QUESTION:
Dear Dr. Heller,
Please comment on this combination (Effexor and Zyprexa) of medications for treatment of chronic depression/BPD.
ANSWER:
Some practitioners describe great results with Effexor, particularly at high doses.
I've not had that experience. In theory this combination should be a good one for
chronic depression and the BPD, but in practicality side effects are going to be a huge
problem. In my experience there are better options.
Effexor needs to be taken in high doses to get the best BPD effectiveness, usually
300-450mg daily. At this dose high blood pressure and other side effects can be a problem
(nervousness, insomnia, nausea, dry mouth, dizziness and others).
Zyprexa is a very effective medication, particularly when the thinking processes
aren't clear. Weight gain is usually an insurmountable problem for long term use - 25
to 100 pound weight gain is common. Some people complain that they "have no
feelings" while taking Zyprexa. I use it short term, particularly for those patients
who are extremely underweight and have no appetite.
