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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by greywolf on April 26, 2004, at 21:52:10
The FDA apparently approved a drug called Symbyax for bipolar depression recently. Does anyone have any experience with it?
Posted by snapper on April 26, 2004, at 22:54:04
In reply to Does anyone know anything about Symbyax for BP?, posted by greywolf on April 26, 2004, at 21:52:10
yeah, its' a combo of Zyprexa and Prozac--- it is'nt really novel or *new* in respect to being any more effective than if you happen to respond to Z. as a MS or Augmenter and Prozac as an AD. in otherwords AP and AD all in one. IMHO just another $$$ deal from Big Pharma. I don't think it has been that much of a hit!
S
Posted by chemist on April 26, 2004, at 23:03:55
In reply to Does anyone know anything about Symbyax for BP?, posted by greywolf on April 26, 2004, at 21:52:10
> The FDA apparently approved a drug called Symbyax for bipolar depression recently. Does anyone have any experience with it?
it's listed, but therapeutic indications are unavailable to me....symbyax is an attempt by lilly - which has not made their numbers for a long time - to reformulate 2 drugs into one (last attempt: serafem, simply a smaller dosage of prozac in a pink pill targeted for the dubious PMDD in women). symbyax is prozac+zyprexa, and the reason it is on the market is that the patent expired on prozac (fluoxetine) 3 years ago, and the PMDD crowd has gotten wise to the fact that you can get generic fluozetine tablets and cut them in half. enough said. symbyax will cost you more than 2 scripts, one for generic fluoxetine, and the other for (still under patent) zyprexa. presumably, the fluoxetine will offset the weight gain associated with zyprexa, but the real reason this combo is out there is to increase revenue for lilly. again, it's prozac + zyprexa. proceed at your own risk, and prozac is among the most stimulating ssris, so unless your bipolar is more towards the depressed side, dump it. even if it is, get the generic fluoxetine and the zyprexa prn......all the best, chemist
Posted by SLS on April 27, 2004, at 6:02:51
In reply to Re: Does anyone know anything about Symbyax for BP? » greywolf, posted by chemist on April 26, 2004, at 23:03:55
> > The FDA apparently approved a drug called Symbyax for bipolar depression recently. Does anyone have any experience with it?
> again, it's prozac + zyprexa. proceed at your own risk, and prozac is among the most stimulating ssris, so unless your bipolar is more towards the depressed side, dump it. even if it is, get the generic fluoxetine and the zyprexa prnI was pretty irritated when I first heard about this combination preparation. Of course it's a money thing, but they can't make money unless doctors are silly enough to prescribe it. This strategy has been used before. Triavil is a very old drug preparation that combines an AD (amitriptyline) with an AP (perphenazine), and, like Symbyax, is available in two ratios of AD/AP. I guess the reason I was irritated was because I felt it would discourage doctors from optimizing an individual's treatment by titrating each drug independently. For those people who need higher dosages of fluoxetine (Prozac), this would foster a situation whereby the patient ends up taking more olanzapine (Zyprexa) than is ideal. This leads to an unnecessary increase in undesirable side effects and risks.
I will disagree with Chemist on one point. To glean the anti-manic, antidepressant, and mood-stabilizing therapeutic effects of Zyprexa, I believe that it should be taken on a daily basis at the same dosage.
- Scott
Posted by greywolf on April 27, 2004, at 12:45:32
In reply to Re: Does anyone know anything about Symbyax for BP?, posted by SLS on April 27, 2004, at 6:02:51
Wow. You guys know your stuff. Thanks for the much needed insights. I'll know more about what I'm talking about when I see my doc.
Thank you.
Posted by chemist on April 27, 2004, at 14:29:57
In reply to Re: Does anyone know anything about Symbyax for BP?, posted by SLS on April 27, 2004, at 6:02:51
> > > The FDA apparently approved a drug called Symbyax for bipolar depression recently. Does anyone have any experience with it?
>
> > again, it's prozac + zyprexa. proceed at your own risk, and prozac is among the most stimulating ssris, so unless your bipolar is more towards the depressed side, dump it. even if it is, get the generic fluoxetine and the zyprexa prn
>
> I was pretty irritated when I first heard about this combination preparation. Of course it's a money thing, but they can't make money unless doctors are silly enough to prescribe it. This strategy has been used before. Triavil is a very old drug preparation that combines an AD (amitriptyline) with an AP (perphenazine), and, like Symbyax, is available in two ratios of AD/AP. I guess the reason I was irritated was because I felt it would discourage doctors from optimizing an individual's treatment by titrating each drug independently. For those people who need higher dosages of fluoxetine (Prozac), this would foster a situation whereby the patient ends up taking more olanzapine (Zyprexa) than is ideal. This leads to an unnecessary increase in undesirable side effects and risks.
>
> I will disagree with Chemist on one point. To glean the anti-manic, antidepressant, and mood-stabilizing therapeutic effects of Zyprexa, I believe that it should be taken on a daily basis at the same dosage.
>
> - Scottchemist here....i defer to Scott in his assertion, as it is clear from his posts that he is much more in-tune with meds such as zyprexa (and is no slouch overall, in my opionion, i think Scott and Panda have quite a bit of excellent knowledge to share, and it all seems to be well-researched and thorough) than i.....all the best, chemist
Posted by snapper on April 27, 2004, at 23:09:47
In reply to Re: Does anyone know anything about Symbyax for BP? » SLS, posted by chemist on April 27, 2004, at 14:29:57
I tend to think that a multi-faceted approach and dialouge in and amongst ourselves in regards to all the *crazy meds* thier pros and cons etc is very important.......SLS you really know your meds
and chemist you really know your "chemistry" I personally glean a lot of worthy info from both of you (not to exclude) any one else here, but, I am utterly amazed at the wealth of info that is available here and think that the mere fact that these types of exchanges of med info are very integral to helping each of us in trying to get *well*...I too am very knowedgeable about meds...however because of the severity of my cognitive difficulties... I find it very hard to retain much of the info that I gather and then my pdoc just seems to think I am too focused on meds.....arrrgghhh!!! I think at times I am 'too knowedgeble on meds and that drives me crazy too!!
Of the 50 or so meds that I have taken in the last 14 years, only 2 or 3 stand out in order of any signifcance to helping me...they are either addicting or they poop out or the s/e's are intolerable or are just plain worthless :( ....anyhow just my thoughts...
snapper
Posted by SLS on April 28, 2004, at 6:05:49
In reply to Re: Does anyone know anything about Symbyax for BP?, posted by snapper on April 27, 2004, at 23:09:47
> Of the 50 or so meds that I have taken in the last 14 years,
Holy crap. You'd give me a run for my money!
> only 2 or 3 stand out in order of any signifcance to helping me
Which ones? What are you trying to treat? I always try to use my reactions to different medication as clues as to what's going on between my ears.
Thanks for your flattering comments.
I hope you find something soon. Your persistent search for answers and stubborness not to give up while struggling just to survive is nothing short of heroic. This is true of many, many people here. We all deserve a pat on the back - every day.
- Scott
Posted by judy1 on April 28, 2004, at 11:08:10
In reply to Re: Does anyone know anything about Symbyax for BP?, posted by snapper on April 27, 2004, at 23:09:47
well I've finally 'met' someone who has taken as many meds as I have. I agree 100% with the earlier posters concerning symbyax- I also see it as a ploy by big pharma to make more money and basically useless as an effective med. Since I also am so treatment resistant, my docs treat episodes- in my case my very destructive manias. I take depakote and zyprexa (if psychotic) until stable and then taper off since I get depressed quite easily from depakote. Depressions are treated with therapy and opiates (fortunately I don't have too many depressive episodes). The only med I take full time is klonopin, and that has been extremely effective for panic disorder.
best of luck- judy
Posted by snapper on April 28, 2004, at 20:20:02
In reply to Re: Does anyone know anything about Symbyax for BP?, posted by SLS on April 28, 2004, at 6:05:49
> > Of the 50 or so meds that I have taken in the last 14 years,
>
> Holy crap. You'd give me a run for my money!
> Yeah isn't rediculous? Of course some of these were only given to me for brief periods of time to augment or what not...none the less it is still dis-heartening :(
> > only 2 or 3 stand out in order of any signifcance to helping me
>
> Which ones? What are you trying to treat? I always try to use my reactions to different medication as clues as to what's going on between my ears.
> Initially we thought we were just treating good ol' run of the mill major depression...loldoxepin made me semi-hypo manic and I quit taking it ...thinking I was well-then re-instated it 3 or 4 other times to no avail!
I have an ugly combo of BP II , GAD,OCD,Sp-w atypical features etc, and I did quite abit of self medicating along the way w/alcohol..in re to best meds, I'd say Parnate
FXR, and Adderall which the latter is obviously not a good long term solution to mental well being! I tend to be very resistant to meds and realize that may hve something to do with a little bit of Dysthymia in childhood and early adult hood... damn its' frustrating---so I guess you could say I have "double or triple depression" lol - I really hate the DSM criteria and categories because I do seem to fit them pretty well . but who knows ?when you'r in the thick of a long un-mitigated depression , it seems that many of the diagnosis' kind of over lap and I try not to dwell on them but.....
> Thanks for your flattering comments.
> Your quite welcome :)
> I hope you find something soon. Your persistent search for answers and stubborness not to give up while struggling just to survive is nothing short of heroic. This is true of many, many people here. We all deserve a pat on the back - every day.
> I hope you find something too very soon and all of the other suffering souls here as well!
> Snapper
> - Scott
This is the end of the thread.
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