Expert: Ivan Goldberg, M.D. - 10/22/2008

Question
Dear Dr. Goldberg,

I would like to know how long a patient can be on Olanzapine. I know of a patient who has been on it for thirteen years and was recently advised by a different Doctor that Olanzapine should only be prescribed for only a year and not longer than that.

Secondly, can Olanzapine cause less blood flow to the lower lobe of the brain?

Tell me about Deproex with regards to how long a patient should take it, the side effects and titration. What other medication should one avoid combining it with?

Please also advise about Oxetol and Rivoltri regarding as above.

What is your advice about a patient who has been on Olanzapine for thirteen years, which was gradually withdrawn and replaced with Deproex and then three weeks later suffers a partial convulsion.

Does smoking have any effect on any of the above medication?

Thank you very much for assisting people and mnaking a difference in their lives through enlightenment. I look forward to your response.

With kind regards,
Rozie

Answer
Hi Rosemary . . .

Whiel people should take any medication for as short a period of time as possible, there are people with chronic psychiatric disorders who require decades of treatment. While the risk of tardive dyskinesia increases with long-term use, people have taken antipsychotic medications such as olanzapine for decades. In my practice, antipsychotic medications are reserved for people with psychotic illnesses . . . they are not used as mood stabilizers or antianxiety agents.

Depakote is often prescribed as a mood stabilizer for patients with bipolar disorder and can be taken for decades.

Lots on information about Depakote can be found at:
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682412.html

Best regards . . .

Ivan
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