapine which made 2 baseless assumptions:
1) The reasons for my state of mind was mainly if not purely psychological.
2) That somehow I was being lazy, something I have accused of all my life, which must have contributed to not having been diagnosed with ADHD in my childhood (quite common from what I have read).
Those two assumption actually perpetuated the mistake of keeping me on Olanzapine for 5 years. Given the way I tested the symptoms by actually going back on Olanzapine, I would have hoped that I had proved the 1st point to be wrong beyond any reasonable doubt. As to the second assumption; don't you think that feeling sick of yourself would create the impetus to "force yourself" to do things and to suggest otherwise, specially in such simplistic terms (pull up your sucks) is actually insulting in suggesting a sub-level intelligence?

Besides I asked about the potential permanent damage by Olanzapine (may be to dopamine receptors) and I don't see any thing relevant to that issue in your answer. Finally, how do you suggest that I force myself to have sex drive?

Forgive me, but I have already had enough of the pseudo-science of behavioral psychology that is not even capable of establishing cause and effects objectively and that is why I submitted my question to forum about medication. Maybe I should have referred my question to the Neuroscience forum.

 

[Johndoedoe.junk]

First off let me share my experience with Zyprexa. I've been on and off the stuff for years. I found it to be very useful while in long term extreme anxiety bouts with suicide and thoughts of hurting myself on the forefront of my mind. The Zyprexa (olanzapine) was basically for use as a rescue medication a lot of times coupled with Ativan to calm me down and it worked nicely for that. Also helped greatly for sleep.

Now on to the side effects. It caused a lot o weight gain, gave me rls (more like restless body syndrome), and made me extremely tired pretty much the entire next day. Felt like I had concrete running through my veins.

My suggestion is if you absolutely need this try to space it apart or use it as a rescue med knowing what it cam do. It sounds like the olanzapine is the contributor to the negative effects you refer to as they go away without the medication and return when it is reintroduced. I still take it from time to time especially if I'm dealing with opiate withdrawal with no other comfort med. Other than that I try to stay away from it. You may want to talk to your doc about other options. It all basically boils down to you and what you can tolerate.

EDIT: Sorry, I realize i didn't address your question about whether the olanzapine is the cause of some of your permanent issues. It was very late/early when I wrote this, my apologies. Seeing as I'm not a medical professional I can't offer a solid diagnosis on that however in my personal opinion I'd say it's very likely. To be on an antipsychotic like that for five years and then to just stop while having other heavy medications thrown in the mix maybe your brain (purely speculation, if you are looking for a medical opinion go see a doctor) didn't have time to "reset" from the olanzapine.

 

[Julianb]

Thanks for your response.
I have since done some reading and there is plenty of evidence that Zyprexa along with many other psychiatric medication cause permanent changes in the brain comparable to strokes. I am certain now that the changes in my personality are deep seated. At the very least, it is similar to people who have been in coma for long periods of time who seem to have forgotten how to walk or talk. Off course had I received the kind of rehabilitation stroke patients receive I might have been able to recover some of the trained behaviour I seem to have lost.