
Suffering From Depression. Taking Oleanz And Getting Side Effect. Should I Continue It?

he has been suffering from dipression for last 12 years.
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Oleanz or Olanzapine is a Antipsychotic drug. It belongs to Second Generation or Atypcal Antipsychotic group. It is second generation because it don't cause Parkinsonian movements side effects. It act by acting on Serotonin Dopamine Receptors or also called as SDA.
It is mainly used in Psychotic disorders like Acute Psychosis, Schizophrenia etc.
It is also used in low doses as Mood Stabilizer drug in Mania of Bipolar Disorder.
In resistant cases of depression it has great effects. If it has been prescribed by a qualified psychiatrist then patents should continue to take it.
It is over all a safe drug and has few side effects as Sedation, excessive sleepiness, increased appetite and elevation of lipid parameters, weight gain. Some other side effects are there but they are non significant. So if you have to take it for long, start doing exercise and take high fiber in diet in order to decrease the risk of weight gain.
Hope I cleared your doubt.
Thanks
Dr. Seikhoo Bishnoi, MD
(Psychiatrist)


will these people have the tendency to commit suicide or co any harmful things to others. Is it curable.
Regards.
Risk of suicide and self harm is higher in patients of Depressive Disorder as compared to general population. Any suicidal intent, idea or threat should be taken seriously in patients of Depression.
Causing harm to others is not very common in patients of Depression. In depression alone there is no violent behavior.
Depression is treatable. With proper treatment from good Psychiatrist symptoms improvement is seen. Treatment is needed for long time for 1st episode at least for 6 months and for 2nd episode 1-1.5 years and for recurrent depression at least continuous for 2 years.
Thanks, Hope I cleared your doubt, if you have more queries you can ask again. If satisfied with answer please review.
Dr. Seikhoo Bishnoi, MD


1. should he take the tablet oleanz life long?
2. Can he work and behave like a normal person?
3. Will it affect the life expectancy.
Regards.
- No need of taking life long, Oleanz in patients of depression is usually prescribed only to control depressive symptoms. Once patients symptoms come under control it is gradually tapered. Patient need to take conventional antidepressants only.
- Yes of course he can work and behave like normal person. But strong compliance to medicines is necessary in order to get fast improvement.
- Oleanz causes improvement in symptoms and over all it should increase the life expectancy of a depressive patient. But excessive weight gain is a side effect so patient should be warned to exercise daily.
Thanks
Dr. Seikhoo Bishnoi


Could you please answer the below
what is the differences between Psychotic disorders like Acute Psychosis, Schizophrenia etc and Bipolar Disorder as you have mentioned earlier.
As you said above the 1st episode at least for 6 months, 2nd episode 1-1.5 year and for recurrent depression at least continuous for 2 year. It means that it can be re-occurring and during the treatment can he do his regular office work.
have asked regarding the life expectancy in comparison with the normal person.
Is this hereditary.
Can he have a normal married life.
Thanks & Regards.
Bipolar disorder is a mood disorder. In bipolar disorder either patient show symptoms of Depression (lower side) or mania (higher side of mood). Violent behavior may be seen in mania but they are manageable easily as compared to Psychotic patient.
Depression is an episodic illness. It tend to occur again if treatment is not taken properly. There is risk of occurring depression again even if individual returns to baseline after treatment. But during the treatment patient can go for work, function normally in social and personal life. But that depends upon presenting features also. A lot of people around us have depression in mild to moderate form. Depression is the cost of our modern life style.
Life expectancy as compared to normal person is less because of risk of self harm, risk of cardiac diseases, risk of accidents etc.
Depression is not definitely hereditary but it tend to run in families. Children of parents of depression have risk higher than normal population to develop depression.
Normal married life can't be commented without seeing patient directly. But I will advise that marriage should be discouraged until he return to base line. He is not able to take decision at present.
Hope I cleared your doubt.
Thanks
Dr. Seikhoo Bishnoi, MD


What is baseline?
Currently patient is taking Oleanz 10mg at night and a tablet for anxiety in the morning still the patient is irregular to work(has taken 1 week leave in the month of XXXXXXX 2013, feb 2013 and now on medical leave for one month). As I said earlier he is suffering from past 12 years and has gone for a MRI scan though he is taking medicines(Oleanz and tablet for anxiety) as advised by the doctor.
he has following
Social withdrawal
suspiciousness
Deterioration of personal hygiene
doesn't react much.
Depression
Oversleeping
Odd or irrational statements
Forgetful; unable to concentrate
Extreme reaction to criticism
Strange use of words or way of speaking
Any possibility for complete recovery?
why he is still like this even after taking the medicines?
the reasons for the MRI scan?
Regards.
When patient on treatment returns to a state which is symptom free and in which he/she can function normal in social, occupational and personal domain then that state can be labelled as baseline state.
The symptoms you have mentioned can occur in Depression with psychotic symptoms or rarely they may be due to Schizophrenia. The symptoms of social withdrawal, suspiciousness, deteriorated personal hygiene, depressed mood, poor social interaction, irrational talks, poor concentration, rejection sensitivity, new words or new way of speaking may be seen in Schizophrenia.
See chances of complete recovery are theoretically nil. With medicines he can return to normal functioning, but complete recovery is rare in most of Psychiatric disorders.
He is still having symptoms even on medicines. The reason may be poor drug compliance on the part of patient, Insufficient drug dosing. The drugs take time to act. Usually 8-12 weeks time is needed for a drug to show its action.
MRI scan is usually not indicated in Psychiatric disorders. But it depends upon Psychiatrist as he might be suspecting some organic lesion.
Hope I cleared your doubt, If you have more questions you can ask again.
Dr. Seikhoo Bishnoi, MD

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