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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Lawrence s. on May 17, 2001, at 1:26:51
Zyprexa, Risperdal fears: My doc mentioned to me that I might benefit from zyprexa / risperdal to augment my antidepressant and/or reduce anxiety. What scares me is that taking an A.P. if you are not psychotic will possibly cause psychosis upon discontinuation. Has anyone taken these for a while and then stopped? If so how did it go? Also once you start taking an A.P. do you have to take it for life? Someone had said years ago with the old A.P.s like Mellaril, Haldol, once you start taking them you can't get off of them. (This was of course one persons opinion).
Posted by SalArmy4me on May 17, 2001, at 2:32:31
In reply to Zyprexa, Risperdal fears, posted by Lawrence s. on May 17, 2001, at 1:26:51
There is no evidence to suggest that atypical antipsychotics lead to psychosis on discontinuation. And they can only help your depression:
O'Connor, Manjula et al. Adding Risperidone to SSRI Improves Chronic Depression. J of Clin Psychopharmacology. 18(1):89-91, Feb 98:
"...These patients had in common: a long course of illness, inadequate response, episodes of major depression, and lack of manic or psychotic symptoms. Risperidone was used for the suicidal ideation and agitation that were present in depression and anxiety. These symptoms, and disturbance in sleep and eating behavior, had responded poorly to an SSRI without risperidone. The improvement with risperidone was fast, and a short-duration of treatment was sufficient to control symptoms in some patients."Shelton, Richard C. et al. A Novel Augmentation Strategy for Treating Resistant Major Depression. Am J of Psychiatry. 158(1):131-134, Jan 2001:
"The combination of olanzapine with fluoxetine in patients with treatment-resistant, nonpsychotic, unipolar depression produced superior improvements over either agent alone across a variety of measures. Clinical responses were evident by the first week, suggesting rapid onset of action... Overall, treatments were well tolerated..."
Posted by Cece on May 17, 2001, at 3:20:02
In reply to Zyprexa, Risperdal fears, posted by Lawrence s. on May 17, 2001, at 1:26:51
I take Zyprexa, at low dose, on an occasional as needed basis. It helps me when I get into a certain kind of agitated, paranoid, ruminating state- other times it seems to make me depressed. My pdoc sez that it is fine to take PRN- it is fast acting, and doesn't require the acclimation period and continuity (at least for me) that AD's do.
Cece
Posted by CraigF on May 17, 2001, at 7:06:22
In reply to Re: Zyprexa, Risperdal fears » Lawrence s., posted by Cece on May 17, 2001, at 3:20:02
I added Risperdal to Serzone with initial success, followed by a bad reaction.
The symptoms (agitation, inexplicable and scary feelings)went away almost immediately, but the experience left me more depressed and discouraged then I had been in a long time.
Never tried Zyprexa (don't want the weight gain) but I'm considering adding Amisulpride.
Posted by Cam W. on May 17, 2001, at 8:43:30
In reply to Zyprexa, Risperdal fears, posted by Lawrence s. on May 17, 2001, at 1:26:51
Lawrence - "Antipsychotic" is just a name. We are finding that the receptor binding profile of the so-called "atypical antipsychotics" allows them to be successfully used in many conditions outside of psychosis (eg. mania, aggression, augmentor of antidepressants, etc.). The atypical antipsychotics probably should be called "mood modifiers".
The same is true for SSRIs. They should not be called antidepressants as they have activity in a number of nondepressive disorders, as well (eg. PMDD, social phobia, OCD, etc.). The problem with labels is that they stigmatize people; either self-induced stigmatization or second-hand, through a second party. One has to look beyond the label to see the person. Unfortunately, political correctness has not fully hit the psychiatric medication. Actually stigmatization starts when you realize that you need to see a doctor for a psychiatric problem.
Also, the older antipsyhotics (conventional neuroleptics, major tranquillers, etc.) need not be taken for life. In many instances they were, and are, used short term (ie. brief psychotic episodes, flare-ups of bipolar mania, intractable hiccups, etc.). There is no need to worry about getting addicted to antipsychotics, nor do you need to worry about getting a psychosis by taking them.
This is not to say that Risperdal™ (risperidone) and Zyprexa (olanzapine) do not have side effects that need to be considered. With Risperdal one needs to stay on low loses (less than 6mg/day) to avoid movement disorders and to try an minimize prolactin (hormone) elevations. These can occur in some people. With Zyprexa one needs to worry about weight gain (which can be controlled with exercise, diet, and diligent monitoring of weight). Again, not everyone gains weight, but many do.
You can do a search of this board for Zyprexa and Risperdal if you need more information on these drugs.
Hope this of some help - Cam
Posted by Sunnely on May 17, 2001, at 18:51:54
In reply to Re: Zyprexa, Risperdal fears » Lawrence s., posted by Cam W. on May 17, 2001, at 8:43:30
Hi Cam,
Thanks for a crystal clear explanation.
Hope you're doing fine.
+++++++++++++++++
> Lawrence - "Antipsychotic" is just a name. We are finding that the receptor binding profile of the so-called "atypical antipsychotics" allows them to be successfully used in many conditions outside of psychosis (eg. mania, aggression, augmentor of antidepressants, etc.). The atypical antipsychotics probably should be called "mood modifiers".
>
> The same is true for SSRIs. They should not be called antidepressants as they have activity in a number of nondepressive disorders, as well (eg. PMDD, social phobia, OCD, etc.). The problem with labels is that they stigmatize people; either self-induced stigmatization or second-hand, through a second party. One has to look beyond the label to see the person. Unfortunately, political correctness has not fully hit the psychiatric medication. Actually stigmatization starts when you realize that you need to see a doctor for a psychiatric problem.
>
> Also, the older antipsyhotics (conventional neuroleptics, major tranquillers, etc.) need not be taken for life. In many instances they were, and are, used short term (ie. brief psychotic episodes, flare-ups of bipolar mania, intractable hiccups, etc.). There is no need to worry about getting addicted to antipsychotics, nor do you need to worry about getting a psychosis by taking them.
>
> This is not to say that Risperdal™ (risperidone) and Zyprexa (olanzapine) do not have side effects that need to be considered. With Risperdal one needs to stay on low loses (less than 6mg/day) to avoid movement disorders and to try an minimize prolactin (hormone) elevations. These can occur in some people. With Zyprexa one needs to worry about weight gain (which can be controlled with exercise, diet, and diligent monitoring of weight). Again, not everyone gains weight, but many do.
>
> You can do a search of this board for Zyprexa and Risperdal if you need more information on these drugs.
>
> Hope this of some help - Cam
Posted by Cam W. on May 17, 2001, at 21:10:07
In reply to Re: Zyprexa, Risperdal fears » Cam W., posted by Sunnely on May 17, 2001, at 18:51:54
Thanks Sunnely. It's nice to know that there are people out there who do not take a reductionistic view of human physiology and biochemistry, and understand what I am talking about.
Sincerely - Cam
This is the end of the thread.
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