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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Jesus is Savior on June 14, 2007, at 16:08:47
I'm diabetic and am taking Zyprexa for anxiety. It is working quite well except it unfortunately is causing spikes in my blood sugar. Anybody know how it does this?
Also, would seroquel make a good substitute for Zyprexa?
-MJ
Posted by Quintal on June 14, 2007, at 17:14:21
In reply to Zyprexa's effect on blood sugar, posted by Jesus is Savior on June 14, 2007, at 16:08:47
Zyprexa is infamous for aggravating and even causing diabetes in formerly healthy people. It's thought to do this by decreasing insulin sensitivity and thereby inducing hyperglycemia. There's evidence that Zyprexa also elevates triglyceride levels and thereby increases the risk of heart disease. Unfortunately it's much the same story with Seroquel, and there are additional concerns over the formation of cataracts with that drug.
Q
Posted by Quintal on June 14, 2007, at 17:22:28
In reply to Zyprexa's effect on blood sugar, posted by Jesus is Savior on June 14, 2007, at 16:08:47
__________________________________________________
Role of Drugs and M3 Receptors in Insulin SecretionIn a recent study, investigators using transgenic mice with either organ-specific absence or overexpression of pancreatic M3 receptors produced opposite effects on insulin secretion.3 Total absence of β-cell M3 receptors resulted in a marked decrease in insulin secretion and glucose intolerance, while overexpression of M3 receptors in the pancreas caused overproduction of insulin and lower plasma glucose levels. This study offers the most compelling evidence to date that M3 receptors in the pancreas have a vital role in regulating insulin secretion. These findings, coupled with those of previous studies4,5 showing that M3 receptors control the secretion of insulin in response to glucose, have profound implications for clinical psychopharmacology.
The atypical antipsychotics olanzapine and clozapine have been found to block insulin secretion mediated by muscarinic receptor activation. Both of these agents act as potent muscarinic receptor antagonists, with resultant undesirable metabolic effects leading to glucose intolerance and diabetes.4 Concentrations as low as 10–100 nmol/L of both of these drugs significantly impaired cholinergic-potentiated secretion of insulin. These concentrations fall well within the range of therapeutic free plasma levels of both drugs. In this animal model, neither glucose infusion alone nor administration of three other antipsychotics—risperidone, haloperidol, or ziprazodone—were found to adversely affect insulin response.
http://www.psychweekly.com/aspx/article/ArticleDetail.aspx?articleid=354
__________________________________________________Q
Posted by Quintal on June 14, 2007, at 17:28:24
In reply to Re: Zyprexa's effect on blood sugar » Jesus is Savior, posted by Quintal on June 14, 2007, at 17:22:28
If you still have your heart set on an antipsychotic it seems as though Geodon would be the least likely to affect your blood sugar.
__________________________________________________Recently, the FDA required the manufacturers of some atypical antipsychotics include a warning about the risk of hyperglycemia and Type II diabetes with atypical antipsychotics. Some evidence suggests that ziprasidone may not be as bad as some of the other atypical antipsychotics (namely, olanzapine (Zyprexa)) at causing insulin resistance and weight gain. In fact, in a trial of long term therapy with ziprasidone, overweight patients (BMI > 27) actually had a mean weight loss overall. Ziprasidone, though, is not a weight loss drug. The weight loss reflected in this study on ziprasidone was really reflective of patients who had gained weight on other antipsychotics who were now trending back toward their baseline. According to the manufacturer insert, ziprasidone caused an average weight gain of 2.2kg (which is significantly higher than other atypicals - quetiapine and aripiprazole).
http://en.wikipedia.org/wiki/Geodon
__________________________________________________Q
Posted by Jesus is Savior on June 14, 2007, at 18:28:46
In reply to Re: Zyprexa's effect on blood sugar » Jesus is Savior, posted by Quintal on June 14, 2007, at 17:14:21
> Zyprexa is infamous for aggravating and even causing diabetes in formerly healthy people. It's thought to do this by decreasing insulin sensitivity and thereby inducing hyperglycemia. There's evidence that Zyprexa also elevates triglyceride levels and thereby increases the risk of heart disease. Unfortunately it's much the same story with Seroquel, and there are additional concerns over the formation of cataracts with that drug.
>
> QThanks Q...so i'm SOL!! Seroquel aggravates diabetes as much as Zyprexa, eh?
-MJ
Posted by Phillipa on June 14, 2007, at 20:04:37
In reply to Re: Zyprexa's effect on blood sugar » Jesus is Savior, posted by Quintal on June 14, 2007, at 17:14:21
Quintal I had no idea about the cataracts thanks for the info. Love Phillipa
Posted by Phillipa on June 14, 2007, at 20:06:49
In reply to Re: Zyprexa's effect on blood sugar » Quintal, posted by Jesus is Savior on June 14, 2007, at 18:28:46
So if benzos don't work well anymore what are the options as I asked my endo today he had no idea? Love Phillipa
Posted by Jesus is Savior on June 14, 2007, at 20:56:14
In reply to Re: Zyprexa's effect on blood sugar » Jesus is Savior, posted by Phillipa on June 14, 2007, at 20:06:49
> So if benzos don't work well anymore what are the options as I asked my endo today he had no idea? Love Phillipa
Your option 'could be' an atypical antipsychotic med such as zyprexa or seroquel (Low Dose). Zyprexa has eliminated ALL of my anxiety. Because of diabetic problem i will reduce my dose, exercise and perhaps increase my glucophage. This med Zyprexa is awesome against anxiety Phillipa. And as you know, all drugs have side effects unfortunately.
-MJ
Posted by Quintal on June 14, 2007, at 20:59:52
In reply to Re: Zyprexa's effect on blood sugar » Quintal, posted by Phillipa on June 14, 2007, at 20:04:37
No problem, good to have you back :-). According to the Wiki article:
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Studies conducted on beagles have resulted in the formation of cataracts—while there are reports of cataracts occurring in humans, controlled studies including thousands of patients have not demonstrated a clear causal association between quetiapine therapy and this side effect. (Reference needed to April 2006 results of CATIE study.) However, the Seroquel® website still recommends users have eye examinations every six months.
http://en.wikipedia.org/wiki/Seroquel
__________________________________________________Q
Posted by Jesus is Savior on June 14, 2007, at 21:20:51
In reply to Re: Zyprexa's effect on blood sugar » Phillipa, posted by Quintal on June 14, 2007, at 20:59:52
> No problem, good to have you back :-). According to the Wiki article:
>Thanks Q :)
Posted by Phillipa on June 14, 2007, at 22:06:02
In reply to Re: Zyprexa's effect on blood sugar » Phillipa, posted by Quintal on June 14, 2007, at 20:59:52
Definitely wouldn't be good for someone who already has a small cataract. But how does the geodon differ? Is it good for anxiety? Can you add and subtract benzos or just take them both? Love Phillipa
Posted by Colleen D. on June 15, 2007, at 17:44:59
In reply to Re: Zyprexa's effect on blood sugar » Quintal, posted by Phillipa on June 14, 2007, at 22:06:02
Hi Jan!
My doc chose the Geodon for me because of my already being overweight and concerned about add'l weight gain. From what I understand so far, all of the atypical APs have a similar mechanism, but I do know that Geodon is the most expensive of all of them. I am supposed to STAY on low dose Klonopin...when I asked if I should eliminate it, my doc said "NO!"
:-) Regards,
Colleen
Posted by Phillipa on June 15, 2007, at 18:54:47
In reply to Re: Zyprexa's effect on blood sugar » Phillipa, posted by Colleen D. on June 15, 2007, at 17:44:59
Coleen how many years have you been on the klonopin and what dose? So he said to take them both to give extra anxiety help? Didn't know it was the most expensive and what dose just got on the computer will check the thread as you may have already answered Love Phillipa ps she can call me Jan it's fine we're friends
Posted by Colleen D. on June 16, 2007, at 8:04:27
In reply to Re: Zyprexa's effect on blood sugar, posted by Phillipa on June 15, 2007, at 18:54:47
> Colleen how many years have you been on the klonopin and what dose?
3 years on Klonopin at 1mg daily - .5 at bedtime, .5 in the a.m.
> So he said to take them both to give extra anxiety help?
Yes, she said that since I had a + response to the Klonopin, I should keep taking it with the Geodon, Zoloft and doxepin.
> Didn't know it was the most expensive and what dose? just got on the computer will check the thread as you may have already answered
Luckily I am poor and have Medicaid coverage. I did see online that it was the most expensive AP. I also have low blood sugar so I don;t think it will hurt my sugar level...40mg 2x daily...1 cap in the a.m. and 1 mid-afternoon. I find it very stimulating, so if I take it too close to bedtime, I don't sleep as well.
Love Phillipa
ps she can call me Jan it's fine we're friends
This is the end of the thread.
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