Q: Treatment Plan & Zyprexa
I WAS DIAGNOSED 11 yrs. AGO W/MANIC DEPRESSION. I DID NOT
METABOLIZE LITHIUM AT
ANY DSG. SO WE TRIED TEGRETOL. (I AM NOW 42)600 MGS. 2xDAY NOW MY DR.(M.D.)
ADDED 10MGS. OF ZYPREXA TO THE MIX. HIS PLAN IS TO INCREASE DSG. EA.
DON'T KNOW WHAT THIS DRUG IS EXCEPT IT IS SUPPOSED TO HELP MY MANIA. I
ALSO TAKE ATIVAN 2MGS. 3xDAY, DILANTIN 200MGS.am
300 MGS. PM, TENORMIN 50mgs. 2xDAY,PLAVIX, NORVASC, ZOCOR, SOMA(PRN), EVISTA, GEEZ I THINK THAT IS ALL. I SUFFER FROM
SEVERE MIGRAINES AT LST 3x A MO. HAVE HAD CERVICAL FUSION, DBL
BY-PASS SURGERY, AND RADICAL TMJ SURGERY. I LIVE IN AL. VERY,
VERY RURAL AND CANNOT FIND ADEQUATE PSYCHIATRIC OR PSYCOLOGICAL
HELP. I ALSO HAVE SEVERE PTSD ANY HELP WOULD BE SO GREATLY
Dear Kim --
Believe it or not there are a lot of folks out there like you. I have
quite a few in my practice. One looks at the medication list and
quivers. Other doctors look at it and think I'm nuts to be using so many
medications. Interactions between them are common, such as your Tegretol
lowering the levels of many of these medications, including the Zyrexa so that
you'd have to take pretty high doses to get the usual effects).
Now Zyprexa does appear to be a good "mood
stabilizer", like Depakote and others; a recent study showed better outcomes
over time than with Depakote. So it's a good choice in some respects, but
from you're list I'd bet weight could be an issue to watch with the Zyprexa.
In general you'd have to be looking for medications
that would replace medications already on your list. That's going
to be tough. Another approach would be to say, hey, you're on a ton of
med's, is there any other modality that could help besides pills? There
are several candidates there: first, a regular physical activity program
should be mandatory, whatever it takes (people have tons of reasons why they
can't, but just about everybody can do something if their life depended
on it, which in this case may be fairly literally true). That can help
with sleep, pain (believe it or not), blood pressure, weight management -- not
to mention all the generic benefits like lowering heart risk.
Then there's psychotherapy. That could be hard to
come by out where you are. Some practitioners are starting to offer online
therapy, but watch out there and be extremely rigorous about making sure you're
dealing with someone reputable, ethical, and who will give you something for
your money (and money it will take...).
Then there's moving to somewhere where you can access
services, I suppose. And there's a lot of good material out there on the
net and in bookstores, libraries -- you can make quite a career out of trying to
read through the self-help materials that already exist, some of which are
really good (again, watch the pocketbook and the source).
I fear that's not really telling you much you didn't
know, but these are the things that come to mind reading your letter. Good
luck with all that.
Published August, 2002