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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by denise190466 on August 29, 2005, at 11:13:54
Hi,
I'm just wondering if anyone else has this experience with Zyprexa. I find if I take 10mg it lifts me for about 7 days and then I start going down hill again. I'm not bipolar and don't understand how it seems to help with the depression when none of the SSRIs, tricyclics, MOAIs do.
Does anyone else have this experience with Zyprexa or use it on an on off basis?
Denise
Posted by Nickengland on August 29, 2005, at 12:38:50
In reply to Does anyone else find this with Zyprexa?, posted by denise190466 on August 29, 2005, at 11:13:54
Hi Denise,
I've never taken Zyprexa, but wondered if it would help if you took the same dosage everyday so you would be able to keep the continued lift?
I played around with Neurontin taking it on and off at different dosages and had energy oneday, none the next etc, albeit a mild difference, but now that i'm taken it regularly, things appear to have evened out more.
Kind regards
Nick
Posted by ed_uk on August 29, 2005, at 12:42:33
In reply to Does anyone else find this with Zyprexa?, posted by denise190466 on August 29, 2005, at 11:13:54
Just thinking out load here (pinched that one from Scott)........
5-HT2 antagonists are thought to downregulate 5-HT2 receptors - unexpectedly. Perhaps a single dose of Zyprexa is sufficient to downregulate your 5-HT2 receptors for 7 days, this might have an antidepressant effect.
Why not take Zyprexa once weekly? If not, you could try Seroquel or Abilify.
Zyprexa, Seroquel and Abilify are all effective in the treatment of depression for some people.
~Ed x
Posted by med_empowered on August 29, 2005, at 18:03:53
In reply to Re: Does anyone else find this with Zyprexa? » denise190466, posted by ed_uk on August 29, 2005, at 12:42:33
hi! Antipsychotics are kind of tricky, especially for mood disorders (this is my experience with them; I cant speak to the experience of using them for schizophrenia). I personally found that low-doses, very short-term, gave me a lift, but long-term, higher (normal therapeutic) doses negated this antidepressant effect and eventually made the depression *worse*. Zyprexa is sometimes used on an as-needed basis; I think its most common with those with bipolar disorder (the idea being I guess that an antipsychotic now and then will "mellow out" a potentially destabilizing mood disorder), but it certainly could work for depression...or at least, I would think so. You could try as-needed, rather than daily, dosing of zyprexa...you could also try lower doses of zyprexa, as-needed or daily, or try a different atypical, again using it as-needed or daily to suit your needs. My own preference would be for abilify since it causes less metabolic weirdness and does a combo antagonist/agonist job at both serotonin and dopamine receptors, but I'm sure zyprexa could be helpful too. Another option might be to explore non-neuroleptic drug therapies that have similar action at serotonin receptors. Theoretically, drugs like Remeron, Trazadone, and Buspar would help some.
Posted by FredPotter on August 29, 2005, at 23:27:00
In reply to Re: Does anyone else find this with Zyprexa?, posted by med_empowered on August 29, 2005, at 18:03:53
I found Zyprexa great at first ( I also take Celexa and lithium). I took 2.5 mg. I became motivated and painted the kitchen etc etc. But after a few weeks it all went wrong. I became agitated, tired, overweight. So now I take just 1.25mg per day and it seems OK. I started putting on the weight before my diet changed too. Metabolic weirdness like you say
Posted by denise1966 on August 30, 2005, at 7:52:26
In reply to Re: Does anyone else find this with Zyprexa? » denise190466, posted by Nickengland on August 29, 2005, at 12:38:50
Hi Nick,
Thanks for the advice but I really don't want to take 10mg of Zyprexa everyday as I don't like having to take it at all.
Kind Regards....Denise
Posted by denise1966 on August 30, 2005, at 7:57:10
In reply to Re: Does anyone else find this with Zyprexa? » denise190466, posted by Nickengland on August 29, 2005, at 12:38:50
Hi Ed,
Thanks, when you say causes the down regulation of 5HT2 receptors what do you mean exactly, does this mean and an increase and what receptors are you referring to, transporters?
Also, if this was the case and the improvement I get is associated with 5HT2 receptors then why don't I get the same effect with Remeron or Buspar? They both made me feel worse to start with, Zyprexa doestn't?
I have thought about taking Zyprexa once a week but I really hate having to take it at all, I'm really hoping this Nardil will kick in and I won't have to take Zyprexa again on Friday. I just want the antidepressants to work like they used to. There was a time when I just took 20mg of Seroxat and felt great on it. I wish one of these highly paid Psychiatrists could explain why they don't work any more. It seems to me they get money for nothing.
What do you take by the way?
Kind Regards.......Denise
Posted by denise1966 on August 30, 2005, at 8:00:27
In reply to Re: Does anyone else find this with Zyprexa?, posted by med_empowered on August 29, 2005, at 18:03:53
Hi Med-Empowered.
Small dose of Zyprexa doesn't do anything for me so it's best if I take high dose once ever seven days if I'm going to have to take it at all.
You mention abilify as doing a combo agonist/antagonist job at both Serotonin and Dopamine receptors but I thought Zyprexa also worked on Serotonin and Dopamine receptors.
What do you mean by metabolic wierdness?
Denise
Posted by denise1966 on August 30, 2005, at 8:01:41
In reply to Re: Does anyone else find this with Zyprexa?, posted by FredPotter on August 29, 2005, at 23:27:00
Hi Fred,
I tried taking 5mg of Zyprexa to no avail so I guess 10mg now and again is best for me.
All the Best.....Denise
Posted by med_empowered on August 30, 2005, at 9:15:57
In reply to To Fred Potter, posted by denise1966 on August 30, 2005, at 8:01:41
hi! Abilify works differently than other antipsychotics...usually, antipsychotics, both the old ones and the new ones, block up the Dopamine receptors, specifically the D2 receptors, in the brain..this is antagonism. Old ones work primarily or entirely on D2 receptors and block it *strongly*; this is why they are associated with movement disorders and that kind of thing. New ones usually block D2, but less strongly than the old ones; they also block off some serotonin receptors, and may have other effects...Geodon, for instance, blocks the reuptake of some neurotransmitters, so its kind of a combo antidepressant and antipsychotic in one. Abilify works on serotonin and dopamine receptors, but it both blocks them (antagonism) and *boosts* them (agonism). So, instead of just blocking serotonin (which in turn boosts dopamine) or blocking dopamine (which helps with psychosis, but can also cause apathy, cognitive impairment, and movement disorders), Abilify is able to both block and (mildly) stimulate the serotonin and dopamine levels in your brain, so the overall effect is more of a "balancing" than a full scale antipsychotic dopamine blockade. That said, abilify is still an antipsychotic, it can still cause EPS and apathy and the dreaded neuroleptic malignancy syndrome (a potentially fatal consequence of dopamine blockade). The difference is that the EPS rates are smaller with Abilify than with the other antipsychotics, it tends to be less sedating (sometimes activating), it has fewer ill effects on cognitive processes (some users say they feel no ill effects at all), and its more or less weight-neutral, so it won't make you gain (or lose) any significant amount of weight. When I said "metabolic weirdness," I meant that Zyprexa and most of the other atypicals have a tendency to make the body go a little nuts. All of the atypicals, except *maybe* abilify, can cause diabetes type II and "insulin resistance"; all of them, except for abilify and geodon, can cause an unhealthy increase in body weight. Zyprexa seems to be a big offender both in the weight gain and in the diabetes categories. Abilify is definitely kinder to your waist line, and is most likely much less likely to cause problems with blood sugar levels.
Posted by ed_uk on August 30, 2005, at 15:13:12
In reply to Re: To EdUk, posted by denise1966 on August 30, 2005, at 7:57:10
Hi Denise,
>down regulation
= decrease in receptor number or 'sensitivity'
>Also, if this was the case and the improvement I get is associated with 5HT2 receptors then why don't I get the same effect with Remeron or Buspar?
Buspar and Remeron are both alpha-2 antagonists, perhaps that made you feel worse. Buspar isn't a 5-HT 2 antagonist.
>What do you take by the way?
Citalopram 80mg
~Ed x
Posted by denise1966 on September 1, 2005, at 7:06:05
In reply to Re: To EdUk » denise1966, posted by ed_uk on August 30, 2005, at 15:13:12
Thanks Ed :-)
Denise
Posted by denise1966 on September 5, 2005, at 5:56:27
In reply to to denise..., posted by med_empowered on August 30, 2005, at 9:15:57
Hi MedEmpowered,
Thanks for this and you're going to hate me because I have more questions.
You say abilify works on both serotonin and dopamine receptors, I thought Zyprexa works on both types of receptors also??
When you say block Serotonin do you mean block the reuptake of it or are there other receptors where it is blocked?
Also when you say boost serotonin, how is it boosted?
Also, I can't see the logic in both blocking and boosting Dopamine and Serotonin, doesn't this sort of counteract things?
Kind Regards.....Denise
This is the end of the thread.
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