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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by MSWGradStudent on June 12, 2006, at 20:06:59
You guys were so very helpful in responding to my posts, I thought I'd post a question concerning my mother. Her psychiatrist, today, gave her Zyprexa and told her to take it along with Geodon.
Has anyone else experienced this combination?
I'm very unfamiliar with this pairing. I work on a psychiatric unit and have yet to see a patient (that I can recall) who was taking two atypicals at the same time though I'm sure it happens on occasion.
My mom had a bad experience w/Zyprexa several years ago. She was one of the patients who developed diabetes. Her list of other meds is extensive as she has both physical and psychological probs she's battling right now.
I guess my main concern is just the introduction of new side effects with a medication that is suggested to treat only as effectively as a medication she's told to continue to take.
Does that make sense? I'm still fairly brain loopy from coming off my own meds. Any information you guys have is greatly appreciated. I just don't want her to be blindsided by any major side effects that could come her way from coupling the two atypicals.
Thanks, take care! Hope you are well!
Posted by med_empowered on June 13, 2006, at 0:20:59
In reply to Geodon Zyprexa together?, posted by MSWGradStudent on June 12, 2006, at 20:06:59
combining atypicals is catching on, but it seems pointless. You rack up more side effects, which totally defeats the point of using atypicals, which were supposed to improve quality of life...
basically, it seems like a good idea **only** for special cases, like treatment-resistant schizophrenia or perhaps something like using low-dose seroquel in a bipolar patient already taking, say, abilify.
Plus, if zyprexa gave your mom diabetes...she probably shouldn't take it. If she has schizophrenia, a different atypical (maybe Abilify?) could be used, possibly along side an anti-convulsant like Depakote or even with Lithium if needed. For bipolars, neuroleptics generally aren't **required** long-term (although some people prefer the newer ones to say, lithium therapy), so there's definitely not much rationale for giving your mom 2 atypicals.
My advice: if your mom **MUST** take an antipsychotic, make it something that isn't zyprexa. You could try Geodon or Abilify, maybe Seroquel or possibly a low-dosed older drug (maybe a "semi-atypical" like Moban or Loxitane). Plus...some people with psychotic disorders can lower or even discontinue neuroleptics as they get older; some do well on bipolar-style meds...so, the best thing to do might be to minimize neuroleptics in general.
Personally, I'd get your mom another doctor...unless she's so flagrantly psychotic that she really **needs** an untested combo, this doc is stepping out of line.
Good luck!
Posted by Phillipa on June 13, 2006, at 11:40:39
In reply to Re: Geodon Zyprexa together?, posted by med_empowered on June 13, 2006, at 0:20:59
If your Mom has diabetes she should not be taking zyprexa. Love Phillipa
Posted by blueberry on June 13, 2006, at 18:44:06
In reply to Geodon Zyprexa together?, posted by MSWGradStudent on June 12, 2006, at 20:06:59
If she has already had diabetes-like reactions to zyprexa in the past, I think it would be very unwise to go that direction again. She has enough problems to deal with already, she doesn't need another serious one.
Why does she take antipsychotics? It may very well be another med would work better and be safer. Depending on what she is taking it for, things that come to mind are klonopin (or other benzo) or depakote or small/medium dose lithium. Depends on what is being treated.
Sometimes different antipsychotics are combined. But it is usually something like adding one to clozapine, or adding something specifically for negative/depressive symptoms such as low dose risperdal or amisulpride. Geodon and zyprexa sounds weird and dangerous to me.
Posted by DanielJ on June 13, 2006, at 19:46:34
In reply to Re: Geodon Zyprexa together?, posted by blueberry on June 13, 2006, at 18:44:06
This seems extreme even with acute psychosis. What is the diagnosis? With schizophrenia usually the starting dose is 10mg, increase to 15 mg or even 20 mg
if it is not effective. Geodon has a lot more side effect potential as in dyskinesia, heart attack etc.. It would help to know the current dosages. ie. 2.5 mg of each may be relatively safe
Posted by MSWGradStudent on June 14, 2006, at 0:58:06
In reply to Geodon Zyprexa together?, posted by MSWGradStudent on June 12, 2006, at 20:06:59
As far as I know, her diagnosis is Bipolar with psychosis. She has never been dx'd with schizophrenia.
She has blind trust for her doctors which is, in my opinion, ridiculous. She's on over 15 perscription pills a day and NONE of her doctors are responsible enough to check with the other specialists' offices to see what she's taking.
They won't give any benzos stronger than ativan b/c she overdosed on xanax in '97 and has a history of attempts.
She refuses to talk to me about it anymore and my father won't push the issue either. I guess it's out of my hands now. My mother is still in charge of her own life and my parents feel very threatened anytime my sister or I try and question anything about their lives... including health.
I'm going to write an editorial to our local paper concerning my personal experience with overperscription of certain medications without checking with other physicians to try and raise community awareness, but beyond that... I'm not sure what I can do...
Thanks for your help guys. I knew the combination sounded odd.
This is the end of the thread.
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