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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by TomG on June 9, 2005, at 21:23:10
I hate to have to face the blood tests that go with the use of this drug, but I feel like the other atyicals are going to fail at treating my negative symptoms. Here is my antipsychotic history and the highest dosages that I tried:
Geodon - 20mgs - worked great for two months and was discontinued because it started causing extreme anxiety.
Zyprexa - 15mgs - did nothing but cause 25lb. weight gain.
Abilify - 15mgs - discontinued because of akathisia
Risperdal - .75mgs - took this along with Nardil over three years ago and wouldn't even consider it a trial because at the time my medications were being switched so fast.
Seroquel - 200mgs - I am taking this now with no improvement
I guess maybe looking at the list I should try pushing the doses to the highest recommended, and I don't think I'm going to resort to the older typical AP's. I would welcome anything anyone has to say about Clozaril.
Posted by Phillipa on June 9, 2005, at 21:47:20
In reply to CLOZARIL?, posted by TomG on June 9, 2005, at 21:23:10
I don't know your diagnosis. But I've watched it perform miracles for schizophrenic patients when i worked in a psych hospital. The WBC thing was a pain. I think the blood work is weekly unless they've changed. But I didn't know anyone who had to quit. Fondly, Phillipa
Posted by TomG on June 9, 2005, at 22:37:19
In reply to Re: CLOZARIL? » TomG, posted by Phillipa on June 9, 2005, at 21:47:20
My doctor thinks I'm schizophrenic,and he hasn't applied the term, but I fit the diagnosis of *simple* schizophrenia to a 'T'.
"An uncommon disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. Delusions and hallucinations are not evident, and the disorder is less obviously psychotic than the hebephrenic, paranoid, and catatonic subtypes of schizophrenia. The characteristic "negative" features of residual schizophrenia (e.g. blunting of affect, loss of volition) develop without being preceded by any overt psychotic symptoms."
Posted by Phillipa on June 9, 2005, at 23:17:54
In reply to Re: CLOZARIL? » Phillipa, posted by TomG on June 9, 2005, at 22:37:19
What other drugs have you tried? Clozaril is great for some people. Fondly, Phillipa
Posted by TomG on June 10, 2005, at 0:23:38
In reply to Re: CLOZARIL? » TomG, posted by Phillipa on June 9, 2005, at 23:17:54
-Prozac
-Wellbutrin
-Serzone
-Remeron
-Paxil
-Effexor
-Celexa
-Zoloft
-Nortripyline
-Nardil (twice)
-Klonopin and Xanax and Ativan
-Provigil
-Lamictal
-Zyprexa
-lithium
-Depakote
-Neurontin
-Risperdal
-Seroquel
-Abilify
-Geodon
-Cymbalta (very briefly)
-fish oil, flaxseed, TruHopeI had 5 good days on lithium that could have been placebo effect and the two good months on Geodon. Some of those drugs have been used in various combinations and most of theme alone.
I've heard Clozaril is one of those drugs that works when all else fails. I thought that Nardil would be one of those kinds of drugs when one of my first quack pee docs thought my diagnosis was only social anxiety, but I can honestly say that the only thing it did was make me smoke more.
Posted by Phillipa on June 10, 2005, at 1:01:02
In reply to Re: CLOZARIL? » TomG, posted by Phillipa on June 9, 2005, at 23:17:54
Sounds like Clozaril may be in order. It really does work wonders when all else fails. You have to register with the company[maybe not anymore] and then weekly send in proof of the WBC tests. But that was 8 years ago when the drug was new. So the pdoc probably doesn't have to do this anymore. Fondly, Phillipa
Posted by sdjeff on June 10, 2005, at 2:42:59
In reply to Re: CLOZARIL? » Phillipa, posted by Phillipa on June 10, 2005, at 1:01:02
Wow. You sound like me, medication wise. My Dx is a little different, but other than that...
Also, I have a friend who is a paranoid schizophrenic. Clozaril has been amazing for him. Zyprexa doesn't do much for me. If I could, (I can't afford the blood tests) I would take Clozaril.
Posted by xbunny on June 10, 2005, at 5:10:03
In reply to CLOZARIL?, posted by TomG on June 9, 2005, at 21:23:10
Hi there,
> I guess maybe looking at the list I should try pushing the doses to the highest recommended, and I don't think I'm going to resort to the older typical AP's. I would welcome anything anyone has to say about Clozaril.
If I were you I would try the following:
a) push the doses of atypical antipsychotics you have tried harder, especially the risperdal .75mg isnt a working dose for sz. Since the geodon worked but gave anxiety try a lower dose or adding an anxiety drug. Similarly for the abilify.
b) try Solian/Amisulpride as far as I know this has a real proven record for the negative symptoms of sz. It worked really well in that respect for me but was next to useless against the positive symtoms. If I were suffering heavy negative symptoms again I would probably take it with a typical.
c) try several different typical antipsychotics, ie a sedating one, an alerting one, a low potency and a high potency. Despite the scare stories and jokes about the thorazine shuffle etc typical antipsychotics also have a proven record and I reckon you owe to yourself to at least try a few.
For me the high potency and alerting antipsychotic depixol/flupenthixol has been a god send, superior for both positive and negative symptoms more than any atypical I have tried.d) try combining an antipsychotic with an antidepressant. According to my last CPN a good many of her sz clients take remeron/mirtazapine in conjunction with there antipsychotics with benefits to all. I also take it and its helps considerably.
e) then consider clozapine, theres nothing wrong with clozapine but really I reckon you should exhaust a lot more possibilities before taking it.
Just my .05$, Bunny
Posted by blueberry on June 10, 2005, at 5:42:05
In reply to CLOZARIL?, posted by TomG on June 9, 2005, at 21:23:10
I have battled negative symptoms for so many years. I don't think there is anything that will completely cure them, but there are things that can improve them dramatically to make you much for functional and comfortable. Primarily you want to focus on meds that affect norepinephrine and dopamine, instead of serotonin. And very often, med combinations are needed.
Just my opinion, but my top choices for you would be:
First, stay with your favorite AP so far. In this case, maybe stay with seroquel. A higher dose might be needed.
Second, add one of the following...prozac, wellbutrin, ritalin, adderall. Desipramine would be a good suggestion too, except that its side effects are too burdensome for most of us. All of these will boost norepineprine and dopamine function, most especially when combined with an AP. Even though prozac is a serotonin med, it dramatically boosts NE and DA when combined with zyprexa or seroquel. They are very synergistic, and the combination can provide results that neither med alone could come close to.
Seroquel might do nothing for you. Prozac, wellbutrin, adderall, or ritalin might do nothing for you. But when combined, that's when the magic can happen.
20mg prozac plus 5mg zyprexa works better on my negative symptoms than any of dozens of different trials I've been through. Ritalin and adderall worked awesome too, except that I enjoyed them so much I was abusing them like street drugs.
Posted by TomG on June 10, 2005, at 11:44:46
In reply to Re: CLOZARIL?, posted by blueberry on June 10, 2005, at 5:42:05
I guess there are some more areas to exaust before jumping to Clozaril. The only thing with the Geodon is that it quit working after two months and attempts to raise it, lower it, add Provigil failed to help it start working again. Prozac is the only drug that has caused me to have hypomania the first time that I took it for an amazing 3 months. I'm not bipolar, but I've taken it on three seperate occasions by itself going up to 60mgs at the highest and it didn't give me hypomania that it did the first time I took it. Possibly combining it with on of these atypicals is the ticket.
The flupenthixol looks promising too. Is that also known as Navane as a brand name?
I forgot what dose of Remeron I took, but it did have me up sort of obsessive cleaning out closets drawers etc. I took it by itself. I found this article that looks at a Clozaril + Remeron combo on negative symptoms.
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256E760027505A
I'm taking Wellbutrin XL 150mgs right now with 100mgs of Seroquel after my doctor lowered it from 200mgs. The Wellbutrin is doing nothing though after 5 days, but I will be patient. I also think raising the Seroquel would be the right thing to do and possibly trying the Zyprexa again would be good raising it to the maximum 30mgs if need be and combining it with some sort of AD.
Posted by ed_uk on June 10, 2005, at 12:18:02
In reply to Re: CLOZARIL? Thanks, Great Responses, posted by TomG on June 10, 2005, at 11:44:46
Hi Tom :-)
>The flupenthixol looks promising too. Is that also known as Navane as a brand name?
No. Navane is thiothixene. Flupenthixol (Depixol, Fluanxol) isn't available in the US. It's been popular in the UK for years though. Thiothixene is chemically quite similar to flupenthixol.
Kind regards,
Ed.
Posted by TomG on June 10, 2005, at 14:19:46
In reply to Re: CLOZARIL? Thanks, Great Responses » TomG, posted by ed_uk on June 10, 2005, at 12:18:02
Thanks, Ed
All these medicines that hold promise for me are in the UK. i.e. amisulpride and flupenthixol. I've asked my doctor three times now about amisulpride and he just writes it down and I never hear another word about it. Maybe I can go on a vacation to London or something and try some antipsychotics. :)
Posted by ed_uk on June 10, 2005, at 17:55:20
In reply to Re: CLOZARIL? Thanks, Great Responses » ed_uk, posted by TomG on June 10, 2005, at 14:19:46
Hi Tom :-)
>Maybe I can go on a vacation to London or something and try some antipsychotics. :)
LOL, you could make a holiday out of it!
Ed.
This is the end of the thread.
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