Has anyone come across or know about this please? Thanks

[TL500]

ehealthme.com/drug-interact...

[jimcaster]

I am not familiar with Olanzapine, but it seems advisable not to take it if you're taking thiamine.

[TL500 in reply to jimcaster]

Thanks Jim. So even not hours apart? Or never?

[jimcaster in reply to TL500]

Good question. I don't know the answer.

[TL500 in reply to jimcaster]

Thanks

[pearlette]

Olanzapine is a well known anti psychotic drug that works on certain dopamine receptors to block the action of dopamine. It also means that a well known side effect of it is motor slowing / aches etc ; also loosey termed drug induced Parkinsonism !

Used mainy treating psychosis in schizophrenia and bipolar depression with mania/other psychosis associated mental health symptoms.

If you have Parkinson's generally you keep away from this group of drugs !

[TL500 in reply to pearlette]

Thanks for your input. This is not for a PD person. It's for someone taking Olanzapine and I want to know if B1 can help them. Do you know if it will interact as the link says. Thanks

[pearlette in reply to TL500]

Thank you. The way the interaction will be because the thiamine competes with the same pathway used by olanzapine. So it would be better not to take the larger doses of B1 used "unconventionally" as used by some of us (With Parkinson's & other neurologically imbued conditions). Doses up to 300mg are used for replacement in high alcohol users /malnutrition etc.

(the above is from my 20 odd years as a practicing acute medicine and intensive care physician with an interest in pharmacokinetics.

A person on olanzapine is likely to be someone who needs it for a condition where the brain needs to be calmed down (Psychosis/anxiety/mania in mood disorders) so high doses of thiamine are counterintuitive.

However if they have altered food intake / or have ineffective absorption due to high alcohol intake, upper bowel surgery/ significant depression/ eating disorders like anorexia or forced starvation , then the chances are they may need olanzapine for treatment of their mental health symptoms and smaller doses of thiamine maybe part of the replacement regime (up to 100mg after a loading phase of 300 mg. ( This comes from my current 7 years as a jobbing psychiatrist post PD diagnosis)

What we need to remember is that high dose thiamine use is a relatively new practice so we do not have information about long term use.

DOI I have experimented with high dose thiamine myself but can barely tolerate more than 200mg and it did wonders for fatigue. Recently I pushed it up to 500mg but realised it was sending my blood pressure sky high .

[TL500 in reply to pearlette]

Thanks pearlette. Can you tell me what do you mean by "jobbing psychiatrist post PD diagnosis"?

And you mean the person taking Olanzapine can take B1 butower dose? Up to 100mg? Thanks

[TL500 in reply to pearlette]

And what do you think about this website please:alternativetomeds.com/blog/...

Thanks

[pearlette in reply to TL500]

Most of what is said is great for "convalescing" after an acute episode.

CBT can help you deal with "normal" life ups and downs for those who may find them overwhelming. The individual needs to be able to work with the therapist.

But truly psychotic states rarely get better without some period of definitive antipsychotic treatment . Left untreated it can either accelerate to florid psychosis with uninhibited impulsive actions that may be dangerous or a chronic unmotivated withdrawn personality

Even mixing natural extracts with chemical medicines have unknown interactions. My own experience was a toxic potentiating reaction when I had a large iced matcha latte with amantadine. Luckily I worked it out myself and drank a few litres of water to get it out without attending an emergency department.

Many herbal treatments for depression may be modulating serotonin levels just like the usual antidepressants.

[TL500 in reply to pearlette]

Is it possible for a person taking Olanzapine for psychosis be cute and off Olanzapine or antipsychotics?

[pearlette in reply to TL500]

It is not unusual for short term olanzapine for short term stress triggers anxiety in certain circumstances. It will reduce anxiety, improve ood and in situations where minor hallucinations get triggered by the anxiety etc. it will reduce the intensity of symptoms. Easily tapered off too. Usually there are no absolutes.

For many first episode psychosis situations we often use an antipsychotic in gradually increased doses. Then you taper it down and use a low maintenance dose for a year or more . Then stop completely.

[TL500 in reply to pearlette]

What is ood?And if it's not first episode? If the young person has gone through a few episodes and now so far on 7.5 mg, still sort of trial and error, and has been nearly three years. Can it be or tapered down and stop completely later on?

What should we do to improve so that there is a chance to stop the meds? Thanks

[JohnPepper]

Here is the link to the MAYO CLINIC Report: healthunlocked.com/cure-par...

John

[TL500 in reply to JohnPepper]

Thanks john

[pearlette]

Hi TL 500

Yes, a low dose of 50 -100mg of thiamine would not cause a problem .

I was thinking of retiring from my previous clinical practice after my diagnosis which required a lot of hand dexterity etc in emergency . I started working in a psychiatry clinic as an assistant to a group of psychiatrists to help with managing the interacting their other conditions when they were admitted in hospital for assessments.

I did not go through a full residency and fellowship type of training which I did in internal medicine and critical care. So I am not rated as a specialist but I now work a lot with people discharged from acute psychiatry hospital stays with psychosis I do not have the responsibility of supervising residency trainees, interns etc. I just see patients full time. Hence the "jobbing psychiatrist"

I do see and prescribe a lot of antipsychotics on a daily basis as the relapsing ones also come my way !

[TL500 in reply to pearlette]

Thanks. For a person who has cerebral palsy and psychosis, who is taking 7.5mg Olanzapine, can he/she take 50mg-100mg Thiamine? According to that article? Thanks

[pearlette in reply to TL500]

With cerebral palsy a number of other factors come into the equation.

As a general rule cerebral palsy implies that some parts of motor function are defiecient due to the oxygen deprivation at birth.

This often manifests a loss of developmen t of muscle mass which is extremely variable. Based on that premise, the dose of 7.5mg may be very modest or very high in this individual.

Then you need to take into account all other aspects of the individuals physiology (muscle mass, kidney function , gut absorption etc)

The article you mention does not present that information. It mostly cites the association of age, gender etc in popultation studied. Subsect analysis is not included. It canot be used to guide me to answer.

But secondly the average current recommended does of maximum daily are less than 10 mg per day in average multivitamin over the counter products.

50 mg s about all you get in " extra strong B Vutamin supplements..

My question would be do they need this amount ?

Why not try not tohave it and see.

[TL500 in reply to pearlette]

Thanks. I don't quite understand what you mean, especially "Why not try not tohave it and see”. Can you explain please? Thanks

[pearlette]

If the person is taking thiamine, see how they do without it a supplement. No ordinary feeding pattern is thiamine free. Most of us get enough thiamine from our diet and do not take supplements. So why not stop any supplemented thiamine and see what happens .

I cannot give you specific advice about tapering olanzapine . I simply do not have the appropriate clinical picture

[TL500 in reply to pearlette]

I hope you don't mind, I've sent a message to your chat. Thanks