Posted by Blue Cheer 1 on January 21, 2002, at 11:22:00
In reply to Re: What do you all think of Zyprexa for BP?, posted by OldSchool on January 21, 2002, at 9:31:42
> >
> > Olanzapine (Zyprexa) has been used to treat all phases of bipolar disorder for several years now.
>
> I have the PDR right in front of me and Zyprexa is only FDA approved for the acute management of mania. Im sure some Pdocs are using it off label for longterm management of bipolar disorder, which I personally do not agree with unless real psychosis is present all the time.It's been over 15 years since I've seen a psychopharmacologist who relies on the PDR. In fact, if I encountered a psychiatrist who restricted his prescribing to the PDR (a reference book), I'd have to go elsewhere. May I ask what state you're from? Atypical APs are *routinely* used in the management of bipolar disorder (including mixed states, mania, bipolar depression, rapid cycling, and for long-term management. A cursory online search will confirm this. As far as AEDs, only Depakote is approved in BD. Since I can't tolerate Depakote at any dose, I use Lamictal and Trileptal -- an excellent combination in my case. There's really not much of an economic incentive for drug companies to seek approval for AEDS in psychiatry, since they're already so widely prescribed.
>
>
>
> >Try a Medline search using keywords "olanzapine bipolar" or "olanzapine fluoxetine". Lilly has been conducting studies using the combination of Zyprexa and Prozac (OFC) for treatment-resistant depression for at least five years (multi-site).
>
> Yeah, I already know that. In fact, I turned down a chance to get into this very study myself which combined Prozac/Zyprexa for TRD.At what site, if you don't mind me asking? I declined to participate in a two-year OFC study at Penn in September, 1997 (ongoing, btw).
I do not agree with using Zyprexa/Prozac for the management of non psychotic TRD. A person whose problem is unipolar major depression is more susceptible to neuroleptic induced movement disorders than are schizophrenics. Im personally trying to get over EPS induced from low dose Seroquel as I write this and I dont appreciate the Seroquel induced EPS. Zyprexa could have caused the same thing to me.
Have you ever considered ECT? I agree with you that all APs (conventional and atypical) carry the risk of incurring EPS and worse -- even NMS. Seroquel and Geodon are least likely to cause movement disorders.
>
> > All of the atypical APs are used to treat bipolar disorder (psychiatric AIDS). :) Personally, I would exhaust AEDs and/or other drugs before adding a neuroleptic.
>
> I think atypicals should be reserved for REAL psychosis and mania and not for TRD.It's actually a decison one should make with their treating psychiatrist -- weighing the risks vs. benefits, and an informed consumer can better participate in his/her care.
>
> Old School
poster:Blue Cheer 1
thread:90705
URL: http://www.dr-bob.org/babble/20020116/msgs/90973.html