Potential side effects (adverse events in fancy pharmaceutical talk) are often used as a rationalization to not take a medication. Many people will stop taking an otherwise working drug because of one or more side effects that are relatively minor and/or often temporary. There may even be ways to counter or mitigate the problematic effects.
It all comes down to a very simple equation: which sucks less?
There is no perfect drug. If you keep switching meds in the hopes of finding something with no side effect, or irrelevant side effects that don’t bug you as much, you could wind up treatment-resistant, and a med that worked before may work not as well as it did the first time, if at all.
1.1 Side Effects All Crazymeds Have
No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.
Drowsiness / fatigue - even when taking stimulants in some circumstances.
Insomnia, instead of or alternating with the drowsiness.
Assorted other minor GI complaints (constipation, diarrhea, etc.)
Generally feeling spacey / out of it
Which can all add up to the ever-helpful ”flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.
All crazy meds can, and probably will affect your dreams
as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.
So don’t operate any heavy machinery and try to avoid driving the first couple of days. We always recommend1 starting a new med Friday night / Saturday morning (or whenever your day off is) so you have an idea of how it will affect you for the first week or two. Keep in mind: most side effects are usually temporary in nature.
2. Zyprexa (olanzapine) Typical Side Effects
Most everyone gets at least one or two of these
Putting on the pounds
Especially excessive daytime sleepiness and general lethargy
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)?
However, given that the overwhelming majority of people who post about meds on teh interwebs do so to complain, and the majority of people who take Zyprexa don’t have access to the Internet, my money is on well over half the people who take Zyprexa gain little or no weight.
Because Zypexa is a potent anticholinergic the anticholinergic side effects like constipation and dry mouth will probably 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 daytime sleepiness go away.
3. Zyprexa (olanzapine) Uncommon Side Effects
You may or may not get one or more of these, so don’t be surprised either way
Kids, don’t try this at home. Zyprexa is not a Viagra substitute. Although who can honestly resist the temptation of being constantly drunk and hard, and always taking a dump whether you want to or not? Zyprexa is a manly med for manly men. And adventuresome women, as Zyprexa can cause clitoral priapism as well!
In Zyprexa’s case the only side effect most people care about is weight gain. Usually in the form of “what pill can I take.” Fortunately there is an answer to that question. Metformin is currently the first-line medication to add for antipsychotic-induced weight gain. Topamax is used, but only if Metformin and/or eating less and exercising more didn’t work.
The results from the real world give it about a fifty-fifty chance, but I think it might be better than that. Being crazy, fat, and taking meds for both is a triple stigmata that no one wants to admit to, even anonymously. The one drawback is metformin works best if you take it soon. Soon being defined as a 5–7% gain in your baseline (i.e. pre-any-med) weight. While controlling your weight usually takes care of things like diabetes and high cholesterol, that’s not always the case when you’re taking an antipsychotic.
There are some studies not included in the above meta-analysis that I think are worth looking. Here’s what happens when starting treatment on a Zyprexa and metformin cocktail.
RESULTS: Of the 40 patients who were randomly assigned, 37 (92.5%) completed treatments. The weight, body mass index, waist circumference, and waist-to-hip ratio levels increased less in the olanzapine plus metformin group relative to the olanzapine plus placebo group during the 12-week follow-up period. The insulin and insulin resistance index values of the olanzapine plus placebo group increased significantly at weeks 8 and 12. In contrast, the insulin and insulin resistance index levels of the olanzapine plus metformin group remained unchanged. Significantly fewer patients in the olanzapine plus metformin group relative to patients in the olanzapine plus placebo group increased their baseline weight by more than 7%, which was the cutoff for clinically meaningful weight gain. There was a significant decrease in SAPS and SANS scores within each group from baseline to week 12, with no between-group differences. Metformin was tolerated well by all patients. CONCLUSIONS: Metformin was effective and safe in attenuating olanzapine-induced weight gain and insulin resistance in drug-naive first-episode schizophrenia patients. Patients displayed good adherence to this type of preventive intervention. --Metformin Addition Attenuates Olanzapine-Induced Weight Gain in Drug-Naive First-Episode Schizophrenia Patients: A Double-Blind, Placebo-Controlled Study
In English: These were people who never took any meds before. Half were started on a cocktail of Zyprexa and metformin, half took Zyprexa and a placebo. Of the ones who took the metformin didn’t have any changes in their insulin levels and fewer of them gained any weight. The Zyprexa worked just as well in both groups. It sorta worked better in the group also taking metformin, in that they had better med compliance and follow-up.
As for taking metformin after you’ve been taking Zyprexa for a while:
In English: 40 people who’ve been on Zyprexa for some time. Over the course of four months the people taking metformin with their Zyprexa lost an average of about three pounds in a range of losing 10 pounds to some people gaining up to five pounds. The people taking the placebo didn’t have any real change in their weight. No change in cholesterol and this time it didn’t make any difference in one type of insulin. Still works better than anything else.
With a relatively low dosage of olanzapine (10 mg daily for 14 weeks), mean BWG in all patients was 5.9, SD 2.8 kg. This figure is congruent with Allison and others’ meta-analysis of a broad olanzapine dosage range showing a BWG of 4.1 kg in 10 weeks.
Metformin did not prevent increases in BWG or WC. Triglycerides also significantly increased. Total cholesterol levels decreased and HDL levels significantly increased under metformin. HDL levels significantly decreased under the placebo as well. The HOMA-IR index decreased in both groups. Three patients with high fasting glucose improved under metformin, while glucose levels deteriorated in 3 placebo patients. Thus, with the exception of the triglyceride levels, metformin displayed a positive metabolic effect that appears dissociated from its ability to prevent olanzapine-induced BWG. Metformin was well tolerated and did not interfere with clinical improvement.
In patients with type 2 diabetes, metformin improves insulin resistance and lipid profile and either has a neutral effect or decreases body weight. We thus hypothesize that olanzapine-induced BWG is mainly associated with direct appetite stimulation (1), a mechanism that is not primarily influenced by metformin. Appetite was, unfortunately, not measured. This hypothesis requires further evaluation. Since BWG during olanzapine treatment reaches a plateau after 39 weeks, it remains unclear whether metformin could exert a positive effect on BWG beyond 14 weeks with olanzapine dosages above 10 mg daily and a larger sample size. -- Metformin for Prevention of Weight Gain and Insulin Resistance With Olanzapine: A Double-Blind Placebo-Controlled Trial
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1 If you have the luxury of both a job and being able to cope with your symptoms not being dealt with for however many days you need to wait in order to do this. Read enough of this site and you can tell I live in a fantasy world.
2 That doesn't involve expensive gene testing or a fearless self-examination of your lifestyle.
Zyprexa is a trademark of someone else. Look on the the PI sheet 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.
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. 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 through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. 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 patient information leaflet (PIL) that comes with your medications and never ever throw them away.
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.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running 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.
‘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?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]