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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!

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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? 

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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? 

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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 

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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. 

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