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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by jms600 on September 29, 2008, at 17:57:54
Hi everyone,
Does anyone know why Zyprexa helps anxiety?? It's not licensed for Generalised Anxiety Disorder yet it seems to help most people with anxiety problems.
I suffer from GAD, panic disorder, social phobia and depression - and I have to say Zyprexa is one of the few drugs that seems to help. OK, it doesn't get rid of my anxiety completely - when I take it I do still get some anxiety and nervousness. However, it does get rid of the racing anxiety and feelings of sheer 'despair'.
So what action does it have on in the brain? What chemicals / receptors does it work with?
Also, are their any other drugs out there which have a similar effect?? I've tried Seroquel but that doesn't even come close to helping my anxiety in the same way Zyprexa does!
So why is Zyprexa so helpful when other drugs (apart from the benzodiazepines of course) fail to help anxiety?
Any advice??
Thanks!
Posted by med_empowered on September 29, 2008, at 18:58:48
In reply to Why is Zyprexa so good for anxiety...??, posted by jms600 on September 29, 2008, at 17:57:54
hey. As much as I hate neuroleptics, I see your point. Low-dose zyprexa killed off some major agitation I was experiencing that Klonopin wasn't touching.
My theory: When you take a benzo, you bind to GABA receptors...GABA in turn inhibits the release of various neurotransmitters all over the brain and reduces electrical activity.
Zyprexa inhibits ALL SORTS of neurotransmitters and weakly binds to certain GABA receptors. And it has sedating properties and anti-cholinergic action (which helps prevent EPS and akathisia).
Back in the day, they would have called zyprexa a "dirty drug" b/c it hits so many targets in the brain (by comparison, Haldol is a "clean" drug, given its selectivity for dopamine receptors). I think the non-specificity of zyprexa's action pretty much makes it a "calm the f*ck" down pill in low-doses.
Posted by Phillipa on September 30, 2008, at 0:38:53
In reply to Re: Why is Zyprexa so good for anxiety...??, posted by med_empowered on September 29, 2008, at 18:58:48
What about the diabetes and weight gaining properties of it? Love Phillipa
Posted by Quintal on October 1, 2008, at 17:30:19
In reply to Why is Zyprexa so good for anxiety...??, posted by jms600 on September 29, 2008, at 17:57:54
I think a lot of the benefits are to do with its action at serotonin receptors - Zyprexa binds more strongly to the serotonin receptors (5-HT2A/C and 5-HT3) than it does to the dopamine receptors, and other drugs that block these receptors (e.g. Remeron, Serzone, agomelatine, Periactin, ondansetron etc) tend to be anxiolytic and have some antidepressant properties. Like you I've found there's something about Zyprexa that hits a spot other drugs don't reach. Again, I think it has something to do with the serotonin antagonism and the effect this has on mood, panic and anxiety that is different to benzos and other anti-anxiety drugs. Zyprexa is I think the only AP that is a 5-HT3 antagonist bar Clozaril. Years ago I wanted to try ondansetron (5-HT3 blocker) because there had been some evidence it and other 5-HT3 antagonists were useful in anxiety disorders. I think Remeron did give me a similar feeling (another strong 5-HT3 blocker), but like Zyprexa it came with such strong sedation that it was impossible to say what was doing what. I would like to try a pure 5-HT3 blocker though just out of curiosity.
Q
Posted by desolationrower on October 1, 2008, at 19:07:22
In reply to Re: Why is Zyprexa so good for anxiety...?? » jms600, posted by Quintal on October 1, 2008, at 17:30:19
i haven't noticed much of that from the memantine i'm on. Other 5ht3 blockers include ginseng and ginger - probably responsible for antiemetic properties.
-d/r
Posted by Quintal on October 2, 2008, at 10:38:23
In reply to Re: Why is Zyprexa so good for anxiety...??, posted by desolationrower on October 1, 2008, at 19:07:22
There may be no connection with 5-HT3, it's just an idea that passed through my head. Ginger does lead to feeling of 'warmth' and wellbeing at high doses and I find that helps with anxiety. Ginseng less so. What does memantine feel like? It's something I think about trying from time to time but never get round to. I am aware that it's a 5-HT3 antagonist.
Q
Posted by jms600 on October 2, 2008, at 16:57:55
In reply to Re: Why is Zyprexa so good for anxiety...??, posted by Quintal on October 2, 2008, at 10:38:23
I found Memantine to be quite calming, whereas Remeron - especially at 45mg+ doses - really made my anxiety a lot worse. At low doses it was quite sedating, but apart from that it didn't have much of an anxiolytic effect either. I think I'm the only person on here that found that Remeron made my anxiety worse!
Posted by Zyprexa on October 5, 2008, at 2:29:50
In reply to Re: Why is Zyprexa so good for anxiety...?? » jms600, posted by Quintal on October 1, 2008, at 17:30:19
I take zyprexa and tried to switch to remeron once and there was no way it compared.
Posted by Quintal on October 5, 2008, at 10:15:59
In reply to Re: Why is Zyprexa so good for anxiety...?? » Quintal, posted by Zyprexa on October 5, 2008, at 2:29:50
Well there were some noticable similarities for me. Obviously they are very different drugs and don't have the same effects, so you can't expect to substitue one for the other.
Q
This is the end of the thread.
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