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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 ed_uk on February 27, 2006, at 19:48:23
To those on Zyprexa.......
What meds do you take to minimise your cardiovascular risk factors?
Low dose aspirin
A statin eg. Lipitor
Metformin (Glucophage)
Anti-hypertensives eg. an ACE inhibitor
Orlistat (Xenical)
Posted by James K on February 27, 2006, at 19:48:23
In reply to Unhealthy Zyprexa, posted by ed_uk on February 25, 2006, at 18:22:34
Back in the old zyprexa days, I mostly took care of my heart with occasional massive blood lettings
James K
Posted by Phillipa on February 27, 2006, at 19:48:23
In reply to Re: Unhealthy Zyprexa » ed_uk, posted by James K on February 25, 2006, at 18:56:00
Oh James!!!!!!!!Fondly, Phillipa
Posted by yxibow on February 27, 2006, at 19:48:23
In reply to Unhealthy Zyprexa, posted by ed_uk on February 25, 2006, at 18:22:34
> To those on Zyprexa.......
>
> What meds do you take to minimise your cardiovascular risk factors?
>
> Low dose aspirin
>
> A statin eg. Lipitor
>
> Metformin (Glucophage)
>
> Anti-hypertensives eg. an ACE inhibitor
>
> Orlistat (Xenical)
>
>
You forgot regular and possibly vigorous excercise... (not that I'm on Zyprexa, but Seroquel has raised my cholesterol, I'm a vegan and while it still passes with flying colours from my doctor it is on the high end of things). I'm curious to see what the panel will be in a bit this time. Not everything is solved with an arsenal of extended medication although if things get severe, you have mentioned possibilities for people.
Posted by fenix on February 27, 2006, at 19:48:23
In reply to Re: Unhealthy Zyprexa » ed_uk, posted by yxibow on February 26, 2006, at 3:34:46
Well, as Ambrose Bierce wrote:
PRESCRIPTION, n. A physician's guess at what will best prolong the situation with least harm to the patient.
Posted by ed_uk on February 27, 2006, at 19:48:24
In reply to Re: Unhealthy Zyprexa » ed_uk, posted by yxibow on February 26, 2006, at 3:34:46
Hi Yxi
Exercise is definitely vital with Zyprexa.
Eddy
PS. You're right, Sudafed PE is useless. Phenylephrine is not an effective oral decongestant. First pass metabolism is very high and renders it ineffective. It doesn't even reach the blood stream! Pseudoephedrine does at least do something!
Posted by ed_uk on February 27, 2006, at 19:48:24
In reply to Unhealthy Zyprexa, posted by ed_uk on February 25, 2006, at 18:22:34
I shouldn't have singled out Zyprexa in my original post. Many other APs are risky RE the cardiovascular system. It's a very major concern IMO.
Ed
Posted by med_empowered on February 27, 2006, at 19:48:24
In reply to Other APs, posted by ed_uk on February 26, 2006, at 11:24:30
Yup yup. Unfortunately, I think add-on drugs might be needed for a lot of APs; even w/ diet and exercise, people can experience tremendous weight gain b/c of these drugs...luckily, some of the drugs (ex: metformin) are relatively clean in terms of side effects, and they're cheap.
Of course...one could always switch to Geodon or Abilify. Or try a low-dose old AP, like Trilafon or Stelazine.
Posted by ed_uk on February 27, 2006, at 19:48:24
In reply to Re: Other APs, posted by med_empowered on February 26, 2006, at 12:19:51
Hi Med
It's true that Abilify is less offensive in the weight gain/cardiovascular department. Amisulpride (Solian) is also not too bad.
>Unfortunately, I think add-on drugs might be needed for a lot of APs
And for a high proportion of those who take them!
Take care
Ed
Posted by Emme on February 27, 2006, at 19:49:05
In reply to Unhealthy Zyprexa, posted by ed_uk on February 25, 2006, at 18:22:34
Just curious. Are you talking about taking additional meds while on APs even in the absence of bad lipid profiles, elevated glucose, excess weight, or high blood pressure?
> To those on Zyprexa.......
>
> What meds do you take to minimise your cardiovascular risk factors?
>
> Low dose aspirin
>
> A statin eg. Lipitor
>
> Metformin (Glucophage)
>
> Anti-hypertensives eg. an ACE inhibitor
>
> Orlistat (Xenical)
>
>
Posted by Phil on February 27, 2006, at 19:49:05
In reply to Re: Unhealthy Zyprexa » ed_uk, posted by Emme on February 27, 2006, at 16:15:40
Posted by ed_uk on February 27, 2006, at 19:49:05
In reply to Re: Unhealthy Zyprexa » ed_uk, posted by Emme on February 27, 2006, at 16:15:40
Emme,
Here is an extract from the UK official data sheet for Zyprexa.........
In placebo-controlled clinical trials (6-12 weeks duration) of elderly patients (mean age 78 years) with dementia-related psychosis and/or disturbed behaviours, there was a 2-fold increase in the incidence of death in olanzapine-treated patients compared to patients treated with placebo (3.5% versus 1.5%, respectively). The higher incidence of death was not associated with olanzapine dose (mean daily dose 4.4mg) or duration of treatment. Risk factors that may predispose this patient population to increased mortality include age >65 years, dysphagia, sedation, malnutrition and dehydration, pulmonary conditions (eg, pneumonia, with or without aspiration), or concomitant use of benzodiazepines. However, the incidence of death was higher in olanzapine-treated than in placebo-treated patients, independent of these risk factors.
In the same clinical trials, cerebrovascular adverse events (CVAE, eg, stroke, transient ischaemic attack), including fatalities, were reported. There was a 3-fold increase in CVAE in patients treated with olanzapine compared to patients treated with placebo (1.3% versus 0.4%, respectively). All olanzapine- and placebo-treated patients who experienced a cerebrovascular event had pre-existing risk factors. Age >75 years and vascular/mixed type dementia were identified as risk factors for CVAE in association with olanzapine treatment. The efficacy of olanzapine was not established in these trials.
Ed
Posted by ed_uk on February 27, 2006, at 19:49:05
In reply to Re: Unhealthy Zyprexa » ed_uk, posted by Emme on February 27, 2006, at 16:15:40
>Are you talking about taking additional meds while on APs even in the absence of bad lipid profiles, elevated glucose, excess weight, or high blood pressure?
In some cases.
ACE inhibitors and statins can reduce the risk of cardiovascular events, even in those who do not have particularly high BP, or high cholesterol respectively. Such additional medication might be warranted for some patients on atypical APs, since the mechanisms by which APs increase the risk of cardiovascular events are not fully understood. APs have been associated with quite a variety of thromboembolic events.
Ed
Posted by Emme on February 27, 2006, at 19:49:48
In reply to Re: Unhealthy Zyprexa » Emme, posted by ed_uk on February 27, 2006, at 17:44:06
This is the end of the thread.
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