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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Spike4848 on January 24, 2002, at 23:23:58
Hey Everyone,
I have always being taught that antipsychotics were not to be used for tradition anxiety disorders such as panic disorder or GAD.
But I am seeing an incredible amount of individuals on Zyprexa/Risperdal for a myriad of disorders .... from generalized anxiety to treatment resistant depression. And I find many people say they are getting relief for the first time in years.
Why are pdoc prescribing antipsychotics like water now? I wonder if it is because doctors who believe benzos are habit forming now have an alternative. I wonder if those pdoc are concerned about the risks of tardive dyskinesia, weight gain, apathy from antipsychotics.
Anyone have any comments?
Spike
PS I have never tried either Zyprexa/Risperdal .... maybe I am missing out!
Posted by ChrisK on January 25, 2002, at 3:14:52
In reply to Overuse of Zyprexa/Risperdal?, posted by Spike4848 on January 24, 2002, at 23:23:58
A few years ago I had an awful problem with suicidal thoughts (and attempts) and it was Zyprexa that dug me out of that hole. At the time it wasn't as widely accepted for depression/anxiety treatment but my pdoc had seen it working for some of his patients with the same type of obsessive thinking that I had.
I think in the last couple of years the AP's have become more accepted as augmentation for mainstream AD's. This board tends to run in med cycles too. Lately it's been a lot of Effexer, Topomax and Lamictal. In the past there have been flurries of posts about Wellbutrin, Remeron, Celexa, etc. There always seems to be a concentration of posts from time to time. I've been around for several years and have seen the way the tides shift.
I think if you are noticing more posts about Ap's it is a combination of MD's trying them more often and the fact that people who come to this board are curious about what they have for choices.
BTW, I also took Risperdal for a little while and hated it. I felt completely numb and just wanted to stay in bed all day. So don't be surprised if you react to one and not another.
ChrisK
Posted by Denise528 on January 25, 2002, at 11:12:59
In reply to Re: Overuse of Zyprexa/Risperdal?, posted by ChrisK on January 25, 2002, at 3:14:52
> Hi,
Just to say, although it hastn't lifted my depression, Zyprexa has been a God Send for me, even at only 5mg. It stopped my suicidal ruminations and gave me that glimpse of light at the end of the tunnel. It also has been really helpful with anxiety. I tried Buspar and that made me worse. Occasionally I take 10mg of Zyprexa and that even seems to help lift my mood a little although I don't really want to take it for depression. I guess I'm still hankering after the feeling that I used to get on just a small amount (20mg) of Paxil.
Denise
Posted by OldSchool on January 25, 2002, at 11:49:52
In reply to Overuse of Zyprexa/Risperdal?, posted by Spike4848 on January 24, 2002, at 23:23:58
> Hey Everyone,
>
> I have always being taught that antipsychotics were not to be used for tradition anxiety disorders such as panic disorder or GAD.
>
> But I am seeing an incredible amount of individuals on Zyprexa/Risperdal for a myriad of disorders .... from generalized anxiety to treatment resistant depression. And I find many people say they are getting relief for the first time in years.
>
> Why are pdoc prescribing antipsychotics like water now? I wonder if it is because doctors who believe benzos are habit forming now have an alternative. I wonder if those pdoc are concerned about the risks of tardive dyskinesia, weight gain, apathy from antipsychotics.
>
> Anyone have any comments?
>
> Spike
>
> PS I have never tried either Zyprexa/Risperdal .... maybe I am missing out!I have severe treatment resistant depression and I have never benefitted from adding atypical anti-psychotics to my antidepressant. More the opposite. Everytime Ive taken atypicals I get worse feeling. I find atypicals "block" the antidepressant effect I get from ADs.
Here is what happens when I take even low dose atypical anti-psychotics (Ive taken low dose Risperdal, Zyprexa and Seroquel before). My tongue gets numb, my muscles get tight and mildly contracted everywhere, the back of my head gets tight and "cinched down" feeling. And I get little muscle twitches everywhere, particularly right after I take the dose. I get physically numb feeling and I find the anti-psychotics makes me "flat" feeling, taking away my personality. Anti-psychotics make me feel very bored. I also have found that atypical anti-psychotics increases suicidal thoughts in me and makes me feel more depressed.
I would much prefer to have bilateral ECT than take any anti-psychotic medication. And I mean that. ECT sounds like it has a better side effect profile to me than atypical anti-psychotics.
Old School
Posted by Ray on January 25, 2002, at 14:19:00
In reply to Re: Overuse of Zyprexa/Risperdal?, posted by OldSchool on January 25, 2002, at 11:49:52
Antipsychotics have been approved for people with overly high dopamine (skitzophrenia, mania).
For depression and anxiety I think they will usually just make things worse.
However, when very low doses of a few of these are combined with certain activating (DA/NE) meds, the combo often provides extra dopamine boost in in the limbic area (reward, emotion are key).
The result can be increase ability to "enjoy" or "experience pleasure", lift mood, anti-anxiety.
Usually only a very low dose of zyprexa or such is tolerable, and must be combined with DA and/or NE enhancing meds for depressed or anxious patients without manic (too high energy) or psychotic features.Ray
> > Hey Everyone,
> >
> > I have always being taught that antipsychotics were not to be used for tradition anxiety disorders such as panic disorder or GAD.
> >
> > But I am seeing an incredible amount of individuals on Zyprexa/Risperdal for a myriad of disorders .... from generalized anxiety to treatment resistant depression. And I find many people say they are getting relief for the first time in years.
> >
> > Why are pdoc prescribing antipsychotics like water now? I wonder if it is because doctors who believe benzos are habit forming now have an alternative. I wonder if those pdoc are concerned about the risks of tardive dyskinesia, weight gain, apathy from antipsychotics.
> >
> > Anyone have any comments?
> >
> > Spike
> >
> > PS I have never tried either Zyprexa/Risperdal .... maybe I am missing out!
>
> I have severe treatment resistant depression and I have never benefitted from adding atypical anti-psychotics to my antidepressant. More the opposite. Everytime Ive taken atypicals I get worse feeling. I find atypicals "block" the antidepressant effect I get from ADs.
>
> Here is what happens when I take even low dose atypical anti-psychotics (Ive taken low dose Risperdal, Zyprexa and Seroquel before). My tongue gets numb, my muscles get tight and mildly contracted everywhere, the back of my head gets tight and "cinched down" feeling. And I get little muscle twitches everywhere, particularly right after I take the dose. I get physically numb feeling and I find the anti-psychotics makes me "flat" feeling, taking away my personality. Anti-psychotics make me feel very bored. I also have found that atypical anti-psychotics increases suicidal thoughts in me and makes me feel more depressed.
>
> I would much prefer to have bilateral ECT than take any anti-psychotic medication. And I mean that. ECT sounds like it has a better side effect profile to me than atypical anti-psychotics.
>
> Old School
Posted by spike4848 on January 25, 2002, at 21:38:50
In reply to Re: Overuse of Zyprexa/Risperdal? » OldSchool, posted by Ray on January 25, 2002, at 14:19:00
Thank everyone .... very interesting stuff.
Spike
Posted by WhiteHare on January 25, 2002, at 22:37:19
In reply to Overuse of Zyprexa/Risperdal?, posted by Spike4848 on January 24, 2002, at 23:23:58
>...I wonder if those pdoc are concerned about >the risks of tardive dyskinesia, weight gain, >apathy from antipsychotics...
I have been sick since 1992 and have been on several anti-psychotics. Currently I am on respirdal. I have doubled my weight. I talk to my doctor about this and she says that weight management isn't an issure she covers. It is so frustrating because the weight causes me to be depressed and anti-social. I also can't exercise very well because I am so out of shape. I was institutionalized for two years because of my illness, and I understand that I am very lucky to have found a medicine that works. But I really wish she could do something about the weight issue
Posted by IsoM on January 26, 2002, at 1:53:47
In reply to Re: Overuse of Zyprexa/Risperdal?, posted by WhiteHare on January 25, 2002, at 22:37:19
> > "...she says that weight management isn't an issure she covers."
It should be an issue for her as a doctor. She's a little out of touch of the average person. I'd think any doctor/psychiatrist who doesn't realise that a person's weight & image of themself is part of their mental make-up, & is important in treating depression, should wake up. Even if she doesn't know how to advice you, she should have someone she can refer you to. You may need to gently "educate" her.
Posted by WhiteHare on January 26, 2002, at 21:29:24
In reply to Risperdal Weight Issue » WhiteHare, posted by IsoM on January 26, 2002, at 1:53:47
> > > "...she says that weight management isn't an issure she covers."
>
> It should be an issue for her as a doctor. She's a little out of touch of the average person. I'd think any doctor/psychiatrist who doesn't realise that a person's weight & image of themself is part of their mental make-up, & is important in treating depression, should wake up. Even if she doesn't know how to advice you, she should have someone she can refer you to. You may need to gently "educate" her.Well I am feeling better today about the whole thing. She did say she felt comfortable confering with my primary MD. I made an appointment with him for a physical. I have rapid heartbeat, shortness of breath, and chest pain occasionally. I think he will be able to talk to her and be an advocate. I was just so upset during my meeting with my psychiatrist that I couldn't communicate with her at all. The entire appoinment lasted less than 10 minutes. Thanks so much for the supportive words and good advice. If involving my primary MD doesn't help, I am going to involve my case manager and my parents. I have a history of going off my medication, and this sure isn't helping. I am finally doing so well in so many areas. I have a stable relationship, a job, and I am socicalizing so much more. But I feel my health is in real jeopardy.
Posted by Mark H. on January 30, 2002, at 0:06:17
In reply to Re: Risperdal Weight Issue, posted by WhiteHare on January 26, 2002, at 21:29:24
Just to add another point of view (without intending to detract from anyone else's):
With Zyprexa we FINALLY have a fast-acting way to interrupt catastrophic downward spiraling and negative obsession without resorting to incarceration, ECT or long-term anti-psychotic intervention.
I can think of no other medication that (for many, at least) allows a person to "re-set" overnight, re-establish normal nocturnal sleep patterns, and get back to a reasonably positive affect and outlook within 24 to 48 hours, SOMETIMES WITH A SINGLE 2.5 TO 5.0 MG DOSE! In this respect, it is a true miracle drug for those who respond well.
I would like to see Zyprexa much more widely prescribed by general practitioners for intermittent use. I think it will eventually have great value in pediatrics as well, perhaps providing a tool that will help a child get back on track without resorting to long-term treatment with methylphenidate (Ritalin).
I believe that Zyprexa is already saving lives -- not just of those who take it, but of others as well, by providing relatively safe relief from states of rage and obsession. As far as I'm concerned, it should be in the First Aid kit of every EMT crew, available for immediate dispensing on the advice of a consulting MD.
I think Zyprexa and other new anti-psychotics, when used judiciously, have the potential to do more to prevent future school shooting catastrophes and adolescent suicides than any other intervention.
Mark H.
Posted by OldSchool on January 30, 2002, at 11:38:01
In reply to Under-use of Zyprexa?, posted by Mark H. on January 30, 2002, at 0:06:17
> Just to add another point of view (without intending to detract from anyone else's):
>
> With Zyprexa we FINALLY have a fast-acting way to interrupt catastrophic downward spiraling and negative obsession without resorting to incarceration, ECT or long-term anti-psychotic intervention.
>
> I can think of no other medication that (for many, at least) allows a person to "re-set" overnight, re-establish normal nocturnal sleep patterns, and get back to a reasonably positive affect and outlook within 24 to 48 hours, SOMETIMES WITH A SINGLE 2.5 TO 5.0 MG DOSE! In this respect, it is a true miracle drug for those who respond well.
>
> I would like to see Zyprexa much more widely prescribed by general practitioners for intermittent use. I think it will eventually have great value in pediatrics as well, perhaps providing a tool that will help a child get back on track without resorting to long-term treatment with methylphenidate (Ritalin).
>
> I believe that Zyprexa is already saving lives -- not just of those who take it, but of others as well, by providing relatively safe relief from states of rage and obsession. As far as I'm concerned, it should be in the First Aid kit of every EMT crew, available for immediate dispensing on the advice of a consulting MD.
>
> I think Zyprexa and other new anti-psychotics, when used judiciously, have the potential to do more to prevent future school shooting catastrophes and adolescent suicides than any other intervention.
>
> Mark H.I totally disagree Mark. Zyprexa should be reserved for psychotic states and mania. It has no uses in depression or anxiety disorders. No anti-psychotic has uses in these disorders. Using atypical anti-psychotics to treat anger, agitation and other non psychotic syndromes is wrong. And leads to BAAAAAAAADDDD side effects. Movement disorders. Are you prepared to take responsibility for the worsened physical and mental health that results from prescribing atypical anti-psychotics to those with depression and anxiety disorders Mark?
Old School...having problems walking as a result of EPS from low dose Seroquel augmentation.
Posted by WhiteHare on January 31, 2002, at 11:21:57
In reply to Under-use of Zyprexa?, posted by Mark H. on January 30, 2002, at 0:06:17
> Just to add another point of view (without intending to detract from anyone else's):
> With Zyprexa we FINALLY have a fast-acting way to interrupt catastrophic downward spiraling and negative obsession without resorting to incarceration, ECT or long-term anti-psychotic intervention...
I agree and disagree with your point of view. Antipsychotics have been a miracle for me, yet the side effects are so intense it's very hard to stay on them.I went off zyprexa in 1995 and was OK for about six months. I decided I wasn't sick anymore and didn't need it (BIG MISTAKE). I then had a psychotic break and ended up in a state mental hospital. Now, I'm on Respirdal and the side effects are just terrible. I'm very unhappy with my pdoc and am changing to another doctor and therapist.
I feel that stress brings on my condition, and that limiting stress is the key to making me well. I try to live a very stress free life, eat right, exercise, and keep a positive mental attitude. My old pdocs idea was to add another mediciation, or increase my dosages of medicine, every time I had a problem.
I feel the anti-psychotics are very valuable for short term use, but that being on them long term is very difficult and should only be done in extreme circumstances. I'm trying to find a doctor who will work with me and lower the meds I am on. I'm staying on my current meds and don't want to stop taking anything without supervision.
Everyone is different and it's extremely inportant to work with a pdoc who knows you and your needs personally, and I would never tell anyone to stop taking meds that a doctor felt would help them. But I think in general meds are overused and therapy and changing ones lifestyle can make a big difference. I think it's unrealistic to take a pill and expect it to change your whole outlook in 24 hours.
Just putting in my two cents. (Hope that's OK).
Posted by NikkiT2 on February 1, 2002, at 16:59:11
In reply to Re: Under-use of Zyprexa?, posted by WhiteHare on January 31, 2002, at 11:21:57
*grins* I'm on Zyprexa (5mg nowl, been up to 10mg though) and have no side affects other than some sleepyness... Its a life saver for me... I had terrible side effects on other anti-psyhotics though - I squirmed and squiggled and twtiched terribly on the other two I tried...
nikki
> > Just to add another point of view (without intending to detract from anyone else's):
>
> > With Zyprexa we FINALLY have a fast-acting way to interrupt catastrophic downward spiraling and negative obsession without resorting to incarceration, ECT or long-term anti-psychotic intervention...
>
> I agree and disagree with your point of view. Antipsychotics have been a miracle for me, yet the side effects are so intense it's very hard to stay on them.
>
> I went off zyprexa in 1995 and was OK for about six months. I decided I wasn't sick anymore and didn't need it (BIG MISTAKE). I then had a psychotic break and ended up in a state mental hospital. Now, I'm on Respirdal and the side effects are just terrible. I'm very unhappy with my pdoc and am changing to another doctor and therapist.
>
> I feel that stress brings on my condition, and that limiting stress is the key to making me well. I try to live a very stress free life, eat right, exercise, and keep a positive mental attitude. My old pdocs idea was to add another mediciation, or increase my dosages of medicine, every time I had a problem.
>
> I feel the anti-psychotics are very valuable for short term use, but that being on them long term is very difficult and should only be done in extreme circumstances. I'm trying to find a doctor who will work with me and lower the meds I am on. I'm staying on my current meds and don't want to stop taking anything without supervision.
>
> Everyone is different and it's extremely inportant to work with a pdoc who knows you and your needs personally, and I would never tell anyone to stop taking meds that a doctor felt would help them. But I think in general meds are overused and therapy and changing ones lifestyle can make a big difference. I think it's unrealistic to take a pill and expect it to change your whole outlook in 24 hours.
>
> Just putting in my two cents. (Hope that's OK).
Posted by WhiteHare on February 1, 2002, at 21:15:33
In reply to Re: Under-use of Zyprexa? » WhiteHare, posted by NikkiT2 on February 1, 2002, at 16:59:11
> *grins* I'm on Zyprexa (5mg nowl, been up to 10mg though) and have no side affects other than some sleepyness... Its a life saver for me... I had terrible side effects on other anti-psyhotics though - I squirmed and squiggled and twtiched terribly on the other two I tried...
> nikkiI am glad you found a medicine that works for you. I have skizoaffective disorder (Latest diagnosis). I don't handle stress well and then I have psychotic breaks. I want to go on an anti-anxiety drug to stop the psychotic breaks from happening in the first place. My pdoc keeps putting me on different anti-psychotics. I have a lot of side effects that I don't like. I am now going to see a new pdoc and therapist and am hopefull. I know there are no magic pills, but I do think things will get better. Good luck.
Posted by NikkiT2 on February 2, 2002, at 12:00:58
In reply to Re: Under-use of Zyprexa?, posted by WhiteHare on February 1, 2002, at 21:15:33
Good luck on your med search... I'm in the UK and we're no way as advanced as the US in reatment for mental health... its taken me alot to try an anti psychotic (I'm borderline personality disorder!) as all the TCA's and SSRI's (and Effexor ) haven't helped a huge amount!!
I've not got to try and talk pdoc into letting me try wellbrutin - its not listed here for MH - just as an aid to giving up smoking!!!!
Nikki x
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