Shown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by ace on October 16, 2005, at 1:58:32
Nardil 90mg
Seroquel 150mg
Xanax 2mg
Anxiety (ALL forms)- 98% abolished
Depression (even though I'm living in a third world condition house!)- 90% abolished
OCD (psychotic elements)- 85%- 95% abolishedOnly problem is extreme weight gain
Topomax- NO help
Metaformim (sp??) - NO help- big s/effects
Should I just stay fat????From an extremely unwell person (over 30 psychiatrists were baffled by my seemingly intractable anxiety, OCD, a depression) I am doing SO well.
Wouldn't i be crazy to stop??
Ace!!!
Posted by med_empowered on October 16, 2005, at 4:08:38
In reply to I'm doing great! BUT............................, posted by ace on October 16, 2005, at 1:58:32
hmmm...tricky situation. I think the first thing to do would be to try to medicate the weight loss, so its easier to lose w/ exercise and diet. If that truly fails, then it may well be time to consider a change in your "core" meds. Have you tried a traditional, stimulant-type diet pill? They would be tricky to use, considering you're taking both an MAIO and an antipsychotic, but the benefits could be great. In addition to the "golden oldies"--phendimetrazine, phentermine, tenuate, didrex-- there's also Meridia. Meridia costs more, and there are some health conerns with it, but from what I understand its been used to counteract zyprexa-induced weight gain with some success...plus, unlike the older, traditional diet pills which were designed and tested for 8-12 weeks of as-needed use, Meridia has some good data behind it for long-term use. With proper monitoring, it could be useful. Although not usually used for weight loss anymore, stimulants such as Dexedrine, Adderall, and Ritalin could also be used; in low-doses, these could help with your depression, possibly offer benefits with motivation, and also work on decreasing intake and upping your metabolism to burn off extra calories. Desoxyn would be a really potent potential add-on, but its not a very popular stimulant. Provigil (modafanil) seems to have some mild weight-reducing properties; I read a case report where adding provigil to a pre-existing clozapine regimine resulted in a significant reduction of weight, although the patient's weight did not quite return to baseline (keep in mind that this is with clozapine, which in addition to causing massive weight gain also causes **dense** sedation; my guess would be that modafanil+your regimine would have more pronounced results). The only problem with modafanil is its new-ness; no one really knows how it works, and I don't know if docs have yet figured out if it can be combined with MAOIs and, if so, how exactly to go about such a combo.
Finally...as much as I hate to suggest you switch up your core meds after having so much success, I kind of think that maybe if you switched out the seroquel you'd feel better. I read a study where patients switched from zyprexa to abilify (this was full-dose treatment for schizophrenia) lost a considerable amount of weight; they also became more active overall. Abilify in and of its self won't drop weight, but it's weight neutral and (usually) non-sedating, so it will allow your body to return to a more normal state and help you lose weight (keep in mind: abilify may cause blood sugar issues, but they don't seem quite as pronounced as those caused by other drugs, and the problem isn't also accompanied by weight gain). Dosing with antipsychotics is tricky, but I bet if you started on a "sub-therapeutic" dose of Abilify (ex: start at 2.5mgs, go to 5 for a little while, maybe try out 7.5...the usual dose is 10-15mgs), you might find a low-dose that works for you. My only advice from experience would be keep it at or below 10mgs; the jump from 10-15mgs meant a huge increase in side-effects for me, and I've heard this from other people, too. The downside would be increased activation and possibly an increase in anxiety (this is usually temporary, and abilify actually helps some people with anxiety) and a reduction in anti-anxiety effects that you were getting from seroquel. All I could recommend there would be possibly upping the xanax for a while or permanently, adding an old-school antihistamine to mimic some of seroquel's actions (hydroxyzine might be good), or possibly keeping LOW dose (say, 25mgs) seroquel on for as-need use in high-anxiety situations. A switch from seroquel to abilify (or geodon..I just find geodon scary b/c of the heart problems) along with co-prescription of a mild stimulant (i.e., modafanil), a weight-reducing medication (i.e., sibutraime) or a blood-sugar adjusting med (i.e, metformin) seems like it could produce the most results in the shortest period of time. Then again..it could also produce the most side effects. Sorry this was sooooooo long..I wish you the best of luck, and please keep us all posted on your progress.
Posted by SLS on October 16, 2005, at 9:35:08
In reply to I'm doing great! BUT............................, posted by ace on October 16, 2005, at 1:58:32
> Nardil 90mg
> Seroquel 150mg
> Xanax 2mg
>Nice combination.
> Only problem is extreme weight gain
Take a quick look at amantadine.
I don't know if it can reverse weight gain, but it certainly seems to help prevent it when antipsychotics are used.
- Scott
Posted by ed_uk on October 16, 2005, at 10:42:18
In reply to I'm doing great! BUT............................, posted by ace on October 16, 2005, at 1:58:32
Hi Andrew,
You can't combine Nardil with sibutramine (Meridia) I'm afraid. Meridia inhibits the reuptake of serotonin. Life-threatening serotonin syndrome would be a likely result.
Old-school diet pills such as phentermine are essentially valueless since they're of no long-term benefit. In addition, stimulant-type drugs can induce severe hypertension and cardiovascular side effects which would be particularly hazardous for someone who's already overweight. Alone, diet pills commonly cause hypertension. In combination with Nardil, a hypertensive crisis is likely.
Orlistat (Xenical) is probably the safest weight loss drug. Serious side effects are unlikely. Orlistat reduces the GI absorption of fat - it is not a stimulant. Unfortunately, oily diarrhea is a particularly common side effect. On the other hand, the diarrhea can be minimised by reducing dietary fat intake. Supplementation with fat soluble vitamins, particularly vitamin D, may be advisable: orlistat has been reported to reduce the intestinal absorption of fat-soluble vitamins.
As Med suggested, switching from Seroquel to Abilify might be advantageous. Abilify is less likely to cause weight gain than other atypical antipsychotics. Whether Abilify would effectively control your anxiety is impossible to predict.
Kind regards
~Ed
Posted by tecknohed on October 16, 2005, at 14:46:58
In reply to I'm doing great! BUT............................, posted by ace on October 16, 2005, at 1:58:32
Hi Ace
Its great that you're doing so well!
I'm afraid I dont have any advise for your weight issue, though i wonder, have you any history of weight/over eating problems, or has your food intake or activity changed? Any metabolism or thyroid problems, past or present (would thyroid hormone be worth a look)? Any carb cravings?I also have a few unrelated questions, if I may?
Is Social phobia part of your anxiety symptoms?
A few months ago I remember you said you had increased the Nardil pretty high and that you had extremely good results. Now you're back on 90mg. What happened?
Also, I wondered if you'd ever used modafinil or adrafinil with Nardil and what experience you had? (I'm on this combo at the mo)
Sorry for all the questions.
Take care,
Teck.
Posted by chand2407 on October 16, 2005, at 18:18:55
In reply to Re: I'm doing great! BUT............................ » ace, posted by ed_uk on October 16, 2005, at 10:42:18
i went to a weight dr and he prescribed phentermine. i was already taking paxil and he told me it was ok. well i took those two meds and i had bad reaction. i started having thoughts of hurting my youngest son. i could not stand to be around him. he went over my mothers house and i went to mhmr and the dr gave me zoloft 50mg. well that worked for about 2 years. and then again i started having those thoughts and he back at my moms house now. the psyc gave me effexor xr and risperdal to take. the effexor xr made my blood pressure go and the risperdal mae me have bad nightmares and headaches in the morning. so i was trying lexapro but it makes me real moody. i also take 100mg of seroquel and it helps out. but i think i still need another med in the morning maybe a triclyceric med. im not sure i have a dr appt in the morning with my med dr not psyc dr because i dont have medicaid no longer. so i am really trying to see what med will go with the seroquel.
Posted by Phillipa on October 17, 2005, at 19:09:26
In reply to i want to share something with you, posted by chand2407 on October 16, 2005, at 18:18:55
Ace! Are you touring the State? Please share that with us. Love Phillipa
Posted by ace on October 18, 2005, at 2:33:38
In reply to Re: i want to share something with you, posted by Phillipa on October 17, 2005, at 19:09:26
> Ace! Are you touring the State? Please share that with us. Love Phillipa
Yes!!! My band will be touring USA in the very near future....email me and sign my forum!!!!You rule!
Ace
Posted by ace on October 18, 2005, at 2:35:24
In reply to Re: I'm doing great! BUT........................, posted by med_empowered on October 16, 2005, at 4:08:38
HOLY SMOKE!!!! Thanks bro!!! How did you right all that!!! It's not going to waste my buddy...I am printing it out and examining it...so thanks heaps dude, and I hope you feel GREAT!!!!
Ace!
> hmmm...tricky situation. I think the first thing to do would be to try to medicate the weight loss, so its easier to lose w/ exercise and diet. If that truly fails, then it may well be time to consider a change in your "core" meds. Have you tried a traditional, stimulant-type diet pill? They would be tricky to use, considering you're taking both an MAIO and an antipsychotic, but the benefits could be great. In addition to the "golden oldies"--phendimetrazine, phentermine, tenuate, didrex-- there's also Meridia. Meridia costs more, and there are some health conerns with it, but from what I understand its been used to counteract zyprexa-induced weight gain with some success...plus, unlike the older, traditional diet pills which were designed and tested for 8-12 weeks of as-needed use, Meridia has some good data behind it for long-term use. With proper monitoring, it could be useful. Although not usually used for weight loss anymore, stimulants such as Dexedrine, Adderall, and Ritalin could also be used; in low-doses, these could help with your depression, possibly offer benefits with motivation, and also work on decreasing intake and upping your metabolism to burn off extra calories. Desoxyn would be a really potent potential add-on, but its not a very popular stimulant. Provigil (modafanil) seems to have some mild weight-reducing properties; I read a case report where adding provigil to a pre-existing clozapine regimine resulted in a significant reduction of weight, although the patient's weight did not quite return to baseline (keep in mind that this is with clozapine, which in addition to causing massive weight gain also causes **dense** sedation; my guess would be that modafanil+your regimine would have more pronounced results). The only problem with modafanil is its new-ness; no one really knows how it works, and I don't know if docs have yet figured out if it can be combined with MAOIs and, if so, how exactly to go about such a combo.
>
> Finally...as much as I hate to suggest you switch up your core meds after having so much success, I kind of think that maybe if you switched out the seroquel you'd feel better. I read a study where patients switched from zyprexa to abilify (this was full-dose treatment for schizophrenia) lost a considerable amount of weight; they also became more active overall. Abilify in and of its self won't drop weight, but it's weight neutral and (usually) non-sedating, so it will allow your body to return to a more normal state and help you lose weight (keep in mind: abilify may cause blood sugar issues, but they don't seem quite as pronounced as those caused by other drugs, and the problem isn't also accompanied by weight gain). Dosing with antipsychotics is tricky, but I bet if you started on a "sub-therapeutic" dose of Abilify (ex: start at 2.5mgs, go to 5 for a little while, maybe try out 7.5...the usual dose is 10-15mgs), you might find a low-dose that works for you. My only advice from experience would be keep it at or below 10mgs; the jump from 10-15mgs meant a huge increase in side-effects for me, and I've heard this from other people, too. The downside would be increased activation and possibly an increase in anxiety (this is usually temporary, and abilify actually helps some people with anxiety) and a reduction in anti-anxiety effects that you were getting from seroquel. All I could recommend there would be possibly upping the xanax for a while or permanently, adding an old-school antihistamine to mimic some of seroquel's actions (hydroxyzine might be good), or possibly keeping LOW dose (say, 25mgs) seroquel on for as-need use in high-anxiety situations. A switch from seroquel to abilify (or geodon..I just find geodon scary b/c of the heart problems) along with co-prescription of a mild stimulant (i.e., modafanil), a weight-reducing medication (i.e., sibutraime) or a blood-sugar adjusting med (i.e, metformin) seems like it could produce the most results in the shortest period of time. Then again..it could also produce the most side effects. Sorry this was sooooooo long..I wish you the best of luck, and please keep us all posted on your progress.
Posted by ace on October 18, 2005, at 2:39:42
In reply to Re: I'm doing great! BUT........................ » ace, posted by tecknohed on October 16, 2005, at 14:46:58
> Hi Ace
>
> Its great that you're doing so well!
Thanks!!! Life is great now!> I'm afraid I dont have any advise for your weight issue, though i wonder, have you any history of weight/over eating problems,
No.
or has your food intake or activity changed?
Yes!!! I eat chocolate by the tonne now!!!!
Any metabolism or thyroid problems, past or present (would thyroid hormone be worth a look)?
No. All NAD.
Any carb cravings?
Nope.
>
> I also have a few unrelated questions, if I may?
Certainly!
>
> Is Social phobia part of your anxiety symptoms?Yes! Used to be quite bad, actually very bad, along with all the other horrid anxiety i had.
>
> A few months ago I remember you said you had increased the Nardil pretty high and that you had extremely good results. Now you're back on 90mg. What happened?
90mg always works like a gem. When I fool around I get into trouble. So Im staying at 90mg!!!>
> Also, I wondered if you'd ever used modafinil or adrafinil with Nardil and what experience you had? (I'm on this combo at the mo)No. Very hard in Australia to gain access to these combos....
>
> Sorry for all the questions.Don't say sorry man!!! Your welcome to ask any anytime!!!
Ace!
>
> Take care,
> Teck.
>
Posted by ed_uk on October 18, 2005, at 16:27:17
In reply to Re: I'm doing great! BUT........................ » tecknohed, posted by ace on October 18, 2005, at 2:39:42
Sorry ACE, I guess my post was depressing :-S
~Ed
Posted by ace on October 19, 2005, at 3:44:15
In reply to Re: I'm doing great! BUT........................ » ace, posted by ed_uk on October 18, 2005, at 16:27:17
> Sorry ACE, I guess my post was depressing :-S
>
> ~Ed
not at all mate. i even printed it out! sorry for not answering, I am just so overloaded with physics, chemistry, bio, etc etc its hard to keep up!!!!But sorry man, and thanks heaps ED!!!!
Take Care bro, peace,
Ace
Posted by ed_uk on October 19, 2005, at 13:36:08
In reply to Re: I'm doing great! BUT........................ » ed_uk, posted by ace on October 19, 2005, at 3:44:15
Hi ACE,
Thanks for sending me the link to your pics btw :-)
~Ed
Posted by Phillipa on October 19, 2005, at 18:50:49
In reply to Re: I'm doing great! BUT........................ » ace, posted by ed_uk on October 19, 2005, at 13:36:08
Hi Ed, I got it first! Had it a long time. For once I'm ahead of you! Fondly PJ O
Posted by clarinette on October 29, 2005, at 6:43:03
In reply to I'm doing great! BUT............................, posted by ace on October 16, 2005, at 1:58:32
My doctor prescribed me topomax to counteract the weight gain with zyprexa. He knew I wouldn't take the zyprexa if I continued to put on weight. Topomax is a mood stabiliser that helps lose weight.
I don't know if it is available in the US
Clara
This is the end of the thread.
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