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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by AngieT on May 17, 2001, at 13:21:51
I am Bipolar II with rapid cycling and hard to treat mood disorder. I have been on many combo's of meds and have had the best 'result' with Prozac and Zyprexa...I have been on Prozac for 12 years and began with the Zyprexa twice now in the last three months. I started out with 2.5 mg and was doing awesome and then it simply stopped working, went into deep depression, suicidal, doctor increased to 5mg felt great, same thing, just a roller coaster I am now up to 15 mg feeling good now but only been on this dose three days and am so afraid it's going to stop working again. It is SO frustrating because it does miracles for my life when it works. I am so sick and tired worrying about being the lab rat again if the Zyprexa doesn't work. When it works I actually feel ALIVE, I have never in my 26 years, ever felt that good and for it to just keep not working drives me crazy=) Has anyone had this problem? What is the highest dosage? I have read 20 mg, but I know that with other drugs going over the average dosage is sometimes done. I just want some help. Mood stabilizers don't do anything for me, Zyprexa is the only antipsychotic I have been on, and wonder maybe if there is a different one that may work???
Posted by anita on May 17, 2001, at 16:53:30
In reply to Zyprexa just quit working/dose info?, posted by AngieT on May 17, 2001, at 13:21:51
Hi Angie,
I have depression and had a similar experience with Risperdal. When I first tried it at a very low dose, it made me feel alive and energetic and optimistic. However, within 2 weeks that effect went away (fortunately, I did not sink into a depression, tho.) The same thing happened when I increased the dose. Yet, two months later, at a still low dose, I started feeling good in a different way. I'm still taking it and it works very well for me.
The initial response you got may be due to a paradoxical increase in dopamine, and every time you raised it, the same effect may have happened. How long did it take to stop working when you started and when you raised the dose? It may be that it will just continue to eventually poop out on you every time you raise the dose, which has happened with others on this list, BUT you may want to stick with one dose and wait for a month or so to see if it has any positive effect in the long run, as it did for me. Or, you could try a different antipsychotic and see if that works better for you.
I wish you luck.
anita
Posted by AngieT on May 17, 2001, at 20:08:05
In reply to Re: Zyprexa just quit working/dose info?, posted by anita on May 17, 2001, at 16:53:30
Hi Anita, thanks for writing, it seems that when I increase the dose I feel better the next day (I take before bed) and I feel good for about a week or week and a half and then I slowly start feeling down and it just gets worse. Is Risperdal the only antipsychotic you have been on? I go to see my pdoc next week and have been reading up on all these drugs, so when I go in I have some idea of 'where' I want to go with this.
Thanks again!
>
> I have depression and had a similar experience with Risperdal. When I first tried it at a very low dose, it made me feel alive and energetic and optimistic. However, within 2 weeks that effect went away (fortunately, I did not sink into a depression, tho.) The same thing happened when I increased the dose. Yet, two months later, at a still low dose, I started feeling good in a different way. I'm still taking it and it works very well for me.
>
> The initial response you got may be due to a paradoxical increase in dopamine, and every time you raised it, the same effect may have happened. How long did it take to stop working when you started and when you raised the dose? It may be that it will just continue to eventually poop out on you every time you raise the dose, which has happened with others on this list, BUT you may want to stick with one dose and wait for a month or so to see if it has any positive effect in the long run, as it did for me. Or, you could try a different antipsychotic and see if that works better for you.
>
> I wish you luck.
>
> anita
Posted by AngieT on May 17, 2001, at 20:08:24
In reply to Re: Zyprexa just quit working/dose info?, posted by anita on May 17, 2001, at 16:53:30
Hi Anita, thanks for writing, it seems that when I increase the dose I feel better the next day (I take before bed) and I feel good for about a week or week and a half and then I slowly start feeling down and it just gets worse. Is Risperdal the only antipsychotic you have been on? I go to see my pdoc next week and have been reading up on all these drugs, so when I go in I have some idea of 'where' I want to go with this.
Thanks again!
>
> I have depression and had a similar experience with Risperdal. When I first tried it at a very low dose, it made me feel alive and energetic and optimistic. However, within 2 weeks that effect went away (fortunately, I did not sink into a depression, tho.) The same thing happened when I increased the dose. Yet, two months later, at a still low dose, I started feeling good in a different way. I'm still taking it and it works very well for me.
>
> The initial response you got may be due to a paradoxical increase in dopamine, and every time you raised it, the same effect may have happened. How long did it take to stop working when you started and when you raised the dose? It may be that it will just continue to eventually poop out on you every time you raise the dose, which has happened with others on this list, BUT you may want to stick with one dose and wait for a month or so to see if it has any positive effect in the long run, as it did for me. Or, you could try a different antipsychotic and see if that works better for you.
>
> I wish you luck.
>
> anita
Posted by anita on May 18, 2001, at 15:43:23
In reply to Re: Zyprexa just quit working/dose info? » anita, posted by AngieT on May 17, 2001, at 20:08:24
Hi again Angie,
Well, it sounds like maybe what you're going through is what happened to me -- theoretically the antipsychotic initally brings about a good response as a result of increasing dopamine, but then the dopamine receptors re-regulate themselves and the good effect wears off. This has happened to another psychobabbler, SLS. Have you tried any dopamine-increasing meds, like Wellbutrin, Ritalin, or amisulpride? Amisulpride may be a good bet -- it too is an antipsychotic that works like an energizing antidepressant at low doses, and a lot of people here seem to have a good response to it without poop-out. It can be ordered from overseas.
Personally I've only tried Risperdal, amisulpride (which lasted about a month or so then pooped out) and Geodon (which I couldn't tolerate). If you're willing to take a chance, you might want to stick with Zyprexa at a steady dose for a few weeks just to see what happens, or start over with another antipsychotic or a dopamine-increasing med. If you choose to stick with Zyprexa, the increase in well-being will probably be gradual rather than dramatic.
anita
> Hi Anita, thanks for writing, it seems that when I increase the dose I feel better the next day (I take before bed) and I feel good for about a week or week and a half and then I slowly start feeling down and it just gets worse. Is Risperdal the only antipsychotic you have been on? I go to see my pdoc next week and have been reading up on all these drugs, so when I go in I have some idea of 'where' I want to go with this.
> Thanks again!
> >
> > I have depression and had a similar experience with Risperdal. When I first tried it at a very low dose, it made me feel alive and energetic and optimistic. However, within 2 weeks that effect went away (fortunately, I did not sink into a depression, tho.) The same thing happened when I increased the dose. Yet, two months later, at a still low dose, I started feeling good in a different way. I'm still taking it and it works very well for me.
> >
> > The initial response you got may be due to a paradoxical increase in dopamine, and every time you raised it, the same effect may have happened. How long did it take to stop working when you started and when you raised the dose? It may be that it will just continue to eventually poop out on you every time you raise the dose, which has happened with others on this list, BUT you may want to stick with one dose and wait for a month or so to see if it has any positive effect in the long run, as it did for me. Or, you could try a different antipsychotic and see if that works better for you.
> >
> > I wish you luck.
> >
> > anita
Posted by katrina on May 18, 2001, at 17:52:08
In reply to Re: Zyprexa just quit working/dose info? Angie, posted by anita on May 18, 2001, at 15:43:23
> My doc suggested a AP called Moban cuz for BPII the AD effects of zyprexa will poop-out
Posted by SLS on May 18, 2001, at 20:59:10
In reply to Re: Zyprexa just quit working/dose info? Angie, posted by katrina on May 18, 2001, at 17:52:08
Hi Katrina.
> My doc suggested a AP called Moban cuz for BPII the AD effects of zyprexa will poop-out
Thanks for posting.
My doctor mentioned Moban (molindone) also. It would be used as an augmenter of antidepressants for my bipolar depression.
What symptoms are you trying to use Moban to treat?
I am having trouble putting together a concrete profile of this drug. It is sometimes referred to as an atypical antipsychotic (Zyprexa, Risperdal, Clozapine, Seroquel, Geodon) and sometimes is grouped with the typical antipsychotics (Thorazine, Haldol, Prolixin, Stelazine, Navane). Antipsychotics are defined as atypical when they produce less EPS movement side effects and possess a reduced risk of producing tardive-dyskinesia compared to the older typical antipsychotics. My doctor tends to qualify Moban as being more atypical. From performing a Medline literature search, I am inclined to place Moban in a position near to Risperdal with Moban having a slightly more typical profile; both drugs being less atypical than Zyprexa and Clozaril.
Other properties sometimes ascribed to Moban include a moderate preference for presynaptic autoreceptors and a weak inhibition of MAO-A. This is a pretty poorly investigated drug for the number of years it has been in existence. It has been around since the 1960s, and was approved for marketing in 1974.
Moban is probably the only antipsychotic that produces weight loss.
I don't know how to feel about Moban. Like anyone else, I am not thrilled to be on a drug that has the capacity to produce EPS and tardive-dyskinesia. I don't know what the true incidence of EPS is for Moban, but my impression is that it is higher than the atypicals as a class. However, I believe there is sufficient reason to consider its use to treat refractory depression.
Sometimes, doctors know better than Medline. If there comes a time when my doctor urges strongly for me to try Moban, I will be inclined to try it.
- Scott
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