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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 yxibow on December 20, 2005, at 22:29:22
I'm considering returning to Zyprexa in combination with the Seroquel I'm on. I should describe a short reason for the medication and condition.. sometime a bit more than 4 years ago I inexplicably developed a somatiform disorder which basically heightens visual awareness, contrast, brightness, etc. The antipsychotics are used for the D2 dampening.
At any rate, when I first started rounds of antipsychotics years back, Zyprexa was an astounding change to my condition -- unfortunately, it caused pseudoparkinsonism, shakiness of the hands, although on the positive side I slept like a baby.
I withdrew once from it, and it more or less went away. I tried it at a lower dose, it had no effect on my condition but my hands were also shaky. I withdrew, and it didn't exactly go away.
So I ponder trying it a third time, knowing that pseudoparkinsonism sometimes reverses itself during treatment. I don't want to end up permanently with pseudoparkinsonism. I want to be able to hold my fork at dinner without being depressed and do intricate work with hand tools, etc. Yes, there's Akineton (biperiden) and propranolol for tremor although there's only so much you can take before you get side effects from them too.
So... after this long posting... people who have taken Zyprexa, what are their experiences with EPS, permanent, or temporary.
Posted by med_empowered on December 20, 2005, at 23:35:30
In reply to Personal experiences with Zyprexa and EPS, a ?, posted by yxibow on December 20, 2005, at 22:29:22
hi! My experience with zyprexa was short-lived--2.5mgs/day gave me **pronounced** akathisia (shaking, fidgeting, hellish anxiety), so that was pretty much that. Sometimes pseudoparkinsonism does go away with treatment...I think this usually happens within the first month of treatment.
I personally would not recommend doing Zyprexa again. Abilify might be a good option. Seroquel is a good one, too. I read some case studies with severe, chronic schizophrenia where abilify was added (full dose) to zyprexa (full dose)...the results were apparently pretty impressive. Maybe you could do low-dose seroquel, plus low-dose abilify? Geodon is also usually pretty good with EPS, but tends to be pretty heavily sedating.
Have you considered Surmontil? Its kind of like a low-grade antipsychotic; it seems to be kind of clozapine-ish in its mild D2 dampening effect. I would imagine that might help you a bit. Plus, it doesn't seem to cause many EPS problems until the doses get crazy high, and I don't think TD is a big problem, either.
Posted by yxibow on December 21, 2005, at 0:33:36
In reply to Re: Personal experiences with Zyprexa and EPS, a ?, posted by med_empowered on December 20, 2005, at 23:35:30
> hi! My experience with zyprexa was short-lived--2.5mgs/day gave me **pronounced** akathisia (shaking, fidgeting, hellish anxiety), so that was pretty much that.
Really.. that's quite surprising, I would rate atypicals in increasing order of EPS (esp. akathisia) as:
Clozaril
Seroquel
Zyprexa
{Geodon, Abilify}
RisperdalSometimes pseudoparkinsonism does go away with treatment...I think this usually happens within the first month of treatment.
Yes.. this I've vaguely heard
>
> I personally would not recommend doing Zyprexa again.I know... its just that it had a profound effect... I'm debating but I'm not doing anything at the moment
Abilify might be a good option.
Abilify was disappointing, I waited for it to come out and it produced akathisia just like Geodon, maybe a tad less
Seroquel is a good one, too.
Which I take at bedtime 900mg.
Maybe you could do low-dose seroquel, plus low-dose abilify?
Possibly lower dose abilify I could stand, I dont know, but I dont know if it has the same D2 and 5HT2a profile that Zyprexa has
Geodon is also usually pretty good with EPS, but tends to be pretty heavily sedating.
Definately not sedating in me... I was writhing in akathisia grabbing the carpet, literally
>
> Have you considered Surmontil? Its kind of like a low-grade antipsychotic; it seems to be kind of clozapine-ish in its mild D2 dampening effect. I would imagine that might help you a bit. Plus, it doesn't seem to cause many EPS problems until the doses get crazy high, and I don't think TD is a big problem, either.TD does occur with tricyclics, although far less than antipsychotics, probably on the order of Zoloft.
The theory of clozapine related effects are more in-vitro than in-vivo, not nearly as proven as antipsychotics and of course added to my regime would make me a zombie as they're generally very to somewhat sleep inducing, or sweat-making, or something else... they're not as clean as SSRIs. I also currently take Cymbalta. But it is curious information about it, thank you.
cheers.
Posted by Sebastian on December 21, 2005, at 11:57:55
In reply to Personal experiences with Zyprexa and EPS, a ?, posted by yxibow on December 20, 2005, at 22:29:22
Permanent. To a much smallar degree, once stoping the med. I never had this problem with zyprexa, but with another med. The problem was real bad when on the med, I could not stop swallowing, untill they took me off the med. Then it just stoped, mostly, I still swallow a little uncontrolably, and that was 7 years ago I took the med. It is not bothersome, but I notice it once in a while, and then I become self concouse of it.
My suggestion would be not to try it again.
Posted by blueberry on December 22, 2005, at 5:50:18
In reply to Personal experiences with Zyprexa and EPS, a ?, posted by yxibow on December 20, 2005, at 22:29:22
EPS is so complicated. Any antipsychotic can do it. Any SSRI can do it. Any tricyclic can do it. Buspar can do it. And it varies so much from person to person. One person can get it intensely from low dose in a short time, while another person won't get it at all even with a high dose over a long time.
I have shakey thumbs in the morning that goes away throughout the day. Was it 10 years of prozac? Was it 5 years of zyprexa? Was it 5 years of the combination? Don't know. Removing the prozac helped a lot, though it initially got worse during the withdrawal. Lowering the zyprexa helped too. Go figure.
This is the end of the thread.
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