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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 woolav on August 17, 2005, at 15:40:51
I am asking because I already take prozac, and have in the past taken zyprexa, even though i Hated zyprexa because of weight gain.
If anyone is taking this med, what side effects have you had??? also, I read that is it not good for the treatment of manic or hypo episodes??
S
Posted by med_empowered on August 17, 2005, at 16:41:45
In reply to Symbyax...........Is it only for depression?, posted by woolav on August 17, 2005, at 15:40:51
hey! Right now, Symbyax is only approved for depression--namely, depressive episodes in Bipolar Disorder, although there's pretty good evidence that atypical+antidepressant combos can be effective for treatment-resistant and/or severe cases of unipolar depression. My guess is that it was tested and approved for bipolar *depression* because there are lots of meds available to treat (hypo)mania, including Zyprexa. From what I've heard from my fellow "mentally interesting" friends, although its only approved for the depressed phase of bipolar disorder, it is being used as long-term maintenace...its really appealing to some docs since it minimizes the number of meds and takes the guess work out of dosing mood-stabilizer+anti-depressant combos. My own guess is that it will end up being used kind of like Triavil, the Elavil+perphenazine combo that hit the market in the 60s or 70s...even though Elavil by itself can cause "switching" and induce/worsen psychosis, the combo has been used for mixed-episodes, agitated depression, psychotic depression, bipolar, and schizophrenia/schizoaffective disorder. But, since Zyprexa can induce/worsen (hypo)mania in some cases when used as monotherapy (this happens with the other atypicals, and the conventional drugs when used at low doses), and Prozac has a reputation for making bipolar people much, much worse, I doubt there will be much use of it for treatment of acute mania...the protocol for controlling mania focuses mostly on sedation, behavioral control, and bringing the mood down to "normal" For that reason, antipsychotics, lithium, depakote, and benzos are all popular for acute mania, but antidepressants are mostly used in the depressed phase or in a long-term treatment combo. That said...Triavil has long been used in "agitated depression," which can often overlap with "mixed-episodes"; with the increasing recognition of mixed episodes, it wouldn't surprise me if Symbyax and future atypical+antidepressant combos were RX'd off-label for "mixed-epsidoes/dysphoric mania".
Posted by rjlockhart98 on August 17, 2005, at 18:47:02
In reply to Re: Symbyax...........Is it only for depression?, posted by med_empowered on August 17, 2005, at 16:41:45
I WAS on Symbyax (6mg Zyprexa/ 25mg Prozac) for a while.
I didnt really like the way it made me feel, i was kinda numbed the next day.
I still have the bottle.....
I take Prozac 20mg and Zyprexa 2.5mg.
Its mostly for Bipolar depression.
I dont think it would help unipolar (depressed 24/7) becuase the Zyprexa would may make it worse.
Best Wishes
Matt
Posted by SLS on August 17, 2005, at 18:58:17
In reply to Symbyax...........Is it only for depression?, posted by woolav on August 17, 2005, at 15:40:51
Although I don't really like the idea of combining into a single pill two drugs that might be better titrated separately, the combination itself should confer some anti-OCD effects as well as antidepressant effects.
- Scott
Posted by linkadge on August 17, 2005, at 20:09:27
In reply to Re: Symbyax...........Is it only for depression?, posted by SLS on August 17, 2005, at 18:58:17
I am under the impression that the majority of atypical antipsychotic augmentation effects in unipolar depression are due to their ability to block the 5-ht2a/c receptors.
I did get some benifit from adding an atyptical to an SSRI, but I got that same benefit from trazedone/remeron etc without the unnessary apathy.
(just my experience)
Linkadge
Posted by woolav on August 18, 2005, at 8:29:29
In reply to Re: Symbyax...........Is it only for depression?, posted by linkadge on August 17, 2005, at 20:09:27
You mentioned trazedone/remeron combo. I believe your not on meds right now, but did u take this combo?
Basically I am looking for meds that dont cause major cognatvie impairment and nor do i want to feel completely sedated..
I have depression and hypo episodes.
S
Posted by woolav on August 18, 2005, at 8:30:05
In reply to Re: Symbyax...Is it only for depression?LINKAGE, posted by woolav on August 18, 2005, at 8:29:29
Posted by linkadge on August 18, 2005, at 17:31:57
In reply to Re: Symbyax...Is it only for depression?LINKAGE, posted by woolav on August 18, 2005, at 8:29:29
I am not completely drug free at the moment. It has been almost 5 months, but I am still battling withdrawl, zaps, inability to walk properly dizziness, feelings of being pushed etc. I also have what appears to be certain permanant dyskinsia from the meds. I take the drugs periodically to relieve some of these symptoms. The drugs are completely and utterly physically and emotionally addicting IMO, (but thats another thread)
Both trazodone and remeron can be sedating unfortunately.
Some of that will wear off.
I know that my best combination was a low dose of an SSRI, with either trazodone or remeron at night.
Another good combo, was trazodone, fish oil, magnesium, taurine.
If you are do take a sedating med at night, strong coffee, or some b12 can get the ball rolling in the morning.Stay away from AP's unless you are truely psychotic.
I would personally treat hypomania with magnesium, and taurine, and perhaps a AD dosage adjustment.
If it accelerates into full blown mania, then perhaps an AP would be more justified.
Linkadge
Posted by woolav on August 19, 2005, at 14:17:42
In reply to Re: Symbyax...Is it only for depression?LINKAGE, posted by linkadge on August 18, 2005, at 17:31:57
This is the end of the thread.
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