Stories of Recovery

Marja's Story

OLANZAPINE vs. FLUPENTHIXOL - As Compared by a Patient

An illness that came to a head in the mid 1960's, and which was eventually diagnosed as bipolar disorder, made it necessary for me to take medications indefinitely. Olanzapine, together with the mood stabilizer, carbamazepine, kept me in perfect balance for several years. I was delighted with it. While I was taking it I was considerably more stable than when I was on perphenazine, the antipsychotic I took for most of my adult life. With this new drug I had virtually no problems with high or depressed moods and no breakdowns at all.

But six months ago, in spite of olanzapine's effectiveness, my doctor and I decided it was time to try a change. I had been having persistent problems with word recall and a flatness that left me uninspired to write or do photography, creative outlets that had always brought much joy.

The poor recall posed more problems that one might expect. I often found myself afraid to join in social conversation, worrying that I might not find the words to finish my thoughts. I sometimes did public speaking and it was embarrassing to get stuck for words. Being a naturally shy person, this problem dampened my already weak confidence.

Since I switched to flupenthixol my quality of life has changed dramatically for the better, and in ways I hadn't expected. The biggest difference is that I have a reduced need for sleep.

From the beginning of my illness until this latest medication switch, I had been on antipsychotics that had a somewhat sedative nature: first perphenazine and then olanzapine. During all those years I hadn't perceived this as a problem. I felt comfortable and my daily functioning was good. But I was always a late riser. I would go to bed between 11 and 12 pm and the next morning slowly start waking up around 9. Then, with a cup of coffee almost spilling onto the bedcovers, I half-dozed for an hour or so before getting dressed.

I felt like a bad mother during my son's elementary school years because I wasn't able to wake up enough to help him get ready for school. Only when he was ready to leave did I drag myself out of bed long enough to make sure that he was properly dressed, had his hair combed, and that he had his lunch. A quick hug and then back to bed for another precious hour of sleep.

For almost forty years I didn't dare commit myself to early appointments or activities that took place before 10 am. I often missed church services. To myself, and to others, I rationalized that I only happened to be a night person. But deep inside I suspected I was just lazy.

Now that I'm on the non-sedative flupenthixol, this has all changed. I still go to bed between 11 and 12 but, without fail, get up before 7, usually at 6:30. When I awake, I'm up within minutes getting my first cup of coffee and I don't go back to bed to drink it. This is now my favourite part of the day, a time to relax, meditate, watch the news. I get an early start on chores and activities. I feel better about myself.

My friends are impressed because they know how I used to be. Yet I think few of them realize what a big difference this has made to my life. My energy has increased and I accomplish much more. All of a sudden I have many more hours in my week. Being fortunate enough to be comfortably supported by my husband, I have generally counted my time more valuable than money. I am now very rich indeed.

Once I had been weaned off olanzapine and totally switched to flupenthixol, I was delighted to notice that I was more clear-headed. Words flowed more freely and my confidence in social situations improved. The flatness is gone. I'm more sensitive to what goes on around me, though not so much that it causes problems.

I haven't recovered my passion for photography yet, but have also been too busy for it. It's on the back burner and I'm confident that one day soon I'll have the time and desire to return to it.

Unfortunately, all medications have some drawbacks, even the good ones. Flupenthixol is no exception. One problem I've encountered is frequent headaches, something I didn't have while on olanzapine. I also find that I'm taking on more commitments than are healthy for me and there is a constant treat of becoming over-extended. I suspect this may be because of my increased energy and extra time, which I feel compelled to use. But although I'm very active, I can slow down enough to take time out for relaxation.

Oh yes, there are a couple of other significant advantages to flupenthixol. At the time I'm writing this, olanzapine costs $7.00 per daily dose of one pill ($210 per month) while flupenthixol costs only $1.00 per day. As well, flupenthixol does not cause weight gain, a problem reported by many who use olanzapine. This was not a serious problem for me. I only gained five pounds when I first started on olanzapine and then leveled off. I lost those pounds when I stopped taking it.

I never fail to be an awe of what power is packed in each little pill of these modern medications. It's amazing how only one a day (in my case taken in conjunction with carbamazepine) can keep away the nightmares of depression, mania, delusions and paranoia that used to be part of my world. My opportunity to survive and thrive has improved tremendously since I first became ill. I lead a close-to-normal life. For this I'm very thankful.

Marja Bergen

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