![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 39. This is the beginning of the thread.
Posted by jerseygal1 on June 27, 2011, at 9:36:23
Anyone have a good experience with zyprexa for depression/anxiety? I've been on pristiq for almost 6 weeks, remeron since November, along with clonazepam for anxiety. Two weeks ago, my pdoc suggested adding 2.5 to 5 mg. of zyprexa to augment above as my depression/anxiety hasn't resolved yet. I've had a couple of med changes since last May that haven't worked. I've been reading all the negative reviews of zypexa, ie: weight gain, possible increased sugar levels, etc. and am a little scared to start zyprexa. I need to hear from some people that have had a good experience with it. Also, will it make you feel more tired/depressed when starting it? I've already tried abilify and seroquel so those aren't options.
Posted by Phillipa on June 27, 2011, at 10:36:24
In reply to Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 9:36:23
For now you can google poster zyprexa as he has been on it for years. Phillipa
Posted by B2chica on June 27, 2011, at 13:08:25
In reply to Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 9:36:23
i have been off and on it since 2003. going off for various reasons. but doc always goes back to it when i'm in crisis. because it is the ONLY one that has worked like a charm with almost no side effects.
Most people that get on it do gain weight but here are some insights from my experience.
1)if i'm am only on 5mg (or less) then i have had NO issues with weight gain. it is only when i go to 10 or higher that i end up not feeling full. If i know i'm going to go up to 10 one thing i do is start to drink Lots of water. anytime i feel hungry i drink water first. this seemed to have helped a couple times i was on it.If gaining too much weight then you need to decide to get off it or stay on.
If you start off slow the sleep issue may not be too bad. i have heard a couple people that got hit hard by the somnolence of it, but it never seemed to bother me that bad..i can only assume because of my bad anxiety.
Regarding my anxiety, i think i would tend to notice an almost instant difference,literally within 24 to 48 hours.
i think the sugar levels thing comes into play after you've been on it for a couple years, or have gained Excess amount of weight.
********
my best example of how quickly it worked is: about a month after i finished nursing my first child, i started heading down. Quick. The short of the story is I ended up having to call my husband to come pick me up from work because i couldn't stop crying and couldn't drive. He took me home to pack my bags, as i called my T and pdoc on the way and that is what they both suggested. I got admitted about 8:00pm, took zyprexa at 9:00pm. The next morning i woke up without crying and could even peak a smile. i wasn't feeling fantastic. but i could somewhat function. (that's not even 24 hours) although i think just being in the hospital helped some as well. But i was released in two days.
From SUPER severe to functional in a few days was awesome for me.
I wasn't top notch. but on a scale i went from below zero to a 5 in a few days.Now, i'm probably an exception, and that instance i'm sure was an exception. But in general zyprexa is to this day my saving grace and has always worked well for me.
THE bad side:
Honestly i have only heard one person on here report that they got diabetes from zyprexa. The rest are ALL the same. the Primary issue with zyprexa is weight gain. There were quite a few i think that couldnt function with how tired it made them, but the biggest issue was always the weight.But i dont know what dosage they were on. and like i said i have Never gained weight on less than 10mg. but i normally need to have 10 and thats why i'm no longer on it, and it will effect my med compliance if i gain too much. i still had pregnancy weight from second child and was gaining weight, so doc who is 'gratefully' sensitive to this decided if i wanted to to try something else.
I wish you the best and be aware of what your limitations are, what dosage you will need and drink lots of water.
Post if you decide to take it.best wishes
b2c
Posted by jerseygal1 on June 27, 2011, at 14:56:12
In reply to Re: Zyprexa - Reluctant to Take, posted by B2chica on June 27, 2011, at 13:08:25
Thanks for your responses. I am getting to the point of desperation but I kept hoping the pristiq would kick in already which it has not (almost 6 weeks). It's hard now because my daughter is home from school (which creates more anxiety because you want to be there for them and put on a happy face) and I just want to be able to enjoy some of the summer with her. I think I will give it a few more days and then start on Thursday when I know my husband will be off from work for a few days. B2C, how are you doing? I know you were struggling too.
Posted by floatingbridge on June 27, 2011, at 16:37:14
In reply to Re: Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 14:56:12
Jerseygal,
(Pristiq is notorious for a delayed response :-/ ).
That zyprexa works so well for some, like B2chica is amazing. I think your idea to wait for the weekend is great.
Very good luck with this.
Posted by JONO_IN_ADELAIDE on June 27, 2011, at 17:40:59
In reply to Re: Zyprexa - Reluctant to Take » jerseygal1, posted by floatingbridge on June 27, 2011, at 16:37:14
Why not give it a try and see what happens - you have nothing realy to lose, ebcause if it doesnt suit yiou, you can easily stop, and a lot to gain if it does work.
Personaly I never found pristiq/effexor very helpful - I did better on a cocktail of Zoloft + Welbutrin
Posted by bleauberry on June 27, 2011, at 18:14:49
In reply to Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 9:36:23
I was on zyprexa for 8 years and I give it high marks. Most psych drugs I give a thumbs down. I took 5mg in combination with 20mg prozac and 300mg adrafinil (similar to modafinil). The only negatives I see with zyprexa are:
1. Try to keep the dose at 5mg for minimal risk of any longterm antipsychotic side effects. 10mg max.
2. Dump the remeron. Zyprexa does a lot of the same as what remeron does, only better, and more extra stuff as well. You already know remeron isn't a good med for you because if it was you would be feeling better than you do. Zyprexa will replace everything it does and a lot more. Probably one of the worst mistakes I've seen people do here over the years is continue to pile one losing med on top of another, hoping that somehow the most recent addition will magically spark all the others to somehow suddenly work great. Sorry, that doesn't happen hardly at all, very rare. Instead people end up on a cocktail of maybe 4 to 6 meds and they feel like crap. I can feel like crap on 2 or 3 meds, I don't need more than that to do it. Anyway, that is a hard road to back out of once you are there. It's like a dead end alley. When you see the entrance, avoid it, go a different way. In this case that means do not add yet another drug without first removing one of the others. I happen to think remeron is the weakest thing in your cocktail.
3. Think stimulants. That might be the missing link. If there is anything that can spark the other meds to life, it is one of the stimulants. Modafinil, adrafinil, or ritalin.
4. Weight gain is common with zyprexa. If that is a problem for you, then you will have to change the things you eat in order to manage that.I see zyprexa as a better med than most in the psychiatric toolbox. I think its positives far outweigh the negatives. In terms of the negatives, those things can be managed effectively. I believe whether a med takes someone over with crazy stuff such as weight gain or not, is more the result of the whether the person is a good custodian of the body or not.
Zyprexa is one of the best. This from someone who is very sensitive to drugs and not particularly a fan of them. If I can take it, especially for as long as I did, anybody can. It helped me a good deal while countless other meds didn't. I think the combo with prozac was important, and in your case the similar companion is pristiq. Ditch the remeron, it screws up the whole recipe. Add a low dose stimulant instead. As for the anxiety stuff, much of it could rapidly disappear on zyprexa, making it possible to wean off the benzos which are probably working against you in terms of mood improvement. Zyprexa is also good at taming the jitters of stimulants.
If your doctor isn't cooperative on the stimulant thing, then:
1. Get another doctor OR...
2. Ask for notriptyline first choice, desipramine second choice. While your doctor probably thinks you are on an SNRI, you really aren't. Effexor/Pristiq serotonin to norepinephrine ratio is 30:1. Almost completely serotonin, 97%. To make a true snri, which I whole heartedly endorse, add a TCA to the pristiq. Or a stimulant.
Posted by jerseygal1 on June 27, 2011, at 20:32:02
In reply to Re: Zyprexa - Reluctant to Take, posted by bleauberry on June 27, 2011, at 18:14:49
I definitely agree with you bleauberry about not adding too many drugs to the mix. I don't think remeron has done anything for me other than to help me sleep good. If it was helping me, I wouldn't still be in the same place. My pdoc had me decrease it when he added the zyprexa but I'm going to ask him about tapering off of it at my next appointment. I hope by then the zyprexa and/or pristiq have started to work.
I'm glad I got some good feedback on zyprexa from a few of you as it makes me feel better about taking it. Weight gain is a concern for me as I'm already a few more lbs than I should be...plus I gained 10 lbs. from remeron. But if I start to feel better, I can get back into going to the gym. And if I can dump the remeron, those 10 lbs. will come off too. Thanks everyone.
Posted by torrid on June 27, 2011, at 20:38:42
In reply to Re: Zyprexa - Reluctant to Take, posted by bleauberry on June 27, 2011, at 18:14:49
berry, do you know how pristic compares to cymbalta in regaurds to the ratio?
Posted by emmanuel98 on June 27, 2011, at 20:41:33
In reply to Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 9:36:23
Zyprexa in combo with lexapro killed my depression, but made me gain weight. Same with the other atypicals. Try it, but weigh yourself weekly.
Posted by morgan miller on June 27, 2011, at 22:53:25
In reply to Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 9:36:23
HUGE Sigh! I am getting so sick and tired of doctors jumping on this antipsychotic bandwagon. If I were a friend or family member, I would say definitely do not take Zyprexa. If you can endure and perservere for a bit longer I am sure you will find something to give you at least enough relief to be able to do other thing to further progress you back to living well again. You are already on 3 medications and your doctor wants you to take Zyprexa? I'm sorry but WTF is going on in this world?! Are you eating well? Exercising? Going to therapy? Taking fish oil? Are you doing everything you possibly can to get yourself to feeling good and being productive? Low dose lithium is a superior choice to Zyprexa. You can even order lithium orotate or aspartate on the internet and take that if you want. Vitamin Research Products has a good one.
Posted by morgan miller on June 27, 2011, at 23:01:48
In reply to Re: Zyprexa - Reluctant to Take, posted by bleauberry on June 27, 2011, at 18:14:49
I'm very surprised to hear you talk so highly of Zyprexa BB. You do know this and other APs have the potential to shrink brain volume? They did in monkeys.
If it's only been 6 wks hang in there. Maybe you need to raise the dose?
What other antidepressants have you been on?
Sorry if my previous post sounded a bit abrasive. I just get frustrated with the psych industry sometimes. IMO, if you are doing something just out of desperation, it's often the case it might not be the best decision. Try to wait this one out until you have exhausted all options. Antipsychotics are bad news, all of them. These drugs should only be used as a last resort in all cases.
Morgan
Posted by torrid on June 28, 2011, at 11:17:01
In reply to Re: Zyprexa - Reluctant to Take, posted by morgan miller on June 27, 2011, at 22:53:25
I agree with morgan miller. Zyprexa carry's risk of getting diabetis. I realize that there is very little known risks at low dose but there could be risk we don't know about. There is no long term studys on the risk of long term low dose use of antiphycotics, antiphotics should be the last resort.
Posted by B2chica on June 28, 2011, at 11:35:42
In reply to Re: Zyprexa - Reluctant to Take » bleauberry, posted by morgan miller on June 27, 2011, at 23:01:48
jerseygall.
pristiq usually took 10-12 weeks to kick in for me. so hang in there and augment till then. Time s*cks when you're feeling like crud, but hang on. after a few months if weight gain becomes an issue you can taper off and by then the pristiq should be working well and you may no longer need the zyprexa, decreasing your med regime even more.
i agree, drop the remeron.
about the monkey trial
that was only shown in monkeys...not humans. also there are contradictory 'results' shown on the internet...google a little more. also that part that it is shown to 'shrink' are allegedly beneficial...infact i'll start from a post here at dr. bob's.
http://www.dr-bob.org/babble/20001102/msgs/48761.html
i will mention that zyprexa is shown to prevent brain loss in people with schizophrenia.(and believed to improve brain function in those using zyprexa that do not have schizophrenia)
it effects the white matter (myelin) in the brain. i have read about this online, but only after i was told this by my pdoc.
Posted by morgan miller on June 28, 2011, at 12:46:49
In reply to Re: Zyprexa - Reluctant to Take, posted by B2chica on June 28, 2011, at 11:35:42
> jerseygall.
> pristiq usually took 10-12 weeks to kick in for me. so hang in there and augment till then. Time s*cks when you're feeling like crud, but hang on. after a few months if weight gain becomes an issue you can taper off and by then the pristiq should be working well and you may no longer need the zyprexa, decreasing your med regime even more.
> i agree, drop the remeron.
>
>
> about the monkey trial
> that was only shown in monkeys...not humans. also there are contradictory 'results' shown on the internet...google a little more. also that part that it is shown to 'shrink' are allegedly beneficial...
>
> infact i'll start from a post here at dr. bob's.
> http://www.dr-bob.org/babble/20001102/msgs/48761.html
>
>
> i will mention that zyprexa is shown to prevent brain loss in people with schizophrenia.(and believed to improve brain function in those using zyprexa that do not have schizophrenia)
> it effects the white matter (myelin) in the brain. i have read about this online, but only after i was told this by my pdoc.I appreciate any positive study done on psychiatric medications, but in my experience, zyprexa did nothing good for my brain or it's function. I also obsessed more about negative things in the morning and was far more likely to lay in bed a go back to sleep while on zyprexa. I and everyone else I have ever known that took zyprexa both ate more, gained weight, and found it difficult to lose weight.
Any chance you can find that study and post it here? Here is the study on monkey and brain volume shrinkage..
Also, no one has mentioned the possibility of tardive dyskinesia. And, D2 antagonism is not something that you want to do to your brain unless it is absolutely necessary. Antagonizing this receptor comes with several potential side effects like parkinsonism and the often long term and permanent tardive dyskinesia.
Posted by morgan miller on June 28, 2011, at 12:55:26
In reply to Re: Zyprexa - Reluctant to Take, posted by B2chica on June 28, 2011, at 11:35:42
B2Chica, it's my understanding that the brain shrinkage volume might only be a good thing for schizophrenics that have been shown to be more likely to have possibly unhealthy larger than normal volume in areas of the brain that brain shrinkage occurs with antispychotics.
Morgan
Posted by B2chica on June 28, 2011, at 14:22:14
In reply to Re: Zyprexa - Reluctant to Take » B2chica, posted by morgan miller on June 28, 2011, at 12:55:26
that's how i understand it too.
Posted by B2chica on June 28, 2011, at 14:24:57
In reply to Re: Zyprexa - Reluctant to Take, posted by morgan miller on June 28, 2011, at 12:46:49
i actually find it hard to find positive studies on AP's, but i ran across it about a year ago after i talked with my pdoc who mentioned it. i dont recall where it was. if i have time i'll try to find it again.
Most of the 'positive' studies are from big pharma.i totally agree with the ate more.
what it does is affect the part of the brain that makes you feel full. so you dont totally feel satiated and eat more. i personally found that i also seemed to crave more carbs.
however, this was only once i went up to 10mg.I know many many people are anti AP. and i understand that. but jerseygall may only augment for a time and then taper off. She is needing some positive insight and was hoping to help her.
i'm sorry you have had previous bad results.
though there is the possibility of TD with AP, it is significantly lower with the 'newer' atypical AP's like zyprexa.
and in my experience and personal researching i dont think there is ANY psych drug made that i would easily hand out. they all have reported terrible side effects many sounding worse than what they are helping. however, at some point we need to make decisions, and hopefully right ones.
Those of us that are more difficult to treat will ourselves and our docs make many, many wrong ones. Hopefully none of them will do permanent damage. But all drugs do run that risk.I wish you the best and hope that you have found something that works great for you.
Best wishes
b2c.
Posted by morgan miller on June 28, 2011, at 15:14:21
In reply to Re: Zyprexa - Reluctant to Take » morgan miller, posted by B2chica on June 28, 2011, at 14:24:57
Hey B2chica,
I agree in certain cases when all proper trials have failed and suffering is to an extreme that is unbearable where one cannot wait, a trial of something like zyprexa just for 6 months is an o.k. idea.
I respect you trying to find something positive about zyprexa to focus on for jerseygirl, I've done the same with certain medications for others. Unfortunately, at this point in time, I see nothing positive or neuroprotective about taking zyprexa unless you are schizophrenic.
I am doing much better, thank you. I contribute part of my progress to getting off zyprexa and going against the grain of traditional psychiatric establishment in treating my bipolar issues.
I hope you too are finding success in whatever you are doing to improve your life and well being.
Morgan
Posted by B2chica on June 29, 2011, at 12:51:33
In reply to Re: Zyprexa - Reluctant to Take, posted by morgan miller on June 28, 2011, at 15:14:21
Posted by jerseygal1 on June 30, 2011, at 16:26:27
In reply to Zyprexa - Reluctant to Take, posted by jerseygal1 on June 27, 2011, at 9:36:23
I guess I started a good debate on this topic. I would prefer not to take zyprexa but, at this point, I just want something to work already. I've been struggling since May of last year after prozac pooped out on me after 11 good years. Since then, I've tried to augment prozac with abilify, seroquel and wellbutrin (not at same time, of course) which didn't work. Then, I tried lexapro with remeron and that didn't work. Now I'm on pristiq (six weeks) with remeron which hasn't worked yet. At my last visit, my pdoc wasn't very optimistic about pristiq working if it hasn't worked yet. But as many of you say, pristiq can take a while to kick in. My pdoc was ready to change my med yet again, to possibly anafranil, but I asked if we could try to augment pristiq with something first. That's when zyprexa came into the picture. So I guess it really wouldn't do much harm to try it cause if nothing changes in the next 2-3 weeks, I'll probably be facing a med change anyway. Thanks everyone for your input.
Posted by morgan miller on June 30, 2011, at 23:14:42
In reply to Re: Zyprexa - Reluctant to Take, posted by jerseygal1 on June 30, 2011, at 16:26:27
Jerseygirl, when prozac "pooped out" did it completely stop working where you were completely depressed all over again? Or, did you just have a moderate depressive episode on it, but still felt it might be helping some? I guess it's hard to tell if you've been on something for that long and you may not remember exactly what it felt like to be off it. Also, did you end up feeling even worse after getting off Prozac? I guess I'm just wondering if your depression was related to emotional triggers and possibly your depression would have been much much worse without Prozac. I often wonder if we too quickly give up on a drug instead of sticking it out and trying other ways to come out of a depressive episode. Does this make any sense?
Morgan
Posted by jerseygal1 on July 1, 2011, at 9:23:02
In reply to Re: Zyprexa - Reluctant to Take, posted by morgan miller on June 30, 2011, at 23:14:42
After prozac pooped out, my pdoc and I tried everything to get a response out of it again. The dose was increased, we also tried stopping it and restarting it, augmenting, and nothing worked. This was over a period of about 8 months. So we gave it a good try before giving it up. Then we finally moved on to lexapro which also did not work. Yes, the original symptoms of depression returned - lots of anxiety mixed with depression.
Posted by floatingbridge on July 1, 2011, at 9:34:32
In reply to Re: Zyprexa - Reluctant to Take, posted by jerseygal1 on July 1, 2011, at 9:23:02
Good luck this weekend if you go forward.
Posted by jerseygal1 on July 1, 2011, at 15:47:25
In reply to Re: Zyprexa - Reluctant to Take » jerseygal1, posted by floatingbridge on July 1, 2011, at 9:34:32
Thanks floatingbridge, and I did start taking zyprexa last night. I'm supposed to take 2.5 mg for 7 days then increase to 5 mg. I felt pretty terrible this AM - felt kind of out of it if you know what I mean, and a little nauseous. But it seemed to pass by about 1 pm. I actually feel pretty good this afternoon. So we'll see how it goes. Thanks for thinking about me.
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.