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Dr. Bob is Robert Hsiung, MD,
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Posted by caraher on March 10, 2007, at 16:26:15
I'm currently taking 90 mg/day Cymbalta (duloxetine) and am doing OK overall, but I have a terrible time waking (I take the dose in the AM) and have bad motivational problems. I generally have the atypical depression pattern (oversleeping, etc.) and would call myself a partial responder to the antidepressants I've tried (Paxil, Wellbutrin, alone and with Cymbalta, imipramine).
My pdoc suggested we consider adding Zyprexa. Any thoughts on or experiences with Zyprexa augmentation of an antidepressant, whether Cymbalta or something else? I've read a bit about the side effects and the controversy with Lilly about weight gain and diabetes risk...
Thanks for any help!
Posted by linkadge on March 10, 2007, at 16:47:59
In reply to Zyprexa (olanzapine) to augment antidepressant, posted by caraher on March 10, 2007, at 16:26:15
I don't know if this would help with atypical depression. Zyprexa usually makes you eat more, sleep more, and reduces motivation.
Perhaps you should look at augmentation with say wellbutrin?
Linkadge
Posted by Phillipa on March 10, 2007, at 17:13:29
In reply to Re: Zyprexa (olanzapine) to augment antidepressant, posted by linkadge on March 10, 2007, at 16:47:59
Also maybe lamictal mood stabalizer said to help an ad work better. Love Phillipa
Posted by Emily Elizabeth on March 10, 2007, at 19:13:12
In reply to Zyprexa (olanzapine) to augment antidepressant, posted by caraher on March 10, 2007, at 16:26:15
I take abilify to augment my antidepressants. Abilify is more weight-neutral than zyprexa. Might that be an option for you? It certainly made a good dent in my depression.
Best,
EE
Posted by med_empowered on March 11, 2007, at 13:27:45
In reply to Re: Zyprexa (olanzapine) to augment antidepressant, posted by Emily Elizabeth on March 10, 2007, at 19:13:12
Zyprexa strikes me as an odd choice for your situation. Its sedating, causes weight gain/metabolic problems...it doesn't seem to be where you want to go with treatment.
Abilify might be a good call, in low doses. Below 10mgs or so, I found it to be a good augmentor; once the dose got up to 10-15mgs/day, I found it to be pretty comparable to any other neuroleptic in terms of side effects--the only difference was a lack of sedation and relative lack of EPS.
But, I don't think an atypical would be the best choice anyway, irrespective of the one you choose. You don't have psychosis or prominent agitation. Have you thought about Provigil? Provigil helps alot of people w/ depression, fatigue, etc.
Someone else mentioned wellbutrin--that might be a good call, too. Low-dose conventional stimulants might be helpful, too, but if your doc is talking antipsychotics I doubt s/he will be up for amphetamine augmentation of your meds.Has the cymbalta helped at all with your core symptoms? If it hasn't, you might want to consider an all-out switch to another agent(s), like to Wellbutrin+Provigil or something or something like that. An MAOI might also be a good call--if you can put up with wash-out, then EMSAM might be worth a whirl.
Posted by yxibow on March 14, 2007, at 3:07:18
In reply to Zyprexa (olanzapine) to augment antidepressant, posted by caraher on March 10, 2007, at 16:26:15
Well I may be foraying back into the waters of Zyprexa, I'm not sure. All I remember is that at 5mg, I needed no benzodiazepines, my depression was greatly lifted, and my primary difficulty was also addressed dramatically.
Unfortunately you're right, it has lipid problems; I currently take Seroquel which has some of its share and I would have to pare my diet even further.
My main problem though is that Zyprexa caused more pseudoparkinsonism than Seroquel. If the Valium I take now is covering the pseudoparkinsonism in Seroquel, it might do the Zyprexa. Otherwise I guess I'll try to stick it out with a lower dose of Seroquel.
This is the end of the thread.
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