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    • Thanks @browri - I really appreciate it.  I've been through most AAPs and a couple of APs, this was one thing to try before clozapine.   I showed your response to my husband and he is supportive of me asking to go off of zyprexa - I was thinking of trying Abilify again.  If I lose weight that will help my mood too. Plus, it's not clear how well zyprexa is working - I've had mood issues off and on.  And in the last week I've had bad anxiety, a day of mild depression, and suicidal thoughts (I'm not suicidal - but me/not me voice tells me stuff like I could drown myself, and to 'do it now').  I see him next Thursday now.
    • There are a few difficult things to unravel here. The first part is that Zyprexa is a dopamine antagonist. With reduced dopamine activity comes increases in prolactin which can cause dyslipidemia, increase blood sugar, general metabolic dysfunction, etc. Second part is that Zyprexa is a strong muscarinic acetylcholine receptor antagonist, particularly M3 which is found on pancreatic cells. Its antagonism correlates positively with type 2 diabetes. Even plain anticholinergics like Cogentin (benztropine) carry a high risk of type 2 diabetes when used on a regular basis. Zyprexa is also a strong adrenergic blocker which can cause glycemic dysfunction as well. There are multiple different ways that Zyprexa can cause type 2 diabetes. More ways than most atypicals except maybe clozapine. Saxenda adds an interesting component to the mix. It works by increasing the conversion of glycogen stored in fat into glucose. So GLP-1 agonists like Saxenda/Victoza (liraglutide), Ozempic/Rybelsus (semaglutide), and Trulicity (dulaglutide) will all contribute to increases in glucose even if they improve HbA1c. This would be particularly pronounced if you are overweight and there's lots of glycogen to convert. However, combined with diet and exercise, the increases in glucose should be marginal, and these medications do in fact have effects in the brain to affect a feeling of satiety. At a dose of 30mg Zyprexa, it is reasonable to suspect that in the long run you may develop type 2 diabetes. That's just statistics really. And that's why Eli Lilly got sued over it. The new guidelines from RANZCP (Australia and New Zealand's equivalent of the American Psychiatric Association) actually have minimized the use of olanzapine to the point that it's not even first-line anymore. Other options are supposed to be tried first and they have basically indicated that there is no space for Zyprexa to be used as maintenance treatment anymore because of the safety issues and newer options being available. It's probably difficult for the world of psychiatry because Zyprexa is a really effective medication but it's hamstrung by its risks.
    • I have "checking" OCD, and I do this a lot....I check things one time, and feel a compulsion to check over and over again multiple times.....You are certainly not alone.
    • Well after thinking alot i think it is indeed my obsessive doubts. I doubt my own memory that i have not done the compulsion.
    • I think it never hurts to at least reach out. There are plenty of people in therapy who no self harm (or other serious symptom history) who still find therapy a helpful way to manage maladaptive thoughts and feelings. As echo said, I don’t think there is a point at which you “qualify” to get help. Worst that happens is you discontinue after a few appointments. Also, even if you don’t see someone regularly, it never hurts to have a contact in case symptoms come back 

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  1. Today
  2. Thanks @browri - I really appreciate it. I've been through most AAPs and a couple of APs, this was one thing to try before clozapine. I showed your response to my husband and he is supportive of me asking to go off of zyprexa - I was thinking of trying Abilify again. If I lose weight that will help my mood too. Plus, it's not clear how well zyprexa is working - I've had mood issues off and on. And in the last week I've had bad anxiety, a day of mild depression, and suicidal thoughts (I'm not suicidal - but me/not me voice tells me stuff like I could drown myself, and to 'do it n
  3. There are a few difficult things to unravel here. The first part is that Zyprexa is a dopamine antagonist. With reduced dopamine activity comes increases in prolactin which can cause dyslipidemia, increase blood sugar, general metabolic dysfunction, etc. Second part is that Zyprexa is a strong muscarinic acetylcholine receptor antagonist, particularly M3 which is found on pancreatic cells. Its antagonism correlates positively with type 2 diabetes. Even plain anticholinergics like Cogentin (benztropine) carry a high risk of type 2 diabetes when used on a regular basis. Zyprexa is also a strong
  4. I have "checking" OCD, and I do this a lot....I check things one time, and feel a compulsion to check over and over again multiple times.....You are certainly not alone.
  5. Well after thinking alot i think it is indeed my obsessive doubts. I doubt my own memory that i have not done the compulsion.
  6. I think it never hurts to at least reach out. There are plenty of people in therapy who no self harm (or other serious symptom history) who still find therapy a helpful way to manage maladaptive thoughts and feelings. As echo said, I don’t think there is a point at which you “qualify” to get help. Worst that happens is you discontinue after a few appointments. Also, even if you don’t see someone regularly, it never hurts to have a contact in case symptoms come back
  7. I was just thinking - I've been anxious this week for no real reason. Then this. Must remember to tell pdoc that.
  8. Yesterday
  9. Thanks @yarnandcats - I appreciate it. I DID get an appointment for next Thursday, so the appointment was bumped up by a week. I think I'll be okay until then. I hope!
  10. just wanted to say sending support your way @jarn no real words of wisdom; i get what you're dealing with, though.
  11. A higher dose of Paxil did that to me, and it sucked balls. It may have helped a little with my regular flavor of depression, but I was left in an apathetic and uncreative state. Trying to write music was like pulling teeth. It was most unenjoyable. I can say that, when meds have *really* helped me, that I did NOT feel apathetic or emotionally numb. Quite the opposite. It seems to me that you are likely still very much depressed; you’re simply not in the ‘death throes’ of the turbulence that comes with the deeper states (or other flavors) of depression. If that’s the case, then your meds
  12. Yeah last night it was a mix of my voice and the main guy who tells me what to do. This morning it was all him. When I had homicidal thoughts last year, pdoc said they were both compulsive (felt compelled) and psychotic (no remorse). My husband has come home to help me, and hopefully I hear back from pdoc soon.
  13. For me, the depression just lifts, sometimes more slowly, and sometimes more quickly. That said, *IF* I launch from depression into mania or a mixed episode (as in recent years), I can definitely feel dread, as I know what is to come. I admit to waiting a bit before taking my prn medication if it’s “just” mania, because it feels so damn good (especially after having been depressed for godonlyknows how long).
  14. My command hallucinations have been in other voices, not my own. That said, I’ve had them come from both inside my head and outside my head. So I’ll have someone else’s voice inside my head compelling me to do something (typically suicidal/homicidal or non-lethal SH), possibly with visuals to boot, OR inanimate objects telling me to do something in their own voices. The objects have been real objects so far, not visual hallucinations. The singular defining feature of these command hallucinations has been that I feel very strongly compelled to perform the command. It can take a lot of stre
  15. I've always thought it was about the compulsion. I don't trust my memory to know that I did it, so I feel compelled to check again. And again...
  16. So after performing my ocd compulsion one time, i immediately forget that i did the compulsion or not. So I do the compulsion again the 2nd time. Is my memory bad or is it something else ? Anybody know something about this ?
  17. Thanks. It helps just knowing I’m not alone in struggling with this. I mean, sure, I knew others have this issue, but it helps to hear someone discuss it. How would you describe the “pre-buy feeling?”
  18. i think this is one of those cases where getting some help (therapy/counseling maybe?) would be a good tool to strengthen your resolve to put off future self harm episodes. since you feel good about controlling your self harm, it might be a good time to examine your triggers that make you want to cut, and make a list of tools that help you get over the urge without injuring yourself. that way, you'll be better prepared if a time comes again where you feel worse or the urge is more overwhelming. i'm similar in that i haven't done any major damage to myself via self harm (though some of my
  19. I’m glad you reached out to pdoc and Toby (and here). I could see how it is possibly ocd, possibly command hallucinations, and possibly both. good to be safe.
  20. Thanks @dancesintherain I think I'm worried they might be command hallucinations - but I hear it inside my head. I've had an OCD/psychotic violent thought combo before, so who knows. I did email pdoc, and Toby is going to come home (he's at work). I need to work though, but it would be good to have him with me. (I'm halfway through a review of a 80 page legal document, fun fun fun)
  21. I've had what sounds like similar things before. I think it wouldn't hurt to call pdoc--can you say what you said here (that you're not feeling suicidal but do feel down and think they're OCD-related)? This feels like one of those better to be safe moments.
  22. I can so relate to this. I chose not to have kids because of my mental illness lost my first husband and all my friends because of not having kids. Have since remarried he too has mental issues, his two sisters live out of town and he has no friends. I have no family other than him and no friends. I just turned 60 and all I think of is getting sick and being old and alone. I searched the internet there is actually a name for us "Elder Orphans". If you have the money there are people you can hire to oversee your care. Forgot the exact name elder care managers or something like that. My wo
  23. The last few days I have suicidal thoughts pop into my head - my husband took one of the dogs out mid-evening yesterday and I went into the washroom and thought ‘You have time to drown yourself before he gets back’. Similar thoughts today - ‘do it now’. I don’t think I’m actually suicidal - I do feel down - I think they're OCD intrusive thoughts...? Am I off? But I’m not sure if I need to see pdoc or not. I don’t think I’m in danger. I was supposed to see him next week but changed it to the March 10th so we could have my lab results (go March 8th).
  24. Last week
  25. thanks jarn. I'm definitely less productive. In a really not good way.
  26. I struggle with it too. Having something deliverable HELPS, but doesn't fix it. I don't think I'm less productive, it just is productive in a different way.
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