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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Caper on May 16, 2004, at 0:42:47
I may have mispelled the name of the med, but what it is is a combination of prozac and zyprexa (which is an anti-psychotic, but supposedly also used for mood stabilization). This is being praised as the first medication specifically FDA approved for Bipolars in a depressed phase. My questions and concerns are:
1. Is anyone taking it? If so could you tell me how it is working or not working for you? Side effects, how long it took to work (if it did), and anything else you'd like to share.
2. Has it caused weight gain? The patient info says 3% of placebo study participants reported weight gain, while 21% of those actually taking the med had weight gain, an average of 8 lbs. I think.3. The info I've read says to use caution when giving it to a patient with a family history of diabetes because it can cause ketoacidosis even in people who were not diabetic before, and often once this happens the patient remains diabetic. I have an extremely strong family history of diabetes, both type I and II, [both of my siblings have been diabetic since childhood and my mom has Type II] so I have not yet started the medication. I fully expect to become diabetic someday, but I'd like to delay it as long as possible! I've gained a lot of weight (though it's coming off now) from my year of alcoholism and I know that weight gain alone increases my risk of developing diabetes. So, I'm afraid to take the medicine, even though I've heard from my doc that it has worked on other patients when nothing else did. Anyone have advice about this?
I heard the medication works great but was then freaked out by the diabetes thing. Any thoughts? Especially from those who might be doctors or some sort or mental health professional?
I'd greatly appreciate any info you may have.
Thanks.
Caper
Posted by Caper on May 16, 2004, at 0:56:32
In reply to Symbyax for Bipolars:can someone share experience?, posted by Caper on May 16, 2004, at 0:42:47
I'd love to hear from anyone who has taken or is currently taking Symbyax, but I'm incredibly nervous and so would especially appreciate a response from a doctor with (even limited) experience with this med. Should I not take it because of the diabetes risk? Nothing else has worked so I'd love to give it a try, but I do _not_ need to add diabetes to my list of diagnoses (bipolar II, PTSD, and alcoholism).
Thanks,
Caper
> I may have mispelled the name of the med, but what it is is a combination of prozac and zyprexa (which is an anti-psychotic, but supposedly also used for mood stabilization). This is being praised as the first medication specifically FDA approved for Bipolars in a depressed phase. My questions and concerns are:
>
> 1. Is anyone taking it? If so could you tell me how it is working or not working for you? Side effects, how long it took to work (if it did), and anything else you'd like to share.
>
>
> 2. Has it caused weight gain? The patient info says 3% of placebo study participants reported weight gain, while 21% of those actually taking the med had weight gain, an average of 8 lbs. I think.
>
> 3. The info I've read says to use caution when giving it to a patient with a family history of diabetes because it can cause ketoacidosis even in people who were not diabetic before, and often once this happens the patient remains diabetic. I have an extremely strong family history of diabetes, both type I and II, [both of my siblings have been diabetic since childhood and my mom has Type II] so I have not yet started the medication. I fully expect to become diabetic someday, but I'd like to delay it as long as possible! I've gained a lot of weight (though it's coming off now) from my year of alcoholism and I know that weight gain alone increases my risk of developing diabetes. So, I'm afraid to take the medicine, even though I've heard from my doc that it has worked on other patients when nothing else did. Anyone have advice about this?
>
> I heard the medication works great but was then freaked out by the diabetes thing. Any thoughts? Especially from those who might be doctors or some sort or mental health professional?
>
> I'd greatly appreciate any info you may have.
>
> Thanks.
>
> Caper
>
Posted by bark2323 on May 16, 2004, at 8:06:33
In reply to Symbyax for Bipolars:can someone share experience?, posted by Caper on May 16, 2004, at 0:42:47
> I may have mispelled the name of the med, but what it is is a combination of prozac and zyprexa (which is an anti-psychotic, but supposedly also used for mood stabilization). This is being praised as the first medication specifically FDA approved for Bipolars in a depressed phase. My questions and concerns are:
>
> 1. Is anyone taking it? If so could you tell me how it is working or not working for you? Side effects, how long it took to work (if it did), and anything else you'd like to share.
I just started taking it like a month ago. Ive taken zyprexa many times before, and prozac once (I couldnt tolerate prozac by itself). I was "up" with some intruding depressive thinking starting to happen when I first went on it. It definately brought be down from my high immediately, though it doesnt really flatten me or anything, and after a few weeks it helped depression some. I have since added wellbutrin which has gotten rid of the rest of the depression. I think if I had waited longer though, I might not have needed the wellbutrin.
> 2. Has it caused weight gain? The patient info says 3% of placebo study participants reported weight gain, while 21% of those actually taking the med had weight gain, an average of 8 lbs. I think.
So far it has increased my appetite, but its to soon to tell if Ive gained any appreciable amount of weight. The increased appetite seems less strong on symbyax than when Ive been on zyprexa alone. The wellbutrin is also there to help the weight gain. You can ask your doc about this or other meds (amantadine and metformin ( metformin is actually used for diabetics) are supposed to help, as are H-2 blockers like axid or tagamet)
> 3. The info I've read says to use caution when giving it to a patient with a family history of diabetes because it can cause ketoacidosis even in people who were not diabetic before, and often once this happens the patient remains diabetic. I have an extremely strong family history of diabetes, both type I and II, [both of my siblings have been diabetic since childhood and my mom has Type II] so I have not yet started the medication. I fully expect to become diabetic someday, but I'd like to delay it as long as possible! I've gained a lot of weight (though it's coming off now) from my year of alcoholism and I know that weight gain alone increases my risk of developing diabetes. So, I'm afraid to take the medicine, even though I've heard from my doc that it has worked on other patients when nothing else did. Anyone have advice about this?
Get glucose tests when you start and periodically throughout the time youre on it. To me, it would be worth the risk; I think its an excellent medicine. But it might not be for you. As a side note, it really decreases my desire for alcohol.
> I heard the medication works great but was then freaked out by the diabetes thing. Any thoughts? Especially from those who might be doctors or some sort or mental health professional?
Seems to work great, but almost everyone does gain some weight, so look into the drugs mentioned above and talk to your doc. Also, supposedly those who have a higher BMI gain less. If you decide not to try symbyax you can always combine another atypical with an antidepressant and theoretically get similar results (risperdal, abilify, and geodon are all not associated with anywhere near as much weight gain as zyprexa), although the researh is best on the symbyax combination.
> I'd greatly appreciate any info you may have.
>
> Thanks.
>
> Caper
>
Hope this helps,
Matt
Posted by B2chica on May 17, 2004, at 8:25:33
In reply to Symbyax for Bipolars:can someone share experience?, posted by Caper on May 16, 2004, at 0:42:47
Hi Caper,
i was on Symbyax a while ago, unfortunately it didn't do me much good. I think i reacted badly to the prozac. My depression shot downward, however i could sort of feel it coming on a few days before i started it. i was on it for three weeks and ended up in the hospital, depression so bad. So i don't know if it was that it didn't work at all yet for me or if it made things worse.
i did get that really "flat" feeling, didn't care for that.
i didn't however, notice any weight gain. of course i had been on zyprexa before and didn't have a problem with weight gain then either.When they took me off the med i had a quite horrible reaction, luckily i was in the hosp. at the time, and the pdoc thought it was due to the zyprexa...but not 100% sure.
I don't want to scare you off trying this drug though. Cuz everyone is a little different and for the most part my pdoc was just raving about it saying it had excellent results...etc. So, just weigh the positive and negative carefully and remember you'll never know till you try. Keep an eye out on that diabetes thing though.
Hope you hear from a doc. about it.Best of luck
B2c.
Posted by Caper on May 18, 2004, at 4:05:42
In reply to Re: Symbyax for Bipolars:can someone share experience?, posted by bark2323 on May 16, 2004, at 8:06:33
Thanks for the info, you've been helpful. The part about decreasing your desire for alcohol is especially encouraging. Did you have a problem with alcohol before starting Symbyax?
Caper
> > I may have mispelled the name of the med, but what it is is a combination of prozac and zyprexa (which is an anti-psychotic, but supposedly also used for mood stabilization). This is being praised as the first medication specifically FDA approved for Bipolars in a depressed phase. My questions and concerns are:
> >
> > 1. Is anyone taking it? If so could you tell me how it is working or not working for you? Side effects, how long it took to work (if it did), and anything else you'd like to share.
> I just started taking it like a month ago. Ive taken zyprexa many times before, and prozac once (I couldnt tolerate prozac by itself). I was "up" with some intruding depressive thinking starting to happen when I first went on it. It definately brought be down from my high immediately, though it doesnt really flatten me or anything, and after a few weeks it helped depression some. I have since added wellbutrin which has gotten rid of the rest of the depression. I think if I had waited longer though, I might not have needed the wellbutrin.
> > 2. Has it caused weight gain? The patient info says 3% of placebo study participants reported weight gain, while 21% of those actually taking the med had weight gain, an average of 8 lbs. I think.
> So far it has increased my appetite, but its to soon to tell if Ive gained any appreciable amount of weight. The increased appetite seems less strong on symbyax than when Ive been on zyprexa alone. The wellbutrin is also there to help the weight gain. You can ask your doc about this or other meds (amantadine and metformin ( metformin is actually used for diabetics) are supposed to help, as are H-2 blockers like axid or tagamet)
> > 3. The info I've read says to use caution when giving it to a patient with a family history of diabetes because it can cause ketoacidosis even in people who were not diabetic before, and often once this happens the patient remains diabetic. I have an extremely strong family history of diabetes, both type I and II, [both of my siblings have been diabetic since childhood and my mom has Type II] so I have not yet started the medication. I fully expect to become diabetic someday, but I'd like to delay it as long as possible! I've gained a lot of weight (though it's coming off now) from my year of alcoholism and I know that weight gain alone increases my risk of developing diabetes. So, I'm afraid to take the medicine, even though I've heard from my doc that it has worked on other patients when nothing else did. Anyone have advice about this?
> Get glucose tests when you start and periodically throughout the time youre on it. To me, it would be worth the risk; I think its an excellent medicine. But it might not be for you. As a side note, it really decreases my desire for alcohol.
> > I heard the medication works great but was then freaked out by the diabetes thing. Any thoughts? Especially from those who might be doctors or some sort or mental health professional?
> Seems to work great, but almost everyone does gain some weight, so look into the drugs mentioned above and talk to your doc. Also, supposedly those who have a higher BMI gain less. If you decide not to try symbyax you can always combine another atypical with an antidepressant and theoretically get similar results (risperdal, abilify, and geodon are all not associated with anywhere near as much weight gain as zyprexa), although the researh is best on the symbyax combination.
> > I'd greatly appreciate any info you may have.
> >
> > Thanks.
> >
> > Caper
> >
> Hope this helps,
> Matt
>
Posted by Caper on May 18, 2004, at 4:11:42
In reply to Re: Symbyax for Bipolars:can someone share experie, posted by B2chica on May 17, 2004, at 8:25:33
Thanks for taking the time to tell how Symbyax worked (or rather, didn't work) for you. It's helpful to know that not everyone gains weight from it, since weight gain contributes to diabetes and that's my main fear. Sorry it didn't work out for you, but I appreciate your info as I make my decision.
Best wishes,
Caper
> Hi Caper,
> i was on Symbyax a while ago, unfortunately it didn't do me much good. I think i reacted badly to the prozac. My depression shot downward, however i could sort of feel it coming on a few days before i started it. i was on it for three weeks and ended up in the hospital, depression so bad. So i don't know if it was that it didn't work at all yet for me or if it made things worse.
> i did get that really "flat" feeling, didn't care for that.
> i didn't however, notice any weight gain. of course i had been on zyprexa before and didn't have a problem with weight gain then either.
>
> When they took me off the med i had a quite horrible reaction, luckily i was in the hosp. at the time, and the pdoc thought it was due to the zyprexa...but not 100% sure.
>
> I don't want to scare you off trying this drug though. Cuz everyone is a little different and for the most part my pdoc was just raving about it saying it had excellent results...etc. So, just weigh the positive and negative carefully and remember you'll never know till you try. Keep an eye out on that diabetes thing though.
> Hope you hear from a doc. about it.
>
> Best of luck
> B2c.
Posted by nmk on May 18, 2004, at 16:18:52
In reply to Re: Symbyax for Bipolars:can someone share experie » B2chica, posted by Caper on May 18, 2004, at 4:11:42
Hi there,
I tried it for four days and had to discontinue due to the SEVERE insomnia it caused. My doc then prescribed 20 mg of prozac in the am and 5 mg of zyprexa in the pm and was still having insomnia. Lowered the prozac dose to 10 mg and am doing much better. I haven't gained weight on this combo because he wrote a script for Glucophage to counteract the effects of the zyprexa weight gain. You may want to ask your doc about this option.
Posted by bark2323 on May 19, 2004, at 8:41:46
In reply to Re: Symbyax for Bipolars:can someone share experience? » bark2323, posted by Caper on May 18, 2004, at 4:05:42
Yes, I did have a problem with alcohol before zyprexa. I still drink now, but only at appropriate times/places like social events etc., instead of using it constantly. It completely takes away my craving for alcohol, along with treating a lot fo things I attempted to treat with alcohol. Id also like to say I am continuing to improve, though I dont know what to attribute to the symbyax or to the wellbutrin, although Im guessing most of it is symbyax. I agree with others that the prozac part is the possible trouble-maker in it, I would just take zyprexa with wellbutrin, but prozac does help a bit with anxiety and wellbutrin hasnt worked alone for me in the past so maybe something is going on there. But for a lot of people prozac is a great antidepressant, possibly better combined with the zyprexa according to "the literature." Zyprexa is the magical part for me though.
matt
Posted by bipolaremt on July 18, 2004, at 14:21:55
In reply to Symbyax for Bipolars:can someone share experience?, posted by Caper on May 16, 2004, at 0:42:47
> I may have mispelled the name of the med, but what it is is a combination of prozac and zyprexa (which is an anti-psychotic, but supposedly also used for mood stabilization). This is being praised as the first medication specifically FDA approved for Bipolars in a depressed phase. My questions and concerns are:
>
> 1. Is anyone taking it? If so could you tell me how it is working or not working for you? Side effects, how long it took to work (if it did), and anything else you'd like to share.
>
>
> 2. Has it caused weight gain? The patient info says 3% of placebo study participants reported weight gain, while 21% of those actually taking the med had weight gain, an average of 8 lbs. I think.
>
> 3. The info I've read says to use caution when giving it to a patient with a family history of diabetes because it can cause ketoacidosis even in people who were not diabetic before, and often once this happens the patient remains diabetic. I have an extremely strong family history of diabetes, both type I and II, [both of my siblings have been diabetic since childhood and my mom has Type II] so I have not yet started the medication. I fully expect to become diabetic someday, but I'd like to delay it as long as possible! I've gained a lot of weight (though it's coming off now) from my year of alcoholism and I know that weight gain alone increases my risk of developing diabetes. So, I'm afraid to take the medicine, even though I've heard from my doc that it has worked on other patients when nothing else did. Anyone have advice about this?
>
> I heard the medication works great but was then freaked out by the diabetes thing. Any thoughts? Especially from those who might be doctors or some sort or mental health professional?
>
> I'd greatly appreciate any info you may have.
>
> Thanks.
>
> Caper
>
Wondering if anyone else has an update on Symbyax?
I will be starting it this week.
This is the end of the thread.
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