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Once a day v split? (I currently take 50 am and 100 pm- I am a slow metabolizer apparently so that low dose isn’t actually that low for me)

Recently my schedule changed to totally brutal. Basically I get home late afternoon (on a good day) and often have to wake up super early. Because of this, I’m thinking the bigger pm dose isn’t conducive to my already awful morning functioning. Was considering taking all 150 right when I get home, that way I avoid morning drowsiness and over sedation at work.

in the past, I’ve advocated against one dose, partially because of morning drowsiness but also becuase I think the am dose holds me together. However, now I’m so tired that I don’t think any holding together will be necessary. Anyone have an opinion?

@browri love your opinion here

 

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On 4/6/2022 at 5:16 PM, Iceberg said:

Once a day v split? (I currently take 50 am and 100 pm- I am a slow metabolizer apparently so that low dose isn’t actually that low for me)

Recently my schedule changed to totally brutal. Basically I get home late afternoon (on a good day) and often have to wake up super early. Because of this, I’m thinking the bigger pm dose isn’t conducive to my already awful morning functioning. Was considering taking all 150 right when I get home, that way I avoid morning drowsiness and over sedation at work.

in the past, I’ve advocated against one dose, partially because of morning drowsiness but also becuase I think the am dose holds me together. However, now I’m so tired that I don’t think any holding together will be necessary. Anyone have an opinion?

@browri love your opinion here

 

I hope this is helpful to share my experience. I’m sorry you have a brutal schedule right now. I hope you can figure out a way to dose your clozapine so that you aren’t so tired. I would say discuss trialing the bigger dose when you get home with your pdoc. Would a temporary increase or some kind of adjustment in your stimulant medication situation be another option to discuss? Or adding something on like provigil or nuvigil or one of the newer ones to temporarily help with the tiredness (I can’t remember if you’re able to try one of these or not…..sorry)?

Your stability is precious. I’d say try only one thing at a time and don’t forget to be kind to yourself too. You always are so helpful and kind to everyone. You deserve the same.

When I was prescribed clozapine I trialed it for just over 6 months. I eventually got up to and took 600 mg. My old pdoc was a fan of dosing it all at once at bedtime for lower doses, but eventually my dose got split into 2 doses like you currently take it. I took 200 mg AM and 400 mg Bedtime in the end.

So do what works for you is what I say. Keep us updated and good luck! I know you can figure this out and get through this!

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I take 175mg at night. I have to sleep 10 hours but once I'm awake I'm alert, unlike when I was on other meds like Seroquel.

My prescription is written so that I also take 25mg in the morning, but I make a judgement call once I'm up for a little bit to see if I need it.

Good luck with trying to figure out what's best for you.

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hey iceberg, sorry to hear that you are going through troubles, but i wanted to offer support and well wishes because you've been so supportive and kind to me.

do you need your prescribing physician's permission to try once daily dosing or do you feel as though you need it, rather? or would you feel comfortable trying taking all or nearly all at night to see how you do during the day?

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On 4/9/2022 at 8:47 AM, basuraeuropea said:

hey iceberg, sorry to hear that you are going through troubles, but i wanted to offer support and well wishes because you've been so supportive and kind to me.

do you need your prescribing physician's permission to try once daily dosing or do you feel as though you need it, rather? or would you feel comfortable trying taking all or nearly all at night to see how you do during the day?

I think he’d be fine with me changing up the schedule a bit as long as I kept him in the loop. I’ve been with him 7 years now so we’re usually on the same page. He actually left the timing up to me several years ago when we were figuring out the dose so I don’t think he feels strongly one way or another. 

the thing is it would be all at night it would be like 4 pm, which means That I’d have the lowest coverage mid afternoon, a time that has been problematic In the past. Taking it all at night would possibly make things worse since the issue is having early morning- mid afternoon shifts. If it was just all at night I’d be less hesitant, but i know one dose in the middle of the day is a bit odd 
 

 

On 4/8/2022 at 7:03 PM, dilemma said:

prescription is written so that I also take 25mg in the morning, but I make a judgement call once I'm up for a little bit to see if I need it.

Hmm… this is an interesting idea. Maybe I’ll bring this up if I can’t figure out the timing on my own 

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On 4/8/2022 at 2:11 PM, Wonderful.Cheese said:

Or adding something on like provigil or nuvigil or one of the

I’d be hesitant to have that plus stim on board. My pdoc does have a patient on that new methylphenadate that you take the night before, but said I should try and manage with the adderall first because it would be a fight with insurance. Usually once I’m up the stim is enough to manage the day, it’s just I need such a jolt to begin with that I worry about oversleeping or being late to things 

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