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Dr. Bob is Robert Hsiung, MD,
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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
Posted by SLS on February 6, 2012, at 11:25:39
In reply to Re: Thinking of Zyprexa » SLS, posted by tensor on February 6, 2012, at 9:42:00
> 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.
Good luck!
- Scott
Posted by ed_uk2010 on February 8, 2012, at 8:01:05
In reply to Re: Thinking of Zyprexa » SLS, posted by tensor on February 6, 2012, at 9:42:00
How are you doing Tensor?
Posted by tensor on February 8, 2012, at 8:09:44
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 8:01:05
> How are you doing Tensor?
Thanks for asking. I took my third dose of 5mg yesterday, and it hasn't helped my lack of motivation and interest. My pdoc suggested 5 or 10mg and I chose 5mg, not sure if I should up the dosage or wait a little longer.
I sleep well, but no increase in hunger. I still have restlessness but I think it's because of Abilify lingering in my body./t
Posted by ed_uk2010 on February 8, 2012, at 10:08:51
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 8:09:44
>it hasn't helped my lack of motivation and interest....
What sort of things do you struggle with most?
>My pdoc suggested 5 or 10mg and I chose 5mg, not sure if I should up the dosage or wait a little longer.
Even though Zyprexa generally works quite quickly, it's still very early days. I suppose you won't know how Zyprexa affects you on its own until Abilify is out of your system.
Posted by tensor on February 8, 2012, at 10:17:52
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 10:08:51
> >it hasn't helped my lack of motivation and interest....
>
> What sort of things do you struggle with most?Fatigue, not enough energy to get things done, basic things like cooking food. I have an increase in anxiety now.
> >My pdoc suggested 5 or 10mg and I chose 5mg, not sure if I should up the dosage or wait a little longer.
>
> Even though Zyprexa generally works quite quickly, it's still very early days. I suppose you won't know how Zyprexa affects you on its own until Abilify is out of your system.
>Do you think it would be a bad idea taking 10mg tonight, I'm desperate. Maybe a higher dose would counteract any Abilify withdrawals? Took last 7.5mg of Abilify at Saturday evening.
Thanks.
Posted by ed_uk2010 on February 8, 2012, at 12:00:27
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 10:17:52
>Fatigue, not enough energy to get things done, basic things like cooking food. I have an increase in anxiety now.
Do you still feel very depressed emotionally or does it feel more like a chronic fatigue state?
>Do you think it would be a bad idea taking 10mg tonight, I'm desperate. Maybe a higher dose would counteract any Abilify withdrawals? Took last 7.5mg of Abilify at Saturday evening.
Do you think you are having Abilify withdrawal symptoms after such a short time on it? I think I higher dose of Zyprexa might help your anxiety, unless it causes akathisia.
Posted by tensor on February 8, 2012, at 12:17:34
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 12:00:27
> Do you still feel very depressed emotionally or does it feel more like a chronic fatigue state?
Chronic fatigue state for sure, but it has started to get to me emotionally too after so long time.
> Do you think you are having Abilify withdrawal symptoms after such a short time on it? I think I higher dose of Zyprexa might help your anxiety, unless it causes akathisia.I don't know, maybe it's some form of rebound anxiety, although it wasn't that good for anxiety. I'll take 10mg of Zyprexa tonight and see how I feel tomorrow. Some extra clonazepam are pretty good against restlessness.
/t
Posted by ed_uk2010 on February 8, 2012, at 13:49:36
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 12:17:34
>Chronic fatigue state for sure, but it has started to get to me emotionally too after so long time.
Have you tried anything like modafinil? I don't remember. Also, do you do any exercise?
>I'll take 10mg of Zyprexa tonight and see how I feel tomorrow. Some extra clonazepam are pretty good against restlessness.
Best of luck. Clonazepam will probably help the restlessness but does it make you more tired?
Posted by tensor on February 8, 2012, at 14:01:03
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 13:49:36
> Have you tried anything like modafinil? I don't remember. Also, do you do any exercise?
I had a long episode of luck with modafinil, but it stopped working after almost a year, have tried it now and then and actually a week ago, but does very little. Increases focus and reduces appetite, that's all. Exercise is a little low right now but did a lot of it in the fall, but failed to see any notable benefits for my energy and mood, actually kind of drained me of energy instead.
> Best of luck. Clonazepam will probably help the restlessness but does it make you more tired?
>I took 7.5mg, so bedtime soon. Yes, clon makes me more tired, it's a trade-off as usual. Thanks Ed.
Posted by ed_uk2010 on February 8, 2012, at 14:43:28
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 14:01:03
>I had a long episode of luck with modafinil, but it stopped working after almost a year, have tried it now and then and actually a week ago, but does very little. Increases focus and reduces appetite, that's all.
I suppose a different stimulant could help, possibly a lot in the short term, but the benefits might not last.
Anyway, sleep well!
Posted by papillon2 on February 9, 2012, at 23:40:31
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 8:09:44
> I sleep well, but no increase in hunger.
Zyprexa can make you gain weight even if you have no increase in appetite or food intake. It does this by changing the way your body processes sugars and fats. As such, while it is good to monitor your appetite and hunger, it would be wise to jump on a scale once a week to keep track of your weight.
Additionally, if you haven't had it done yet, it would be prudent to get your baseline cholesterol, trigliceride and fasting blood sugar levels checked so you can monitor these too over time.
Posted by tensor on February 10, 2012, at 3:48:16
In reply to Re: Thinking of Zyprexa, posted by papillon2 on February 9, 2012, at 23:40:31
> > I sleep well, but no increase in hunger.
>
> Zyprexa can make you gain weight even if you have no increase in appetite or food intake. It does this by changing the way your body processes sugars and fats. As such, while it is good to monitor your appetite and hunger, it would be wise to jump on a scale once a week to keep track of your weight.
>
> Additionally, if you haven't had it done yet, it would be prudent to get your baseline cholesterol, trigliceride and fasting blood sugar levels checked so you can monitor these too over time.Thanks for bringing this up, because I've been thinking of this. My daily calorie intake is below my calculated resting metabolic rate, is it even possible to gain weight under such circumstances? I eat a very healthy diet, no added sugar, no candy.
We did a baseline about a month ago, and the values were within reference, although I was on Abilify back then, don't know if that skewed the values in some way./t
Posted by BiggyFrank on February 10, 2012, at 11:26:06
In reply to Thinking of Zyprexa, posted by tensor on February 3, 2012, at 8:14:15
i am depressed for about 5 years, i use in the past so many thing that it will be too long to write.
I think that you have an Neuroleptic like Zyprexa is because maybe no just depression at my opinin.
Risperdal= lot of weight gain, it freeze you.
Zyprexa = bit of weight gain, keep bit less freeze.
Seroquel = the best Rx to give to anyone for sleep.As for abilify or there is another one that is like two molecules in one pill i think it is Prozzac. Just like Tylenol with Cafeine. I really think that treatment of severe depression is to start higher than lower.
Now i am on Amphetamines it's far from a Paxil and Seroquel Rx. Why there is Zyprexa, Zoloft, when it work in like 2-3 days. Modafinil,Dexedrine,Clonazepam save my life. (i still can sleep with that cocktail) LOL :)
Posted by tensor on February 10, 2012, at 12:00:33
In reply to Re: Thinking of Zyprexa » tensor, posted by BiggyFrank on February 10, 2012, at 11:26:06
> I think that you have an Neuroleptic like Zyprexa is because maybe no just depression at my opinin.
It's treatment-resistant unipolar depression, no psychosis. I have some issues with anxiety also.
> As for abilify or there is another one that is like two molecules in one pill i think it is Prozzac. Just like Tylenol with Cafeine. I really think that treatment of severe depression is to start higher than lower.
> Now i am on Amphetamines it's far from a Paxil and Seroquel Rx. Why there is Zyprexa, Zoloft, when it work in like 2-3 days. Modafinil,Dexedrine,Clonazepam save my life. (i still can sleep with that cocktail) LOL :)Happy to hear you found something that works!
So exactly what combo are you on right now, and for what diagnosis? I could try amphetamines or Concerta, but I'm afraid that if they work it won't be for a long time. Modafinil does not have the same impact on mood, motivation and energy it once had.
Thanks for your input.
/t
Posted by papillon2 on February 12, 2012, at 7:17:39
In reply to Re: Thinking of Zyprexa » papillon2, posted by tensor on February 10, 2012, at 3:48:16
> Thanks for bringing this up, because I've been thinking of this. My daily calorie intake is below my calculated resting metabolic rate, is it even possible to gain weight under such circumstances? I eat a very healthy diet, no added sugar, no candy.
In my experience, yes. I would not have believed it myself had it not happened to me. Like you, I have a very healthy, clean diet: low fat, lean protein, no junk / processed garbage. My weight is ordinarily very stable and I've never been in the middle of the healthy weight range for my height let alone overweight.
On Zyprexa, I gained 6kgs (13-odd lbs) in 5wks despite:
- my usual diet, only stricter (I only ate the healthiest of healthy food, rather than just healthy food, if that makes sense)
- absolutely no increase in portion sizes (following a set diet)
- ignoring all inappropriate hunger signals.
- carrying out a stupendous amount of high-intensity cardiovascular exercise (but not the kind that packs on muscle).There is no way in hell that my food intake and energy output would not have been in deficit, at least not ordinarily. If I were otherwise to do the above, weight would fall off me. Oh and after a few weeks of stabilization after stopping Zyprexa, I lost 2kgs (4.4lbs) in 2wks despite the exact same diet and a regular amount of exercise, instead of going hell for leather.
Some suggest that what Zyprexa and other AAPs do is raise your 'set' weight in addition to making it easier to gain weight. If this is the case, as it seems to be, then if you already have a good diet and exercise regime all you can do is stop yourself from gaining an ever greater amount of weight. Had I not had such high self-control, what would I have gained - 20, 30, 40lbs???
Who knows, maybe you'll luck out and no get weight gain as a side effect. Here's hoping.
> We did a baseline about a month ago, and the values were within reference, although I was on Abilify back then, don't know if that skewed the values in some way.
It may not be a true baseline, but it's still a reference point which is the main thing.
This is the end of the thread.
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