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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Greg on October 12, 2000, at 20:45:55
All,
Saw my new pdoc today and after a lenghty session, he decided that my prior doc's diagnosis of Bipolar II was correct. He says that the diagnosis of manic depression was wrong though, and after he explained to me what it really was, I must agree. He thinks my anxiety is probably triggered thru the BP.
Anyway, he changed my meds. He took me off the Tegretol and started me on Zyprexa and Neurontin. The Neu I've taken before with some success, but I've never taken the Zyprexa. Is there anyone out there who's taken it that would share their successes/failures with me? I'd appreciate the input.
Thanks Ya'll,
Greg
Posted by JohnL on October 13, 2000, at 4:37:02
In reply to Zyprexa, any insider info?, posted by Greg on October 12, 2000, at 20:45:55
Greg,
Zyprexa is proving to be a very good medication. Originally developed for treating schizophrenia, it has since showed good results in treating a wide variety of other conditions including anxiety, depression, resistant depression, mania, and bipolar. It has recently been approved the treatment of bipolar. It can be good on its own or as an add-on.What to expect from it? Well, good sleep for one. Any daytime drowsiness should subside after a week or two. But the drowsiness takes a while to kick in, so it might best be taken in late afternoon or at dinner time. Bedtime might be too late and cause excessive morning drowsiness.
But the big one many people have experienced is weight gain. Even me for example. I am 145pounds, always have been, and I can eat as much as I want and never gain a pound. Yet when I took Zyprexa I gained weight for the first time in my life. About 10 pounds in a couple weeks. It was startling. Not a bad thing, since I'm skinny anyway, but rather startling.
There have been folks here who have found amazing results with Zyprexa. Generally when that happens, I think they notice it kicks in about week 3 or 4, though some notice improvement quicker than that. Personally I noticed an improvement almost immediately, like within 3 days. If you are curious why I don't take Zyprexa now, it's because I experienced a side effect my pdoc called akathesia...that is, I had weak yet restless legs. He could have treated that with another medication, but we instead decided to keep exploring. Whether Zyprexa is right for you or not is anyone's guess, but the clinical results and the anecdotal results are in your favor.
John
Posted by ChrisK on October 13, 2000, at 7:18:26
In reply to Zyprexa, any insider info?, posted by Greg on October 12, 2000, at 20:45:55
I am a big fan of Zyprexa. When I started taking it I had constant thoughts of death and suicide. Within days of starting the Zyprexa I was able to concentrate and think more clearly. It really leveled out my thought process.
In the past couple of years I have tried to stop taking Zyprexa but started to feel worse within days. The only reason for these attempts to stop is that there are some concerns about long term use. I don't have any of the symptoms associiated with problems so I stay on it. The only thing I did find was the weight gain. I am now losing it slowly but it came on very quickly.
I take 7.5 mg around dinner time and have no problems with sleep or waking up feeling rested.
Good Luck with it.
Chris
Posted by salarmy4me on October 14, 2000, at 3:42:58
In reply to Zyprexa, any insider info?, posted by Greg on October 12, 2000, at 20:45:55
> All,
>
> Saw my new pdoc today and after a lenghty session, he decided that my prior doc's diagnosis of Bipolar II was correct. He says that the diagnosis of manic depression was wrong though, and after he explained to me what it really was, I must agree. He thinks my anxiety is probably triggered thru the BP.
>
> Anyway, he changed my meds. He took me off the Tegretol and started me on Zyprexa and Neurontin. The Neu I've taken before with some success, but I've never taken the Zyprexa. Is there anyone out there who's taken it that would share their successes/failures with me? I'd appreciate the input.
>
> Thanks Ya'll,
> GregI think Zyprexa got a bad rap. I took it for a couple months and liked it. It caused no weight gain and calmed me down a lot.
Posted by Greg on October 14, 2000, at 19:12:09
In reply to Re: Zyprexa, any insider info? » Greg, posted by ChrisK on October 13, 2000, at 7:18:26
Chris,
The pdoc started me at a dose of 2.5mg. Do you know if that's a common starting dose? Do you have any thoughts as to whether he will want to increase it if it does work, or if it doesn't? I must admit that already feeling a little calmer. I'm cautiously optimistic....
Thanks for the feedback,
Greg> I am a big fan of Zyprexa. When I started taking it I had constant thoughts of death and suicide. Within days of starting the Zyprexa I was able to concentrate and think more clearly. It really leveled out my thought process.
>
> In the past couple of years I have tried to stop taking Zyprexa but started to feel worse within days. The only reason for these attempts to stop is that there are some concerns about long term use. I don't have any of the symptoms associiated with problems so I stay on it. The only thing I did find was the weight gain. I am now losing it slowly but it came on very quickly.
>
> I take 7.5 mg around dinner time and have no problems with sleep or waking up feeling rested.
>
> Good Luck with it.
>
> Chris
Posted by ChrisK on October 17, 2000, at 5:53:26
In reply to Re: Zyprexa, any insider info? » ChrisK, posted by Greg on October 14, 2000, at 19:12:09
Greg,
Hope this works out for you. 2.5 mg is a very common starting point. I started at 5mg split into two doses and ended up with one 7.5mg dose.
I have found it to have a calmong effect that goes beyond sedation and more into the way my thought process works.
Good Luck with this trial.
Posted by Cam W. on October 17, 2000, at 6:53:17
In reply to Zyprexa, any insider info?, posted by Greg on October 12, 2000, at 20:45:55
Greg - Just a note. I see dosage ranges of 1.25mg (an elderly gent) to 35mg daily. I have read that they have used 60mg of Zyprexa™ (olanzapine) daily for treatment refractory schizophrenia in the UK. I am from the school of thought that if 30mg doesn't work after 4 weeks, it's time to try Clozaril™ (clozapine) [or perhaps augmenting the Zyprexa with with a low dose of Orap™ (pimozide) or Loxapac™ (loxapine)].
Doses for bipolar disorder are generally lower (up to 10mg daily), but I have seen it higher (I believe the person has schizoaffective disorder, if I am not mistaken). Remember, as with most meds, start low and increase the dose slowly. The 2.5mg dose is a usually dose for the elderly, and does work in many cases of agitation in Alzheimer's disease.
Continue to feel "cautiously optimistic". Some of the effects you may be feeling could be start-up side effects. After a week or so it may feel like some of the effect is disappearing (esp. sedation), but the dose may just need to be increased slightly. An early response is good, though, but let the new med cocktail "re-organize" your neurochemical mix before arriving at any final conclusions.
As for splitting the Zyprexa tablets. It can be done, but after the hard coating is broken, the Zyprexa beginas to turn brown and loses potency. The tablets should not be split more than a week in advance of taking them. Also, wash your hands (before and esp. after) as Zyprexa is slightly caustic and can really burn if you accidentally rub it in your eyes. As well, Zyprexa can be mixed with many fluids without losing potency (eg water, juices, and even colas).
The Tegretol™ (carbamazepine) dose may need to be adjusted upward after a month or so. It induces it's own metabolism (CYP-3A3/4), and maybe that of Zyprexa (to a slight extent, but other enzymes also metabolize the Zyprexa - CYP-2D6). Therefore, you may require slight upward dosage adjustments of either or both meds, as treatment continues.
Just some notes from the peanut gallery - Cam
Posted by Greg on October 17, 2000, at 7:39:48
In reply to Re: Zyprexa, any insider info? » Greg, posted by Cam W. on October 17, 2000, at 6:53:17
Thanks to all for your feedback, it is greatly appreciated. As I've said before, I'm not really knowledgable about meds (although I'm getting better) and the "Doctor Speak" that you find at most websites only serves to confuse me further. It's nice to have real live people to share info with.
Cam and Chris,
Cam you mention a possible caustic effect if the Zy gets into your eyes. Could this be a possible cause for a mild comeback of my Acid Reflux? Chris, have you experienced this at all?
Greg
> Greg - Just a note. I see dosage ranges of 1.25mg (an elderly gent) to 35mg daily. I have read that they have used 60mg of Zyprexa™ (olanzapine) daily for treatment refractory schizophrenia in the UK. I am from the school of thought that if 30mg doesn't work after 4 weeks, it's time to try Clozaril™ (clozapine) [or perhaps augmenting the Zyprexa with with a low dose of Orap™ (pimozide) or Loxapac™ (loxapine)].
>
> Doses for bipolar disorder are generally lower (up to 10mg daily), but I have seen it higher (I believe the person has schizoaffective disorder, if I am not mistaken). Remember, as with most meds, start low and increase the dose slowly. The 2.5mg dose is a usually dose for the elderly, and does work in many cases of agitation in Alzheimer's disease.
>
> Continue to feel "cautiously optimistic". Some of the effects you may be feeling could be start-up side effects. After a week or so it may feel like some of the effect is disappearing (esp. sedation), but the dose may just need to be increased slightly. An early response is good, though, but let the new med cocktail "re-organize" your neurochemical mix before arriving at any final conclusions.
>
> As for splitting the Zyprexa tablets. It can be done, but after the hard coating is broken, the Zyprexa beginas to turn brown and loses potency. The tablets should not be split more than a week in advance of taking them. Also, wash your hands (before and esp. after) as Zyprexa is slightly caustic and can really burn if you accidentally rub it in your eyes. As well, Zyprexa can be mixed with many fluids without losing potency (eg water, juices, and even colas).
>
> The Tegretol™ (carbamazepine) dose may need to be adjusted upward after a month or so. It induces it's own metabolism (CYP-3A3/4), and maybe that of Zyprexa (to a slight extent, but other enzymes also metabolize the Zyprexa - CYP-2D6). Therefore, you may require slight upward dosage adjustments of either or both meds, as treatment continues.
>
> Just some notes from the peanut gallery - Cam
Posted by shar on October 17, 2000, at 16:08:20
In reply to Re: Zyprexa, any insider info? » Greg, posted by Cam W. on October 17, 2000, at 6:53:17
That would be the green flame shooting out....well, this is a np.
Posted by Greg on October 17, 2000, at 17:09:25
In reply to Cam--Any green/blue flame danger with Zyprexa? np, posted by shar on October 17, 2000, at 16:08:20
Oh Shar, you crack me up LOLOLOLOL
> That would be the green flame shooting out....well, this is a np.
Posted by ChrisK on October 17, 2000, at 17:56:26
In reply to Re: Zyprexa, any insider info? - Cam, Chris, All, posted by Greg on October 17, 2000, at 7:39:48
Greg,
I have never had the experience you or Cam described but then again I have never split my pills. Zy comes in the 7.5 mg pills that I take.
Also, as a side note to this discussion, Zeldox is supposed to be on the US market almost any day now. This is Pfizer's new anti-psychotic which mimmicks Zyprexa in many ways but is supposed to have fewer side effects. My pdoc and I are both hoping that it will be released by the first of the year.
Chris
Posted by Cam W. on October 17, 2000, at 21:09:22
In reply to Re: Zyprexa, any insider info? - Cam, Chris, All, posted by Greg on October 17, 2000, at 7:39:48
> Cam you mention a possible caustic effect if the Zy gets into your eyes. Could this be a possible cause for a mild comeback of my Acid Reflux? Chris, have you experienced this at all?
>Greg - Good question. It sounds plausible, but the reflux is probably due some receptor either causing a leaky (or relaxed) pyloric valve (the valve at the entrance to the stomach that keeps the food in the stomach) or causing excess acid production. Then again, it could be a number of things, like involuntary suppression of blue &/or green flames (sorry all, an inside joke).
It probably wouldn't be the Zyprexa causing the burning. The burning is from the refluxed stomach acid. Most people can even take dissolved Zyprexa without stomach upset. I have had a few people complain of stomach upset, but it is usually a start-up side effect. The Zyprexa powder burns sensitive tissues (esp. the eyes). I don't really think it is too caustic to mucous membranes, either (in most people).
I believe that the Neurontin™ (gabapentin) or even Tegretol™ (carbamazepine) would cause more dyspepsia than the Zyprexa. Let's just split the difference and say that all the meds contribute to the reflux (not a scientific answer, but an easier answer that just might be correct - then again, maybe not). Almost every oral drug monograph lists some form of stomach upset as a side effect.
Monitor your tummy status over the next couple of weeks and report back.
Good luck - Cam
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