Posted by Sunnely on March 7, 2002, at 19:55:16
In reply to OH GOSH, I'm so upset, more confused than ever, posted by Janelle on March 7, 2002, at 18:13:15
1. Not sure why you have to change meds just because you changed psychiatrist. If the meds are working, I see no reason to change them.
2. What is the Zyprexa or Seroquel prescribed for? Although both are antipsychotics (Zyprexa is also approved for mania), doctors are using them for other reasons (off label) such as augmentation treatment for tx-resistant or partial response depression or bipolar disorder, anxiety, insomnia, dementia with agitation, parkinson's disease with psychosis, etc. In these situations, the dose of these medications are generally much lower than for treatment of psychosis such as schizophrenia. Zyprexa and Seroquel are both sedating so they are good choice in promoting sleep. However, one person's response and side effects may vary from another.
3. If Effexor 150 mg/day is helping you, why switch to Serzone? You are right that Serzone could be sedating and so combining it with Seroquel may compound this problem. This is not only due to pharmacodynamic drug interaction (additional effect on the site of action) but also pharmacokinetic drug interaction (Serzone potently inhibits the metabolism of Seroquel via CYP3A4 enzyme).
4. Although lithium is a good mood stabilizer, it is more effective in mania than depression. However, it is also effective as an augmentor to antidepressants in treatment-resistant or partial-response depression, and used a lot for this reason. Indeed Lithium has a narrow margin of safety, but with close monitoring clinically and of blood levels, this drug can be given safely.
If you had previous success with Lamictal, is it possible to try it again? Lamictal appears to be more effective in bipolar depression (depression with history of hypomania) than in acute mania.
> I'm in the process of switching meds due to a change in pdocs, but after reading the responses to my questions further above, I'm now having serious doubts about the switching ... what to do or not to do is now increasing my anxiety, giving me a headache (literally) ... I just don't know what to do ... any comments greatly appreciated.
>
> 1. Do I switch from Zyprexa to Seroquel - well, after a few days on Seroquel, it sure as heck gets me to sleep - I get very drowsy and woozy soon after taking it (50 mg). However, I'm feeling progressively worse each DAY that I'm on it - it seems to have a hangover effect that is troublesome.
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> Zyprexa not nearly as sedating as Seroquel. The Zyprexa 2.5mg did NOTHING for me, 5.0 was tolerable, but 7.5 was too much.
>
> 2. Do I switch to Serzone from EffexorXR - well, since the Seroquel is proving so sedating do I really want to add another sedating med - I hear that Serzone is quite sedating and I'm not convinced of its efficacy for depression. EffexorXR 150mg is helping me.
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> 3. Do I start taking Lithium (Lithobid) as a mood stablizer (had previous success with Lamictal) - what I read in the responses to my first post about that have me VERY concerned about the safety (toxicity) of Lithium and how much help it would even be for depression which is more of a problem for me than hypomania.
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> I find myself in quite a quandry ... I'm so sick and tired of feeling sick and tired and now these med issues are really getting to me. Thanks to whoever can offer some support or suggestions.
poster:Sunnely
thread:96930
URL: http://www.dr-bob.org/babble/20020307/msgs/96944.html