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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by uncouth on October 22, 2009, at 23:06:22
despite zyprexa working substantially better than ziprasidone, after 6 weeks, the weight is creeping up and the appetite and food consumption feels simply out of control. i'm always hungry, and always craving...like a drug...food.
not good.
i am stopping zyprexa 5mg in favor of trying abilify again. few questions:
1) some talk about abilify is that it works well for unipolar but not for bipolar...but some doctors say that very low doses (2.5mg) ARE effective for bipolar 2, even if higher doses are not.
any truth to this? anyone ahve this experience?
2) what is the standard equivalent dose of 5mg zyprexa? i'm guessing 10mg abilify?thanks
uncouth
Posted by Maxime on October 22, 2009, at 23:27:32
In reply to Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 22, 2009, at 23:06:22
Expect weight gain on 10 mg of Abilify.
Posted by Phillipa on October 22, 2009, at 23:54:46
In reply to Re: Can't handle zyprexa weight gain, onto Abilify » uncouth, posted by Maxime on October 22, 2009, at 23:27:32
Really? How did you figure this out is there a chart or something? Interesting know someone on 2.5 no weight gain. Phillipa
Posted by Maxime on October 23, 2009, at 6:19:49
In reply to Re: Can't handle zyprexa weight gain, onto Abilify » Maxime, posted by Phillipa on October 22, 2009, at 23:54:46
It's dosage specific. Maybe no weight gain at 2mg but at 10?, yes, Look at how much Scott gained ... 35 pounds.
Posted by Zyprexa on October 23, 2009, at 11:52:04
In reply to Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 22, 2009, at 23:06:22
If Abilify didn't work the first time, why would it work now? I tried that many times and it just made my life worse.
5mg zyprexa is equivelent to 7mg abilify. If I were you I would try 5mg abilify. Abilify is strong medicine and it builds slowly.
I didn't have wieght gain on any dose of abilify. But I was coming off zyprexa at the same time. Abilify made me pretty crazy. I couldn't function at work or school. I just kept trying it, pushing to make it work, because of weight and sugar concerns. The end result I lost my job. And I could tell it was not working. But kept trying different things with it. None of them worked. And when I came off the abilify each time, I had a long washout peroid which was worse than being on the abilify, and lasted 4 times as long as I was on it.
Have you tried perphenazine. Its much beter than abilify and similar to zyprexa without the weight issues. You might try that. Its the closest thing to zyprexa that I have tried. I still take it for 3 years now, along with the zyprexa.
Posted by uncouth on October 23, 2009, at 12:36:43
In reply to Re: Can't handle zyprexa weight gain, onto Abilify » uncouth, posted by Zyprexa on October 23, 2009, at 11:52:04
what do you mean "couldn't function?" were you just too depressed? or agitated?
last time i was on abilify i was also on an MAOI and it was pre-ECT...so hoping this time is different. i just can't handle the hunger/weight issues with zyprexa...even with metformin...im gaining weight too fast and all i think about is eating.
Posted by ricker on October 23, 2009, at 12:45:25
In reply to Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 22, 2009, at 23:06:22
Did you take the "Zydis" formulation of Zyprexa? I find it helps quite a bit with the hunger as it bypasses the stomach ( from what I've read and it seems true for me?)
This may sound harsh but when I'm in a true chronic depressive state, the last thing on my mind is added weight gain from a med that has the ability to lift me out of that black hole. Add in it's ability to greatly reduce cycling, irritable moods swings etc. Zyprexa just plain works for me. I will deal with the weight-gain issues in a proactive way as it's a small price to pay IMO.
I find that when I'm feeling stable is the time when I begin to procrastinate about my added weight from Zyprexa. That's the worst thing I could do as I know I'm asking for trouble if I begin looking for other options. Most of us here know that when we reach a positive place as far as remission, it's best to leave things (meds) as they are and deal with the unwanted side-effects as best we can.
Dumping Zyprexa due to weight issues and looking to try another atypical does not mean you will feel the same positive effects you experienced with Zyprexa, and it most certainly does not mean you won't be challenged with additional side-effects such as dystonia, T/D etc. Weigh-gain is not just an Zyprexa issue, the other atypicals can challenging as well.
Regards, Rick
Posted by Zyprexa on October 23, 2009, at 23:05:47
In reply to Re: Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 23, 2009, at 12:36:43
Couldn't function because I was not getting sleep. Also I was just out of it, my mind was not operating normaly. Feeling like I was going to pass out when I stood up. Couldn't concentrate work/school.
Posted by morganator on October 23, 2009, at 23:10:33
In reply to Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 22, 2009, at 23:06:22
I hate it as well! Plus I don't think it ever did all that much for me. Antipsychotics Suck!
Posted by Zyprexa on October 23, 2009, at 23:14:06
In reply to Re: Can't handle zyprexa weight gain, onto Abilify » uncouth, posted by ricker on October 23, 2009, at 12:45:25
Rick is right. Just because one AP works well, doesn't mean that they all work just as well. There is a real difference between APs, unlike SSRIs, which seem to be pretty similar. With APs its like your mind is in a totaly different place with each one. I've tried a lot of APs and they all are very different. I've tried all the Atipicals, except seroquel, which I often wonder if its similar to zyprexa. But since it has the weight issue too, I didnt' try it.
Posted by uncouth on October 24, 2009, at 0:03:33
In reply to Re: Can't handle zyprexa weight gain, onto Abilify, posted by Zyprexa on October 23, 2009, at 23:14:06
I completely agree, and in fact have posted something almost exactly along the lines of your arguments very recently myself. Unfortunately, the weight gain and appetite increase is pretty serious, and im already taking metformin.
My hope is that zyprexa over teh past 6 weeks was enough to get me out of teh pit and renormalize things, and now abilify is enough to keep me steady. However, if abilify isn't doing the trick, I will go back to zyprexa. I agree, it is silly to worry about weight when one is trying to treat a serious, life threatening depresison.
Posted by theconfusedone on October 25, 2009, at 1:50:31
In reply to Re: Can't handle zyprexa weight gain, onto Abilify » Zyprexa, posted by uncouth on October 24, 2009, at 0:03:33
I have recently been put on zprexa and I am tapering down from lexapro 40mgs for the last 4 to 5 years which have stopped working. I started on 2'5mgs of zyprexa and notticed my appetite shooting up and I'm also quite tired a lot. I'm noow on 5mgs zyprexa for the last week but my appetite is the same but I just have less energy.
I think it is a combination of overeating and metabolism issues, but I don't care for the time being cause it's one really great med for me as it has pulled me out of the darkest dingiest place I've every been and It's beginning to give me my life back.. I do think I will def need to go to 10mg when I taper off those goddamn lexapro (Brain zaps are doing my nut in) At least now I'm able to go for walks again and not feel paranoid or angry with myself. I think the answer is plenty of exercise, swimming walking etc and when we feel the need to eat,,, eat sensibly and smaller portions.
Posted by Rosy Crucifiction on October 25, 2009, at 11:20:14
In reply to Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 22, 2009, at 23:06:22
I know a lot of folks have issues with the weight gain from meds. It's a shame to give up a med that works for a side effect. Particularly if the side effect can be dealt with. I have spoken to several folks who have had good experiences adding metformin (stabilizes insulin levels - thus can help prevent craving and glucose storage as fat). Any experiences? I've used it. It has few side effects and MAY increase longevity.
see: http://jama.ama-assn.org/cgi/content/abstract/299/2/185Also, a new weight loss drug is in stage three. It is a combination of wellbutrin and naltrexone. Contrave. here's some info:
http://www.medpagetoday.com/MeetingCoverage/ENDO/14787
Please let me know if anyone has experiences with either of these combos. THANKS!
Posted by manic 666 on October 25, 2009, at 12:22:17
In reply to Re: zyprexa weight gain, treatment options, posted by Rosy Crucifiction on October 25, 2009, at 11:20:14
i hate weight gain , being a sex god to all women, my six pack is now a 24 pack , my pork sword needs a battery charger,an every jiont in my body ache,s ,apart from that im jumping for joy.when my anxierty was curred by a mass intake of alchol i was slim ,but the yellow complection didnt suit me.
Posted by softheprairie on October 26, 2009, at 4:12:19
In reply to Can't handle zyprexa weight gain, onto Abilify, posted by uncouth on October 22, 2009, at 23:06:22
Uncouth, I see that you said if the Abilify doesn't work that you'd go back to Zyprexa. You seem to have ruled perphenazine out already. I want to put in another good word for perphenazine.
I liked the mood effect of Zyprexa, but not the weight, lipid, etc. effects. Abilify didn't work for me (in fact caused akathisia). I am currently pleased with perphenazine (as a part of a larger cocktail), have been on it a few years at low doses, and have not gotten tardive dyskinesia.
Posted by Rosy Crucifiction on October 26, 2009, at 10:09:26
In reply to Re: zyprexa weight gain, treatment options, posted by Rosy Crucifiction on October 25, 2009, at 12:20:14
Here is a study showing a difference between olanzapine and ziprasidone in glucose tolerance. I do think metformin is a worthwhile addition to atypical antipsychotic therapy.
Original ArticleEffects of Olanzapine and Ziprasidone on Glucose Tolerance in Healthy Volunteers
Julia Sacher1, Nilufar Mossaheb1, Christoph Spindelegger1, Nikolas Klein1, Thomas Geiss-Granadia1, Robert Sauermann2, Edith Lackner2, Christian Joukhadar2, Markus Müller2 and Siegfried Kasper1
Atypical antipsychotics have been linked to a higher risk for glucose intolerance, and consequentially the development of type 2 diabetes mellitus (DM2). We have therefore set out to investigate the acute effects of oral administration of olanzapine and ziprasidone on whole body insulin sensitivity in healthy subjects. Using the standardized hyperinsulinemic euglycemic clamp technique we compared whole body insulin sensitivity of 29 healthy male volunteers after oral intake of either olanzapine 10 mg/day (n=14) or ziprasidone 80 mg/day (n=15) for 10 days. A significant decrease (p<0.001) in whole body insulin sensitivity from 5.7 ml/h/kg (=mean, SM=0.4 ml/h/kg) at baseline to 4.7 ml/h/kg (=mean, SM=0.3 ml/h/kg) after oral intake of olanzapine (10 mg/day) for 10 days was observed. The ziprasidone (80 mg/day) group did not show any significant difference (5.2plusminus0.3 ml/h/kg baseline vs 5.1plusminus0.3 ml/h/kg) after 10 days of oral intake. Our main finding demonstrates that oral administration of olanzapine but not ziprasidone leads to a decrease in whole body insulin sensitivity in response to a hyperinsulinemic euglycemic challenge. Our finding is suggestive that not all atypical antipsychotics cause acute direct effects on glucose disposal and that accurate determination of side effect profile should be performed when choosing an atypical antipsychotic.
Posted by uncouth on October 27, 2009, at 11:14:55
In reply to Re: zyprexa weight gain, treatment options, posted by Rosy Crucifiction on October 26, 2009, at 10:09:26
Just as an FYI, my week-long experiment of going off zyprexa and replacing with abilify has come to an end. Conclusion -- abilify noticably worsened my mood, and contrary to some reports, I believe it actually increased impulsivity, reduced focus, and caused me to feel worse mood-wise. I was at 10mg.
I will deal with the zyprexa weight-gain another way (amantadine and metformin perhaps). I took my first dose last night (5mg) in a week and wow, I woke up this morning after sleeping well, feeling qualitatively different.
Zyprexa really is a different beast. My only concern is it's cognitive effects...I should know more today about whether it is reducing my verbal fluency after I write a few essays. I found writing to be easier yesterday when I was free of zyprexa for about a week.
Thanks all
uncouth
Posted by Zyprexa on October 27, 2009, at 12:29:52
In reply to Re: zyprexa weight gain, treatment options, posted by uncouth on October 27, 2009, at 11:14:55
I found that I had a wash out period where I felt worse for some time before feeling better again. I don't know if you will have this or anyone else. But that is what happened to me each time I tried abilify and went back to the zyprexa.
This is the end of the thread.
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