![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Janelle on August 21, 2001, at 22:34:24
Collette - first, YAYAY! I'm so happy for you that the Zyprexa is kicking in to help you fall asleep (ah, how I remember that "Elavil feeling" well! And what a perfect phrase to describe the lulling type of drowsiness that Zyprexa brings on ... at least that's how it is for me.
Now, for the pesky WEIGHT GAIN potential with Zyprexa - I have been fighting it like the dickens (drinking lots more water), and still have gained about 5 very UNwanted pounds. I would like to share something I read ON HERE and that is that after 6-8 weeks the increased appetite from Zyprexa GOES AWAY! And I'm about at that time frame and HAVE indeed noticed that I no longer have night-time munchies or daytime cravings!
However, I should add that per my pdoc, I'm also taking Lamictal and began dividing the dose/pills to taking one in am, one in late afternoon, and pdoc says that Lamictal reduces appetite, so I could be experiencing a "balancing" out between Zyprexa increasing appetite and Lamictal decreasing it!
Collette and other "Zyprexa newbies" who are starting to get good results - hang in there with it, and hopefully the increased appetite and any weight gain will go away with some time.
GOOD LUCK!
-Janelle
Posted by cb on August 22, 2001, at 9:06:54
In reply to COLETTE/others: ZYPREXA + Weight gain:, posted by Janelle on August 21, 2001, at 22:34:24
> My son gained 40 lbs in a few months on zyprexa - one of his drs read about adding Axid (acid reflux med) to combat the weight gain with zyprexa- I don't really understand how that works - and he has been dropping the weight pretty quickly. DOn't know whether it's due to the Axid or just time. He has been on zyprexa now for 9 months.
Posted by Cam W. on August 22, 2001, at 9:25:58
In reply to Re: COLETTE/others: ZYPREXA + Weight gain:, posted by cb on August 22, 2001, at 9:06:54
Janelle - Actually, the Axid™ (nizatidine) is supposed to be taken at the start of Zyprexa™ (olanzapine) therapy, and is supposed to prevent the weight gain caused by the Zyprexa. We have had several people try it and have not had any success. Still, approximately 70% of people taking the Zyprexa (with or without taking Axid) gain weight.
A few years ago, on this site, Dr.Stephen Stahl (editor of The Journal of Clinical Psychiatry) was misquoted as saying he backed the use of H2-antagonists (like Axid, Zantac, Tagamet, etc.) for mirtazapine weight gain. Stahl sent a note to Dr.Bob stating that he did not think that H2-antagonists would prevent weight gain.
I have been hearing the H2-antagonist for the prevention of weight gain story for a couple of years now. It came out of the Eli Lilly head office in the U.S. and first pertained to Tagamet™ (cimetidine). I corralled the speaker who said it, after the presentation, and asked where he got his information. He said that he got it from Eli Lilly. When I asked about a possible mechanism of action, he said that cimetidine was a very "dirty" drug ie. attaches to many different receptors) and it was probably not the involvement H2-receptor.
I know of several psychiatrists who have tried cimetidine, ranitidine (Zantac™) and nizatidine (Axid™) with no more than the 30% of Zyprexa consumers not gaining weight (and they wouldn't have gained weight, anyway).
BTW - Axid is also made by Eli Lilly. - Cam
Posted by Collete on August 22, 2001, at 9:58:09
In reply to Re: COLETTE/others: ZYPREXA + Weight gain:, posted by cb on August 22, 2001, at 9:06:54
> > My son gained 40 lbs in a few months on zyprexa - one of his drs read about adding Axid (acid reflux med) to combat the weight gain with zyprexa- I don't really understand how that works - and he has been dropping the weight pretty quickly. DOn't know whether it's due to the Axid or just time. He has been on zyprexa now for 9 months.
CB, Not withstanding Cam W's information, I am still interested in the time of day that your son was told to take the Zantac. Was it WITH his Zyprexa or what? Thank you, Collette
Posted by Greg on August 22, 2001, at 10:09:27
In reply to Re: COLETTE/others: ZYPREXA + Weight gain:, posted by cb on August 22, 2001, at 9:06:54
I've been on Zyprexa for about 10 months and have gained about 45lbs. My doc recently started me on Topamax and says that it may help me to lose some weight, we'll see. I'm sure exercise and a better diet wouldn't hurt me either.
Greg
> > My son gained 40 lbs in a few months on zyprexa - one of his drs read about adding Axid (acid reflux med) to combat the weight gain with zyprexa- I don't really understand how that works - and he has been dropping the weight pretty quickly. DOn't know whether it's due to the Axid or just time. He has been on zyprexa now for 9 months.
Posted by Janelle on August 22, 2001, at 11:51:45
In reply to Re: COLETTE/others: ZYPREXA + Weight gain: » cb, posted by Cam W. on August 22, 2001, at 9:25:58
You always give such articulate, well-informed answers to questions here, people direct questions directly to U on here, and in this particular thread you said something like "we tried ..." so I'm wondering R U a doctor of some kind or a researcher? Very curious! (BTW, thanks for the info on antacid use with Zyprexa. Thankfully, the appetite increase I WAS feeling with it seems to have dissipated! Thanks.
-Janelle
Posted by Cam W. on August 22, 2001, at 11:57:08
In reply to CAM: Who R U?! I ask because... » Cam W., posted by Janelle on August 22, 2001, at 11:51:45
Janelle - I am just a lowly unemployed community pharmacist who reads way too much ;^)
- Cam
Posted by Janelle on August 22, 2001, at 14:21:28
In reply to Re: CAM: Who R U?! I ask because... » Janelle, posted by Cam W. on August 22, 2001, at 11:57:08
Cam - appreciate the info; I never stopped to think you could be a PHARMACIST. You're not "just a lowly" one; you're knowledgeable, articulate and very helpful here!
Also, pharmacists often know MORE than even pdocs about meds, especially possible interactions among them.
Thanks again,
Janelle
Posted by cb on August 22, 2001, at 15:11:49
In reply to Re: COLETTE/others: ZYPREXA + Weight gain: » cb, posted by Collete on August 22, 2001, at 9:58:09
> He was taking 300 mg Axid twice daily. He took his in the morning and in the evening(dinner). He then took his zyprexa a couple of hours before he wanted to go to sleep (anywhere from 8 - midnight). He was on a zyprexa dose of 20 mg. Now he is down to 10 mg.
In regard to the zyprexa - it has been good for him but he is now suffering from severe anxiety that the drs think may be related to the high dose of the zyprexa. They are having him reduce the dose slowly to see if the anxiety dissipates and to make sure that the lithium can keep him stable without the zyprexa. Dr said that apparently sometimes it is like a switch has been thrown and lowering the dose does not lower the anxiety. We will see! The zyprexa has been a miracle drug for his sleep problems.
It does sound a little suspicious that the drug company came up with this weight gain fix. Maybe it was just a placebo effect but it seemed to help him.
Posted by ChrisK on August 23, 2001, at 4:24:17
In reply to Re: CAM: Who R U?! I ask because... » Janelle, posted by Cam W. on August 22, 2001, at 11:57:08
Cam,
Sorry about the unemployed part - hope you have some prospects. You are definitely not lowly. You are very well respected around here and I'm sure by your colleages. My pediatrician while growing up was actually a Pharmacist before becoming an MD and it worked out great because he knew more about the meds on the market than anybody.
Best of luck finding a new job.
Chris
> Janelle - I am just a lowly unemployed community pharmacist who reads way too much ;^)
> - Cam
Posted by shelliR on August 23, 2001, at 23:43:25
In reply to Re: CAM: Who R U?! I ask because... » Janelle, posted by Cam W. on August 22, 2001, at 11:57:08
Cam,
what does a community pharmacist actually do? I guess what I'm wondering is if all your skills were used in your last position. I was thinking that you might consider teaching; you have the pharmacological knowledge and you are excellent at explaining things. Are you ever thought about that?
Anyway, not an attempt to steer you away from what you were doing, if you really enjoyed it. Maybe a community pharmacist does teach (as well as of course, educate). Just wanted to throw out an idea.
Best wishes, Shelli
Posted by Cam W. on August 24, 2001, at 0:07:02
In reply to Re: CAM: Who R U?! I ask because... » Cam W., posted by shelliR on August 23, 2001, at 23:43:25
> what does a community pharmacist actually do?
Shelli - I am the guy who fills prescriptions. I guess they are called retail pharmacists in the U.S. I also did some consulting at a mental health clinic. Basically, my job is teaching ; I try to educate people on their medication, so that they can become informed consumers. I doubt that I could lecture to students day-in and day-out (I do give lectures to pharmacy students once a year).
I doubt that the kind of job that I would like even exists. I would like someone to pay me a decent wage to learn stuff (just stuff, in general). Perhaps an Aristotle to Fredrick the Great, sort of position (Plato to Alexander the Great?).
In the meantime, I will get a job as a retail pharmacist, count pills by fives, and stick labels on bottles; and dream about what coulda been.
Thanks Shelli. - Cam
Posted by mair on August 24, 2001, at 21:42:30
In reply to Re: CAM: Who R U?! I ask because... » Janelle, posted by Cam W. on August 22, 2001, at 11:57:08
> Janelle - I am just a lowly unemployed community pharmacist who reads way too much ;^)
> - CamCam - just blow this post off if you think this is none of my business, but since when are you unemployed. Previous posts left me with the impression that you worked at a place you liked.
Mair
Posted by Cam W. on August 24, 2001, at 22:27:43
In reply to Re: CAM: Who R U?! I ask because... » Cam W., posted by mair on August 24, 2001, at 21:42:30
Mair - Yes, I did enjoy where I was working, but my ex-boss holds the contract, and he finally found something that he could terminate me over. I think he was scared that a "crazy person" could not be trusted and would hurt his family name. He also refuses to turn the contract over to me, even though I developed the entire program.
Besides, I have no problem telling people what I think, and he may have been intimidated by that. It was a toxic situation, and I should have been out of there years ago. It would be nice to find a similar job, but since I was the one who initiated it as a pilot project, there are not too many like it. I really do not want to move out of my area, if I don't have to.
- Cam (the pawn)
> Cam - just blow this post off if you think this is none of my business, but since when are you unemployed. Previous posts left me with the impression that you worked at a place you liked.
>
> Mair
Posted by Jane D on August 24, 2001, at 23:19:31
In reply to Re: CAM: Who R U?! I ask because... » mair, posted by Cam W. on August 24, 2001, at 22:27:43
> It was a toxic situation, and I should have been out of there years ago.
Cam,
Then for this part I'm glad for you. I think it can be very hard to leave a situation in which there is some good even if the bad outweighs it. I imagine it is even harder if the good is something you've created. You must always be looking at the situation as what it could be, not what it is. But a toxic work situation can destroy you. So while I empathize with how you must be feeling I would also like to congratulate you on your timely escape.
Jane
Posted by Jackster on August 26, 2001, at 4:08:59
In reply to Re: CAM: Who R U?! I ask because... » shelliR, posted by Cam W. on August 24, 2001, at 0:07:02
> In the meantime, I will get a job as a retail pharmacist, count pills by fives, and stick labels on bottles; and dream about what coulda been.
>
> Thanks Shelli. - CamAs an agoraphobic who was a (miserable) accountant for 8 years and is now living the dream of being a graphic designer - I think its still what could be.....
Jackie
Posted by Cam W. on August 26, 2001, at 7:21:21
In reply to Re: CAM: What could still be.... » Cam W., posted by Jackster on August 26, 2001, at 4:08:59
Jackie - You are right. I really have to get a handle on my negative self-thoughts. I do realize that I can still be productive, and that time will be a big healer (as soon as I let it). Sometimes time goes too fast and too slow, at the same time.
Thanks - Cam
Posted by mair on August 26, 2001, at 11:10:13
In reply to Re: CAM: What could still be.... » Jackster, posted by Cam W. on August 26, 2001, at 7:21:21
> Cam - Sorry to hear about the old job - I know you got to do alot of different (more academic) things that you liked. However, life is too short to spend much time tolerating small minded bosses too.
About a year ago, I walked into my pharmacy and discovered that the pharmacist who had been there for several years had abruptly left. I have no idea why he left or where he went. I do know that I haven't felt quite the same level of security since. This guy had been there through every one of my interminable med changes, and had the opportunity to see me at my depressed worst. In the beginning I was using so many different things and frequently had very short term prescriptions so I was in there alot. We never talked much but he was great with questions when I asked and we talked enough for me to realize that he knew my name and could place me together with my meds history. Since I really didn't share the presence of my illness with others, it was okay not to have to pretend anything with him. I was in my pdoc's office one day when he called in a prescription for more meds even though I was mid-prescription on the same medication. I could tell just from listening to one end of the call that the pharmacist was questioning him pretty closely about this and that my pdoc was a little taken aback over having to explain himself to my pharmacist. I found it very reassuring to know that this guy was paying enough attention to question something that didn't seem to make alot of sense on face. The point is that the retail pharmacist plays a critical role and while he can be invisible to some patients he can also be very important to others.
Mair
Posted by susan C on August 26, 2001, at 12:15:59
In reply to CAM - don't undersell yourself, posted by mair on August 26, 2001, at 11:10:13
There are few people I put top on my list to listen to and one of those few is my pharmasist. You, with the responses you give on ths board, made me realize how much I depend on my 'pill counter' and how having one who is knowledgable and involved really makes a difference. Thank you for taking the time to be here and share your observations. By the way Keppra Guinee pig here, I am up to 2000mg (`plus 1000 mg Depakote and other things) and still get dizzy, no conclusions yet....
Susan C
Posted by Cam W. on August 26, 2001, at 12:27:56
In reply to Re: CAM - don't undersell yourself, posted by susan C on August 26, 2001, at 12:15:59
Thanks everyone; I know that I know my stuff; it's just that when they give jobs I apply for to other people, it's a kick in the ego (the "What's wrong with me?", crap - I know it's not me... maybe < lol >). I have been considering a hospital job because I've never worked in a hospital, and I think the experience could only help. Besides, most of the pdocs I hang with at conferences and presentations work mainly out of hospitals, so it would be neat to see them work, from the other end (ie. not in retail).
Just sitting here redoing my resume, with a hospital focus. That 10 Minute Resume site is easy, especially for someone who hasn't had to look for a job in over 13 years.
Wish me luck (and I'll get off of here before Dr.B. moves this thread to PSB < lol >). - Cam
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
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.