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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by obsessivechris on March 15, 2002, at 18:54:02
Hi, i have ocd and i need some advice from you.
I am currently taking zyprexa (5 mg) and have been for close to 4 years. I want to get off of it because i have gained 100 pounds while on the drug, i weighed 140 when i started it, now i weigh 240 and i gained the weight really fast too, like 30 pounds a month. I tried exercising, walking 3 miles a day and i can't lose any weight, only gain. My docs have tried to get me off it a few times, which left the ssri's that i was taking at the time as my only med (luvox,celexa and prozac). And each time after a week of being off the zyprexa, my ocd got real bad. Let me explain to you as to what i mean by real bad:
I am the pure obsessive type, i don't have rituals for relief(i wish i did, i used to and it was not even close to this bad, i wouldget relief from the rituals, when i am not on the zyprexa, i got no relief, its just pure torture).I have obsessions with body parts, like having a heart attack, swallowing my tongue, going blind, deaf, ect. And while off the zyprexa, thats all i would think about during my waking hours and eventually it would get so bad to where i couldn't sleep and i had to start the zyprexa again. I would get psycho somatic pains in the areas i was obsessing on- the chest, throat,eyes, some in the head too. Then i would obsess on the imaginary pain that wasn't there and that made the anxiety even worse, unbearable would be the better word. I could barely talk on the phone and could not use the computer, let alone get out of the house, as i was so anxious. I don't even know if the term anxious would do justice in terms of describing what i was going through.
So my question to you is, why is zyprexa the only drug that has worked for me even though i am not psychotic? Furthermore, since the ssri's do not help, do you have any other drugs you would recommend that i ask my doctor about? I really don't want to keep taking zyprexa or any anti psychotics for that matter (i tried risperdal it didn't help, tried geodon and it helped somewhat but the weight gain was still there) because of the weight gain and sleepiness i get, i can sleep for 10 hours and still be tired. What urks me also is that taking the zyprexa seems like the only option because of the symptoms i get while being off it, its like i am trapped. *It should be noted that i experienced these same symptoms before i first started taking zyprexa. plse help.
sry for the essay...... i need help.... i am at my whits end... i feel so low and depressed especially with all the weight gain.. i cant lose it... :(
Posted by crazychickuk on March 15, 2002, at 18:56:49
In reply to shall i end it!!!!, posted by obsessivechris on March 15, 2002, at 18:54:02
your not alone hunny....go bk to the doc and tell him/her the way u feel.... and try other meds maybe u need an MOQI?
Posted by xjs7 on March 15, 2002, at 19:29:36
In reply to shall i end it!!!!, posted by obsessivechris on March 15, 2002, at 18:54:02
Hi Chris,
I also have a problem with severe anxiety that does not seem to respond to anything but antipsychotics, so you are not alone in that regards. I really have no idea why some anxiety disorders respond best to antipsychotics, even when the person is not psychotic. The SSRI's like Paxil also did not work on my anxiety (panic and agoraphobia). In fact, Paxil exacerabated the problem.
From your message I infer that you are considering suicide because of the weight gain. I hope you do not make an attempt at it, especially when medications have proven to be effective on your symptoms. If one medication (Zyprexa in your case) works on you, chances are that another medication would also work.
You say that Geodon was partly effective and also caused weight gain. From your message it seems that you gained the majority of your weight very fast with the Zyprexa, like in the first few months. Perhaps you did not give the Geodon enough time. It takes a lot of time sometimes to lose weight.
I certainly don't know enough about your situation to make a solid suggestion as to your next course of action; however, I am sending this message just to emphasize that there are other options psychiatry has to offer. There is a wide variety of antipsychotics (atypical and typical), not to mention older antidepressants besides Luvox, Celexa, and Prozac, and benzodiazepines, which have proven very effective for many suffering from severe anxiety.
Many people, including myself, feel 'trapped' on their medication; but if you look at this from a different angle, this means that the medication is making a positive change in your life overall.
I urge you to keep looking for the right drug for your condition, one that does not cause unacceptable side effects. And it is simply not true to say that you cannot lose the weight--anyone can lose weight!
I hope you find an answer soon.
xjs7
> Hi, i have ocd and i need some advice from you.
> I am currently taking zyprexa (5 mg) and have been for close to 4 years. I want to get off of it because i have gained 100 pounds while on the drug, i weighed 140 when i started it, now i weigh 240 and i gained the weight really fast too, like 30 pounds a month. I tried exercising, walking 3 miles a day and i can't lose any weight, only gain. My docs have tried to get me off it a few times, which left the ssri's that i was taking at the time as my only med (luvox,celexa and prozac). And each time after a week of being off the zyprexa, my ocd got real bad. Let me explain to you as to what i mean by real bad:
> I am the pure obsessive type, i don't have rituals for relief(i wish i did, i used to and it was not even close to this bad, i wouldget relief from the rituals, when i am not on the zyprexa, i got no relief, its just pure torture).I have obsessions with body parts, like having a heart attack, swallowing my tongue, going blind, deaf, ect. And while off the zyprexa, thats all i would think about during my waking hours and eventually it would get so bad to where i couldn't sleep and i had to start the zyprexa again. I would get psycho somatic pains in the areas i was obsessing on- the chest, throat,eyes, some in the head too. Then i would obsess on the imaginary pain that wasn't there and that made the anxiety even worse, unbearable would be the better word. I could barely talk on the phone and could not use the computer, let alone get out of the house, as i was so anxious. I don't even know if the term anxious would do justice in terms of describing what i was going through.
> So my question to you is, why is zyprexa the only drug that has worked for me even though i am not psychotic? Furthermore, since the ssri's do not help, do you have any other drugs you would recommend that i ask my doctor about? I really don't want to keep taking zyprexa or any anti psychotics for that matter (i tried risperdal it didn't help, tried geodon and it helped somewhat but the weight gain was still there) because of the weight gain and sleepiness i get, i can sleep for 10 hours and still be tired. What urks me also is that taking the zyprexa seems like the only option because of the symptoms i get while being off it, its like i am trapped. *It should be noted that i experienced these same symptoms before i first started taking zyprexa. plse help.
> sry for the essay...... i need help.... i am at my whits end... i feel so low and depressed especially with all the weight gain.. i cant lose it... :(
Posted by obsessivechris on March 15, 2002, at 19:55:46
In reply to finding the 'right' medication » obsessivechris, posted by xjs7 on March 15, 2002, at 19:29:36
thanx for that... but i need some sugestions...any one plse...
Posted by JohnX2 on March 15, 2002, at 20:25:20
In reply to Re: finding the 'right' medication » xjs7, posted by JohnX2 on March 15, 2002, at 20:22:59
This was for chris.
>
> Hi Chris,
>
> Don't let the "anti-psychotic" term on zyprexa mean anything to you. That is just a label that has to do with the process used to get the medicine approved with the FDA.
>
> Most medications used to treat manic-depression are antiepileptics, but we don't have epilepsy, just as you are not psychotic.
>
> One thing that is really nice about these atypical antipsychotics Zyprexa,Geodon,etc is how they work both on the "serotonin" chemical system and the "dopamine" chemical system. Remember the regular medicines for OCD like Paxil, Luvox, etc work on the serotonin system. But these medicines are not perfect by any means. In fact these antipsychotic medicines do something very specific in the serotonin system that quickly helps to relieve agitation/anxiety that the pharmaceutical companies would DIE to somehow incorporate into these SSRI medications. This would give these SSRI medications an extra "widget" to cause less side effects/start up anxiety and a quicker response time.
>
> It just so happens that the chemical structures that are really good at massaging these serotonin structures that quickly relieve anxiety/agitation also block dopamine (which gives them some anti-psychotic profile). This is why the medicines usually get FDA approval 1st for treatments like schizophrenia. But many doctors prescribe them for anxiety,sleep,depression,mania in manic-depression, OCD, etc. I have taken zyprexa for my bipolar disorder (manic-depression). It helped my sleep and agitation quite a bit.
>
> Best Regards
> John
>
>
>
>
> > Hi Chris,
> >
> > I also have a problem with severe anxiety that does not seem to respond to anything but antipsychotics, so you are not alone in that regards. I really have no idea why some anxiety disorders respond best to antipsychotics, even when the person is not psychotic. The SSRI's like Paxil also did not work on my anxiety (panic and agoraphobia). In fact, Paxil exacerabated the problem.
> >
> > From your message I infer that you are considering suicide because of the weight gain. I hope you do not make an attempt at it, especially when medications have proven to be effective on your symptoms. If one medication (Zyprexa in your case) works on you, chances are that another medication would also work.
> >
> > You say that Geodon was partly effective and also caused weight gain. From your message it seems that you gained the majority of your weight very fast with the Zyprexa, like in the first few months. Perhaps you did not give the Geodon enough time. It takes a lot of time sometimes to lose weight.
> >
> > I certainly don't know enough about your situation to make a solid suggestion as to your next course of action; however, I am sending this message just to emphasize that there are other options psychiatry has to offer. There is a wide variety of antipsychotics (atypical and typical), not to mention older antidepressants besides Luvox, Celexa, and Prozac, and benzodiazepines, which have proven very effective for many suffering from severe anxiety.
> >
> > Many people, including myself, feel 'trapped' on their medication; but if you look at this from a different angle, this means that the medication is making a positive change in your life overall.
> >
> > I urge you to keep looking for the right drug for your condition, one that does not cause unacceptable side effects. And it is simply not true to say that you cannot lose the weight--anyone can lose weight!
> >
> > I hope you find an answer soon.
> >
> > xjs7
> >
> > > Hi, i have ocd and i need some advice from you.
> > > I am currently taking zyprexa (5 mg) and have been for close to 4 years. I want to get off of it because i have gained 100 pounds while on the drug, i weighed 140 when i started it, now i weigh 240 and i gained the weight really fast too, like 30 pounds a month. I tried exercising, walking 3 miles a day and i can't lose any weight, only gain. My docs have tried to get me off it a few times, which left the ssri's that i was taking at the time as my only med (luvox,celexa and prozac). And each time after a week of being off the zyprexa, my ocd got real bad. Let me explain to you as to what i mean by real bad:
> > > I am the pure obsessive type, i don't have rituals for relief(i wish i did, i used to and it was not even close to this bad, i wouldget relief from the rituals, when i am not on the zyprexa, i got no relief, its just pure torture).I have obsessions with body parts, like having a heart attack, swallowing my tongue, going blind, deaf, ect. And while off the zyprexa, thats all i would think about during my waking hours and eventually it would get so bad to where i couldn't sleep and i had to start the zyprexa again. I would get psycho somatic pains in the areas i was obsessing on- the chest, throat,eyes, some in the head too. Then i would obsess on the imaginary pain that wasn't there and that made the anxiety even worse, unbearable would be the better word. I could barely talk on the phone and could not use the computer, let alone get out of the house, as i was so anxious. I don't even know if the term anxious would do justice in terms of describing what i was going through.
> > > So my question to you is, why is zyprexa the only drug that has worked for me even though i am not psychotic? Furthermore, since the ssri's do not help, do you have any other drugs you would recommend that i ask my doctor about? I really don't want to keep taking zyprexa or any anti psychotics for that matter (i tried risperdal it didn't help, tried geodon and it helped somewhat but the weight gain was still there) because of the weight gain and sleepiness i get, i can sleep for 10 hours and still be tired. What urks me also is that taking the zyprexa seems like the only option because of the symptoms i get while being off it, its like i am trapped. *It should be noted that i experienced these same symptoms before i first started taking zyprexa. plse help.
> > > sry for the essay...... i need help.... i am at my whits end... i feel so low and depressed especially with all the weight gain.. i cant lose it... :(
Posted by TSA West on March 15, 2002, at 21:18:23
In reply to Re: finding the 'right' medication, posted by obsessivechris on March 15, 2002, at 19:55:46
You need to try clomipramine, the most serotonergic antidepressant there is. Clomipramine is the gold standard by which antidepressants are measured for OCD-fighting capability. Also, it is still the most cost-effective medication among inpatients with depression, due to its affinity for the serotonin and norepinephrine pump.
> thanx for that... but i need some sugestions...any one plse...
Posted by Sue Doe on March 15, 2002, at 21:45:14
In reply to shall i end it!!!!, posted by obsessivechris on March 15, 2002, at 18:54:02
plse help.
...... i need help.... i am at my whits end... i feel so low and depressed especially with all the weight gain.. i cant lose it... :(Maybe your downfall is actually a virtue. If you are indeed compulsive, be compulsive. I have found that by reading the intelligent and sympathetic posts found here, I have learned more about my condition and how to deal with it than I have with years of research. These folks know their stuff.
Keep asking, and keep reading. Be compulsive. I believe that better health and understanding is available to all of us.
I believe that we are not ill. We are just different. Our brains work differently than most guy's. We need to learn what's up.
Hope I said something. I thought I did.
Sue Doe (Nym)
Posted by Kat26 on March 16, 2002, at 0:50:43
In reply to Be obsessive, chris. And keep searching here! » obsessivechris, posted by Sue Doe on March 15, 2002, at 21:45:14
Hello Chris
as a longtime OCD-sufferer (now fortunately under control with Prozac, which in my case helps a lot) I understand that this TERRIBLE illness can make you feel desperate (but the answer to your question, should you end it all, is nevertheless NO!! There is always hope).
Somebody suggested Clomipramine (Anafranil), which is definitely worth a try!
Also,PLEASE, whatever you try, don't give up hope. I have een at a point where i could hardly imagine it ever getting better, and still it did.
I did have compulsions too (checking stuff etc), but I remember when I was younger (13, 14...) I had those body-obsessions a lot, would wake up my parents in the middle of the night to tell them, I feel a pain in my heart, could I be having a heart attack, etc... so embarrassing, but I couldn't do anything about it!
Are you in any kind of therapy?Kat26
Posted by Chloe on March 16, 2002, at 20:31:57
In reply to Re: finding the 'right' medication, posted by obsessivechris on March 15, 2002, at 19:55:46
Chris,
I don't know if it would be appropriate for you and your diagnosis...But Topamax, an anticonvulsant, is often prescribed to patients who experience severe weight gain from psychiatic meds, particularly depakote and the atypical antipsychotics (like Zyprexa). Topamax tends to have an appetite suppressant quality, and perhaps added to your Zyprexa regime, could aid in your weight problem.Let me just say though, Topamax is not a miracle cure. It's not one of the most easily tolerated medications. I had trouble with side effects. But others manage ok on it. Check Topamax out in the archives...You can obsess about that for a while :) since there are a lot of good information there.
Take care and don't give up!
Chloe
Posted by Cressida on March 16, 2002, at 23:36:04
In reply to shall i end it!!!!, posted by obsessivechris on March 15, 2002, at 18:54:02
My situation is best described as someone who has ADD, with relatively severe OCD in addition. I was recently put on Zyprexa for insomnia, but it seems to be improving my anxiety and obsessive-compulsive tendencies. I am rather surprised over this spill-over affect, but I'm extremely glad and grateful for it...finally something that really, really works. Now, I do feel "bad" and "guilty" in a strange sense, as I am not yet willing to give full credit to an anti-psychotic drug. I really don't at all, but I have to get over it. Maybe you can suggest a trial of a medication from another class of drugs; i.e. the atypical ADs like Remeron, Serzone, Effexor, or Wellbutrin. Maybe you can change any bad eating habits. Maybe you can start lifting weights three times a week. Anyhow, I wish you well. Hang in there and don't be so hard on yourself. You're definately trying.
Posted by Denise528 on March 17, 2002, at 10:41:15
In reply to I am OCD and new to Zyprexa » obsessivechris, posted by Cressida on March 16, 2002, at 23:36:04
Cressida,
You sound like you are reading my mind. This time round Zyprexa is the only drug which has helped me when the SSRIs and tryciclics used to. I too cannot quite come to terms with the fact that it is an Anti Psychotic that is helping me and not an AD. This is bugging me so much that I keep coming off it, am now trying lithium, prozac, Sam-e, St Johns Wort, B Complex vitamens, omega 3 fatty acids,none of which are doing anything at all. Sometimes when I take 10mg of Zyprexa I actually feel quite good the next day but I can't seem to accept the fact that an AP is helping me and an AD istn't. I just wish I could just take 20mg of Paxil like I used to and the depression would instantly lift. I'm still not sure whether to give in and just take the Zyprexa or not, I'll continue to read the arguments for and against and see if I can somehow persuade myself that taking them istn't so bad.
Denise
Posted by Cressida on March 17, 2002, at 16:33:32
In reply to I am OCD and new to Zyprexa Cressida, posted by Denise528 on March 17, 2002, at 10:41:15
Yeah, it's strange when it seems you're reading your own writing. Well, I take 20mg of Paxil as well; I really do. Is it presently part of your medication regimen?
Regarding Zyprexa, I'm kinda hoping my pdoc increases the dose from 2.5/5mg to 10mg or 15mg on my next appointment, which is in roughly two weeks. In the previous post I mentioned that it's having an affect I didn't anticipate - it's working more like an AD than a AP; it's working more like an anti-anxiety & anti-obsessive AD than a AP. Keep in mind that I do not know much about theory or action of anti-psychotic drugs. Maybe it's working as designed...???...Anyhow, anxiety, OCD and ADD are three issues I deal with on a daily basis, and I'm glad Zyprexa is having such a positive spanning affect on them. Zyprexa has made an impact where others have not. It is also not creating strange or odd side-effects that I experience sometimes with SSRIs (i.e. fleeting episodes of depersonalization and increased anxiety). Moreover, it appears that Zyprexs starts working faster than many of the ADs; prior to Paxil I was on 100-200mg of Zoloft. Since my well-being is more important than a social stigma, I've been trying to disregard my own negative opinions about psychotropic medications. Maybe you, Denise528, need to do some re-thinking if you want to remain happy and healthy. So, good luck with persuading yourself, etc...Take care. &8-]~John (a.k.a. Cressida / Sweenz)
Posted by Denise528 on March 18, 2002, at 12:43:41
In reply to A Small World Indeed - How Similar We Are..., posted by Cressida on March 17, 2002, at 16:33:32
Hi,
Yes I was on Paxil, which used to work wonderfully but doestn't seem to work anymore which is so frustrating. The Zyprexa has helped me enourmously although without wanting to sound ungrateful or greedy I'm not getting the same feeling that I did with Paxil. Whilst the Zyprexa takes away the anxiety, gives me an appetite, lots more energy and better concentration sometimes I feel slightly detached on it. I agree that it works very quickly, it gives me calm and serenity within 24 hours but then paxil only used to take 4 days to work. I plan to try all of the drugs that I can and if no other works then I'll go back to the Zyprexa. Hopefully it will still continue to help me, believe me it is the thought that the Zyprexa is there if needed that keeps me going. Good luck in your search although it sounds as though you've already found the right medication for you.
Denise
Posted by OldSchool on March 18, 2002, at 21:21:55
In reply to I am OCD and new to Zyprexa Cressida, posted by Denise528 on March 17, 2002, at 10:41:15
> Cressida,
>
> You sound like you are reading my mind. This time round Zyprexa is the only drug which has helped me when the SSRIs and tryciclics used to. I too cannot quite come to terms with the fact that it is an Anti Psychotic that is helping me and not an AD. This is bugging me so much that I keep coming off it, am now trying lithium, prozac, Sam-e, St Johns Wort, B Complex vitamens, omega 3 fatty acids,none of which are doing anything at all. Sometimes when I take 10mg of Zyprexa I actually feel quite good the next day but I can't seem to accept the fact that an AP is helping me and an AD istn't. I just wish I could just take 20mg of Paxil like I used to and the depression would instantly lift. I'm still not sure whether to give in and just take the Zyprexa or not, I'll continue to read the arguments for and against and see if I can somehow persuade myself that taking them istn't so bad.
>
> DeniseDid you try Anafranil and get a good blood level of that? How about high dose Buspar augmentation of high dose Luvox? I hate to hear about people with OCD having to resort to atypical anti-psychotics.
Old School
Posted by Cressida on March 20, 2002, at 22:44:48
In reply to Re: I am OCD and new to Zyprexa Cressida, posted by OldSchool on March 18, 2002, at 21:21:55
I have tried neither Anafranil nor Luvox. As far I know I'm taking Zyprexa for a sleep disturbance. However, it seems to be helping my OCD and anxiety a little - an unexpected positive side-effect I guess. I take 20mg or Paxil for my OCD, anxiety and depression.
A question: Is 20mg an average or low dose? If I'm still obsessing over trivial things; still experiencing a lot of generalized anxiety; and still really moody, are those reason enough to suggest an increase of Paxil to the doctor? Sometimes I'm unsure on how to approach a situation like this with my pdoc. Another problem of mine is doubting too much. Is that OCD or anxiety? &:-]
~John (a.k.a. Cressida)
Posted by Kat26 on March 21, 2002, at 17:45:24
In reply to Follow-up: Zyprexa, Paxil, and a ???, posted by Cressida on March 20, 2002, at 22:44:48
Hello,
I am a fellow OCD sufferer. I have heard OCD being called "the doubting disease", so I guess doubting is a common symptom. Anxiety actually IS a symptom of OCD, if you ask me. But I know what you mean, OCD as opposed to "general anxiety disorder" or something like that, right?Kat26
This is the end of the thread.
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