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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by david999 on January 24, 2002, at 18:23:37
Hi, is it safe to take Zyprexa and a MAOI? I was taking 5 mg of Zyprexa for aniexty but it wasn't really helping and I was thinking about taking a MAOI medication with Zyprexa. Thanks.
Dave
Posted by OldSchool on January 24, 2002, at 19:26:06
In reply to Zyprexa and MAOIs?, posted by david999 on January 24, 2002, at 18:23:37
> Hi, is it safe to take Zyprexa and a MAOI? I was taking 5 mg of Zyprexa for aniexty but it wasn't really helping and I was thinking about taking a MAOI medication with Zyprexa. Thanks.
>
> DaveDave you shouldnt take zyprexa for anxiety. Its not a correct use of anti-psychotics. There are many other medications effective for anxiety which dont carry the potential side effects and risks zyprexa carries. Like benzos, buspar, neurontin, beta blockers and yes, MAOIs. MAOIs by themselves are probably some of the single most effective meds for anxiety. Nardil in particular is very effective for anxiety problems.
You probably wouldnt need zyprexa with an MAOI.
Old School
Posted by david999 on January 24, 2002, at 19:52:12
In reply to Re: Zyprexa and MAOIs?, posted by OldSchool on January 24, 2002, at 19:26:06
Hi, thanks for the response. I was wondering if Zyprexa is the opposite of MAIOs. Does Zyprexa decrease the amount of dopamine and MAIOs increase it? I have a sort of a problem. I been taking Zyprexa for a speech problem because there have been tests that say that people who stutter have a higher level of dopamine the normal people and Zyprexa has been used to treat stutterers I also have a social aniexty order though and want to take something for that. So far, the Zyprexa hasn't been helping my speech, any ideas?
David
Posted by OldSchool on January 24, 2002, at 20:26:46
In reply to Re: Zyprexa and MAOIs?, posted by david999 on January 24, 2002, at 19:52:12
> Hi, thanks for the response. I was wondering if Zyprexa is the opposite of MAIOs. Does Zyprexa decrease the amount of dopamine and MAIOs increase it? I have a sort of a problem. I been taking Zyprexa for a speech problem because there have been tests that say that people who stutter have a higher level of dopamine the normal people and Zyprexa has been used to treat stutterers I also have a social aniexty order though and want to take something for that. So far, the Zyprexa hasn't been helping my speech, any ideas?
>
> DavidI dont know anything about stuttering or speech problems so Im not going to pretend to. That is a question for your doctor. But I can tell you that Zyprexa decreases the amount of dopamine AND serotonin. Zyprexa is a dopamine and serotonin antagonist.
MAOIs on the other hand potently increase levels of both dopamine and serotonin, as well as a wide variety of other brain neurotransmitters. MAOIs increase everything basically.
All anti-psychotics are dopamine antagonists...thus they block dopamine levels.
Posted by ray on January 25, 2002, at 14:29:48
In reply to Re: Zyprexa and MAOIs?, posted by OldSchool on January 24, 2002, at 20:26:46
I've pondered Parnate + Zyperexa in past.
Was based on 1 day trial of 2mg zyprexa add in (dr. gave me samples), maybe about 2 years ago.1)Added 2mg to Nardil 60 + Klonopin.
2)As expected got sedated.
3)Added 150 Wellbutrin.
4)Incredible. Dramatic effect rest of day.
Never thought more because too many meds but learned something.Currently trying low dose amisulpride.
Very interesting reminds me of zyperexa experience.
However not quite right with my regimen.
Cannot tolerate except very low dose (< 10mg/day!)Eldepryl makes sense. Decreases prolactin to counter amisulpride increase.
Eldepryl even low dose blocks sedation from tramadol for example, wheareas Nardil will not at 60mg, it will lead to increasing sedation and with enough tramadol serotonin syndrome (VERY BAD NEWS). (NOTE: NOT MAOI SCARE TACTIC, TRAMADOL + MANY ANTIDEPRESSANTS CAN LEAD TO SEROTONIN SYNDROME).
Anyway point being Eldepryl even low dose (perhaps even moreso than at higher dose), generally offsets anti-dopaminergic effect of anti-DA meds.Parnate inbetween Nardil and Elderpyl might go well with Zyprexa at very low dose.
Ray
> > Hi, thanks for the response. I was wondering if Zyprexa is the opposite of MAIOs. Does Zyprexa decrease the amount of dopamine and MAIOs increase it? I have a sort of a problem. I been taking Zyprexa for a speech problem because there have been tests that say that people who stutter have a higher level of dopamine the normal people and Zyprexa has been used to treat stutterers I also have a social aniexty order though and want to take something for that. So far, the Zyprexa hasn't been helping my speech, any ideas?
> >
> > David
>
> I dont know anything about stuttering or speech problems so Im not going to pretend to. That is a question for your doctor. But I can tell you that Zyprexa decreases the amount of dopamine AND serotonin. Zyprexa is a dopamine and serotonin antagonist.
>
> MAOIs on the other hand potently increase levels of both dopamine and serotonin, as well as a wide variety of other brain neurotransmitters. MAOIs increase everything basically.
>
> All anti-psychotics are dopamine antagonists...thus they block dopamine levels.
Posted by OldSchool on January 25, 2002, at 15:48:26
In reply to Re: Zyprexa and MAOIs? » OldSchool, posted by ray on January 25, 2002, at 14:29:48
> I've pondered Parnate + Zyperexa in past.
> Was based on 1 day trial of 2mg zyprexa add in (dr. gave me samples), maybe about 2 years ago.
>
> 1)Added 2mg to Nardil 60 + Klonopin.
> 2)As expected got sedated.
> 3)Added 150 Wellbutrin.
> 4)Incredible. Dramatic effect rest of day.
>
> Never thought more because too many meds but learned something.
>
> Currently trying low dose amisulpride.
> Very interesting reminds me of zyperexa experience.
> However not quite right with my regimen.
> Cannot tolerate except very low dose (< 10mg/day!)
>
> Eldepryl makes sense. Decreases prolactin to counter amisulpride increase.
> Eldepryl even low dose blocks sedation from tramadol for example, wheareas Nardil will not at 60mg, it will lead to increasing sedation and with enough tramadol serotonin syndrome (VERY BAD NEWS). (NOTE: NOT MAOI SCARE TACTIC, TRAMADOL + MANY ANTIDEPRESSANTS CAN LEAD TO SEROTONIN SYNDROME).
> Anyway point being Eldepryl even low dose (perhaps even moreso than at higher dose), generally offsets anti-dopaminergic effect of anti-DA meds.
>
> Parnate inbetween Nardil and Elderpyl might go well with Zyprexa at very low dose.
>
> Ray
>Hi Ray, just watch out for those nasty movement disorders. Once you get one its hard to get rid of and it aint no fun.
Old School
Posted by cara52 on January 25, 2002, at 16:10:43
In reply to Re: Zyprexa and MAOIs?, posted by OldSchool on January 25, 2002, at 15:48:26
> > I've pondered Parnate + Zyperexa in past.
> > Was based on 1 day trial of 2mg zyprexa add in (dr. gave me samples), maybe about 2 years ago.
> >
> > 1)Added 2mg to Nardil 60 + Klonopin.
> > 2)As expected got sedated.
> > 3)Added 150 Wellbutrin.
> > 4)Incredible. Dramatic effect rest of day.
> >
> > Never thought more because too many meds but learned something.
> >
> > Currently trying low dose amisulpride.
> > Very interesting reminds me of zyperexa experience.
> > However not quite right with my regimen.
> > Cannot tolerate except very low dose (< 10mg/day!)
> >
> > Eldepryl makes sense. Decreases prolactin to counter amisulpride increase.
> > Eldepryl even low dose blocks sedation from tramadol for example, wheareas Nardil will not at 60mg, it will lead to increasing sedation and with enough tramadol serotonin syndrome (VERY BAD NEWS). (NOTE: NOT MAOI SCARE TACTIC, TRAMADOL + MANY ANTIDEPRESSANTS CAN LEAD TO SEROTONIN SYNDROME).
> > Anyway point being Eldepryl even low dose (perhaps even moreso than at higher dose), generally offsets anti-dopaminergic effect of anti-DA meds.
> >
> > Parnate inbetween Nardil and Elderpyl might go well with Zyprexa at very low dose.
> >
> > Ray
> >
>
> Hi Ray, just watch out for those nasty movement disorders. Once you get one its hard to get rid of and it aint no fun.
>
> Old SchoolHey Old school Please elaborate on what a movement disorder is and what you mean by it
being very hard to get rid of it?
Posted by OldSchool on January 25, 2002, at 17:25:01
In reply to Movement disorder Old School- Elaborate, posted by cara52 on January 25, 2002, at 16:10:43
> > Hi Ray, just watch out for those nasty movement disorders. Once you get one its hard to get rid of and it aint no fun.
> >
> > Old School
>
> Hey Old school Please elaborate on what a movement disorder is and what you mean by it
> being very hard to get rid of it?Movement disorders are the bane of the anti-psychotic drugs. Movement disorders includes a wide range of drug induced neurological disorders. This can range from EPS "extrapyramidal syndrome" to Tardive Dyskinesia to dystonia to parkinsons type symptoms. Anti-psychotic drugs block dopamine, which when the dopamine blockade is bad enough this can cause movement disorders to develop.
The older "typical" anti-psychotics cause movement disorders the most. Like Haldol, Thorazine, etc. The newer "atypical" anti-psychotics are purported to cause fewer movement disorders than the old anti-psychotics. This is true, however the risk for the atypicals is not zero. The atypicals can and do sometimes cause EPS and other movement problems.
Movement disorders are a bitch to deal with because once they develop, its not a psych condition its a physical, neurological condition. And many times drug induced movement disorders can be difficult to get rid of and be quite chronic. In the case of TD, it can also be quite embarassing and people will stare at you and stuff.
A mild movement disorder scenario might be the following. You go on an anti-psychotic and develop transient mild EPS. You might experience muscle contractions, "twitches" and other very mild parkinsons type symptoms. This will probably go away when the drug is stopped.
A worst case scenario might include the following. You go on an anti-psychotic drug and it induces a terrible condition known as Tardive Dyskinesia or even Parkinsons disease. Hard to get rid of and quite disabling. Quite chronic and longterm.
Treatments for movement disorders includes various drugs like anti-cholinergics, dopamine agonists like Amantadine, high dose vitamin E, klonopin, Buspar. Also, ECT is supposed to be quite effective for anti-psychotic drug induced movement disorders. ECT is used "off label" for parkinsons.
All that being said, the best way to deal with drug induced movement disorders is prevention. Dont let it occur to begin with.
Old School
Posted by david999 on January 25, 2002, at 18:33:14
In reply to Zyprexa and MAOIs?, posted by david999 on January 24, 2002, at 18:23:37
Hi, thanks for all the respones. They been very helpful. I talked to my doc today and he said I could try Celexa or Paxil. I'm off the Zyprexa and not going to try an MAOi. I picked Celexa but think I made a mistake and should of picked Paxil. I read many messages about how more sedating Paxil was. I think the more sedate I am the better I can talk (I currently have a speech disorder and block on words). Can anyone tell me how more sedating Paxil is over Celexa? I was wondering if I should switch. Thanks.
David
Posted by Dwight on January 27, 2002, at 18:46:33
In reply to Re: Zyprexa and MAOIs?, posted by david999 on January 25, 2002, at 18:33:14
David,
I have spasmodic dysphonia, a voice disorder similar to stuttering, and I've found that both Nardil and Neurontin help it to some extent. I believe that SD and stuttering are closely related--both have something to do with dopamine dysregulation in basal ganglia I think. The social anxiety goes along with both, as well as avoiding certain things--answering phone, saying name, etc. There's also a post in the Tips sections by a doc who claims one of his patients was cured of his stuttering by Nardil. I think both meds are worth a shot--probabaly more likely to work than the SSRIs. Also, both neurontin and nardil are helpful for social phobia.
good luck, Dwight> Hi, thanks for all the respones. They been very helpful. I talked to my doc today and he said I could try Celexa or Paxil. I'm off the Zyprexa and not going to try an MAOi. I picked Celexa but think I made a mistake and should of picked Paxil. I read many messages about how more sedating Paxil was. I think the more sedate I am the better I can talk (I currently have a speech disorder and block on words). Can anyone tell me how more sedating Paxil is over Celexa? I was wondering if I should switch. Thanks.
>
> David
Posted by kregpark@yahoo.com on January 29, 2002, at 3:25:28
In reply to Re: Zyprexa and MAOIs?, posted by OldSchool on January 25, 2002, at 15:48:26
>
> Hi Ray, just watch out for those nasty movement disorders. Once you get one its hard to get rid of and it aint no fun.
>
> Old SchoolOld School: (btw, kregpark=ray, ray got booted I guess).
You make a very good point. I have been looking into that stuff lately and it doesn't all look real rosy white with those drugs.
I figured before obviously it's wrong for low dopamine SP folks, but even in augmentation there is the EPS which I had not known virtually anything about until reading lately.
ray
Posted by Dwight on January 29, 2002, at 20:22:32
In reply to Re: Zyprexa and MAOIs?, posted by Dwight on January 27, 2002, at 18:46:33
> David,
> I have spasmodic dysphonia, a voice disorder similar to stuttering, and I've found that both Nardil and Neurontin help it to some extent. I believe that SD and stuttering are closely related--both have something to do with dopamine dysregulation in basal ganglia I think. The social anxiety goes along with both, as well as avoiding certain things--answering phone, saying name, etc. There's also a post in the Tips sections by a doc who claims one of his patients was cured of his stuttering by Nardil. I think both meds are worth a shot--probabaly more likely to work than the SSRIs. Also, both neurontin and nardil are helpful for social phobia.
> good luck, Dwight
>
>
>
>
>
>
>
> > Hi, thanks for all the respones. They been very helpful. I talked to my doc today and he said I could try Celexa or Paxil. I'm off the Zyprexa and not going to try an MAOi. I picked Celexa but think I made a mistake and should of picked Paxil. I read many messages about how more sedating Paxil was. I think the more sedate I am the better I can talk (I currently have a speech disorder and block on words). Can anyone tell me how more sedating Paxil is over Celexa? I was wondering if I should switch. Thanks.
> >
> > David
Posted by david999 on January 30, 2002, at 16:46:45
In reply to Re: MAOIs and Stuttering, for David. , posted by Dwight on January 29, 2002, at 20:22:32
Thank you for the message. It was very helpful. Could you tell me where that article is at? I was trying to find it but without luck. Thank you very much.
David
This is the end of the thread.
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