Posted by ed_uk2010 on January 27, 2015, at 17:57:16
In reply to Re: Multiple mechanism with Zyprexa and some atyp, posted by Lamdage22 on January 27, 2015, at 14:04:16
Essentially...
I'm trying to understand you better, rather than making too many suggestions based on inadequate evidence. There is often a tendency for people to make A LOT (of sometimes inappropriate) suggestions on forums like this without really knowing much/anything about the person they're making suggestions to. I'm keen to avoid this type of thing. It can be harmful.
This is the impression I get....
You have a long history of depressive illness, and some anxiety. Various trials of medication did not provide relief. You then had an episode in which you became delusional and rather out of control while taking Parnate. This episode has been difficult for you to recover from. You are currently not psychotic but feel depressed most of the time and have trouble sleeping.
Is that about right?
I don't need to know exactly, but how old are you now and how old were you when your mental health problems began? Have you ever had a psychotic or manic episode when NOT taking an antidepressant? The Parnate episode sounds like drug-induced psychosis.
About trazodone....
Have you ever taken it before?
It seems that Seroquel has been beneficial to you over quite a long period of time. You mentioned being stable on Seroquel alone at one point. Seroquel is known to have antidepressant, antimanic and antipsychotic properties. I can't really say whether you would develop psychotic symptoms again if you reduced Zyprexa too much. I think the risk depends partly on whether your psychotic symptoms occur only in response to certain antidepressants (eg. Parnate), or whether they occur spontaneously. Obviously, if you have a history of delusions, psychosis or loss of control in the *absence* of triggering medication, you are more likely to experience psychosis on reducing Zyprexa than if you experience such symptoms only when triggered by meds. Consideration of this issue is important because it could help you, and your doctor, decide whether they is any chance of reducing your antipsychotic meds in the presence of a sedating drug such as trazodone for sleep.... or whether this would be unwise. The major purpose of reducing Zyprexa would be to reduce your weight or improve your physical health, I assume? So, it would only really be of value to reduce Zyprexa if, a) you are currently needing to lose more weight even in the presence of metformin and b) if you were able to find a replacement for Zyprexa which would treat your insomnia and maintain your stability without causing weight gain itself.
poster:ed_uk2010
thread:1074889
URL: http://www.dr-bob.org/babble/20150102/msgs/1075648.html