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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 psychosage on June 9, 2006, at 22:45:25
What kind of labwork would be good to request when using antipsychotics like Risperdal, Zyprexa, etc? I am concerned about diabetes and the pancreas.
Posted by yxibow on June 10, 2006, at 1:03:42
In reply to labwork for antipsychotics, posted by psychosage on June 9, 2006, at 22:45:25
> What kind of labwork would be good to request when using antipsychotics like Risperdal, Zyprexa, etc? I am concerned about diabetes and the pancreas.
I'm not sure about the pancreas connection unless you have a misfunctioning or underfunctioning pancreas. Risperdal isn't a worry for diabetes.
Diabetes workups are easily done at any doctor/clinic's office -- usually one should fast the night before and morning to not alter the sugar levels. This is the fasting plasma glucose test. This would be most useful if you havent started it, and some weeks after you started it, to note any change.
Posted by med_empowered on June 10, 2006, at 3:35:27
In reply to Re: labwork for antipsychotics » psychosage, posted by yxibow on June 10, 2006, at 1:03:42
if you're going on the atypicals, labs are a good call. Blood sugar tests are a must. In addition, doing cholesterol and triglycerides might be good. Periodic glucose monitoring is a good idea, especially if you do put on any weight.
Adding metformin to zyprexa sometimes prevents weight gain or reduces gained weight; I imagine that might help with metabolic issues with other atypicals as well.
Posted by blueberry on June 10, 2006, at 8:22:41
In reply to labwork for antipsychotics, posted by psychosage on June 9, 2006, at 22:45:25
The two lab tests to do on any antipsychotic are fasting glucose and liver function. The liver function test actually applies to any psychiatric medication, not just antipsychotics. My doctor has me do these 2 or 3 times a year.
A rather inexpensive way to stay on top of blood sugar developments is to buy a glucose meter at the drug store and check it yourself once a week. Check it in the morning after not eating for 12 hours. Glucose meters come with guidelines that show what the normal ranges should be. If you notice your readings are getting out of the normal range then begin more frequent testing at various times of the day and contact your doctor.
If you are not significantly overweight and you are not on a high dose, the risks are low. I've been taking zyprexa for 6 years in doses ranging from 15mg to 2.5mg, now at 2.5mg, and my glucose readings vary between the midway point and the high point of normal ranges.
Posted by heaven help me on June 10, 2006, at 10:41:47
In reply to Re: labwork for antipsychotics, posted by blueberry on June 10, 2006, at 8:22:41
Blueberry, You've probably already answered this 100 times, but can you tell me about what has happened with you in terms of Weight gain over these years you have beenon Zyprexa???? Do you take anything to combat it? Are your liver panels always good?
thank you!
blessings
mary
Posted by blueberry on June 10, 2006, at 19:20:17
In reply to Re: labwork for antipsychotics » blueberry, posted by heaven help me on June 10, 2006, at 10:41:47
Hi Mary. Actually now that you mention, nobody has ever asked me about my zyprexa weight gain. It was minimal. I went from 138 to 145 and then it settled back to 140 on its own a few months later.
After weaning off it though, yikes. I went from 142 to 129 in a month. Scary. Went back on 2.5mg just to save my life. That was a month ago. Since then I have gone from 129 to 134, so weight gain really hasn't been much of a factor for me. I am still significantly underweight.
Liver tests and glucose fasting tests have always been fine over the 6 years with zyprexa.
> Blueberry, You've probably already answered this 100 times, but can you tell me about what has happened with you in terms of Weight gain over these years you have beenon Zyprexa???? Do you take anything to combat it? Are your liver panels always good?
> thank you!
> blessings
> mary
Posted by Phillipa on June 10, 2006, at 20:44:35
In reply to Re: labwork for antipsychotics » heaven help me, posted by blueberry on June 10, 2006, at 19:20:17
Agree fasting glucose, liver enzymes tests and a complete blood work up periodically. Love Phillipa
Posted by heaven help me on June 11, 2006, at 15:42:09
In reply to Re: labwork for antipsychotics » blueberry, posted by heaven help me on June 10, 2006, at 10:41:47
So, you've been on Zyprexa 6 years?? I was on it for 1 and 1/2 w/ a 35lb weight gain (of which I needed about 15 of) but my blood sugars were in the diabetes range so I was taken off the Zyprexa. The weight has *fallen* off, and I am on Lamictal and Geodon which seem to be good but I am always interested in Zyprexa because I found it very stabilizing for me. I guess I want to ask what other meds are you on along with the Zyprexa? And how are you feeling?
xoxo
mary
Posted by yxibow on June 12, 2006, at 6:10:34
In reply to Re: labwork for antipsychotics, posted by Phillipa on June 10, 2006, at 20:44:35
> Agree fasting glucose, liver enzymes tests and a complete blood work up periodically. Love Phillipa
Yeah... I forgot about the ALT/bilirubin, although that's really a test for anyone especially someone like myself on multiple agents that go through the liver (few go through the kidney alone).
I'm not so sure about home monitoring of glucose levels -- a lab test will tell you where you are in a particular set of ranges that are calculated to specific standards.
Now if your doctor suggests glucose monitoring, that's another story -- but that's if diabetes actually hits :/... that's why (although your insurance company will probably hit you for multiple times in a year) fasting lab tests quarterly especially for Zyprexa is important -- its less necessary for Seroquel and Risperdal doesnt really carry that high of a risk. It carries a high risk of other nasty things like major EPS at high doses.
Posted by xbunny on June 12, 2006, at 8:44:10
In reply to labwork for antipsychotics, posted by psychosage on June 9, 2006, at 22:45:25
> What kind of labwork would be good to request when using antipsychotics like Risperdal, Zyprexa, etc? I am concerned about diabetes and the pancreas.
the only health checkups I have had done in regards to antipsychotics is an ECG (I think) to check for QT interval changes. Im not sure if this is still an issue for atypical antipsycotics like risperdal or zyprexa though nor what the consequences of a prolonged QT interval is...
Bunny
Posted by ed_uk on June 12, 2006, at 13:30:35
In reply to Re: labwork for antipsychotics, posted by xbunny on June 12, 2006, at 8:44:10
Hi Buns
A prolonged QT interval is associated with an abnormal heart rhythm called torsades de points. It can occasionally lead to sudden death. The risk was particularly high with thioridazine (Mellaril), which is why it was discontinued.
Ed
Posted by yxibow on June 13, 2006, at 18:37:15
In reply to Re: labwork for antipsychotics » xbunny, posted by ed_uk on June 12, 2006, at 13:30:35
> Hi Buns
>
> A prolonged QT interval is associated with an abnormal heart rhythm called torsades de points. It can occasionally lead to sudden death. The risk was particularly high with thioridazine (Mellaril), which is why it was discontinued.
>
> EdBranded Mellaril was discontinued by Novartis to cover their ***. ANDAs continue in the US for generic companies for Thioridazine which does pose a higher risk of QTc intervals. You can see which generic companies are marketing on Costco's site for example (MYL), Mylan.
Geodon, which originally was linked to a very small percentage of them and was discontinued, a new NDA was resubmitted and approved after a post-marketing Phase III study of 4000 patients on Geodon which showed no prolongation.
This is the end of the thread.
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