Health QuestionsCategory: MedicationsZyprexa as stand alone med for BP II
PBF asked 3 years ago

Hi.  (I posted my antipsychotic related question here cause there is no AP section yet)
 
I realize that even though psych meds help me stay stable, they cost me A LOT of my mental sharpness.  Too much.  Shit I have no short term memory, have problems concentrating and space out…  People at work have been telling me I space out.  I have wanted to quit meds on and off but think I need one maintenance med to keep me stable.  I am aware that completely quitting everything just like that would not be wise.
 
I’m now on three different drugs as it is – celexa, zyprexa and klonopin.  That’s a lot.  I would like to have only the low dose zyprexa just to prevent relapse (5 to 7.5 mg).    Zyprexa acts as a mood stabilizer for me and helps with depression.  I don’t know, would like to get off the celexa and klonopin.  Could discuss this with doc.  Maybe I’d regain some of my mental abilities.  Anyone with BP function just on one med?  Input would be appreciated.
 
Cheers,
 
PBF

4 Answers
kawaiicatty answered 3 years ago

Re: Zyprexa as stand alone med for BP II
Monotherapy/maitenence dosing is a complicated issue, and it all depends on what drug you’re thinking about doing it on. Zyprexa is approved as a long term drug for BP, as is lithium. I think it depends on what type of doc you have (whether they like the idea of monotherapy) and how well you’d actually tolerate a maitenence dose. Have you been stable on your combo for long? I’m taking abilify and prozac, which is not quite monotherapy, but I was solely on lithium, and it didn’t really work that well for me. I can tell you from my experience (all 4 years of it Cheesy) that most docs don’t like the idea of maitenence dosing/monotherapy for younger patients and those who haven’t been on a med for long, maybe under a couple of years? Basically, you have to be stable for a while, and not have any flare ups of depression or mania, and not be having problems with your meds.  
 
As for getting off of klonopin and celexa, I know klonopin cannot be stopped cold turkey with risk of seizures and other generally bad things. So you’d have to taper down over time, depending on how high your dose is. Celexa is much the same–can’t give you seizures, but you’d kinda need to taper down on this one as well. Maybe you could ask your doctor to reduce the doses of klonopin and celexa, and leaving the zyprexa the same? Also, you mentioned loosing mental clarity–could it be that something is too high, leaving you in a stupor? From reading on the zyprexa page, the zombie effect is supposed to wear off.

gretl answered 3 years ago

Re: Zyprexa as stand alone med for BP II
I agree that a lot of it depends on how long you’ve been stable on your current cocktail, and how you got to this point.  Myself, I’ve had to stick with an antidepressant and PRN benzo in addition to a mood stabilizer.  Haven’t had any luck tapering either of them, and don’t really care to try anymore!
 
Quote:

I have no short term memory, have problems concentrating and space out… People at work have been telling me I space out.

If this is really effecting you, then you may have stable moods but you’re not exactly functional.  If you’ve been stabilized for awhile, it totally makes sense to discuss these concerns with your pdoc.  How often are you taking the Klonopin?
 
And not to alarm you, but the thing about other people noticing you spacing out makes me think seizures should be ruled out.  Do you find yourself actually missing time?  Any history of neurological weirdness in your past (besides the obvious!)?

Anonymous answered 3 years ago

Re: Zyprexa as stand alone med for BP II
PBF,
As with Catty, I also was on monotherapy with Li which kept off mania but did squat for depression.  I can’t imagine BP treatment without an AD.
 
Just my opinion!

PBF answered 3 years ago

Re: Zyprexa as stand alone med for BP II
Thanx for the replies guys.  I will keep the antidepressant, don’t know if zyprexa alone would be good enough for depression.  But I’ll try to lower my klonopin intake to improve my cognitive skills.
 
PBF