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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 DanielJ on November 10, 2005, at 9:08:51
I hope this makes sense but in my sons case he has been on 2 medications for 2 1/2 years. Over the past year we have been able to cut his Zyprexa dosage from 20 mg to 12.5 mg he is less tired now but the other med = Zoloft we have not yet attempted to reduce. Has anyone else been able to cut down their dosage on APs and ADs successfully without adding other meds?
Posted by Phillipa on November 10, 2005, at 19:39:50
In reply to Over Medication and Dosage Reduction, posted by DanielJ on November 10, 2005, at 9:08:51
Daniel I forgot his diagnosis was it schizophenia? Fondly, Phillipa
Posted by DanielJ on November 10, 2005, at 20:45:20
In reply to Re: Over Medication and Dosage Reduction (nm), posted by DanielJ on November 10, 2005, at 20:43:18
Yes Philip, the Undifferentiated variety.
Posted by Phillipa on November 10, 2005, at 21:00:43
In reply to Re: Over Medication and Dosage Reduction, posted by DanielJ on November 10, 2005, at 20:45:20
Unfortunately the Board is quiet tonight. The experts Ed_uk, Scott, Link, and others are not posting tonight. Usually they do on the weekend. Maybe some replies by Saturday morning. Wish I could help you more but feel unqualified to. Fondly, Phillipa
Posted by HappyGirl on November 11, 2005, at 0:54:12
In reply to Over Medication and Dosage Reduction, posted by DanielJ on November 10, 2005, at 9:08:51
Hi:
Recalling your previous posts, ... your son has Shizophrenia.In regard to med. and dosage reduction, ... in my case, Bipolar II with rapid cycler which means I have Rapid cycler on the top of Bipolar II. It's a quite 'bad' case of Bipolar, although I never have psychotic and delusional symtoms. I have only 'regular' Bipolar 'manic' episodes along with major depressive symptoms.
With a proper/right med. combo. over 5 or so years, however my condition VERY slowly improved to the point where I feel 'normal,' not sufferring any manic and depressive episodes, except some 'triggers' which I need to avoid on daily basis.
In my case, until mid.- August, I had Lithium 900 mg., Zyprexa 5 mg., along with two ADs, Wellbutrin SR 300 mg. and Trazodon 150 mg. However, I cut down completely Lithium along with Trazodone, from 150 mg. to 100 mg., without any 'withdrawal' symptoms. I have been stabilized with other remaining meds., Zyprexa, two ADs. So to speak, 'remission' with meds.
Then, in my opinion through the experience, ... yes, your son is ABLE to reduce AD, 'if' he feels less depression. It must be, however, gradually and very carefully. If he does feel depression or any other 'bad' symtoms due to a reduction on meds., then he needs to go back to the dosage on which he feels 'comfortable.'
However, before doing so, ... you and your son may need to talk to his pdoc. first. Because, when I mentioned my pdoc. regarding a med. and dosage reduction, he definitely annoyed, seeing me not asking him, ... not play a doctor again or something like this sort of comment. However, his pdoc. might be NOT the same as mine. Good Luck!!!
H.G.
Posted by Sebastian on November 11, 2005, at 8:56:30
In reply to Over Medication and Dosage Reduction, posted by DanielJ on November 10, 2005, at 9:08:51
My luck is varied in reducing meds. Usualy I can get away with it for a while but in the end I need to go right back up in dose. Or the addition of some thing else, which also usualy does not work for so long.
I am looking at going back up in dose of zyprexa right now, to the 10 mg dose I have taken for so long. And quiting the geodon. Also since the addition of geodon and decreases of zyprexa, my drinking has gone up, way up. I think the geodon does not work. I wanted it to so bad because of lack of side-effects, other than a mild case of blury vision. I used to drink 1 drink a week on 10 mg zyprexa, now I was drinking 3-4 a day. I have cut back a little recently as the zyprexa was incresed, now 2 a day. Not to mention the voices I've started hearing since being on geodon. Never realy had voices like these before, ever. I'm not sure but I think the geodon makes me worse.
Posted by HappyGirl on November 11, 2005, at 14:33:04
In reply to Re: Over Medication and Dosage Reduction, posted by Sebastian on November 11, 2005, at 8:56:30
Hi Sebantian:
My 'only,' ... but 'serious' problem after a reduction and elimination meds. is 'stomack' problem. It's called 'Acid Reflux' from which I sufferred BEFORE my Bipolar started coming up. Then, I can NOT complain of, but it's a big 'financial' dent. Because, as you may know, 'Prevacid 30 mg.' here in the US is around $150.00. Since my 'med./rx' coverage has been exhausted already, due to the med. combo., mostly 'Zyprexa' along with 'WB sr'(half a year until switched to the generic, 'bupropion SR). Then, I need to pay a fortune, around $300.00 per month for the Prevacid, twice per day. Because, just one 'capsule 30 mg.' does not alleviate the 'acid' in my stomach. I neither drink nor smoke. Just love 'spicy foods' tho'.Either way, ... it seems that I've stuck this 'awful' financial dent, although luckily my 'dear' family understands my problem and has been helping at the best they can.
Just wonder, ... how can you 'drink' SO much? Bupropion SR often brings up 'Acid' problem, reading the others. Sounds like you have 'iron stomach' to withstand both 'legal' and 'illegal' stuff, as reading your previous post, ... 'street drug.'
I turly envy your 'super-strong' stomach.
H.G.
Posted by med_empowered on November 12, 2005, at 19:41:35
In reply to Over Medication and Dosage Reduction, posted by DanielJ on November 10, 2005, at 9:08:51
If your son has depression (which is often a BIG part of schizophrenia), reducing the antidepressant should be done very, very carefully. Personally, I think maybe you should try a switch instead of a taper; Remeron has been shown to decrease the negative symptoms of schizophrenia. On the downside, it can cause weight gain, so it may not be the med of choice. Provigil might be worthwhile; its a mild stimulant that also seems to alleviate negative symptoms for some people...since its an anti-narcolepsy drug, you might also get some reduced daytime sedation. Good luck!
Posted by DanielJ on November 13, 2005, at 7:14:05
In reply to Re: Over Medication and Dosage Reduction, posted by med_empowered on November 12, 2005, at 19:41:35
I guess I was hazy on the reason for the recent dosage reduction of Zyprexa. The last month or two He was getting tired/sleepy earlier in the evening than usual. It seems that the reduction has helped a bit. The latest was from 15 mg to 12.5 mg. He seems to be less sleepy in the evening and we are OK now as long as the Schiz. symptoms don't reappear. Catatonia is usually the first to show itself and we haven't seen that since he cut down from 20 mg to 7.5 mg over one month period. Went right back up to 15 mg the next day and has been taking 15 mg per day up to a month ago when the Doc dropped him to 12.5.
I believe Zoloft helps with the personality symptoms and also the obsessive ones so we will be cautious reducing the dosage on this med.
Posted by HappyGirl on November 13, 2005, at 10:10:43
In reply to Re: Over Medication and Dosage Reduction, posted by DanielJ on November 13, 2005, at 7:14:05
Hi:
One thing I know very well regarding the 'Zyprexa' is that this AP has not only AP capaciy but also Anti-Dep. efficacy along with a number of 'good' qualify. For this reason, I believe that the Zyprexa keeps a very first-runner in the market, despite 'Diabetes' scare.In my case, two ADs, WB sr and Trazodone is NOT enough for my major depression which is one of BP symptoms. For this, the Zyprexa is a tremendous 'booster' to 'fine-tune' my 'two' ADs. Practically, Trazodone 100 mg. is NOT a real AD, to say the least. Rather it's a 'sleep-well' med. Other AD, WB sr also is said to be NOT a good AD for a BP individual like me. Then, in that respect, the Zyprexa is a VERY last med. for me to reduce its dosage.
Your son's case, however, as for a Shizo., then I'm not REALLY familiar with, ... however already from the 20 mg. to 12.5 mg./15 mg. reduction. In my opinion, it sounds to me, NOT a good idea to reduce the Zoloft dosage. At least, he gets more stabilized. In the future, however, he feels REALLY less-depressive, then to try a reduction of the Zoloft very slowly and cautiously.
H.G.
Posted by med_empowered on November 13, 2005, at 15:07:43
In reply to Re: Over Medication and Dosage Reduction, posted by DanielJ on November 13, 2005, at 7:14:05
when you say "personality symptoms," what are you referring to? I'm a bit confused. Some people are able to reduce their antipsychotic dosages by taking benzos; yes, it means adding more medicine, but usually the combo leads to fewer side effects and greater quality of life than using only an antipsychotic. If your son demonstrates a lot of agitation/anxiety or tension, that might be a good thing to try. Adding metformain (glucophage, glucophage XR) can help with the zyprexa-induced metabolic "issues"...some docs think it seems to help with mood-stabilization as well. If sedation is a really big problem, you might want to consider a switch to Abilify, which is usually non-sedating (sometimes its even activating, depending on the dose).
Posted by DanielJ on November 14, 2005, at 7:36:42
In reply to Zoloft reduction..., posted by med_empowered on November 13, 2005, at 15:07:43
Personality issues with schizophrenia are very profound. Flat Affect with suppressed anger are the common ones with my son. I believe over a few months Zoloft did a great deal to alleviate this. He attends High School and He laughs and even cries now which is wonderful his emotions and his memory have been restored. The "zombie" effects that accompany schizophrenia are really scary. He tried Abilify first and it made him hallucinate, gave him vomiting and diarhea do not think we will be going back to that one.
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