How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Z Your Own Question

Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4522
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Type Your Mental Health Question Here...
Dr. Z is online now
A new question is answered every 9 seconds

What alternatives to zyprexa would there be? It works quite

Resolved Question:

What alternatives to zyprexa would there be? It works quite well at stabilising mania but causes daytime sedation and rapid weight gain which I do not feel comfortable with. I have adverse reactions to antidepressants. My GP recently quit and I am waiting for a psychiatrist ap't on 30th August - would like to be informed enough to ask about alternative medication.
Submitted: 11 months ago.
Category: Mental Health
Expert:  Dr. Z replied 11 months ago.

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that you are having these side effects associated with the Zyprexa

DoctorZ :

May I ask, since you mentioned Zyprexa helps by stabilizing your mania, are you taking this medication for treatment of Bipolar Disorder?

Customer:

yes

DoctorZ :

Okay, well unfortunately weight gain and sedation are known side effects to most anti-psychotics used for Bipolar Disorder. Abilify may be beneficial for you as the incidence rate for weight gain and sedation is less than other antipsychotics. Also the use of a mood stabilizer may help with your symptoms (e.g. Lithium and Depakote), although they have significant incident rates of weight gain and some incidence rates of sedation

DoctorZ :

So you may want to ask about Abilify, but it may not be as successful in managing your manic symptoms as the Zyprexa

Customer:

Would they go by those names here in Australia?

DoctorZ :

Abilify is called Aripiprazole in Australia and Lithium should just be called Lithium. And Depakote could be called Divalproex or Valproate semisodium in Australia

Customer:

What is the benefit of using a mood stabiliser with the antipsychotic? I never have before. Was put on zyprexa during a hospital admission 2009 and left on it for 3 1/2 years by my GP Dr. No other psychoactive meds at all since that time.

DoctorZ :

Mood stabilizers were first created specifically for Bipolar Disorder, they help stabilize your mood to prevent manic and depressive episodes from happening. Sometimes if you add an antipsychotic medication to a mood stabilizer it can lessen the chance of manic episodes, but that combination is usually reserved for individuals resistant to the mood stabilizer. Typically a mood stabilizer is the first line of treatment for Bipolar Disorder.

DoctorZ :

Lithium is considered the gold standard for Bipolar Disorder, but the side effects can be severe so you have to get routine blood tests for it, while Depakote is considered a safer mood stabilizing medication.

DoctorZ :

Usually antipsychotic medications with the Bipolar Disorder are used for short term treatment or for long term treatment in resistant individuals

Customer:

Just looked up depakote and it also has listed side effects of drowsiness and weight gain!! And I've never heard anyone have good experience with lithium (natural therapies course I did was very anti about it). Anyway at least you've given me something to ask the psychiatrist about. I am nervous about any change of medication but hopeful that I can be more functional with a change, and stop the constant weight gain - clothes that fit are getting expensive and I have a whole wardrobe I can't use. Not that this is a priority for the change of meds, just saying it's another consequence of zyprexa for so long.

DoctorZ :

Yes mood stabilizers will have those side effects, thats why I mentioned those two side effects as well with them, but I wanted to give you all the information possible. But Abilify does have a lower incidence rate for weight gain and drowsiness, so you may be able to try that and see if it helps manage you manic symptoms like the Zyprexa does.

DoctorZ :

Is there anything else I can assist you wit today or anything else you would like to ask me?

Customer:

When I come out of depression after several months and start to be hypomanic I find it difficult to tell that it's actually hypomania and not just a return to a more balanced range of emotion and motivation. Any advice on how to know for sure?

DoctorZ :

I can understand that is difficult to distinguish. You may want to try these electronic mood trackers to help you keep track of your different moods to help you better distinguish between normal mood and hypomania.

Customer:

I am using them already. I live alone and am not working and, possibly due to lack of triggers (good thing) do not rapid cycle at all I think. But any sort of major life event can push me into hypomania, which then leads to the zyprexa dose being put up. Then when the hypomania passes I turn into a zombie, zoning out at any time of the day and even when driving. It is hard to convince the CATT team at the hospital that I am ready for a dose decrease and my GP quit so I don't have good support currently. Each of the new doctors I've seen has told me they are leaving soon and are not the one for me to see long term. I feel I coped all these years coz I had one therapeutic relationship I could really count on but she has quit suddenly a few weeks ago and it's been a long wait to see the psychiatrist for the first time - 3 days to go and I'm quite nervous about it. How can I best cover all my needs in what will probably be a relatively short appointment? I can't afford to see her more than once every 6 weeks or so as I'm on disability pension and she doesn't bulk bill.

Customer:

I think I've forgotten what 'normal' mood even means.

DoctorZ :

I am sorry that you are going through this, I can imagine how difficult this is for you. Because of your limited funds your options are limited, I usually would say to see a CBT therapist once a week to help you through this transition. For your situation, while I know you do not like the side effects, a mood stabilizer will be best for you to feel "normal." Depakote and Lithium are the best for manic and hypomanic symptoms, but you may also try another mood stabilizer called Lamictal, which is good for depressive episodes, and use an antpsychotic medication like Abilify to help control the mania and hypomania. There is a very low incidence rate for weight gain and drowsiness associated with Lamictal, so the side effects should not bother you

Customer:

I have done a course in CBT and use it all the time and it does help but doesn't prevent hypomania and worse episodes, just helps me manage them when they are upon me. Thanks for the med suggestions. I will have to see what the psychiatrist recommends as I can't just put myself on them, they are all prescription only as far as I know. Then I have to hope I find a good GP who will be sticking around and be supportive.

DoctorZ :

Yes unfortunately CBT has its limits and cannot prevent the mood swings attributed to Bipolar Disorder, only prescription medication has been known to help with that. I hope that your new psychiatrist puts you on a good medication regimen that will work for you and have less incidence of side effects.

DoctorZ :

Also last time I checked Depakote Extended Release was not available in Australia but that was a year ago and it also has a lower incidence rate of weight gain and drowsiness, so that can be something to ask about as well

Customer:

Thanks for your time. I'm all out of questions I can put into words!

DoctorZ :

I understand, but I am glad that I was able to help you

DoctorZ :

If you have any other questions or concerns, please feel free to contact me again at anytime

Customer:

I won't really know how to rate you properly until I've tried the meds you suggest but overall you have been quite helpful thanks.

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4522
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and 3 other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education