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Re: zyprexa for atypical depression? OldSchool

Posted by SLS on March 31, 2002, at 12:32:50

In reply to Re: zyprexa for atypical depression?, posted by OldSchool on March 28, 2002, at 21:41:50

> > Has anybody had any experience with Zyprexa for atypical depression? I'm also taking Celexa and Wellbutrin, have never had any psychotic symptoms.

> If you have no psychotic symptoms I would leave the Zyprexa alone. Is not worth the risk of EPS and other neurological damage.

Hi OldSchool.

I think the relevant question is:

What is the percentage of neuroleptic-naive people taking Zyprexa at dosages of 5.0mg or less that develop EPS? What about TD?

I don't know.

Lilly is currently testing a preparation that contains a combination of Prozac and Zyprexa. Although I think this is a silly idea, there is a precedence for this sort of thing. Triavil would be an example (amitriptyline + perhenazine).

The marketing ploy is thinly veiled, of course. Lilly wants to milk every last drop of fluoxetine as they can, now that it is off patent and available as a generic. Repackaging it as Sarafem with the indication for PMDD is an attempt to do this. So, too, is the once-a-week version of Prozac. Cam W. made a good comment regarding the idea of having to take one pill only once a week. He proposed that this protocol is counterproductive. One is much more likely to forget to take a pill each Monday than they are to take one every day.

The main reason I think that producing one pill containing both Prozac and Zyprexa is that it precludes the ability to optimize the dosage of either of them. I'm guessing that they will combine 20mg of Prozac with 2.5mg of Zyprexa. Some people don't respond to Prozac until dosages of 60mg are reached. It makes no sense to expose someone to more than 5.0mg of Zyprexa if it is not necessary. How much more difficult is it for a patient to take two pills instead of one? Of course, most of us here have no problem with the idea of polypharmacy. We usually need more than one drug to get us well. I think many doctors still think in terms of treating depression with one drug at a time. This is silly to.

Zyprexa has antidepressant properties, especially when combined with antidepressants. It might even be most successful when combined with Prozac than for any other drug. I don't know. I am sure that Prozac + Zyprexa will get more people well than Prozac alone. It already has.

As with any other treatment decision, one must weigh the risks versus the potential benefits of choosing to take Zyprexa to augment antidepressants. I have tried a whole bunch of things to treat my bipolar depression without success. When I decided to try Zyprexa, I did so with the information available concerning the risks of it producing EPS or TD. I thought the rates of occurrences of these things were low enough to feel comfortable taking it - especially at dosages of 5.0mg and less.

- Scott




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