# Zyprexa ?



## F'd (Apr 9, 2005)

Has anyone had any luck with this med and if so at what dose ?


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## Tom Servo (Sep 19, 2005)

I've never tried that stuff, but if you do a forum keyword search you'll find a lot of references to it. Do you just have DP/DR, or do you have other symptoms as well? Have you tried any other meds already?


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## F'd (Apr 9, 2005)

i am curently taking 25mg zyprexa 100mg lamictal and 1.0 klonopin a day i am having some success with this combo but still not my ideal feeling ... my biggest symptom is the disconnected feeling and the bizarre thought pattern that goes on in my head that is not my own ... have you had any luck with any meds and if so which one-


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## Tom Servo (Sep 19, 2005)

F said:


> i am curently taking 25mg zyprexa 100mg lamictal and 1.0 klonopin a day i am having some success with this combo but still not my ideal feeling ... my biggest symptom is the disconnected feeling and the bizarre thought pattern that goes on in my head that is not my own ... have you had any luck with any meds and if so which one-


Parnate and xanax have helped me a lot with inability to visualize my thoughts in my head and the feeling that everything looks unreal. I recently added lamictal to try and get rid of the rest of the emotional numbness. I'm only at 100mg; the target dose for DR/DP is 200, I think.

Have you topped out on the lamictal at 100mg? A lot of the folks for whom it has worked said they felt nothing at all on it until a month or so at 200 mg.

"Bizzare thought pattern"... Is it that you are having unusual _kinds_ of thoughts, or is it more the way your own thoughts feel to you and the way they look inside your head?


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## F'd (Apr 9, 2005)

its actually alittle bit of both my thoughts dont feel like my own like they have created there on identity inside myself that is not my own ...my pdoc wants to get the lamictal up to 200 since i am only taking 100 and feeling something but not enough most of my unusal thoguhts are all rageful which is not like me at all because i am a very peaceful person when you say paranex is that paxil i neevr heard of hit


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## Tom Servo (Sep 19, 2005)

F said:


> its actually alittle bit of both my thoughts dont feel like my own like they have created there on identity inside myself that is not my own ...my pdoc wants to get the lamictal up to 200 since i am only taking 100 and feeling something but not enough most of my unusal thoguhts are all rageful which is not like me at all because i am a very peaceful person when you say paranex is that paxil i neevr heard of hit


Can I suggest that you post the question about the rage and stuff in the DP/DR Discussion Forum? I'm a nice guy who gets rageful thoughts too, but I've had that my whole life, so I'm not sure I have a very good answer for you. This forum doesn't get looked at nearly as often; I think you'll get a lot more responses over there. I'll be at 200 mg of lamotrigine in a week, though. I'll be sure and let you know if it takes any of the edge off my anger. Apparently lamotrigine can be good for that sort of thing, depending on what is causing it. I'd recommend trying it for a month at 200 mg before trying Zyprexa. For one thing, you don't write like someone who is psychotic. For another, Zyprexa tends to make people feel really really sh*tty. Have you asked you doctor about it? If he's trying Paxil, lamotrigine, and klonopin, it sounds like he has more on the ball than a lot a lot of those bozos. I know you aren't to happy with the results, but these things really do take months to work.

Parnate and Paxil are different. Both are anti-depressants, but Parnate is an MAOI which are pretty rarely used (I think I'm the only board member taking one) and Paxil is an SSRI. I know you're pretty new to this board, but I don't know how much you know about all the various kinds of medicines. I can send you a link or two that goes into what does what if you want.


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## F'd (Apr 9, 2005)

i usaully dont post on this board becasue i usaully post on hppdonline because i have that disorder as well so you never know what med your gonna take that is gonna do what to ya but im a really curios to try an anti-depressant but not sure which one is safe for me he says he wants me to be stable for 6 months before he makes any changes in meds but in your preference what is the best for rage as far as anti-depressants or mood stabilizers go my fear is my rage which is my cycle of hell


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## Tom Servo (Sep 19, 2005)

F said:


> i usaully dont post on this board becasue i usaully post on hppdonline because i have that disorder as well so you never know what med your gonna take that is gonna do what to ya but im a really curios to try an anti-depressant but not sure which one is safe for me he says he wants me to be stable for 6 months before he makes any changes in meds but in your preference what is the best for rage as far as anti-depressants or mood stabilizers go my fear is my rage which is my cycle of hell


For me, the best anti-rage med so far has to be lamotragine. I'm less likely to want to tear peoples heads off now. I still get pissed if they're rude but I don't get inappropriately furious as often. Wait until you've been at 200-250 mg for a month or so before being dissatisfied with lamotrigine and wanting to add something else. It really may be just the med for you for several of your symptoms.


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## F'd (Apr 9, 2005)

thanx ....im at 150mg lamictal right now with 25 mg zyprexa and 1.0 mg klonopin still feeling the rageful thoguhts hoping praying that at 200 mg they wil decrease alot and i can have my life back instaed of lviing in fear hwos things for you are you up to 200 yet ?


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## Tom Servo (Sep 19, 2005)

Yeah, I've been at 200mg for just over a week now. I'm prone to two types of rage thoughts: the "I'm going to make so-and-so really sorry they ever pissed me off" type where I can literally feel my fists and jaw clench and I picture myself swinging a baseball bat, and the even more disturbing type where I'm sitting around, minding my own business, when out of nowhere, I get an unwanted horrible image that pops into my head. It's like I have to wince and shake my head to get it out. Man, I'm sure glad we're on this forum that almost no one reads. This isn't the sort of thing I like to tell many people - it really bothers me.

The first type has gotten better, thank god (I really am basically a nice guy, in spite of making myself sound like Jason or Michael Meyers in this note). The second, I dunno yet. I've had about 90% fewer of those since I started taking Parnate anyway, so it'll be a while before I'm able to tell.

How long until you hit 200 mg? Have the lamotrigine or Zyprexa helped at all yet, or are the rage thoughts just as frequent/intense as before?


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## F'd (Apr 9, 2005)

im not up to 200 mg lamictal yet i will be on monday as far as the 25mg of zyprexa and 1.0 of klonopin go i mean they help a little but not where i need to be to have my life back totally .. its pretty amazing or sorry should i say lol that our thinking patterns as messed up as they are are very similar ... so please tom any meds that have helped with rage , concentration or anxiety please send them through thanx again


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## Homeskooled (Aug 10, 2004)

Tom and F'd, 
Try to get that Lamictal up to 225. I've never really heard of a psychiatrist going higher, but you can go up to 500mg a day of Lamictal for epilepsy. Personally, I dont think antipsychotics, like Zyprexa, are a good idea for DP. They _will_ help to deaden your mood, as it cuts off your dopamine and serotonin supplies to your neurons, but thats not the point of good psychiatry. The point is to find the source of the rages and make it fully functional again, not to indirectly deaden the brain. In my mind, the true DP killer is Lamictal and Klonopin together, _without an antidepressant_. There is too much anecdotal evidence that they make the temporal lobes further erratic and inflamed. Once you've calmed them down with the anticonvulsants, if you are still having obsessive thoughts, then I recommend Celexa, or in extreme cases, Anafranil. But only if you have to have it, and only after the activity in the temporal lobes has been calmed down. The great thing about Anafranil (clomipramine) is that it was one of the first medicines that Daphne Simeon found helped DP all by itself. Its an antiobsessive medicine - it is used for *extreme* cases of OCD. Classified as a tricyclic, it is really a very powerful SSRI. I've never known anyone to try this, but I bet that if you are given to extreme obsessiveness along with OCD, that Lamictal with Anafranil would be a great combo. My two cents....

Peace
Homeskooled


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## Tom Servo (Sep 19, 2005)

Homeskooled? Wow, what are YOU doing over here in this forum? :shock:

So you think lamotrigine w/o anti-d's would be preferable? That seems to go against the findings in the M. Sierra et al articles "A placebo-controlled, cross-over trial of lamotrigine in depersonalization disorder" and "Understanding and treating depersonalisation disorder", but then, maybe you know something I don't. Come to think of it, you seem to know a LOT of things that I don't. I'm sure I'm the very first person ever to notice this, but you seem to be pretty smart.


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## Homeskooled (Aug 10, 2004)

Dear Tom, 
Its just my opinion, but I think that there are 2 reasons for that. In that study they noticed that fluoxetine with lamotrigine seemed to up the efficacy to something around 60 percent cured or greatly improved ( I read this study a while ago). (1) As I said before, anecdotal evidence has shown that while SSRIs help with the obsessions which occur with DP, it can intensify the rages from unknown sources, inner monologue being increased, feelings of DR and DP....and the worst was actually found to be fluoxetine in this regard. Perhaps the efficacy would have been higher had they used something milder, and with far less side effects, like Celexa, or proven on its own to help, like Anafranil. Either way, they tend to help with obsessive thinking in DP, thus their use together (2) I tend to think that DPers with hypergraphia, existential thoughts, mood swings, etc...whose symptoms are not responding as one would like to with one anticonvulsant should try adding a gentler one with it too see if it works as an "adjunct" therapy, just as is done with epilepsy. Using only one anticonvulsant in epileptic medicine is known as "monotherapy", and we know that this doesnt always stop seizures. Thats why I would consider Lamictal and Klonopin, _without_ an AD to be a "DP killer". One could always add Celexa or Anafranil to that mix for obsessiveness, but only if necessary. Of course, this is only my own theory on the matter, but if I were ever to make it through med school and start a DP clinic, this is what I would recommend with today's medicine. I dont think this would work with the "washed out" DP that some drug users have, where their affect feels "flat" and colors look grey, etc...I beleive that is a depressive state that comes from a brain exposed to far to many drugs, and can probably be remedied best by nutrition, B vitamins, abstinence, and antidepressants. I also dont think this will work with DPers with a strong element of HPPD. I also beleive that to be a completely different animal, with brain irregularities which expand far beyond the temporal lobe. For marijuana use induced DP and non-drug induced, however, I believe this will work, and those are the vast majority of DPers I have seen.

Peace
Homeskooled


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## Tom Servo (Sep 19, 2005)

Hmmm, I think I see what you mean. Sounds like maybe the population in the studies may not have covered the entire range of causes of DP, in fact they almost surely did not, and that the responders/non-responders were probably not grouped by their respective causes. I actually have more to ask on this, but I'm writing this while goofing off at work. Boss coming, gotta go!


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## F'd (Apr 9, 2005)

I've been taking 25mg zyprexa for 6 weeks now and i think and feel all it does is make me hungry, slows my thoughts down a little bit and makes me tired so you think 225mg of lamictal and how many mg of klonopin to be the dp killer but what for the treatment of the rage ?


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## Space Cadet (Nov 17, 2005)

I would be careful with Zyprexa. In my experience it's really addictive. Withdrawal symptoms are nausea, extreme insomnia and anxiety. These can last for 2 months or more. Basically like benzo's but not quite as bad.


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## Homeskooled (Aug 10, 2004)

Dear F'd, 
Zyprexa will do that. Its main side effect is weight gain. You see, the beauty of it is that both the rage and the DP originate in the same lobes of the brain. Solve one and you've solved the other. Have one, you'll have the other. Lamictal and Klonopin should stop the rages _and_ the DP, or at least mitigate them. Ask your psychiatrist what he used to use for people with anger issues. I bet he tells you Depakote or Tegretol. Guess what kind of medicines those are? Anticonvulsants. Guess what Lamictal and Klonopin are? Anticonvulsants. Psychiatry has classically used anticonvulsants as mood stabilizers. I've actually known someone on here who was put on Tegretol whose DP and rages went away. It just has more side effects (not real good for the liver, sometimes too strong a med for some people) than Lamictal, and Lamictal has DP studies done on it as well as antidepressant properties, so I suggest it first.

Peace
Homeskooled


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## Tom Servo (Sep 19, 2005)

That goes a long way toward explaining why I've had less of that "blood boiling" feeling lately. I figured it was just that the lamotrigine was augmenting the Parnate, which it may also be doing.

Oh, that reminds me - you (Homeskooled, that is) mentioned that you felt that lamotrigine w/o an anti-d is preferable. I've had such good results with Parnate for the last 12 years that I'm really reluctant to give it up. I suppose I could quit for a while and see what happens, but it has been my experience that if one of these meds works and you stop taking it, it'll never work again. That happened to me with Prozac. I was DP-free for two years, got lazy about getting a refill and didn't take any for 7 days or so, the symptoms came back with a vengeance, and that was it for Prozac; even at twice the dose I had previously been taking, it never did anything for me again, other than to make me gain 25 pounds. Am I generalizing about how all meds work based on one experience, or do you think it's a valid concern?

Are you planning on specializing in psychiatry/neurology? I sure hope so.


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## Homeskooled (Aug 10, 2004)

Dear Tom, 
That would be _exactly_ why you're having less rages lately. Well, if I had been the doctor you were seeing from the beginning, I wouldnt have put you on Parnate. Yes, it can keep the DP going artificially, even when it would have run out of steam on its own, as it puts some excitatory neurotransmitters in the temporal lobe that keep it from being calmed down. You'll never see a neuroligist start an epilepsy patient on an antidepressant until after he begins the anticonvulsant. But I agree with you that antidepressants dont necessarily work the same way twice for anyone. Now that you are on it, yes, it is probably better to stay on it, but you can always try lowering the dose a bit. Dr. Amen, the psychiatrist I like, always starts antidepressants _after_ stabilizing the temporal lobe. Yes, I would love to go into psychiatry and neurology Tom, but I dont know if I can because of my extreme sensitivity to chemicals now. I think I may have liver damage from the porphyria (its a hepatic porphyria) because I am very tired and all of my hormones are testing low normal. The binding globulins for all the hormones originate in the liver. So just keep my health in your prayers....I'm trying to decide whether to pursue a job here or to move further out into the country to distance myself from exhaust and cars. Currently, I may be doing health reporting for my local NBC affiliate if I dont go for the county job.

Peace
Homeskooled


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## F'd (Apr 9, 2005)

So homeskool whats your final opinon if i was your patient comes to you complaining of dp and rage as my main 2 issues with anxiety a close second what would be your drugs of choice to put me on ...


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## Homeskooled (Aug 10, 2004)

Honestly, F'd, you arent on a bad combo. Your dosage is screwy, though. The one thing you say that worries me is that your "thoughts dont feel like your own". Alot of people on here say that, but is your doctor giving you Zyprexa because he thinks your symptoms could be a little psychotic? I wouldnt know unless I talk to you. Such as, do your thoughts speak to you, or are they just unusual thoughts for _you_ to be thinking? I think its probably the former, so I would lower your Zyprexa to 5-10mgs, up the Klonopin to 2-3 (which is where I've seen alot of success for DPers), and up the Lamictal to 200-225. I bet you'd see an overall improvement in mood, rage, and DP. Thats my money, anyways. Both the Klonopin and Lamictal will stabilize the rages and rageful thoughts, as well as anxiety, and if the rages or thoughts are almost uncontrollable, a little Zyprexa will help to keep them sedated, although it would not be my drug of choice unless you truly find the rage and thoughts to be out of your control, in which case it might be necessary. I'm very, very wary of psychiatry's uses of antipsychotics.

Peace
Homskooled


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## F'd (Apr 9, 2005)

no my thoughts dont speak to me its more like they come out of another part of my being and are horrible thoughts and i cant block them out feels like im not in control of them at all its very scary but i dont hear voices or see stuff i just got deep depression with anxiety about my rage ... what would of been your replacement for zyprexa i wonder ?


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## Homeskooled (Aug 10, 2004)

Then I would take you off of antipsychotics completely, unless you've lost control and hurt someone. Rageful and violent thoughts of unknown origin commonly originate in the temporal lobes. Therefore I would simply up your Lamictal to 200-225 and your klonopin to 2-3 mgs, and wait and see. If the Lamictal didnt work with the Klonopin at those doses, then I'd try Tegretol, which is the king of anti-seizure drugs and one of the best mood stabilizers for rage. Problem is that its rough on the liver, _very_ strong, lots of side effects, and hasnt been studied with DP. My "first line treatment "(as the doctors say) for DP/temporal lobe disorders for the time being is Lamictal.

Peace
Homeskooled


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## F'd (Apr 9, 2005)

ive never hurt anyone in my whole entire life but i have never felt the way i do this year ever before in my life i carry a diagnosis of ocd before all of this but it was a break up that sent this sh#t through the roof so i would have to say for sure that ive come close but never acted feels like im running from my rage rather then wanting to act on it if that makes any sense


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