![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 128. This is the beginning of the thread.
Posted by Nohope on April 25, 2004, at 0:50:43
Hi,
I am currently using Abilify but am thinking of switching to Seroquel because the agitation on Abilify is just terrible.
I have been on Seroquel for a very short time once before and found it *extremely* sedating. Does this sedation go away - if so in how long? Does Seroquel give you "energy" or do you feel like a zombie? Is "brain fog" a problem? Very importantly, is sexual function affected? Any other affects I should be aware of?
Thanks very much.
Nohope
Posted by chemist on April 25, 2004, at 1:02:10
In reply to Seroquel users: a couple of questions, posted by Nohope on April 25, 2004, at 0:50:43
> Hi,
>
> I am currently using Abilify but am thinking of switching to Seroquel because the agitation on Abilify is just terrible.
>
> I have been on Seroquel for a very short time once before and found it *extremely* sedating. Does this sedation go away - if so in how long? Does Seroquel give you "energy" or do you feel like a zombie? Is "brain fog" a problem? Very importantly, is sexual function affected? Any other affects I should be aware of?
>
> Thanks very much.
>
> Nohope
>
hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
Posted by SLS on April 25, 2004, at 2:42:43
In reply to Re: Seroquel users: a couple of questions » Nohope, posted by chemist on April 25, 2004, at 1:02:10
Hi Chemist.
Regarding Seroquel:
> hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished...
That's pretty cool. I didn't know that. I always wondered why people were able to retain the hypnotic effect long-term with such low dosages, while others experience no such effect at 700mg.
- Scott
Posted by Nohope on April 25, 2004, at 2:47:12
In reply to Re: Seroquel users: a couple of questions » Nohope, posted by chemist on April 25, 2004, at 1:02:10
> hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
Thank you very much. Any more info on Seroquel you can share?
Nohope
Posted by chemist on April 25, 2004, at 22:22:51
In reply to Re: Seroquel users: a couple of questions » chemist, posted by Nohope on April 25, 2004, at 2:47:12
> > hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
>
> Thank you very much. Any more info on Seroquel you can share?
>
> Nohope
>
>
hi there....seroquel hits th 5-HT_{2} and dopamine_{2} receptors pretty hard....it is an atypical antipsychotic that, along with risperidone and ziprasidone, has recently been on the radar for mood stabilizing effects. ziprasidone (geodon, zonegran) is more weight-neutral than the others, with wieght-gain with seroquel being less a problem than risperidone and slightly more than that of ziprasidone. the extrapyrimidal side effects - especially with ziprasidone, which include SJS and a prolonged QT interval, making this one my least favorite - are reduced vs. typical antipsychotics. all in all, seroquel is superior in my opinion, although i have one client whoo is truly schizophrenic and like risperidone the best, although dietary adjustments are necessary and exercise (never a bad thing) is important for weight-gain.....if you want to roll the dice, you could do worse than seroquel....let me know if you need more info, i will provide what i can....all the best, chemist
Posted by Escher Dementian on April 26, 2004, at 2:02:38
In reply to Seroquel users: a couple of questions, posted by Nohope on April 25, 2004, at 0:50:43
Seroquel dropped me in my tracks like 'pill-induced-narcolepsy'.
Posted by shadows721 on April 26, 2004, at 2:03:47
In reply to Re: Seroquel users: a couple of questions » Nohope, posted by chemist on April 25, 2004, at 22:22:51
I haven't noticed if seroquel affect sex drive. I don't have any from Lexapro. If you have low blood pressure, be careful with Seroquel dosage. It dropped my b/p to 88/56. I was majorly dizzy. I am on the low dosage for sleep. It really helps. I prefer it to an addictive benzo.
Posted by nmk on April 26, 2004, at 11:01:55
In reply to Re: Seroquel users: a couple of questions » Nohope, posted by chemist on April 25, 2004, at 22:22:51
> > > hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
Hi Chemist,
I take 12.5 mg of seroquel at night along with 1 mg of klonopin for sleep. This combo knocks me out and provides 8 hours of restful sleep. The problem is, I wake up feeling depressed, sometimes agitated, and do not seem to snap out of it on most days. During the day I take 75 mg of zoloft and either 1 mg of ativan or .5 mg of klonopin as needed for anxiety. This provides some relief but I still feel depressed on most days.
I see my pdoc tomorrow and want to come in armed with some information and would very much appreciate your insight. First of all, could any of my meds or med-combo's be exacerbating the depression? Do I need to taper down or increase anything? BTW, I was taking 50 mg of zoloft just four days ago but as the depression worsened, my pdoc asked me to double it until I see him on Tues. The double dose made me sick to my stomach for two days so I backed down to 75 mg today and the gastro problems have subsided.
The thought of changing AD's is frightening since I have tried effexor, remeron, lexapro along with two mood stabilizers, trileptal and lamictal, all to no avail. My moods actually cycled more frequently while on these meds than now. My pdoc thinks I may have BP II but isn't definitive in his diagnosis.
Any thoughts? I really appreciate all of your information and posts.
Thanks,
Nicole
Posted by lauram on April 26, 2004, at 11:55:51
In reply to Re: Seroquel users: a couple of questions » chemist, posted by nmk on April 26, 2004, at 11:01:55
I am BPII. I am on Lamictal 300mg taken in divided doses twice a day. I have been on Seroquel for two years. I take 75mg at night and am guaranteed a good night sleep. I have not built up any tolerance, it works the same night after night. These two meds together have controlled my mood swings wonderfully.
Initially the grogginess from the Seroquel was dramatic. After being on it for a month or so the grogginess in the AM was less but still there. I started getting up at a regular time regardless of how sleepy I felt. I get up and within 30 minutes the grogginess is gone and I feel great. Lamictal and Seroquel have worked wonders for me. Just my experience.
Posted by chemist on April 26, 2004, at 16:42:25
In reply to Re: Seroquel users: a couple of questions » chemist, posted by nmk on April 26, 2004, at 11:01:55
> > > > hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
>
> Hi Chemist,
>
> I take 12.5 mg of seroquel at night along with 1 mg of klonopin for sleep. This combo knocks me out and provides 8 hours of restful sleep. The problem is, I wake up feeling depressed, sometimes agitated, and do not seem to snap out of it on most days. During the day I take 75 mg of zoloft and either 1 mg of ativan or .5 mg of klonopin as needed for anxiety. This provides some relief but I still feel depressed on most days.
>
> I see my pdoc tomorrow and want to come in armed with some information and would very much appreciate your insight. First of all, could any of my meds or med-combo's be exacerbating the depression? Do I need to taper down or increase anything? BTW, I was taking 50 mg of zoloft just four days ago but as the depression worsened, my pdoc asked me to double it until I see him on Tues. The double dose made me sick to my stomach for two days so I backed down to 75 mg today and the gastro problems have subsided.
>
> The thought of changing AD's is frightening since I have tried effexor, remeron, lexapro along with two mood stabilizers, trileptal and lamictal, all to no avail. My moods actually cycled more frequently while on these meds than now. My pdoc thinks I may have BP II but isn't definitive in his diagnosis.
>
> Any thoughts? I really appreciate all of your information and posts.
>
> Thanks,
>
> Nicole
>
>
> hi nicole, sounds like your depression isn't being helped by the seroquel + klonopin + ativan...as for zoloft, seems like you have found a dose you are comfortable with. perhaps the seroquel is overkill, and leaving that out of your regimen might allow the zoloft to do the job....you've got 3 ``downers'' and only one ``upper'' to work with, so i'd try cutting back on one of the downers and see how it pans out.....all the best, chemist
Posted by jtevers on April 26, 2004, at 17:59:10
In reply to Re: Seroquel users: a couple of questions » nmk, posted by chemist on April 26, 2004, at 16:42:25
fellow posters:
i had been diagnosed in 2000 with bipolar and have suffered the symptoms and side effects of treatment since. any insight or questions you have will be helpful.
while i have been taking larger doses of seroquel than discussed, many of it's pitfalls and virtues i understand are not dose-related.
like weight gain... i have gained 60 lbs. totally in two divided increments during two winters on seroquel. hence my new and ongoing trial with geodon (reputed to be weight neutral). i hope the geodon will allow me to shed a few.
while my dose of seroquel over the past year has been variable the amount of sleep it causes has been (to me) an irritating constant. i sleep no less than 10 hours a night. while the geodon / ziprasidone i am trying causes the polar opposite ... any insight with insomnia? i would prefer to try something that, unlike an antipsychotic, will not cause weight gain and, unlike a benzo, may last longer.
please be careful i understand that both of these aspects of seroquel, the sedation and weight gain, are caused by transient, but complete, blockade of histamine. i do not understand that this effect is dose-related.
i also experience discomfort on geodon (perhaps you can help me through this one) referred to as akithisia (jitteriness) and vertigo (dizziness) and while a remedy for each has been proposed both, you guessed it, also cause weight gain. inderal and antihistamines are often used to fight these side effects and both pack the pounds on and would be contradictory to the purpose for my switch from seroquel to geodon. do you have any insight with akithisia or vertigo?
thanks, everyone, for your 2 cents.
Posted by jerrympls on April 27, 2004, at 21:03:11
In reply to Re: Seroquel users: a couple of questions » Nohope, posted by chemist on April 25, 2004, at 1:02:10
> hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemistWith all due respect Chemist - Seroquel in the 150-200 range will knock out a horse for 3 days. I started on Seroquel 25mg during the day for anxiety. Now I take 200mg for insomnia. I've been on it for a year. The sluggishnesss and hangover are still present. Weight gain is horrific.
Now, this is my experience - and I bet if you do a search you'll find many on this board taking Seroqeul will tell you it's VERY sedating.
Jerry :-)
Posted by chemist on April 27, 2004, at 22:02:52
In reply to Re: Seroquel users: a couple of questions » chemist, posted by jerrympls on April 27, 2004, at 21:03:11
>
> > hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
>
> With all due respect Chemist - Seroquel in the 150-200 range will knock out a horse for 3 days. I started on Seroquel 25mg during the day for anxiety. Now I take 200mg for insomnia. I've been on it for a year. The sluggishnesss and hangover are still present. Weight gain is horrific.
>
> Now, this is my experience - and I bet if you do a search you'll find many on this board taking Seroqeul will tell you it's VERY sedating.
>
> Jerry :-)hi jerry, i welcome your news....i have taken seroquel at the 50 mg level and found it to be an excellent hypnotic....the higher doses, after titration, are *supposed* to be less sedating and more mood-stabilizing, although i cannot confirm from personal experience, just what i have leard from patients and in the literature...sorry to hear that it is not working out for you; is geodon a potential alternative? all the best, and thank you for the info, chemist
Posted by jerrympls on April 27, 2004, at 22:31:08
In reply to Re: Seroquel users: a couple of questions » jerrympls, posted by chemist on April 27, 2004, at 22:02:52
> >
> > > hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
> >
> > With all due respect Chemist - Seroquel in the 150-200 range will knock out a horse for 3 days. I started on Seroquel 25mg during the day for anxiety. Now I take 200mg for insomnia. I've been on it for a year. The sluggishnesss and hangover are still present. Weight gain is horrific.
> >
> > Now, this is my experience - and I bet if you do a search you'll find many on this board taking Seroqeul will tell you it's VERY sedating.
> >
> > Jerry :-)
>
> hi jerry, i welcome your news....i have taken seroquel at the 50 mg level and found it to be an excellent hypnotic....the higher doses, after titration, are *supposed* to be less sedating and more mood-stabilizing, although i cannot confirm from personal experience, just what i have leard from patients and in the literature...sorry to hear that it is not working out for you; is geodon a potential alternative? all the best, and thank you for the info, chemistHey Chemist-
Well, I think I'm going to be tapering off the Seroquel because I can barely get up and go to work the hangover is so bad for me. However, it's a double-edged sword because I need something strong to knock me out and keep me asleep. The BEST sleep I've ever gotten was when I was on the barbituate Nembutal. I'd give anything for that. I slept so well - and when I woke up I felt refreshed and no hangover. However, as you probably know - docs are very very uneasy prescribing a barbituate for sleep. Unfortunate for me. Ambien 20mg used to help as well - but after being on and off it for 10 years, its effects are very weak.
So, the only thing lefts is a very sedating antidepresant or antipsychotic - or - something along the lines of Atarax or a benzo. I grow a fast tolerance to benzos unfortunately.
My pdoc brought up Abilify - but from what I've read it CAUSES insonia and terrible akathesia.
My diagnosis is Major Depression - treatment resistant with GAD. I take 375mg of Effexor XR, 10mg Valium 4x daily, Seroquel 200 hs, Ambien 20mg hs/prn and Concerta 56mg in a divided dose twice daily.
Now that I think about it - a couple months ago my pdoc brought up Chloral Hydrate. I tried that about 9 years ago and didn't find it helpful - but my brain chemistry hhas changed over 9 years and perhaps it would be perfect?
*sigh* I wish I didn't have to count on a med to help me sleep....but....gotta as for now.
Thanks for listening ;-)
Jerry
Posted by chemist on April 27, 2004, at 22:47:44
In reply to Re: Seroquel users: a couple of questions » chemist, posted by jerrympls on April 27, 2004, at 22:31:08
> > >
> > > > hi there, chemist here....seroquel in low dosages is a hypnotic, but as you increase, the grogginess will go away. if you want to go to sleep, take 25 to 50 mg at bedtime: you're out like a light. as you work your way towards 150-200 mg, the effects you are seeking will take hold and the hypnotic aspect of te drug will be diminished....all the best, chemist
> > >
> > > With all due respect Chemist - Seroquel in the 150-200 range will knock out a horse for 3 days. I started on Seroquel 25mg during the day for anxiety. Now I take 200mg for insomnia. I've been on it for a year. The sluggishnesss and hangover are still present. Weight gain is horrific.
> > >
> > > Now, this is my experience - and I bet if you do a search you'll find many on this board taking Seroqeul will tell you it's VERY sedating.
> > >
> > > Jerry :-)
> >
> > hi jerry, i welcome your news....i have taken seroquel at the 50 mg level and found it to be an excellent hypnotic....the higher doses, after titration, are *supposed* to be less sedating and more mood-stabilizing, although i cannot confirm from personal experience, just what i have leard from patients and in the literature...sorry to hear that it is not working out for you; is geodon a potential alternative? all the best, and thank you for the info, chemist
>
> Hey Chemist-
>
> Well, I think I'm going to be tapering off the Seroquel because I can barely get up and go to work the hangover is so bad for me. However, it's a double-edged sword because I need something strong to knock me out and keep me asleep. The BEST sleep I've ever gotten was when I was on the barbituate Nembutal. I'd give anything for that. I slept so well - and when I woke up I felt refreshed and no hangover. However, as you probably know - docs are very very uneasy prescribing a barbituate for sleep. Unfortunate for me. Ambien 20mg used to help as well - but after being on and off it for 10 years, its effects are very weak.
>
> So, the only thing lefts is a very sedating antidepresant or antipsychotic - or - something along the lines of Atarax or a benzo. I grow a fast tolerance to benzos unfortunately.
>
> My pdoc brought up Abilify - but from what I've read it CAUSES insonia and terrible akathesia.
>
> My diagnosis is Major Depression - treatment resistant with GAD. I take 375mg of Effexor XR, 10mg Valium 4x daily, Seroquel 200 hs, Ambien 20mg hs/prn and Concerta 56mg in a divided dose twice daily.
>
> Now that I think about it - a couple months ago my pdoc brought up Chloral Hydrate. I tried that about 9 years ago and didn't find it helpful - but my brain chemistry hhas changed over 9 years and perhaps it would be perfect?
>
> *sigh* I wish I didn't have to count on a med to help me sleep....but....gotta as for now.
>
> Thanks for listening ;-)
>
> Jerry
>
hi jerry, sounds like quite a coktail! had a brief experience with nembutal years and years ago, but as you say, good luck in getting a script. is the effexor and concerta overstimulating you? all the best, chemist
Posted by jtevers on May 4, 2004, at 16:52:43
In reply to Re: Seroquel users: a couple of questions » chemist, posted by jerrympls on April 27, 2004, at 21:03:11
> With all due respect Chemist - Seroquel in the 150-200 range will knock out a horse for 3 days. I started on Seroquel 25mg during the day for anxiety. Now I take 200mg for insomnia. I've been on it for a year. The sluggishnesss and hangover are still present. Weight gain is horrific.
>
> Now, this is my experience - and I bet if you do a search you'll find many on this board taking Seroqeul will tell you it's VERY sedating.
>
> Jerry :-)to one and all, esp. chemist, jerry and friends,
i have been on seroquel since a 2001 diagnosis of bipolar disorder and am currently on my third attept to switch to geodon.
i have gained over 70 lbs. in two divided increments over the past two winters all of which will not respond to diet ( tried Atkins ) or exercise ( i walk, jog, or swim daily ) ... hence, the switch to geodon.
but, now i am experiencing the polar opposite of the "sleep problem" i lived with on seroquel. where once i slept over 10 hours per night ( i agree, jerry, that the hypersomnia caused by seroquel diminishes only very slightly and i was forced to take most of my dose at night ), and am not sleeping a wink on geodon.
i want to lose weight and would rather a little to too much sleep. i am fighting to stay on geodon but don't know how to get a wink of sleep without adding seroquel... any advice? i have heard that benzos and even ambien are of little help long term.
wish me luck and i thank you for your time.
Posted by chemist on May 4, 2004, at 19:18:39
In reply to seroquel to geodon ... weight and sleep?, posted by jtevers on May 4, 2004, at 16:52:43
>
> > With all due respect Chemist - Seroquel in the 150-200 range will knock out a horse for 3 days. I started on Seroquel 25mg during the day for anxiety. Now I take 200mg for insomnia. I've been on it for a year. The sluggishnesss and hangover are still present. Weight gain is horrific.
> >
> > Now, this is my experience - and I bet if you do a search you'll find many on this board taking Seroqeul will tell you it's VERY sedating.
> >
> > Jerry :-)
>
> to one and all, esp. chemist, jerry and friends,
>
> i have been on seroquel since a 2001 diagnosis of bipolar disorder and am currently on my third attept to switch to geodon.
>
> i have gained over 70 lbs. in two divided increments over the past two winters all of which will not respond to diet ( tried Atkins ) or exercise ( i walk, jog, or swim daily ) ... hence, the switch to geodon.
>
> but, now i am experiencing the polar opposite of the "sleep problem" i lived with on seroquel. where once i slept over 10 hours per night ( i agree, jerry, that the hypersomnia caused by seroquel diminishes only very slightly and i was forced to take most of my dose at night ), and am not sleeping a wink on geodon.
>
> i want to lose weight and would rather a little to too much sleep. i am fighting to stay on geodon but don't know how to get a wink of sleep without adding seroquel... any advice? i have heard that benzos and even ambien are of little help long term.
>
> wish me luck and i thank you for your time.
>
>
chemist here...sorry to hear about the weight gain and that increased seroquel poved to be as sedating as lower doses....and equally problematic is geodon......i can only relate my experience with sleep and benzos/ambien, and i have found that ambien worked quite well for me when i needed it, and that earlier trials of xanax and halcion put me to sleep, but the hangover was a little much: it took a lot of coffee to get out of the fog in the a.m. if i recall, there is an edge on ambien over benzos in that your stages of sleep are preserved, i.e., on ambien you get a ``quality'' snooze and with benzos there are some stages that are not visited for the requisite amounts of time....all the best, chemist
Posted by nmk on May 5, 2004, at 10:25:13
In reply to Re: seroquel to geodon ... weight and sleep? » jtevers, posted by chemist on May 4, 2004, at 19:18:39
> chemist here...sorry to hear about the weight gain and that increased seroquel poved to be as sedating as lower doses....and equally problematic is geodon......i can only relate my experience with sleep and benzos/ambien, and i have found that ambien worked quite well for me when i needed it, and that earlier trials of xanax and halcion put me to sleep, but the hangover was a little much: it took a lot of coffee to get out of the fog in the a.m. if i recall, there is an edge on ambien over benzos in that your stages of sleep are preserved, i.e., on ambien you get a ``quality'' snooze and with benzos there are some stages that are not visited for the requisite amounts of time....all the best, chemist
Dear Chemist,I am struggling with the same issues but with Zyprexa weight gain instead. My doctor has prescribed 500mg of Glucophage (Metformin) and says this should help reduce the weight gain. Any insights on this med and its effectiveness? I know it messes with your insulin levels and am also concerned about the safety of this med on a long term basis. As always, I appreciate your responses and your vast knowledge of meds.
Thanks,
Nicole
Posted by chemist on May 5, 2004, at 11:12:23
In reply to Re: seroquel to geodon ... weight and sleep? » chemist, posted by nmk on May 5, 2004, at 10:25:13
> > chemist here...sorry to hear about the weight gain and that increased seroquel poved to be as sedating as lower doses....and equally problematic is geodon......i can only relate my experience with sleep and benzos/ambien, and i have found that ambien worked quite well for me when i needed it, and that earlier trials of xanax and halcion put me to sleep, but the hangover was a little much: it took a lot of coffee to get out of the fog in the a.m. if i recall, there is an edge on ambien over benzos in that your stages of sleep are preserved, i.e., on ambien you get a ``quality'' snooze and with benzos there are some stages that are not visited for the requisite amounts of time....all the best, chemist
>
>
> Dear Chemist,
>
> I am struggling with the same issues but with Zyprexa weight gain instead. My doctor has prescribed 500mg of Glucophage (Metformin) and says this should help reduce the weight gain. Any insights on this med and its effectiveness? I know it messes with your insulin levels and am also concerned about the safety of this med on a long term basis. As always, I appreciate your responses and your vast knowledge of meds.
>
> Thanks,
>
> Nicole
>
hi nicole.....i am puzzled about the metformin for weight control....you can expect hypoglycemia, but i am unaware of of a med for diabetes mellitus being used to counter the weight-gain associated with an atypical antipsychotic....are your triglycerides very high?....this is the only thing i can think of as a reason why this med is being prescribed with respect to concurrent use of zyprexa, which (if i recall) has been shown to increase triglyceride levels...i am not certain if this alone (elevated triglycerides) is the reason why zyprexa is associated with weight-gain in almost enveryone who takes it...seems that, given the number (and types) of receptors it hits, that reduction of triglycerides with metformin would not be the remedy in toto. ask your doctor about the rationale, and i'll do some digging to see if there are any pubs that indicate that this has been successful....more soon, and all the best, chemist
Posted by chemist on May 5, 2004, at 12:08:33
In reply to Re: seroquel to geodon ... weight and sleep? » chemist, posted by nmk on May 5, 2004, at 10:25:13
hi nicole...a quick perusal of pubmed reveals: yes, elevated trglycerides have been found in patients on zyprexa; one study found that zyprexa use precipitated diabetes mellitus but 5 of the six patients had some risk for diabetes mellitus before the study, and a switch to seroquel resulted in moderation of ``glycaemic control'' in 2 of the 6 patients (yes, a small cohort but valuable information); a study of zyprexa vs. risperidone revealed that the zyprexa group had high triglycerides, low HDL cholesterol levels, high cholesterol:HDL, high apolipoprotein B, smaller LDL peak particle diameters, and higher fasting insulin concentrations than the risperidone group, conclusions that zyprexa altered metabolic profile for increased risk of atherosclerosis (essentialy, they researchers were looking for a link to heart trouble) over those taking risperidone; another found elevated levels of a protein involved with regulation of glucose metabolism and insulin sensitivity in schizophrenic patients on either zyprexa or risperidone. the protein concentration dropped as the zyprexa patients put on weight, and in the risperidol group, the protein concentration remained high regardless of weight gain/loss; another indicates that weight gain on zyprexa was statistically significant vs. risperidone, seroquel, and haldol; another looked at weight gain in smoking/non-smoking schizophrenics who were taking zyprexa or risperidone. in the zyprexa group, smokers/non-smokers gained weight, yet in the risperidone group, smokers gained less weight than the non-smokers, conclusions being that zyprexa offsets the (common) weight loss seen in smokers but risperidone does not, implying that zyprexa does indeed change your metabolic system; another points to weight gain resulting from affinity for H_{1} histaminergic and alpha_{1} adreneergic receptors, in addition to ``changes in insulin sensitivity'' (among others), and they found that metformin was effective in decreasing weight gain associated with atypical anti-psychotics (Curr. Drug Targets, 5:279-299, 2004); another found that hyperglycemia occurs with treatment of only clozapine or zyprexa, and that weight gian came before onset of hyperglycemia in 2/3 of the patients with hyperglycemia. i note that this study was a 7-year long one, and the study group was 86,349 patients in 35 mental institutions, and that the _total_ number of hyperglycemic patients was 9 (nine, not a typo); okay, that's it for this....seems like zyprexa is pretty-well documented to cause alteration of metabolic pathways and maybe (in the one study) metformin can send your system towards the `right'' side...hope this helps, all the best, chemist
Posted by nmk on May 5, 2004, at 14:07:39
In reply to Re: seroquel to geodon ... weight and sleep? » nmk, posted by chemist on May 5, 2004, at 12:08:33
> hi nicole...a quick perusal of pubmed reveals: yes, elevated trglycerides have been found in patients on zyprexa; one study found that zyprexa use precipitated diabetes mellitus but 5 of the six patients had some risk for diabetes mellitus before the study, and a switch to seroquel resulted in moderation of ``glycaemic control'' in 2 of the 6 patients (yes, a small cohort but valuable information); a study of zyprexa vs. risperidone revealed that the zyprexa group had high triglycerides, low HDL cholesterol levels, high cholesterol:HDL, high apolipoprotein B, smaller LDL peak particle diameters, and higher fasting insulin concentrations than the risperidone group, conclusions that zyprexa altered metabolic profile for increased risk of atherosclerosis (essentialy, they researchers were looking for a link to heart trouble) over those taking risperidone; another found elevated levels of a protein involved with regulation of glucose metabolism and insulin sensitivity in schizophrenic patients on either zyprexa or risperidone. the protein concentration dropped as the zyprexa patients put on weight, and in the risperidol group, the protein concentration remained high regardless of weight gain/loss; another indicates that weight gain on zyprexa was statistically significant vs. risperidone, seroquel, and haldol; another looked at weight gain in smoking/non-smoking schizophrenics who were taking zyprexa or risperidone. in the zyprexa group, smokers/non-smokers gained weight, yet in the risperidone group, smokers gained less weight than the non-smokers, conclusions being that zyprexa offsets the (common) weight loss seen in smokers but risperidone does not, implying that zyprexa does indeed change your metabolic system; another points to weight gain resulting from affinity for H_{1} histaminergic and alpha_{1} adreneergic receptors, in addition to ``changes in insulin sensitivity'' (among others), and they found that metformin was effective in decreasing weight gain associated with atypical anti-psychotics (Curr. Drug Targets, 5:279-299, 2004); another found that hyperglycemia occurs with treatment of only clozapine or zyprexa, and that weight gian came before onset of hyperglycemia in 2/3 of the patients with hyperglycemia. i note that this study was a 7-year long one, and the study group was 86,349 patients in 35 mental institutions, and that the _total_ number of hyperglycemic patients was 9 (nine, not a typo); okay, that's it for this....seems like zyprexa is pretty-well documented to cause alteration of metabolic pathways and maybe (in the one study) metformin can send your system towards the `right'' side...hope this helps, all the best, chemist
Chemist,WOW!!!!!!! Thanks for the information. I didn't expect you to do all you have done in regard to researching the literature so I greatly appreciate your help.
I work in an educational institution and have access to all of the medical journals. I would like to read some of the journal articles you came across in your discoveries. Does "Curr. Drug Targets" stand for "Current". Are there any other journals that would help me in my quest to better understand the actions of these meds?
Again, you have been a wonderful help to me and all the best to you too!
Nicole
Posted by nmk on May 5, 2004, at 14:16:02
In reply to Re: seroquel to geodon ... weight and sleep? » nmk, posted by chemist on May 5, 2004, at 12:08:33
Hi again,
Here is a good link describing the relationship between AP's and weight gain, along with various treatment options.
Again, thanks a bunch!
Nicole
http://www.psycheducation.org/hormones/Insulin/weightgain.htm
Posted by chemist on May 5, 2004, at 14:36:56
In reply to Re: seroquel to geodon ... weight and sleep? » chemist, posted by nmk on May 5, 2004, at 14:07:39
> > hi nicole...a quick perusal of pubmed reveals: yes, elevated trglycerides have been found in patients on zyprexa; one study found that zyprexa use precipitated diabetes mellitus but 5 of the six patients had some risk for diabetes mellitus before the study, and a switch to seroquel resulted in moderation of ``glycaemic control'' in 2 of the 6 patients (yes, a small cohort but valuable information); a study of zyprexa vs. risperidone revealed that the zyprexa group had high triglycerides, low HDL cholesterol levels, high cholesterol:HDL, high apolipoprotein B, smaller LDL peak particle diameters, and higher fasting insulin concentrations than the risperidone group, conclusions that zyprexa altered metabolic profile for increased risk of atherosclerosis (essentialy, they researchers were looking for a link to heart trouble) over those taking risperidone; another found elevated levels of a protein involved with regulation of glucose metabolism and insulin sensitivity in schizophrenic patients on either zyprexa or risperidone. the protein concentration dropped as the zyprexa patients put on weight, and in the risperidol group, the protein concentration remained high regardless of weight gain/loss; another indicates that weight gain on zyprexa was statistically significant vs. risperidone, seroquel, and haldol; another looked at weight gain in smoking/non-smoking schizophrenics who were taking zyprexa or risperidone. in the zyprexa group, smokers/non-smokers gained weight, yet in the risperidone group, smokers gained less weight than the non-smokers, conclusions being that zyprexa offsets the (common) weight loss seen in smokers but risperidone does not, implying that zyprexa does indeed change your metabolic system; another points to weight gain resulting from affinity for H_{1} histaminergic and alpha_{1} adreneergic receptors, in addition to ``changes in insulin sensitivity'' (among others), and they found that metformin was effective in decreasing weight gain associated with atypical anti-psychotics (Curr. Drug Targets, 5:279-299, 2004); another found that hyperglycemia occurs with treatment of only clozapine or zyprexa, and that weight gian came before onset of hyperglycemia in 2/3 of the patients with hyperglycemia. i note that this study was a 7-year long one, and the study group was 86,349 patients in 35 mental institutions, and that the _total_ number of hyperglycemic patients was 9 (nine, not a typo); okay, that's it for this....seems like zyprexa is pretty-well documented to cause alteration of metabolic pathways and maybe (in the one study) metformin can send your system towards the `right'' side...hope this helps, all the best, chemist
>
>
> Chemist,
>
> WOW!!!!!!! Thanks for the information. I didn't expect you to do all you have done in regard to researching the literature so I greatly appreciate your help.
>
> I work in an educational institution and have access to all of the medical journals. I would like to read some of the journal articles you came across in your discoveries. Does "Curr. Drug Targets" stand for "Current". Are there any other journals that would help me in my quest to better understand the actions of these meds?
>
> Again, you have been a wonderful help to me and all the best to you too!
>
> Nicole
>
>
hi nicole...sorry, i should have included all the citations from the abstracts i was perusing...Current Drug Targets it is, you are correct. here's what i did to get the abstracts, if you do the same, you will see the reference. so: go to www.pubmed.org and in the white box near the top type in the word olanzapine. then you can start scrolling, and if your institution has online access to the journals, you can keep clicking and download the pdf or simply read the article on-line....a few of the journals that came up were American Journal of Psychiatry, Journal of Affective Disorders, Journal of Clinical Psychiatry, Journal of Clinical Psychopharmacology, Journal of Psychopharmacology, Schizophrenia Research, and Current Drug Targets.....hope this helps, let me know if i steered you right or wrong....all the best, chemist
Posted by chemist on May 5, 2004, at 14:37:45
In reply to One link you may want to read » chemist, posted by nmk on May 5, 2004, at 14:16:02
> Hi again,
>
> Here is a good link describing the relationship between AP's and weight gain, along with various treatment options.
>
> Again, thanks a bunch!
>
> Nicole
>...and my thanks to you! all the best, chemist
> http://www.psycheducation.org/hormones/Insulin/weightgain.htm
Posted by nmk on May 6, 2004, at 8:57:23
In reply to Re: seroquel to geodon ... weight and sleep? » nmk, posted by chemist on May 5, 2004, at 14:36:56
Thanks for the web address....I will do some surfing today. You have been a great help and I truly appreciate it.
Nicole:)
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