Question:
I have been on several meds for quite some time, but have also beenexperiencing some cardiac symptoms -- both high blood pressure, andrapid pulse, some "skipping" of heart beats -- which may or may not berelated to the meds. As an experiment, my doctor and I have agreedthat I will be getting off the meds, one at a time. (First, off onemed, see what effect that has. Then, if no effect, back on the med,then off the next med, etc.)

The doctor has indicated that, if getting off the meds should result indecreased blood pressure, or decreased pulse (or both), the resultshould start to be evident after about a week or so. I'm posting hereto get a second opinion. Assuming one these meds is, in fact, causingincreased BP or pulse rate to begin with, will these side effectssubside after just one week off the medicine?

The meds are: Desipramine, Remeron, Provigil

I also take a low dose of Zyprexa and a moderate dose of Depakote, butthe doctor seems pretty sure these should not have any cardiac relatedeffects. Is he correct here?

Answer: You don't mention your age, but note, too, the warning at the top of the PI:

WARNINGIncreased Mortality in Elderly Patients with Dementia-Related Psychosis -Elderlypatients with dementia-related psychosis treated with atypical antipsychoticdrugs are atan increased risk of death compared to placebo. Analyses of seventeenplacebo-controlledtrials (modal duration of 10 weeks) in these patients revealed a risk ofdeath in thedrug-treated patients of between 1.6 to 1.7 times that seen inplacebo-treated patients. Overthe course of a typical 10-week controlled trial, the rate of death indrug-treated patientswas about 4.5%, compared to a rate of about 2.6% in the placebo group.Although thecauses of death were varied, most of the deaths appeared to be eithercardiovascular(e.g., heart failure, sudden death) or infectious (e.g., pneumonia) innature.ZYPREXA (olanzapine) is not approved for the treatment of patients withdementia-related psychosis (see WARNINGS).

One doctor was considering prescribing Zyprexa for the cognitive damage myhusband suffered under Lipitor, in addition to myopathy, elevated CKbordering on rhabdomyolysis, and nerve damage. I'm glad it didn't happen.Note this:

Postintroduction ReportsAdverse events reported since market introduction that were temporally (butnot necessarilycausally) related to ZYPREXA therapy include the following: allergicreaction(e.g., anaphylactoid reaction, angioedema, pruritus or urticaria), diabeticcoma, pancreatitis,priapism, rhabdomyolysis, and venous thromboembolic events (includingpulmonary embolismand deep venous thrombosis). Random cholesterol levels of ?240 mg/dL andrandom triglyceridelevels of ?1000 mg/dL have been rarely reported.