Psycho-Babble Medication Thread 65072

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Zyprexa and celexa

Posted by elderweissblue on June 1, 2001, at 15:33:57

My psych was angry with me because I had stopped zyprexa, she nearly freaked, and has me put off idea of the celexa for now, though before she said I was going to be switched to celexa only, because it would have been cheaper. Now she tells me she never intended to take me off zyprexa. she wants me on zyprexa now. I take 5mg of it. Ive been labelled with psychosis though I have never hallucinated or heard voices. I think too much and have conversations in my head, talk to myself alot. BUT I can distinguish between fantasy and reality, I just like to fantasize and ruminate. I know I have an anxiety disorder and the klonopin has helped alot. I personally think I have an ingranied personality disorder and that theres no hope for me. I guess Ill continue feeling worthless and useless for the rest of my life. Screw this life!

 

Re: Zyprexa and celexa ยป elderweissblue

Posted by SalArmy4me on June 1, 2001, at 20:27:54

In reply to Zyprexa and celexa, posted by elderweissblue on June 1, 2001, at 15:33:57

Your doctor is trying to replicate the findings of the first to study fluoxetine + olanzapine:

Shelton, Richard C. M.D. et al. A Novel Augmentation Strategy for Treating Resistant Major Depression. American Journal of Psychiatry. 158(1):131-134, January 2001:
"In the present study, the combination of olanzapine with fluoxetine in patients with treatment-resistant, nonpsychotic, unipolar depression produced superior improvements over either agent alone across a variety of measures. Clinical responses were evident by the first week, suggesting rapid onset of action. Overall, the three treatments were well tolerated. For example, 9 (90%) of the patients receiving olanzapine plus fluoxetine completed double-blind therapy. The rates of extrapyramidal symptoms did not differ significantly between treatment groups. Previous long-term observations of olanzapine treatment suggest a significantly lower risk of tardive dyskinesia than with haloperidol. Although the observation period in the present study was short, the absence of acute extrapyramidal symptoms (which may predict a risk for subsequent tardive dyskinesia) was encouraging. In this study, one treatment-emergent event among patients treated with olanzapine, both in monotherapy and in combination with fluoxetine. Combined olanzapine and fluoxetine appears to be an effective and well-tolerated treatment for treatment-resistant depression.

In contrast with the significant response observed with the combined therapy, neither fluoxetine nor olanzapine alone was effective in this resistant population. It therefore appears that neither the serotonin reuptake blockade of fluoxetine nor the pleiotropic receptor effects of olanzapine (18, 19) individually were beneficial in treating resistant depression. Concomitant administration of fluoxetine and olanzapine results in a small increase in olanzapine maximum concentration and area under the curve, zero to infinity, and a small decrease in olanzapine plasma clearance (unpublished work by Gossen et al.). Such changes, although statistically significant, are small in comparison to the overall variability between individuals and are unlikely to result in a clinically significant pharmacokinetic interaction.



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