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MadMan
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olanzapine (Zyprexa)
« on: Feb 20th, 2004, 10:42am » |
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I am an infrequent poster here. I do check-in regularly to see what's new. Some of you may remember me from my topomax posts. I mentioned in them that I was feeling the "sides" of irratability & weight loss.
The wife got me to go see my Dr. about this. Apparently living with me has been harder on her than I realized. Plus I was beginng to look skeletal.
The Dr. has weened me off topomax & placed me on olanzapine 2.5 mg.
Been on it now for about 4 days. Four pain free days. I ran a search here on the board before I started taking it & only found a few posts about olanzapine (Zyprexa). But most seemed to be possitive.
As always I will keep you informed. This time with not only my observations but those of my wife also. It seems that an outside observer is sometimes necessary to catch all of the "down-sides" to a drug.
Wish me luck.
- James
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floridian
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Good luck. And keep us posted.
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Tiannia
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Re: olanzapine (Zyprexa)
« Reply #2 on: Feb 20th, 2004, 2:25pm » |
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Sorry never heard of Zyprexa.
I hope that it works for you.
Tiannia
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Karla
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Re: olanzapine (Zyprexa)
« Reply #3 on: Feb 20th, 2004, 9:05pm » |
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The nuero that I saw at the headache/pain clinic recomended that I try zeprexa. However, I am not able to try it because I am on geodon, a different antiphycotic for mental health reasons. I have read case studies report where they tested a group of people with ch with zyprexa and had wonderful results. Good luck with it and keep us posted.
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Karla
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Bob_Johnson
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Re: olanzapine (Zyprexa)
« Reply #4 on: Feb 21st, 2004, 8:54am » |
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1: Headache 2001 Sep;41( :813-6
Olanzapine as an Abortive Agent for Cluster Headache.
Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.
OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. The initial olanzapine dose was 5 mg, and the dose was increased to 10 mg if there was no pain relief. The dosage was decreased to 2.5 mg if the 5-mg dose was effective but caused adverse effects. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and two patients became headache-free after taking the drug. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. It alleviates pain quickly and has a consistent response across multiple treated attacks. It appears to work in both episodic and chronic cluster headache.
------------------------------------------------------------------------ --------
Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
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Bob Johnson
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floridian
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Re: olanzapine (Zyprexa)
« Reply #5 on: Feb 21st, 2004, 12:13pm » |
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Olanzapine works on the 5-ht2 serotonin receptors, as well as the dopamine recptors. Clusterbusters (Psilocybin and LSD) also act on the 5-ht2 receptors, but have certain side effects and are difficult to obtain in some places. Some cause for optimism here, although zyprexa also has some side effects (diabetes, hyperglycemia and pancreatitis)- special warnings were issued in the U.K. and Japan.
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| « Last Edit: Feb 21st, 2004, 12:36pm by floridian » |
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MarkV2
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Re: olanzapine (Zyprexa)
« Reply #6 on: Feb 21st, 2004, 4:14pm » |
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MadMan,
Are you chronic or episodic? Are you using olanzapine as an abortive or as a preventative?
Curious, as I am tapering off of Topamax because of side effects, and will be looking for a new drug shortly when I start getting hit again.
Thanks in advance,
Mark
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Re: olanzapine (Zyprexa)
« Reply #7 on: Feb 21st, 2004, 7:13pm » |
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ZYPREXA can cause TD (Tardive Dyskensia). MHNI makes you sign an informed consent paper before taking this drug. If this drug does give you TD...discontinuing it will not make the TD go away.
ALSO, A new report just out caused Lilly to lose .18 per share (2/20/04) due to new warnings that Zyprexa raises the risk of death in older patients.
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MarkV2
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Re: olanzapine (Zyprexa)
« Reply #8 on: Feb 21st, 2004, 9:06pm » |
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Quote:| ZYPREXA can cause TD (Tardive Dyskensia). |
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 Good info Unsolved. I think I'll keep looking for a new med.
thx,
Mark
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Bob_Johnson
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Re: olanzapine (Zyprexa)
« Reply #9 on: Feb 22nd, 2004, 11:27am » |
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These warnings about side effects are a good example of how incomplete information is misleading and can deny clusterheads a potentially helpful treatment.
When used to abort a cluster attack the dose is either 5 or 10mg. ONE time only!
The warnings about side effects come from the use of drugs of this class by patients with conditions where dosing is daily and, generally, long term. When used for off label applications--such as cluster--the side effects data published by the mfg/listed in PDR, have little relevance.
One of the major drawbacks of getting drug info from popular internet sites is that they don't provide data on the frequency of the side effect. IF you will look in PDR, you will find data on the percent of occurrence of side effects--and the variation is often broad. But, agan, these will be data coming from patients who are using the med regularly/daily.
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Bob Johnson
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Re: olanzapine (Zyprexa)
« Reply #10 on: Feb 22nd, 2004, 11:50pm » |
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Quote:| When used to abort a cluster attack the dose is either 5 or 10mg. ONE time only |
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Has anyone ever used this to successfully abort an attack? It won't work for me. And as far as ONE time only...my doc..TODD ROZEN...prescribed it @ 5-10 mg in the a.m. and another 5-10 mg @ night. (everyday as a preventive)...didn't work.
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PS...where did you get your dosing information ?
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| « Last Edit: Feb 22nd, 2004, 11:51pm by UN_SOLVED » |
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MadMan
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Re: olanzapine (Zyprexa)
« Reply #11 on: Feb 23rd, 2004, 9:37am » |
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irt: Mark
I am chronic. Have been for 5 years. Was on topomax for the last two years. Prior to that a mix of Imetrex, Maxalt, & other "trips".
The post about TD concerns me. I am set to see my M.D. again in two weeks. Between now & then I am going to look into this issue more.
Right now I am on 2.5 mg/day as a preventative.
Had a mild CH on Sat. Night. Was able to stop it with an abortive.
-James
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| « Last Edit: Feb 23rd, 2004, 9:37am by MadMan » |
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floridian
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Re: olanzapine (Zyprexa)
« Reply #12 on: Feb 23rd, 2004, 11:43am » |
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Quote:| These warnings about side effects are a good example of how incomplete information is misleading and can deny clusterheads a potentially helpful treatment. |
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Bob,
I agree, that the side effects need to be considered in perspective. Some people are looking for zero-risk medicines, which isn't possible. I am not trying to scare any one from a medicine that they and their doctor think could help. That is a decision for them to make. I am only trying to add to the discussion so people make informed decisions. I agree with you that most of the side effects are associated with long term use, not occasional use to abort. The comments from Madman and Unsolved who are on olanzapine long term to prevent don't surprise me - lots of doctors may be trying this, and I am sceptical they all adequately inform their patients of the risks. I couldn't find any quantification of the increased risk of diabetes or pancreatitis - different studies have been conducted on different populations, using different methods. But it does seem there is a risk, and it is something to consider.
And I am optimistic - I think 5-ht2 drugs may replace the triptans (5-ht1 drugs) on the front-line for treating CH - but that is just an opinion; we'll have to see how the trials and people's personal experiences turn out.
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| « Last Edit: Feb 23rd, 2004, 11:54am by floridian » |
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Bob_Johnson
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Re: olanzapine (Zyprexa)
« Reply #13 on: Feb 23rd, 2004, 12:35pm » |
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Unsolved:
Dosing information in the message posted above this one. This med has become my first line response because, at 5mg, it has been 100% effective within 20-minutes.
It is the enduring frustration around cluster that the range of success in using a med is so wide. I guess Imirtex injection is the exception, with it being about effective for nearly 90% of folks using it. I've had my share of failures with verapamil and even O2. So I'm sorry that Zyprexa hasn't worked for you.
=============
Here is an example of the importance of context about side effect reports. Found this barely 10-minutes after first posting this message.
From Medscape: "Eli Lilly and Co. on Friday said it has warned doctors that its schizophrenia treatment Zyprexa significantly raises the risk of death and stroke..."
But--the context of this report is missing--and critical.
"Eli Lilly and Co. on Friday said it has warned doctors that its schizophrenia treatment Zyprexa significantly raises the risk of death and stroke in elderly patients with dementia."
This is why we can't accept reports without an understanding the the population affected, issues of dose, duration, and so on.
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| « Last Edit: Feb 23rd, 2004, 12:58pm by Bob_Johnson » |
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hdbngr
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Re: olanzapine (Zyprexa)
« Reply #14 on: Feb 23rd, 2004, 12:58pm » |
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I faxed Bob Johnson's original information about Zyprexa ( posted 3 weeks ago?) to my Doctor's office and heard back from her on Friday. She thinks the Zyprexa is a good idea, and recommended a three day trial (tapering similar to a prednisone burst) or to take it to abort a single headache only.
She was excited about the "has consistent response among multiple treated attacks and seems to work for chronic sufferers"
She seems well-aware of possible side effects....I have to report for labwork to establish baseline blood sugar and liver functioning before I try it, then see her again in one month.
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Lizzie2
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Re: olanzapine (Zyprexa)
« Reply #15 on: Feb 24th, 2004, 2:05am » |
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Hey Unsolved,
I thought you had said in your other post that the zyprexa was helping you? Did it stop working?  I'm sorry if that's the case!!
I've used 2.5, 5, and 10mgs to help bring down the level of my New Daily Persistent Headache, but I've never tried it to abort a cluster. I'm not sure if it would work for me or not because even for the NDPH, I had to sleep (which wasn't hard on zyprexa!) before I would notice any kind of relief. I have taken it daily at 5-10mg/night, but other than making me exhausted, I never really got too much relief from it.
That's just my experience!
Lizzie 
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Re: olanzapine (Zyprexa)
« Reply #16 on: Feb 25th, 2004, 1:30am » |
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First of all, let me say I'm glad it is working for some of you. I started On Zyprexa while an inpatient at MHNI. I honestly thought that just maybe I found a drug that would help (finally). And to be honest, It may have helped...temporarly. After being on it for about a week and a half, the headaches returned. My doctor suggested I up the dose. I ended up taking a total of 20 mg a day (as a preventative)... once the headaches re-started though, they would not stop.
To be honest with you all...if the Zyprexa would help me, I'd take it regardless of the side effect warnings. I'm just that tired of having all the headaches.
Bob ... I'm glad to hear you're getting relief from this drug. Let me say this...when I said "Zyprexa can cause TD"...it was not incomplete, innaccurate, or misleading. It can cause TD ! I realize that all drugs can have side effects also. I hope you have no problems with it and I doubt you will.
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MadMan
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Re: olanzapine (Zyprexa)
« Reply #17 on: Feb 25th, 2004, 2:36pm » |
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I'm still on 2.5mg
Go to see my M.D. in a week.
Had a CH last night. (woke me up) Middle of the scale.
Took an abortive and it ended it.
Have had some small CH's in the past few days. All minor & ended quickly. Except for the one last night.
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Samantha_Smith
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Re: olanzapine (Zyprexa)
« Reply #18 on: Mar 1st, 2004, 10:32am » |
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Please alllow me to echo some of what Bob_Johnson posted. .....
I've had TD a few times and it wasn't a big deal. Yes, the symptoms definitely sucked such as tongue hanging out of mouth, eyes rolling up and to the left, knee bouncing, crooked neck, etc. The meds that cause me to have TD are Haldol, Reglan, compazine, and Mellaril.
Compazine is probably the NUMBER ONE anti-nausea medication that ER's use to treat patients who are vomiting and/or sick to their stomach but you don't see them stopping the use of it.
Once I noticed the onset of the TD I either went back to the ER and got a shot of Benadryl or took a few Benadryl tablets at home. Like Bob Johnson said--usually people that get chronic TD are using the medication on a long term, everyday basis. Perhaps with the newer anti-psychotics it is possible to take the medication once and have TD forever.
Every medication has a risk. Imitrex has four possible LIFE-THREATENING adverse affects including atrial fibrillation, ventricular fibrillation, ventricular tachycardia, and MI (along with several other non life-threatening adverse affects.) So are people on this board going to stop taking Imitrex? Not me.
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MadMan
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Re: olanzapine (Zyprexa)
« Reply #19 on: Mar 1st, 2004, 11:19am » |
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Well, had a bad weekend.
Sat. night was up three times with CH.
Sun. afternoon had a bad one that lasted 2 hours.
Zyprexa doesn't seem to be working for me as a preventative. *sigh*
I even tolked to the M.D. over the phone & have upped my dosage to 5 mg.
Still not working.
Go to see my M.D. tomorrow.
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MarkV2
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Re: olanzapine (Zyprexa)
« Reply #20 on: Mar 1st, 2004, 7:17pm » |
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Hope you have a good outcome and get some good advice from your doc James -
Mark
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Lizzie2
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Re: olanzapine (Zyprexa)
« Reply #21 on: Mar 1st, 2004, 7:49pm » |
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Samantha, I had a severe adverse reaction to haldol which included TD. It DID go away after benedryl, but my tongue swelled up the entire size of my mouth and I couldn't stop clicking it. Part of the reaction was anaphylaxis, and we realized that I'm allergic to haldol. Benedryl always helped me, but I had to go through 3 reactions before they realized it was the haldol causing it! Kinda scary!
Lizz
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Samantha_Smith
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Re: olanzapine (Zyprexa)
« Reply #22 on: Mar 1st, 2004, 10:12pm » |
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Lizz--
Don't feel bad. I hear ya sister!!!The first time I had TD (after a shot of Compazine) in the ER) I thought I was going insane so I went to my shrink. She told me that the (TD) symptoms was actually me "acting out" against my parents and I was sent home. (WTF!!!???) She instructed my parents to send me to my room every time I bounced my knee (a common TD symptom). It took about 3 days for the TD to go away. Anyway....it took me several years before I discovered that phenothiazine class of drugs and some of their cousins cause TD. The stupidity and cruelty of the doctor was worse than the TD itself. XXX OOO Samantha
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MadMan
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Re: olanzapine (Zyprexa)
« Reply #23 on: Mar 29th, 2004, 9:25am » |
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Well, Ive been on Zyprexa now for over a month.
M.D. even boosted me to 10mg/day.
It's not working. I'm having 1 or 2 CH per day. With a real monster about every 3rd day.
Am suppose to go see M.D. this Fri. but am going to see if I can move up my appointment.
I had high hopes for this treatment.
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Renee
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Re: olanzapine (Zyprexa)
« Reply #24 on: Mar 29th, 2004, 7:43pm » |
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fyi....I am chronic and have run the course of most all the drugs available with no help until my neuro gave me the following:
zonegran 100mg at bedtime for 3 weeks then bump to 200 mg. I'm in week 3, I think! It makes me sleepy and I do sleep thru the night but my CH is under control. I've not had over a kip 7 CH since starting the Zonegran. I also switched from Imitrex to Zomig tablets that you dissolve under your tongue and I still keep the old faithful o2 around.
Anyway...just wanted to let y'all know about Zonegran and ya might inquire with your neuro about it.
Now if I could only figure out what is going on with this new headache on top of my head!!!
good luck and pf days ahead to all,
renee
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