![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by crazyjoe on December 19, 2011, at 17:40:19
have a friend on 30 zyprexa..30 abilify..6 klonopin ..divided 3 times a day..2000 depakote for bipolar /schizo..wow lots of meds ..seems to now have come down withsome ocd traits dr put him on 150 luvox and the ocd seems to have become worse...is this possible
Posted by Christ_empowered on December 19, 2011, at 18:26:55
In reply to bipolar /schizo, posted by crazyjoe on December 19, 2011, at 17:40:19
Your friend is medicated into oblivion. Above max dose zyprexa+max dose Abilify alone=PROBLEMS. Add in lots of Klonopin, and you have a recipe for disaster. My wild guess would be that the high dose combined antipsychotics are causing OCD-ish symptoms because of frontal lobe syndrome. The Luvox will only make that worse. Is your friend a voluntary outpatient, or is he being forcibly medicated?
Posted by mellow on December 19, 2011, at 19:14:36
In reply to Re: bipolar /schizo, posted by Christ_empowered on December 19, 2011, at 18:26:55
Too much meds!
Posted by Phillipa on December 19, 2011, at 21:19:27
In reply to Re: bipolar /schizo, posted by mellow on December 19, 2011, at 19:14:36
Bipolar Schizophrenia or affective disorder? Phillipa
Posted by crazyjoe on December 20, 2011, at 6:30:07
In reply to Re: bipolar /schizo, posted by Phillipa on December 19, 2011, at 21:19:27
i'm sorry the zyprexa is 20 mg and abilify is 15 mg a day...my fault ...still seems like lots of meds...my friend does not see a private psych but one assigned to him
Posted by Christ_empowered on December 20, 2011, at 19:17:32
In reply to Re: bipolar /schizo, posted by crazyjoe on December 20, 2011, at 6:30:07
If its forced medication--like outpatient commitment or something--I don't know what you do. You could try Mind Freedom or the CCHR (www.cchr.org) and see if they can help do something. Mind Freedom and some other organizations will move people into other states to get them out of forced treatment. Kind of hardcore, but sometimes necessary. Then again...all these drugs are administered orally and there aren't any widely used blood levels test (except for the depakote), so I imagine your friend could start tapering the neuroleptics on his own and see what happens.
I honestly can't believe they use THAT MUCH zyprexa, plus a standard dose of Abilify, plus lots of depakote, plus a high dose of klonopin. That's intense. Personally, I'd try slowly reducing the Klonopin on my own, like 1/4mgs every two weeks or something. That would reduce sedation.
Adding Luvox seems like sheer nonsense to me.
Posted by crazyjoe on December 20, 2011, at 20:52:32
In reply to Re: bipolar /schizo, posted by Christ_empowered on December 20, 2011, at 19:17:32
the zyprexa is the highest but is still within but thank you so much for you help....do you think the luvox is just a waste of time...lots of meds at high doses ...don't get it
Posted by Christ_empowered on December 20, 2011, at 21:01:43
In reply to Re: bipolar /schizo, posted by crazyjoe on December 20, 2011, at 20:52:32
Dude,its as if the shrink is launching chemical warfare on this guy's brain. Is is treatment resistant schizophrenia? I mean, even then, its overkill, but I could kinda sorta see the zyprexa+abilify, maybe some Klonopin, too. But adding a hefty dose of depakote AND luvox to the mix? Man oh man...what a waste of time, money, and brain cells.
Klonopin can cause depression. Actually, all of those meds can cause depression in some people, and combined...who the hell knows whats going on?
I think the "OCD" is from too much antipsychotic floating around in the system. If you do that, you can get frontal lobe syndrome, which can involve obsessive thinking, social withdrawal, and apathy. Luvox is an SSRI, so all it does is--get ready for this--reduce frontal lobe activity. That's why SSRIs are good for OCD; they calm down the frontal lobes a bit so you don't care as much (or at all...).
Anyway, that combo scares me, and this doctor scares me.
Posted by crazyjoe on December 20, 2011, at 22:33:15
In reply to Re: bipolar /schizo, posted by Christ_empowered on December 20, 2011, at 21:01:43
i totally agree with you ...i'll let you know how it goes ....thanx
Posted by Phidippus on December 21, 2011, at 16:28:42
In reply to Re: bipolar /schizo, posted by Christ_empowered on December 19, 2011, at 18:26:55
His OCD symptoms are probably a direct result of the large amounts of antipsychotics he is on. He should just be on Clozaril.
Eric
Posted by crazyjoe on December 26, 2011, at 9:47:13
In reply to Re: bipolar /schizo » Christ_empowered, posted by Phidippus on December 21, 2011, at 16:28:42
saw my friennd his abilify was down to 15mg -zyprexa 20 mg ..depakote 2000 klonopin 6mg divided 3 times a day and luvox 150....seemed very confused.....is it the pills or the condition...bipolar/schizo/ocd supposedly..how much is enough
Posted by Christ_empowered on December 26, 2011, at 13:57:25
In reply to Re: bipolar /schizo, posted by crazyjoe on December 26, 2011, at 9:47:13
My guess is that he has severe frontal lobe syndrome from the luvox+zyprexa+abilify, sedation from the depakote+klonopin, and cognitive impairment from all the meds combined. Its also possible, I suppose, that the underlying condition is causing something, but I think its really just the drugs. Lots of people do well on just one antipsychotic OR depakote; mixing 2 full dose antipsychotics and adding depakote is a little...well...crazy.
It happens. Unfortunately, with a severe mental illness on the record, lots of docs will look at that and go "must be schizophrenia/bipolar/whatever," and then they'll either just shrug it off or add more meds. If your friend has the option of seeing someone else--even a family doctor--I'd do that. If nothing else, a general practitioner would make sure that your friend isn't completely sedated and they could do labs that (I'm guessing) this shrink hasn't done, like blood sugars, triglycerides, cholesterol, liver enzymes, etc.My personal, completely non-professional advice: taper off the zyprexa first. That stuff is sedating enough w/o anything else on board. With everything else in place, its just mind-numbing overkill. Then he can work on tapering off other stuff (I'd ditch the depakote, personally).
Posted by crazyjoe on December 26, 2011, at 15:26:01
In reply to Re: bipolar /schizo, posted by Christ_empowered on December 26, 2011, at 13:57:25
thanx he does have his blood work done because he's in a system that requires it and records have been turned over to this system from another system... only 2 pdocs their and cannot go to personal dr i did know he always had anger and compliance problems but just got reaquainted with him recently
Posted by Phillipa on December 26, 2011, at 19:50:02
In reply to Re: bipolar /schizo, posted by crazyjoe on December 26, 2011, at 9:47:13
Who is your friend? How well did you know him/her before? Phillipa
Posted by crazyjoe on December 26, 2011, at 21:30:50
In reply to Re: bipolar /schizo » crazyjoe, posted by Phillipa on December 26, 2011, at 19:50:02
pretty well, high school friends...started to have these problems in early 20's
This is the end of the 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.