Paperskyscrapers Posted August 1, 2021 Share Posted August 1, 2021 Hi, I have been on clozapine for 4 years. During this time, I gained 40 lbs and developed diabetes. I want to get rid of clozapine, but I need to present my pdoc with alternatives. Are there alternatives to clozapine? It's working well, but I can't stand the weight gain and diabetes anymore. Thanks! Link to comment Share on other sites More sharing options...
Iceberg Posted August 1, 2021 Share Posted August 1, 2021 7 hours ago, Paperskyscrapers said: Hi, I have been on clozapine for 4 years. During this time, I gained 40 lbs and developed diabetes. I want to get rid of clozapine, but I need to present my pdoc with alternatives. Are there alternatives to clozapine? It's working well, but I can't stand the weight gain and diabetes anymore. Thanks! Clozapine is often regarded as on its own in treating difficult symptoms. What are you trying to treat? Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 1, 2021 Author Share Posted August 1, 2021 schizoaffective disorder Link to comment Share on other sites More sharing options...
Iceberg Posted August 2, 2021 Share Posted August 2, 2021 Unfortunately there isn’t an easy switch candidate from clozapine, I’d say it would depend on if anything has worked for you in the past and maybe looking at something similar to that. Have you tried most of the atypical antipsychotics? Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 2, 2021 Author Share Posted August 2, 2021 yes I have.. That's my problem. Link to comment Share on other sites More sharing options...
Iceberg Posted August 2, 2021 Share Posted August 2, 2021 did anything work at all? Also, if you are mainly treating psychosis you could try a typical, but the long term side effects can be just as problematic. You could also try a polypharm approach. A common one is to back off the clozaril dose a bit and add in low dose abilify to see if that can reduce metabolic issues, but unfortunately that often doesnt happen Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 4, 2021 Author Share Posted August 4, 2021 I'm on 3 mg risperidone, 200 mg clozapine, 900 mg lithium, and 300 mg lamotrigine. I'm looking to replace clozapine altogether. I saw how diabetes took my mom, and I don't want to take chances. I'm really caught between a rock and a hard place. Link to comment Share on other sites More sharing options...
Iceberg Posted August 4, 2021 Share Posted August 4, 2021 Just off the top of my head here, not necessarily great suggestions - have you ever tried saphris? Might be good if you need the sedation. If you don’t there is a new med called caplyta which is supposed to have low blood impact but it’s very different and very new. I’m not sure id add a typical to 3mgs Risperidone. Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 5, 2021 Author Share Posted August 5, 2021 Those are not available where I live (the Philippines)... unfortunately.... that's why I'm out of options Link to comment Share on other sites More sharing options...
Iceberg Posted August 5, 2021 Share Posted August 5, 2021 Oh sorry didn’t realize where you were located. Do you have amisulpride there? Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 5, 2021 Author Share Posted August 5, 2021 Yes, we do. Would that be a good alternative? Link to comment Share on other sites More sharing options...
Iceberg Posted August 6, 2021 Share Posted August 6, 2021 I have read a few studies (one of my favorites here cuz it shows that often psych meds are just a dice roll) https://www.thelancet.com/article/S0140-6736(19)31135-3/fulltext that list amisulpride as one of the few antipsychotics that rises above the rest in terms of some (but not all) symptoms. However it can be pretty different from cloz Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 6, 2021 Author Share Posted August 6, 2021 I have an appointment with my pdoc later. I'll see what he comes up with. Link to comment Share on other sites More sharing options...
Iceberg Posted August 6, 2021 Share Posted August 6, 2021 Good luck ! Link to comment Share on other sites More sharing options...
Paperskyscrapers Posted August 6, 2021 Author Share Posted August 6, 2021 Thank you! I have in mind aripripazole or amisulpride as you suggested Link to comment Share on other sites More sharing options...
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