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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by rod on July 13, 2001, at 6:18:08
Hi everybody,
I take Zyprexa + Amitriptyline for 3 weeks now, and my depression got worse since I take Zyprexa. But it might be the mixture, which causes this. Feel like it kind of sedates me too much, and makes me really down.
Now I started taking Prozac, 20mg in the morning, instead of 25 mg Amitr. in the morning and I feel much better now. It got that _quickly_ better, that it can olny be because I dont take Amitr. in the morning. Startted prozac just today, took my first pill. So I think the combination of Zyprexa and Amitriptyline is not very good for me. I plan to substitute or reduce the dosage of Amitr. as fast as my doc allows.
Anyone else experienced the same with this mixture??
Posted by SalArmy4me on July 13, 2001, at 8:14:42
In reply to Zyprexa + Amitriptyline, anyone else out there?, posted by rod on July 13, 2001, at 6:18:08
The Zyprexa + Prozac combination is synergistically effective in depression, according to this study and case reports:
The American Journal of Psychiatry
Volume 158(1) January 2001 pp 131-134
A Novel Augmentation Strategy for Treating Resistant Major Depression:"...Alternatively, combined administration {of olanzapine and fluoxetine} likely introduces a pharmacodynamic synergy. Zhang and colleagues (20) demonstrated that 3 hours after administration of olanzapine, norepinephrine and dopamine concentrations in the rat prefrontal cortex returned to baseline values. With fluoxetine treatment, norepinephrine and dopamine levels increase to 188% and 143% of baseline values, respectively. However, when both drugs 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.
The antidepressant efficacy observed in the current study with the combined administration of olanzapine and fluoxetine is intriguing. The robust effect size and rapid onset of action suggest promise for this approach. Because of the small group size, these results should be considered preliminary. Nevertheless, considering the public health impact of treatment-resistant depression, these results and future treatment alternatives should be welcomed. To this end, we are currently conducting studies to investigate further the efficacy and safety of combined olanzapine and fluoxetine in the treatment of patients with refractory depression..."
Posted by rod on July 14, 2001, at 3:25:32
In reply to Re: Zyprexa + Prozac » rod, posted by SalArmy4me on July 13, 2001, at 8:14:42
thanks Sal,
I have high hopes in this mixture! But when I take the Amitr. midday, 2 hours later I feel very bad again. Strange, isnt it? Switches from looking forward in to the future and then at evening nothing but suicide in my head till next morning when I awake things are good again. But I will stay in track and take things as my doc prescribed it. Maybe I have to go through this, and after some time get out of this forever.
This is the end of the thread.
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