Posted by SLS on November 9, 2000, at 20:49:52
In reply to Re: Serzone and Aching Muscles-Dr.Scott (SLS), posted by shellie on November 9, 2000, at 16:14:23
Dear Shellie,
> I am doing really badly.
I'm sorry.
Hang in there.
It is so easy to say - almost too easy. I know how many times people have said that to me when I was doing really badly. Although it doesn't take any of the pain away, hearing it seems to offer hope that it will soon end. I know it will. Hearing it also helps me to remember that I have people around me (even if it is only you :-)) who care, who are supportive, and who are available to reach out to and communicate my pain and suffering to.
I wish I could do more for you than type a few words.
My dearest Shellie, I think it may be time to consider either Lamictal and/or Risperdal (I don't recall for sure, but didn't you have a problem with Risperdal)?. Both usually produce only mild to moderate weight gain. If raising the dosage of Nardil to 90mg does not produce substantial relief - which may not show up for two weeks after a dosage change - I think it may be time to f_ck the weight gain and get better.
You may not know to what degree dietary and exercise changes will combat the weight gain until you try.
If you did have a problem with Risperdal, can you describe in exact details what you experienced?
I won't even try to push Zyprexa down your throat at this point. :-o My gut tells me that Zyprexa may be generally more efficacious for depression than the others, although the others do work. Seroquel certainly represents a viable alternative since it produces much less weight gain and is less likely than Risperdal to cause EPS. However, Risperdal is the least likely to produce weight-gain.
Hopefully, ziprasidone (Zeldox) will be released by spring 2001. It is sort of like a Zyprexa without weight-gain. I will be interested in trying it myself so long as cardiac side effects don't become an issue. I'll let you know how much weight I gain, if any (wishful thinking).
I want very badly to change from Parnate to Nardil. Parnate makes me feel somewhat flat and unmotivated. It helps me to stay off the bottom and gives me mental energy. However, my doctor wants to try a couple "quick" augmenting strategies first. From what I am beginning to see, low dosages of the atypical neuroleptic antipsychotics (Clozaril, Risperdal, Zyprexa and Seroquel) are particularly effective when combined with an MAOI.
I am now taking Parnate 80mg + desipramine 300mg + Lamictal 300mg.
I now realize that I was beginning to feel better during the week I had added Risperdal. I stopped after a week because it affected the way I walked, and I was concerned that it was EPS. My doctor felt pretty confident that it was not. He gave me the option of trying either Zyprexa or Risperdal first, and cross over to the other if the first one did not work. After 3 days, I can say that I feel slightly better for having added Zyprexa. I am starting at 2.5mg. 5mg will probably turn out to be optimal, but we'll see. I had a hard time deciding between the two drugs. The only thing about Zyprexa that caused me hesitate taking it was the GD weight-gain. I am vain too.I have already begun to change my eating habits in anticipation of the battle. If Zyprexa works great with Nardil (once I change over), I think it will be worth the trade-off. This idea doesn't seem so terminal at the moment because I anticipate being able to try switching to Zeldox in six months.
> I hope you are doing better than me.
I guess we have something in common. I hope you are doing better than me.
Love,
Scott---------------------------------------------------------------
2: Acta Psychiatr Scand 2000 Jun;101(6):416-32
Atypical antipsychotics and weight gain--a systematic review.
Taylor DM, McAskill R
Maudsley Hospital, London, UK.
OBJECTIVE: To review systematically data relating to weight changes with atypical antipsychotics. METHOD: We conducted a Medline search on October 29 1999 and covered the period 1980-99. All recovered papers were examined for further relevant reports. In addition, we wrote to pharmaceutical manufacturers and 10 practising clinicians to ask them to provide other relevant reports known to them. RESULTS: Eighty reports mentioning change in body weight were retrieved. Data relating to weight changes were of variable quality. Weight changes were indicated by a variety of measures. The majority of reports related to short-term changes. CONCLUSION: All atypical drugs, with the exception of ziprasidone, have been associated with weight increases. Clozapine seems to have the highest risk of weight gain, followed by olanzapine and quetiapine. There is probably a lower risk with risperidone, sertindole and zotepine and a still lower risk with amisulpride. Ziprasidone appears not to be associated with weight gain. In the absence of more compelling data, these rankings must be considered approximate and preliminary. Longer, more robust trials are needed.
Publication Types:
Review
Review, tutorialPMID: 10868465, UI: 20324317
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poster:SLS
thread:48444
URL: http://www.dr-bob.org/babble/20001102/msgs/48577.html