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Dr. Bob is Robert Hsiung, MD,
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Posted by tensor on February 4, 2012, at 4:04:03
In reply to Re: Thinking of Zyprexa, posted by Zyprexa on February 4, 2012, at 3:10:20
> Zyprexa is the only AAP that works for me. It didn't give me diabetes, but geodon did, which went away when stoped. No sex sideffects with it. It made me gain weight but I needed that in the beginning. And I've managed to lose weight on a 10mg dose by diet and exercise. I still take it keeping weight down seems easy. I've been taking it for the last 14 years and still works great! I've tried abilify and that was awfull. never taken seroquel, since sideffects are similar I have not. Zyprexa is great for sleep problems. I took risperdal which didn't help at all. Perphenazine I've taken for the past 4 years seems to be effective, if you are looking for some thing with out weight gain. But is sort of similar to zyprexa. Thats my second choice. I still take it and it seems to help keep zyprexa dose down.
What dosage would you recommend for me, initially?
Thanks.
Posted by tensor on February 4, 2012, at 4:06:26
In reply to Thinking of Zyprexa, posted by tensor on February 3, 2012, at 8:14:15
Can you cross-titrate Zyprexa with 7.5mg of Abilify?
Thanks.
Posted by tensor on February 4, 2012, at 4:13:53
In reply to Re: Thinking of Zyprexa, posted by Zyprexa on February 4, 2012, at 3:10:20
> Zyprexa is the only AAP that works for me. It didn't give me diabetes, but geodon did, which went away when stoped. No sex sideffects with it. It made me gain weight but I needed that in the beginning. And I've managed to lose weight on a 10mg dose by diet and exercise. I still take it keeping weight down seems easy. I've been taking it for the last 14 years and still works great! I've tried abilify and that was awfull. never taken seroquel, since sideffects are similar I have not. Zyprexa is great for sleep problems. I took risperdal which didn't help at all. Perphenazine I've taken for the past 4 years seems to be effective, if you are looking for some thing with out weight gain. But is sort of similar to zyprexa. Thats my second choice. I still take it and it seems to help keep zyprexa dose down.
How bad are the anticholinergic effects? Compared to, say, the TCAs?
Thanks.
Posted by tensor on February 4, 2012, at 4:27:43
In reply to Re: Thinking of Zyprexa, posted by emmanuel98 on February 3, 2012, at 18:45:17
> Geodon and seroquel did nothing for me -- no weight gain, no mood improvement. Zyprexa, abilify and risperdal greatly and rapidly improved my mood, but caused rapid weight gain as well. It had nothing to do with how much I ate or exercised. I tried dieting and working out more, but still gained 2-3 pounds a week. Not everyone gains weight though, and when they do, it tends to occur immediately, so you would know after a couple of weeks and could stop if it seems to be out of control. But the weight gain is no joke. I gained 55 pounds from my various trials of AAPs. Once I went off them -- and it was disappointing because I responded so well to them -- I lost 47 pounds.
May I ask what dosage you were on? I wonder if I can keep Remeron in my regimen, in combination with Zyprexa it could be the weight gaining champion.
Thanks.
Posted by ed_uk2010 on February 4, 2012, at 6:39:57
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 3, 2012, at 13:19:13
>Are the fears for diabetes exaggerated?
Difficult to say. I think there's a particular risk in the long-term if a large weight gain has occurred.
>Would you say the benefits would outweigh the risks in my case?
Probably yes, because if it doesn't help after a few weeks you can taper off. You will not keep taking it unless it produces a clear benefit.
Posted by ed_uk2010 on February 4, 2012, at 6:41:54
In reply to Re: Thinking of Zyprexa » tensor, posted by tensor on February 3, 2012, at 13:20:36
>How bad are the sexual side effects? Had no trouble on Seroquel, not on Abilify either.
Zyprexa does not usually produce a large prolactin elevation, and so I would not expect sexual side effects to be bad.
Posted by ed_uk2010 on February 4, 2012, at 6:43:27
In reply to Re: Thinking of Zyprexa » Zyprexa, posted by tensor on February 4, 2012, at 4:13:53
>How bad are the anticholinergic effects? Compared to, say, the TCAs?
Usually mild.
Posted by tensor on February 4, 2012, at 7:43:49
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 4, 2012, at 6:41:54
Posted by ed_uk2010 on February 4, 2012, at 8:07:02
In reply to One more thing.., posted by tensor on February 4, 2012, at 4:06:26
> Can you cross-titrate Zyprexa with 7.5mg of Abilify?
I don't think you will need to. I think you can just stop the Abilify first, but check with your doctor to see what he recommends.
If you do benefit from Zyprexa, I wonder whether you will still need Remeron?
Posted by tensor on February 4, 2012, at 8:32:28
In reply to Re: One more thing.. » tensor, posted by ed_uk2010 on February 4, 2012, at 8:07:02
> > Can you cross-titrate Zyprexa with 7.5mg of Abilify?
>
> I don't think you will need to. I think you can just stop the Abilify first, but check with your doctor to see what he recommends.
>
> If you do benefit from Zyprexa, I wonder whether you will still need Remeron?The plan is to replace Remeron and escitalopram with fluoxetine, so I would take the Zyprexa-fluoxetine combo.
Posted by Zyprexa on February 4, 2012, at 22:46:16
In reply to Re: Thinking of Zyprexa, posted by SLS on February 4, 2012, at 3:32:39
I would probably be so skinny if I never got on the zyprexa. I was not eating and losing weight fast.
Posted by Zyprexa on February 4, 2012, at 22:54:15
In reply to Re: Thinking of Zyprexa » Zyprexa, posted by tensor on February 4, 2012, at 4:04:03
I would probably start at 5mg and work up to 10, or what ever seems needed. Its fairly quick acting, you will deffinitly know about a dose in one week, if not the first day.
I started at 15mg and that knocked me out, sleeping for 18 hours and eating mini wheats out of the box and going back to sleep. I went down to 10 and thats where I've pretty much stayed.
Posted by Zyprexa on February 4, 2012, at 22:58:52
In reply to One more thing.., posted by tensor on February 4, 2012, at 4:06:26
yes I took zyprexa and abilify at the same time for a while, then stoped the abilify. I went cold turky off abilify and suffered a major withdraw stage where I needed a higher dose of zyprexa for a while, a much higher dose, 30-50mg.
Posted by Zyprexa on February 4, 2012, at 23:02:41
In reply to Re: Thinking of Zyprexa » Zyprexa, posted by tensor on February 4, 2012, at 4:13:53
I don't know what anticholinergic effects are. Isn't remeron a TCA? I tried to swtich zyprexa for remeron and had a bad experience. NIghtmares.
Posted by Zyprexa on February 4, 2012, at 23:06:32
In reply to Re: One more thing.. » ed_uk2010, posted by tensor on February 4, 2012, at 8:32:28
If you do zyprexa and fluoxitine. I found a major difference between brand Prozac and the generic. The brand of coarse is much better.
Posted by tensor on February 5, 2012, at 3:23:25
In reply to Re: Thinking of Zyprexa, posted by Zyprexa on February 4, 2012, at 23:02:41
Posted by SLS on February 5, 2012, at 5:47:17
In reply to Re: One more thing.., posted by Zyprexa on February 4, 2012, at 22:58:52
> yes I took zyprexa and abilify at the same time for a while, then stoped the abilify. I went cold turky off abilify and suffered a major withdraw stage where I needed a higher dose of zyprexa for a while, a much higher dose, 30-50mg.
That's interesting. Abilify is much more potent than Zyprexa at binding to the D2 receptor. Perhaps there was a supersensitivity thing going on there. Unlike Zyprexa, Abilify also binds to the D3 receptor. Any withdrawal effects coming from this would probably not be counteracted by Zyprexa.
Did you feel that Zyprexa was less potent while you were taking Abilify?
These are just musings. I make no claim as to the validity of any of my theories.
- Scott
Posted by tensor on February 5, 2012, at 9:10:58
In reply to Re: One more thing.. » Zyprexa, posted by SLS on February 5, 2012, at 5:47:17
> > yes I took zyprexa and abilify at the same time for a while, then stoped the abilify. I went cold turky off abilify and suffered a major withdraw stage where I needed a higher dose of zyprexa for a while, a much higher dose, 30-50mg.
>
> That's interesting. Abilify is much more potent than Zyprexa at binding to the D2 receptor. Perhaps there was a supersensitivity thing going on there. Unlike Zyprexa, Abilify also binds to the D3 receptor. Any withdrawal effects coming from this would probably not be counteracted by Zyprexa.I thought Zyprexa binds to D1-D4.
http://www.psychiatrist.com/pcc/pccpdf/v05s03/v05s0302.pdf
http://www.psychresidentonline.com/atypical%20antipsychotics.htm
http://ajp.psychiatryonline.org/article.aspx?articleid=175102> These are just musings. I make no claim as to the validity of any of my theories.
Got it. :)
Posted by SLS on February 5, 2012, at 10:03:05
In reply to Re: One more thing.. » SLS, posted by tensor on February 5, 2012, at 9:10:58
> > Unlike Zyprexa, Abilify also binds to the D3 receptor.
> I thought Zyprexa binds to D1-D4.
Thanks for checking me on that. I really like the links you provided.
> http://www.psychiatrist.com/pcc/pccpdf/v05s03/v05s0302.pdf
> http://www.psychresidentonline.com/atypical%20antipsychotics.htm
> http://ajp.psychiatryonline.org/article.aspx?articleid=175102
- Scott
Posted by tensor on February 6, 2012, at 0:47:16
In reply to Thinking of Zyprexa, posted by tensor on February 3, 2012, at 8:14:15
Just talked to my pdoc, starting Zyprexa 5mg tonight instead of Abilify. Hopefully it will work better.
Posted by Zyprexa on February 6, 2012, at 6:07:46
In reply to Re: One more thing.. » Zyprexa, posted by SLS on February 5, 2012, at 5:47:17
Yes, zyprexa was almost useless while on or for a little while afterwards of being on abilify.
Posted by SLS on February 6, 2012, at 6:27:16
In reply to Re: One more thing.. » SLS, posted by Zyprexa on February 6, 2012, at 6:07:46
> Yes, zyprexa was almost useless while on or for a little while afterwards of being on abilify.
Thank you for reporting that. It helps me in my efforts to figure this stuff out.
It is too bad that Jeroen continues to ignore my pleas that he discontinue Abilify and add back Seroquel. I have been suggesting that he do this for at least two years. I am tempted to give up trying. Unfortunately, I can't offer him guarantees.
- Scott
Posted by ed_uk2010 on February 6, 2012, at 6:35:33
In reply to Re: Thinking of Zyprexa, posted by tensor on February 6, 2012, at 0:47:16
>Just talked to my pdoc, starting Zyprexa 5mg tonight instead of Abilify. Hopefully it will work better.
I hope so too :)
Posted by SLS on February 6, 2012, at 7:49:08
In reply to Re: Thinking of Zyprexa, posted by tensor on February 6, 2012, at 0:47:16
> Just talked to my pdoc, starting Zyprexa 5mg tonight instead of Abilify. Hopefully it will work better.
Are you planning on tapering Abilify?
If you are doing a cross-over substitution from Abilify to Zyprexa, you might want to be aware that there might be a temporary mild-to-moderate increase in depression or anxiety. It would probably be tolerable and transient, but I wouldn't want you to mistake Abilify withdrawal for a negative reaction to Zyprexa.
- Scott
Posted by tensor on February 6, 2012, at 9:42:00
In reply to Re: Thinking of Zyprexa » tensor, posted by SLS on February 6, 2012, at 7:49:08
> Are you planning on tapering Abilify?
>
> If you are doing a cross-over substitution from Abilify to Zyprexa, you might want to be aware that there might be a temporary mild-to-moderate increase in depression or anxiety. It would probably be tolerable and transient, but I wouldn't want you to mistake Abilify withdrawal for a negative reaction to Zyprexa.
>
>
> - ScottThanks for the advice and heads up. I won't cross-titrate but switch right off. I actually took 5mg of Zyprexa this morning and I could feel a decrease in anxiety within an hour, I couldn't wait to bedtime, was too dysphoric. Will take it at bedtime from now on.
Actually it's Ratiopharm generic olanzapine, cost me a little over 3, a *bit* cheaper than the brand Zyprexa./t
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