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Re: Zyprexa, any insider info? » Greg

Posted by Cam W. on October 17, 2000, at 6:53:17

In reply to Zyprexa, any insider info?, posted by Greg on October 12, 2000, at 20:45:55

Greg - Just a note. I see dosage ranges of 1.25mg (an elderly gent) to 35mg daily. I have read that they have used 60mg of Zyprexa™ (olanzapine) daily for treatment refractory schizophrenia in the UK. I am from the school of thought that if 30mg doesn't work after 4 weeks, it's time to try Clozaril™ (clozapine) [or perhaps augmenting the Zyprexa with with a low dose of Orap™ (pimozide) or Loxapac™ (loxapine)].

Doses for bipolar disorder are generally lower (up to 10mg daily), but I have seen it higher (I believe the person has schizoaffective disorder, if I am not mistaken). Remember, as with most meds, start low and increase the dose slowly. The 2.5mg dose is a usually dose for the elderly, and does work in many cases of agitation in Alzheimer's disease.

Continue to feel "cautiously optimistic". Some of the effects you may be feeling could be start-up side effects. After a week or so it may feel like some of the effect is disappearing (esp. sedation), but the dose may just need to be increased slightly. An early response is good, though, but let the new med cocktail "re-organize" your neurochemical mix before arriving at any final conclusions.

As for splitting the Zyprexa tablets. It can be done, but after the hard coating is broken, the Zyprexa beginas to turn brown and loses potency. The tablets should not be split more than a week in advance of taking them. Also, wash your hands (before and esp. after) as Zyprexa is slightly caustic and can really burn if you accidentally rub it in your eyes. As well, Zyprexa can be mixed with many fluids without losing potency (eg water, juices, and even colas).

The Tegretol™ (carbamazepine) dose may need to be adjusted upward after a month or so. It induces it's own metabolism (CYP-3A3/4), and maybe that of Zyprexa (to a slight extent, but other enzymes also metabolize the Zyprexa - CYP-2D6). Therefore, you may require slight upward dosage adjustments of either or both meds, as treatment continues.

Just some notes from the peanut gallery - Cam


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poster:Cam W. thread:46233
URL: http://www.dr-bob.org/babble/20001012/msgs/46543.html