Posted by Cam W. on October 22, 2000, at 11:52:27
In reply to Nizatidine for Zyprexa (olanzapine) Weight Gain , posted by SLS on October 21, 2000, at 12:09:30
Scott - The jury is still out on the Axid preventing Zyprexa-induced weight gain. Most of the docs I know have tried it and don't believe it. We have one doc in town who really thinks it does work (according to the Lilly rep). If it does work, you should notice that the weight gain hasn't started in the first 8 weeks. This doc says that he has had good results (approx. 20% don't gain weight), but I don't know if he took into account those that do have a good response to Zyprexa and do not gain gain weight.
I know it sounds hard to believe, but I have seen several people not gain weight on Zyprexa and also have a decrease in psychotic symptoms. I do not know of any reasons why this is so, but it does happen. I am sure that in both the Zyprexa-induced weight gain and non-weight gain groups, there are patient-dependent variables that have not been considered.
I was at a lecture a year or so ago and the presenter stated the same results with cimetidine (Tagamet™ - same family as Axid™). I cornered him afterward for an explanation. He told me that this was the info the company (Lilly) had given him. I asked the rep and he hadn't heard of it. I talked to some of the "Doogies" (read pyschiatry residents), as well as some of the docs and we came up with a couple of hypotheses.
1) Something weird is happening at the H1 receptor. Tagamet and Axid are H2 receptor blockers. Blocking H1 (as seen with antihistamines) causes weight gain. I don't think that Tagamet stimulates H1 receptors to cause weight loss, though.
2) Tagamet is a "dirty" drug. It binds to all sorts of other receptors in the body. Could it be the binding to these other receptors that prevents weight gain? Axid is a cleaner drug, so this makes the "dirty" drug theory even less probable.Also, I believe that Toby made a similar claim a couple of years ago and used Dr.S.Stahl as a reference. Stahl wrote back to Dr.Bob claiming that he didn't make this claim and saw no reason why it would work, and Dr.B. relayed the info to PB.
A couple of cents - Cam
poster:Cam W.
thread:46967
URL: http://www.dr-bob.org/babble/20001022/msgs/47071.html