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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by ace on April 12, 2003, at 0:38:42
Here's my OCD/resdidual anxiety augmenters...
Ok gang - Lithium is not working, At the moment I am just waiting out to discontinue it.
Pindolol - I took it for one day 2.5 tds - the bastard made me depressed! That's out of the question.
Don't think I will bother with Clonidine or Bromocriptine.This is the big issue - I was big on Zyprexa UNTIL I heard of the withdrawal reaction. I read someone didn't sleep for 5 days! And there are other insomnia posts. I can't go without my sleep because it makes the derealization severe and anxiety.
Risperidone doesn't seem to be as bad on withdrawal. And there are many trials (But not as many as Zyprexa) supporting it's use as an augmentative agent in OCD.
What do you guys think? Would Zyprexa definately bring on insomnia on withdrawal. Help, cause this is ALL that is stopping me from using it. I have slept well with Nardil - would this counteract Zyprexa's insomnia?
What about Risperidone? Any withdrawal? How about I take the Zyprexa dose at morning (mane)?
Please help.
Ace.
Posted by xjs7 on April 12, 2003, at 1:12:00
In reply to Big Zyprexa/Risperidone decision - Advice???????, posted by ace on April 12, 2003, at 0:38:42
I'm sorry, but I just don't think these are good meds for OCD. I think there are good reasons why they are not first-line medications for OCD or anxiety disorders. My personal experience is with antipsychotics is that they do not work for obsessions or anxiety for very long. Sure, at first they lowered my anxiety levels, but gradually I became more and more anxious and obsessive. I do wish you success in whatever meds you choose to take, but I suspect that Zyprexa/Risperdal are not the solution.
xjs7
Posted by ace on April 12, 2003, at 1:28:29
In reply to Re: Big Zyprexa/Risperidone decision - Advice?????, posted by xjs7 on April 12, 2003, at 1:12:00
Posted by xjs7 on April 12, 2003, at 19:32:53
In reply to Check out the clinical trials supporting their use (nm) » xjs7, posted by ace on April 12, 2003, at 1:28:29
Sure, there are clinical trials that seem to indicate that APs are effective for anxiety, but there are clinical trials for all the other drugs you have tried to augment with as well. In my experience, APs are not good for anxiety. I have read that they can actually exacerbate OCD. APs are not first choice meds for OCD because they are not as effective as SSRI's or other antidepressants and benzodiazepines for most people. (In my opinion, of course.)
xjs7
Posted by ace on April 12, 2003, at 22:55:04
In reply to Re: Check out the clinical trials supporting their, posted by xjs7 on April 12, 2003, at 19:32:53
> Sure, there are clinical trials that seem to indicate that APs are effective for anxiety, but there are clinical trials for all the other drugs you have tried to augment with as well.
That maybe true, but absolutely not to the same extent. On the net there is one or two Pinodol clinical trials for OCD. For Zyprex there is at least 6 I've found. Also there is much anecdotal evidence for Zyprexa over other OCD augmenters.
In my experience, APs are not good for anxiety.
YOUR experience. In many others they are brilliant. Look above to the post of the chap on Zyprexa/Klonopin.
I have read that they can actually exacerbate OCD.
I have seen a couple of reports about this but they are far outwighed by the good reports. And usually the exacerbate OCD, or rather CAUSE OCD, in people who did not have oCD.
APs are not first choice meds for OCD because they are not as effective as SSRI's or other antidepressants and benzodiazepines for most people. (In my opinion, of course.)
I aggree that's why I want to use one as a augmenter to my Nardil. Benzodiazepines do hardly anything, IMO. Except Klonopin.
>
> xjs7I know what you are saying but I can't except it. Look at this...
OCD Augmenters
1. Pindolol - 1 or 2 trials
2. Bromocriptine- 1 I've seen
3. Lithium - 1 or 2 trials
4. Clonodine - 1 trial I've seen
5. Buspar - don't know cause I can't take with Nardil.
6. Haldol - 1 trial I THINK I remember seeing
7. Fenfluramine - Maybe 1
8. SSRI + Anafranil - Plenty, but I can't take Anafranil with Nardil.
9. Gabapentin - 1 I think
10 Tegretol -1
11. Zyprexa 7 or 8
12. Risperidone - 4 or 5.The vast majority of anecdotal reports I've heard support Zyprexa, Risperidone, and Anafranil.
Ace.
Posted by xjs7 on April 12, 2003, at 23:25:06
In reply to Re: Check out the clinical trials supporting their » xjs7, posted by ace on April 12, 2003, at 22:55:04
Hi Ace,
It sounds like you have thought about this a lot. I am sure you know of all the risks of the APs (TD, EPS, diabetes). I wish you luck in reducing your obsessions. I sincerely wish the APs were great anxiety-reducing meds, but unfortunately they are not that effective for a lot of people (including myself).
xjs7
Posted by ace on April 12, 2003, at 23:50:50
In reply to Re: Check out the clinical trials supporting their, posted by xjs7 on April 12, 2003, at 23:25:06
> Hi Ace,
>
> It sounds like you have thought about this a lot. I am sure you know of all the risks of the APs (TD, EPS, diabetes). I wish you luck in reducing your obsessions. I sincerely wish the APs were great anxiety-reducing meds, but unfortunately they are not that effective for a lot of people (including myself).
>
> xjs7
Hi!,I intend to do 2.5mg Zyprexa. At that dose, even over a period of several years, the risk of ESP is very small.
Your right, I have thought heaps. With my Nardil I tried Pindolol - that depressed me. The Lithium is not helping - soon to go. The only other options I have are Clonidine and Bromocriptine. Clonidine has been known to make anxiety worse and it's a bit like Pindolol so I've scrapped that. Bromocriptine is a dopamine agonist, which, although shown to sometimes work, is the opposite think you want to to do to an OCD brain.
I am really limited because of the Nardil in what I can augment. I love Nardil but.
I should have said I also have depersonalization disorder with phobic anxiety. Nardil has helped a lot, but there is still too much there. Zyprexa has been known to treat this prob too. So hopefully it will kill the OCD and the depersonalization/derealization with phobic anxiety.
BTW, what are you on for your OCD? It's too bad the APs don't help. But I've seen some fantastic results with them. I know the risks, but, honestly, my probs are so painful at times, I am going to take the risk. Sometimes I think I shouldn't, but as soon as the pain/fear/terror comes back I say to myself "who cares, I need help now"
So please tell me what you have found helpful for your illness and thankyou for the dialogue.
All the best,
Ace.
Posted by xjs7 on April 13, 2003, at 22:24:32
In reply to Re: Check out the clinical trials supporting their » xjs7, posted by ace on April 12, 2003, at 23:50:50
Hi Ace,
I read your post about TD. It is good that you are learning about the problems with APs. Sometimes I forget that everyone here doesn't know about these things. Tardive dykinesia and dystonia are definite risks--but they are risks worth taking when the problems are severe or disabling.
I take an AP for psychosis--this means I take a much higher dose than those typically used for anxiety or depression. The AP does not help with anxiety (OCD) or depression, so I take Celexa but it doesn't work 100%. It stops the suicidal thoughts but that's about all it does. I really don't know what to do about the obsessive thoughts; currently I am simply waiting it out, hoping that they will go away one of these days. I may attempt therapy one of these months. Medications help a lot but they aren't perfect.
xjs7
Posted by missliz on April 14, 2003, at 1:22:21
In reply to Big Zyprexa/Risperidone decision - Advice???????, posted by ace on April 12, 2003, at 0:38:42
Didn't read the whole thread, but I'd go with Risperdal. Zyprexa has a lot of hidious side effects, huge wheight gain, joint problems, heart disease, diabetes, on and on. Risperdal has side fx too, but not like the damage Zyprexa can do. Actually, Abilify is the new wonder drug, supposedly minimal to no side effects. Ask your doc about it.
missliz
Posted by linkadge on April 14, 2003, at 9:07:44
In reply to Re: Big Zyprexa/Risperidone decision - Advice?????, posted by missliz on April 14, 2003, at 1:22:21
I entirely disagree with the statement that a lot of people find AP's ineffective for anxiety
and ocd. Perhaps some find them ineffective but in my experience AP's can help improve anxiety that has not responded to anything else.My mother, (Bipolar 25 yrs) had only partial sucess with Lithium and depakote. After adding
AP thioridazine she felt as if a weight that had been on her shoulders for 25 years had finally lifted. AP's can reduce suicidal tendancies, they can relieve anticipatory anxiety, as well as anxiety with the slightest psychotic twinge.
Yes they do have their risks, but that does not negate the fact that for many they are effective in reducing anxiety.Linkadge
Posted by Mimi on April 14, 2003, at 18:55:47
In reply to Big Zyprexa/Risperidone decision - Advice???????, posted by ace on April 12, 2003, at 0:38:42
> Here's my OCD/resdidual anxiety augmenters...
>
> Ok gang - Lithium is not working, At the moment I am just waiting out to discontinue it.
>
> Pindolol - I took it for one day 2.5 tds - the bastard made me depressed! That's out of the question.
> Don't think I will bother with Clonidine or Bromocriptine.Ace,
Zyprexa causes weight gain for sure. Risperdal does not, usually. MIMI
>
> This is the big issue - I was big on Zyprexa UNTIL I heard of the withdrawal reaction. I read someone didn't sleep for 5 days! And there are other insomnia posts. I can't go without my sleep because it makes the derealization severe and anxiety.
>
> Risperidone doesn't seem to be as bad on withdrawal. And there are many trials (But not as many as Zyprexa) supporting it's use as an augmentative agent in OCD.
>
> What do you guys think? Would Zyprexa definately bring on insomnia on withdrawal. Help, cause this is ALL that is stopping me from using it. I have slept well with Nardil - would this counteract Zyprexa's insomnia?
>
> What about Risperidone? Any withdrawal? How about I take the Zyprexa dose at morning (mane)?
>
> Please help.
>
> Ace.
>
Posted by Ritch on April 16, 2003, at 23:17:44
In reply to AP's can help, posted by linkadge on April 14, 2003, at 9:07:44
> I entirely disagree with the statement that a lot of people find AP's ineffective for anxiety
> and ocd. Perhaps some find them ineffective but in my experience AP's can help improve anxiety that has not responded to anything else.
>
> My mother, (Bipolar 25 yrs) had only partial sucess with Lithium and depakote. After adding
> AP thioridazine she felt as if a weight that had been on her shoulders for 25 years had finally lifted. AP's can reduce suicidal tendancies, they can relieve anticipatory anxiety, as well as anxiety with the slightest psychotic twinge.
>
>
> Yes they do have their risks, but that does not negate the fact that for many they are effective in reducing anxiety.
>
>
>
> Linkadge
The only AP (including other several conventional and atypical) that I could take without dystonia or akathisia was thioridazine. It did work quite well (at 10-30mg hs) for insomnia and next-day agitation associated with depression. The bad news is that after 2-3 years of chronic dosing of it during the early '80's I developed a cataract and a pigmented retina.
This is the end of the thread.
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