The Consequences of Acute Treatment
My attending told me she’d gotten a call from an outpatient psychiatrist who was complaining about our choice of medications while patients are acutely psychotic in the hospital. “You put them on Zyprexa and they all get fat!”
When you’re in the acute hospital setting (and this is one of my big beefs with residency training in the US), you kind of forget that patients go out into the real world after you discharge them. So when you want to quickly get control of their symptoms, you use a strong antipsychotic, which has the risk of pretty severe weight gain–sometimes 30-40 pounds. Now, I absolutely believe that a person being not psychotic is a higher quality of life than being a little overweight, but 30-40 pounds is quite a lot; you get into the range that people are going to develop diabetes and have bad cholesterol levels.
The problem is that whatever you start a patient on in the hospital, they’re likely to stay on as an outpatient. (If something works, you don’t mess with it!) So where’s the balance? Do you put someone on a newer antipsychotic like Geodon that has less weight gain? If it doesn’t work, do you switch to a weight-gaining one? I wish I knew the answer.
Thanks for recognizing that doctors need to care for patients once they leave the hospital. That’s probably the most valuable lesson you will learn in medical school and residency.
best,
Flea
Hi
As you mentioned in your blog you use it for the seek of time, “to quickly get control of their symptoms.” is it worth the risk to give your patient the antipsychotic knowing they will gain weight and that will lead to diabetic and high blood pressure.just to save time or make your job easier. I don’t think so!!! but then again you are the Doctor not me.
Thanks for the heads up on Zyprexa complications.
{Only 9 percent of adult Americans think the pharmaceutical industry can be trusted right around the same rating as big tobacco}
Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly’s $14.6 billion revenue last year.
Zyprexa is the product name for Olanzapine,it is Lilly’s top selling drug.It was approved by the FDA in 1996 ,an ‘atypical’ antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.
Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta?
Yes! They sell a drug that causes diabetes and then turn a profit on the drugs that treat the condition that they caused in the first place!
I was prescribed Zyprexa from 1996 until 2000.
In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.
—-
Daniel Haszard http://www.zyprexa-victims.com
My consultant uses olanzapine regularly – just reminds patients to eat well and exercise. They put on weight due to increased appetite I think, so giving them lifestyle advice is pretty important.