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Dr. Bob is Robert Hsiung, MD,
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Posted by tensor on February 4, 2012, at 7:43:49
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 4, 2012, at 6:41:54
Posted by ed_uk2010 on February 4, 2012, at 8:07:02
In reply to One more thing.., posted by tensor on February 4, 2012, at 4:06:26
> Can you cross-titrate Zyprexa with 7.5mg of Abilify?
I don't think you will need to. I think you can just stop the Abilify first, but check with your doctor to see what he recommends.
If you do benefit from Zyprexa, I wonder whether you will still need Remeron?
Posted by tensor on February 4, 2012, at 8:32:28
In reply to Re: One more thing.. » tensor, posted by ed_uk2010 on February 4, 2012, at 8:07:02
> > Can you cross-titrate Zyprexa with 7.5mg of Abilify?
>
> I don't think you will need to. I think you can just stop the Abilify first, but check with your doctor to see what he recommends.
>
> If you do benefit from Zyprexa, I wonder whether you will still need Remeron?The plan is to replace Remeron and escitalopram with fluoxetine, so I would take the Zyprexa-fluoxetine combo.
Posted by Zyprexa on February 4, 2012, at 22:46:16
In reply to Re: Thinking of Zyprexa, posted by SLS on February 4, 2012, at 3:32:39
I would probably be so skinny if I never got on the zyprexa. I was not eating and losing weight fast.
Posted by Zyprexa on February 4, 2012, at 22:54:15
In reply to Re: Thinking of Zyprexa » Zyprexa, posted by tensor on February 4, 2012, at 4:04:03
I would probably start at 5mg and work up to 10, or what ever seems needed. Its fairly quick acting, you will deffinitly know about a dose in one week, if not the first day.
I started at 15mg and that knocked me out, sleeping for 18 hours and eating mini wheats out of the box and going back to sleep. I went down to 10 and thats where I've pretty much stayed.
Posted by Zyprexa on February 4, 2012, at 22:58:52
In reply to One more thing.., posted by tensor on February 4, 2012, at 4:06:26
yes I took zyprexa and abilify at the same time for a while, then stoped the abilify. I went cold turky off abilify and suffered a major withdraw stage where I needed a higher dose of zyprexa for a while, a much higher dose, 30-50mg.
Posted by Zyprexa on February 4, 2012, at 23:02:41
In reply to Re: Thinking of Zyprexa » Zyprexa, posted by tensor on February 4, 2012, at 4:13:53
I don't know what anticholinergic effects are. Isn't remeron a TCA? I tried to swtich zyprexa for remeron and had a bad experience. NIghtmares.
Posted by Zyprexa on February 4, 2012, at 23:06:32
In reply to Re: One more thing.. » ed_uk2010, posted by tensor on February 4, 2012, at 8:32:28
If you do zyprexa and fluoxitine. I found a major difference between brand Prozac and the generic. The brand of coarse is much better.
Posted by tensor on February 5, 2012, at 3:23:25
In reply to Re: Thinking of Zyprexa, posted by Zyprexa on February 4, 2012, at 23:02:41
Posted by SLS on February 5, 2012, at 5:47:17
In reply to Re: One more thing.., posted by Zyprexa on February 4, 2012, at 22:58:52
> yes I took zyprexa and abilify at the same time for a while, then stoped the abilify. I went cold turky off abilify and suffered a major withdraw stage where I needed a higher dose of zyprexa for a while, a much higher dose, 30-50mg.
That's interesting. Abilify is much more potent than Zyprexa at binding to the D2 receptor. Perhaps there was a supersensitivity thing going on there. Unlike Zyprexa, Abilify also binds to the D3 receptor. Any withdrawal effects coming from this would probably not be counteracted by Zyprexa.
Did you feel that Zyprexa was less potent while you were taking Abilify?
These are just musings. I make no claim as to the validity of any of my theories.
- Scott
Posted by tensor on February 5, 2012, at 9:10:58
In reply to Re: One more thing.. » Zyprexa, posted by SLS on February 5, 2012, at 5:47:17
> > yes I took zyprexa and abilify at the same time for a while, then stoped the abilify. I went cold turky off abilify and suffered a major withdraw stage where I needed a higher dose of zyprexa for a while, a much higher dose, 30-50mg.
>
> That's interesting. Abilify is much more potent than Zyprexa at binding to the D2 receptor. Perhaps there was a supersensitivity thing going on there. Unlike Zyprexa, Abilify also binds to the D3 receptor. Any withdrawal effects coming from this would probably not be counteracted by Zyprexa.I thought Zyprexa binds to D1-D4.
http://www.psychiatrist.com/pcc/pccpdf/v05s03/v05s0302.pdf
http://www.psychresidentonline.com/atypical%20antipsychotics.htm
http://ajp.psychiatryonline.org/article.aspx?articleid=175102> These are just musings. I make no claim as to the validity of any of my theories.
Got it. :)
Posted by SLS on February 5, 2012, at 10:03:05
In reply to Re: One more thing.. » SLS, posted by tensor on February 5, 2012, at 9:10:58
> > Unlike Zyprexa, Abilify also binds to the D3 receptor.
> I thought Zyprexa binds to D1-D4.
Thanks for checking me on that. I really like the links you provided.
> http://www.psychiatrist.com/pcc/pccpdf/v05s03/v05s0302.pdf
> http://www.psychresidentonline.com/atypical%20antipsychotics.htm
> http://ajp.psychiatryonline.org/article.aspx?articleid=175102
- Scott
Posted by tensor on February 6, 2012, at 0:47:16
In reply to Thinking of Zyprexa, posted by tensor on February 3, 2012, at 8:14:15
Just talked to my pdoc, starting Zyprexa 5mg tonight instead of Abilify. Hopefully it will work better.
Posted by Zyprexa on February 6, 2012, at 6:07:46
In reply to Re: One more thing.. » Zyprexa, posted by SLS on February 5, 2012, at 5:47:17
Yes, zyprexa was almost useless while on or for a little while afterwards of being on abilify.
Posted by SLS on February 6, 2012, at 6:27:16
In reply to Re: One more thing.. » SLS, posted by Zyprexa on February 6, 2012, at 6:07:46
> Yes, zyprexa was almost useless while on or for a little while afterwards of being on abilify.
Thank you for reporting that. It helps me in my efforts to figure this stuff out.
It is too bad that Jeroen continues to ignore my pleas that he discontinue Abilify and add back Seroquel. I have been suggesting that he do this for at least two years. I am tempted to give up trying. Unfortunately, I can't offer him guarantees.
- Scott
Posted by ed_uk2010 on February 6, 2012, at 6:35:33
In reply to Re: Thinking of Zyprexa, posted by tensor on February 6, 2012, at 0:47:16
>Just talked to my pdoc, starting Zyprexa 5mg tonight instead of Abilify. Hopefully it will work better.
I hope so too :)
Posted by SLS on February 6, 2012, at 7:49:08
In reply to Re: Thinking of Zyprexa, posted by tensor on February 6, 2012, at 0:47:16
> Just talked to my pdoc, starting Zyprexa 5mg tonight instead of Abilify. Hopefully it will work better.
Are you planning on tapering Abilify?
If you are doing a cross-over substitution from Abilify to Zyprexa, you might want to be aware that there might be a temporary mild-to-moderate increase in depression or anxiety. It would probably be tolerable and transient, but I wouldn't want you to mistake Abilify withdrawal for a negative reaction to Zyprexa.
- Scott
Posted by tensor on February 6, 2012, at 9:42:00
In reply to Re: Thinking of Zyprexa » tensor, posted by SLS on February 6, 2012, at 7:49:08
> Are you planning on tapering Abilify?
>
> If you are doing a cross-over substitution from Abilify to Zyprexa, you might want to be aware that there might be a temporary mild-to-moderate increase in depression or anxiety. It would probably be tolerable and transient, but I wouldn't want you to mistake Abilify withdrawal for a negative reaction to Zyprexa.
>
>
> - ScottThanks for the advice and heads up. I won't cross-titrate but switch right off. I actually took 5mg of Zyprexa this morning and I could feel a decrease in anxiety within an hour, I couldn't wait to bedtime, was too dysphoric. Will take it at bedtime from now on.
Actually it's Ratiopharm generic olanzapine, cost me a little over 3, a *bit* cheaper than the brand Zyprexa./t
Posted by SLS on February 6, 2012, at 11:25:39
In reply to Re: Thinking of Zyprexa » SLS, posted by tensor on February 6, 2012, at 9:42:00
> I actually took 5mg of Zyprexa this morning and I could feel a decrease in anxiety within an hour, I couldn't wait to bedtime, was too dysphoric. Will take it at bedtime from now on.
Good luck!
- Scott
Posted by ed_uk2010 on February 8, 2012, at 8:01:05
In reply to Re: Thinking of Zyprexa » SLS, posted by tensor on February 6, 2012, at 9:42:00
How are you doing Tensor?
Posted by tensor on February 8, 2012, at 8:09:44
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 8:01:05
> How are you doing Tensor?
Thanks for asking. I took my third dose of 5mg yesterday, and it hasn't helped my lack of motivation and interest. My pdoc suggested 5 or 10mg and I chose 5mg, not sure if I should up the dosage or wait a little longer.
I sleep well, but no increase in hunger. I still have restlessness but I think it's because of Abilify lingering in my body./t
Posted by ed_uk2010 on February 8, 2012, at 10:08:51
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 8:09:44
>it hasn't helped my lack of motivation and interest....
What sort of things do you struggle with most?
>My pdoc suggested 5 or 10mg and I chose 5mg, not sure if I should up the dosage or wait a little longer.
Even though Zyprexa generally works quite quickly, it's still very early days. I suppose you won't know how Zyprexa affects you on its own until Abilify is out of your system.
Posted by tensor on February 8, 2012, at 10:17:52
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 10:08:51
> >it hasn't helped my lack of motivation and interest....
>
> What sort of things do you struggle with most?Fatigue, not enough energy to get things done, basic things like cooking food. I have an increase in anxiety now.
> >My pdoc suggested 5 or 10mg and I chose 5mg, not sure if I should up the dosage or wait a little longer.
>
> Even though Zyprexa generally works quite quickly, it's still very early days. I suppose you won't know how Zyprexa affects you on its own until Abilify is out of your system.
>Do you think it would be a bad idea taking 10mg tonight, I'm desperate. Maybe a higher dose would counteract any Abilify withdrawals? Took last 7.5mg of Abilify at Saturday evening.
Thanks.
Posted by ed_uk2010 on February 8, 2012, at 12:00:27
In reply to Re: Thinking of Zyprexa » ed_uk2010, posted by tensor on February 8, 2012, at 10:17:52
>Fatigue, not enough energy to get things done, basic things like cooking food. I have an increase in anxiety now.
Do you still feel very depressed emotionally or does it feel more like a chronic fatigue state?
>Do you think it would be a bad idea taking 10mg tonight, I'm desperate. Maybe a higher dose would counteract any Abilify withdrawals? Took last 7.5mg of Abilify at Saturday evening.
Do you think you are having Abilify withdrawal symptoms after such a short time on it? I think I higher dose of Zyprexa might help your anxiety, unless it causes akathisia.
Posted by tensor on February 8, 2012, at 12:17:34
In reply to Re: Thinking of Zyprexa » tensor, posted by ed_uk2010 on February 8, 2012, at 12:00:27
> Do you still feel very depressed emotionally or does it feel more like a chronic fatigue state?
Chronic fatigue state for sure, but it has started to get to me emotionally too after so long time.
> Do you think you are having Abilify withdrawal symptoms after such a short time on it? I think I higher dose of Zyprexa might help your anxiety, unless it causes akathisia.I don't know, maybe it's some form of rebound anxiety, although it wasn't that good for anxiety. I'll take 10mg of Zyprexa tonight and see how I feel tomorrow. Some extra clonazepam are pretty good against restlessness.
/t
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Dr. Bob is Robert Hsiung, MD,
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