Posted by SLS on November 14, 2000, at 16:49:10
In reply to ZYPREXA OR AMISULPIRIDE? to johnl,andrew or anyon, posted by rogdog on November 14, 2000, at 11:51:17
> I am just received a starter pack of zyprexa after a total let don with a trial of seroquel.. andrew, I read a previous post about your experience with zyprexa(i think it was you, or mabey it was John?)i cant remember. anyways, i was going to order some amisulpiride but my doctor wanted me to give zyprexa a "shot", I always here that it is augmented with something else, have you or anyone else out there had success with an antipsychotic alone? thanks for the input, rog
Hey Rog.No. I haven't. But I met a girl for whom Zyprexa alone produced an antidepressant response.
I think Zyprexa is the best of the atypicals to treat depression. It makes an effective augmenting agent for SSRIs and MAOIs. I don't know how well it may work with other drugs.
Lilly has sponsored studies to assess the efficacy of combining Zyprexa with Prozac. They have been ongoing for over a year, but I don't know if any of the results have been published. Keep in mind that Lilly sells both drugs. However, I would look at any robustly positive results as being indicative of true efficacy.
I have been taking Parnate + desipramine + Lamictal. I added Zyprexa 2.5mg about a week ago and have increased it today to 5mg. It is helping.
The biggest drawback for me is that it can cause significant weight gain. I don't know exactly how universal this is at the reduced dosages used to treat depression.
If I gain too much weight, I will look to try to Zeldox (ziprasidone), a drug that acts very much like Zyprexa, but without the weight gain. The FDA has given Zeldox an "approvable" letter. I believe the only stumbling block at this point is the wording of the package insert with regards to possible changes in cardiac function. To my knowledge, there have been no cases of adverse events regarding this. The risk is considered more theoretical than phenomenological.
If you are in a position to make a choice as to whether to try amisulpride or sulpiride before going to Zyprexa, I would consider it if your symptoms are primarily anergic and anhedonic. With either of these drugs, if they are going to work, they usually demonstrate some sort of improvement within the first ten days. Neither of these drugs is usually associated with weight-gain, although they are both capable of producing increases in prolactin, and EPS. Zyprexa has a lower risk of EPS. However at the low dosages of amisulpride and sulpiride frequently used to treat depression and dysthymia, any risk is greatly reduced.
Zyprexa is worth a try. If weight-gain is not an issue with you, I would probably try it first, given its availability.
Good luck.
- Scott-------------------------------------------------------------
: Expert Opin Investig Drugs 2000 Apr;9(4):819-828
Ziprasidone: comprehensive overview and clinical use of a novel antipsychotic.
Daniel DG, Copeland LF
Clinical Studies Ltd., Falls Church, VA and Department of Psychiatry and
Behavioral Sciences, George Washington University, Washington DC 20037, USA.[Record supplied by publisher]
Ziprasidone (5-[2-(4-(1,2,-benzisothiazol-3-yl) piperazin-l-yl] ethyl]-6 -chloro indolin-2-one hydrochloride hydrate) is a novel antipsychotic with a pattern of receptor occupancy and preclinical attributes predictive of broad therapeutic efficacy and a favourable tolerability profile in the treatment of psychotic illness. Clinical trials indicate that ziprasidone is effective against positive, negative and affective symptoms in schizophrenia and schizoaffective disorder with minimal motor, cognitive, weight gain, prolactin related, or anticholinergic side effects. In addition, an im. formulation appears to be rapidly effective with significantly less motor side effect liability than haloperidol.
PMID: 11060712
poster:SLS
thread:48787
URL: http://www.dr-bob.org/babble/20001102/msgs/48806.html