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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by llurpsienoodle on November 6, 2007, at 9:42:49
Well, I am doing much better overall, but from time to time I have dissociative episodes which have psychotic features. (hallucinations, delusions, etc)
I would like to continue taking my AD (zoloft 50mg) and probably abilify (5mg) and klonopin prn for anxiety (.25-.5mg)
Main Dx- PTSD with mood lability (one day there will be a bipolar Dx for folks like me. yay)
I see pdoc on friday, so any input you guys have would be great. I tend to have episodes lasting about 4 hours until I exhaust myself by taking max daily dose of klonopin all at once. (1.5mg)
thanks much,
llurp
Posted by yxibow on November 6, 2007, at 10:52:04
In reply to short acting medication for psychosis, posted by llurpsienoodle on November 6, 2007, at 9:42:49
> Well, I am doing much better overall, but from time to time I have dissociative episodes which have psychotic features. (hallucinations, delusions, etc)
>
> I would like to continue taking my AD (zoloft 50mg) and probably abilify (5mg) and klonopin prn for anxiety (.25-.5mg)
>
> Main Dx- PTSD with mood lability (one day there will be a bipolar Dx for folks like me. yay)
>
> I see pdoc on friday, so any input you guys have would be great. I tend to have episodes lasting about 4 hours until I exhaust myself by taking max daily dose of klonopin all at once. (1.5mg)
>
> thanks much,
> llurp
Seroquel has a half life of 6 hours, but there's no real "quick fix" or "magic bullet" for psychosis. It takes time for any AP to build up in the blood but that's what I'd recommend for short half life.Otherwise, if your fighting short manic episodes you've pretty much mentioned it.
Dissociative episodes come and go for some people and its a question of living with it or increasing the AP I think in the end.
Posted by Phillipa on November 6, 2007, at 11:59:39
In reply to short acting medication for psychosis, posted by llurpsienoodle on November 6, 2007, at 9:42:49
Lurpsie yxibow is right. What do you think you pdoc will prescribe or suggest? Phillipa
Posted by llurpsienoodle on November 6, 2007, at 12:55:21
In reply to Re: short acting medication for psychosis » llurpsienoodle, posted by yxibow on November 6, 2007, at 10:52:04
>
> Seroquel has a half life of 6 hours, but there's no real "quick fix" or "magic bullet" for psychosis. It takes time for any AP to build up in the blood but that's what I'd recommend for short half life.
>
thanks yxibow!
What kind of doses are you talking about? I used to take 25-50 mg for sleeping, about a year ago. Then for a while I was doing great on 300mg, but also gaining a pound a week...-Ll
Posted by yxibow on November 6, 2007, at 19:10:03
In reply to Re: short acting medication for psychosis » yxibow, posted by llurpsienoodle on November 6, 2007, at 12:55:21
>
> >
> > Seroquel has a half life of 6 hours, but there's no real "quick fix" or "magic bullet" for psychosis. It takes time for any AP to build up in the blood but that's what I'd recommend for short half life.
> >
> thanks yxibow!
> What kind of doses are you talking about? I used to take 25-50 mg for sleeping, about a year ago. Then for a while I was doing great on 300mg, but also gaining a pound a week...
>
> -LlSome people may only need 25 or 50mg for psychosis but yes, in the level of 200-400mg. I face the same problem with weight on Seroquel at the moment, I'm not quite sure how I'm going to solve it other than forcing myself to eat as little as necessary and looking at my portions.
Yes, the medication is weight gaining in itself depending on the person but it also increases appetite and one doesn't always notice it, like measuring out your cereal, etc. And of course like I should be doing but things are complicated right now, excercising more -- walking.
If you were doing "great" on a dose but gaining weight, maybe think about doing more cardiovascular excercise on that dose that worked for you. And always prudent the minimum dose that is effective for you.
Posted by Zyprexa on November 6, 2007, at 19:49:03
In reply to Re: short acting medication for psychosis » llurpsienoodle, posted by yxibow on November 6, 2007, at 19:10:03
I take zyprexa, it has the effect of making me gain weight. I found that taking an anti-diabetic medicine, metformin, keeps the weight off, diabetes away, increases metabolism.
One thing that I noticed while on abilify, was a huge appatite, and I was losing the weight, I could not eat enough to keep blood sugar high enough. I was also taking some zyprexa too. Not sure what would happen with you though.
Posted by Mishal on November 7, 2007, at 6:28:35
In reply to short acting medication for psychosis, posted by llurpsienoodle on November 6, 2007, at 9:42:49
Librium (chlordiazepoxide) is a distinctive benzo sometimes used to control psychotic breaks. It is well studied in Alcohol related psychosis.
Dosage could be 25 to 40 mg as needed.
Here is an excerpt:
Chlordiazepoxide
Brand Name: Librium, LibritabsOverview
Librium is one brand name for chlordiazepoxide, an antianxiety drug. It is a sedative, a hypnotic, an anxiolytic, and a muscle relaxant.Why is this drug prescribed?
Librium is used to treat:
1.Mild anxiety and tension
2.Acute alcohol withdrawal
3.Pre and post-surgery anxiety
4.Tension due to muscle spasms
5.Insomnia
6.Other disorders which cause anxiety, INCLUDING PSYCHOSIS
7.Acute anxiety or panichttp://www.whatmeds.com/meds/chlordiazepoxide.html
Posted by Mishal on November 7, 2007, at 6:38:22
In reply to short acting medication for psychosis, posted by llurpsienoodle on November 6, 2007, at 9:42:49
Forgot to add this:
EFFECTS OF CHLORDIAZEPOXIDE IN SEVERELY DISTURBED OUTPATIENTS
FELIX BAMBACE M.D.1
1 Director, San Antonio State Adult Mental Health Clinic.Of 73 outpatients with predominantly psychotic diagnoses the results of Librium therapy were excellent in 39 and good in 11. The drug relieved symptoms of anxiety, phobias, obsessive thinking and compulsive behavior, exogenous depressions, and conversion reactions. Librium was less effective in manic-depression, psychotic depressions and paranoid-type schizophrenia. Slight and transient side effects, mainly drowsiness and ataxia, occurred in a few cases. Patients with a long history of illness and hospitalization, who had not responded to previous medication with one or several of the phenothiazines, showed marked improvement under Librium therapy.
Am J Psychiatry 118:69-70, July 1961
doi: 10.1176/appi.ajp.118.1.69
1961 American Psychiatric Association
Posted by llurpsienoodle on November 9, 2007, at 13:00:56
In reply to Re: short acting medication for psychosis » llurpsienoodle, posted by yxibow on November 6, 2007, at 10:52:04
decided on rapid dissolve Zyprexa with warning that I only use it when I'm ready for bed, since it's going to be working in about 5-10 minutes.
knock on wood that I never have to use it
-Ll
Posted by kaleidoscope on November 9, 2007, at 17:58:53
In reply to Re: short acting medication for psychosis, posted by llurpsienoodle on November 9, 2007, at 13:00:56
Hi Llurpsie
>decided on rapid dissolve Zyprexa with warning that I only use it when I'm ready for bed, since it's going to be working in about 5-10 minutes.
Zyprexa won't work quite that quickly :) Peak blood levels occur 5 to 8 hours after taking a single tablet, although you should notice effects much earlier than that.
Here is some information from the Zyprexa data sheet...
Olanzapine orodispersible tablet (Zyprexa Zydis, Zyprexa Velotab) is bioequivalent to olanzapine coated tablets, with a similar rate and extent of absorption. Olanzapine orodispersible tablets may be used as an alternative to olanzapine coated tablets.
Olanzapine is well absorbed after oral administration, reaching peak plasma concentrations within 5 to 8 hours. The absorption is not affected by food.
Posted by cactus on November 10, 2007, at 1:56:32
In reply to Re: short acting medication for psychosis » llurpsienoodle, posted by kaleidoscope on November 9, 2007, at 17:58:53
Li hon, I'd just up your clonazepam, I'm on 6mg a day now but have just been put on a small dose of seroquel to start tapering off my night time dose. Zyprexa made me really, really fat in a very short period of time, but everyone is different. Good luck, that was just my personal experience with it
Posted by yxibow on November 10, 2007, at 3:10:26
In reply to Re: Librium: parenthesis » llurpsienoodle, posted by Mishal on November 7, 2007, at 6:38:22
High dose Valium has also been indicated in journal articles for psychosis but as I have experienced over time, I've habituated to at least part of it. Not sure how long one should take Librium for psychosis.
Posted by llurpsienoodle on November 10, 2007, at 7:16:07
In reply to Re: Librium, posted by yxibow on November 10, 2007, at 3:10:26
> High dose Valium has also been indicated in journal articles for psychosis but as I have experienced over time, I've habituated to at least part of it.
I think this is a concern, esp. since I already take klonopin and the occasional xanax. I *think??* valium may interact with abilify/lamictal? can't remember. my porous mind...
>Not sure how long one should take Librium for psychosis.
or whether it's one of these drugs that needs to reach steady state plasma concentration to show many benefits...
ll
not that I'll have to worry about it. my pdoc is kind of old-school. not likely to Rx librium when there are still many AP left to try
Posted by Phillipa on November 10, 2007, at 19:20:35
In reply to Re: Librium » yxibow, posted by llurpsienoodle on November 10, 2007, at 7:16:07
Li you can take valium with lamictal as I have. Librium is older and not as strong to me. I've been on an ad, chloral hydrate, xanax, and klonopin all at the same time and even seroquel for one night for sleep. Seroquel was too strong and pdoc took me off it after one night as I almost fainted. Phillipa
Posted by Justruckn on November 11, 2007, at 13:39:47
In reply to short acting medication for psychosis, posted by llurpsienoodle on November 6, 2007, at 9:42:49
If you are having short episodes you should eliminate Subliminal Distraction exposure as the possible source.
Subliminal Distraction was discovered when it caused mental breaks for office workers in the 1960's. The cubicle solved that problem.
No one has realized that SD is a problem of human physiology when there are too-small crowded spaces and living arrangements. That room or space does not have to be a business office.
I have a five-year historical research project to define the problem.
Where there are temporary dissociative or psychotic episodes most victims recover with no treatment once the stimulus to the subconscious stops.
One example is ICU Psychosis. Qi Gong and Kundalini Yoga also have these short episodes when too many group session are used in a compact time frame.
The research notes are at VisionAndPsychosis.Net.
No treatment or therapy is involved and searching activities for exposure will not interfere in any treatment you now have.
I suggest the Jumping Frenchmen of Maine, Culture Bound Syndromes, and Panic Attack pages.
Posted by Zyprexa on November 12, 2007, at 13:04:13
In reply to Re: short acting medication for psychosis, posted by llurpsienoodle on November 9, 2007, at 13:00:56
I did not know what the advantage of that was, before.
Posted by Zyprexa on November 12, 2007, at 13:07:48
In reply to Re: Librium » yxibow, posted by llurpsienoodle on November 10, 2007, at 7:16:07
Actualy peak plazma is 3 hours after dose of regular zyprexa. I usualy notice the effects after one hour. Non fast version.
Posted by kaleidoscope on November 12, 2007, at 15:29:15
In reply to Re: peak plazma)), posted by Zyprexa on November 12, 2007, at 13:07:48
>Actualy peak plazma is 3 hours after dose of regular zyprexa.
Well not according to the studies performed by the manufacturer. I didn't make the numbers up!
K
Posted by llurpsienoodle on November 12, 2007, at 15:51:20
In reply to Peak plasma » Zyprexa, posted by kaleidoscope on November 12, 2007, at 15:29:15
They are SO cute. Each tablet comes wrapped in its own little foil pouch.
Caution- do not hand out to trick or treaters!
-Ll
Posted by llurpsienoodle on November 12, 2007, at 15:54:13
In reply to Peak plasma » Zyprexa, posted by kaleidoscope on November 12, 2007, at 15:29:15
I wonder if zyprexa is one of those psychotropic meds that has the most action as plasma levels change the most rapidly?
if so, the fast acting sort should make a big difference, because it dumps into the plasma all at once?
Then there's the bioavailability.
These statistics are all so fuzzy anyways. I prefer to run my own studies. Sample Size = 1. Participant code = ll
-ll
Posted by Zyprexa on November 12, 2007, at 22:33:29
In reply to Peak plasma » Zyprexa, posted by kaleidoscope on November 12, 2007, at 15:29:15
You are sort of right, I just read the zyprexa.com website and it reaches peak plazma concentrations in 6 hours. The last time I read it, about 4 years ago, it said 3-5 hours.
Posted by kaleidoscope on November 13, 2007, at 14:23:24
In reply to Re: Peak plasma » kaleidoscope, posted by llurpsienoodle on November 12, 2007, at 15:54:13
Hi L
Zyprexa Zydis is not particularly rapidly absorbed. The oro-dispersable formulation is thought to have similar pharmacokinetics to standard Zyprexa tablets. This is because the dissolution of the tablet is not the rate-limiting step in absorption. Zyprexa Zydis does not 'dump' in the plasma all at once, it is gradually absorbed over several hours. Because Zyprexa is such a potent psychoactive, effects may start to appear relatively quickly after taking a dose of Zyprexa - maybe after 30 to 60 minutes. This will of course depend on the individual.
Zyprexa Zydis was invented mainly to make more money for the manufacturer, it does not have any outstanding advantages over standard Zyprexa tablets. The Zydis formulation is intended to help people who have difficultly swallowing..... and to facilitate the administration of Zyprexa to unwilling psych patients. It is unlikely to 'get to work' much (if any) more quickly than normal Zyprexa tablets. I would not call it 'rapid acting' Zyprexa.
Good luck with Zyprexa. I hope you find it helpful. Regardless of which formulation you take, it may help you :)
Posted by LlurpsieNoodle on November 13, 2007, at 17:57:59
In reply to Zyprexa Zydis, posted by llurpsienoodle on November 12, 2007, at 15:51:20
WOW! what a good med!
I took it and fell asleep within about 30 minutes and slept for 10 hours. woke up without hangover and felt really positive all morning and afternoon. Felt calm, and I didn't even take my klonopin this am.I will give it another shot tonight
-Ll
Posted by suebirds on November 15, 2007, at 16:00:02
In reply to Re: Zyprexa Zydis first try, posted by LlurpsieNoodle on November 13, 2007, at 17:57:59
has any one ever come off of zyprexa if so how did it go did u have any side effects coming off of it I just started my second week of weaning down off of it so far I have been doing alright but I don't drop my dose again until Wednesday I just want off this med Im also on 40 mgs of paxil and .5mgs of klonopin so I am hoping I don't need it any long since I am pretty sure the paxil is working finally.
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