Is it worth to get back on olanzapine?

[Jesus_ist_König]

Im suffering there is smth taking control of me 2 days every week or more. I feel drained and raped by that thing. Im losing control. But olanzapine on the other hand eats up your brain.

 

[iwannasleeponurlap]

Sure.


What you’re describing sounds very distressing—especially the feeling that something is taking control of you and that it keeps happening repeatedly. Whether this is related to psychosis, severe anxiety/dissociation, or something else, it’s a sign that you shouldn’t have to deal with it alone and that you need proper medical support.


About olanzapine: it’s an antipsychotic medication that can be very effective for conditions like psychosis, severe agitation, or manic episodes. For some people, it can reduce exactly the kind of experiences you’re describing and help restore stability.


But your concern is also valid. Olanzapine can cause side effects like heavy sedation, emotional “blunting,” weight gain, and a sense of mental slowing or fog. When people say it “eats your brain,” they usually mean this dulling effect—not that it actually damages the brain.


So the honest answer to “is it worth it?” is:
It depends on the balance between:

• how severe and controlling your symptoms are
• how much stability the medication could give you
• and how you personally tolerate side effects

What stands out most in what you said is this: you’re having episodes where you feel taken over and lose control. That level of symptom often does point toward needing some form of antipsychotic or mood-stabilizing treatment, at least temporarily. But it does not automatically mean olanzapine specifically, and it does not have to be a high dose or long-term treatment.


A psychiatrist can often adjust things, for example:

• much lower doses to reduce side effects
• switching to a different medication with less sedation
• using it only during crisis periods
• or combining treatments to minimize the “foggy” feeling

One important thing: don’t restart or change olanzapine on your own. With symptoms like yours, it really needs medical guidance to get it right.


And I want to be direct here: if you feel like you are “losing control,” that’s a strong sign you should contact a doctor or crisis service soon rather than trying to push through it alone.


If you want, tell me what those episodes feel like in more detail (thoughts, sensations, perception changes, urges). That can help clarify what kind of support is most appropriate.

 

[Jesus_ist_König]

Sure.


What you’re describing sounds very distressing—especially the feeling that something is taking control of you and that it keeps happening repeatedly. Whether this is related to psychosis, severe anxiety/dissociation, or something else, it’s a sign that you shouldn’t have to deal with it alone and that you need proper medical support.


About olanzapine: it’s an antipsychotic medication that can be very effective for conditions like psychosis, severe agitation, or manic episodes. For some people, it can reduce exactly the kind of experiences you’re describing and help restore stability.


But your concern is also valid. Olanzapine can cause side effects like heavy sedation, emotional “blunting,” weight gain, and a sense of mental slowing or fog. When people say it “eats your brain,” they usually mean this dulling effect—not that it actually damages the brain.


So the honest answer to “is it worth it?” is:
It depends on the balance between:

• how severe and controlling your symptoms are
• how much stability the medication could give you
• and how you personally tolerate side effects

What stands out most in what you said is this: you’re having episodes where you feel taken over and lose control. That level of symptom often does point toward needing some form of antipsychotic or mood-stabilizing treatment, at least temporarily. But it does not automatically mean olanzapine specifically, and it does not have to be a high dose or long-term treatment.


A psychiatrist can often adjust things, for example:

• much lower doses to reduce side effects
• switching to a different medication with less sedation
• using it only during crisis periods
• or combining treatments to minimize the “foggy” feeling

One important thing: don’t restart or change olanzapine on your own. With symptoms like yours, it really needs medical guidance to get it right.


And I want to be direct here: if you feel like you are “losing control,” that’s a strong sign you should contact a doctor or crisis service soon rather than trying to push through it alone.


If you want, tell me what those episodes feel like in more detail (thoughts, sensations, perception changes, urges). That can help clarify what kind of support is most appropriate.

If you look into the pubmed studies you see that it actually eats your brain. A 1.2% reduction of the prefrontal cortex after 36 weeks of use.

 

[iwannasleeponurlap]

If you look into the pubmed studies you see that it actually eats your brain. A 1.2% reduction of the prefrontal cortex after 36 weeks of use.

I looked at the specific study you’re referring to, and yes — it does report an average ~1.2% reduction in cortical thickness over 36 weeks in a randomized trial of olanzapine exposure in a very specific clinical population (psychotic depression patients in remission conditions).
But the conclusion you’re drawing from that (“it eats your brain”) is not what the science actually supports. Here’s the key distinction that gets missed:

1. “Brain volume change” ≠ “brain damage” in the way people imagine​

MRI-measured cortical thickness changes can reflect:

• changes in water balance and tissue composition
• synaptic pruning or reorganization
• changes from illness activity vs recovery
• medication effects on dopamine/glutamate systems
• stress/hormonal state changes

These are not the same thing as neurons being destroyed or “brain loss” in a toxic sense.
Even in that study itself, the authors explicitly note:

• illness relapse also caused brain changes
• both medication and psychosis affect brain structure
• effects are region-specific and not uniform

So the brain is not simply “shrinking because of a drug,” but changing under multiple competing biological pressures.

---

2. The 1.2% figure is real — but often misunderstood​

That number is:

• a group average
• over 36 weeks
• in a specific diagnostic group
• measured as cortical thickness (not total brain “mass” or “neurons”)

And importantly:

• it is in the same range as changes seen from aging, stress, and psychiatric illness itself
• other analyses show schizophrenia/psychosis itself is associated with progressive cortical thinning, sometimes larger than medication-associated changes

So the key scientific issue is:

separating illness effects from medication effects is extremely difficult, and both likely contribute.

---

3. “Antipsychotics shrink the brain” is not a settled conclusion​

The full body of evidence is mixed:

• some studies show associations with reduced gray matter volume
• others show no effect or region-specific changes
• many show that untreated psychosis is also linked to brain volume loss over time

There is no consensus that olanzapine or other antipsychotics cause progressive neurotoxic brain loss in healthy brains.

---

4. What matters clinically (and what gets lost in internet reading)​

The real medical question is not:

“Does this cause measurable MRI changes?”

It is:

“Does this reduce dangerous symptoms enough to justify side effects, and can we minimize dose/impact?”

For people experiencing what you described earlier (episodes of losing control, feeling taken over), untreated symptoms themselves carry risks that are usually considered much more serious than the potential structural MRI changes.

---

5. The important part for you specifically​

Right now your brain is doing something very common in this situation:

• it is locking onto one frightening biological interpretation (“brain damage”)
• and turning uncertainty into a very concrete catastrophic conclusion

But the actual science is:

• small, mixed, context-dependent structural changes exist in some studies
• interpretation is uncertain
• and it does not translate into “olanzapine destroys your brain”

---

Bottom line​

The claim “olanzapine eats your brain” is not scientifically accurate in the way it’s usually meant online.
What is accurate is:

• it can cause noticeable cognitive and metabolic side effects in some people
• it can also reduce severe psychiatric symptoms that themselves are destabilizing
• brain imaging studies show small average structural differences in some contexts, but causation and meaning are not straightforward

---

If you want, I can help you think through a more practical decision question instead, like:

• “If I go back on it, how do I minimize the fog/side effects?”
• or “what alternatives exist that are less sedating than olanzapine?”

Because the real decision is usually about function and stability vs side effects, not MRI percenta

 

[Jesus_ist_König]

I looked at the specific study you’re referring to, and yes — it does report an average ~1.2% reduction in cortical thickness over 36 weeks in a randomized trial of olanzapine exposure in a very specific clinical population (psychotic depression patients in remission conditions).
But the conclusion you’re drawing from that (“it eats your brain”) is not what the science actually supports. Here’s the key distinction that gets missed:

1. “Brain volume change” ≠ “brain damage” in the way people imagine​

MRI-measured cortical thickness changes can reflect:

• changes in water balance and tissue composition
• synaptic pruning or reorganization
• changes from illness activity vs recovery
• medication effects on dopamine/glutamate systems
• stress/hormonal state changes

These are not the same thing as neurons being destroyed or “brain loss” in a toxic sense.
Even in that study itself, the authors explicitly note:

• illness relapse also caused brain changes
• both medication and psychosis affect brain structure
• effects are region-specific and not uniform

So the brain is not simply “shrinking because of a drug,” but changing under multiple competing biological pressures.

---

2. The 1.2% figure is real — but often misunderstood​

That number is:

• a group average
• over 36 weeks
• in a specific diagnostic group
• measured as cortical thickness (not total brain “mass” or “neurons”)

And importantly:

• it is in the same range as changes seen from aging, stress, and psychiatric illness itself

Cant be 36 weeks = 9 months
9 months = 3/4 year
3/4 year = 1.2%
3 years = 4.8%
60 years = 96%

After 60 years my brain would have shrunk 96% jfl, not possible wont take it

• other analyses show schizophrenia/psychosis itself is associated with progressive cortical thinning, sometimes larger than medication-associated changes

So the key scientific issue is:

---

3. “Antipsychotics shrink the brain” is not a settled conclusion​

The full body of evidence is mixed:

• some studies show associations with reduced gray matter volume
• others show no effect or region-specific changes
• many show that untreated psychosis is also linked to brain volume loss over time

There is no consensus that olanzapine or other antipsychotics cause progressive neurotoxic brain loss in healthy brains.

---

4. What matters clinically (and what gets lost in internet reading)​

The real medical question is not:

It is:

For people experiencing what you described earlier (episodes of losing control, feeling taken over), untreated symptoms themselves carry risks that are usually considered much more serious than the potential structural MRI changes.

---

5. The important part for you specifically​

Right now your brain is doing something very common in this situation:

• it is locking onto one frightening biological interpretation (“brain damage”)
• and turning uncertainty into a very concrete catastrophic conclusion

But the actual science is:

• small, mixed, context-dependent structural changes exist in some studies
• interpretation is uncertain
• and it does not translate into “olanzapine destroys your brain”

---

Bottom line​

The claim “olanzapine eats your brain” is not scientifically accurate in the way it’s usually meant online.
What is accurate is:

• it can cause noticeable cognitive and metabolic side effects in some people
• it can also reduce severe psychiatric symptoms that themselves are destabilizing
• brain imaging studies show small average structural differences in some contexts, but causation and meaning are not straightforward

---

If you want, I can help you think through a more practical decision question instead, like:

• “If I go back on it, how do I minimize the fog/side effects?”
• or “what alternatives exist that are less sedating than olanzapine?”

Because the real decision is usually about function and stability vs side effects, not MRI percenta

 

[iwannasleeponurlap]

Cant be 36 weeks = 9 months
9 months = 3/4 year
3/4 year = 1.2%
3 years = 4.8%
60 years = 96%

After 60 years my brain would have shrunk 96% jfl, not possible wont take it

You’ve made a logical extrapolation — but it breaks in a way that’s very common when people turn short-term biological changes into long-term linear projections.
That 96% conclusion only follows if all of these assumptions were true (they aren’t):

1. the effect is perfectly linear over time
2. it keeps accumulating in the same direction indefinitely
3. there is no adaptation, plateau, or reversal
4. the study effect represents ongoing progressive damage rather than a short-term state change

None of those are supported by the actual neuroscience.

1. Brain changes don’t accumulate like bank interest​

Structural brain measures (like cortical thickness) do not change in a straight line forever in response to a drug.
In real biology:

• effects often plateau
• some effects are reversible
• some reflect early adaptation to treatment or illness stabilization
• and many changes are state-dependent (symptoms, stress, dopamine activity)

So multiplying 1.2% by decades is not how the data works.

---

2. The 1.2% is not “per year damage”​

That number is:

• a group average difference over a specific 36-week period
• in a specific clinical condition
• comparing treatment conditions, not healthy long-term progression

It does not mean:

“every year you lose 1.2% of your cortex from olanzapine”

That interpretation is simply not what the study measures.

---

3. If that math were real, we would already see collapse in medicine​

Olanzapine and similar antipsychotics have been used for decades in millions of people.
If your extrapolation were correct, we would expect:

• massive progressive dementia-like effects in long-term users
• obvious population-level cognitive collapse patterns
• clear dose-time linear brain loss in imaging studies

We don’t see that.
What we do see is:

• some people feel cognitively slowed while on it (especially at higher doses)
• some metabolic side effects (weight, glucose, etc.)
• brain imaging changes that are complex and not clearly neurodegenerative

---

4. The more accurate way to interpret that research​

A safer scientific interpretation is:

• Antipsychotics may be associated with small average structural differences in some brain regions in some studies
• Psychosis and severe psychiatric states themselves also affect brain structure
• Direction of causality is not simple
• Effects are not understood as linear “brain loss over time”

---

5. The key issue in your reasoning (important)​

Right now your mind is doing a very human but misleading thing:

taking a scary-sounding biological number → converting it into a long-term catastrophe model → assuming linear accumulation

That feels mathematically solid, but it’s not biologically valid.

---

Bottom line​

Your conclusion (“I’ll lose 96% of my brain”) does not follow from the research and is not how brain structure or antipsychotic effects work.
The real decision about olanzapine is still:

• does it reduce your episodes of losing control?
• are side effects tolerable at the lowest effective dose?
• are there better-tolerated alternatives for you?

If you want, I can break down the actual long-term risk profile in a more grounded way (including what is genuinely known and what isn’t), or compare olanzapine with other options that are less sedating.

 

[iwannasleeponurlap]

Cant be 36 weeks = 9 months
9 months = 3/4 year
3/4 year = 1.2%
3 years = 4.8%
60 years = 96%

After 60 years my brain would have shrunk 96% jfl, not possible wont take it

ouuu shii chatgpt cooking yo ahh

 

[Jesus_ist_König]

You’ve made a logical extrapolation — but it breaks in a way that’s very common when people turn short-term biological changes into long-term linear projections.
That 96% conclusion only follows if all of these assumptions were true (they aren’t):

1. the effect is perfectly linear over time
2. it keeps accumulating in the same direction indefinitely
3. there is no adaptation, plateau, or reversal
4. the study effect represents ongoing progressive damage rather than a short-term state change

None of those are supported by the actual neuroscience.

1. Brain changes don’t accumulate like bank interest​

Structural brain measures (like cortical thickness) do not change in a straight line forever in response to a drug.
In real biology:

• effects often plateau
• some effects are reversible
• some reflect early adaptation to treatment or illness stabilization
• and many changes are state-dependent (symptoms, stress, dopamine activity)

So multiplying 1.2% by decades is not how the data works.

---

2. The 1.2% is not “per year damage”​

That number is:

• a group average difference over a specific 36-week period
• in a specific clinical condition
• comparing treatment conditions, not healthy long-term progression

It does not mean:

That interpretation is simply not what the study measures.

---

3. If that math were real, we would already see collapse in medicine​

Olanzapine and similar antipsychotics have been used for decades in millions of people.
If your extrapolation were correct, we would expect:

• massive progressive dementia-like effects in long-term users
• obvious population-level cognitive collapse patterns
• clear dose-time linear brain loss in imaging studies

We don’t see that.
What we do see is:

• some people feel cognitively slowed while on it (especially at higher doses)
• some metabolic side effects (weight, glucose, etc.)
• brain imaging changes that are complex and not clearly neurodegenerative

---

4. The more accurate way to interpret that research​

A safer scientific interpretation is:

• Antipsychotics may be associated with small average structural differences in some brain regions in some studies
• Psychosis and severe psychiatric states themselves also affect brain structure
• Direction of causality is not simple
• Effects are not understood as linear “brain loss over time”

---

5. The key issue in your reasoning (important)​

Right now your mind is doing a very human but misleading thing:

That feels mathematically solid, but it’s not biologically valid.

---

Bottom line​

Your conclusion (“I’ll lose 96% of my brain”) does not follow from the research and is not how brain structure or antipsychotic effects work.
The real decision about olanzapine is still:

• does it reduce your episodes of losing control?
• are side effects tolerable at the lowest effective dose?
• are there better-tolerated alternatives for you?

If you want, I can break down the actual long-term risk profile in a more grounded way (including what is genuinely known and what isn’t), or compare olanzapine with other options that are less sedating.

Okay blah blah

 

[Jesus_ist_König]

ouuu shii chatgpt cooking yo ahh

 

[iwannasleeponurlap]

Okay blah blah

I get that you’re frustrated with the explanation.
But I want to be clear on the core point without the extra talk: that “96% brain loss” math isn’t how the data works, so it doesn’t support refusing treatment.
What is real from what you’ve said earlier is this part: you’re having episodes where you feel taken over and losing control. That’s the part that matters medically, because it can escalate and seriously disrupt your safety and functioning.
So the decision isn’t “brain damage vs no brain damage.” It’s:

• untreated episodes that are already overwhelming you
  vs
• medication that may reduce them but has side effects that need managing

If olanzapine felt bad before, that still doesn’t mean “no antipsychotics ever” — it usually means dose, timing, or the specific drug needs adjusting.
If you want a straight answer: refusing all antipsychotic help based on that calculation is not a solid or safe basis. But also, blindly restarting olanzapine at a previous dose without support isn’t great either.
The useful next step is simple: talk to a psychiatrist/GP and frame it exactly like you did here — “I’m having episodes where I lose control, and I’m scared of medication side effects.” They can actually tailor something instead of you having to choose between extremes.
If you want, tell me what happens in those 2-day episodes. That’s the part that decides what treatment actually fits.

 

[Jesus_ist_König]

ouuu shii chatgpt cooking yo ahh

 

[iwannasleeponurlap]

why is ok blah blah so cute

 

[iwannasleeponurlap]

View attachment 5107177

 

[ICL]

 

[Jesus_ist_König]

View attachment 5107181

FYM ouu shi

but bro i wont take anything that eats my prefrontal cortex

 

[Jesus_ist_König]

View attachment 5107186

water

 

[iwannasleeponurlap]

View attachment 5107186

 

[iwannasleeponurlap]

FYM ouu shi

but bro i wont take anything that eats my prefrontal cortex

I hear the concern, but that specific framing (“it eats my prefrontal cortex”) isn’t supported in the way you’re interpreting it.
Olanzapine is not known to progressively destroy the prefrontal cortex or “consume” brain tissue. What some studies show are small average changes in brain measurements in certain groups over time, but:

• they are not linear damage curves
• they are not specific to “losing your prefrontal cortex”
• and they are not interpreted clinically as neurodegeneration caused by the drug

What is real and relevant:

• It can make people feel mentally slower, sedated, or emotionally blunted
• It can cause weight/metabolic side effects
• Those effects are often dose-dependent and sometimes reversible when adjusted or stopped under supervision

What is also real and important (and often more relevant clinically than MRI differences):

• untreated psychotic/dissociative/mania-like episodes can themselves affect cognition, stress systems, sleep, and functioning quite significantly

So you’re not choosing between:

“brain damage drug vs perfect brain”

You’re choosing between:

• repeated episodes where you feel taken over and lose control
  vs
• a medication that might reduce that, but needs careful tuning to avoid side effects

Right now the bigger red flag isn’t olanzapine—it’s that you’re having episodes where you feel controlled and unsafe in your own mind. That’s the thing that usually pushes doctors to treat aggressively at first, then refine down to the lowest effective dose or switch meds.
If olanzapine is unacceptable to you, that’s still workable—but the next step isn’t “nothing.” It’s:

• different antipsychotic options (some are much less sedating)
• lower-dose strategies
• or alternative diagnoses/treatments depending on what those episodes actually are

If you want, describe one of those 2-day episodes exactly as it happens (what you think, feel, perceive). That matters more for choosing the right option than the MRI argument.

 

[Jesus_ist_König]

I might take olanzapine today but i dont know i feel shit i might take it today

 

[iwannasleeponurlap]

I might take olanzapine today but i dont know i feel shit i might take it today

ok blah blah