Psycho-Babble Medication Thread 1109017

Shown: posts 1 to 16 of 16. This is the beginning of the thread.

 

Olanzapine

Posted by Jadde on March 14, 2020, at 18:25:12

Many years ago a neurologist prescribed Olanzapine for me for depression (wasnt the reason for my appt). It had never been mentioned by my pdoc. Surprisingly it worked to get me out of a dark place. At some point I stopped taking it as it was a serious weight gainer and started to lose its effectiveness. However, I experienced a serious relapse upon discontinuing a combo of olanzapine/Ritalin/ klonopin. Stupid, I know. I was traveling out of the country and didnt want to worry about having meds to explain. Fast forward, I am now taking 5mg for sleep.

My questions:

Could small dose of 5mg be whats keeping me out of the dark place while d/cing Nardil?

Would 5mg be enough to cause weight gain?

I am sleeping 12 hours a night, could this be the result of 5mg of olanzapine?

Anyone have a withdrawal strategy that worked?

Could olanzapine counter effects of MAOI? My doc says it would help Nardil to work but I dont always trust his opinions.

Thanks for any thoughts.

Jade

 

Re: Olanzapine

Posted by Christ_empowered on March 14, 2020, at 19:51:07

In reply to Olanzapine, posted by Jadde on March 14, 2020, at 18:25:12

hi. olanzapine can be quite helpful, but the weight gain, metabolic problems (even in the absence of weight gain, according to one former psychiatrist...), plus typical tranquilizer adverse effects...

are very real, should be discussed before and during treatment. anyway...

some people are prescribed metformin w/ olanzapine. its a type II diabetes drug...to mitigate metabolic problems, weight gain. not a perfect solution, but it does work for some people. I read an 'alternative medicine' review that suggested there's some data supporting relatively high dose (1200mgs/day) alpha lipoic acid in people on 'atypicals,' to reduce the metabolic risks.

I would think/assume that low to mid dosage olanzapine might help with MAOI treatment, so in that sense it would (possibly?) make the MAOI experience "better," maybe. back in the day, Parnate was often balanced out with neuroleptics (stelazine appears to have been a favorite) and/or sedatives. just...a random, off The Google example.

have you had an AIMS test?

hope this helps. :-)

 

Re: Olanzapine

Posted by undopaminergic on March 15, 2020, at 8:50:37

In reply to Olanzapine, posted by Jadde on March 14, 2020, at 18:25:12

>
> My questions:
>
> Could small dose of 5mg be whats keeping me out of the dark place while d/cing Nardil?
>

It is possible. It's not just about olanzapine alone, but it may have additive or even synergistic effects combined with others drugs such as Nardil.

> Would 5mg be enough to cause weight gain?
>

Could be if you are highly sensitive to this adverse effect.

> I am sleeping 12 hours a night, could this be the result of 5mg of olanzapine?
>

I think it is the olanzapine in combination with the Nardil. Are you also taking anything in addition to those 2?

> Anyone have a withdrawal strategy that worked?
>

I could quit cold turkey without problem, but the prescribing psychiatrist stepped down the dose gradually.

> Could olanzapine counter effects of MAOI? My doc says it would help Nardil to work but I dont always trust his opinions.
>

Either way is possible.

If you need an antipsychotic in the mix, I would suggest eg. cariprazine, which is activating. If available to you, I might also suggest amisulpride (or the older sulpiride) or flupenthixol (also spelt flupentixol). Lurasidone could work too, but some people get somnolence from it.

-undopaminergic

 

Re: Olanzapine Christ_empowered

Posted by Jadde on March 15, 2020, at 11:12:38

In reply to Re: Olanzapine, posted by Christ_empowered on March 14, 2020, at 19:51:07

> hi. olanzapine can be quite helpful, but the weight gain, metabolic problems (even in the absence of weight gain, according to one former psychiatrist...), plus typical tranquilizer adverse effects...
>
> are very real, should be discussed before and during treatment. anyway...
>
> some people are prescribed metformin w/ olanzapine. its a type II diabetes drug...to mitigate metabolic problems, weight gain. not a perfect solution, but it does work for some people. I read an 'alternative medicine' review that suggested there's some data supporting relatively high dose (1200mgs/day) alpha lipoic acid in people on 'atypicals,' to reduce the metabolic risks.
>

I actually have metformin but Ive never taken it. Just afraid to add even more side effects to an MAOI.

> I would think/assume that low to mid dosage olanzapine might help with MAOI treatment, so in that sense it would (possibly?) make the MAOI experience "better," maybe. back in the day, Parnate was often balanced out with neuroleptics (stelazine appears to have been a favorite) and/or sedatives. just...a random, off The Google example.
>

Are you thinking the olanzapine works synergistically with MAOIs? Or than it works to contain any mania? Or, that it relieves some side effects ie sleep?

> have you had an AIMS test?

No, why do you ask?

>
> hope this helps. :-)

Yes! Thank you :)

Jade

 

Re: Olanzapine

Posted by Jadde on March 15, 2020, at 11:21:06

In reply to Re: Olanzapine, posted by undopaminergic on March 15, 2020, at 8:50:37

> >
> > My questions:
> >
> > Could small dose of 5mg be whats keeping me out of the dark place while d/cing Nardil?
> >
>
> It is possible. It's not just about olanzapine alone, but it may have additive or even synergistic effects combined with others drugs such as Nardil.
>
> > Would 5mg be enough to cause weight gain?
> >
>
> Could be if you are highly sensitive to this adverse effect.

I am. I have never been overweight unless taking a med with this side effect. I gained 30lbs on Nardil. Depressing in and of itself.

> > I am sleeping 12 hours a night, could this be the result of 5mg of olanzapine?
> >
>
> I think it is the olanzapine in combination with the Nardil. Are you also taking anything in addition to those 2?

Its strange, I went from no sleep to 12 hours each night (no naps tho). Im thinking I want to nix the olanzapine after the Nardil.

>
> > Anyone have a withdrawal strategy that worked?
> >
>
> I could quit cold turkey without problem, but the prescribing psychiatrist stepped down the dose gradually.

I would do it gradually.

>
> > Could olanzapine counter effects of MAOI? My doc says it would help Nardil to work but I dont always trust his opinions.
> >
>
> Either way is possible.
>
> If you need an antipsychotic in the mix, I would suggest eg. cariprazine, which is activating. If available to you, I might also suggest amisulpride (or the older sulpiride) or flupenthixol (also spelt flupentixol). Lurasidone could work too, but some people get somnolence from it.

I dont need an A/P on Nardil. Parnate, yes.

>
> -undopaminergic
>

Thanks for your help!

Jade

 

Re: Olanzapine

Posted by undopaminergic on March 15, 2020, at 11:44:46

In reply to Re: Olanzapine, posted by Jadde on March 15, 2020, at 11:21:06

>
> Its strange, I went from no sleep to 12 hours each night (no naps tho).

And all you changed was to reduce the dose of Nardil? That *is* strange, because Nardil tends to have sedative effects. Then again, Nardil can be activating for some people, and apparently it is in your case.

> > > Could olanzapine counter effects of MAOI? My doc says it would help Nardil to work but I dont always trust his opinions.
> > >
> >
> > Either way is possible.
> >
> > If you need an antipsychotic in the mix, I would suggest eg. cariprazine, which is activating. If available to you, I might also suggest amisulpride (or the older sulpiride) or flupenthixol (also spelt flupentixol). Lurasidone could work too, but some people get somnolence from it.
>
> I dont need an A/P on Nardil. Parnate, yes.

I meant that some people get an enhanced response to their antidepressant regimen from an adjunctive antipsychotic (AP). It does not make much intuitive sense, but some APs are officially approved for this use, which suggests that it is not unsual for this to be better than placebo.

-undopamnergic

 

Re: Olanzapine undopaminergic

Posted by Jadde on March 15, 2020, at 18:27:12

In reply to Re: Olanzapine, posted by undopaminergic on March 15, 2020, at 11:44:46


> I meant that some people get an enhanced response to their antidepressant regimen from an adjunctive antipsychotic (AP). It does not make much intuitive sense, but some APs are officially approved for this use, which suggests that it is not unsual for this to be better than placebo.
>
> -undopamnergic
>

Yes, it does not make much intuitive sense to me. Does it simply add an oomph of A/D on its own? Does it actually work synergistically with Nardil? Or, does it work to prevent hypomania/mania, in which case does it also blunt the energetic qualities of Nardil? And finally, maybe it is prescribed to remedy side effects such as insomnia. I dont know.

As you can probably tell, I am very ignorant in regards to psych meds and how they work. I guess thats why Im here :)

Thanks for your help!

Jade

 

Re: Olanzapine

Posted by Christ_empowered on March 15, 2020, at 20:14:03

In reply to Re: Olanzapine undopaminergic, posted by Jadde on March 15, 2020, at 18:27:12

ok. -not- an expert. just...oddly fascinated, largely because it affects me, and lots of others. with that disclaimer out of the way (LOL)...

most (all?) antidepressants reduce frontal lobe function. its...part of how they work, reducing agitation, anxiety, ruminations, and...emotional intensity. sad, but true. :-(

the neuroleptics reduce frontal lobe activity a whole, whole lot. its more pronounced with some than with others. abilify is less of a numbing drug (but trust me, there's a numbing element) than zyprexa. so...

additional sedation (may or may not be useful), plus a reduction in agitation, emotional intensity, probably (I would think, hope) with less pronounced straight up apathy than,say, equivalent doses of Thorazine.

is it helpful? can be. if the depression is characterized by ruminations, guilt, crying spells, phobias, anxiety...I could see it being quite helpful. if its more lethargy, fatigue, oversleeping, overeating...I would probably ask to try (or add in) something else, personally.

there's also drug-drug interactions to consider. i don't know about MAOIs, but most of the more popular antidepressants increase neuroleptic blood levels. so, if you were on, say, Elavil...a 5mgs dose of olanzapine might affect the CNS (and body as a whole...) more like a 7.5, 10mgs dose. that's something that seems to come into play more in Schizophrenia and Schizoaffective disorder.

AIMS tests are under-utilized. they just check for TD. TD is far less common with many atypicals than with equivalent doses of old drugs. olanzapine I think is on the lower end of the atypicals, in terms of causing TD. ziprasidone, if I recall correctly, is on the higher end. Abilify seems to be lower, it seems safer in the animal models, but...cases of TD are popping up all over, so there's that.

hope this helps.

 

Re: Olanzapine

Posted by Lamdage22 on March 16, 2020, at 2:24:14

In reply to Re: Olanzapine, posted by Christ_empowered on March 15, 2020, at 20:14:03

To me Neuroleptics blunted the AD effect of Nardil. However that may not be the case for everyone.

 

Re: Olanzapine

Posted by undopaminergic on March 16, 2020, at 4:18:59

In reply to Re: Olanzapine undopaminergic, posted by Jadde on March 15, 2020, at 18:27:12

>
> > I meant that some people get an enhanced response to their antidepressant regimen from an adjunctive antipsychotic (AP). It does not make much intuitive sense, but some APs are officially approved for this use, which suggests that it is not unsual for this to be better than placebo.
> >
> > -undopamnergic
> >
>
> Yes, it does not make much intuitive sense to me. Does it simply add an oomph of A/D on its own? Does it actually work synergistically with Nardil?
>

It's something about the combination. It think it is synergistic. It does not always work, but it may be worth trying. Lithium is an alternative in this role of augmentation.

> Or, does it work to prevent hypomania/mania,

Yes, depending on dose. I think some APs work better than others for this purpose.

> in which case does it also blunt the energetic qualities of Nardil?

Many APs are sedative, so yes.

> And finally, maybe it is prescribed to remedy side effects such as insomnia. I dont know.
>

That is pretty common, to use APs with an antihistamine action for insomnia. So other drugs than APs can be used, eg. doxepin, if they are antihistamines. Cyproheptadine (Periactin) seems to be a particularly good choice because it has been reported to improve the quality of sleep.

> As you can probably tell, I am very ignorant in regards to psych meds and how they work. I guess thats why Im here :)
>

I am still learning too.

> Thanks for your help!

You're welcome.

-undopaminergic

 

Re: Olanzapine

Posted by Lamdage22 on March 16, 2020, at 4:35:00

In reply to Re: Olanzapine, posted by undopaminergic on March 16, 2020, at 4:18:59

I would recommend low dose lithium to anyone with suicidal (or even homicidal) thoughts. I take 225.

 

Re: Olanzapine

Posted by rose45 on March 19, 2020, at 16:30:21

In reply to Olanzapine, posted by Jadde on March 14, 2020, at 18:25:12

im on 40mg parnate and it stopped working after I reduced it. 2.5mg of olanzapine miraculously got it working again. I dont know if its the synergy between the meds. But stupidly, I then reduced the olanzapine ever so slightly, and that was a huge mistake,because the whole mix now does not work and I dont know what to do. Ive gone back on the 2.5 mg olanzapine but its not working. Is it only me, who is so sensitive to changes in doses of meds ? Any ideas gratefully received. At the time olanzapine was a miracle - but it didnt make me sleep.Parnate is different to nardil, because of the insomnia it causes. At the moment Im taking 40 mg parnate and 2.5 mg olanzapine.

 

Re: Olanzapine

Posted by undopaminergic on March 20, 2020, at 1:39:45

In reply to Re: Olanzapine, posted by rose45 on March 19, 2020, at 16:30:21

> im on 40mg parnate and it stopped working after I reduced it. 2.5mg of olanzapine miraculously got it working again. I dont know if its the synergy between the meds. But stupidly, I then reduced the olanzapine ever so slightly, and that was a huge mistake,because the whole mix now does not work and I dont know what to do. Ive gone back on the 2.5 mg olanzapine but its not working. Is it only me, who is so sensitive to changes in doses of meds ? Any ideas gratefully received. At the time olanzapine was a miracle - but it didnt make me sleep.Parnate is different to nardil, because of the insomnia it causes. At the moment Im taking 40 mg parnate and 2.5 mg olanzapine.
>

You can try increasing the olanzapine to 5 mg, which might help sleep. Another drug you can try for sleep is cyproheptadine (Periactin).

To potentiate the tranylcypromine (Parnate), you can try a higher dose, or augmentation with lithium and/or stimulants.

-undopaminergic

 

Re: Olanzapine

Posted by Lamdage22 on March 20, 2020, at 3:51:11

In reply to Re: Olanzapine, posted by rose45 on March 19, 2020, at 16:30:21

It is not only you. The body gets accustomed to the meds much more than we think.


> im on 40mg parnate and it stopped working after I reduced it. 2.5mg of olanzapine miraculously got it working again. I dont know if its the synergy between the meds. But stupidly, I then reduced the olanzapine ever so slightly, and that was a huge mistake,because the whole mix now does not work and I dont know what to do. Ive gone back on the 2.5 mg olanzapine but its not working. Is it only me, who is so sensitive to changes in doses of meds ? Any ideas gratefully received. At the time olanzapine was a miracle - but it didnt make me sleep.Parnate is different to nardil, because of the insomnia it causes. At the moment Im taking 40 mg parnate and 2.5 mg olanzapine.

 

Re: Olanzapine Lamdage22

Posted by tom2228 on March 20, 2020, at 15:42:13

In reply to Re: Olanzapine, posted by Lamdage22 on March 20, 2020, at 3:51:11

> It is not only you. The body gets accustomed to the meds much more than we think.

I can definitely attest to that. Im on 130mg Parnate, 75mg Desoxyn and 15mg Dexedrine (plus Klonopin, Abilify, lithium). No shame or self-judgment, but its getting kinda ridiculous with the numbers. The meds work but I barely feel like Im taking any stimulant at all, even short days when I smoosh my doses closer together (=higher levels). Could be just the side-effect-free nature of Desoxyn, or just massive tolerance but surely its frustrating being on all this and still sluggish.

Either way, what got it working again somewhat was incr Parnate from 100mg to 130mg. I second attempting a dose up, and if that doesnt work perhaps adjunctive stimulating med. Sometimes its simply a matter of what our brain needs, whatever that looks like.
>
>
> > im on 40mg parnate and it stopped working after I reduced it. 2.5mg of olanzapine miraculously got it working again. I dont know if its the synergy between the meds. But stupidly, I then reduced the olanzapine ever so slightly, and that was a huge mistake,because the whole mix now does not work and I dont know what to do. Ive gone back on the 2.5 mg olanzapine but its not working. Is it only me, who is so sensitive to changes in doses of meds ? Any ideas gratefully received. At the time olanzapine was a miracle - but it didnt make me sleep.Parnate is different to nardil, because of the insomnia it causes. At the moment Im taking 40 mg parnate and 2.5 mg olanzapine.
>
>

 

Re: Olanzapine

Posted by undopaminergic on March 21, 2020, at 4:50:45

In reply to Re: Olanzapine Lamdage22, posted by tom2228 on March 20, 2020, at 15:42:13

> > It is not only you. The body gets accustomed to the meds much more than we think.
>
> I can definitely attest to that. Im on 130mg Parnate, 75mg Desoxyn and 15mg Dexedrine (plus Klonopin, Abilify, lithium). No shame or self-judgment, but its getting kinda ridiculous with the numbers. The meds work but I barely feel like Im taking any stimulant at all, even short days when I smoosh my doses closer together (=higher levels). Could be just the side-effect-free nature of Desoxyn, or just massive tolerance but surely its frustrating being on all this and still sluggish.
>

With amphetamine doses that high, I would be concerned about potential neurotoxicity. That could in fact be a reason why you need such doses.

But you're in a difficult situation, because you need these medications for symptom relief.

-undopaminergic


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