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In January, when I was still on 30mg zyprexa, I had bloodwork done and my triglycerides were....6.15?  Over 600, anyways, and under 200 is normal.  I was really upset.

GP said I ate too many peanuts.  Pdoc said, nonsense, it's all zyprexa.  

Retested today.  2.67.  So it's fallen quite a bit, but still high.  My HDL has risen (a bit), but so has my LDL and cholesterol generally.  

I currently take 15mg zyprexa, and 20mg loxapine.  

I had been thinking (and raised with pdoc) about going down to 10mg zyprexa.  I've been pretty stable for at least 1.5 months on 15mg.  

Now I'm wondering if I should ask to stay on loxapine (which works VERY well for me; used to be on it as my sole AP) and add in an AAP that has failed for me in the past...Abilify and Latuda I remember as being fairly weight neutral.  I would also like to lose some weight.  

In September 2019, before I started on zyprexa (Feb. 2020), my triglycerides were 1.6.  

In good news, I stopped taking victoza (liraglutide; had to change from saxenda (also liraglutide) because insurance stopped covering it) because I haven't had the munchies.  And...it's expensive, even with my insurance.  I'd be paying $45 every couple of weeks.  So I've not taken it for 2-3 weeks I think - maybe longer, but aren't sure - and my A1C was still 5.2, or normal, and where it was when I was taking saxenda.  So I don't think I'd developed diabetes which liraglutide was masking.   

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21 hours ago, jarn said:

In January, when I was still on 30mg zyprexa, I had bloodwork done and my triglycerides were....6.15?  Over 600, anyways, and under 200 is normal.  I was really upset.

GP said I ate too many peanuts.  Pdoc said, nonsense, it's all zyprexa.  

Retested today.  2.67.  So it's fallen quite a bit, but still high.  My HDL has risen (a bit), but so has my LDL and cholesterol generally.  

I currently take 15mg zyprexa, and 20mg loxapine.  

I had been thinking (and raised with pdoc) about going down to 10mg zyprexa.  I've been pretty stable for at least 1.5 months on 15mg.  

Now I'm wondering if I should ask to stay on loxapine (which works VERY well for me; used to be on it as my sole AP) and add in an AAP that has failed for me in the past...Abilify and Latuda I remember as being fairly weight neutral.  I would also like to lose some weight.  

In September 2019, before I started on zyprexa (Feb. 2020), my triglycerides were 1.6.  

In good news, I stopped taking victoza (liraglutide; had to change from saxenda (also liraglutide) because insurance stopped covering it) because I haven't had the munchies.  And...it's expensive, even with my insurance.  I'd be paying $45 every couple of weeks.  So I've not taken it for 2-3 weeks I think - maybe longer, but aren't sure - and my A1C was still 5.2, or normal, and where it was when I was taking saxenda.  So I don't think I'd developed diabetes which liraglutide was masking.   

A couple thoughts: think trying lower does of 10 (carefully) is a reasonable idea. Usually when pdoc has me go down on a med we make a contingency of what I should do if things get worse before my next appt after we lower the med.

second, that (all those long term changes) might work, but I feel like that is something to take reallyyyy slow and do one small change at a time... would you add a new AP or switch out zyprexa entirely. If doing a full switch, going back to one of those weight neutral might be very risky because the pharmacology is so different. If adding on, I would be super careful working yourself on to 3 aps. That invites a lot of possible issues . 

3- what are you trying to treat specifically with abilify/latuda replacement (can’t see sig sorry)? If mania/psychotic symptoms I would be worried that those meds will give you less coverage than Zyprexa, especially if you need a little sedation. Other options might be geodon (I personally hate) and Vraylar (approved for mania/psychosis/BP depression). I liked it as an add on, but I haven’t heard a lot of anecdotal success stories and I’m getting the impression it hasn’t lived up to expectations. 
 

as far as loxapine, I would definitely try to keep it (if pdoc is ok) while working the zyprexa changes to avoid 2 big shifts at once   

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32 minutes ago, Iceberg said:

A couple thoughts: think trying lower does of 10 (carefully) is a reasonable idea. Usually when pdoc has me go down on a med we make a contingency of what I should do if things get worse before my next appt after we lower the med.

second, that (all those long term changes) might work, but I feel like that is something to take reallyyyy slow and do one small change at a time... would you add a new AP or switch out zyprexa entirely. If doing a full switch, going back to one of those weight neutral might be very risky because the pharmacology is so different. If adding on, I would be super careful working yourself on to 3 aps. That invites a lot of possible issues . 

3- what are you trying to treat specifically with abilify/latuda replacement (can’t see sig sorry)? If mania/psychotic symptoms I would be worried that those meds will give you less coverage than Zyprexa, especially if you need a little sedation. Other options might be geodon (I personally hate) and Vraylar (approved for mania/psychosis/BP depression). I liked it as an add on, but I haven’t heard a lot of anecdotal success stories and I’m getting the impression it hasn’t lived up to expectations. 
 

as far as loxapine, I would definitely try to keep it (if pdoc is ok) while working the zyprexa changes to avoid 2 big shifts at once   

Thanks iceberg!!!!  

Yes, I wanted to go down to 10mg last appointment, but he said he wanted to see me stable a bit longer (I had some mild psychosis a bit ago).  

I think we'd switch out zyprexa entirely, if I know my pdoc and it's also my own preference.  I don't see the added benefit of being on 3 APs, and the increased side effect issues is unattractive to me.

I'd be treating psychosis (predominant with me) as well as hypo/mania that seems to breakthrough for me (though historically depression has been worse than the ups for me, but that seems to be shifting a bit).  

I hate geodon too.  I've never been so sedated in my life.  I was hiking once by myself and woke up to find myself somewhere different then where I'd last been.  Thankfully still on a trail.  

I don't have a good impression of Vraylar either - it might be approved in Canada, but that's also not an option I'm interested in.  

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4 hours ago, jarn said:

Thanks iceberg!!!!  

Yes, I wanted to go down to 10mg last appointment, but he said he wanted to see me stable a bit longer (I had some mild psychosis a bit ago).  

I think we'd switch out zyprexa entirely, if I know my pdoc and it's also my own preference.  I don't see the added benefit of being on 3 APs, and the increased side effect issues is unattractive to me.

I'd be treating psychosis (predominant with me) as well as hypo/mania that seems to breakthrough for me (though historically depression has been worse than the ups for me, but that seems to be shifting a bit).  

I hate geodon too.  I've never been so sedated in my life.  I was hiking once by myself and woke up to find myself somewhere different then where I'd last been.  Thankfully still on a trail.  

I don't have a good impression of Vraylar either - it might be approved in Canada, but that's also not an option I'm interested in.  

Risperdal/invega? 

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8 hours ago, Iceberg said:

Risperdal/invega? 

Been on Invega - 6mg? 9mg?  Lost in the mists of time. 

I lactated like nobody's business on that, it was my old pdoc (same practice as my current one) and he put me on...bromocriptine?  Don't remember, but something to reduce prolactin.  Eventually had some sort of psychotic issue, and got changed.  

Personally the best for me would be loxapine monotherapy with a higher dose. But doing that I got elevated prolactin.  Current pdoc doesn't like the idea of prolactin lowering meds, no idea why.  Maybe I can press him on that.

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