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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by DanielJ on January 19, 2004, at 10:00:02
My 16 yr old son is being treated for schizophrenia. He was taking 10 mg Zyprexa for about 3 weeks when he had a violent episode and ended up in a crisis center. He was also taking Klonopin but the duty psy Dr. took him off it and put him on Zoloft 50mg. as well as upping his Zyprexa to 20 mg. He came home in 10 more days because he was showing improvement, but seemed to be agitated and still obsessive. His paranoia and delusions were gone though and in 2 weeks his regular Dr. increased his Zoloft to 100 mg.. A month later it was reduced to 75 mg. He has continued to improve over the past 6 months but is often hyperactive in the afternoons usually between 4 pm and 7 pm when he gets his 20 mg Zyprexa. My question is that I think he needs the 75 mg Zoloft but I wondered if the Zyprexa should be reduced since there is a cumulative build up over time and he might be reaching the over medicated syndrome? Is anyone taking 20 mg or more zyprexa? He has gained 35 pounds in the last 2 months.
Posted by Sebastian on January 19, 2004, at 12:04:06
In reply to Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 10:00:02
I don't know much about schitzophrenia. But I think if he acts better on the 20 mg zyprexa and is not sleeping all the time, that he should stick with the dose. zyprexa only takes about 5 days to build up in your system.
Posted by HappyGirl on January 19, 2004, at 13:23:58
In reply to Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 10:00:02
Hi:
To be frank, this 'Forum' consists mostly 'depression' and 'Bipolar Disorder,' then I have no good knowledge as to your son's med. regimen. However, as seeing your son's condition, 'Hyper' seems to need close attention. Normally, Bipolar has this, 'hyper'mood due to manic side of Bipolar. For this remedy, most of time it needs Mood Stabilizer, such as Depakote, Lithium and more to say.
As being said this, above, .... in the past, your son was put on 'Klonopin' that has a calming effect, generally for 'Anxiety.' On this med., he seemed to NOT having those 'hyper,' ... then in my guess, probably, your son needs some 'calming' form of med., or even, Lithium that may give him to not get 'hyper.'
Also, 'Weight Gain' issue related to Zyprexa is very rampant, ... seeing his age, at 16 your son hates to see this side-effect. In my suggestion, try to make an appointment with a psychiatrist, ... not the regular doc./GP, because shizophrenia and Bipolar are both regarded serious form of mental illness, hence both condition needs expertise and experience in regard to psycho-medication issues.
H.G.
Posted by DanielJ on January 19, 2004, at 14:34:32
In reply to Re: Reducing Zyprexa Dosage, posted by HappyGirl on January 19, 2004, at 13:23:58
Thanks for advice. My son has been seeing a psychiatrist since his first episode back in July.
He is back in High School now and has regained his sense of humor and normal personality (it has taken almost 5 mo. on the meds to accomplish this.)
I believe the hyper activity has taken the place of his pacing (or playing basketball in the driveway for 2 hours a day) there is a kind of psychotic energy that seems to manifest itself in the afternoons but perhaps the hyperactivity will decrease just like the need too pace did. Recovery seems to be a slow process for this. His next P Dr appt. is in 12 days. I think he will make some changes but I don't know what they will be.
Posted by HappyGirl on January 19, 2004, at 15:12:02
In reply to Re: Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 14:34:32
Hi:
In Bipolar, there is 'hyper' that is a kind 'over-activity' that enhances the energy level more than you normally have, ... manic side of Bipolar,... very similar to your son's.
Also, there is Bipolar I with psychotic and delusitonal episodes, ... then one of my Bp friends dxed at first mistakingly 'Shizophrenia,' ... but turned out to be 'Bipolar I.' Hence, Bipolar I and Shizophrenia has similar episodes, such as psychotic/delusional and also anger. Rage/Anger is VERY characteristic in Bipolar, for this I myself taking 5 mg. Zyprexa along with other meds. It works both anger/rage and psychotic/delusional. In my case, it works on 'cycling.' However, like your son, 'weight gain' is annoying and negative side effect, for this your son may need AP combo., like 'Zyprexa' and 'Abilify' or 'Geoden.' The last two meds have NO weight problem to worry about. Some of folks taking this two AP combo., because 'Weight issue' is something NOT acceptable,... not everyone, but majority. Talk to his pdoc.
Sometime, some of pdocs. disregard this issue over the benefit from Zyprexa, ... but anyway, you and your son need to ask some solution for this, like by asking AP Combo.
In my knowledge, 20 mg. Zyprexa seem NO med. over-prescribe, if your son has Shizo., due to his condition. Even, some of Bipolar needs 'that amount' of Zyprexa, ... believe or not, because of the severity of Bipolar condition. Then, I hear/read a lot of weight issues on this, as a result.
Hopefully, your son's next appt. with his pdoc. going well!!!
Please post back if there is any questions you have.
H.G.
Posted by girl1969 on January 19, 2004, at 16:54:34
In reply to Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 10:00:02
Hi,
Just wanted to let you know that I am bipolar 1 and took 20 mg of Zyprexa for two years. The only side effect I had was weight gain, which was not responsive to diet or exercise.
As earlier posters mentioned, there are some weight neutral alternatives, such as Abilify and Geodon. Both of those drugs were developed specifically for schizophrenia.
Best of luck,
Girl
Posted by Sebastian on January 19, 2004, at 18:03:27
In reply to Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 10:00:02
I think the hyperactivity right before the dose of zyprexa is due to when he takes the dose. It might be a good idea (this is what I do) to take it before bed, this way the amount in his body is not as much durring the day, also it will put him to sleep, less likely to eat right after the pill, should even out the over activity.
Geodon and Abilify are good substitutes too. I take a lower dose (for PTSD) zyprexa with small dose Abilify. The only thing with abilify is it gives you energy, like coffee. Geodon will put him to sleep, but the ups and downs are all day, because of short half-life, you take it twice. I'm not sure but I think it also lowers blood presure, which might be good.
Posted by missinglynx on January 20, 2004, at 5:54:12
In reply to Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 10:00:02
Daniel, I take Abilify and found it didnt increase my weight or have any sedating side effects.... I do lift weights 3 times a week to "prevent: weight gain or add it as muscle, DOES he get alot of sports activity or belong to a gym?
I take 15 mgs of Abilify and 1.25 mgs of Zyprexa!! good luck with your son
Posted by DanielJ on January 20, 2004, at 6:59:53
In reply to Reducing Zyprexa Dosage, posted by DanielJ on January 19, 2004, at 10:00:02
Thanks all for your help. My son's improvement over the last 6 months has been remarkable. At first we thought he would have to be institutionalized for most of his life. He was angry, violent at times, agitated, paranoid,delusional, obsessive and full of psychotic energy.
After 6 months of taking Zoloft and Zyprexa he is more normal than he has been in 2 years. There was a long time when he would laugh for no reason and stare fixedly without any expression while watching a comedy movie (scary stuff this behavior). He spent most of the day yesterday with an old friend of his. His friends were frightened of his past behavior but I think they are giving him a chance now that they realize that he is "back". Hopefully excercise and some minor changes could improve things even more.
Posted by Sebastian on January 20, 2004, at 11:29:45
In reply to Re: Reducing Zyprexa Dosage, posted by DanielJ on January 20, 2004, at 6:59:53
You need to be carefull with his diet. zyprexa has a tendancy to make food taste realy good. Make sure he gets vegies, exercise, water or diet, and not over eat. Force the diet!
Posted by HappyGirl on January 20, 2004, at 17:17:18
In reply to Re: Reducing Zyprexa Dosage, posted by DanielJ on January 20, 2004, at 6:59:53
Hi DanielJ:
One more thing about which I would like to add is that most of the pdocs. are hesitant to prescribe other form of the med, as seeing the Zyprexa has been SO helpful to your son's condition. The reason is that even all of AP meds. seem having the same effective property, but there is a VERY slight difference among AP meds. For instance, both Abilify and Geodon have other 'bad side-effect'/insomnia. Then, your son's pdoc. may not rx other form of AP. In that case, the following web-site that has almost everything related to Zyprexa, ... including 'Weight Loss' article that might be helpful to your son's weight issue due to Zyprexa.http://www.psycheducation.org/depression/meds/olanzapine.htm
H.G.
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