![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by capricorn on March 2, 2007, at 19:46:09
http://www.abc.net.au/rn/allinthemind/stories/2007/1860792.htm
Posted by Phillipa on March 2, 2007, at 21:44:23
In reply to The Zyprexa story, posted by capricorn on March 2, 2007, at 19:46:09
I know wouldn't touch it with a l0 foot pole. Love Phillipa
Posted by yxibow on March 2, 2007, at 23:28:31
In reply to Re: The Zyprexa story » capricorn, posted by Phillipa on March 2, 2007, at 21:44:23
> I know wouldn't touch it with a l0 foot pole. Love Phillipa
Actually it helped me better than Seroquel; they both have weight gain liabilities, and both change lipid profiles, Zyprexa just does more especially at higher doses. My problem with Zyprexa was pseudoparkinsonism which is worse (I think, I have a fair amount of Valium on board now) than Seroquel.
I had shakiness after and during handling power tools and various things that would make my hands eventually shaky, like waving them in the air fast.I don't know what it would do to me today, when my disorder was worst it lifted my depression within a few days, I didn't need benzodiazepines any more, and the bright lights at night dimmed dramatically. Of course its hard to say now because anything back in those days would be dramatic, now gains or losses are subtle.
As far as the diabetes issue, I certainly don't speak for Lilly; this has been kicking around for quite some time.
In its earliest days, which would have been almost ten years ago, it was pushed by doctors for a lot of things; so was Seroquel as I remember in college by the ** of a psychiatrist who had her fiefdom over the mental health clinic. It was informed consent; the PI did mention weight gain vs. placebo although the amount was probably not significantly noticed because typical trials don't last large numbers of months.
Liability also lies with doctors and visual observations would certainly have set off signals that weight gain was imminent and tests should have been done to determine diabetic potential. I still have those tests done myself, even with Seroquel, at physicals because there are some risks involved.
In the end, regardless of blame, there are few perfect atypicals -- I wish I could combine the good parts of Zyprexa and Seroquel; the rest, well, for me akathisia is too much in general.
There are more atypicals that will probably come on the market by 2010 or so, I'm sure -- they are still early in the pipeline.Unless you count Invega (paliperidone), the metabolite / patent extension of Risperdal, which is currently over $10 a day in its initial price offerings making it the second highest cost atypical to Clozaril.
Of course if I added up the "real" cost of my 7+ pharmaceutical agent polypharmacy and not the already overpriced copays, who knows what the actual daily cost per day of my "mix" is.
-- tidings
Posted by alienatari on March 2, 2007, at 23:35:27
In reply to Re: The Zyprexa story » capricorn, posted by Phillipa on March 2, 2007, at 21:44:23
*force feeds zyprexa to Jan*
> I know wouldn't touch it with a l0 foot pole. Love Phillipa
Posted by med_empowered on March 3, 2007, at 16:40:01
In reply to Re: The Zyprexa story ))phillipa, posted by alienatari on March 2, 2007, at 23:35:27
Here's the thing: I'm all for trying to get better meds for "schizophrenia" (the term is so incredibly vague and broad I think it should always been in quotes), but...how much better can they be if they're just like Thorazine, only causing fewer observable side effects?
All the antipsychotics block D2. Some are more tolerable; some suck and should be banned. Aren't there other ways to go about treating psychosis? Some case studied suggest opiates. I seem to recall one of marijuana's components acting similarly in animal studies to clozaril, except it worked on some alternate pathway (glutamate, maybe?). Seriously--today's drugs are just slightly more tolerable versions of yesterday's drugs. I don't think we should be surprised that lots of patients hate them and that they have horrid side effects; blocking D2 for a long term tends to cause pretty significant problems.
Posted by yxibow on March 3, 2007, at 17:06:29
In reply to Re: The Zyprexa story ))phillipa, posted by med_empowered on March 3, 2007, at 16:40:01
> Here's the thing: I'm all for trying to get better meds for "schizophrenia" (the term is so incredibly vague and broad I think it should always been in quotes), but...how much better can they be if they're just like Thorazine, only causing fewer observable side effects?
>
> All the antipsychotics block D2. Some are more tolerable; some suck and should be banned. Aren't there other ways to go about treating psychosis? Some case studied suggest opiates. I seem to recall one of marijuana's components acting similarly in animal studies to clozaril, except it worked on some alternate pathway (glutamate, maybe?). Seriously--today's drugs are just slightly more tolerable versions of yesterday's drugs. I don't think we should be surprised that lots of patients hate them and that they have horrid side effects; blocking D2 for a long term tends to cause pretty significant problems.
But blocking D2 (and other Dx) also dampens voices and other hallucinations caused by schizophrenia. And it blocks other things caused by overactive dopamine in people without schizophrenia, such as myself.
There's quite a difference between Thorazine and Seroquel, occupation may be there, but one lets go and grabs back and lets go far more than the other.
Posted by UgottaHaveHope on March 4, 2007, at 11:47:53
In reply to Re: The Zyprexa story » Phillipa, posted by yxibow on March 2, 2007, at 23:28:31
> Liability also lies with doctors and visual observations would certainly have set off signals that weight gain was imminent and tests should have been done to determine diabetic potential. I still have those tests done myself, even with Seroquel, at physicals because there are some risks involved.
>Jay: I take Seroquel, too. What exact tests do you order from the doctor to monitor any possible problems from the drug? Thanks, Michael
Posted by yxibow on March 4, 2007, at 15:50:32
In reply to Re: Q about Seroquel testing - Yxibow » yxibow, posted by UgottaHaveHope on March 4, 2007, at 11:47:53
> > Liability also lies with doctors and visual observations would certainly have set off signals that weight gain was imminent and tests should have been done to determine diabetic potential. I still have those tests done myself, even with Seroquel, at physicals because there are some risks involved.
> >
>
> Jay: I take Seroquel, too. What exact tests do you order from the doctor to monitor any possible problems from the drug? Thanks, Michael
I have more frequent physicals; specifically I believe the diabetes/sugar test, but considering my weight gain (some left from Remeron in the past ) also an EKG and cholesterol/lipid panel.
My psychiatrist was overcautious when we started it and did a second eye exam (it was shown that stuffing beagles with Seroquel could cause glaucoma but we're talking a quite a difference in dose. To date I don't think there is a conclusive human case of it.) I also insist on fairly frequent AIMS tests for TD (since I have some odd EPS from Seroquel), which are on the spot subjective muscle exams by a psychiatrist. They're routine and fairly quick.I think that covers the Seroquel angle
-- tidings
Posted by Sandra62 on March 4, 2007, at 15:56:37
In reply to Re: Q about Seroquel testing - Yxibow » UgottaHaveHope, posted by yxibow on March 4, 2007, at 15:50:32
I thought it was cataracts not glaucoma that the poor sweet Beagles got from Seroquel?
Posted by yxibow on March 5, 2007, at 2:40:20
In reply to Re: Q about Seroquel testing - Yxibow, posted by Sandra62 on March 4, 2007, at 15:56:37
> I thought it was cataracts not glaucoma that the poor sweet Beagles got from Seroquel?
You're right I believe.. cataracts. Wrong diagnosis of overdosed beagles.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.