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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Karen Curtis on October 20, 2001, at 13:44:59
Hi all- I have posted before concerning my son, Evan (12) and the problems I was having regarding his bipolar
1-psychosis dx and trying to control it with several medications. BTW, we have a wonderful pdoc. Evan is still
experiencing some disturbing thoughts along with some psychosis- primarily "thoughts", as he describes it, telling
him things- however, he knows this is not real and is "in his imagination". He has some paranoia. Since Evan as
been on geodon, this has lessened, but is still bothersome, and my son has not gone back to school for this
reason. He also takes depakote, lithium (want to discontinue soon) and started lamictal a few weeks ago, but he is
only up to 25mg daily at this point. Though it is hard to distinguish the mood problems from psychosis at times, the
underlying paranoia makes me think that the psychosis is still bothersome. AND NOW MY QUESTIONS- I
spoke to the pdoc the other day, and he said to up the geodon to 160mg, as he believes that under a certain
dosage, the drug simply is not very effective. Evan has been at 160 for three days. That is the max dose. He has
been on risperdal (pooped out), seroquel (too weak), and now geodon. The pdoc mentioned clozaril- I would
dread putting him on that drug- side effects! I am thinking zyprexa- he was on it once before, but only 5mg a day-
that is nothing. But he gained weight!! We want to stop the lithium asap, as that is one of the few drugs he gains
weight on- the depakote did not cause weight gain. Does zyprexa ALWAYS cause one to gain allot of weight??
We have tons of support from his school, it is not an issue- we are going to send Evan to a therapeutic day school
for a few months. Thanks for some knowledgeable, informative replies please!!! Karen Curtis
Posted by Abajo on October 20, 2001, at 18:07:06
In reply to HELP!! zyprexa VS clozaril-side effects, which ??, posted by Karen Curtis on October 20, 2001, at 13:44:59
karen, I can only speak for myself as an adult male who started zyprexa a little over a month ago. I started at 2.5mgs on it. I found that I had to take it to 15mgs for it to really be effective. I take it for panic associated illusions/hallucinations. I was surprised at how mild the drug was. But I am always starving on it. I have to watch this very closely. I had dropped 25lbs this spring before starting zyprexa. I have gained most of it back and I have cut back on what I eat. I am in contact with another person who also takes 15mgs and has no cravings and has noticed no weight problems. Point is everyone reacts differently to drugs. But I would certainly try the zyprexa before trying clozaril. What have you got to lose. The use of clozaril seems to be left as a last resort because of it's side affects. I don't like the weight gain, but I will trade it for relief from the panic associated illusions/hallucinations. I think a lot of people are not comfortable responding to your post because it involves a young person and that is always a touchy situation.
Posted by Karen Curtis on October 21, 2001, at 11:11:48
In reply to Re: HELP!! zyprexa VS clozaril-side effects, which ?? » Karen Curtis, posted by Abajo on October 20, 2001, at 18:07:06
> karen, I can only speak for myself as an adult male who started zyprexa a little over a month ago. I started at 2.5mgs on it. I found that I had to take it to 15mgs for it to really be effective. I take it for panic associated illusions/hallucinations. I was surprised at how mild the drug was. But I am always starving on it. I have to watch this very closely. I had dropped 25lbs this spring before starting zyprexa. I have gained most of it back and I have cut back on what I eat. I am in contact with another person who also takes 15mgs and has no cravings and has noticed no weight problems. Point is everyone reacts differently to drugs. But I would certainly try the zyprexa before trying clozaril. What have you got to lose. The use of clozaril seems to be left as a last resort because of it's side affects. I don't like the weight gain, but I will trade it for relief from the panic associated illusions/hallucinations. I think a lot of people are not comfortable responding to your post because it involves a young person and that is always a touchy situation.
Oh thankyou!! I did not think of that- people being reluctant to respond because it concerns a 12 year old! I am used to posting to the medications board at CABF - where we are all parents of young kids with Bipolar. But I think you are right- I will ask for the zyprexa before the clozaril. My son was on 5mg of zyprexa at age nine for 3 weeks- and he was also on tegretol, so it did not really count! Karen Curtis
Posted by Chloe on October 21, 2001, at 20:56:06
In reply to Re: HELP!! zyprexa VS clozaril-side effects, which ??, posted by Karen Curtis on October 21, 2001, at 11:11:48
Karen,
I am sorry you are having so much trouble regulating your son's meds. I am NOT qualified to really help you in any way, except that I was put on Clozaril in my early twenties. It is a wonderful drug and was extremely effective for my dissociating. And I know that it has transformed many severe schizophenics lives. I know this because I had to go to the "Clozaril Clinic" once a week for blood work to make sure my white blood count did not fall below 1000, know as agranulocytosis. It was amazing to me to see a floridly psychotic person begin Clozaril, and two weeks later come to the clinic, "normal" and looking for employment!Anyway, though Clozaril works so well, it does have it's drawbacks. One is the weekly lab work and the other is almost guarenteed weight gain. I quickly gained about 15 pounds in 6 weeks(But I didn't care or notice, because I felt so much better!). And from what I have read, it is not as easily controlled through diet, like it can be with Zyprexa (if you literally starve yourself until the cravings wane after 9 months or so!)
An up side, is the risk for eps and td are quite low on clozaril.
But, unfortunately for me, my blood count did drop after six weeks, and I had to abruptly stop Clozaril. This was very difficult, because the med was really working...The weight abuptly fell away as well.So, I said all that to say, both meds have there pros and cons. Having taking both, though I am not schizophrenic, I would say by far, Clozaril is more effective and causes less TD. Zyprexa is the safer of the two in that it does not potentially suppress WBC's and require stringent blood monitoring. Both can cause substantial weight gain.
Not to complicate things more, but if weight gain is really an issue, what about adding a bit of Topamax for appetite suppression? My pdoc thinks Topamax is great for Depakote (though fortunately not an issue for you) or antipsychotic induced weight gain.
I hope this ramble is some what helpful. I just thought I would share my experience on both of these meds.
Best of luck finding the most effective combo for your son.
Chloe
Posted by Karen Curtis on October 22, 2001, at 9:41:33
In reply to Re: HELP!! zyprexa VS clozaril-side effects, which ?? » Karen Curtis, posted by Chloe on October 21, 2001, at 20:56:06
> Karen,
> I am sorry you are having so much trouble regulating your son's meds. I am NOT qualified to really help you in any way, except that I was put on Clozaril in my early twenties. It is a wonderful drug and was extremely effective for my dissociating. And I know that it has transformed many severe schizophenics lives. I know this because I had to go to the "Clozaril Clinic" once a week for blood work to make sure my white blood count did not fall below 1000, know as agranulocytosis. It was amazing to me to see a floridly psychotic person begin Clozaril, and two weeks later come to the clinic, "normal" and looking for employment!
>
> Anyway, though Clozaril works so well, it does have it's drawbacks. One is the weekly lab work and the other is almost guarenteed weight gain. I quickly gained about 15 pounds in 6 weeks(But I didn't care or notice, because I felt so much better!). And from what I have read, it is not as easily controlled through diet, like it can be with Zyprexa (if you literally starve yourself until the cravings wane after 9 months or so!)
> An up side, is the risk for eps and td are quite low on clozaril.
>
>
> But, unfortunately for me, my blood count did drop after six weeks, and I had to abruptly stop Clozaril. This was very difficult, because the med was really working...The weight abuptly fell away as well.
>
> So, I said all that to say, both meds have there pros and cons. Having taking both, though I am not schizophrenic, I would say by far, Clozaril is more effective and causes less TD. Zyprexa is the safer of the two in that it does not potentially suppress WBC's and require stringent blood monitoring. Both can cause substantial weight gain.
>
> Not to complicate things more, but if weight gain is really an issue, what about adding a bit of Topamax for appetite suppression? My pdoc thinks Topamax is great for Depakote (though fortunately not an issue for you) or antipsychotic induced weight gain.
>
> I hope this ramble is some what helpful. I just thought I would share my experience on both of these meds.
> Best of luck finding the most effective combo for your son.
> ChloeThankyou SO MUCH Chloe!!! Yes, I know clozaril is a miracle drug for some, and my sons pdoc did say that it was a trade off- trading side effects for wellness. And the problem with my son is not weekly blood draws- he doesn't really mind that!! The side effect that most concerns me is drooling. Weight gain is an issue too, but I THINK it can be controlled with my son. I think I will have to investigate clozaril furthur, thanks again- Karen Curtis
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