Posted by Mitch on January 1, 2002, at 12:27:46
In reply to Re: Has anyone read, Your Drug May Be Your Problem, posted by OldSchool on January 1, 2002, at 11:43:03
> > As with nearly everything, there are politics and money involved. We probably are going to see a period of reduced polypharmacy in the next few years (for good or ill). I noticed that Lilly is going to market fluoxetine/olanzapine together in one pill for treatment resistant depression.
>
> This is going to mess up a lot of people who are primarily mood disordered, IMO. While Zyprexa plus SSRI can work for many non psychotic treatment resistant depressives, Zyprexa brings with it all the risks of the development of movement disorders. Persons with unipolar major depression are at much higher risk of development of movement disorders than are persons with psychotic disorders.
>
> I found even low dose Zyprexa numbed my tongue up and made my muscles stiff, just as low dose Risperdal did and low dose Seroquel did.
>
> What is going to happen when Eli Lilly gets this Zyprexa/Prozac combo FDA approved for non psychotic TRD is you are going to see a rash of EPS and other movement disorders in individuals who really shouldnt be on anti-psychotics. Yes, I realize that the official pharmaceutical literature will tell you that the newer atypical anti-psychotics do not cause movement disorders at high rates, this is not necessarily true in individuals who are primarily mood disordered.
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> I am a perfect example of this. I was recently dxed with a nasty case of EPS from augmenting 50 mg Seroquel with an SSRI for slightly over a month. I have TRD unipolar major depression.
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> I predict a rash of movement disorders and subsequent lawsuits against Eli Lilly if Zyprexa plus Prozac is FDA approved for non psychotic TRD.
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> People with refractory mood disorders would be much better off and safer if they would just go back to basics and have old fashioned ECT rather than messing with all these weird psychopharmacology cocktails. ECT is actually safer than neuroleptics in individuals whose problem is a mood disorder.
>
> Old School
I agree that the newer "atypicals" can be nearly as troublesome as the older conventional antipsychotics. I was on low-dose Thorazine and Mellaril for probably a total of four or five years back in the early 80's. I got switched off of them onto safer benzos (which worked nearly as well-I am bipolarII). I wasn't taking the AP's for psychosis, but for agitated mixed anxiety/depressive states. Later I found that Xanax, Ativan, or Klonopin worked just as well without all of the other problems. I tried Risperdal and Seroquel a few years ago and re-experienced EPS problems with both of them. I think they are very tempting for pdocs to use because they attack so many symptoms at once and they don't have to go round and round with their patients switching and augmenting meds constantly. I feel uncomfortable posting negative stuff about AP's though, because I am afraid people who *are* psychotic won't take their meds and will wind up more miserable. However, it seems that most of the people who post here are not taking them for psychosis... It really is a dilemma. I guess if you could follow some general rule of thumb about them.. maybe if you get EPS from low-doses of all sorts of AP's and you aren't psychotic.. don't take them. If you get no EPS at all and they are helping you (even if you don't have psychosis), you just need to be informed and aware of the risks. However there is a positive correlation between EPS experiences and TD later on.. so one could alternately say that if you aren't experiencing any EPS with them *now* you likely *will not* develop any long-term problems -therefore they are beneficial and you should continue to take them until something less risky comes along that is comparably effective??Mitch
poster:Mitch
thread:88357
URL: http://www.dr-bob.org/babble/20011222/msgs/88426.html