Posted by ed_uk2010 on December 18, 2013, at 14:16:30
In reply to At a dead end - options?, posted by vbs on December 18, 2013, at 0:50:35
> Hi fellow babblers, I'm wondering what other anti-psychotic meds I could try. I have schizoaffective disorder & currently take the following:
>
> Zyprexa 20 mg
> Invega Sustenna injection
> Cymbalta, 60 mg
>
> The problem is that I'm still hearing voices a lot.In schizophrenia, where multiple antipsychotics have proved to be ineffective, only clozapine (Clozaril) has been demonstrated to be reliably useful in terms of reducing hallucinations/delusions and improving functioning. The same may apply to schizoaffective disorder.
You could of course try a merry-go-round of other antipsychotics, but quite frankly I would consider clozapine if your hallucinations are still frequent and disturbing.
You may find the side effects of clozapine to be rather similar to the high dose of Zyprexa that you currently take, except than increased salivation is a common problem with clozapine, often requiring an additional med to reduce this. The need for frequent blood tests is unfortunate, but they almost always come back normal. Dizziness, drowsiness, dyspepsia and constipation are common with clozapine, but can usually be dealt with. Treatment is often optimised by measuring the clozapine blood level. This is useful for patients who do not appear to be responding to normal doses. In this situation, increasing the dose without checking the clozapine level can cause a seizure if the blood level is already high. On average, men tend to require slightly higher doses than women. Smokers usually require substantially higher doses than non-smokers.
Clozapine is annoying.... blood tests, monitoring, cautious dose adjustments, risk of side effects etc. The main advantage is that it works.
poster:ed_uk2010
thread:1056467
URL: http://www.dr-bob.org/babble/20131209/msgs/1056487.html