Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by jimmygold70 on December 21, 2006, at 14:49:49
I'm talking Lamictal 200 MG and Zyprexa 5 MG as stabilizers for bipolar disorder, or BPD or whatever. The Lamictal keeps me from going down much of the time, and Zyprexa - from going mixed (I rarely ever go upper than mixed). When I don't take it I get anger, ruminations and become impulsive. And I've lost my current job for that syndrome.
The problem is that Zyprexa made me gain 50 pounds over 12 months and , I now have fatty liver infiltration and I have to lose weight. It seems like I have to go off the Zyprexa - execrcise + diet didn't work.Now for the alternatives I've tried for this:
Risperdal - very effective for anger, but even in doses as low as 0.25 MG my prolactin gets sky high and I become totally impotent
Sulpiride - not very effective but even worse than Risperdal regarding prolactin & libido. Same for amisulpride (Solian).
Seroquel - cannot tolerate more than 150 MG (sedation), but it is not effective enough at this dose. Tiredness doesn't go away even after a month. Impossible to function.
Geodon - Doses < 100 MG - uneffective. Above that - somewhat effective but too sedating.
Tegretol XR - Make me feel terrible, empty, completely untolerable
Valproic Acid - Tried it long ago was partially effective and partially tolerable
Any similar experience? Any ideas?
Thanks!
Jimmy
Posted by ronaldo on December 21, 2006, at 16:25:48
In reply to Antipsychotics and Mood Stabilizers Deadlock, posted by jimmygold70 on December 21, 2006, at 14:49:49
Jimmy
I have been taking Lithium at 900 mg and Zyprexa at 5 mg and also 10 mg. I am tapering off the Zyprexa, down to 3.75 mg now (1/2 of a 7.5 mg tablet). Zyprexa was giving me flat affect and negative symptoms like anhedonia, avolition etc... Funny thing is I now find the 3.75 much more effective than the 5 mg. LESS is sometimes better. I only took Zyp for insomnia in the first place.
Could you try Zyprexa at 2.5 mg or even 3.75 mg?
ronaldo
Posted by med_empowered on December 21, 2006, at 17:29:00
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock » jimmygold70, posted by ronaldo on December 21, 2006, at 16:25:48
maybe Klonopin? 1-3mgs/day helps some people w/ mood issues..if you go too high, though, I think you run the risk of *increasing* mood lability.
Trileptal and Lithium are probably good options--Trileptal b/c it tends to be weight neutral (although some people lose or gain weight) and lithium b/c the lithium/lamictal combo has proven effective for some patients...that said, if weight gain is an issue, you might want to steer clear of lithium, depakote, risperdal, seroquel, and certain ADs.
Abilify might help, but there's a definite akathisia for a lot of people the first couple weeks..your doc may want to provide you something for that in advance.
Topamax might help, it also induces weight loss, but it makes some people stupid--very, very stupid--and it isn't approved for bipolar so..its iffy, at best. Weirdly enough, some bipolars/schizoaffectives do well on Wellbutrin; you might consider adding it into the mix, since it also causes an average weight loss of 5lbs.
Posted by blueberry1 on December 21, 2006, at 18:40:46
In reply to Antipsychotics and Mood Stabilizers Deadlock, posted by jimmygold70 on December 21, 2006, at 14:49:49
Topomax is a mood stabilizer that also has weight loss as a side effect. It is sometimes prescribed with zyprexa to control the weight. I have never tried it and can't comment on it.
What about a benzodiazepine if you have to stop zyprexa? That could calm things down and keep you nice and mellow with no anger probably. Finding one that doesn't make you more depressed is tricky though. Xanax has some antidepressant action to it, though klonopin is the one usually used as a sort-of mood stabilizer calming agent. Sometimes valium or diazepam.
Posted by kelv on December 21, 2006, at 21:03:23
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock, posted by med_empowered on December 21, 2006, at 17:29:00
> maybe Klonopin? 1-3mgs/day helps some people w/ mood issues..if you go too high, though, I think you run the risk of *increasing* mood lability.
>
> Trileptal and Lithium are probably good options--Trileptal b/c it tends to be weight neutral (although some people lose or gain weight) and lithium b/c the lithium/lamictal combo has proven effective for some patients...that said, if weight gain is an issue, you might want to steer clear of lithium, depakote, risperdal, seroquel, and certain ADs.
>
> Abilify might help, but there's a definite akathisia for a lot of people the first couple weeks..your doc may want to provide you something for that in advance.
>
> Topamax might help, it also induces weight loss, but it makes some people stupid--very, very stupid--and it isn't approved for bipolar so..its iffy, at best. Weirdly enough, some bipolars/schizoaffectives do well on Wellbutrin; you might consider adding it into the mix, since it also causes an average weight loss of 5lbs.
>
>You seem VERY adverse to atypical APs. Risperdal has been a life saver at times, when high doses of benzos havn't done the job. It shuts up and silences the noise in my head. I use it on an as needed basis, rather than a fixed schedule.
PS-Johnny Cash would take Thorazine to sleep when he had been without sleep for days due to a heavy intake of Dex and speed.
Posted by jimmygold70 on December 22, 2006, at 0:58:57
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock » jimmygold70, posted by blueberry1 on December 21, 2006, at 18:40:46
> Topomax is a mood stabilizer that also has weight loss as a side effect. It is sometimes prescribed with zyprexa to control the weight. I have never tried it and can't comment on it.
Tried it once and it made me very stupid. I'm stupid enough otherwise - can't allow this (-:
> What about a benzodiazepine if you have to stop zyprexa? That could calm things down and keep you nice and mellow with no anger probably. Finding one that doesn't make you more depressed is tricky though. Xanax has some antidepressant action to it, though klonopin is the one usually used as a sort-of mood stabilizer calming agent. Sometimes valium or diazepam.
I'm already on Klonopin 2.5 MG / day, and have all possible benzos at home. Lorazepam does the trick at high doses (at least 2 MG several times a day) but it makes me very drowsy and I don't believe it'll work while tolerance is built. Same for Valium. Same for Xanax.
Posted by jimmygold70 on December 22, 2006, at 1:07:40
In reply to Re: Med Empowered?, posted by kelv on December 21, 2006, at 21:03:23
I like Risperdal. It's great. It simply makes me impotent over time. Taking it 'as needed' is not enough for me - I manage people, if I lose my temper they'll give me the axe again. I need constant stabilization.
Haven't tried Thorazine but being that sensitive to hyperprolactinemia which occurs to me with Risperdal, sulpiride, amisulpride - wouldn't it happen with Ridazine as well?
BTW I also tried perphenazine which was effective bith no side effects but EPS (-:
> You seem VERY adverse to atypical APs. Risperdal has been a life saver at times, when high doses of benzos havn't done the job. It shuts up and silences the noise in my head. I use it on an as needed basis, rather than a fixed schedule.
>
> PS-Johnny Cash would take Thorazine to sleep when he had been without sleep for days due to a heavy intake of Dex and speed.
>
Posted by jimmygold70 on December 22, 2006, at 1:23:12
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock, posted by med_empowered on December 21, 2006, at 17:29:00
I'm already taking Klonopin and Wellbutrin. My full regimen is:
Paxil - paroxetine - 10 MG
Wellbutrin - bupropion - 300 MG
Concerta - methylphenidate - 36 MG
Zyprexa - olanzapine - 5 MG
Klonopin - clonazepam - 2.5 MG
Lamictal - lamotrigine - 200 MG> maybe Klonopin? 1-3mgs/day helps some people w/ mood issues..if you go too high, though, I think you run the risk of *increasing* mood lability.
More Klonopin doesn't help much. Ye, it's even disinhibiting in higer doses, or at least that's my experience (-:
> Trileptal and Lithium are probably good options--Trileptal b/c it tends to be weight neutral (although some people lose or gain weight) and lithium b/c the lithium/lamictal combo has proven effective for some patients...that said, if weight gain is an issue, you might want to steer clear of lithium, depakote, risperdal, seroquel, and certain ADs.Trileptal (oxcarbamazepine) is very similar to Tegretol (carbamaepine), which I find very hard to tolerate (emptiness, makes me down).
Lithium - tried but it does me terrible Acne.> Abilify might help, but there's a definite akathisia for a lot of people the first couple weeks..your doc may want to provide you something for that in advance.
Would really like to try Abilify but we don't have it in my country. Do you know of a good mail-order pharmacy? how much it costs?
> Topamax might help, it also induces weight loss, but it makes some people stupid--very, very stupid--and it isn't approved for bipolar so..its iffy, at best. Weirdly enough, some bipolars/schizoaffectives do well on Wellbutrin; you might consider adding it into the mix, since it also causes an average weight loss of 5lbs.Already taking Wellbutin. Tried Topamax but it made me, as you say, very stupid (-:
Thanks,
Jimmy
Posted by jimmygold70 on December 22, 2006, at 1:25:26
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock » jimmygold70, posted by ronaldo on December 21, 2006, at 16:25:48
I've tried cutting Zyprexa down to 3.75 MG and it made me very impulsive and angry the day after. Butmaybe it was just a bad day. You never know. But it may worth a retry.
> I have been taking Lithium at 900 mg and Zyprexa at 5 mg and also 10 mg. I am tapering off the Zyprexa, down to 3.75 mg now (1/2 of a 7.5 mg tablet). Zyprexa was giving me flat affect and negative symptoms like anhedonia, avolition etc... Funny thing is I now find the 3.75 much more effective than the 5 mg. LESS is sometimes better. I only took Zyp for insomnia in the first place.
>
> Could you try Zyprexa at 2.5 mg or even 3.75 mg?
>
> ronaldo
>
Posted by linkadge on December 27, 2006, at 17:58:22
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock » ronaldo, posted by jimmygold70 on December 22, 2006, at 1:25:26
Well, if Johnny Cash took antipsychotics they must be ok.
I'm just kidding.
But seriously, if it helps, and you've tried everything else and aware of the risks, go ahead and take an AP at the lowest effective dose.
Linkadge
Posted by kelv on January 5, 2007, at 23:17:31
In reply to Re: Antipsychotics and Mood Stabilizers Deadlock, posted by linkadge on December 27, 2006, at 17:58:22
> Well, if Johnny Cash took antipsychotics they must be ok.
>
> I'm just kidding.
>
> But seriously, if it helps, and you've tried everything else and aware of the risks, go ahead and take an AP at the lowest effective dose.
>
> LinkadgeHe took AP's to knock himself out from so much sleep deprevation from all the speed he took, he didn't have Schizophrenia.
Johnny Cash sure LOVED his Dex (he abused it from 1958-67) but to quote him,
"I'd go into the desert and the demons would speak to me, 'go on John take another 20mgs Dex' but i'v already just had 40mgs, he'd say, 'go on take more you'll be ok'"
Benzo's will only bolster Gaba-receptors, relaxing someone, Thorazine-even 25-50mgs in a normal person-will slow their mental processors to a crawl.
Posted by LlurpsieBlossom on January 6, 2007, at 14:16:25
In reply to Antipsychotics and Mood Stabilizers Deadlock, posted by jimmygold70 on December 21, 2006, at 14:49:49
Hi Jimmyg,
I see my pdoc next week for what seems like the same issue- weight gain.Ive gained about 15 lbs in 2 mos since I increased seroquel to 300mg. I was able to tolerate seroquel at that dose, but it took about 2-3 weeks for the sedation to become tolerable.
I take provigil for sedation from antidepressant cymbalta. Is provigil available to you? perhaps you can try geodon again and take provigil for the sedation, which HOPEfully will go away after a while.
Thanks for your experiences and writing about this. Im not bipolar, but I do have intrusive thoughts and seroquel has helped me a lot with that. i think that klonopin also helps. i take .5mg on days when things seem out of control. if i take it in the evening, though, I definitely have a hangover the next day. drowsy and grumpy. grrr!
my next options are abilify or geodon. and of course exercise and diet. yep. welcome to 2007. the year of the blubber.
Ll
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