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clinic

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  1. Thx for the reply. Should i worry about prolactin on amisulpride ? Is prolactin elevation on amisulpride equivalent to paliperidone/risperidone ?
  2. Pdoc said start at 50mg amisulpride. Increase 50mg every week till 200mg. Once there than start decreasing clozapine by 25mg. Thats what im worried about the most, that low amisulpride doses will increase dopamine and cause psychosis.
  3. Went to pdoc again today to change meds. We removed olanzapine from prx ansd changed it to amisulpride. So i will be taking clozapine + amisulpride now. He said clobazam and clonazepam r different benzo and can be taken together
  4. oh well, i started waking up middle of the night on olanzapine to eat stuff. Maybe i should try amisulpride
  5. Well my heart says to first try clonazepam. If it does not work then I will taper down clozapine and taper up olanzapine.
  6. Went to the pdoc today and had a heavy debate with him. I told him i have 2 main problems - anxiety and too much sleeping. He said we are not 100% sure if anxiety is induced by clozapine. He said we can decrease clozapine by 25mg every week and add olanzapine only if paranoia comes. But I declined, i said we add olanzapine first 2.5mg and then 5mg. He agreed after heavy arguments - he said we can take 5mg for 10 days, then reduce clozapine from 200mg to 175mg. If it works then he said to meet him again. He will further reduce clozapine dose. If anxiety does not improves after eventually when i come to clozapine 100mg, then i might need to try another benzo(clonazepam)
  7. Cuz rest of the aap are not that effective as these except clozapine. I'm thinking olanzapine + risperidone would be nice combination.
  8. http://www.kcl.ac.uk/ioppn/news/events/2013/september/Leucht-2013-15-antipsychotics-meta-analyses.pdf page 4 and 5
  9. I’m going to change my aap in my next pdoc visit this week. Which one should i ask my pdoc for ? Amisulpride or olanzapine ? Well if we compare both of them Amisulpride + no weight gain + no significant sedation + more effective than olanzapine in improving positive symptoms[1] - does not improves cognitive deficits - high dose dependent qtc prolongation - massive prolactin elevation which is not dose dependent Olanzapine + works for cognition as well + no major eps side effects - weight gain - more sedative than amisulpride - less effective than amisulpride in improving positive symptoms I think im gonna go with olanzapine [1] http://www.kcl.ac.uk/ioppn/news/events/2013/september/Leucht-2013-15-antipsychotics-meta-analyses.pdf
  10. pdoc suggested adding 5mg olanzapine, and start decreasing clozapine by 25mg. But I will get more clear instructions once i visit him.
  11. That sounds better. No instructions as of yet. Once I meet him and get the prescription, i will start then. omg, that sounds worse. But doesnt having stable blood levels of olanzapine take time ? Edit: doesnt one needs to take 2.5mg olanzapine for atleast 5 days to create blood levels ? Then increasing it every 5 days. I mean increase olanzapine every 5 days and then decrease clozapine every 5 days
  12. Thats way to fast taper down of clozapine and taper up of olanzapine. I know my pdoc, he will prolly give 2.5mg olanzapine for 1 week, then 5mg on 2nd week, then 7.5mg on 3rd week, then 10mg on 4th week. Once we get to 10mg olanzapine for atleast 1 week, we will taper down clozapine slowly like reduce 50mg every week. I will stop at 100mg clozapine and wait while I completely check if paranoia is there or not. If not, i will further decrease clozapine slowly to 0mg.
  13. I got text from my main pdoc, he approved and said i can shift to olanzapine with gradual tapering.
  14. I just got reply from my 2nd pdoc, he told me to not take 2 benzos at the same time. So thats the end of clonazepam
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