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    • The issue you might run into is the blood tests... I don’t mind getting blood taken at all, but I’ve found the logistics of all the required tests can be a massive pain in the ass. For what it’s worth, cloz did work infinitely better than zyprexa for me 
    • Anhedonia is not considered a type of depression, but rather a symptom of depression. Types of deep-seated depression are usually diagnosed as Major Depressive Disorder (Unipolar) or Bipolar Depression, Dysthymia (chronic depression).  There are also types based on external or non-mental physical factors, such as Seasonal Affective Disorder (SAD), Peripartum/Postpartum Depression, Premenstrual Dysphoric Disorder (PMDD) and general Situational Depression. Psychotic Depression is also a type, based on different causes. Refractive, or Treatment-Resistant, Depression is a description, but I believe it can apply to more than one type if the case does not respond to treatment. Anhedonia, the loss of the ability to feel pleasure in things one formerly enjoyed, is symptomatic of more than one type, but not necessarily all - it often becomes most noticeable, and in my experience has progressed to a gradually more acute state, over the course of long-term, protracted depression. Anhedonia does play a part, I think, in the growing sense of numbness some of us feel who have been on medications for the long haul. If our mood states are like trying to walk from one point to another, depression is like falling into a crevasse; bipolar is having to climb out of the Grand Canyon and then straight up Everest just to get across the street. The meds' job is to level the terrain, but science doesn't yet know how to make them work subtly; they work like bulldozers, and leave everything flat. No downs, but no ups, either. Without sadness, joy is meaningless. If we're safe from despair, what do we need hope for? The cruelty of the situation for depressives is that it's dangerous for us to try to ease back into the risky nature of the human experience. While people not prone to depression can experience the ups and downs of life with resilience, those same downs run the risk of tipping us depressives back over the edge into the crevasse again. We want to feel normally, but we know deep down that it wouldn't take much to trigger another long, dark spell. That, I think, is why therapy in combination with medication has been shown to be more effective than medication alone. When we develop the mental cognitive resilience to resist the tendency toward depression, we can take greater risks to try to live normally.  The entire premise of this site is that we're all in a sucky situation with no good alternatives, and the best we can do is decide for ourselves which sucks less - the meds or the MI. One way or the other, something's going to suck. That doesn't have to mean life isn't worth living. There's always something that could be worse, and six days out of seven you can say, "At least it isn't Thursday." (Eeyore had it so right.) The empowering thing is that we get to make that decision ourselves.
    • 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.

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