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Dr. Kumar: I Am Starting A Trial Of Low-dose Olanzapine
Question: Dr. Kumar:
I am starting a trial of low-dose olanzapine (2.5 mg or less) to help with some hypromanic behavior, racing thoughts, etc.
This is in addition to 10mg of Celexa, 100mg Lamictal, .25mg klonopin that I already take. I also have been taking either 2.5 mgs of ritalin or 100mg of modafinil to offset cognitive and other side effects of the regimen. I take 25 mgs of trazodone for sleep.
Should I discard any of the drugs that I'm currently taking now that I am taking Olanzapine? For example, either of the stimulants which might elevate dopmamine; or trazodone which has its own antagonism on 5ht receptors?
thank you
I am starting a trial of low-dose olanzapine (2.5 mg or less) to help with some hypromanic behavior, racing thoughts, etc.
This is in addition to 10mg of Celexa, 100mg Lamictal, .25mg klonopin that I already take. I also have been taking either 2.5 mgs of ritalin or 100mg of modafinil to offset cognitive and other side effects of the regimen. I take 25 mgs of trazodone for sleep.
Should I discard any of the drugs that I'm currently taking now that I am taking Olanzapine? For example, either of the stimulants which might elevate dopmamine; or trazodone which has its own antagonism on 5ht receptors?
thank you
Brief Answer:
Consultation
Detailed Answer:
Hello,
Thanks for reverting back to me.
Although updates are not provided but it appears to me that other than the racing thoughts and hypomanic behaviour are the impending problems on the current date.
Since your doctor decided to add Olanzapine I feel there is definite need to either decrease or remove Celexa. In my opinion reducing to 10 mg Celexa to 5 mg of Celexa can be most rewarding at this stage.
In my opinion the stimulants and Trazodone need to be continued at this stage as they are unlikely cause for Racing thoughts.
I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Consultation
Detailed Answer:
Hello,
Thanks for reverting back to me.
Although updates are not provided but it appears to me that other than the racing thoughts and hypomanic behaviour are the impending problems on the current date.
Since your doctor decided to add Olanzapine I feel there is definite need to either decrease or remove Celexa. In my opinion reducing to 10 mg Celexa to 5 mg of Celexa can be most rewarding at this stage.
In my opinion the stimulants and Trazodone need to be continued at this stage as they are unlikely cause for Racing thoughts.
I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thank you for getting back to me!
The racing thoughts and hypomania actually seem to be caused from the existing regimen, but the doctor wants to keep the celexa (or some antidepressant/anxiety med) in the mix. I have tried lamictal alone but it doesn't provide relief relief at doses I can tolerate.
We also were attracted to Zyprexa to boost the antidepressant effects and help with interpersonal sensitivity/anxiety/agency. It is one of the few antipsychotics I haven't tried yet in addressing possible bipolar2/borderline/trauma symptoms.
I am hoping to keep modafinil in the mix to offset cognitive and weight gain effects of zyprexa.
I added the zyprexa friday night and felt a little weird the next day, especially around lunchtime (very confused and slow..driving was difficult). After food and a very small bit of klonopin it went away. but the racing thoughts, constant songs running through my head, and desire to drink started right up too!
I haven't taken it again because I'm afraid it will affect my work or social skills.
The racing thoughts and hypomania actually seem to be caused from the existing regimen, but the doctor wants to keep the celexa (or some antidepressant/anxiety med) in the mix. I have tried lamictal alone but it doesn't provide relief relief at doses I can tolerate.
We also were attracted to Zyprexa to boost the antidepressant effects and help with interpersonal sensitivity/anxiety/agency. It is one of the few antipsychotics I haven't tried yet in addressing possible bipolar2/borderline/trauma symptoms.
I am hoping to keep modafinil in the mix to offset cognitive and weight gain effects of zyprexa.
I added the zyprexa friday night and felt a little weird the next day, especially around lunchtime (very confused and slow..driving was difficult). After food and a very small bit of klonopin it went away. but the racing thoughts, constant songs running through my head, and desire to drink started right up too!
I haven't taken it again because I'm afraid it will affect my work or social skills.
Brief Answer:
I think it is too early to call a quit Zyprexa
Detailed Answer:
Hello,
Thanks for reverting back to me.
I also feel that there is need to minimize the dose of Antidepressant as they are likely to cause hypomania/racing thoughts which are most troublesome at this stage. In case he want to keep let him keep the half of the existing dose rather than keeping it as full dose. This will help the depression and will have minimum effects on hypomania.
In regard to Zyprexa I feel you need to give it more time as it is very common to have troublesome side effects during first few days of treatment. In case the prescribed dose is not tolerable start with half dose and increase it to recommended dose after a span of one week.
I hope this helps you further.
Tanks and regards.
I think it is too early to call a quit Zyprexa
Detailed Answer:
Hello,
Thanks for reverting back to me.
I also feel that there is need to minimize the dose of Antidepressant as they are likely to cause hypomania/racing thoughts which are most troublesome at this stage. In case he want to keep let him keep the half of the existing dose rather than keeping it as full dose. This will help the depression and will have minimum effects on hypomania.
In regard to Zyprexa I feel you need to give it more time as it is very common to have troublesome side effects during first few days of treatment. In case the prescribed dose is not tolerable start with half dose and increase it to recommended dose after a span of one week.
I hope this helps you further.
Tanks and regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the info. I suspended the trial for now but will return to it. I like the new profile pic, it's pretty sharp :)
Brief Answer:
Follow up.
Detailed Answer:
Hello,
Thanks for follow up and compliment.
I am glad to know that you are willing to give a fair trial to Zyprexa as initial experience is often replaced with passage of time specially in case of psychiatric medications.
Thanks again compliment.
Thanks and regards.
Follow up.
Detailed Answer:
Hello,
Thanks for follow up and compliment.
I am glad to know that you are willing to give a fair trial to Zyprexa as initial experience is often replaced with passage of time specially in case of psychiatric medications.
Thanks again compliment.
Thanks and regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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