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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by bipolarspectrum on February 14, 2006, at 15:10:38
Hi,
My pdoc has talked about loxapine as a possible option to replace seroquel in the future... does anyone have any experience with this drug??? my biggest worry is if it is sedating???
bps
Posted by med_empowered on February 15, 2006, at 1:19:04
In reply to anyone have any experience regarding LOXAPINE???, posted by bipolarspectrum on February 14, 2006, at 15:10:38
Loxapine (I think the brand name is "Loxitane") is a kind of odd antipsychotic. Chemically, its pretty closely related to the TCAs--in fact Asendin (amoxapine) breaks down (partially) into loxapine, which is partly responsible for amoxapine's therapeutic action.
Anyway, Loxapine was introduced a little later than the other old-school antipsychotics-1970s, I think. It tends to cause less sedation. Some docs seem to think its atypical-ish, b/c of some possible serotonin action, but overall there's not much evidence that its as well tolerated as, say, zyprexa (although weight gain isn't that big an issue with loxapine).
Do you have florid psychosis? If you don't absolutely **need** an antispychotic, my advice would be to taper the seroquel, boost up your mood stabilizer(s),and see how that goes. Long-term, mood stabilizers are probably better than antipsychotics, even the newer ones (especially for people with mood disorders...they tend to get EPS/TD more often).
Moban is sometimes used in bipolar. It can sometimes cause weight loss, it tends to be high in akathisia, but it doesn't seem to cause EPS/TD that often, so its atypical-ish (really, its just an odd drug all around).
Have you tried a multi-mood stablizer regime? Sometimes an anticonvulsant PLUS lithium, possibly with a third drug (another mood stabilizer) works well. Even in depression, lots of bipolars can avoid antidepressants and/or antidepressants by optimizing the mood stabilizer and/or adding another mood stabilizer (ex: lithium plus lamictal).
So..anyway, sorry this was so long...my own advice based on experience would be 1) avoid neuroleptics or 2) keep neuroleptic dosage low, and go for something with a pretty good track record--unfortunately, that would probably mean something like Zyprexa, which can cause sedation and weight gain.
GOod luck!
Posted by bipolarspectrum on February 15, 2006, at 15:34:18
In reply to Re: anyone have any experience regarding LOXAPINE?, posted by med_empowered on February 15, 2006, at 1:19:04
Thanx for replyin medempowered,
I've tried most things iwth lithium, i would like something to boost the lithium's antidepressant effects.. loxapine is an answer from my pdoc... but its so old that im skepticall... if it reallly was good, wouldnt it be used more??
bps> Loxapine (I think the brand name is "Loxitane") is a kind of odd antipsychotic. Chemically, its pretty closely related to the TCAs--in fact Asendin (amoxapine) breaks down (partially) into loxapine, which is partly responsible for amoxapine's therapeutic action.
>
> Anyway, Loxapine was introduced a little later than the other old-school antipsychotics-1970s, I think. It tends to cause less sedation. Some docs seem to think its atypical-ish, b/c of some possible serotonin action, but overall there's not much evidence that its as well tolerated as, say, zyprexa (although weight gain isn't that big an issue with loxapine).
>
> Do you have florid psychosis? If you don't absolutely **need** an antispychotic, my advice would be to taper the seroquel, boost up your mood stabilizer(s),and see how that goes. Long-term, mood stabilizers are probably better than antipsychotics, even the newer ones (especially for people with mood disorders...they tend to get EPS/TD more often).
>
> Moban is sometimes used in bipolar. It can sometimes cause weight loss, it tends to be high in akathisia, but it doesn't seem to cause EPS/TD that often, so its atypical-ish (really, its just an odd drug all around).
>
> Have you tried a multi-mood stablizer regime? Sometimes an anticonvulsant PLUS lithium, possibly with a third drug (another mood stabilizer) works well. Even in depression, lots of bipolars can avoid antidepressants and/or antidepressants by optimizing the mood stabilizer and/or adding another mood stabilizer (ex: lithium plus lamictal).
>
> So..anyway, sorry this was so long...my own advice based on experience would be 1) avoid neuroleptics or 2) keep neuroleptic dosage low, and go for something with a pretty good track record--unfortunately, that would probably mean something like Zyprexa, which can cause sedation and weight gain.
>
> GOod luck!
This is the end of the thread.
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