Posted by SLS on October 4, 2012, at 6:56:03
In reply to Re: PS. what should i do? » SLS, posted by phidippus on October 3, 2012, at 23:32:10
I hate to burst you bubble, but opinions do not go unchallenged here.
"Your definition is fine, I just think its too bipolar specific"
I thought that bipolar disorder was the issue we were discussing. You believe that lithium is acting as a mood stabilizer for you, despite your not having bipolar disorder. I really can't dispute your belief that the diathesis of your condition does not lie along the bipolar spectrum without further evidence.
Re: Zyprexa as a mood stabilizer?
Your opinion that Zyprexa is nothing more than an antimanic agent has merit as it is sometimes portrayed in the medical literature. However, there doesn't seem to be a consensus at this point. Scientific data is limited for Zyprexa monotherapy. However, it is not terribly common that any one drug effectively treats bipolar disorder - even lithium. It is fascinating when lithium monotherapy completely resolves bipolar I disorder, though. It is quite dramatic.
The value that a drug has as a mood stabilizer is measured by time to relapse. There are studies indicating that time to relapse in bipolar order is greater with Zyprexa than with placebo.
"Lithium continues as our oldest well-established maintenance treatment in bipolar disorder with somewhat better efficacy in preventing mania than depression. Lamotrigine, olanzapine, and quetiapine have bimodal efficacy in preventing both mania and depression..."
http://www.ncbi.nlm.nih.gov/pubmed/22510036
"Lithium levels ≥0.6 mmol/L and olanzapine doses ≥10mg/day may be necessary for optimal protection against manic/mixed or depressive episodes, respectively in patients with bipolar I disorder."
http://www.ncbi.nlm.nih.gov/pubmed/20430594
The following three studies were performed in associated with Lilly, the manufacturer of Zyprexa. They were performed by well-published researchers. I segregated them because some people will invalidate the work of these researchers on the basis that Lilly was involved.
http://www.ncbi.nlm.nih.gov/pubmed/16449478
http://www.ncbi.nlm.nih.gov/pubmed/19054570
http://www.ncbi.nlm.nih.gov/pubmed/15994710
The following studies reported no therapeutic effect or mixed results:
http://www.ncbi.nlm.nih.gov/pubmed/19828571
http://www.ncbi.nlm.nih.gov/pubmed/19160237
http://www.ncbi.nlm.nih.gov/pubmed/16426094
It is hard to argue with Terrence Ketter.
Zyprexa certainly has antidepressant properties and makes a good augmenter, especially when combined with antidepressants like Prozac. Zyprexa can even precipitate a manic reaction. Personally, I have observed in others that Zyprexa has a potent anti-suicide effect. I am guessing that it is equally effective to Clozapine, a related drug. This, however, is not the same thing as maintenance mood stabilization.
> My point is simply that Zyprexa is not a mood stabilizer. Its mechanism of action differentiates it from Lithium and all the anticonvulsants called mood stabilizers
Must a drug have same properties as another in order treat the same illness effectively? This does not follow from logic. You lose your own argument because anticonvulsants do not have the same physiological properties as lithium, yet they can be effective.
All in all, I still question the classification of Zyprexa as a mood stabilizer as it is strictly defined for the treatment of bipolar disorder. However, it does act as an antimanic and/or an antidepressant for some percentage (unknown) of people who take it, especially when used as an augmenting agent as is often done with lithium.
If you have no problem with lithium shutting down your kidneys, I don't understand why you would have a problem with Zyprexa producing diabetes. Both sequelae are serious. You value lithium because it works for you. Others value Zyprexa because it works for them.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1027311
URL: http://www.dr-bob.org/babble/20121001/msgs/1027540.html