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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by FredPotter on July 23, 2005, at 3:32:01
I wonder if anyone can give me some help. I was prescribed 2.5 mg a day of Zyprexa for treatment resistant depression and anxiety (evening nameless dread, sinking feeling over nothing, too much sleeping and anhedonia). I already take lithium and 40 mg Celexa.
Well for the first 3 weeks or so I felt better than I have for a long time. Now though it's beginning to slip, so I've doubled the dose of Zyprexa.
Has anyone found Z helpful for symptoms like these? I realise I'm still on a small dose.
Thanks
Fred
Posted by blueberry on July 23, 2005, at 6:49:23
In reply to Zyprexa, anxiety and depression, posted by FredPotter on July 23, 2005, at 3:32:01
I have found zyprexa helpful for the symptoms you described. I have tried doses from 2.5mg to 10mg and I like 5mg the best. Any less and there is too much anxiety. Any more and it actually makes me a little depressed. Kind of like I have a therapeutic window.
You'll never guess what worsened those symptoms for me though...lithium. With zyprexa in the mix, you may find you can go without the lithium. Lithium helped me in some ways, but actually made the symptoms you described more pronounced. I felt better after I got rid of it. Anxiety especially was a lot worse on with lithium.
Celexa probably mixes well with zyprexa, but most of the literature suggests prozac is the best with zyprexa. I like prozac the best of all the ssri's.
The time of day that I take zyprexa has a huge effect on how well it works for me. It's almost like a completely different drug, depending on when I take it. I used to take it at about 7:00 or 8:00 in the evening. But I always woke up with this horrible feeling of impending doom, a sinking feeling in the gut like abandonment, and sort of a butterflies in the stomach feeling. It went away mostly during the morning, but was hell to wake up to every single day. I tried it at 5:00p.m. instead and was pleasantly surprised to see all that morning crap gone. Experimenting with different dosing times can be helpful.
Though zyprexa is helpful to me for the symptoms you described, more helpful than any of dozens of meds I've tried, it isn't perfect. I'm not sure anything is. But I'm better off than at any time in my life. I wouldn't even think of going without my prozac and zyprexa.
Posted by ed_uk on July 23, 2005, at 16:57:59
In reply to Zyprexa, anxiety and depression, posted by FredPotter on July 23, 2005, at 3:32:01
Hi Fred,
Just a bit of encouragement........
Banga takes Abilify for anxiety and depression. It pooped out at 2.5mg but continued to work well when she increased to 5mg. I know it's not Zyprexa but it's still an AP!
Kind regards
~Ed
Posted by FredPotter on July 23, 2005, at 19:02:19
In reply to Re: Zyprexa, anxiety and depression » FredPotter, posted by ed_uk on July 23, 2005, at 16:57:59
Thank you Blueberry and Ed for your helpful posts. I'm going to try less Li as you suggest BB. I don't like the shakes from Li and I'm not bipolar. You used the word "abandoned".I've always had that feeling.But contrary to what they say in CBT the thought doesn't precede it. I get the word by groping around for words to describe the feeling. All my morbid feelings come before the thoughts
Fred
Posted by 4WD on July 23, 2005, at 23:04:17
In reply to Re: Zyprexa, anxiety and depression, posted by blueberry on July 23, 2005, at 6:49:23
> I have found zyprexa helpful for the symptoms you described. I have tried doses from 2.5mg to 10mg and I like 5mg the best. Any less and there is too much anxiety. Any more and it actually makes me a little depressed. Kind of like I have a therapeutic window.
>
> You'll never guess what worsened those symptoms for me though...lithium. With zyprexa in the mix, you may find you can go without the lithium. Lithium helped me in some ways, but actually made the symptoms you described more pronounced. I felt better after I got rid of it. Anxiety especially was a lot worse on with lithium.
>
> Celexa probably mixes well with zyprexa, but most of the literature suggests prozac is the best with zyprexa. I like prozac the best of all the ssri's.
>
> The time of day that I take zyprexa has a huge effect on how well it works for me. It's almost like a completely different drug, depending on when I take it. I used to take it at about 7:00 or 8:00 in the evening. But I always woke up with this horrible feeling of impending doom, a sinking feeling in the gut like abandonment, and sort of a butterflies in the stomach feeling. It went away mostly during the morning, but was hell to wake up to every single day. I tried it at 5:00p.m. instead and was pleasantly surprised to see all that morning crap gone. Experimenting with different dosing times can be helpful.
>
> Though zyprexa is helpful to me for the symptoms you described, more helpful than any of dozens of meds I've tried, it isn't perfect. I'm not sure anything is. But I'm better off than at any time in my life. I wouldn't even think of going without my prozac and zyprexa.
Did you not have issues with terrible food cravings?Marsha
Posted by med_empowered on July 24, 2005, at 1:57:04
In reply to Re: Zyprexa, anxiety and depression » blueberry, posted by 4WD on July 23, 2005, at 23:04:17
hey! Zyprexa is a tricky drug, and using antipsychotics for mood-disorders is tricky business itself. Here's my experience: low-dose APs (my fave is Abilify) will help, for a while. BUT, if you bump up too far, you lose all the antidepressant effect, and instead get a numbing, dulling effect. At higher-end doses you also start running into EPS...akathisia, tremors, that kinda thing. Also, keep in mind that although the risk of tardive dyskinesia with atypical antipsychotics is decidedly lower than with traditional antipsychotics (I think the best research I've seen pointed to a 1% chance per year on atypicals for people with schizophrenia, compared to about 3% a year for those with schizophrenia on traditional doses of traditional antipsychotics), it certainly isnt zero. If you don't have bipolar, lithium seems to me to be too much of a pain to use, unless nothing else works. Soo...maybe you could talk to your doc about ditching the lithium and going for anti-psychotic augmentation instead? I think Abilify may prove to be the best AP on the market for mood-disorders...it tends to be kinda activating, and you don't get the "numbing" effect until you hit higher doses (think 20mgs+). Plus, its a mood-stabilizer, it can reduce anxiety (some people get worsened anxiety though, keep this in mind) and, MOST IMPORTANTLY--it has a significantly lower risk of causing diabetes, weight gain, or other metabolic weirdness compared to the other atypicals on the market. Even if you dont have any risk factors for diabetes, keep in mind that the other atypical APs--paricularly Zyprexa--have a tendency to cause problems.
This is the end of the thread.
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