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Re: What are the overall best antipsychotics...?

Posted by undopaminergic on April 14, 2020, at 8:08:21

In reply to What are the overall best antipsychotics...?, posted by Skeletor on April 13, 2020, at 10:02:46

> What are the overall best (atypical) antipsychotics for Depression, Anxiety, Agitation, OCD, Bipolar...?

Low-dose flupenthixol, amisulpride, and sulpride, are effective in their own right for depression. Flupenthixol is typically regarded as typical (pun partly intended), but some have called it partially atypical. Newer drugs that may help for the same indication are aripiprazole and cariprazine.

As anti-manics, you would choose one of the more anti-histaminergic drugs, eg. olanzapine, risperidone, quetiapine. Likewise for anxiety.

> "Best" as in being effective with fewer side effects. Which ones were the best for you? Which ones did you take? What condition(s) did you treat? What side effects did you get? How did the antipsychotics compare to "conventional" antidepressants?

As anti-psychotics, the most potent I've tried is actually the anti-depressant trimipramine, followed by clozapine.

I've been fortunate in that I haven't had any weight gain from the clozapine.

Flupenthixol at higher doses (4+ mg or so) produced anorgasmia.

> Can antipsychotics be an alternative to "conventional" antidepressants?

See above. Certainly sulpiride outperformed most of the antidepressants I've taken, such as SSRIs and bupropion. Indeed, it transiently outperformed stimulants! Alas, after tolerance set in, there were no effects at all.

> What are the risks? What are the benefits? Do they make you a tomato with time? Psychiatrists prescribe them more often in recent times, it seems.

They are quite overprescribed in my opinion. The worst risk is tardive dyskinesia that persists after drug cessation.





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