QUESTION:
Dear Dr. Heller,
My doctor gave me a prescription for Paxil and Zyprexa. I have been reading a lot about both of these drugs on the net, and now I am scared to take them. She also said that sometimes Zyprexa locks the jaw, and said that if this happens take Benadryl. Is this information correct? To make matters worse, I wish she would have told me what my illness is. She prescribed Zyprexa 5 mg and Paxil 20mg. Please help me if you can.
Thanks.
ANSWER:
Like everything else in life, a decision needs to be made about the benefits versus the
risks. It's dangerous for you to drive in your car or use electricity, yet you
believe the benefits outweigh the risks. The same is true for medication.
Paxil is the safer of the two. The worst problems are withdrawal if you quit it abruptly,
and many patients with the generalized anxiety disorder (GAD) - especially the
"cognitive GAD" - experiencing a worsening of their anxiety symptoms.
Zyprexa is an "antipsychotic" medication that works by blocking the
neurotransmitter dopamine. If it blocks too much dopamine in a certain brain area (basal
ganglia) you get an imbalance with too much acetyl choline. This can cause a
"dystonic reaction" - where the muscles can go into spasm. The head and neck are
most commonly affected. It's not a dangerous side effect, but it is scary. It's
not that common, and happens most commonly with high doses. By blocking acetyl choline
with Benadryl, the basal ganglia goes back into balance and the spasms subside. Patients
who get these dystonic reactions can take Benadryl or similar medication prior to taking
Zyprexa.
Many individuals get groggy on Zyprexa. Some individuals complain they don't
"have feelings" while taking it. Weight gain is a common side effect - and it
can be extreme.
