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Re: I am thinking about combinationRexulti and Saphris

Posted by SLS on May 7, 2018, at 6:57:24

In reply to I am thinking about combinationRexulti and Saphris (nm), posted by Lamdage22 on May 7, 2018, at 2:33:29

How would you discontinue Seroquel?

I like Saphris. Rexulti is like a milder Abilify. It is milder with respect to dopamine D3 receptor partial agonism. It has less akathisia as far as I can tell. I think you should first switch from Seroquel to Saphris before making any other changes. Saphris definitely has antidepressant and anti-anxiety properties. I don't really know the mechanisms behind this. It does act as a partial agonist of 5-HT1a receptors and a full agonist at D2 and 5-HT2 receptors. It is also a 5-HT7 receptor antagonst. This is currently being studied for depression.

I'm not a doctor, but I don't like Seroquel because, like Zyprexa, it causes weight gain and diabetes. If all you are using it for is sleep, 1000 mg/day doesn't make sense to me. The metabolite of Seroquel, norquetiapine, is a NE reuptake inhibitor (like desipramine). This might not be too good for sleep and anxiety when it is taken at dosages over 200 mg/day. Perphenazine might make a good substitute for Seroquel. You could then d/c Zyprexa and bring Saphris on board. With perphenazine and Saphris, I doubt you would need metformin. If you go with Rexulti, you may have to continue with it. Rexulti is not a bad drug, but I think Abilify is more potent as an antidepressant.

- 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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