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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by LlurpsieNoodle on December 5, 2007, at 19:22:16
Hi all, I am 28yr old with PTSD. My past PTSD symptoms included (depressive episodes, suicidal ideation, flashbacks -auditory/visual hallucination type, anxiety and specific phobia)
Current symptoms are mild anxiety.
Last year I took seroquel and put on about 15 lbs. I lost that dieting this summer. Now it's starting to go back on. I changed a couple of meds in August, so I think it might be related to Zoloft or abilify.
I've been trying to control poundage with diet and some exercise (key word is *trying!*) for some time now, but my appetite is high, especially for sweets and in the evening.
current meds
Zoloft 50mg (could I reduce that to 25mg? been about 4mos since last depression)
Lamictal 200mg (not sure what this one is doing for me, but maybe it's an appetite supressant?)
Abilify 10mg (I was on 5mg since september, but just went up 2 days ago)prn
Klonopin- I take about .5mg daily
Sonata- I take about 2,3x a week
Zyprexa (Zydis) 10mg - I have taken about 2-3 times a week for the past 3 weeksI would like a mood stabilizer and an antidepressant. I think that abilify is a good one. Since I increased my dose, I haven't had to use as much klonopin.
ideas? T says I'm probably over-medicated right now
thanks,
-Ll
Posted by Jimmyboy on December 5, 2007, at 19:31:13
In reply to poundage and redundant medication, posted by LlurpsieNoodle on December 5, 2007, at 19:22:16
Well definitely diet and exercise are important. I started a gluten-free diet and lost 20 lbs in a month.. but its very rigorous so, I'm not sure its worth losing a little weight for most people..
I would look into supplementing with CLA and Sesamin. Both help burn fat and I know sesamin makes you feel "fuller faster" - sesamin could also be helpful for depression and fatigue . Here are some links if you are interested in reading more. Good luck
http://www.lef.org/magazine/mag2005/jun2005_report_cla_01.htmhttp://www.bodybuilding.com/fun/southfacts_sesamin.htm
JB
Posted by LlurpsieNoodle on December 5, 2007, at 19:35:02
In reply to Re: poundage and redundant medication, posted by Jimmyboy on December 5, 2007, at 19:31:13
thanks for the sesamin info. I've been taking 24oo mg of CLA (tonalin) for about 2 weeks now.
at least I didn't gain any weight over tgiving
sighLl
Posted by Phillipa on December 5, 2007, at 23:53:09
In reply to Re: poundage and redundant medication » Jimmyboy, posted by LlurpsieNoodle on December 5, 2007, at 19:35:02
Lurpsie I have tonalin here never took does it work? I'd suspect the zyprexa it's a big weight gainer the worst. My sister and her daughter went to zoloft and both lost weight. So I don't think it's that and 50mg is low. Love Phillipa
Posted by rskontos on December 6, 2007, at 8:43:23
In reply to poundage and redundant medication, posted by LlurpsieNoodle on December 5, 2007, at 19:22:16
Li, there is a website called radiantrecovery.com that also has information on meds and sugar cravings that you might be interesting in looking at for suggestions. Their 7 steps program is hard and I only got to step 2 but I lost 10 lbs just doing the steps 1 and 2. Which aren't that hard overall. It isn't dieting really. It is a program geared to depression and meds, addicitive meds etc. I found it when I was trying to taper off cymbalta which sent me into sugar cravings so bad that is all I wanted and I mean only hard candy nothing else. I didn't add exercise as I couldn't not with tapering off cymbalta it was all I could do to get out of bed shower and rest. Good luck and look at that site. It really helped me.
rsk
Posted by Justherself54 on December 6, 2007, at 9:49:27
In reply to Re: poundage and redundant medication, posted by rskontos on December 6, 2007, at 8:43:23
unfortunately between Zoloft and Lexapro I gained 80 pounds! I've always had a battle with my weight and tend to be a sloth when it comes to exercise (I have fibromyalgia too)..the cravings for sweets was overpowering for me..I wish I had some suggestions for you..it's an awful feeling when you see your weight increase and still go into the "zone" where you stuff yourself with sweets and you don't care at that particular time what you're putting in your mouth! I really hope you can find something that helps the cravings..
Posted by nellie7 on December 6, 2007, at 10:34:46
In reply to poundage and redundant medication, posted by LlurpsieNoodle on December 5, 2007, at 19:22:16
Hi Llurpsie,
Trying to prevent weight gain while taking meds can be a real challenge.
Have you considered seeing a dietician? Maybe you can get some tips on how to control sugar cravings.
One thing you can try is to eat complex carbohydrates. They can help keep a steady blood sugar level and are supposed to prevent the constant hunger which results from sugar levels rising and falling.
Take care,
Nellie.
Posted by LlurpsieNoodle on December 6, 2007, at 21:10:20
In reply to Re: poundage and redundant medication » LlurpsieNoodle, posted by nellie7 on December 6, 2007, at 10:34:46
thank you all for your kind posts. I saw a dietician about 8 months ago. I was successful dieting this summer, but then I changed meds, and my resolve weakened. hence more poundage.
I feel that it's time for a shake-up in the meds I'm taking. T agrees & thinks that I'm overmedicated for someone who is so functional. I have a stressful job and am also doing some coursework right now.
Zydis is an oral form of zyprexa that is thought to be absorbed through the mouth membranes and bypasses the stomach. This mode of abosorption is associated with less weight gain (4lbs vs 16lbs in one study)
lamictal is weight neutral, I'm not sure if it's doing anything for me?
abilfy is potential for weight increase. who knows?
why does my cat have 2 white whiskers on one side and only one on the other side.
some things will always remain a mystery.
I'd be happy using zyprexa prn for antipsychotic, and go off of the abilify. perhaps lower my dose of zoloft to 25mg. I tend to respond well to AD.
what do you think?
-Ll
Posted by Phillipa on December 7, 2007, at 0:15:45
In reply to Re: poundage and redundant medication » nellie7, posted by LlurpsieNoodle on December 6, 2007, at 21:10:20
Lurpsie zydis? Haven't heard of that. But a lot of people here would love to know what you know about it when was it realeased etc. you know they say zyprexa can stop suicidal thoughts really fast. Love Jan
Posted by nellie7 on December 7, 2007, at 5:05:37
In reply to Re: poundage and redundant medication » nellie7, posted by LlurpsieNoodle on December 6, 2007, at 21:10:20
Llurpsie, if you respond well to antidepressants, then maybe you really don't need so much AP medication. You might be able to get off the abilify and settle for Zydis as an AP only. This, of course, needs to be discussed with your pdoc and any change in meds should be made slowly and carefully.
Best wishes,
Nellie.
Posted by llurpsienoodle on December 7, 2007, at 8:14:10
In reply to Re: poundage and redundant medication » LlurpsieNoodle, posted by nellie7 on December 7, 2007, at 5:05:37
> Llurpsie, if you respond well to antidepressants, then maybe you really don't need so much AP medication. You might be able to get off the abilify and settle for Zydis as an AP only. This, of course, needs to be discussed with your pdoc and any change in meds should be made slowly and carefully.
>
> Best wishes,
> Nellie.Thank you for reminding me (I'm being sincere!). I tend to jump into things headfirst (I suppose that's called a "dive") and then I get into trouble.
I have had no problem coming off of AP's but my experience with cymbalta was one of the precipitating causes of my being hospitalized...
I think I'll wait until after the holidays. (after I gain 10lbs, most likely)...
thanks for your help :) nice to meet you :)
-Ll
Posted by Phillipa on December 7, 2007, at 12:29:22
In reply to Re: poundage and redundant medication » nellie7, posted by llurpsienoodle on December 7, 2007, at 8:14:10
Lurpsie did some googling and can't find that the side effects of zydis are any different from the regular zyprexa. Do you have a link as this what I found googling zydis on a few websites. Phillipa
GENERIC NAME: olanzapine
BRAND NAME: Zyprexa, Zydis
DRUG CLASS AND MECHANISM: Olanzapine is a medication that is used to treat schizophrenia and acute manic episodes associated with bipolar I disorder. Olanzapine belongs to a drug class known as atypical antipsychotics. Other members of this class include clozapine (Clozaril), risperidone (Risperdal), aripiprazole (Abilify) and ziprasidone (Geodon). The exact mechanism of action of olanzapine is not known. It may work by blocking receptors for several neurotransmitters (chemicals that nerves use to communicate with each other) in the brain. It binds to alpha-1, dopamine, histamine H-1, muscarinic, and serotonin type 2 (5-HT2) receptors. Olanzapine was approved by the FDA in 1996.PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 2.5, 5, 7.5, 10, 15, 20 mg. Intramuscular Injection: 10 mg vial.
STORAGE: Tablets should be kept at room temperature, 20-25°C (68-77°F).
PRESCRIBED FOR: Olanzapine is used for treating schizophrenia and acute mixed, or manic episodes associated with bipolar disorder. It also is used as maintenance therapy for bipolar disorder and treating agitation due to schizophrenia or bipolar disorder.
DOSING: The usual oral dose for treating schizophrenia is 10 mg once daily. Therapy is initiated with 5-10 mg/day and the dose may be increased by 5 mg a day in weekly intervals. Doses greater than 10 mg daily have not been shown to be more effective than 10 mg daily. The safety and efficacy of doses greater than 20 mg daily have not been evaluated.
Treatment of bipolar disorder usually is initiated with oral doses of 10-15 mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. Doses greater than 20 mg daily have not been evaluated. In clinical trials, doses of 5-20 mg daily were effective.
The usual dose for treating agitation due to schizophrenia or bipolar disorder is 10 mg administered by intramuscular injection. Additional 10 mg doses may be administered, but the efficacy of total daily doses greater than 30 mg daily have not been adequately evaluated.
DRUG INTERACTIONS: Carbamazepine (Tegretol) can reduce blood concentrations of olanzapine, possibly necessitating higher doses of olanzapine. Other drugs that also may reduce blood levels of olanzapine are omeprazole (Prilosec) and rifampin. Smoking may also reduce blood concentrations of olanzapine. Ciprofloxacin (Cipro), diltiazem (Cardizem; Dilacor; Tiazac), erythromycin, and fluvoxamine (Luvox) may have the opposite effect, that is, they may increase blood levels, and the dose of olanzapine may need to be reduced. Olanzapine can cause orthostatic hypotension, a drop in blood pressure upon rising that may cause dizziness or even fainting. Taking olanzapine with either diazepam (Valium), other related benzodiazepines or alcohol can exaggerate the orthostatic hypotension caused by olanzapine.
PREGNANCY: There are no adequate studies of olanzapine in pregnant women. Olanzapine should only be administered to pregnant women if the benefits justify the unknown risks.
NURSING MOTHERS: Olanzapine is excreted into breast milk. Therefore, it is recommended that olanzapine not be used by nursing mothers.
SIDE EFFECTS: Side effects seen with olanzapine include akathisia (an inability to sit still), constipation, dizziness, drowsiness, insomnia, dry mouth, orthostatic hypotension (see DRUG INTERACTIONS), tremor, and weight gain.
Several disorders of movement also may occur with olanzapine, for example, extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes). Tardive dyskinesia (involuntary movements of the mouth, tongue, jaw, or eyelids) also may occur in 1 in 100 patients receiving olanzapine. Some cases can be irreversible. The likelihood of developing tardive dyskinesia increases with prolonged treatment.
There may be an increased risk of increased blood sugar levels and diabetes with olanzapine as well as the other antipsychotic medications in its class. Patients should be tested during treatment for elevated blood sugar. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes
Posted by llurpsienoodle on December 7, 2007, at 13:37:00
In reply to Re: poundage and redundant medication » llurpsienoodle, posted by Phillipa on December 7, 2007, at 12:29:22
http://www.psycheducation.org/hormones/Insulin/weightgain.htm
I didn't read the studies themselves, just the precis that I linked.
-Ll
Posted by Phillipa on December 7, 2007, at 19:43:29
In reply to weight gain zyprexa vs. zydis, posted by llurpsienoodle on December 7, 2007, at 13:37:00
Reminds me a bit of EMSAM bypassing to stomach. So you will be the first official babbler to try this med and hopefully report back. Phillipa
Posted by LlurpsieNoodle on December 8, 2007, at 7:02:18
In reply to Re: poundage and redundant medication, posted by rskontos on December 6, 2007, at 8:43:23
> Li, there is a website called radiantrecovery.com that also has information on meds and sugar cravings that you might be interesting in looking at for suggestions. Their 7 steps program is hard and I only got to step 2 but I lost 10 lbs just doing the steps 1 and 2. Which aren't that hard overall.
Starting today I'm going to add a protein serving to my breakfast. I'm having a whey protein shake as I type this. I hope the tryptophan doesn't make me too too sleepy!
thank you so much for the link :)
-Ll
Posted by LlurpsieNoodle on December 8, 2007, at 7:08:15
In reply to Re: poundage and redundant medication, posted by Justherself54 on December 6, 2007, at 9:49:27
I'm going to continue with my supplements, which include tonaling 2000? 2400? mg chromium picolinate and multi vitamin, fish oil, A&D, E, lecithin
and add
1 protein serving for breakfast
tagamet at night when I take the zoloft. Some very very sketchy research shows that this might help slightly with SSRI weight gain? I'm willing to give it a try. in 3 days I *have* noticed a change.
I will meet with pdoc after the holidays.
ClearSkies will be happy to note that my weight is down one-half pound. This was a hard-fought battle, with a palm-pilot sword and an elliptical shield.
I will continue to post to this thread if/as I make progress
thanks all, for your contributions. any more ideas?
-Ll
Posted by nellie7 on December 8, 2007, at 10:54:34
In reply to Re: poundage and redundant medication » nellie7, posted by llurpsienoodle on December 7, 2007, at 8:14:10
.
> Thank you for reminding me (I'm being sincere!). I tend to jump into things headfirst (I suppose that's called a "dive") and then I get into trouble.
I have that tendency too :)
>
> I have had no problem coming off of AP's but my experience with cymbalta was one of the precipitating causes of my being hospitalized...Another reason to suspect that ADs are more important for you than APs...
> I think I'll wait until after the holidays. (after I gain 10lbs, most likely)...
>
> thanks for your help :) nice to meet you :)Thanks, likewise:)
Nellie.
Posted by linkadge on December 8, 2007, at 14:19:57
In reply to Re: poundage and redundant medication, posted by nellie7 on December 8, 2007, at 10:54:34
>I have had no problem coming off of AP's but my >experience with cymbalta was one of the >precipitating causes of my being hospitalized...
This could be indicitive of the propensity for antidepressants to produce nasty withdrawl.
The fact that a drug produces withdrawl is not necessarily indicitive of the nature or sevarity of ones underlying disorder.
For instance, klonazepam withdrawl put me in the hosptital, but that doesn't necessarily mean that I need to be on a benzodiazapine.
Linkadge
Posted by rskontos on December 8, 2007, at 18:38:26
In reply to Re: poundage and redundant medication » rskontos, posted by LlurpsieNoodle on December 8, 2007, at 7:02:18
Llurpsie, your are welcome. Are you using the tagamet for upset stomach or because of hopeful weight loss. Because if so....when I was withdrawing from cymbalta a website I went to recommended CLA, vitamin E and Power Barley Formula to help with GI issues that cymbalta causes as well gastric problems and to just help the liver detox and low and behold if my appetite didn't go to nil. Nada, nothing. I made myself eat. Something about the combination of CLA with vitamin E and the Barley Formula. You can get the barley formula at www.globaldnasolutions.com and it is great is you have IBS or other gastric issues. I have a rare form of collitis according to my gastric doctor and that barley formula has saved me. But it is good for the helping the liver rid itself of meds to. Anyway check it out. The protein is helping me now curb my sugar issues. I hope it helps you.... When you want a sweet eat some protein instead. That is what I do, it isn't nearly as fun but you aren't supposed to gain weight from and you will stop having the cravings. Take care.... rk
Posted by LlurpsieNoodle on December 8, 2007, at 20:30:51
In reply to Re: poundage and redundant medication » LlurpsieNoodle, posted by rskontos on December 8, 2007, at 18:38:26
That's really good advice! My h is like that. when he feels like a snack, he goes for chicken wings. sure they're fatty, but dang if h doesn't have a toned ab section?
My journey towards carb salvation will have to begin tomorrow. I'm making omega 3 health bread tonight. it has ground flaxseed and ground walnuts, low sugar, low fat, and prunes and cinnamon for sweet (only 3tbsp sugar for the whole thing.
-Ll
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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