Posted by Cam W. on February 27, 2001, at 21:30:00
In reply to Re: Which is worse: Zyprexa weight gain or Risperdal » katrina, posted by SalArmy4me on February 27, 2001, at 20:34:47
•Sal - Just a few things to clear up. I hope you don't mind.
> Zyprexa has more of a chance of helping you than Risperdal, because it has been proven to have effects on serotonin--thus enhancing the actions of antidepressants. I'll have to get that study for you...
• Both Zyprexa and Risperdal augment the effects antidepressants, but both block 5-HT2A/C receptors, not enhance serotonin directly. They may have an indirect effect on serotonin by taking some of the dopaminergic tone off of serotonin system (unlikely a mechanism of action in antidepressant augmentation, though). It is probably their mood stabilizing effects that augment antidepressant activity.
>
> Here are the benefits of Zyprexa:
> --It will calm you down all day; when I took it, I thought it was better than a benzo.
> --It has no anticholinergic effects.•Zyprexa has strong anticholinergic effects (Ki = 1.9 to 2.5 nM) whereas Risperdal does not bind to muscarinic/cholinergic receptors. Thus this is part of Zyprexa's calming effect (that and it's potent antihistiminergic - Ki = 7nM - effect).
> --It has no sexual side-effects.
> --It will definitely help you sleep.•The improvement in sleep is directly related to Zyprexa's anticholinergic and antihistaminergic effects.
> --Zyprexa is convienient because it is taken only once at night.
•Risperdal can also be taken once daily.
> --It is covered by insurance.
•In Alberta, Risperdal is covered by all government insurance plans and, until recently, our national Native Affairs coverage of Zyprexa was by special authorization only, whereas Risperdal, because of overall lower treatment costs (especially with the lower doses - < 6mg/day) has always been covered by this plan.
> --It augments antidepressants.•So does Risperdal.
> --Despite what rumors go around, Tardive Dyskenisia on Zyprexa is very rare.
•The same with Risperdal when doses of < 6mg/day are used. These doses have actually been found to be more effective than higher doses (more isn't always necessarily better).
>
> I took 10 mg of it at bedtime for 3 months, and I had no drowsiness in the morning. I didn't have any weight gain either.•I'm glad you pointed that out. Many people do not gain weight with Zyprexa and many of those who do gain only enough to bring them back to a normal weight after being underweight. Some people do gain quite a bit of weight on Zyprexa vs Risperdal. I have seen several cases of people gain >20kg over a year. This is usually due to an increase in eating inappropriately (chips & soda) rather than a balanced diet.
•On the whole, both drugs are very effective when used properly. Their indications for use seem to grow daily (as antipsychotics, as antidepressant augmentation, as antimanic agents, in OCD, in Tourette's, and a couple of others that I can't think of at the moment).
•I would say that if one doesn't work for you, try the other. They do have different secondary binding affinities that make them appropriate for different people (eg. low dose Risperdal - 0.25mg to 0.5mg - is probably better for the elderly due to falls seen because of the anticholinergic effects of Zyprexa; Zyprexa is better for those with sleep disturbances).
•Sincerely - Cam
poster:Cam W.
thread:55031
URL: http://www.dr-bob.org/babble/20010221/msgs/55046.html