Posted by bleauberry on June 23, 2009, at 17:48:57
In reply to Re: Update on starting Zyprexa- positive results!!, posted by jerrypharmstudent on June 22, 2009, at 0:57:53
> Anyone know the exact mechanism of action for Zyprexa and if it would interfere with Adderall in any way. Since I started taking the Zyprexa it seems like my Adderall isn't giving me the "oompf" it was giving me before. A minor issue, but just wondering.
>
> thanks
> JerryAs with all meds, no one knows how these meds work. Through animal studies we can get a basic idea of what they do, but that is likely just the tip of the iceberg. Zyprexa is an antagonist at a whole bunch of receptors, including D1 through D4, adrenergic, several serotonin receptors, and others. As tricyclics are considered "dirty" drugs in terms of their non-selectivity, hitting a bunch of targets, Zyprexa is also a dirty drug. To me, that is a good thing. I think the more selective a drug is, the less useful it is in moderate to severe cases. Selective is more appropriate for mild cases. My opinion.
In one study they determined that Zyprexa turned up the volume on about 30 genes and turned down the volume on about 30 others. (some of the ones turned up were the ones that turn food into fat storage, and thus the weight gain if a change of lifestyle does not go along with the prescription)
Even if we knew exactly what the meds do, do we know what that means in terms of individual patient results? We don't. There is no substitute for personal trial.
I tried both Ritalin and Adderall when I was on Zyprexa. There was no interference that I could perceive. Adderall made me very depressed just like it did when I wasn't on Zyprexa, and Ritalin boosted my mood and energy just like it did when I wasn't on Zyprexa. Probably the only interference was that the stimulants tended to cut down on the Zyprexa appetite, and Zyprexa helped to get to sleep.
Here is a weird one for you. A case study on pubmed. A patient in a hospital had psychotic depression. It was not responding to the antipsychotic. Don't ask me why they did this, I don't know what they were thinking (but it is a good example of how logic doesn't much matter in psychiatry), but they added Ritalin. Psychotic, and added a stimulant? Geez. Now, that does not seem wise, does it? Well, the ritalin went all the way from a starting dose of 5mg to 40mg, at which time the patient's psychosis and depression both disappeared into remission.
Go figure. I don't think we can figure any of this stuff out in advance.
poster:bleauberry
thread:902319
URL: http://www.dr-bob.org/babble/20090620/msgs/902803.html