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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 Bob12 on February 13, 2016, at 6:13:26
Hi,
I am concerned about the increased OCD and increased blood sugar levels from Zyprexa.
I am considering Perphenazine as a replacement, via cross taper.
I would like the lowest dose of Perphenazine possible, which seems to be 2mg ,3 X a day.
Any advice would be appreciated.
thanks
Bob12
Posted by Christ_empowered on February 13, 2016, at 20:40:28
In reply to Perphenazine to replace Zyprexa, posted by Bob12 on February 13, 2016, at 6:13:26
I"m not a doctor, clearly, but...I'd just work with your prescriber. The lower doses of mid-potency typicals are often fairly tolerable. EPS is more of a problem, so do please watch out for that. I'd personally recommend taking some antioxidants w/ the perphenazine to reduce (maybe...) the TD risk. That's what I do w/ my combo (includes 30mgs/Abilify), and so far...no tics, twitches, tremor, stiff gait, etc.I don't know how much zyprexa you're taking or how you'd do the cross-taper. I imagine the switch could trigger some problems (?), so maybe consult The Google so you know how to distinguish between underlying problems and anything that might pop up from switching.
Posted by Bob12 on February 14, 2016, at 4:24:02
In reply to Re: Perphenazine to replace Zyprexa, posted by Christ_empowered on February 13, 2016, at 20:40:28
Thanks for the advice. I am currently taking 17.5 mg of Zyprexa, and my goal is 2 or 4 mg of perphenazine per day. ( a small dose)
Posted by SLS on February 14, 2016, at 8:16:17
In reply to Perphenazine to replace Zyprexa, posted by Bob12 on February 13, 2016, at 6:13:26
I am unfamiliar with the use of perphenazine in treating OCD. I hope it works for you. The medical literature indicates that risperidone is good for OCD, but I believe it is used in conjunction with a serotonergic antidepressant.
Personally, I did not react well to perphenazine. It made me feel too drugged up. It was chosen to treat depersonalization and derealization when I was in my 20s. I have bipolar depression. I think perphenazine is less likely to produce EPS than the other older typical neuroleptic antipsychotics.
Have you tried CBT or exposure therapy in conjunction with pharmacotherapy?
Have you tried clomipramine (Anafranil)? The anticholinergic side effects are not much fun, but it may be the most potent OCD drug available. It would be interesting to investigate SNRIs like Effexor and Cymbalta. They usually have fewer side effects than clomipramine.
- Scott
Posted by Bob12 on February 14, 2016, at 9:57:17
In reply to Re: Perphenazine to replace Zyprexa » Bob12, posted by SLS on February 14, 2016, at 8:16:17
Hi,
I would consider the antidepressants, but the problem is I must replace the Zyprexa to treat the paranoia, without raising blood sugar levels.
This is why I am interested in Perphenazine. Now it seems the lowest I can get of Perphenazine is 4 mg once a day, at night.
I might leave 5 mg of Zyprexa (down from current 17.5 mg) because this may minimize the blood sugar issue.
thanks
Bob12
Posted by Zyprexa on February 19, 2016, at 1:52:11
In reply to Re: Perphenazine to replace Zyprexa, posted by Bob12 on February 14, 2016, at 9:57:17
I tried to replace the zyprexa with perphenazine almost a decade ago. Never happened. I now take some zyprexa and some perphenazine. The mix is working realy well with added Cannabidiol. I was at a place where I was taking atleast 20mg zyprexa and my sugars were high at the time. I think the sugar problem was from the geodon I took right before all this. It did go away over time. Now I take 13-20mg zyprexa and 3x 8mg perphenazine a day. I take the zyprexa split into 3 doses a day, which works better than one dose at once. I am also taking Teva olanzapine now, it seems to be the one which has least weight gain. I've maintained my wieght at about 200lbs for the last 4 years now.
What i'm saying is perphenazine didn't replace the zyprexa well enough. But the mix at lowere doses of each was better than one or the other.
I don't get any side effects from either med except sedation. And zyprexa induces a little hunger, I was not eating before taking it. Perphenazine is no more sedating than zyprexa. You could probably take more than 2 mg, which would not have that much of an effect.
But who knows you might replace zyprexa. Will mention that the blood sugar problem takes time to fix itself. I was diabetic 6 years ago. Not now. And they say diabeties never goes away. I don't take any meds for diabeties anymore, for a long time. I would reduce the zyprexa slowly while raising the perphenazine over time. Not all a once.
This is the end of the thread.
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