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Hi I Told You I Would Write A Separate Question
Question: Hi I told you I would write a separate question about mood stabilizer combos:
I wanted to know your opinion on a trileptal/low-dose olanzapine combo...
I recently came off MAOIs combined with Lamictal...I am still on lamictal and tianeptine, with benzo at nighttime. I feel a very "empty" depression and apathy coming back, along with strong bouts of irritability, nervousness and verbal problems around people at work and friends/loss of confidence, and ruminative anxiety and interpersonal sensitivity.
Trileptal with the Lamictal helped briefly with the anger, paranoid ideations, and lifted mood...but I soon became more irritable and unstable throughout the day. Not sure how the tianeptine effects the mix.
I have some type of comorbid depression/complex trauma/borderline/BPII stuff most of my life. Zyprexa is one of the newer antipsychotics I have not tried but I'm worried about the weight gain. The other ones have made my anger worse and made me feel very dissociated and zombie-like.
I read that zyprexa is good for borderline symptoms like paranoid ruminations/anger/interpersonal sensitivity AND helps with dysthymia/anhedonia. I know trileptal has helped me feel more emotionally open and less fearful at first, but I think it the serotonin release; and the effect on lamictal metabolism, creates spontaneous anger and lability through the day.
Is there any way to avoid the zyprexa weight gain? Will it likely affect my sex life or flatten me emotionally?
I am fine dropping the lamictal as I know it helps with mood but also increases anger and rumination with me (I know this is rare but it is true for me). I am also fine dropping the small doses of clonazepam. Also open to other suggestions.
I wanted to know your opinion on a trileptal/low-dose olanzapine combo...
I recently came off MAOIs combined with Lamictal...I am still on lamictal and tianeptine, with benzo at nighttime. I feel a very "empty" depression and apathy coming back, along with strong bouts of irritability, nervousness and verbal problems around people at work and friends/loss of confidence, and ruminative anxiety and interpersonal sensitivity.
Trileptal with the Lamictal helped briefly with the anger, paranoid ideations, and lifted mood...but I soon became more irritable and unstable throughout the day. Not sure how the tianeptine effects the mix.
I have some type of comorbid depression/complex trauma/borderline/BPII stuff most of my life. Zyprexa is one of the newer antipsychotics I have not tried but I'm worried about the weight gain. The other ones have made my anger worse and made me feel very dissociated and zombie-like.
I read that zyprexa is good for borderline symptoms like paranoid ruminations/anger/interpersonal sensitivity AND helps with dysthymia/anhedonia. I know trileptal has helped me feel more emotionally open and less fearful at first, but I think it the serotonin release; and the effect on lamictal metabolism, creates spontaneous anger and lability through the day.
Is there any way to avoid the zyprexa weight gain? Will it likely affect my sex life or flatten me emotionally?
I am fine dropping the lamictal as I know it helps with mood but also increases anger and rumination with me (I know this is rare but it is true for me). I am also fine dropping the small doses of clonazepam. Also open to other suggestions.
Brief Answer:
Consultation
Detailed Answer:
Hello,
Thanks for writing another interesting question.
First of all I feel there is no rationalisation with combination of trileptal and olanzapine. Olanzapine is kind of anti psychotic which helps in psychosis (paradoind ideas), depression, anxiety, bipolar disorder in addition to various psychiatric disorders. It is true that it causes weight gain in select patients but it is worth trying in your case but with absence of trileptal. Trileptal stablizes the mood and this can be well accomplished by olanzapine itself.
However I need to add here that when it comes of action olanzapine and quetiapine have similar profile and can be interchanged in some cases. This is because propensity to cause weight gain is less with quetiapine in compare to olanzapine.
Most of the individuals with use of olanzapine can still maintain their weight provided there is better adoption of exercise and diet. Those who fail to adhere to low calorie diet tend to gain weight, sometimes excessively.
Regarding the sexual side effects as per my experience there is limited problems in most patients, if any. I mean to say that sexual side effects are uncommon among the individuals who were kept on olanzapine. It does not make you excessively numb and the feeling of emptiness is not encountered in most patients.
I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Consultation
Detailed Answer:
Hello,
Thanks for writing another interesting question.
First of all I feel there is no rationalisation with combination of trileptal and olanzapine. Olanzapine is kind of anti psychotic which helps in psychosis (paradoind ideas), depression, anxiety, bipolar disorder in addition to various psychiatric disorders. It is true that it causes weight gain in select patients but it is worth trying in your case but with absence of trileptal. Trileptal stablizes the mood and this can be well accomplished by olanzapine itself.
However I need to add here that when it comes of action olanzapine and quetiapine have similar profile and can be interchanged in some cases. This is because propensity to cause weight gain is less with quetiapine in compare to olanzapine.
Most of the individuals with use of olanzapine can still maintain their weight provided there is better adoption of exercise and diet. Those who fail to adhere to low calorie diet tend to gain weight, sometimes excessively.
Regarding the sexual side effects as per my experience there is limited problems in most patients, if any. I mean to say that sexual side effects are uncommon among the individuals who were kept on olanzapine. It does not make you excessively numb and the feeling of emptiness is not encountered in most patients.
I hope this answers you.
Feel free to write back to me if you have more questions.
Thanks and regards.
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Above answer was peer-reviewed by :
Dr. Kampana
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