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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by B2chica on November 21, 2011, at 15:38:59
zyprexa works so well for me but i cant handle the weight gain.
just out of curiosity is there anything else out there that works similar to zyprexa without the weight gain?
what is that magic bullet that is the key?
i think dopamine.
are there any meds out yet that do triple? seratonin, norepi and dopamine?and what is that Ach key. something tells me that works.
i was thinking tca maybe nortriptaline but not sure if have weight gain with that?anyone?
sorry kinda out of it. bad day.
bad mood. screwing up allday so i took bunch gabapentin to chill me. now i'm out of it.
ok.
ill checking this tomorroy.
i'm leaving work now.
b2c.
Posted by jono_in_adelaide on November 21, 2011, at 16:04:34
In reply to what other than zyprexa?, posted by B2chica on November 21, 2011, at 15:38:59
Geodon has a much better record where weight gain is concerned, and woud be worth a try. Risperidone is also somewhat better.
To ht noradrenalin, dopamine and seretonin, try taking the atypical of your choice plus Effexor XR 150mg/day (provided an antidppressant isnt contraindicated in your condition)
What disorder are you treating?
Posted by creepy on November 21, 2011, at 17:18:46
In reply to what other than zyprexa?, posted by B2chica on November 21, 2011, at 15:38:59
tried adding metformin, topamax or an NRI?
Posted by Phillipa on November 21, 2011, at 17:39:55
In reply to Re: what other than zyprexa?, posted by creepy on November 21, 2011, at 17:18:46
Metformin might help?Phillipa
Posted by Christ_empowered on November 21, 2011, at 21:27:53
In reply to Re: what other than zyprexa?, posted by jono_in_adelaide on November 21, 2011, at 16:04:34
metformin and high doses of alpha lipoic acid can help, according to some studies. I think I read that sufficient doses of green tea extract can also be helpful.
Maybe low-dose loxapine?
Posted by Zyprexa on November 22, 2011, at 14:50:30
In reply to what other than zyprexa?, posted by B2chica on November 21, 2011, at 15:38:59
The key is to take as little zyprexa as possible that works. And exercise. And a realativly good diet, with veggies and not too much calories. It doesn't have to be too strict though. My job keeps me on my feet and I go to the gym once a week for a realy intense work out. So I have been losing weight this past year, 10 lbs. I'm not sure but think taking perphenazine with the zyprexa helps cut down appatite. Perphenazine is the most like zyprexa that I have tried. Which also does not have weight gain. I've tried geodon, abilify, risperdal. none of which helped. Oh, and drink a lot of water or zero calorie drinks to help the weight gain. I drink a lot or diet soda.
Posted by jono_in_adelaide on November 22, 2011, at 17:05:29
In reply to what other than zyprexa?, posted by B2chica on November 21, 2011, at 15:38:59
Summary
Antipsychotic medications are widely prescribed and carry a variable propensity to cause weight gain and its attendant sequelae hyperglycaemia, hypertension and hyperlipidaemia.These metabolic risks, along with smoking and poor lifestyle habits, occur between two and five times more often in patients with psychosis than in the general population. Early detection and intervention for cardiometabolic risks, and a judicious tailoring of the use of antipsychotic medications can help to improve long-term outcomes in these patients.
Potential of atypical antipsychotics to cause weight gain
Drug Metabolic potential
clozapine
olanzapine
quetiapine high
risperidone
amisulpride
paliperidone mildmoderate
aripiprazole
ziprasidone low
Posted by Phidippus on November 22, 2011, at 18:41:53
In reply to what other than zyprexa?, posted by B2chica on November 21, 2011, at 15:38:59
Zyprexa does do its job well. Olanzapine has a higher affinity for 5-HT2 serotonin receptors than D2 dopamine receptors. Other affinities are (Ki, nM):
dopamine D1: 31
dopamine D2: 11
serotonin 5-HT2A: 4
serotonin 5-HT2C: 11
muscarinic M1: 79
adrenergic alpha1: 19
histamine H1: 7SO, Zyprexa likes to block seratonin receptors, but still hits dopamine receptors as well.
I have been on most or all of the AAPs and my recommendation would be Invega. Of all the AAPs, Invega feels closest to Zyprexa.
Eric
Posted by bleauberry on November 23, 2011, at 14:09:18
In reply to what other than zyprexa?, posted by B2chica on November 21, 2011, at 15:38:59
Zyprexa is so unique I am not aware of another one that feels similar to it. The closest I can think of that I've tried is amisulpride, except amisulpride didn't have the sedation or weight gain stuff. A straight forward approach for seratonin/ne is zoloft/nortriptyline combo.
Posted by SLS on November 23, 2011, at 14:22:04
In reply to Re: what other than zyprexa?, posted by bleauberry on November 23, 2011, at 14:09:18
> Zyprexa is so unique I am not aware of another one that feels similar to it.
Probably Clozaril, but who wants to deal with the blood-tests and weight gain?
> except amisulpride didn't have the sedation or weight gain stuff.
I believe you have increased prolactin secretion with amisulpride. I don't think this is limited to higher dosages.
- Scott
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