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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by Joel Maxuel on November 23, 2002, at 21:09:24
Hi,
I just got started on Clozapine a couple of weeks ago, and even though the success rate for it is around 60%, I'm looking around for some stories about it, see how well it worked (and didn't work). Also, to see if there is any sexual difficulties (ie dysfunction) associated with the drug. Your thoughts are valuable to me.--
Joel Maxwell
ShamelessPlug(http://www.maxuel.ca);
Posted by xjs7 on November 26, 2002, at 22:27:39
In reply to Success with Clozapine (Clozaril), posted by Joel Maxuel on November 23, 2002, at 21:09:24
Hi Joel,
I do not have any experience with clozapine, but I am interested in it, as it is my "last resort" treatment if nothing else works. Also, a different poster on this board was looking for information about Clozaril.
So, perhaps you could keep this board updated on your progress with this medication. I know that I and at least one other person would be interested in how things work out for you.
I hope things go well.
xjs7
Posted by Joel Maxuel on November 27, 2002, at 12:52:51
In reply to Re: Success with Clozapine (Clozaril), posted by xjs7 on November 26, 2002, at 22:27:39
> I do not have any experience with clozapine, but I am interested in it, as it is my "last resort" treatment if nothing else works. Also, a different poster on this board was looking for information about Clozaril.Even though its a last resort drug, It is known for being a lot stronger than Risperdal and Zyprexa. Seroquel is middle of the road. IMHO Seroquel should be selected first, or maybe the new Geodon, if its available. (That is, for hard cases like me.)
> So, perhaps you could keep this board updated on your progress with this medication. I know that I and at least one other person would be interested in how things work out for you.
Well, I am extremely tired on this medication. I'm usually very tired as it is, so I spend a lot of my time in bed or on the couch. I sometimes offset that by having either a half pot or a full pot of coffee. Today my sister and mother noticed red spots on my arms, and my mom thinks it is hives (She had hives for several years now). So far I've had no sign of agranulocytosis, which is good, since I'm on accutane too, and I'm not sure if that's the proper thing to do, mixing two drugs having the possiblity of getting agranulocytosis. Theres not more I can say, except about my ase in the respect that I never had much of the positive symptons, just the negative ones, and maybe the cognitive ones.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by Joel Maxuel on November 28, 2002, at 20:37:49
In reply to Re: Success with Clozapine (Clozaril), posted by Joel Maxuel on November 27, 2002, at 12:52:51
C'mon, there must be another pchizophrenic out there that is on Clozapine. Lets see: 1% of the pop have pchizophrenia, maybe around 1/10 of them are on clozapine (you have to count in those who are on the street with no access to medication), so around 500,000,000 people with internet access, makes 500,000 people.
There gotta be at least a dozen of them who go to this message board.
Be heard!
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by Joel Maxuel on December 2, 2002, at 13:43:38
In reply to Re: Success with Clozapine (Clozaril), posted by Joel Maxuel on November 27, 2002, at 12:52:51
Just writing to update all of ya about my Clozapine venture. Well, this morning I awoke at 8:00, feeling quite refreshed, although I did not get up until 11:30. I think the calcuim-magnesium-zinc supplements are working, although i'm probably taking too much zinc. Clozapine still makes me tired, which I offset that by taking 3 large cups of coffee (as in 8 cups by their measurment, my cup=one mason jar [its a mason jar /w a hanmdle on it, bought at walmart, some place i usually don't go to. Which reminds me, I need to return my frosty mug, cause it cracked and all the non-toxic fluid leaked out.])
There's not really much left to say. I never got my libido back since I was on Paxil last year (well, i started to get it back, then i was put on zyprexa, then risperidrone). Of course, I haven't been trying to get it back either, it seems.....unnecessary. I'd rather not be defined by it, so I avoid it.
I haven't got hives since that first day, so it was just a one time thing I guess. Something to continue to watch out for, probably.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by Dave1 on December 3, 2002, at 20:39:42
In reply to Mmmmmm, Coffee, the other dark meat., posted by Joel Maxuel on December 2, 2002, at 13:43:38
Hi Joel,
I was wondering how the clozaril is helping your psychotic symptoms. I have taken risperdal, zyprexa, etc for problems associated with my depression, but so far none has helped.
Thanks,
Dave
Posted by Joel Maxuel on December 4, 2002, at 16:43:52
In reply to Re: Mmmmmm, Coffee, the other dark meat., posted by Dave1 on December 3, 2002, at 20:39:42
> I was wondering how the clozaril is helping your psychotic symptoms. I have taken risperdal, zyprexa, etc for problems associated with my depression, but so far none has helped.As yes, those _other_ antipsychotic's. I seemed pretty resistant on the other ones. Well, the zyprexa was too much for me, became very agitated and shaky, not in a TD way either. Risperdal is too mild, for a tough case like me. Anyways, I haven't noticed anything from clozaril yet. Positive symptoms are hard to comeby for me anyways, unless I start not believeing that most people out there are driven by their hormones, if you'd call that a delusion. Negative symptome, I still have those, and will probably continue to have hose until 6 weeks after being on the "right" dose. Right now I'm on 75mg, and the norm I hear id 200mg. Can someone confirm that for me?
What other AP's did you take? Seroquel? Any from the typical family?
I'm still sleeping too much. That whole waking up at 8:00 bit was just merely a glitch. I'm not sure if I'm more tired now than I was previously, before i was put on clozaril, I think I was, but I was always tired. I guess I should be glad that I AM getting sleep, even if it's not restfull.
I think I'm coming down with the cold which means my white blood cell count is decreasing, I think. Hopefully, it stays within allowable limits.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by Dave1 on December 4, 2002, at 17:54:15
In reply to Psycho(tic)? I thought all this time I was Schizo!, posted by Joel Maxuel on December 4, 2002, at 16:43:52
Yes, all the atypicals, plus haldol and stelyzine. When I did research on the clozaril, it said that 2/3 of resistant patients respond. That sounds pretty good, but I rarely respond to anything. I never responded to the anti-depressants either. Pretty scary being resistant.
Dave
Posted by xjs7 on December 4, 2002, at 18:25:41
In reply to Psycho(tic)? I thought all this time I was Schizo!, posted by Joel Maxuel on December 4, 2002, at 16:43:52
From the Expert Consensus Guideline Series Treatment of Schizophrenia 1999, the average target dose for clozapine for a first episode is 300 mg a day, and 400-450 mg for a recurrent episode. (You can download this document at http://www.psychguides.com/.) So, 75 mg is a very low dose.
xjs7
Posted by Joel Maxuel on December 4, 2002, at 19:56:21
In reply to Re: Psycho(tic)? I thought all this time I was Schizo!, posted by Dave1 on December 4, 2002, at 17:54:15
> Yes, all the atypicals, plus haldol and stelyzine. When I did research on the clozaril, it said that 2/3 of resistant patients respond. That sounds pretty good, but I rarely respond to anything. I never responded to the anti-depressants either. Pretty scary being resistant.
When I looked it up, it was 60%. Oh well, thats probably the canadian figure. We must be more resistant to the medication. Being resistant, and sensitive to the meds at the same time, or even just being resistant _is_ scary.
As for the Rx amounts, 400mg does seem to be a lot. Just think, i'm going to be getting to that sometime, maybe before the new year, well probably not, my pdoc has a bit of a historty of going half arsed on the meds.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by Joel Maxuel on December 5, 2002, at 12:06:13
In reply to Clozapine doses, posted by xjs7 on December 4, 2002, at 18:25:41
Posted by comftnumb on December 7, 2002, at 14:50:40
In reply to Re: Mmmmmm, Coffee, the other dark meat., posted by Dave1 on December 3, 2002, at 20:39:42
Geodon's came on the market February of 2001 so it's the newest antipsychotic besides Abilify, which came out November 18th (aripiprazole).
I haven't tried Abilify, no one has really, so if you want to give it a shot you'll have to be a guinea pig. It's FDA approved, so I would consider it safe.
I'm on Geodon right now and it works great. I used to be on Zyprexa and I gained 30lbs and slept 12hours a day. Since switching to Geodon I sleep 8hours a day and have lost 35lbs.
Posted by xjs7 on December 7, 2002, at 15:41:04
In reply to Geodon or Abilify: alternatives, posted by comftnumb on December 7, 2002, at 14:50:40
Geodon is a great drug for me too--I take 120 mg and have been on it for almost the whole time it has been available (in the U.S.). I haven't gained any weight from it. I don't know why psychiatrists prescribe Zyprexa so much--people who have mental illness don't need weight gain and diabetes to deal with. Clozapine also causes a lot of weight gain (more than Zyprexa I think) but it is superior for some refractory patients, so its use is justified.
Geodon does make me sleep a little too much--I need at least 10 hours of sleep a night or else I need to take an afternoon nap. Also, I get extrapyramidal problems from it, so I have to take benztropine (Cogentin). Other than that, Geodon is great, and I recommend it to anyone who needs this class of medications.
xjs7
Posted by Joel Maxuel on December 7, 2002, at 17:03:59
In reply to Re: Geodon or Abilify: alternatives, posted by xjs7 on December 7, 2002, at 15:41:04
Both of them sound really good, especially ther geodon, I know someone who is on it (who took it while it was in the testing stage), but neither still hasn't been realeased in Canada. At least I'm very sure none of them have.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by Sebastian on December 10, 2002, at 21:56:55
In reply to Re: Geodon or Abilify: alternatives, posted by Joel Maxuel on December 7, 2002, at 17:03:59
Well I have a prescription for Abillify, I start taking it tomorow. I hope it proves to be as effective as the Zyprexa I've been taking, without the weight-gain. I'll tell you tomorow, if anyone doesn't first.
Sebastian
No, I skiped over the Geodon in fear of twice a day and somnolence
Posted by katiemom on December 12, 2002, at 10:46:43
In reply to Re: Abilify; alternative to Zyprexa I hope!, posted by Sebastian on December 10, 2002, at 21:56:55
I'll be interested in how Abilify works. I tried Geodon and for my Psychosis is worked really good. I was able to think clearly and started to become social. Unfortunatly it caused my Anxieties to get very bad, even though my pdoc put me on Paxil CR, which made things worse. Please let me know how it works and if you get anyside affects.
Colleen
Posted by sebastian on December 12, 2002, at 13:39:48
In reply to Re: Abilify; alternative to Zyprexa I hope!, posted by katiemom on December 12, 2002, at 10:46:43
Collen
Abilify sucks! I was up all night till about 6-7am when I took a little pice of Zyprexa to put me to sleep. Mostly I had felt nosiated, wanted to throw up. I never felt like that when I have missed a dose of the Zyprexa before.
Sebastian
Posted by comftnumb on December 14, 2002, at 0:55:22
In reply to Re: Abilify not a alternative to Zyprexa, posted by sebastian on December 12, 2002, at 13:39:48
I wouldn't give up on it so quickly. When I started Wellbutrin I couldn't sleep well for about a week. Then over the next month my sleep got progressively better until it was normal again.
A lot of side effects to meds go away. Be patient. Give it a chance.
Posted by Joel Maxuel on December 14, 2002, at 16:05:53
In reply to Re: Success with Clozapine (Clozaril), posted by xjs7 on November 26, 2002, at 22:27:39
I'm not sure what to say. But it is about that time to report what has been happening. My so-called "delusions" are still going strong, which in result put me into some danger, and within a couple days I may be facing that danger again. The next couple of days would in fact be the anniversary of my operation, the result of my "delusions." if they don't go away, and I start to feel my negative symptoms go away, would that mean I'm right? I recently wrote a rant about my feelings, and mention of my "delusions" and posted it on my website. Still feel like not going anywhere (I guess), and still feel depressed. At least I'm not wasting my time totally, although i did get up at 1:30, which is longer than usual, and usual usually means 12:00.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by SLS on December 14, 2002, at 16:06:21
In reply to Re: Abilify not a alternative to Zyprexa, posted by sebastian on December 12, 2002, at 13:39:48
> Abilify sucks! I was up all night till about 6-7am when I took a little pice of Zyprexa to put me to sleep. Mostly I had felt nosiated, wanted to throw up. I never felt like that when I have missed a dose of the Zyprexa before.
>
Hi.It sounds like you are experiencing the side effects one would expect of a dopaminergic antidepressant. That's exciting.
- Scott
Posted by SLS on December 14, 2002, at 16:09:06
In reply to Clozapine (Clozaril) Update, posted by Joel Maxuel on December 14, 2002, at 16:05:53
Have you tried Risperdal?
I know Clozaril is considered "the most potent" of the atypicals reserved for difficult cases, but which others have you tried?
- Scott
Posted by Joel Maxuel on December 14, 2002, at 16:14:43
In reply to Re: Clozapine (Clozaril) Update » Joel Maxuel, posted by SLS on December 14, 2002, at 16:09:06
> Have you tried Risperdal?
>
> I know Clozaril is considered "the most potent" of the atypicals reserved for difficult cases, but which others have you tried?I have tried risperdal and zyprexa. I was up to 5mg of risperidrone while I was in hospital, figured it was accounting to the reason why i was sleeping so much so i'd swallow only the 3mg, slip the other 2 under my tongue and spit it out only a minute later.
As for the zyprexa, i was only on 0.75mg, which I figure was a small dose, but i was too sensitive on it, I'd become jumpy, shaky, and unable to concetrate. Lucky me, my university (Dalhousie) had a faculty strike at the time so it didn't affect much of my school work.
--
Joel Maxuel
ShamelessPlug(http://www.maxuel.ca);
Posted by SLS on December 14, 2002, at 16:25:53
In reply to Re: Abilify; alternative to Zyprexa I hope!, posted by Sebastian on December 10, 2002, at 21:56:55
Abilify (aripiprazole) info:
http://www.lexi.com/web/content/newdrugs/chapter/mono/newdrugsdisp.jsp?id=hf008613
Posted by SLS on December 14, 2002, at 16:44:27
In reply to Re: Clozapine (Clozaril) Update, posted by Joel Maxuel on December 14, 2002, at 16:14:43
There is an antipsychotic drug called Moban (molindone) that is not used very often. It chemically distinct from other neuroleptics. It has qualities of both the older neuroleptics and the newer atypical ones. It binds to every receptor, unlike most others, but not very tightly. It is similar to Seroquel in this regard. It does not cause weight gain and has a relatively low rate of EPS. Even EPS is trial and error. It is hard to predict which drugs will produce it in any one individual.
I wish you luck in finding something quickly.
- Scott
Posted by sebastian on December 14, 2002, at 18:38:36
In reply to Re: Abilify; alternative to Zyprexa I hope!, posted by SLS on December 14, 2002, at 16:25:53
It's not so bad anymore! It was just the first day. Only one problem now. I have to take 2.5-mgs of Zyprexa with it, because of the lack of sleep I had on the first day and everything else. Hopefuly I will get compleatly off the Zyprexa in a few days.
I feel much more like I can handle the change now. I even lost a few pounds!!!
Sebastian
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