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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Dingbat on November 6, 2004, at 7:21:16
Hi
I've recently been diagnosed Bipolar II. I'm on a mood stabiliser (Epilim CR 1500mg daily, aka valproate) and Zyprexa 5mg at night. The Zyprexa doesn't seem to help me or my pocket (it's hellish expensive) very much. A while back I used Fluanxol (flupenthixol tablets) 2mg daily, and it worked better than Zyprexa (for me) --- even my wife (who is usually very anti-meds) 'liked me on Fluanxol'.
I will need to discuss switching from Zyprexa to Fluanxol with my doctor, but would like opinions/info on its use in bipolar (particularly bipolar II) before doing so.
Any opinions/info, etc. would be most appreciated.
Regards
Dingbat
Posted by ed_uk on November 6, 2004, at 16:59:29
In reply to Fluanxol (flupenthixol) for Bipolar ???, posted by Dingbat on November 6, 2004, at 7:21:16
Hello....
Were you using Fluanxol to treat depression? What were the benefits of flupenthixol compared with olanzapine?
Ed
Posted by Dingbat on November 7, 2004, at 10:34:26
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by ed_uk on November 6, 2004, at 16:59:29
> Hello....
> Were you using Fluanxol to treat depression? What were the benefits of flupenthixol compared with olanzapine?
> EdHi Ed
At that time (about 1 year ago now) I was still Dx as a "treatment resistant depressive" with "comorbid anxiety". Fluanxol was prescribed because all the usual meds had failed ME! Fluanxol (at doses of 1-3mg) is marketed as both an antidepressant and as having anti-anxiety properties. Curiously, it also has certain 'activating properties' (I don't know what the drug company REALLY means by that term)? Of most benefit to me were Fluanxol's ability to reduce irritability and agitation and promote pro-social behavior (reduced social apathy and social anxiety).
It also doesn't cost as much as the "new" atypicals!!! That's one BIG benefit over olanzapine (Zyprexa). In addition, it is considered 'weight gain neutral' whereas most of us experience ridiculous (?dangerous) weight gain on Zyprexa. Last, you don't feel so 'drugged'. Zyprexa - even at small doses (2.5mg-5mg nocte) made me feel 'drugged' the next day. Fluanxol may have a few side-effects for the first 5-7 days of treatment, but after that you hardly know you're taking it - except for the benefits (which my wife and kids labelled: 'profound'!).
While Zypreza may still be the drug of choice when one is hospitalised fotr psychosis/mania, I think that Fluanxol is possibly better as a chronic treatment? Any opinions/experiences out there???
Hope that helps ...
Cheers4now
Dingbat
Posted by ed_uk on November 7, 2004, at 10:57:06
In reply to Fluanxol (flupenthixol) for Bipolar ???, posted by Dingbat on November 6, 2004, at 7:21:16
Hello again!
Flupenthixol is a classical/typical neuroleptic which is marketed (in England) as an AD at low doses (Fluanxol) and as an AP at high doses (Depixol). Occasionally, Fluanxol has been reported to induce mania/hypomania so that's something you need to watch out for!
It sounds like it was very effective for your depression. If you decide to go back on the Fluanxol it's important to make sure that you're taking the minimum necessary dose, this is because it can cause tardive dyskinesia. The risk of TD is small if you are only taking a very low dose. The risk increases with length of treatment. Some people can benefit from doses as low as 0.5mg/day! Overall, the small risk of TD from low dose Fluanxol may be less important than the risk of obesity on Zyprexa (which also occasionally causes TD). This is something that you and your pdoc will need to discuss.
Posted by Dingbat on November 7, 2004, at 22:14:45
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by ed_uk on November 7, 2004, at 10:57:06
Hi Ed
Thanx for your info. Fluanxol is marketed pretty much the same way here in South Africa (which tends to follow UK trends in branding, etc.). I agree, 'the activating effects' have been known to induce hypo/mania particularly when there IS another antidepressant on board and NO mood-stabiliser. I'm not so sure that the Zyprexa-induced obesity is so harmless ... recent studies/warnings from PRO-Zyprexa mood experts suggest that the rapid and profound obesity induced by this drug (and a list of others used in Bipolar!) place users at increased risk for diabetes, etc.
But I would agree that a nice low dose like Fluanxol 1mg daily should reduce the risk of TD and (hopefully) hypo/mania. I don't think I'd use this medicine if I had been diagnosed Bipolar I. And, they're not even sure that I am Bipolar II yet --- it's a case of let's treat you for Bipolar II and, if your target symptoms remit, then we know the diagnosis is correct!?
Cheers4now
Dingbat
Posted by crazychickuk on November 8, 2004, at 3:53:54
In reply to Re: Fluanxol (flupenthixol) for Bipolar ??? » ed_uk, posted by Dingbat on November 7, 2004, at 22:14:45
Hi, i had this drug but was to afraid to take it..... i have depression and severe anxiety and of course panick attacks ...
I was worried about it cus it was a med of a different kind to what iu have had in the past ssri's snri's etc that never agreed with me...
What affects did it give you?
Posted by ed_uk on November 8, 2004, at 8:16:11
In reply to Re: Fluanxol (flupenthixol) for Bipolar ??? » ed_uk, posted by Dingbat on November 7, 2004, at 22:14:45
Hello Dingbat!
I certainly don't think the weight gain from Zyprexa is harmless! I was just saying that you'd have to decide what you were most worried about: the risk of TD with flupenthixol or obesity from the olanzapine.
All the best...
Ed.
Posted by Dingbat on November 8, 2004, at 8:22:57
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by crazychickuk on November 8, 2004, at 3:53:54
Hi
It might be worth trying this medicine under the watchful eye of your pdoc. It is not a 'typical' antidepressant and it is not an antidepressant. In fact, it's not that typical an anti-psychotic either since it is marketed for the treatment of co-existing anxiety and depression. I have never seen it advocated as a treatment for Panic Disorder.
I find it is a good anti-depressant (rapid acting), moderate anti-anxiety agent, and tends to make me more outgoing and sociable. That's at the low doses of 1-2mg per day. At these doses I never had any side-effects.
Cheers4now
Dingbat
Posted by Dingbat on November 8, 2004, at 8:32:28
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by ed_uk on November 8, 2004, at 8:16:11
Hi Ed
I didn't think you were saying the rapid weight gain from Zyprexa was harmless and I did understand your very good point re possible TD from Fluanxol. Just spoke to my pdoc who says the risk of TD at very low doses of Fluanxol (less than 3mg daily) is negligble. In fact, she says she's seen more TD in Zyprexa patients! She cannot recall ever seeing TD in a patient on very low dose Fluanxol. Says she'll check this out with her colleagues though.
In the meanwhile I've decided, with pdoc's blessing, to abandon Zyprexa!!! I've gained about 1-1.5kg per week in the month I've been on it (dose range 5-10mg nocte)!
She's re-prescribed the Fluanxol (1mg daily) and asked me to persist with the Epilim (valproate) CR (controlled release) 500mg tds for a few more weeks. I can live with that.
Maybe I'm not Bipolar II ????????????
Cheers4now
Dingbat
Posted by ed_uk on November 8, 2004, at 9:06:43
In reply to Re: Fluanxol (flupenthixol) for Bipolar ??? » ed_uk, posted by Dingbat on November 8, 2004, at 8:32:28
Hello..
She's almost certainly right that the risk of TD is very low at such low doses of Fluanxol. Just make sure that you use the lowest effective dose. 10mg Zyprexa is a common dose to use in schizophrenia so it wouldn't be surprising if she's seen some cases of tardive dyskinesia in people taking olanzapine at these doses!
I'm glad you're stopping the Zyprexa. It sounds like you weren't that happy on it.
Ed
Posted by crazychickuk on November 8, 2004, at 20:02:03
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by ed_uk on November 8, 2004, at 9:06:43
I as given it by my physciatrist last yr to take when i am really anxious or when i am really depressed.. she said never take it after 5 pm at night cus it will keep me awake.. i as given 2 mg mg's .. i stil have it in the cupboard.. i was to scared to take it though..
Posted by aazospiro on November 9, 2004, at 19:42:13
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by crazychickuk on November 8, 2004, at 20:02:03
Can this be use along with methylphenidate and depakote for depression??? Cant tolerate SSRI's
Posted by Dingbat on November 10, 2004, at 3:29:13
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by crazychickuk on November 8, 2004, at 20:02:03
Hi CrazyChikUK
Fluanxol may well help you. Your Psychiatrist obviously thought so otherwise s/he would not have prescribed it for you. Why don't you 'phone the Psychiatrist and check with her/him if it is still OK to use the Fluanxol? Also check the expiry date on the medication itself!
Your Pharmacist might also be a good person to talk to regarding whether or not it is still safe for you to try the Fluanxol out as s/he will probably know what other medications you are on (and may offer to 'phone you Psychiatrist for you).
It is true that you should avoid taking this medicine in the late afternoon/early evening as it can keep you awake owing to its 'activating properties'.
Good Luck
Dingbat
Posted by NKP on April 3, 2011, at 6:39:59
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by ed_uk on November 7, 2004, at 10:57:06
> Hello again!
> Flupenthixol is a classical/typical neuroleptic which is marketed (in England) as an AD at low doses (Fluanxol) and as an AP at high doses (Depixol). Occasionally, Fluanxol has been reported to induce mania/hypomania so that's something you need to watch out for!
> It sounds like it was very effective for your depression. If you decide to go back on the Fluanxol it's important to make sure that you're taking the minimum necessary dose, this is because it can cause tardive dyskinesia. The risk of TD is small if you are only taking a very low dose. The risk increases with length of treatment. Some people can benefit from doses as low as 0.5mg/day! Overall, the small risk of TD from low dose Fluanxol may be less important than the risk of obesity on Zyprexa (which also occasionally causes TD). This is something that you and your pdoc will need to discuss.What is the likelihood of getting TD from long term (several years) use of low dose (0.5 mg or less per day) Fluanxol?
Posted by X-ray on April 5, 2011, at 8:38:30
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by NKP on April 3, 2011, at 6:39:59
> > Hello again!
> > Flupenthixol is a classical/typical neuroleptic which is marketed (in England) as an AD at low doses (Fluanxol) and as an AP at high doses (Depixol). Occasionally, Fluanxol has been reported to induce mania/hypomania so that's something you need to watch out for!
> > It sounds like it was very effective for your depression. If you decide to go back on the Fluanxol it's important to make sure that you're taking the minimum necessary dose, this is because it can cause tardive dyskinesia. The risk of TD is small if you are only taking a very low dose. The risk increases with length of treatment. Some people can benefit from doses as low as 0.5mg/day! Overall, the small risk of TD from low dose Fluanxol may be less important than the risk of obesity on Zyprexa (which also occasionally causes TD). This is something that you and your pdoc will need to discuss.
>
> What is the likelihood of getting TD from long term (several years) use of low dose (0.5 mg or less per day) Fluanxol?Hi,
I switched from buspirone to flupenthixol two years ago.
I take 0,5 mg in the morning and 0,5 mg in the afternoon, which is a low dose.
So 0,5 mg of flupenthixol is a very low dose.
I don't have expert knowledge, but I'm pretty sure that the risk of getting TD on 0,5 mg of flupenthixol is minimal.
Best regards,
X-ray
Posted by NKP on April 10, 2011, at 13:47:41
In reply to Re: Fluanxol (flupenthixol) for Bipolar ???, posted by X-ray on April 5, 2011, at 8:38:30
> > > Hello again!
> > > Flupenthixol is a classical/typical neuroleptic which is marketed (in England) as an AD at low doses (Fluanxol) and as an AP at high doses (Depixol). Occasionally, Fluanxol has been reported to induce mania/hypomania so that's something you need to watch out for!
> > > It sounds like it was very effective for your depression. If you decide to go back on the Fluanxol it's important to make sure that you're taking the minimum necessary dose, this is because it can cause tardive dyskinesia. The risk of TD is small if you are only taking a very low dose. The risk increases with length of treatment. Some people can benefit from doses as low as 0.5mg/day! Overall, the small risk of TD from low dose Fluanxol may be less important than the risk of obesity on Zyprexa (which also occasionally causes TD). This is something that you and your pdoc will need to discuss.
> >
> > What is the likelihood of getting TD from long term (several years) use of low dose (0.5 mg or less per day) Fluanxol?
>
> Hi,
>
> I switched from buspirone to flupenthixol two years ago.
>
> I take 0,5 mg in the morning and 0,5 mg in the afternoon, which is a low dose.
>
> So 0,5 mg of flupenthixol is a very low dose.
>
> I don't have expert knowledge, but I'm pretty sure that the risk of getting TD on 0,5 mg of flupenthixol is minimal.
>
> Best regards,
> X-rayThank you very much.
This is the end of the thread.
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