Mirtazapine And Olanzapine Use - Peripheral Edema?


Feb 2, 2015

Does anyone have personal experience of this problem? A 79-year-old friend with vascular dementia has been prescribed a whole series of atypical antipsychotic drugs over the past eight months, all with varying disastrous results. And yes - I know this is an off-label use of this group but they still get prescribed for dementia sufferers all over the western world.

She's been on mirtazapine 20mg once daily for about five years (with no apparent ill effects) and olanzapine 10 mg once a day for three months. Two months ago she very rapidly - over a few days - developed massive swelling of her left hand, with complete loss of use of the middle, ring and little fingers of that hand. An X-ray was inconclusive, mainly as she couldn't straighten the three affected fingers, and her doctor has been mystified by this ever since. He finally decided it was arthritis but it didn't look much like it to me, given the degree of swelling and deformity, and the speed with which it had come on. Anti-inflammatory drugs have been prescribed, but with minimal effect.

I visit her in her high-security psycho-geriatric unit at least three times a week. Last Tuesday (six days ago) she was still feeding herself perfectly normally with her right hand, once her food had been cut up for her. Three days later, she could no longer hold a spoon, fork or cup. Her right hand isn't swollen but I can clearly see the identical deformity in her last three fingers as in her left hand. All three fingers on both hands are curled up and twisted over each other.

After raising Cain at the home, I've managed to get her an emergency appointment at a rheumatology clinic tomorrow. In preparation for this, I've been doing some research over the weekend (and no, not on Wikipedia) and have discovered peripheral oedema (swelling) is a rare, but known, side-effect of olanzapine. I also found a long paper that had clearly been published in a learned journal on the subject of peripheral oedema with combined mirtazapine and olanzapine use. Unfortunately, it was in Turkish!

Has anyone suffered from this and how quickly did it improve once the olanzapine dosage was reduced? Also, how serious is the rebound psychosis when olanzapine is withdrawn?

She was originally on risperidone, but when that had to be tailed off because it left her with severe Parkinson-like symptoms, it left her way more psychotic than she'd been at the outset, with the result she stabbed another resident in the lovely retirement home she was living in. She's stayed that way ever since, hence the transfer to a grim high-security psychiatric unit, where she'll end her days. She was subsequently put on clozapine for a couple of months, which caused terrible athetotic movements - constant bobbing, weaving movements of head, jaw, tongue, arms and upper trunk - which made her life unbearable. I have to say, however, that when that was gradually withdrawn, I didn't notice any rebound psychosis.

I'm furious with myself for not researching this sooner, as I'm a former nurse, though neuro was my speciality. I'm even more furious with her idiot doctor for prescribing a med that isn't authorised for dementia, then failing to notice she was suffering from a known side-effect. Ditto the nursing staff at the home. When I mentioned this to the head nurse today, she blithely said she'd known all along it was a side-effect of olanzapine - though I suspect she was just covering up her ignorance.

My friend is beside herself, and it breaks my heart to see her like this. She knows there's something wrong, but doesn't understand what it is. She can't feed herself at all now. I tried her with a biscuit this afternoon and she couldn't even hold that. She's already dangerously underweight (BMI 17) and now she's refusing to let the staff feed her, as she's not used to that. I'm the only one who's allowed to feed her, albeit only a few mouthfuls, but I'm 71 myself and can't continue going in twice a day. In the meantime she's screaming and shouting all day and all night in anguish and sheer terror, and attacking everyone who goes near her. She tried to bite my face today.

Sometimes patients who've been on this class of drugs for long periods know much more about them than the professionals, which is why I'm posting here. Is this terrible condition likely to be a result of olanzapine (and possibly mirtazapine)? And can we expect severe rebound psychosis if her doctor tails it off? (Always assuming he even agrees to do that.) Also, does anyone have any experience of other recently-developed anti-psychotics that don't cause appalling side-effects of one kind or another? Though I have to say, from my own nursing experience, that I suspect there's no such animal.

View 1 Replies



Advertisement

Peripheral Neuropathy With Severe Edema From The Waist Down

I have peripheral neuropathy with severe edema from the waist down.  My doctor will not give me water pills.  Is there anything I can take homeopathically?

View 7 Replies

Mirtazapine :: Low Dose Of Olanzapine For Insomnia

I'm guessing you've tried the usual suspects, zopiclone, temazepam etc etc

When my insomnia got so bad I couldn't even function any more, my psychiatrist tried me on a low dose of olanzapine. It did help me. It is also a pig to get off though... There are no easy solutions I'm afraid. CBT did help me too, but I had to really work at it.

View 1 Replies

Olanzapine :: Bad Feelings While Quitting

I recieved super bad feelings when i got under 100% dose of olanzapine and couldn't sleep and up-ed my dose to 10mg (from around 6mg i guess). the feelings came when i was falling asleep.

it came like 3 times, like 70% of my cells were being pressured together.... (i'm describing the super bad feelings) it scared me A LOT when it happened and i am very scared to up my dose again because i think then these super bad feelings might come again...

they came for like 7 seconds these 3 times combined, these 3 times happened in like 1 minute. it would not surprise me if these super bad feelings were Life-threatening but i told my psychiatrist about it and he didn't know what it was but said that it was not Life-threatening.

so now i am trying to quit very slowly so i never have to up my dose again. lowering my dose by 0,625 mg each time.

i was hoping that someone here knows what these super bad feelings were and could shed some light on it. it would help me ALOT if i knew that these super bad feelings were not dangerous.

i'm not 100% certain that these feelings were caused by me uping my Olanzapine dose alot but i think so.

View 1 Replies

Olanzapine And Lithium For Six Months - Cravings For Food

My son has been on this drug and lithium for six months after a manic episode and diagnosis of BP. I do not feel it has helped him at all. In some ways it has caused further problems as he developed cravings for foods with high fat and sugar content, he began to smoke which he hadn't previously, and then progressed to some cannabis. He has no willpower to resist these cravings and has put on loads of weight. He has also lost all spark and been very depressed despite antidepressant medication.

View 2 Replies

Peripheral Neuropathy :: Gabapentin And Amitriptyline

Was on 600mg Gabapentin 3 times a day for peripheral neuropathy to little effect. Was prescribed Amitriptyline, took 25mg for 3 days then 50mg for 5 days - replacing the 2 Gabapentin at night. Reduced Amitriptyline to 25mg after awful side effects. Took for 2 days with 300mg at night (in addition to the 600mg in morning and new GP said stop Amitriptyline and increase morning dose to 900 mg. Was OK for a while, but then feet and lower legs started severe pins and needles, difficult to walk. Disturbed sleep last night and feet and legs still bad. Is this withdrawal from Amitriptyline? How long will it last? GP rang and said gradually increase Gabapentin to 900 mg 3 times a day and if necessary go to 1200 mg 3 times a day.

View 7 Replies

Eye Care :: Distortion Of Peripheral Vision

I'm wondering if anyone has ever experienced distortion in their peripheral vision. It's a bit difficult to explain, but it's almost like objects are a different shape in my peripheral vision than when I look straight at them. It often looks like straight lines are bent in my peripheral vision, or objects just seem to shift position but then shift back when I look back at them. Sounds very odd I know. I do have astigmatism on both eyes, but is this a normal symptom of that?

I have some other odd visual symptoms, such as trembling vision (straight lines appear to tremble) and light sensitivity. I had a virus about 6 weeks ago which I'm still struggling to recover from - achiness, fatigue, some muscle weakness. I've had blood tests, MRI brain scan and my eyes fully inspected by 2 ophthalmologists.

View 1 Replies

Peripheral Vascular Disease, Floaters And Anxiety

I had a PVD about 2 years ago, plus I've always had floaters, however, I just had a new floater and the doctor did laser eye surgery. I always have a great deal of anxiety and since this just happened right before I was to go out of the country on vacation I had a major panic attack and couldn't force myself to go. I was scared to be in a foreign land for fear something would happen. I don't want this to control my life, but now it has.

View 1 Replies

Gabapentin :: Miracle Drug For Sciatica And Peripheral Neuropathy

I suffer from sciatica and peripheral neuropathy in the feet.  Have tried to address both with diet restrictions and daily walks.  Yet, the arthritis like pain in the back of my calfs and legs is getting intolerable.

My girlfriend has extensive lung problems and chronic resultant pain from coughing for hours on end - in the back and thorax areas.  She was prescribed Gabapentin to relieve that pain.  Works for her.

So she gave me two tabs to try for my problems.  It was as though a miracle had taken place.  No pain whatsoever.  Almost no side effects - other than a slight feeling of increased relaxation.

View 4 Replies

Menopause :: Light Flashes At The Peripheral Edge Of Vision?

Anyone else experience flashes of light at the peripheral edge of their vision?

Over the last week I keep having them and swing my head round, like a flash has gone off.

View 4 Replies

Multiple Sclerosis :: Loss Of Peripheral Vision/Digestive Issues ?

About a year ago or so I started to notice a change in my Peripheral vision. I found myself having to completely look to my right while driving because of a blind spot and I also noticed when I shaved my underarms I could no longer see them (very blurry) if that makes any sense. I didn't have and insurance so I had to wait. Fast forward to last month. I saw an Ophthalmologist thinking it was vision problems of some sort. Well, I miserably failed the test that checks for peripheral vision. He then looked at the optic nerve and didn't see anything that would suggest normal vision loss. He said I have lost almost all Peripheral vision in my right eye and a good amount on my left. He referred me to a neurologist that I will see this Monday. I was glad because I had also been having some issues with what seems like pinched nerves in the neck and shoulders, I thought it could be related to some nerve issues. So my other issue which I didn't correlate as being possibly related until today is that I have been having some major digestive problems that have flared up on and off since February. I am having a lot of indigestion, gas and constipation.. The constipation is pretty bad, sometimes I can't go and I resort to taking laxatives for relief. And I have this really annoying muscle twitching in my lower abdomen! It feels like a vibration, I have been having that for a couple of weeks now. I have been so miserable that I made an appt for next week to see a gastro doctor. But then tonight I Googled the vibrating issue and was noticing that there were many people on MS boards with similar problems. And then it hit me that there seems to be a lot of coincidences between my issues and MS. Now I am worried. Did any of you experience similarities before a diagnosis? And how are people diagnosed?

View 3 Replies

Mirtazapine :: Weight Gain On Mirtazapine 30mg

I have just started on the 30m Mirtazapine and it's my 3rd night taking them ans i have read up on a lot of different forums that there are patients gaining weight off these? well i would like to know what the odds are of gaining weight because i have always had problems with weight gain, i can never put on any weight, no matter how much i eat, i have a fast metabolism and i am wondering, will the mirtazapine surpass my high metabolism. also in some cases i've heard it slows your metabolism down too..   but it would actually be a benefit for me to gain some extra weight.

View 5 Replies

Mirtazapine :: Tapering Off Mirtazapine - Spinning Myself In Circles

For the first time in a very long time, I'm finally in a good enough place to make the step in coming off my Anti-depressant. I've been on Mirtazapine 45mg for the last 4/5 years and before that a string of various of medications.

Despite my anxiety been kind of excessive at the moment, after a discussion with my GP, he was happy to let me begin tapering down the dose. The problem is with my anxiety I feel it mainly physically rather than mentally so it makes me a little oversensitive to any changes that take place in my body.

I guess what I am searching for is some reassurance so I can stop driving myself up the wall, exhausting google search on mirtazapine withdrawal. 6 nights ago I started my first reduction so 45 mg to 30mg. In all honesty it's not been that bad, a few waves of nausea, headaches and random aches and pains. Those I was expecting so don't mind too much. The trouble is that for the last 3 days, I've found myself a little short of breath for most of the day. It's nothing that's outwardly noticeable at the moment, but it's there and is slightly concerning. Has anyone else experienced this when tapering?

I'm kind of freaked out a little because one of my fears that's arisen since the mirtazapine is the that i will develop random allergies and my brain is wondering if I've suddenly developed an allergy to my meds (ridiculous, I know!) The other thing is that the rest of my family has had either viral chest problems lately so maybe I've just picked up that and it's a coincidence? Or it could just be the anxiety.

I'm totally spinning myself in circles at the moment so any wise words are most welcome at this point. If I know it is just withdrawal and nothing that can actually hurt me then I'm fine with whatever effects it throws at me.

View 92 Replies

Mirtazapine :: No Appetite After Stopping Mirtazapine?

3 days ago I decided to stop taking mirtazapine 45 mg but since then I have not had any appetite for any foods at all. Is this a normal symptom.

View 1 Replies

Vision / Eye :: Flying Black Dots In My Peripheral Vision

I'm not particularly worried about this but I'd rather know what it is. I quite commonly will get, after stretching or getting up suddenly, flying black dots in my peripheral vision. These tiny black dots just appear, fly in a direction, then disappear. A bit like a swarm of flies in the corner of my eye except they keep appearing and disappearing individually. It might last up to five seconds or so. Then it's gone and I feel fine. I'm pretty sure I've had this for years.

View 1 Replies

Eyes :: Floaters PVD - Peripheral Vascular Disease Both Eyes

I'm late 5s,have had floaters since my 20s,back then they were small black or clear dots,fast forward,late fifties,now i've had pvds in both eyes,vitreous gel shrinks and pulls away from the back of the eye,now i have these clear to gauzy larger floaters,plus one large clumpy black one and I can't ignore them anymore. PVD is age related. I am just lucky enough to have these awful larger ones that can blur and obstruct vision. How does a person deal with it. Oh yes I also am starting to have dry eyes. Both also can cause hazy vision. Unless you've experienced it,no one else can relate

View 3 Replies

Anyone Tried Muro 128 For Dry Eye Or Corneal Edema?

My doctor suggested Muro 128 ointment 5% at night following a corneal abrasion (scratch) & corneal swelling with vision blurriness following that. Steroid drops tried but didn't resolve the blurriness. The Muro 128 seemed to clear it up magically. The only thing is, the doc now recommends I use it for 6 months! I have dry eye anyway but wondering why you would use drops which draw fluid out of your cornea for that length of time? Would be interested if anyone else has used Muro 128 on long or short term basis.

View 2 Replies

Undiagnosed And Rare Edema

I have had rt thigh, calf and hip edema since 1/14 (8 months). It came on out of nowhere. No injury. Neg for DVT, neg MRI for mass, neg mass on abdominal CT scan. Multiple hypodense, Ill defined nodules were identified on spleen and a few on liver. CT scan of chest identified multiple hilar lymphadenopathy. This prompted bx. Dx: Sarcoidosis. Had 2 unsuccessful rounds of prednisone. Now getting Remicade tx. I feel better overall, but the edema. Has not changed. My sarcoid dr (pulmonologist ) thinks this may be totally unrelated to the sarcoid.

I'm desperate for an answer. Vascular consult was neg. any clues?  

I was originally told this could be a spinal compression issue. I do have a hx of lower back pain/spasms.

View 10 Replies

Hip Replacement :: Pitted Edema

Swelling on the top of my foot and on the right outside of my ankle  ( on the operated leg) will not go away. I wake up in the morning, its fine but gradually by 3 hours later its swell bad,and if u press it it stays indented. I called my Dr about it,they gave me 7 pills of Lasix for water retention -but it didnt work ( didnt make me pee any more then usual) AND it made me feel weird. Dizzy and just sickish. I called back and they said since my BP is normal to low side that maybe I didn't need the lasix to get a milder over the counter. I got a natural one -from the health food store -BUT STILL. I took the TED hose off a week ago. I lay ice on there and froze a pair of socks that I put on.Nothing is helping apart from laying down at night.  I don't have heat pain fever or swelling behind the knee. ANY BODY ELSE dealing with this? I'm 4 weeks since op tomorrow.

View 4 Replies

Glaucoma And Macular Edema?

2 years ago I had a piece of steel melted into my eye. I went to the emergency room and they called in an eye specialist. After a dew painstaking hour They got all of the steel removed from my eye. But the specialist tells me i need to see another doctor because it looks like I got glaucoma. So finally I got the nerve to go see the doctor. I don't like to go to doctors. Any how, she said i do have glaucoma after 3 visits to her. Also they had a specialist there at the last visit. They brought a different machine with them. They took a bunch of tests to confirm I have glaucoma and other problems. Macular thickening, leakage of fluid inside my eye, aneurysms, cotton walls. They have appointments scheduled all over the state with specialists now. I am 40 years old. They tested me for diabetes and high blood pressure. All negative. They are not sure why I am having such bad eye problems. Any thought? The eye doctor told me they will start a treatment for the glaucoma in a couple weeks after I see the next specialist.

View 2 Replies

Postherpetic Neuralgia And Edema

My 91 year old father contracted Shingles in November 2014 and from being totally independent  - living alone and driving a car he had to move into care as has suffered postherpetic neuralgia since. He has shooting pains going down the sciatic nerve in his right leg.  It seems like he has been on every drug known to man and although some of his pain has been alleviated he still has excruciating episodes.  His only means of relief is to stand so can spend hours sitting/standing/sitting/standing.  He has, however, since the shingles suffered edema in his right leg also.  Amazingly he still tries to maintain some independence and tries to walk, however, this is so difficult now that his leg is so heavy and swollen.  I don't seem to be getting any answers as to why he has this Edema.  He never had it before the shingles and although he had it mildly afterwards it is now extremely bad.  I'm wondering whether it could be the medications that he's on and would be interested if anyone else as experienced this and what the cause was.

View 4 Replies





Copyrights 2005-15 www.bigresource.org, All rights reserved