Augmenting antidepressants for treatment-resistant depression and various panic & anxiety disorders, including PTSD and OCD. Monotherapy for those same panic & anxiety disorders. Tourette’s, EPS, TD and other tic/movement disorders.
How Long Until Zyprexa Starts Working (Onset of Action)
Fast. Really fast. You should start feeling better the next day. OK, the next day “better” could be relative in that you may not give a rat’s ass about anything at all, but that usually goes away and is replaced by something that closely approximates the mysterious condition known as “normal.”
Likelihood of Working
Excellent. Zyprexa has a great track record with schizophrenia and bipolar disorder.
Lilly recommends starting at 10–15mg of Zyprexa once a day to treat bipolar disorder. If no improvement is seen go up to by 5mg a day to a maximum of 20mg a day.
All I can say is, unless you’re seriously flipped out that is way too high to start and way too fast to hit the maximum dosage.
If you’re taking other meds to treat the bipolar disorder we suggest starting at 2.5mg of Zyprexa a day. If you’re not taking any other meds then you and your doctor need to figure out how crazy you are on a scale of 2.5 to 10mg of Zyprexa. After that increase the dosage by 2.5mg a day every 4–5 days as required. If you need to increase the dosage faster than that, maybe you should be taking a short vacation in a psychiatric hospital.
The recommended dosage for schizophrenia starts with 5–10mg of Zyprexa a day with a target dosage of 10mg a day. You can go up to 15mg of Zyprexa a day after a week, but the clinical trials show that 10mg a day is the usual effective maintenance dosage.
I don’t know enough about schizophrenia to argue with them, other than I don’t like target dosages. If your symptoms are under control at 5mg, then stay at 5mg and talk to your doctor about increasing the dosage if and when any symptoms return.
How to Stop Taking Zyprexa (Discontinue, Withdrawal)
Your doctor should be recommending that you reduce your dosage of Zyprexa by 5mg a day every six days if you need to discontinue Zyprexa. Making it a week is just easier to remember. You can stop immediately if it’s an emergency, but I wouldn’t recommend doing that without a doctor’s supervision. The major problem with stopping antipsychotics is a sudden return of your symptoms.
There is no better med for a severe and/or complicated mental health crisis, like smashing-everything-in-sight dysphoric mania, psychotic depression with intense anxiety, or someone with schizophrenia who is having a psychotic episode with auditory and visual hallucinations.
You’ll gain five pounds the moment you fill the prescription. Long-term use carries the risk of type 2 diabetes (diabetes mellitus).
Interesting Stuff your Doctor Probably didn’t Tell You about Zyprexa
How quickly Zyprexa is metabolized varies fairly widely by different groups of people. Smokers clear it 40% faster than non-smokers. Men clear it 30% faster than women. Old people take 1.5 times longer. To quote the PI sheet, “The clearance in young smoking males, for example, may be 3 times higher than that in elderly nonsmoking females.”
Zyprexa’s Potential Side Effects (Adverse Reactions)
Typical Side Effects
Headache, weight gain, nausea, obesity, dry mouth, getting fat, constipation, putting on the pounds, sleepiness, general lethargy, and not giving a damn about anything (emotional blunting). Combine the lethargy and blunting and you get what’s known as zombification. Have I mentioned Excessive body weight gain (BWG)?
Actually most people who take Zyprexa gain little, if any weight. For tips on how to prevent, and possibly predict how much, if any weight gain you’ll be dealing with, see Zyprexa’s detailed side effects page.
Because Zypexa is a potentanticholinergic the anticholinergic side effects like headache, constipation and dry mouth can hang around, they just won’t be as bad as they are at first. That’s the price you pay for EPS, TD and other movement disorders being rare.
Eventually the lethargy and sleepiness go away.
Uncommon Side Effects
Diabetes, increased cholesterol and other problems associated with excessive weight gain. Accidental injury. Increased breast size (porno boobs or man boobs, take your pick), with or without lactation, loss of libido and a host of other sexual dysfunctions, and other symptoms of too much prolactin (hyperprolactinemia). Dizziness, irregular heart beat, feeling faint after standing up, and other symptoms of really low blood pressure (orthostatic hypotension). The orthostatic hypotension typically comes and goes with dosage increases.
Freaky Rare Side Effects
Getting intoxicated from water (#points!) and getting hung over with no previous intoxicating effects (#FML). Fecal incontinence. Sleep eating and sleep smoking. Priapism (i.e. the never-ending hard-on) from an overdose along with Neurontin and at a high dosage all by itself. There have been other reports of this freaky rare side effect when mixing Zyprexa with other meds, including lithium. Kids, don’t try this at home as a Viagra substitute. Although who can honestly resist the temptation of being constantly drunk, hard, smoking on the sly, and always taking a dump whether you want to or not? Maybe I should rethink not taking Zyprexa just because I couldn’t get out of bed.
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on olanzapine’s pharmacokinetics page.
How olanzapine Works
the current best guess at any rate
Zyprexa works by being a broad-spectrum atypical antipsychotic that impedes the transmission of serotonin, norepinephrine, and dopamine at a bunch of receptors. It is also a potent anticholinergic (which helps to prevent antipsychotic-induced movement disorders like TD and EPS), and one of, if not the most potent antihistamine on the planet, which is one reason why it makes you so tire and makes you gain so much weight. Another reason being its effect on the corticotropin-releasing hormone/factor; a tasty brain juice that deals with mood and metabolism. Or: why comfort foods make us feel good.
Zyprexa is one of those meds that people love to hate, and the damage done to Zyprexa’s reputation due to Eli Lilly’s suppression of data regarding diabetes and weight gain has overshadowed what a life-saving medication it is. Zyprexa as monotherapy may or may not be a long-term solution for most people, but as a rescue med there’s none better.
Of course anything that is mainly used as a treatment for only 6–8 weeks3, as a rescue med, or relatively low-dosage add-on isn’t going to account for 40% of a corporation’s revenue the way Zyprexa did for Lilly during its heyday in the early 2000s; so it’s not surprising that Lilly wanted to hide little details about dosage-related side effects like weight gain, lipids, and blood sugar. Getting approval to treat bipolar disorder forever is a cash-cow any corporation would literally kill for.
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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 If you look at the full prescribing information for every medication discussed on this site you'll see that almost all of them are approved to treat a condition for six to eight weeks. Anything after that is officially an off-label prescription that your insurance company can not cover, or charge a higher co-pay for. That's how they can get away with trying to force you to take a medication that doesn't work as well as the one you've been taking for several years.
4 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
5 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
If you have any questions not answered here, please see the Crazymeds Zyprexa discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
Last modified on Saturday, 26 April, 2014 at 15:35:11 by JerodPoore
Zyprexa, and all other drug names on this page and used throughout the site, are a trademark of someone else. Zyprexa’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot. Know your sources! Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList, NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internetis a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.