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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Don_Bristol on April 15, 2006, at 19:12:33
I have recently been given some Olanzapine (Zyprexa) to add to my Parnate. The doc said to start on a 2.5mg tablet of Zyprexa but I am cautious and started on half one of those tablets (=1.25mg).
1.25mg is a near-trivial dose as the usual starting dose is approx 5mg to 15mg a day. Then it is raised but not more than 20mg a day. maintenance can be as low as 5mg.
However after just 1.25mg I feel zonked. I can't face taking the same again the next night - especially as the halflife of Zyprexa is 1 to 2 days and about half of yesterday's does will still be in me.
Maybe I have over-responded because I am also taking Parnate and perhaps the two meds together increase dopamine and, to a lesser extent, serotonin. I am assuming (with no real evidence at all) the sedation come from this sort of neurotransmitter action of Parnate and Zyprexa.
QUESTION: Does the sedation on Olanzapine improve noticeably? If so, then typically how soon? Or am I likely to be disappointed if I expect it to go to about a fourth of what it is now - especially if I have to increase the dose a little bit?
Thank you for any info.
Posted by med_empowered on April 15, 2006, at 23:36:34
In reply to Does sedation on Olanzapine decline with time?, posted by Don_Bristol on April 15, 2006, at 19:12:33
zyprexa sedation is kind of like the sedation w/ the older drugs (such as Thorazine) from back in the day...you can see varying amounts of improvement, but there may still be some lethargy remaining, although this isn't always the case and does depend on dosage.
Have you tried Abilify? Some people have problems with the start-up (anxiety and such), but its weight neutral and doesn't seem to cause diabetes, either, which is a definite plus...also, it tends to be non-drowsy (although some people do have problems with sedation--its just not all that common, compared to most other antipsychotics).
Why are you taking the zyprexa? I don't mean to pry, but if its for anxiety or something, you can take care of that WITHOUT an antipsychotic--a benzo would do nicely, as would any number of mood-stabilizers.
Good luck!
Posted by tizza on April 16, 2006, at 1:50:09
In reply to Re: Does sedation on Olanzapine decline with time?, posted by med_empowered on April 15, 2006, at 23:36:34
I took 10mg of zyprexa for 4 months and it always had the same effect. Zombie syndrome and it didn't get better for me over those 4 months either. I'm quite sensitive to most psych drugs except benzo's. Paul
Posted by blueberry on April 16, 2006, at 14:29:48
In reply to Does sedation on Olanzapine decline with time?, posted by Don_Bristol on April 15, 2006, at 19:12:33
I took zyprexa for 5 years. Started at 2.5mg which was added to ongoing prozac. Had been taking remeron for a year to counteract the stimulation and insomnia of prozac, but it wasn't ever strong enough to overpower prozac.
Zyprexa gave me the best sleep of my life. After about a year it kind of faded and I moved up to 5mg. The zombiness during the day went away in maybe a month or so. I didn't mind it because I just felt so much better. But the good sleep continued for a long time.
Anyway, the zombiness does go away, maybe not as fast as some meds, but the good sleep lasts a long time. After 5 years at 5mg, and 15mg temporary for a couple months, I did have some minor eps symptoms. Minor tremors and muscle twitches, nothing alarming. I've been off zyprexa 2 months and they went away.
I say if zyprexa helps you in more ways than just sleep, stay with 1.25mg. Some people do fine with that dose for a long time. No need to push it higher if you don't want to. In the long run I would put an upper ceiling on it of 2.5mg. I doubt diabetes or eps or anything like that is going to be much more of a risk than placebo or ssri at that dose.
Posted by Don_Bristol on April 16, 2006, at 16:14:51
In reply to Re: Does sedation on Olanzapine decline with time?, posted by med_empowered on April 15, 2006, at 23:36:34
On April 15, 2006, at 23:36:34 med_empowered wrote:
>
> Why are you taking the zyprexa? I don't mean to pry,
> but if its for anxiety or something, you can take care
> of that WITHOUT an antipsychotic--a benzo would do
> nicely, as would any number of mood-stabilizers.
>
Hello med_empoweredTo answer your query I can say that I am taking Zyprexa to help deal with my DYSTHYMIA. If you are not familiar with it then dysthymia is a long running lower-level depression.
http://www.a-silver-lining.org/BPNDepth/criteria_d.html#DysthymicDisorderand I have dysthymia with ATYPICAL features
http://www.a-silver-lining.org/BPNDepth/criteria_s.html#SpecAtypical
in my case: mild hypersomnia (ref 2), strong rejection sensitivity (ref 4) and strong response to "enjoyable events" (doesn't seem listed anymore but used to be called "reactive mood").I take Parnate for this but it seems that a low dose of the new atypical neuroleptics have ben seen to be useful in depressive states.
---------
Secondly, I also have some personality traits which are unproductive and which would almost qualify me as having one of the personality disorders. Again an MAOI might (just, just) help with PD although MAOIs are not really proven as being useful.
There is also some small evidence that Zyprexa and the atypical neuroleptics may have a useful role in this condition.
---------
Thirdly, my new p-doc suspects there could be an element of soft bipolar or CYCLOTHYMIA in me (or maybe the bright periods I exerience are part of the atypical dysthymia). if there is then I am a RAPID CYCLER
http://www.a-silver-lining.org/BPNDepth/dsmiv.html#CycD
http://www.a-silver-lining.org/BPNDepth/criteria_s.html#SpecRapidAs before, Zyprexa and the atypical neuroleptics can help with bipolar type problems. i don't think there is as strong a case here for the MAOI.
Rgds Don
Posted by Don_Bristol on April 16, 2006, at 18:04:53
In reply to Re: Does sedation on Olanzapine decline with time?, posted by tizza on April 16, 2006, at 1:50:09
> I took 10mg of zyprexa for 4 months and it
> always had the same effect. Zombie syndrome
> and it didn't get better for me over those 4
> months either. I'm quite sensitive to most psych
> drugs except benzo's. PaulJeeze, Paul, if you are quite sensitive to meds and could take 10mg Zyprexa for 4 months then I must be even more sensitive if I get zonked out for nearly 2 days on one 1.25mg dose!
To be fair, I suspect that the Parnate I am taking must have nreacted with the Zyprexa.
However it does not seem from your experience that the sedation I felt will decline a lot.
Don
Posted by Don_Bristol on April 16, 2006, at 18:24:18
In reply to Re: Does sedation on Olanzapine decline with time?, posted by blueberry on April 16, 2006, at 14:29:48
Blueberry wrote:
>
> [trimmed]
>
> I took zyprexa for 5 years. Started at 2.5mg
> which was added to
> ongoing prozac.
>
> Zyprexa gave me the best sleep of my life.
> After about a year it kind of faded and I
> moved up to 5mg.
>
Blueberry, thank you for posting. I am very interested in what you write because there are some good similarities between my situation and yours.You say that took only 2.5mg daily or a year and it helped you sleep well. I would like to compare my 'Day 1' experience of real sedation (nighttime and daytime) with your experience. I took one dose of 1.25mg Zyprexa in the evening and it made me sleep like a baby at night and made it hard to function all the next day. I took no more Zyprexa and found that it was with me even throught nighttime #2 when I slept for several hours more than usual. Jeeze. That is a long and clear effect from a mere chip of Zyprexa taken from a 5mg pill!
QUESTION: What was the sedation (night's sleep and day's alertness/functioning) like for you when you started that 2.5mg in your very earliest days of being on Zyprexa such as days 1 to 10?
My Parnate does not reduce the quality of my sleep but it definitely makes me less inclined to sleep if I take it too late in the day. Perhaps you were getting poor quality sleep from Prozac and therefore the Zyprexa sleep/sedation .
Blueberry wrote:
>
> The zombiness during the day went away in
> maybe a month or so.
>
> I didn't mind it because I just felt so much
> better.
>
> But the good sleep continued for a long time.
>
> ...
>
> Anyway, the zombiness does go away,
> maybe not as fast as some meds,
> but the good sleep lasts a long time.
How much better did the zombiness get after a month?Was it just noticeably better or was it significantly better?
Was it the welcome restfulness you got from your sleep that made you perist for as long as a month even though you were made into a (daytime) zombie by Zyprexa?
> After 5 years at 5mg, and 15mg temporary for a
> couple months, I did have some minor eps
> symptoms.Seems that you have had a lot of experience with Zyprexa. Have you tried any of the other similar atypical neuroleptics and are able to comment on how sedating they are relative to one another?
Take care.
Don
Posted by B2chica on April 17, 2006, at 9:26:03
In reply to Does sedation on Olanzapine decline with time?, posted by Don_Bristol on April 15, 2006, at 19:12:33
hey, jus twanted to chime in here. i'm on 10 zyprexa and started at 5. it knocked me out at first and zombie lasted a few weeks. after that, it's really the only thing that has consistently helped with my sleep (and other issues). but just wanted to let you know that solmnence is a big part of zyprexa, which was what i needed. the sleep thing stayed good throughout usage, the zombie during the day thing only lasted a few weeks four at the most.
good luck
b2c.
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