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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 theconfusedone on November 1, 2009, at 4:39:05
Hi all, My current meds are 10mg lexapro, 5mg zyprexa and zimovane 7.5mg x2 amounst other meds which are not relevant to this forum.
I've been tapering down from 40mg of lexapro 20mgs x 2 daily for the last month of which I've been on for the last 5 years and in my oppinion have stopped working as my anxiety was uncontrollable on them.
My Psych didn't want to listen so my doc took over and put me on zyprexa 2.5mgs daily during the taper off lexapro for the first 2 weeks which gave me a couple of hours relieve each day after i took them, he then doubled to 5mgs two weeks later which are doing the same and some days I need to take an extra one in the evenings when it gets bad.
Is this the way zyprexa works or is this psychological on my part. I really do find 10mgs is my dose but I find it hard to tell the doc that I'm self medicated again because I'm starting to feel that they think I'm taking the P**s just to get more drugs..
I really am starting to get paranoid now and this is making me want to buy the drugs black market when I know this too is wrong..
Can anybody please shed some light on this as I feel I'm going crazy over it and my appointment is tuesday with the doc and I want to try to be as honest as possible with him.
Kindest regards,
theconfusedone
Posted by bleauberry on November 1, 2009, at 5:51:51
In reply to How long do the effects of Zyprexa last., posted by theconfusedone on November 1, 2009, at 4:39:05
Since anxiety is the primary issue at hand, my feeling is that no antipsychotics should be used until safer conventional treatments have been tried, such as xanax or klonopin. All medications have longterm risks, but with the antipsychotics the stakes are raised quite a bit.
But I've already gotten ahead of myself. The first thing is this. I do not believe a strategy makes any logical sense whatsoever when it takes a medication that is not working...as in lexapro in this case...and adding something else to it. Why not just ditch the loser? Easier said than done, I realize, been there done that many times, but still, the logic is glaring.
Since lexapro isn't doing the trick, it might be considered to switch straight across to something else...amitriptyline, zoloft, zoloft+nortriptyline. I can think of others as well, but just have a hunch they may be anxiety-prone as well.
I am not a fan of Cymbalta, but it could be considered. A better choice might be Savella. I mention both of these because the norepinephrine reuptake component has the potential to shut down excess adrenaline activity, through negative feedback loops. I found that to be true with me. These kinds of cases usually, in my mind, indicated a level of adrenal gland insufficiency, which in my mind can be directly caused by longterm SSRI usage (strains the adrenal glands by forcing them to overwork in an effort to match the artificially unbalanced high level of serotonin).
Along that same line of thinking...norepinephrine...the tricyclics offer that as well as strong antihistamine which is usually strongly anti-anxiety. And anti-cholinergic, if overactive choline is a hidden problem. The TCAs cover a lot of bases. Specifically I'm thinking of either amitriptyline monotherapy or ssri+nortriptyline combo therapy.
On the other hand, if you have depression and lexapro is working well for that, but anxiety is the problem, then I would add something else to lexapro specifically for the anxiety. In my mind, an antipsychotic would be a last choice, not a first choice. First choice add on would be xanax for immediate control, klonopin as a second choice if xanax wasn't right, and the third part of the plan would be to add a tricyclic...either amitriptyline or nortriptyline...with the goal of eliminating the xanax/klonopin.
I could be wrong, but I see two primary topics here. First, lexapro probably should not be in the mix. Second, antipsychotics for anxiety should be last-line, not first-line. Just my opinions.
To answer your original question...I was on zyprexa for 8 years. I usually took it about 4pm, excellent anti-anxiety up until bedtime, then good sleep...but then strong anxiety kicking in at waking, smoother during the day, and then a strong wave in afternoon that made me crave my upcoming dose. What I didn't know at the time was that all of this was not actually anything related to zyprexa or how long it lasts, it was a shot adrenal system. Adrenal herbs or norepinephrine meds put a stop to that stuff within days. Zyprexa only served to temporarily cover it up for a few hours, and in actuality probably make it worse in the longterm due to its alpah-2 receptor blocking, common to most antipsychotics, that causes even more adrenaline to be released.
Posted by Phillipa on November 1, 2009, at 10:15:32
In reply to Re: How long do the effects of Zyprexa last., posted by bleauberry on November 1, 2009, at 5:51:51
I'd say benzo also as they worked wonderfully for me for close to 35 years now don't do much just avoid withdrawal according to pdoc. Phillipa
Posted by ricker on November 1, 2009, at 12:20:38
In reply to How long do the effects of Zyprexa last., posted by theconfusedone on November 1, 2009, at 4:39:05
I'm taking 20mg of lexapro, 5mg of zyprexa, 100mg of lamictal and clonazepam 0.5mg 2x/day.
I just recently stopped taking zoloft 100mg and started the lexapro and find it works better for my anxiety.
I also find myself increasing the zyprexa to 10mg for a week or so when my depression flares up and then drop it back down to 5mg when I begin to feel better.
Maybe you should consider adding clonazepam to help with the anxiety end of things? I would take it 2 or 3 times daily for several months until your system adjusts to the lower dose of lexapro and the recent addition of zyprexa.
Although zyprexa can provide immediate relief, it can take weeks or several months before you stabilize.Regards, Rick
Posted by Zyprexa on November 1, 2009, at 12:49:14
In reply to How long do the effects of Zyprexa last., posted by theconfusedone on November 1, 2009, at 4:39:05
I think you should tell the doctor that the zyprexa is working and you would like a higher dose. The doctor was already moving you up in dose. So I can't see them having a problem with 10mg. Zyprexa is an excelent med, I've taken it for the last 11 years. The half life of zyprexa is 1-2 days. So taking it once a day should work, with the right dose. I take 10mg by the way, realy good dose.
Posted by theconfusedone on November 1, 2009, at 13:17:07
In reply to Re: How long do the effects of Zyprexa last., posted by Zyprexa on November 1, 2009, at 12:49:14
> I think you should tell the doctor that the zyprexa is working and you would like a higher dose. The doctor was already moving you up in dose. So I can't see them having a problem with 10mg. Zyprexa is an excelent med, I've taken it for the last 11 years. The half life of zyprexa is 1-2 days. So taking it once a day should work, with the right dose. I take 10mg by the way, realy good dose.
Thank you everyone for your replies but I'm inclined to think that this was the answer I really wanted to hear, I'm just so confused as some instances doctors don't like for us patients to tell them their business and tend to do the opposite of what we ask especially seen as I have a history of alcohol addiction on top of this even though I'm sober close on 5 years with 1 slip a few months ago because of depression and uncontrollable anxiety issues.
I think I will come straight out and ask for the higher dose.
Also Bleauberry I do think this is the med for me as it really does seem to make me feel a lot better. Thank you for the time you've spent typing it but it's a little too advanced for me I'm afraid..
Posted by rjlockhart04-08 on November 1, 2009, at 19:56:43
In reply to How long do the effects of Zyprexa last., posted by theconfusedone on November 1, 2009, at 4:39:05
Usally 24hours
Posted by theconfusedone on November 2, 2009, at 2:04:33
In reply to Re: How long do the effects of Zyprexa last., posted by Phillipa on November 1, 2009, at 10:15:32
> I'd say benzo also as they worked wonderfully for me for close to 35 years now don't do much just avoid withdrawal according to pdoc. Phillipa
I've already told Doc Benzo's (xanax) are a no-goer with me as I tend to self medicate with them and end up in a worse situation. I would love to be able to take them sensibly but I can't. Thank you Phillipa.
This is the end of the thread.
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