Depression/Mental Health Forum
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Avatar universal


My brother (46 years old, dx at age 17) has been on 20mg/day of Zyprexa for approx 1 month (we switched him from haldol injections). He is  schizophrenic, lives with me, & is a heavy smoker (approx 3-4 packs/day with no current interest in stopping although he did kick the caffeine habit). I've been reading up on zyprexa & smoking and noted that zyprexa clearance is 40% higher in smokers vs. non smokers. He is experiencing some breakthrough symptoms (mostly auditory hallucinations which give him an angry disposition) that the Zyprexa is not alleviating. His psychiatrist stated that she is willing to increase his dosage to 30mg if the voices continue to bother him. My questions are:
1. Is 30mg of Zyprexa a common & safe dose? Most of the literature states that 10mg is the common/target dose.
2. Should the dosage of Zyprexa be adjusted due to heavy smoking?  
3. Since research seems to indicate that smoking does not interfere with the absorption & clearance of Abilify, should we try that? Is Abilify recommended for people with chronic schizophrenia?
4. Are you aware of any research comparing Abilify to Zyprexa?
5. What are your experiences/preferences with medications for schizophrenics who are heavy smokers.

Thanks for this site,
7 Responses
242532 tn?1269553979
I can answer the part about Zyprexa.  The local expert here believes that 30mg could be an appropriate dose, given the circumstances you describe, but of course, that is a decision that you and your doctor must make.

Abilify is such a new drug that no one here has any direct experience to add to what you already know about the drug. If Zyprexa does not work at the higher doeses, perhaps it is worth a try.
Avatar universal
forgot to add:
Is it better to increase Zyprexa to 30mg, or stay on 20mg Zyprexa with Haldol prn?
Avatar universal
Abilify looks good in paper, very few people have experience with it.

Is alway better to use one drug than combinations, in particular
Haldol which has nasty side effects; but some people require more than one antipsychotic.

People on Zyprexa tend to gain weight and there are cass of diabetes. Risperdal and Seroquel are other choices
Avatar universal
i am pipolar and all anidepressants made me worse, i started on 5 mg of zyprexza,and stopped at 15 mg which my doctor insissted was to high for bipolers but it worked so well for me im now med free and have been for many months! zyprexza could have very well saved me from much future damage. if i ever feel i need to go back,ill not think twice to do so. i did find that it alone worked much better for me than with another drug in conjuntion..
Avatar universal
Can you tell me your age and how long you were on zyprexa? Also did you have any other disorders? My 13 year old son who has had adha since he was 6 is now starting Zyprexa. The doctor thinks he might be bipolar. Thanks
Avatar universal
Hello, I am new to the forum and wanted to tell my experience with Zyprexa.

So far my doctor has not made a complete diagnosis, but he has started with severe depression w/ psychosis, OCD, and a list to long to post because most everyone knows one or two problems can go much deeper. On top of that he is looking into Bipolar, but no definate decision as of yet.

I am taking 20mg of Zyprexa, 40mg of Paxil, and 10mg of Diazepam. I am not having any problems with any of the meds, but I do believe they need to be increased for better results (or at least I would like to try and see). From what I have read 20mg of Zyprexa is safe, but there have not been enough clinical studies to prove safety above that, which doesn't really bother me when it comes to trying a higher dose because basically I have been put on so many different drugs since I was 15 that I just want to know what it's like to be "normal" for once!

I would like to think maybe I am normal and maybe everyone else has the problem of perceiving the world around them for what it really is, because there are so many people who have the same issues. But then I realize some of the things I experience (paranoia, voices, hullucinations, etc.) can't possibly be what life is suppost to be about and all the torment it causes in my so called "regular life" or within my mind.

One day it will be better, and I hope everyone on this website keeps their chin up and tries hard to never give up on what they want for themself.

Thanks for the insite of knowing I am not alone!
inter nos intra muros
Avatar universal
I was on Zyprexa for about a year.  It worked really well but it interfered with my life too much it made me sleep about 14 hours a day.
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