Advice required
 

Hi folks

i dont come here that often, but you are alaways in my thoughts.................

i was diagnosed BP2 in 2006................but only ever prescribed anti-deppressants........10 months ago at a family party i lost the plot [so to speak]....stress+alcohol lead me to suicidal thoughts and amassive row with my wifes family [FIL Will not speak to me even now...or ever again apparantly]

since that day i have been on Olanzapine and when required Promazine

Problem is i feel so bloody depressed.........................i have had lots of reasons for these feeling but i thought the meds would suppress these feelings............is this normal...............

David

Dear David,

How much Olanzapine (Zyprexa) and how much and how often for the Promazine /Sparine?

Does the Olanzapine cause you to eat?

I have not taken Olanzapine but I know that it does not always help with depression.

Here is a link to crazy meds (one of my favorite web sites): http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Zyprexa

M

hi Mari

10mg of olanazaine at night [gained two stone inten months] Promazine 25mg as and when required

really fed up with weight gain

David

Zyprexa
 

David,

Yikes about that much weight.
Someone who has used Zyprexa will show up in a half day or so and give you a more informed response.
I think it helps to avoid carbs and embrace veggies and protein . . . .
. . . . . it is really hard not to gain weight on Zyprexa.
My guess (and I have no experience) is that you could come down in the dose of Olanazaine at this point. Your situation is different from what it was ten months ago.

M

David,

You might not need 10 mgs a day of the Zyprexa ESPECIALLY if since 2006, you have mostly been dealing with depression. Can you take less on your own or do you have to get in contact with the person who prescribes your medications?


(I am a little depressed and my brain is working slowly. That is why I have to work in little posts like this for now. )

Mari

just my 2 cents...there are other anti psychotics out there that don't cause weight gain. I take geodon, lamictal and klonipin to sleep.
what anti depressant are you taking. I am shocked that they have not put you on a mood stabiliser. I think you would benefit from lamictal it has antidepressant qualities as well as being a mood stabilizer. IT is in the anti convulsant family. I am sorry for your weight gain. and am sorry that you had the suicidal lthoughts....do you still struggle with them?
families are supposed to forgive us when we have mental health issues....Do they know how badly you were at that time?
((((HUGS))))
always nice to see you
bizi

Zyprexa, appetite, drugs, depression, thoughts
 

Hi there David! :hug:

so sorry to hear about that "loss of plot" incident... oh my Zyprexa. been there, done that. and the weight gain....

i've cycled through going on and off Zyprexa several times now and - well, my bone is, i *WILL* not stay on it because i *SHALL* turn into an elephant... no a whale, if i stay on it continuously. in a couple of months, the first time, i ended up 1 1/2 times my starting weight. ugh.

the first time i was given Zyprexa i was changed from my then-stabilizer to Zyprexa... it did help with depression although i cannot remember well whether i was also then on an antidepressant.

the weight gain is very very hard to fight... Mari's advice is the best one can do, as far as going counter-tendency. Unfortunately however, Zyprexa interferes directly with our insulin response (from the mouth of a diabetologist) - that is why we get so hungry and also why it can cause diabetes directly. I, whose aappetite is normally congruous with my actual needs, could no longer "follow" my appetite when on Zyprexa, for I had a perpetual and atrocious "Feed me Seymour!!!" sensation the entire time. And being used to following my appetite i often crumbled into feeding frenzies. I am not sure what happens if one does not eat more while on Zyprexa. I'd probably advise scheduling a greater number of smaller meals (6 per day) - as though you were hypoglycemic, the last being a snack before bed that contains some protein and fats... a glass of whole milk would do.

when i was taken off Zyprexa (due to the massive weight gain) the first time, i was already much more stable. i was switched first to Seroquel which didn't agree with me, and then to Depakote ER, which I've taken ever since. I normally take 800mg of it, if i show manic sx - we step it up as needed to a max of 1500. Then, if i'm still loopy, or sooner if i have thought disturbances I use Zyprexa as an add on. however i don't keep it on board for more than a week or two if it can be helped.

DOSAGE: 10 mg is a decent dosage, even for prophylaxis, although often 5mg will be ok for prophylaxis. dosage varies a great deal though, not just based on individual response, but depending on one's state at one time versus another time. i have used different dosages at different times (ranging 5-20mg).

I have found it could be useful "as needed" if i start feeling weird or having weird thoughts at all. my pdoc tells me he doesn't have other pts who do this but whatever works, right? I've found in some cases just taken for a few days it works wonderfully to "clean up my head" - it calms me down big time too and affords me excellent sleep, and after only 2-3 days i might feel much better, but that's if taken at first sign of trouble. weight-wise, i gain when i take it for say 5 days or more.

-----------------------------------------------

MY ADVICE for your current situation:

Get in to see your psychiatrist ASAP.

If s/he feels you could still benefit from mood stabilization, ask for a different mood stabilizer.

• Depakote is an excellent treatment and prophylactic for mania and mixed states, but does not treat nor prevent pure depression.
• Seroquel has been approved in the US for treatment of depression in bipolars, as well as for acute mania, mixed episodes, and adjunctive maintenance treatment. It is sometimes used off-label as monotherapy for maintenance. This is an atypical neuroleptic drug, like Zyprexa, usually causes some weight gain but not as much, and like Zyprexa can trigger metabolic syndrome. Also, little is known about the odds of developing Tardive Dyskinesia - there is risk of this with ALL neuroleptics, not just the older ones.
• Geodon (ziprasidone) is another atypical neuroleptic like Zyprexa, but is weight neutral, useful for acute mania and mixed episodes, and adjunctive maintenance treatment. It is used off-label as monotherapy for maintenance. This drug can affect heart rhythm so EKG is necessary to clear you for it. Not aware of its effects on depression. Tardive Dyskinesia is a possible risk as above. I don't know its prescribability in the UK. Unlike the US, here it is strictly prescribable for schizophrenia.
• oxcarbazepine ("Trileptal"/US, ??/UK) is the sequel to carbamazepine - AED class stabilizer useful for prophylaxis of mania, no effect on depression. You probably won't be offered the older carbamazepine nowadays, although it is very effective - i took it for several years.
• Zebinix (eslicarbazepine, UK only) - newer AED class drug - active metabolite of oxcarbazepine. It is prescribable for epilepsy in the UK. I have no idea if they will prescribe off-label as a mood-stabilizer. Effects would be like those of oxcarbazepine, but possibly fewer side effects.
• Lithium is the classic and effective treatment/preventive for mania. If one does not need so much that one's mood is "flattened" it can help with depression, otherwise it can foster apathy and listlessness, which has the opposite effect. Lithium is also complicated, requiring regular labs as well as careful everyday management.
• Lamictal is considered a mood stabilizer but not generally useful for mania prophylaxis. Its indications are 1, to increase time between dysthymic episodes, and 2. as an adjunctive antidepressant. I took it for a while, and it did seem to lengthen my cycling time considerably - i had been rapid cycling. Hard to say whether it helped me with depression as i always had an SSRI on board while taking it.

For your current depression, I'd request an antidepressant that has worked well for you in the past. If you are willing to stay on a stabilizer, the doc hopefully won't have a problem prescribing the antidepressant, especially as that has been your primary medication in the past.

-------------------------------
IN GENERAL
-------------------------------

............. regarding SITUATIONAL DEPRESSION...

i have never found it to be corrected 100% by medications. Not even an antidepressant. An antidepressant usually helps me to a lesser or greater extent in those conditions.

I believe that having a therapist with whom you can talk things through is of paramount importance when you have situational depression, since being bipolar it can easily escalate a major depressive episode. Depression isolates us, and situational depression is no exception. It may not be possible to talk with those around us if they are involved in the disturbing situation. At best, their emotional attachment to us can create great difficulty for them in hearing our pain. When a situation provides concrete reasons for this pain, it exacerbates the tendency of our loved ones to want to "fix it" rather than listen to us and offer comfort. In my experience, both parties end up frustrated, with the depressed party feeling even more alone, and more depressed.

Frequency is NOpTional. I'd recommend trying to see someone once a week or at very least biweekly for a while. If the public health system won't allow it, i would see what the private sector offers. licensed counselors are cheaper, and in my experience are often skillful and empathic people who can be even more helpful than their "more qualified" colleagues.

i hope things take a turn for the better for you David, and soon!

Keep posting here. we will try to help you clamber up that steep hill to wellness. we care, and we understand being depressed, even if we don't know exactly the things that are going on.

lots of ((((HUGGGGGGGGS)))) to you dear David. I've missed you on here.

:Heart: :grouphug:

~ waves ~ oh dear i've written a book ... sigh. i hope i didn't ramble uselesly too much. sorry for being so tedious.

Dear Bizi,

Just some notes on these drugs.

AED is not synonymous with mood stabilizer. AED is a type of drug with primary indication being treatment of epilepsy and simil-epileptic seizures.

Neuroleptic is synonymous with antipsychotic, and not synonymous with mood stabilizer. This is a type of drug with primary indication being treatment of psychotic symtpoms.

Mood stabilizing treatments come from both these groups of drugs.

David IS on a mood stabilizer. Zyprexa IS considered a mood stabilizer, and an excellent one, at that. Likewise Geodon!

Lamictal is considered a stabilizer, but it has a different profile than most. As you say, it has an indication for depression. It also has an indication for time between cycles, but it is NOT indicated for acute mania or prophylaxis after a manic episode, unlike Geodon, or Zyprexa, which do have in their indications treatment of acute mania. as well as prevention of manic relapse.

:hug::hug::hug:

~ waves ~

Excellent information waves!

David I have no experience with either of the meds you are on. I just wanted to share though that I am on lithium and depakote and am stable. Situational anxiety and depression still arise but not to the degree that it was. I just want to give you hope that there are other effective alternatives to the Zyprexa. :Heart:

Hi david
 

I am thinking of you. I have situational depression at times too because of my highly disfunctional family. I hope you can find something to help you feel better. I hope there can be resolution in your family. We need to forgive each other our faults, or flaws, and move on. You will be in my thoughts and prayers, and so will your family. ginnie