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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by yellowbird01 on March 13, 2012, at 21:15:44
I had an appt with pdoc today and he gave me a script for Zyprexa 2.5mg PRN (up to twice/day, but we both understand I'll take only take it occasionally). My dx is major recurrent depression, not in a current episode although working towards it at this rate... with a 2nd dx of "triggered like crazy" recently. I also take 50mg lamictal/day which seesm to help me depression. I'm very petite and tend to be sensitive to small doses of things. I also have xanax prn 0.25mg, sometimes I'll take 0.5mg... it helps with anxiety but my greater problem now isnt quite anxiety.. it's more just the emotional intensity when the triggers hit me hard in the last week or so, and I cant get out of it, and end up feeling self destructive. Hoepfully that makes sense.
So, anyone know anything about zyprexa as a PRN? Anyone tried this? What should I expect?
Posted by Phillipa on March 13, 2012, at 23:11:59
In reply to zyprexa PRN, posted by yellowbird01 on March 13, 2012, at 21:15:44
I've read on here that it will stop any suicidal thoughts right away. Heresay of course. Phillipa
Posted by papillon2 on March 14, 2012, at 3:15:29
In reply to Re: zyprexa PRN » yellowbird01, posted by Phillipa on March 13, 2012, at 23:11:59
Zyprexa (and Seroquel) are prescribed PRN quite frequently in psych hospitals. Practically everyone's on it. You can expect some sleepiness and possibly increased appetite (especially for carbs) and weight gain.
Posted by b2chica on March 14, 2012, at 9:05:58
In reply to Re: zyprexa PRN, posted by papillon2 on March 14, 2012, at 3:15:29
ditto what papillion said.
i am on zyprexa prn. though i haven't been taking it for a couple months as i had such a weight gain the last time.
but i'm almost to a point where i really need to get back on it.
some people do have withdrawl issues so depending on what dose your on. when getting off, taper down, or go everother day for a week or so whatever works.last year i did zyprexa prn about three times. each time about 2-3 weeks at a shot. worked well.
best wishes.
Posted by yellowbird01 on March 14, 2012, at 11:55:43
In reply to Re: zyprexa PRN, posted by b2chica on March 14, 2012, at 9:05:58
Thanks everyone for the info. If I dont take it frequently.. lets say I end up just taking it once a week, or twice a week... would I be likely to gain any weight? I have a history of an eating disorder... I'm basically recovered and at a healthy weight, but gaining weight would be a major trigger for me and likely lead into some bad behaviors. If so, i may need to talk to pdoc about a different prn.
Posted by papillon2 on March 14, 2012, at 14:55:45
In reply to Re: zyprexa PRN, posted by yellowbird01 on March 14, 2012, at 11:55:43
I'm not sure, but I would think that the incidence (or amount) of weight gain / appetite increase would be lower than with regular use.
I also have a history of an eating disorder (anorexia). I ceased Zyprexa due to uncontrollable weight gain, a resurgence in eating disordered thoughts and associated anxiety/paranoia. I decided it was doing more harm than good. I was on a regular, nightly dose for anxiety and sleep; thanks to its side effects, Zyprexa was not helping with either!
The important thing is to be honest with yourself and your treatment team, weigh the costs vs. benefits carefully (not just before deciding to take the medication, but also while taking it) and SPEAK UP if the side effects become an issue BEFORE they become a major problem. This goes for any medication or side effect.
You know yourself the best. If you think your recovery is strong enough and your coping skills developed enough to weather a potential trigger, I would go for it. You may not experience this side effect and it would be a shame to unnecessarily rule out what could be a really helpful medication, if it is safe to do so.
However, if your eating disorder recovery is at all precarious you may decide that it is not worth the risk of relapse. This is not a matter to be taken lightly.
Incidentally, I take other medication (Nortriptyline and Lithium) which are renowned for causing weight gain, but which have not done so for me. So you see, it need not be a fait acompli.
Posted by b2chica on March 14, 2012, at 14:59:52
In reply to Re: zyprexa PRN » yellowbird01, posted by papillon2 on March 14, 2012, at 14:55:45
and just so you know i never gained any weight when i was at 5mg. it is only when i go up to 10 (which i normally need to do).
but it also takes about three days for the hunger to get to an uncontrollable states. and thats again at the 10mg not 5.
it seems that at 5 if i do feel a bit hungry i drink water and i'm fine.
so if you start to get hunger feelings on it, just make sure you are drinking lots of water. this will help.Best wishes.
b2c.
Posted by Zyprexa on March 15, 2012, at 6:11:16
In reply to Re: zyprexa PRN, posted by b2chica on March 14, 2012, at 14:59:52
I agree with the water. I drink lots and not having any problems with keeping the weight off. I take 10mg day with a prn of 5mg twice a week. I find that the uncontrolable hunger I used to get with it took a couple days to kick in. So if you are not taking it every day it might not be a problem. Especialy at that low a dose. I will say that if I went off it one time and couldn't eat, but took half a 2.5mg and was able to eat wtihin 45min. So its hard to say what will happen.
Posted by papillon2 on March 15, 2012, at 9:12:43
In reply to Re: zyprexa PRN, posted by Zyprexa on March 15, 2012, at 6:11:16
Drinking water and ignoring inappropriate hunger cues certainly helps, but sometimes these types of dietary modifications can only rein in the rate of weight gain, rather than stopping it entirely.
I was seriously doing everything possible not to gain weight, barring axing whole meals entirely (a slippery slope I refused to go down, but in any case that would likely only slow one's metabolism). The weight gain defied logic; energy out well exceeded energy in, but not in a way that would entail going into starvation mode.
Something very fishy happens with food metabolism on Zyprexa. I don't think I'd have believed that weight gain could be so uncontrollable had I not experienced it personally.
Anyway, as I said, this may not be an issue with PRN usage.
Posted by yellowbird01 on March 15, 2012, at 9:28:12
In reply to Re: zyprexa PRN, posted by papillon2 on March 15, 2012, at 9:12:43
Thanks everyone for all the info. It is very helpful. I'm going to give it a try at least once and see how it goes. I worry about intentionally ignoring hunger cues because even when I know the hunger is "fake", that's a slippery slope for me into ignoring true hunger cues. I think I'll try taking it, drinking a lot of water as you all suggested, and hopefully that'll work out. If not, I'll call pdoc and see what else we can do. Thanks!
Posted by Zyprexa on March 16, 2012, at 0:50:17
In reply to Re: zyprexa PRN, posted by papillon2 on March 15, 2012, at 9:12:43
Zyprexa weight gain is not uncontrolable. I've lost substantial amounts of weight taking zyprexa, 30lbs in one month. It just takes diet and exercise.
Posted by papillon2 on March 16, 2012, at 1:02:23
In reply to Re: zyprexa PRN, posted by yellowbird01 on March 15, 2012, at 9:28:12
> I worry about intentionally ignoring hunger cues because even when I know the hunger is "fake", that's a slippery slope for me into ignoring true hunger cues.
This is a very good point. Know thy potential triggers and plan ahead!
You know, even if you do run into some problems and have to discontinue, I think you'll get a real sense of mastery over ED by listening to your body and feelings, and advocating for yourself. I know I did.
I bet there is no way in hell you'd have agreed to take a medication with these potential side effects when in the throes of your eating disorder. The fact that you are willing to try it and know how to look after yourself shows just how far you have come. :-)
Posted by papillon2 on March 16, 2012, at 1:36:26
In reply to Re: zyprexa PRN, posted by Zyprexa on March 16, 2012, at 0:50:17
> Zyprexa weight gain is not uncontrolable. I've lost substantial amounts of weight taking zyprexa, 30lbs in one month. It just takes diet and exercise.
I respectfully disagree. It is not uncontrollable for everyone, some like you can lose weight, but for some people diet, exercise and good habits only stem the rate of weight gain, not stop it entirely. This was the case for me.
You're talking to a recovered anorexic. I know how to control my weight.
Zyprexa changes the way your body processes and stores food. This is well researched. There is also research to suggest that it changes the body's natural set weight. Maybe my weight gain would have leveled out, but in the midst of a resurgence of eating disordered thoughts I was not going to risk finding out.
Also, remember that some of the weight you are losing was gained due to not having the sort of dietary and exercise routines to have now. If your diet and exercise is already perfect and it remains perfect yes, you can still gain weight on Zyprexa.
If I had "dieted" and exercised more I'd have been (a) malnourished (you can have malnutrition at any weight) and (b) been diagnosed with EDNOS and compulsive over-exercising. The only reason I'd be diagnosed with EDNOS and not AN is that Zyprexa would have kept my weight too high to fulfill the AN diagnostic criteria.
Just in case I have not made myself clear, I am a recovered anorexic. I KNOW how to freaking control my weight!!!!
Posted by B2chica on March 16, 2012, at 7:47:23
In reply to Re: zyprexa PRN, posted by yellowbird01 on March 15, 2012, at 9:28:12
yellowbird.
please know that what i meant by the water is that the way zyprexa works in how it messes with your hunger cues in that its not that your hungry all the time, but you dont know when to stop. you dont feel satiated.
so please dont ignore hunger cues. but drink water first. 1)many times when you feel hunger you are actually thirsty. 2)drink water a good amount like full glass or two 3)IF you are still hungry than by all means eat. try eating a diet heavier in protien and vegetables and 4)becareful not to drink too much water and not enough food as it will get your blood sugar way out of wack.and last but not least. i think the guidelines for normal water intake is half your body weight in ounces a day. for example if i weighed 150lbs, then i would need to drink 75 OUNCES in water a day.
Use that as a guideline.Best wishes and feel free to contact anytime. I hope the zyprexa trial goes well for you.
b2c.
Posted by phidippus on March 17, 2012, at 19:48:00
In reply to zyprexa PRN, posted by yellowbird01 on March 13, 2012, at 21:15:44
I used to take Xyprexa 5mg prn. It works well for turning the dial down on key-ed up states and helpful for anxiety.
Eric
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