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Re: neuroleptic induced dysphoria

Posted by SLS on December 3, 2017, at 20:39:28

In reply to Re: neuroleptic induced dysphoria, posted by linkadge on December 3, 2017, at 19:25:21

> Any experience with cariprazine?
> This agent has d2/d3 partial agonist activity.
> Linkadge

I reacted badly to cariprazine (Vraylar). I had looked forward to trying this drug for quite awhile because of its high D3/D2 binding ratio. Unfortunately, it produced profound dysphoria almost immediately. I elected to discontinue the drug at that point because I was unwilling to take the chance that the dysphoria would persist. The active metabolite of cariprazine (didesmethylcariprazine) has a half-life of 2-3 weeks. That's just too long to hope that a hellish side effect will disappear on its own. It would take months for the drug to leave the body once therapeutic levels are reached.

What do you think of brexpiprazole (Rexulti)? Its D3/D2 binding ratio is less than that of Abilify. Perhaps it is less liable to produce dysphoria. I don't know. I feel better on Abilify than I did on Rexulti.

There has to be a better way.

I am doing better since reducing the dosage of prazosin from 30 mg/day to 15 mg/day. I'm not sure where I'll end up, though. The higher dosage promoted dysphoria and cognitive impairments. It took me awhile to realize that the dysphoria produced was not the same thing as the original depression. Sometimes, these things creep up on you so gradually that you don't recognize them as being side effects.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




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