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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Janelle on September 27, 2001, at 21:58:37
Anyone here (SalArmy4Me, this could be right up your alley! Ditto for JohnL !) know if Zyprexa works even slightly on Serotonin levels (kind of like an SSRI, but not to the same extent) ??? I heard somewhere that it does, but I'd like confirmation or rebuttal of this from the well-informed and knowledgeable people on here! Thanks.
Posted by SalArmy4me on September 28, 2001, at 1:11:40
In reply to Zyprexa and Serotonin ???, posted by Janelle on September 27, 2001, at 21:58:37
Zyprexa works best in combination with Prozac treatment (for depressive states), and on norepinephrine as well as dopamine.
The American Journal of Psychiatry. Volume 158(1) January 2001 pp 131-134. A Novel Augmentation Strategy for Treating Resistant Major Depression
"With fluoxetine treatment, norepinephrine and dopamine levels increase to 188% and 143% of baseline values, respectively. However, when both fluoxetine and olanzapine are given, norepinephrine and dopamine levels increase to 269% and 349% of baseline values, respectively. This suggests a neurochemical basis for the synergistic antidepressant effect observed in the present trial. The prefrontal cortex is rich in mesocorticolimbic dopamine innervation (21-23). Coupled with the well-chronicled role of norepinephrine in mood states (24), this suggests potential targets for treating resistant depression..."
Posted by SLS on September 28, 2001, at 11:50:22
In reply to Re: Zyprexa and Serotonin ??? » Janelle, posted by SalArmy4me on September 28, 2001, at 1:11:40
> Zyprexa works best in combination with Prozac treatment (for depressive states), and on norepinephrine as well as dopamine.
>
> The American Journal of Psychiatry. Volume 158(1) January 2001 pp 131-134. A Novel Augmentation Strategy for Treating Resistant Major Depression
>
> "With fluoxetine treatment, norepinephrine and dopamine levels increase to 188% and 143% of baseline values, respectively. However, when both fluoxetine and olanzapine are given, norepinephrine and dopamine levels increase to 269% and 349% of baseline values, respectively. This suggests a neurochemical basis for the synergistic antidepressant effect observed in the present trial. The prefrontal cortex is rich in mesocorticolimbic dopamine innervation (21-23). Coupled with the well-chronicled role of norepinephrine in mood states (24), this suggests potential targets for treating resistant depression..."
Hi Sal.Do you think using Zyprexa in combination with Prozac is better than using it combination with any of the other SSRIs?
Thanks.
- Scott
Posted by SLS on September 28, 2001, at 12:19:15
In reply to Zyprexa and Serotonin ???, posted by Janelle on September 27, 2001, at 21:58:37
> Anyone here (SalArmy4Me, this could be right up your alley! Ditto for JohnL !) know if Zyprexa works even slightly on Serotonin levels (kind of like an SSRI, but not to the same extent) ??? I heard somewhere that it does, but I'd like confirmation or rebuttal of this from the well-informed and knowledgeable people on here! Thanks.
Hi Janelle.My turn.
You ask a very interesting question. I think I'll look into it.
What is known about Zyprexa and some of the other "atypical" antipsychotics (Geodon, Risperdal, Seroquel, and Clozaril) is that it blocks a serotonin (5-HT) receptor known as 5-HT2a. I believe that this results in reducing, rather than increasing, the rate at which these serotonergic neurons fire. Some of the antidepressants do this as well (trazodone, Serzone, and Remeron).
The action that Prozac and the other SSRIs are noted for are their ability to increase the concentration of serotonin in the gap between neuron_1 and neuron_2. It accomplishes this by preventing neuron_1 from removing the serotonin from this gap. Neuron_1 communicates its messagee to neuron_2 by releasing serotonin into the gap. Neuron_2 becomes stimulated to relay this message along to the next neuron when enough of its receptors are occupied by the serotonin released by neuron_1. Under normal circumstances, neuron_1 cleans up after itself by absorbing the serotonin it has released and recycling it to use again. It does this by using little delivery trucks known as transporters. SSRIs (Selective Serotonin Reuptake Inhibitors) inhibit this reuptake of serotonin by preventing the transporters from doing their jobs. So of course, this leads to an accumulation of serotonin in the gap and an increase in the number of receptors along neuron_2 to be occupied and stimulated.
I have not yet encountered any information suggesting that Zyprexa inhibits the reuptake of serotonin. However, some studies have reported that Geodon does.
* serotonin = 5-HT = 5-HydroxyTryptomine = monoamine neurotransmitter
I hope this explanation helped.
- Scott
Posted by SLS on September 28, 2001, at 14:11:46
In reply to Re: Zyprexa and Serotonin ??? » SalArmy4me, posted by SLS on September 28, 2001, at 11:50:22
> > Zyprexa works best in combination with Prozac treatment (for depressive states), and on norepinephrine as well as dopamine.
> >
> > The American Journal of Psychiatry. Volume 158(1) January 2001 pp 131-134. A Novel Augmentation Strategy for Treating Resistant Major Depression
> >
> > "With fluoxetine treatment, norepinephrine and dopamine levels increase to 188% and 143% of baseline values, respectively. However, when both fluoxetine and olanzapine are given, norepinephrine and dopamine levels increase to 269% and 349% of baseline values, respectively. This suggests a neurochemical basis for the synergistic antidepressant effect observed in the present trial. The prefrontal cortex is rich in mesocorticolimbic dopamine innervation (21-23). Coupled with the well-chronicled role of norepinephrine in mood states (24), this suggests potential targets for treating resistant depression..."
>
>
> Hi Sal.
>
> Do you think using Zyprexa in combination with Prozac is better than using it combination with any of the other SSRIs?
>
> Thanks.
>
>
> - ScottEli Lilly has been working towards the marketing of a preparation that contains both Prozac and Zyprexa. Beginning two or three years ago, they have been funding clinical trials to provide a basis for this.
I will be very curious to see if the other SSRIs are equipotent to Prozac in combination with Zyprexa. It might very well be that Prozac is superior.
I'm really not too crazy about the idea of manufacturing a single preparation containing both drugs. I should think it makes more sense to encourage titrating towards the optimal dosage of both drugs individually. What's so hard about taking two pills instead of one? Some people need as much as 60mg of Prozac. If you start out first with the 2-for-1 preparation, how are you going to effectively treat such a case without having to switch to the individual preparations in order to reduce the potential for producing EPS. I doubt every doctor will opt for making this switch, and will instead allow for increasing the dosage of Zyprexa along with the Prozac as they increase the dosage of the new preparation.
There is some precedence for this kind of thing, though. Triavil is a combination of Elavil (amitriptyline) and Trilafon (perphenazine).
- Scott
Posted by ttt on November 10, 2001, at 16:57:59
In reply to Re: Zyprexa and Serotonin ??? » Janelle, posted by SLS on September 28, 2001, at 12:19:15
I stopped zyprexa and had chronic insomnia.
Does anyone know an explanation of how zyprexa works on serotonin to cause insomnia?
Does anyone know how to cure this type of insomnia?
This is the end of the thread.
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